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Objective:To summarize the clinical characteristics of plastic bronchitis caused by severe mycoplasma pneumoniae pneumonia in children, to find the risk factors for plastic bronchitis, and to provide references for judging the prognosis and comprehensively formulating treatment plans.Methods:We retrospectively analyzed the clinical data(146 cases)of children with severe mycoplasma pneumoniae pneumonia who underwent bronchoscopy in the Department of Pediatric Respiratory Medicine of Shengjing Hospital of China Medical University from January 2017 to December 2019.According to whether it was plastic bronchitis, all patients were divided into plastic bronchitis group(68 cases) and non-plastic bronchitis group(78 cases), and the gender, age, laboratory examination indicators, imaging characteristics and treatment of children were collected under the circumstances.The single factor with clinical significance and statistical significance would be subjected to multivariate Logistic regression analysis.Results:There were no significant differences in gender, age, heat duration, white blood cell count, C-reactive protein value, and interleukin-6 value between the two groups(all P>0.05). The percentage of neutrophils, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, D-dimer, number of cases of pleural effusion, length of hospital stay, and number of endoscopy in the plastic bronchitis group were higher than those in non-plastic bronchitis group, the number of right upper lobe consolidation cases was less than that in the non-plastic bronchitis group, and the differences were statistically significant( P<0.05). Multiple Logistic regression analysis showed that pleural effusion( OR=4.898, 95% CI 2.195-10.926) and lactate dehydrogenase ( OR=1.051, 95% CI 1.003-1.101) were independent predictors of plastic bronchitis in children with severe mycoplasma pneumoniae pneumonia. Conclusion:For children with severe mycoplasma pneumoniae pneumonia, if lung CT shows that the upper lobe of the non-right lung is uniformly compacted and complicated with pleural effusion, lactate dehydrogenase is significantly increased, and attention should be paid to the possibility of plastic bronchitis.Timely improvement of fiberoptic bronchoscopy may shorten the course of the disease and reduce the occurrence of complications.
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Objective:To investigate the clinical efficacy of locking proximal femur plates (LPFP) revision and artificial hip joint revision after failure of proximal femoral nail antirotation (PFNA) internal fixation in elderly patients with intertrochanteric fracture.Methods:A retrospective case control study was conducted on the clinical data of 43 patients with PFNA internal fixation failure in the elderly admitted to Henan Provincial People's Hospital between March 2014 and October 2018. There were 23 males and 20 females, aged 65-83 years [(71.2±2.0)years]. The course of disease was 60-267 days [(83.1±3.6)days]. According to Evans classification, there were 11 patients with type II fractures, 13 with type III and 19 with type IV. There were 23 patients in artificial hip joint revision group and 20 patients in LPFP revision group. The operation time, intraoperative blood loss, postoperative hospitalization time, total hospitalization time, Harris score and complications were recorded and evaluated in two groups.Results:All patients were followed up for 12-28 months, with an average of 13.6 months. Between artificial joint revision group and LPFP revision group, the operation time and intraoperative blood loss were similar ( P>0.05), but there were significant difference in postoperative hospitalization time [(7.1±3.2)days vs. (13.2±2.9)days] and total hospitalization time [(10.2±2.8)days vs. (16.4±3.4)days] ( P<0.05). In artificial joint revision group, the Harris hip score was (21.1±3.7)points preoperatively, and was respective (70.7±4.8)points, (74.6±4.1)points, (78.6±3.3)points, (82.9±5.2)points, (83.8±5.8)points and (84.9±6.4)points at postoperative 1, 2, 3, 6, 9, 12 months. In LPFP revision group, the Harris score was (21.7±3.2)points preoperatively, and was respective (59.9±2.1)points, (64.79±3.4)points, (70.1±4.2)points, (73.9±4.2)points, (76.2±6.3)points and (77.9±6.8)points at postoperative 1, 2, 3, 6, 9, 12 months. The Harris score in artificial joint revision group was gradually improved compared with LPFP revision group ( P<0.05). One patient with superficial wound infection occurred in each group, and the wound healed after frequent dressing changes. Distal femoral fractures occurred in one patient of artificial joint revision group and distal femoral fractures in three patients of LPFP revision group, but all patients were healed after being fixed with wire. Conclusion:For elderly patients with PFNA internal fixation failure of intertrochanteric fracture, artificial hip revision has shorter hospital stay and better hip joint function recovery than LPFP internal fixation, although the effect in operation time and intraoperative blood loss are similar.
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Objective:To investigate the clinical characteristics and imagological changes of atopic children with ADV pneumonia.Methods:One hundred and twenty cases of children with ADV pneumonia selected from Shengjing Hospital of China Medical University Pediatric Respiratory Department from June 2018 to December 2019.According to whether had atopy and severity of pneumonia, the children were divided into atopic group 42 cases (mild pneumonia 30 cases, severe pneumonia 12 cases)and non-atopic group 78 cases(mild pneumonia 50 cases, severe pneumonia 28 cases). The children were treated according to the guidelines of ADV pneumonia diagnosis and treatment.Laboratory examination, clinical manifestations, clinical features during hospitalization, pulmonary imaging changes at admission, at discharge and follow-up 1 month after discharge were statistically analyzed.Results:There were statistically significant differences in the proportion of severe cough and wheezing between the atopic children and non-atopic children with mild pneumonia( P=0.041, P=0.004, respectively). There was no statistically significant difference between the two groups in the proportion of children with small airway changes indicated by lung CT at admission and 1 month after discharge( P>0.05). The risk of wheezing during hospitalization of atopic children was 2.32 times as much as that of non-atopic children with mild pneumonia.The risk of developing severe cough was 1.72 times as much as that of non-atopic children with mild pneumonia.There were statistically significant differences in the proportion of wheezing after admission and after discharge between the atopic children and non-atopic children with severe pneumonia( P=0.002, P=0.034, respectively). There were significant differences in the proportion of small airway changes at admission and at discharge between the two groups( P=0.001, P=0.009, respectively). The risk of wheezing during hospitalization of atopic children was 1.94 times as much as that of non-atopic children with severe pneumonia.The risk of wheezing after discharge was 1.98 times as much as that of the non-atopic children with severe pneumonia.The risk of small airway change on admission in atopic children group was 1.25 times as much as that of non-atopic children with severe pneumonia.The risk of having small airway changes 1 month after discharge in atopic children group was 2.31 times as much as that of non-atopic children with severe pneumonia. Conclusion:Atopic children with ADV pneumonia had severe cough and wheezing, and atopic children with severe pneumonia are prone to small airway changes, long imaging recovery time and regular follow-up, which should be paid attention by clinicians.
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Objective:To explore the clinical characteristics of children with atopic mycoplasma pneumoniae pneumonia and to provide evidence for the diagnosis and treatment of children with atopic mycoplasma pneumoniae pneumonia.Methods:One hundred and eighty cases of children diagnosed with mycoplasma pneumoniae pneumonia in Shengjing Hospital of China Medical University from January 2018 to December 2018 were selected. According to whether they had atopic constitution, they were divided into atopic mycoplasma pneumoniae pneumonia(AMPP)group(84 cases)and non-atopic mycoplasma pneumoniae pneumonia(NAMPP)group(96 cases). The clinical data of age, sex, fever time, hospital stay, application time of macrolides, white blood cells, CRP, LDH, and lung CT were collected from the two groups, and the differences in clinical manifestations, laboratory examinations and imaging manifestations of the two groups were analyzed retrospectively.Results:(1)Both the absolute value of eosinophils and total IgE values in the AMPP group were higher than those in the NAMPP group, and the difference was statistically significant( P<0.05). The incidence of severe mycoplasma pneumoniae pneumonia(SMPP)and/or refractory mycoplasma pneumoniae pneumonia(RMPP)and chest imaging manifestations of interstitial pneumonia in the AMPP group was higher, and the difference was statistically significant( P<0.05). (2)The incidence of wheezing in the AMPP group was 48.81%(41 cases/84 cases), which was significantly higher than that in the NAMPP group 22.92%(22 cases/96 cases). The duration of cough and wheezing in the AMPP group was longer than that in the NAMPP group( P<0.05), with statistically significant differences( P<0.05). (3)In the AMPP group, 36.90%(31 cases /84 cases)of the children received intravenous methylprednisolone treatment, which was significantly higher than the 20.83%(20cases /96 cases)of the NAMPP group. Lung rales absorption time in the AMPP group[(9.73±3.59)d] was significantly longer than that in the NAMPP group[(7.52±2.44)d], and the difference was statistically significant( P<0.05). Lung CT examination showed that the absorption of lung inflammation in the AMPP group was worse than that in the NAMPP group, with a statistically significant difference( P<0.05). The hospitalization time of children in the AMPP group[(10.88±4.17)d] was longer than that in the NAMPP group[(9.68±2.68)d], with a statistically significant difference( P<0.05). Conclusion:The condition of AMPP is more serious than that of NAMPP, and it is more likely to cause incomplete absorption of pulmonary inflammation.
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Objective @#To learn the preference and determinants for institute-based care of the elderly in Zhejiang Province. @*Methods @#By multi-stage sampling and convenient sampling methods,three communities and three villages from Hangzhou,Jinhua and Yongkang as investigation spots,respondents who aged 60 years or above and lived for one year or more were selected for a questionnaire survey to learn their preference for institute-based care. Logistic regression analysis was used to explore the influencing factors for preference of institute-based care among the elderly. @*Results @#A total of 390 valid questionnaires were collected,accounting for 91.76%. Among them,there were 219 men and 171 women, accounting for 56.15% and 43.85; 155 old people chose institute-based care,accounting for 39.74%. The results of multivariate logistic regression analysis illustrated that the elderly who had three children or more had less preference for institute-based care（OR=0.072,95%CI：0.007-0.742）;the elderly who lived with spouse（OR=0.395,95%CI：0.188-0.833）,with children（OR=0.323,95%CI：0.132-0.791）,with spouse and children（OR=0.305,95%CI：0.139-0.673）,compared with the elderly who lived alone,had less preference for institute-based care;the elderly who lived in rural areas,compard with the elderly who lived in urban areas had less preference for institute-based care（OR=0.404,95%CI：0.224-0.730）;the elderly without chronic diseases had less preference for institute-based care（OR=0.485,95%CI：0.292-0.805）. @*Conclusion @#Having three or more children,living with spouse,living with children,living with spouse and children,living in rural areas and living without chronic diseases are determinants for choosing institute-based care among the elderly.
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Objective To investigate the effects of atomized budesonide on neonatal bronchopulmonary dysplasia after discharge from hospital to 6 months of gestational age correction.Methods Analyse clinical data of fifty children with BPD,observe the effects of atomized budesonide (0.5mg inhaled q12h,at least 4weeks,course(15.4 ±6.16) weeks.When wheezing or dyspnea occurred:1mg of budesonide and 1.25ml of albuterol and ipratropium bromide inhaled q12h,2 ～ 4weeks.When respiratory frequency,heart rate and blood oxygen saturation reached normal,three concave improved obviously,lung rale disappeared,gradually reduce to no treatment)improving the clinical symptoms of children with BPD in 6 months after discharge,and observe the effects of atomized budesonide on reducing respiratory tract infection (including upper respiratory tract infection,pneumonia,wheezing and hospitalization).Results Through budesonide aerosol therapy,respiratory frequency and heart rate of children with BPD could be reduced,blood oxygen saturation could be elevated,and three concave could be improved at corrected gestational age of 3 months and 6 months.(P ＜ 0.05),and at 3 months of corrected gestational age,the mean therapy time in treatment group is(56.8 ±26.9) d,this shows that 4weeks'treatment of budesonide aerosol could improve clinical symptoms;Also with budesonide aerosol therapy,the time of oxygen inhalation after hospital could be shortened (P ＜0.05);but respiratory infection of children with BPD in 6 months after discharge could not reduced (P ＞ 0.05).Conclusion The treatment of budesonide atomization can improve the clinical symptoms of children with BPD after discharge from hospital to 6 months of gestational age correction,improve oxygen and shorten the time of oxygen inhalation after hospital,cannot reduce the incidence of respiratory infection.
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Objective To screen the active compounds targeting lung cancer stem cells (LCSCs) from the sponge Aaptos aaptos.Methods The A549-Nanog-GFP model of LCSCs was constructed.Western blot and immunofluorescence were used to examine the expression of pluripotency markers in screening model.The established LCSCs model was used to screen 8 fractions of Aaptos aaptos dichloromethane extract.The active fraction was separated by various chromatographic methods.CCK8 assay was used to screen the compounds for anti-LCSCs activity in vitro.Results LCSCs model with high expression of CD44 and ALDH1A1 protein was successfully constructed.The fraction D6 showed significant inhibitory activity in LCSCs(P<0.01).Four aaptamine alkaloids were isolated from this fraction.Compound AP-1 has good activity against LCSCs(P<0.01)with IC50 value(3.84±0.12) μmol/L.Conclusion AP-1 isolated from the spongeAaptos aaptos exhibited significant activity against LCSCs.
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Objective To investigate the effect of the asthmatic mice's airway inflammation and bronchial hyperresponsiveness treated with curcumin.Methods The mice were divided into three teams randomly,the normal mice,the asthmatic mice and the curcumin mice.The mice of three teams were detected by lung function,Giemsa dying,HE and PAS dying,and ELISA.Results After the Mch concentration of 6.25 g/L,the value of Penh in asthmatic mice was higher than the control mice,which was sighifiantly different(P ＜ 0.01).However,the value of Penh in curcumin team was lower than asthmatic mice,which was sighifiantly different (P ＜0.01).The number of total white blood cells and eosinophils was higher in asthmatic mice than the contol,which was sighifiantly different(P ＜0.01).However,the number in curcumin team was lowered than asthmatic team(P ＜ 0.01).The IgE content of BALF in asthmatic mice was higher than the control,which was significantly different(P ＜ 0.01).However,the content in curcumin team was lowered than the asthmatic mice,which had a significant difference(P ＜0.01).Pathology of HE staining in asthmatic mice showed the thickening bronchial wall,narrow lumen,peribronchial and perivascular infiltration with a large number of eosinophil-based inflammatory cells,lumen with many inflammatory secretions.However,the curcumin team was alleviated than the asthmatic mice.There were more goblet cells and more mucus secretion in the asthmatic mice by PAS staining.However,the curcumin team was alleviated than the asthmatic mice.Conclusion Curcumin can alleviate the airway inflammation,mucus secretion,airway hyperresponsiveness and the IgE content of bronchoalveolar lavege fluid.
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Objective To investigate the effect of the asthmatic mice's contents of NF-κB、IκB、p-IκB treated with curcumin.Methods Thirty Balb/c mice were divided into three groups randomly,the normal mice,the asthmatic mice and the curcumin mice.The bronchial hyperresponsiveness of the three groups were exanined by lung function.The NF-κB 、IκB 、p-IκB content of three teams were tested.Results The content of cytoplasm NF-κB in asthmatic mice was lower than the control (P ＜ 0.01).However,the content of cytoplasm NF-κB in curcumin team was more than the asthmatic mice (P ＜ 0.05).In the other hand,The content of nuclear NF-κB in asthmatic mice was more than the control(P ＜0.01).However,the content of nuclear NF-κB in curcumin mice was lower than the asthmatic mice (P ＜ 0.05).The content of cytoplasm p-hκB in asthmatic mice was more than the control and the content of IκB was lower than the control(P ＜ 0.01).Howerer,the content of IκB in curcumin team have much more than the asthmatic mice and the content of p-IκB have much lower than the control(P ＜ 0.01).Condusion Curcumin alleviates the airway hyperresponsiveness of the asthmatic mice through the suppression of NF-κB transcribe to the nuclear via alleviating the phosphorylation of I-κB.
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Objective To detect the expression of long non-coding RNA (lncRNA) CCAT1 in human papillary thyroid cancer, and to observe the effect of CCAT1 down-regulation on the invasion and migration of human papillary thyroid cancer.Methods The expression of CCAT1 was detected in human normal thyroid Nthy-ori 3-1 cells and human papillary thyroid cancer TPC-1 cells.CCAT1 siRNA plasmid was transfected into TPC-1 cells.The effect of CCAT1 down-regulation on cell invasion and migration was observed by Transwell chamber assay and scratch test, and the expressions of BRAF, MUC15 and RKIP proteins were detected by Western blot.Results The level of CCAT1 in human papillary thyroid cancer TPC-1 cells was significantly higher than that in human normal thyroid Nthy-ori 3-1 cells.CCAT1 down-regulation significantly inhibited the invasion and migration of TPC-1 cells.The Transwell invasion assay revealed that the number of migrated TPC-1 cells in the CCAT1 down-regulation group was significantly lower than that in the control group.The scratch test showed an increased distance between cells in the CCAT1 down-regulation group compared to the control group, suggesting a reduced cell motility.The expressions of BRAF and MUC15 proteins were decreased in the CCAT1 down-regulation group, while that of RKIP protein was increased.Conclusions The expression of CCAT1 in papillary thyroid cancer cells is significantly higher than that in normal human thyroid cells.Down-regulation of CCAT1 in papillary thyroid cancer cells may inhibit the cell invasion and migration by regulating the expression of BRAF, MUC15 and RKIP proteins.
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Objective To investigate the effect of the asthmatic mice's contents of nuclear factorerythroid-2-related factor 2,Nrf2 and HO-1 reated with curcumin in lung tissue.Methods All 45 mice were divided into three teams randomly,the normal mice,the asthmatic mice and the curcumin mice group.We tested the expression of Nrf2 and HO-1 of three mice teams in lung by immunolfluorescence technique.We tested the protein contents of Nrf2 and HO-1 of the three teams in the lung tissue by Western blot.We tested the binding activity of Nrff2 and ARE of the three teams in lung by EMSA.Results The expression of Nrf2 and HO-1 in curcumin group was significantly higher than that in asthma group and normal control group by immunolfluorescence technique.There was no sigrnificant difference in content of cytoplasm Nrf2 protein in lung tissue between three groups by western blot(P ＞ 0.05).The content of nuclear Nrf2 and HO-1 protein in the lung tissue of the curcumin group was significantly higher than that in the other two groups,the difference is statistically significant (Nrf2,P ＜0.05;HO-1,P ＜0.01).The binding activity of Nrf2-ARE in lung tissue of curcumin group was significantly higher than that of asthma group and control group,with statistical significance(P ＜ 0.05).Conclusion Curcumin can increase the protein contents of the Nrf2 and HO-1 of mice and enhance the expression of them.
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Objective To investigate the level and its influencing factors of quality of life for burn patients undergoing amputation,and take treatment measures for clinical nursing. Methods The single factor analysis method was taken on the burn patients undergoing amputation in different social demographic characteristics from January 2013 to July 2016. Results The score of quality of life was (56.08 ± 17.97) points,and the four dimensions scored as physical function (63.64 ± 27.51) points, mental health(54.76±20.28)points,social relations(58.71±19.19)points and general health(46.00±18.61)points, which were at a low level.Multiple regression analysis showed that the influencing factors of quality of life were patient education, marital status, cost source, economic conditions, prosthetic replacement, and amputation site,which had a statistically significant difference between the effects on the quality of life(F/t=4.367,3.836,4.436,4.412,2.916,4.591,P<0.01)and into stepwise multiple regression equations.The patient′s age and career had statistically significant(F=3.495,3.640,P<0.05),but not into stepwise multiple regression euqtions. Conclusions Burn patients undergoing amputation are physical and spiritual double whammy,through to the influencing factors,clinical medical staff to be able to make this part of the population cause enough attention,enhancing the quality of life,strive for an early return to family and society.
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Objective To observe the efficacy of bacterial lysate(bronchovaxom) in the acute phase of respiratory tract infection and to prevent recurrent respiratory tract infections.Methods From April 2014 to A-pril 2015,in pediatric respiratory ward of Shengjing hospital of China Medical University,80 children with recur-rent respiratory tract infection were randomly divided into treatment group and control group,with 40 cases in each group.The control group patients were received routine anti-infection and symptomatic treatment,the treat-ment group patients were received oral bacterial lysis products for 3 months on basis of the conventional anti-in-fection and symptomatic treatment.To observe the duration of clinical symptoms of two groups of children with respiratory tract infection in the acute phase,antibiotic use and hospital stay changes;observed the number of re-spiratory infections occurred again within 1 year;measured the levels of serum immunoglobulin before and 6 months after treatment. Results Compared with the control group,the duration of symptoms such as fever, cough and other symptoms of respiratory tract infection,the duration of pulmonary rales,the use of antibiotics and the length of hospital stay were significantly shortened in the treatment group,and the number of respiratory infections was significantly reduced,the difference significant(P<0.05).After treatment,the levels of IgG and IgA in the treatment group were significantly higher than those before treatment,and the immunoglobulin IgG and IgA in the treatment group were significantly higher than those in the control group(P<0.05).Conclusion Oral bacterial lysis products to prevent respiratory infections,not only can reduce the duration of various clini-cal symptoms of respiratory tract infection,shorten the use of antibiotics and hospital stay,and can improve chil-dren's immunity,reduce the number of respiratory infections again.
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Objective To evaluate gene transfection in liver , lung and kidney by ultrasound , microbubble and recombinant adenovirus mediated exogenous stromal cell derived factor-1α ( SDF-1α) gene transfer to the heart in rats with acute myocardial infarction( AMI) . Methods Forty AMI SD rats were randomly divided into control and experimental groups:myocardial infarction + ultrasound irradiation group (M+ U/control group , n = 10) ,and 3 experimental subgroups on the basis of pAd-EGFP/SDF-1α ( The biotin recombinant adenovirus expressing enhanced green fluorescent protein and SDF-1α) . Genes transfection length of time:1 day ,2 days and 3 days of transfection ( M +S1+U ,M+S2+U and M+S3+U group) . The expression of EGFP in liver ,lung and kidney were detected by laser scanning confocal microscopy at 7 days after administration . Results There was a little expression of EGFP in the liver ,lung and kidney in the drug delivery group and no expression in the control group .The differences in the expression of EGFP between all the gene delivery groups and the control group were statistically significant ( P <0 .05) . With the increase of the number of medication days , the target gene transfection increased slightly ,but there was no significant difference among the different drug delivery groups . Conclusions When the ultrasound ,microbubble and recombinant adenovirus mediated exogenous SDF-1αgene transfer to the heart in AMI rats ,liver ,lung and kidney tissues will also be transfected . However ,with the increasing of the days of administration , the transfection of target gene in non-target tissue produces only a slight accumulation . The transfection area of target gene in non-target tissue is not linear correlated with the days of administration .
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Objective To construct the uItrasound microbubbIes co-carrying recombinant adenovirus containing stromal cell derived factor 1 (SDF-1α) and bone morphogenetic protein 2 (BMP2),and to study the maximum efficiency of carrying adenovirus and the optimum proportion of double gene combined with ultrasound contrast agents.Methods Microbubbles were combined separately with recombinant adenovirus co-expression of enhanced green fluorescent protein and SDF-1α(pAd-EGFP/SDF-1α) as well as red fluorescence protein and BMP2 (pAd-RFP/BMP2) via biotin-streptavidin method,and the maximum efficiency of carrying DNA in microbubbles was detected.Three microbubbles with binary vectors were prepared by blending the two above-mentioned pAd at different ratio (1 ∶1,1 ∶ 2,2 ∶ 1) into the microbubbles.The microbubbles with binary vectors were evaluated though physiochemical properties,fluorescence microscope and flow cytometry to test the carrying rate of DNA in microbubbles.Results There was no significant difference in PH,average diameter and concentrations between targeted microbubbles and control group (P ＞0.05).The carrying efficiency of DNA increased with virus loads in microbubbles,but lowered if further increasing virus amount after reaching saturation.When the proportion of binary vectors and microbubbles was 1 ∶ 1,its efficiency of carrying SDF-1α gene and BMP-2 was approximately equal,and flow cytometry demonstrated that the positive rate of microbubbles labeled by both fluorescein isothiocyanate(FITC) and rhodamine was (65.6 ± 0.5)％.However,it was (59.0 ± 2.3)％ when their proportion was the 2 ∶ 1,which was significantly lower than those when other two proportions (1 ∶ 1 and 1 ∶ 2).Under the fluorescence microscope,the targeted microbubbles were equally surrounded by bright green or red fluorescence.Conclusions Ultrasound microbubbles of double genes carrying EGFP/SDF-1a and RFP/BMP2 is made successfully via biotin-streptavidin method.The optimal proportion of combining microbubbles with double gene is 1 ∶1,which can reveal the optimum load rate and stable combination.
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Objective To understand the correlation of gene detection of Mycoplasma pneumoniae and clinical refractory Mycoplasma pneumoniae pneumonia.Methods (1) For children with Mycoplasma pneumoniae pneumonia in our hospital with serum Mycoplasma pneumoniae antibody positive,we collected the pharyngeal swab specimens over the same period,applied nested PCR to amplify 23SrRNA gene and undergoing electrophoresis and find out 97 cases of both positive,conducted DNA sequencing analysis of macrolide resistant gene to isolate the mutants,compared clinical manifestations of drug-resistance gene group with no drug-resistance gene mutation group.(2) Ninety-seven cases of mycoplasma pneumonia (MPP) patients were devided into the general MPP group (68 cases) and refractory MPP group (29 cases),retrospectively analyzed clinical manifestation,laboratory examination and differences of imaging performance.Multivariate logistic regression analysis for the performance of refractory Mycoplasma pneumoniae pneumonia was carried out to examine whether there is relevance between the mutant of drug-resisting gene and refractory Mycoplasma pneumonia.Results (1) Seventeen of 97 cases (17.5％) were found out without mutations,the other 80 cases (82.5％) exist drug-resistance gene mutations.(2) Mutation of drug-resistance gene group showed high CRP values,heating time,hospitalization time,macrolide drug application time,application of macrolides fever time and longer cough,by statistical analysis with statistical significance,higher incidence of lobar pneumonia.(3) Compared to general MPP group,refractory MPP group showed high peripheral blood neutrophil percentage percentage,CRP,calcitonin) and lactate dehydrogenase (LDH) values,heating time,hospitalization time,macrolide drug application time,application of macrolides fever time and longer cough.There was significant difference (P ＜ 0.05);macrocyclic lactones drug application time and resistance gene mutation and refractory Mycoplasma pneumonia were correlated.Conclusion MPP drug-resistant genes are widespread.Drug resistance gene mutations group shows long clinical symptoms duration,slow recovery rate,higher CRP value,higher rates of lobar pneumonia.Compared with ordinary MPP group,there are higher drug resistance mutation rate,inflammatory indexes and lactate dehydrogenase value,large ring lactone class drugs after a longer time of cough and fever in RMPP group.Drug application time and resistant gene mutations are associated with RMPP.
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Objective To study the morphological changes of external eyes before and after epicanthoplasty combined with blepharoplasty and to explore a simple and efficient method to correct epicanthus. Methods A total of 120 eyes in 60 patients were operated on with the inverted L-sharp epicanthoplasty combined with double-eyelid blepharoplasty and the follow-up began 2 months after the surgery. The height and physiognomic length of the eyelid and the length and angle of the eyelash were measured and compared with preoperative meansurements, as well as the distance of the inner canthus. The ratios between the inner-canthus distance and the physiognomic eyelid breadth and the diameter of eyebrow and eye were also described. Results The contours of the eyelid fissure and the double-eyelid were natural and the surgical scare was seen unconspicuous 3 months after the operation. Changes in the palpebral fissure , the angel and length of the exposed eyelash were all significantly different by paired-sample t test (P < 0.01). The vertical and horizontal lines through the entocanthion and the vertical line through the gnomic ectocanthion combined with the horizontal line through the brow ridge formed a square structure. Conclusions This inverted L-shape epicanthoplasty combined with blepharoplasty may be effective in reconstructing the contours of the entocanthions as well as the shape of the double eyelids. It can also achieve better cosmetic effects in the proportional relation between the eyes and eyebrows. Therefore, it deserves clinical promotion.
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Purpose To investigate the c1inicopatho1ogica1 and immunohistochemica1 characteristics of enteropathy-associated T-ce11 1ymphoma( EATL)and to eva1uate the criteria of diagnosis and differentia1 diagnosis. Methods There were enteropathy-associated T-ce11 1ymphoma patients co11ected with c1inica1 data(n=9). Histo1ogica1 features were observed under microscope by HE staining and by immunohistochemstry. EBV was tested by in situ hybridization. Results EATL type Ⅰ showed a variab1e histo1ogy consisting of medium-sized to 1arge 1ymphoid ce11s with round or po1ygona1 nuc1ei,containing remarkab1e nuc1eo1i. EATL typeⅡshowed that tumor ce11s were medium-sized,with round,hyperchromatic nuc1ei. Nuc1ear debris and necrosis cou1d be seen easi1y. A 1arge number of his-tiocytes and neutrophi1s formed the inf1ammatory background. Immunohistochemica1 findings showed that tumor ce11s of two types were diffuse1y positive for CD3,CD43 and TIA-1,whi1e negative for CD4,CD5,CD20,CD79a. Tumor ce11s of EATL type II expressed CD56 and CD8,but negative in EATL typeⅠ. A high pro1iferation index was demonstrated by Ki-67. EBER was negative detection. There were seven patients with fo11ow-up data from 0 to 18 months. Four patients died within 10 months and three patients died within 18 months. Conclusions EATL is a rare type of 1ymphoma with intestina1 invo1vement. Patients often present with chronic abdomina1 pain,diarrhea,persistent fever and abdomina1 mass for a 1ong time. Intestina1 perforation occurs in some cases. Diagnosis shou1d be corre1ated to c1inica1 symptoms whi1e the fina1 diagnosis is main1y based on the patho1ogica1 features and the immune phenotypes.
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Objective To investigate the relationship between the content of stromal cell-derived factor-1 (SDF-1) in myocardium in different period of myocardial infarction and left ventricular function.Methods Twenty three Chinese miniature pigs were randomly divided into the experimental group and the control group.The swines in experimental group were prepared as acute myocardial infarction model by ligating anterior descending coronary artery and were randomly divided into 6 subgroups according to the different time points after infarction.The left ventricular end-diastolic diameter (LVDd),left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were measured respectively.Global circumferential strain (GCS) and global radial strain (GRS) of left ventricle were measured.The content of SDF-1 were also measured by real-time quantitative PCR.Results Compared with the control group,SDF-1 levels were significantly elevated,and LVEF,LVFS,GCS and GRS were reduced.However,LVDd were significantly increased.The content of SDF-1 and GCS has a negative correlation (r =-0.580,P =0.000).Conclusions The content of SDF-1 in myocardial tissue have a certain relationship with GCS of left ventricular myocardium.
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Objective To investigate the value of preoperative risk assessments and countermeasures on ultrasound-guided radiofrequency ablation for benign thyroid nodules.Methods The preoperative risk assessments of 311 benign solid thyroid nodules in 274 patients were divided into level 0-Ⅳ,among which 38 nodules on level 0,69 nodules on level Ⅰ,36 nodules on level Ⅱ,59 nodules on level Ⅲ,109 nodules on level Ⅳ.Treatments were performed by moving shot technique or multiplanar shot technique,using Leverage Displacement or Hydrodissection to prevent the adjacent vital structures from thermal injuries.Results 311 thyroid nodules were completely ablated.In ablating the 59 nodules on risk level Ⅲ,thermal injuries were effectively avoided in 30 cases by using Leverage Displacement,while recurrent laryngeal nerve injuries happened in 2 cases using Hydrodissection for 29 nodules.The difference between these two methods on risk level Ⅲ had no statistical significance(P =0.237).To avoid thermal injuries during ablation for 109 nodules on risk level Ⅳ,using Leverage Displacement for 102 nodules,recurrent laryngeal nerve injuries happened in 1 case,while using Hydrodissection for 7 nodules,recurrent laryngeal nerve injuries happened in 2 cases.The difference between the two methods on risk level Ⅳ had statistical significance(P =0.010).No thermal injury happened during ablation for 143 nodules on risk level 0-Ⅱ.Conclusions Preoperative risk assessment on thyroid nodules is helpful in preventing potentially avoidable complications.Proper use of Leverage Displacement can protect adjacent vital structures from thermal injuries during ablation for nodules,which is easy and simple to handle and has a certain practical application value.