1.Mixed Infection And Risk Factors In Children With Severe Adenovirus Pneumonia2.Observtion Efficiency Of Salmeterol Xinafoate And Flutcasone Propionate Aerosol In Childhood Asthma

Objective To investigate the mixed infection and analyze theetiology and risk factors in children with severe adenovirus pneumonia.Methods A retrospective analysis was performed on the clinicaldata of756children with adenovirus pneumonia between June2009toJune2011.Pathogens and the risk factors were studied in216severe cases.Results Of the216severe cases，143（66.2%）were aged from6months to2years，and161(74.5%）developed the disease in winter andspring.177（81.9％）were affected by1-4Pathogens besides adenovirus，including74cases （34.3%）infected with one pathogen as an addition.Atotal of334pathogenstrains were identified from the respiratory secretionsand sera of the216cases.dominated by Gram-negative bacteria（124strains），108strains(32.3%) were viruses，and40strains（12.0%）werefunguses.Single chi-square test analysis indicated that congenital heartdisease,congenital anomalies airway development, nutritional anemia,frequent lung infection, malnutrition,and previous surgical history were risk factors relevant to severe adenovirus pneumonia. Multiple logisticregression analysis indicated that congenital heart disease,congenitalanomalies airway development, nutritional anemia, frequent lung infectionand previous surgical history were independence risk factors associatedwith severe adenovirus pneumonia, OR value respectively is3.3、11.1、7.2、14.3、12.9，(P<0.05）Conclusion Severe adenovirus pneumonia mostly seen inchildren aged from6months to2years and occurs frequently in the winterand spring. Many cases are also infected with other pathogens.Mostcommonly Gram-negative bacteria. Haemophilus influenzae,Escherichiacoli,Baumanii,Klebsiella pneumoniae ranke the top in Gram-negativebacteria.Streptococcus pneumonia was the most common amongGram-positive bacteria.Congenital heart disease,congenital anomaliesairway development, nutritional anemia,frequent lung infection,malnutrition and previous surgical history were risk factors associated withsevere adenovirus pneumonia. Objective To compare the efficiency of Salmeterol xinafoate andFluticasone Propionate Aerosol and Fluticasone Propionate only patientswith moderate and severe asthma.Methods89cases of pedantic moderate and severe athsma fromChongqing medical university affiliated children’s hospital outpatientdepartment between October2011to February2013,the patients wererandomly divided into two groups:the combination group inhaled125μgSeretide Evohaler,the single treatment group inhaled Fluticasone of equalamounts.Forced expiratory volume in one second (FEV1)、peak expiratoryflow（PEF）were determined and observed in two groups at1、3、6monthsof treatment,and compared the control difference of efficacy after treatmentfor3、6months.Results FEV1、PEF of combination group campared with the singlehormone treatment group there were significant differences（P<0.05）at1、3、6months of treatment. Compared the lung function of two groups beforeand after1month of therapy,FEV1、PEF of combination group wereimproved significantly（P<0.05）,FEV1、PEF of single treatment group aftertreatment for1months were improved slowly（P>0.05）. FEV1、PEFof twogroups at3、6months of treatment obviously improved compared with before treatment,and had significantly improved （P <0.05).Butcombination group improved significantly compared with the singletreatment group（P <0.05).statistical significance（P <0.05).The controlrole of two groups were80.9%、59.6%respectively after treatment for3months,and were difference between two groups. The control role were92.8%、76.6%respectively after treatment for6months, were significantdifference between two groups.Conclusion Salmeterol xinafoate and Fluticasone PropionateAerosol which reduced the frequency of acute attack and hospitalization,and improved lung function, and control the clinical symptomssignificantly compared with Inhale Fluticasone Propionate only,had goodsecurity and compliance.