2011年 · 第49卷第10期

interstitial lung disease (ILD) is a group of heterogeneous diseases with some common clinical, imaging and pathological features, but different etiologies. Clinically manifested as increased breathing or dyspnea; Chest imaging showed diffuse pulmonary lesions; Pulmonary function manifests as restrictive ventilatory dysfunction and/or abnormal gas exchange; The pathological manifestation is inflammation of the alveolar wall, which can be partially or completely relieved or can progress, leading to destruction of the alveolar structure and varying degrees of fibrosis. At present, there are more than 200 known causes of ILD. Because of the wide and complex etiological spectrum, the diagnosis is difficult, and it has always been regarded as a difficult disease in respiratory specialty. In the past, the etiology and diagnosis strategies of ILD in children mainly referred to adult studies, but children are not the epitome of adults. The etiology, manifestations and prognosis of ILD have their own characteristics^[1]。 The Children's ILD Collaborative Group of the Respiratory Group of the Pediatrics Branch of the Chinese Medical Association summarized the etiological spectrum of children's ILD in 11 hospitals and during 2009. This article was published in this journal^[2]This is the first multi-center, prospective clinical study on the etiological spectrum of childhood ILD in China. It preliminarily reveals the etiological spectrum of childhood ILD in China, accumulates experience in the diagnosis of childhood ILD, and finds that there are still some problems in the diagnosis of childhood ILD. Some problems need to be solved urgently. In the process of sorting out children's ILD in 11 hospitals in 2009, it was found that children's ILD not only has a high misdiagnosis rate, but also has a long misdiagnosis time, which affects the prognosis of children. Therefore, it is necessary to promote and learn the accumulated experience in the diagnosis of childhood ILD, pay attention to its progress and understand the existing problems, which is necessary to improve the diagnosis level of childhood ILD.

A 6-year-old male suffered from repeated cough for more than 3 years, which was not cured for a long time. Children often have unexplained dry cough at the age of two and a half, which is light during the day and heavy at night. They often have dry cough in the middle of the night to the early morning, often causing vomiting, which occurs once every 2 to 3 days. There is no wheezing, and there are no nasal symptoms such as sneezing, runny nose, itchy nose and nasal congestion. He has been to many hospitals in Dalian, Shenyang, Harbin, Beijing, etc., and was diagnosed with cough variant asthma. He has been treated with montelukast sodium, loratadine syrup, procaterol hydrochloride, and inhaled salmeterol fluticasone. The disease seems to be effective at first, but the effect is poor after long-term use. The doctor had injected interferon, and the local hospital also used BCG polysaccharide nucleic acid injection for one course of treatment, all of which were ineffective. Chest X-ray or chest CT and pulmonary function tests were performed many times, but no abnormalities were found. Past history: I have suffered from eczema since childhood and have recovered. No allergies to food and medications were seen. No family history of allergy.

At 12: 55 on August 17th, 2011, Professor Zhou Huakang, the former editor-in-chief of Chinese Journal of Pediatrics, left us forever. Professor Zhou died at the age of 97.

Professor Qian Yijian, a famous expert in cardiovascular diseases and geriatrics in China, honorary president of Beijing Hospital, outstanding member of the Communist Party of China, and outstanding editor-in-chief of Chinese Medical Association series magazines, died in Beijing on July 6, 2011 at the age of 86. In the early morning of July 12th, representatives from all walks of life and editors of Chinese Medical Association series magazines went to Beijing Hospital to bid farewell to Mr. Qian. In the farewell room, wreaths sent by Chinese Medical Association, Chinese Medical Association magazines and many Chinese Medical Association series magazines were placed. On July 21st, Beijing Hospital held a grand symposium in memory of Professor Qian Yijian. Nearly 100 people, including Huang Jiefu, Vice Minister of Health, Lin Jiabin, President of Beijing Hospital, and the author attended the symposium.

Since exhaled nitric oxide (eNO) was discovered in 1991, after many years of extensive and in-depth exploration, the academic community has gradually understood it clearly in recent years. Therefore, it is helpful to fully understand the changes of eNO in asthma patients and clarify its clinical positioning, which is helpful to correctly choose the use of this technology and guide the practical clinical work.

With the increasing survival rate of premature infants and neonates with severe hypoxic-ischemic encephalopathy (HIE), neonatal brain injury and its accompanying neurological sequelae such as cerebral palsy have become an important issue in pediatric field. Among the children with cerebral palsy, premature infants accounted for the highest proportion^[1]。 About 25% of children with HIE survival have long-term sequelae^[2]。 Recent studies have confirmed that mild hypothermia can improve the prognosis of children with moderate HIE but is not effective for severe HIE^[3]。 There is no recognized effective treatment for severe HIE and premature infants with brain injury except conventional symptomatic and supportive treatment. Therefore, there is an urgent need for safe and effective therapeutic drugs for neonatal brain injury.

As an important structure of blood circulation in fetal period, ductus arteriosus communicates systemic and pulmonary circulation together with foramen ovale. From the first breath of the newborn, the lungs begin real breathing movement, and the fetus-newborn transition of blood circulation undergoes a series of changes, so it no longer relies on pathways such as venous ducts, arterial ducts and foramen ovale physiologically. If the ductus arteriosus continues to be open and the diameter is large after birth, it will certainly cause abnormal hemodynamic changes. The ductus arteriosus usually closes functionally within 48 hours after birth in most term infants. Therefore, it is generally considered that persistent patent ductus arteriosus (pPDA) is still present at 72 h after birth^[1]。 However, in low birth weight infants, the proportion of pPDA increased significantly, showing a negative correlation with gestational age: the incidence of pPDA at 96 h postnatal in newborns with birth weight>1500 g<5%^[2]； While in ultra-low birth weight infants (birth weight<1000 g), the proportion of pPDA is as high as more than 65%^[3]。

bronchiolitis obliterans (BO) is a pulmonary bronchiolocclusive disease characterized by progressive dyspnea and obstruction of airflow, which was reported by scholars as early as 1901. BO is a pathological concept characterized by the occlusion of the lumen caused by inflammation and fibrosis of the bronchioles and their surroundings. The disease has less incidence in pediatrics, and there are few previous related reports. Since the late 1980s, with the development of high-resolution CT (HRCT) which can detect subtle changes in small airways and new pathogenic reports, people's awareness and interest in BO have increased, and the literature reports on BO have begun to increase.

The quality of birth population is one of the key factors affecting the quality of population, including the incidence of birth defects, the proportion of congenital disabilities in the disabled population, the prevalence of main genetic diseases in the population, perinatal mortality, etc. The quality of the birth population will directly or indirectly affect the health standards of children, adults and the elderly. Since the 1980s, 800,000~1.2 million babies with birth defects were born in China every year, accounting for about 4% ~6% of the total birth population, accumulating year by year. Birth defects have not only become an important problem affecting the quality of population and human capital, but also caused a heavy economic burden to families and society. The impairment of children's birth and development quality is not only manifested in one aspect of birth defects, but may also be manifested in many aspects of children's development process, including the functions of immune, nervous, endocrine and other systems. Therefore, primary intervention targeting a single birth defect alone tends to be effective in promoting the overall health of embryonic development.