Computed Tomography Image Texture under Feature Extraction Algorithm in the Diagnosis of Effect of Specific Nursing Intervention on Mycoplasma Pneumonia in Children

To evaluate the effect of specific nursing intervention in children with mycoplasma pneumonia (MP), a feature extraction algorithm based on gray level co-occurrence matrix (GLCM) was proposed and combined with computed tomography (CT) image texture features. Then, 98 children with MP were rolled into the observation group with 49 cases (specific nursing) and the control group with 49 cases (routine nursing). CT images based on feature extraction algorithm of optimized GLCM were used to examine the children before and after nursing intervention, and the recovery of the two groups of children was discussed. The results showed that the proportion of lung texture increase, rope shadow, ground glass shadow, atelectasis, and pleural effusion in the observation group (24.11%, 3.86%, 8.53%, 15.03%, and 3.74%) was significantly lower than that in the control group (28.53%, 10.23%, 13.34%, 21.15%, and 8.13%) after nursing ( P < 0.05 ). There were no significant differences in the proportion of small patchy shadows, large patchy consolidation shadows, and bronchiectasis between the observation group and the control group ( P > 0.05 ). In the course of nursing intervention, in the observation group, the disappearance time of cough, normal temperature, disappearance time of lung rales, and absorption time of lung shadow (2.15 ± 0.86 days, 4.81 ± 1.14 days, 3.64 ± 0.55 days, and 5.96 ± 0.62 days) were significantly shorter than those in the control group (2.87 ± 0.95 days, 3.95 ± 1.06 days, 4.51 ± 1.02 days, and 8.14 ± 1.35 days) ( P < 0.05 ). After nursing intervention, the proportion of satisfaction and total satisfaction in the experimental group (67.08% and 28.66%) was significantly higher than that in the control group (40.21% and 47.39%), while the proportion of dissatisfaction (4.26%) was significantly lower than that in the control group (12.4%) ( P < 0.05 ). To sum up, specific nursing intervention was more beneficial to improve the progress of characterization recovery and the overall recovery effect of children with MP relative to conventional nursing. CT image based on feature extraction algorithm of optimized GLCM was of good adoption value in the diagnosis and treatment of MP in children.

Effect of Aerosol Inhalation of Budesonide Suspension on Clinical Efficacy, Remission Time of Asthma and Disappearance Time of Rales in Children with Mycoplasma Pneumoniae Pneumonia

To investigate the effect of aerosol inhalation of budesonide suspension on clinical efficacy, remission time of asthma and disappearance time of rales in children with mycoplasma pneumoniae pneumonia. Methods: 100 cases of mycoplasma pneumoniae pneumonia in our hospital from February 2019 to February 2021 were randomly divided into study group (n = 50) and control group (n = 50). The control group was given azithromycin intravenous drip followed by oral treatment, and the study group was given aerosol inhalation of budesonide suspension on the basis of the control group. Results: Compared with the control group, disappearance time of rales in the study group, remission time of cough, remission time of asthma and time of hospitalization in the study group were relatively short (P<0.05), and the efficacy in the study group was relatively high (P<0.05). There was no significant difference in the incidence of nausea, vomiting, abdominal pain, diarrhea and hoarseness between the two groups (P>0.05). The improvement of FVCS FEV1 and PEF and other indexes was relatively high in the study group by comparing with the control group (P<0.05). Conclusion: Aerosol inhalation of budesonide suspension in children with mycoplasma pneumoniae pneumonia can effectively enhance the therapeutic effect, promote the improvement of lung function, and reduce the disappearance time of rales and remission time of asthma, so it can be popularized.

Clinical Study of Iodine-Glycerol Combined With Valvaguang in the Treatment of Acute Pharyngitis

To explore the clinical effect of iodine-glycerol combined with Weivaguang in the treatment of acute pharyngitis. Methods: A total of 118 patients with acute pharyngitis treated in our hospital from July 2017 to December 2019 were selected as the research object, and they were randomly divided into 59 cases in the control group and the study group by random number table method. The group was given Weivaguang treatment on the basis of the control group, comparing the disappearance time, signs or symptoms score, inflammatory factors [tumor necrosis factor alpha (TNF-±), C-reactive protein (CRP), interleukin (IL-6)] Level and therapeutic effect. Results: The throat disappearance time, throat pain disappearance time, hoarseness disappearance time, and pharyngeal edema disappearance time of the study group were significantly shorter than those of the control group, and the differences were statistically significant (P <0.05). Repeated measurement data analysis of variance showed that the difference in the subject’s intra-subject effect was statistically significant (P <0.05), with the group factor as the source and the time factor and group interaction as the source within the subject There was no statistically significant difference in effect comparison (P > 0.05), which shows that the signs or symptoms scores have a tendency to change with time; the sign or symptom scores of the two groups are compared: after 5 days of treatment <2 days after treatment <before treatment, the differences are both Statistically significant (P <0.05); before the treatment, there were no statistically significant differences in the signs or symptoms scores between the two groups (P > 0.05). After 2 days of treatment and 5 days of treatment, the signs or symptoms of the study group were significantly lower than the control Group, the difference was statistically significant (P <0.05). Before treatment, the levels of TNF-±, CRP, and IL-6 were not statistically significant (P > 0.05); after treatment, the levels of TNF-±, CRP, and IL-6 decreased in both groups, and the study group and the control The group comparison was significantly lower, and the differences were statistically significant (P <0.05). The therapeutic effect of the study group was better than that of the control group (P <0.05), and the total effective rate of treatment in the study group was 96.61%, significantly higher than 81.36% of the control group, the difference was statistically significant (P <0.05). Conclusion: The application of iodine-glycerin combined with valvaguang in the treatment of acute pharyngitis can effectively shorten the disappearance time of patients’ clinically relevant indicators, relieve signs or symptoms, reduce the body’s inflammatory response, and improve the therapeutic effect.

Shuanghuanglian oral preparations combined with azithromycin for treatment of Mycoplasma pneumoniae pneumonia in Asian children: A systematic review and meta-analysis of randomized controlled trials

Background Mycoplasma pneumoniae is one of the main causes of community-acquired pneumonia. Due to the imperfect immune system of children, this also causes Mycoplasma pneumoniae pneumonia (MPP) to be more common in children. Globally, the incidence of MPP in children is gradually increasing. This study was the first to systematically review the clinical efficacy and safety of Shuanghuanglian (SHL) oral preparations combined with azithromycin in the treatment of MPP in children. Methods This study fully retrieved 3 Chinese databases and 5 English databases to search the randomized controlled trials (RCTs) of SHL oral preparations combined with azithromycin in the treatment of children with MPP. The search time is from the inception to September 2020. Data extraction and risk bias evaluation were performed independently by two researchers. We conducted a Meta-analysis of all the outcome indicators. Besides, Meta-regression, subgroup analysis, and heterogeneity analysis were used for the primary outcomes to find the possible potential confounding factors. Results Finally, we included 27 RCTs involving 2884 patients. SHL oral preparations combined with azithromycin were better than azithromycin alone in response rate (RR = 1.14, 95% CI[1.11, 1.18]; low certainty evidence), disappearance time of fever(MD = -1.72, 95% CI[-2.47, -0.97]; low certainty evidence), disappearance time of cough (MD = -2.95, 95% CI[-3.55, -2.34]; low certainty evidence), and disappearance time of pulmonary rales (MD = -2.13, 95% CI[-2.88, -1.38]; low certainty evidence). The Meta-regression results showed that the course of disease, age, and method of administration may be the source of heterogeneity. Subgroup analysis and sensitivity analysis have found that the results were stable. For other related clinical symptoms, T lymphocytes, and Serum inflammatory factors, SHL oral preparations combined with azithromycin was better than azithromycin alone, and the difference was statistically significant. For adverse events with low certainty evidence, safety needs further verification. Conclusion Based on the results of meta-analysis with low certainty evidence, we believed that SHL oral preparations combined with azithromycin likely be effectively improved clinical symptoms compared with azithromycin alone. Low certainty evidence showed that SHL may safety with no serious adverse events. Due to these limitations, the safety needs further verification. More high-quality, multicenter, and large-sample RCTs should be tested and verified in the future.

Chinese Herbal Medicine for the Treatment of Children and Adolescents With Refractory Mycoplasma Pneumoniae Pneumonia: A Systematic Review and a Meta-Analysis

Objectives: Chinese herb medicine (CHM) is one of the most popular complementary and alternative therapies, which has been widely used to treat Refractory Mycoplasma Pneumoniae Pneumonia (RMPP). However, the effect and safety of CHM remain controversial. Hence, we conducted this meta-analysis to evaluate whether CHM combination therapy could bring benefits to children and adolescents with RMPP.Methods: Seven databases were used for data searching through November 11, 2020 following the PRISMA checklist generally. Review Manager 5.3, Trial sequential analysis 0.9.5.10 Beta software and Stata16.0 were applied to perform data analyses. Mean difference or risk ratio was adopted to express the results, where a 95% confidence interval (CI) was applied.Results: In general, this research enrolled 17 trials with 1,451 participants. The overall pooled results indicated that CHM was beneficial for children and adolescents with RMPP by improving the clinical efficacy rate [RR = 1.20, 95% CI (1.15, 1.25), p &lt; 0.00001], shortening antipyretic time [MD = −2.60, 95% CI (−3.06, −2.13), p &lt; 0.00001], cough disappearance time [MD = −2.77, 95% CI (−3.12, −2.42), p &lt; 0.00001], lung rale disappearance time [MD = −2.65, 95% CI (−3.15, −2.15), p &lt; 0.00001], lung X-ray infiltrates disappearance time [MD = −2.75, 95% CI (−3.33, −2.17), p &lt; 0.00001], reducing TNF-α level [MD = −5.49, 95% CI (−7.21, −3.77), p &lt; 0.00001]. Moreover, subgroup results suggested that removing heat-phlegm and toxicity therapy had more advantages in shortening antipyretic time, cough disappearance time, lung X-ray infiltrates disappearance time and reducing TNF-α level. Meanwhile promoting blood circulation therapy seemed to be better at relieving lung rale. However, regarding adverse events, the two groups displayed no statistical difference [RR = 0.97, 95% CI (0.60, 1.57), p = 0.91].Conclusion: Despite of the apparently positive results in relieving clinical symptoms, physical signs and reducing inflammation, it is premature to confirm the efficacy of CHM in treating RMPP because of the limitation of quality and the number of the included studies. More large-scale, double-blind, well-designed, randomized controlled trials are needed in future research.

Traditional Chinese Medicine Oral Liquids Combined With Azithromycin for Mycoplasma pneumoniae Pneumonia in Children: A Bayesian Network Meta-Analysis

Background:Mycoplasma pneumoniae pneumonia (MPP) causes flu-like symptoms in children, increasing the burden on the health and education systems. In China, traditional Chinese medicine oral liquids (TCMOLs) combined with azithromycin (TCMOLs + Azithromycin) is commonly used to treat MPP in children. However, TCMOLs with the optimal clinical applicability remain unknown. Here, we evaluated the clinical effectiveness and safety of TCMOLs + Azithromycin in children with MPP.Methods: We searched PubMed, Embase, Cochrane Library, Ovid, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and VIP information resource integration service platform databases for eligible randomized controlled trials (RCTs) published from database inception to October 2020. Two reviewers independently performed data extraction and risk of bias assessment. After Bayesian random effect modeling and surface under the cumulative ranking curve (SUCRA) scoring, we ranked each intervention. We assessed heterogeneity using multivariate meta-regression for potential modifiers and used the Grading of Recommendations, Assessment, Development, and Evaluation to rate pooled evidence’s certainty.Results: In the 63 included RCTs with 6,410 children, five different TCMOLs were combined with azithromycin. TCMOLs + Azithromycin had significantly better primary outcomes than did azithromycin alone. Of all TCMOLs, Xiaoer Xiaoji Zhike (XEXJZK)+Azithromycin showed the best effectiveness with respect to the response rate (odds ratio [OR] = 6.5, 95% credible interval [CrI] = 4.3–10; low certainty) and pulmonary rales disappearance time (mean difference [MD] = −2.1, 95% CrI: −2.9 to −1.2; low certainty) with SUCRA 85 and 80%, respectively. Pudilan Xiaoyan + Azithromycin showed the highest effectiveness with respect to cough disappearance time (MD = −2.6, 95% CrI: −3.4 to −1.7; very low certainty) and fever disappearance time (MD = −1.8, 95% CrI: −2.3 to −1.3; very low certainty) with SUCRA 87 and 87%, respectively. The difference in the adverse effects between TCMOLs + Azithromycin and azithromycin alone was nonsignificant.Conclusion: Of the different TCMOLs, XEXJZK may be the best option to combine with azithromycin to treat children with MPP. However, our results should be interpreted with caution due to the low certainty of evidence. In general, TCMOLs’ safety remains unclear because of a lack of evidence. More high-quality RCTs are needed to further evaluate efficacy and safety of these TCMOLs.

Clinical efficacy of phentolamine in the treatment of feeding intolerance in premature infants with low birth weight

Objective: To discuss the clinical efficacy of phentolamine in the treatment of feeding intolerance in premature infants with low birth weight. Methods: Seventy-one low-birth-weight infants with feeding intolerance were randomly divided into the phentolamine group and the erythromycin group (38 patients and 33 patients, respectively). The infants were given basic treatment, such as gastric lavage, temporary fasting, nutritional support and abdominal massage. The phentolamine group was intravenously pumped with phentolamine as the basis of basic treatment, while the erythromycin group was given erythromycin as the basis of basic treatment. The time for gastrointestinal symptoms to disappear, the time the basic standard was reached, the time parenteral nutrition was used, the total time enteral feeding was implemented, the length of stay, and the increase in physical indexes according to the corrected gestational age of 40 weeks of the two groups were compared. Results: There was no significant difference between the phentolamine group and the erythromycin group in vomiting disappearance time or the increase in physical indicators at the corrected gestational age of 40 weeks (P>0.05), while the abdominal distension disappearance time, the time of restoration to birth weight, the time to reach the basic standard, the total time of parenteral nutrition, the total time of enteral feeding, and the length of stay in the phentolamine group were shorter than those in the erythromycin group, with significant differences (P<0.05). Conclusion: Phentolamine has a significant effect on alleviating symptoms and shortening the treatment time while treating feeding intolerance in premature infants with low birth weight, without adverse events, so it is worthy of clinical promotion. doi: https://doi.org/10.12669/pjms.36.7.2633 How to cite this:Li H, Li B, Wen X. Clinical efficacy of phentolamine in the treatment of feeding intolerance in premature infants with low birth weight. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2633 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Xiao’er Xiaoji Zhike Oral Liquid Combined with Azithromycin for Mycoplasma pneumoniae Pneumonia in Children: A Systematic Review and Meta-Analysis

Background. This study was aimed at systematically evaluating the clinical effect and safety of Xiao’er Xiaoji Zhike oral liquid in the treatment of Mycoplasma pneumoniae pneumonia (MPP) in children and providing evidence-based references for clinical application. Methods. The databases like Chinese Biomedical Literature Database, China Network Knowledge Infrastructure, Wan Fang Database, Chinese Scientific Journal Database, PubMed, EmBase, and the Cochrane Library were systematically investigated via searching clinical trials about Xiao’er Xiaoji Zhike oral liquid in treating MPP from the establishment of these databases to Jun 8, 2020, the valid data from which were entered meta-analysis. The quality of evidence was assessed by GRADE criteria. Results. Totally, 15 trials and 1500 patients were involved in this review. It showed that clinical efficacy of trial group was more superior than control group at the outcome measures of cough disappearance time, lung rale disappearance time, fever subsidence time, total effective rate, lung X-ray infiltrates disappearing time, reduction of hospital stay, immunological indexes, and some other measures. And the differences between groups were statistically significant. There was no statistical difference in the adverse effects between two groups. Lung X-ray infiltrates disappearing time and cough disappearance time were separately high- and moderate-quality evidences while lung rale disappearance time and fever subsidence time were all low in accordance with GRADE criteria. Conclusions. In accordance with trials with low methodological quality, Xiao’er Xiaoji Zhike oral liquid combined with azithromycin seems to be safe and superior to azithromycin alone for the treatment of MPP in children. However, further trials with rigorous methodology need to be implemented for these potential benefits.

Comparative Efficacy of Chinese Herbal Injections for Treating Pediatric Bronchopneumonia: A Bayesian Network Meta-Analysis of Randomized Controlled Trials

Introduction. Pediatric bronchopneumonia is one of the common respiratory diseases in pediatrics. Chinese herbal injections (CHIs) are widely used to treat pediatric bronchopneumonia. In this study, we examined the efficacy of CHIs in the treatment of pediatric bronchopneumonia using a network meta-analysis (NMA). Methods. Randomized controlled trials (RCTs) of CHIs combined western medicine (WM) versus WM were searched from electronic databases. WinBUGS 1.4.3 and Stata 13.0 were adopted to compute calculations and prepare graphs, respectively. Results. 168 RCTs with 21917 patients were included. The results revealed that Xixinnao injection (XXN) + WM had the most probability to be the best intervention in the four aspects of rate of clinical efficacy, antipyretic time, cough disappearance time, and lung shadow disappearance time. While as to lung shadow disappearance time, asthma disappearance time, and hospitalization time, Yanhuning injection (YHN) + WM could be the best intervention. The safety of CHIs needs to be further assessed. Conclusions. Based on this NMA, XXN + WM and YHN + WM were potential optimal therapies in pediatric bronchopneumonia, and their safety should be strictly monitored.