Objective To analyze the clinical characteristics of Mycoplasma pneumoniae pneumonia in children under 2 years old. Methods The clinical features and treatment outcomes were analyzed in 57 children under 2 years old and compared with 153 children more than 2 years old. Results Compared with children more than 2 years old, in children under 2 years old, the number of cases with fever was fewer, the fever peak was lower and the lasting time was shorter. However, in children under 2 years old, the severe pulmonary signs were more common, the incidence of wheeze was higher, meanwhile, the count of white blood cells (WBCs) was signiifcantly increased, more small pieces of lfuff shadow was showed on chest X-ray, and the pulmo-nary complications were fewer, less corticosteroid was needed for treatment. After one-week therapy, the chest X-ray shadows were disappeared in most of children. Complications out of lungs, such as rash, liver function damage and cardiac damage can be found in both groups and no signiifcant difference (P>0.05). Conclusions Mycoplasma pneumoniae pneumonia in children under 2 years old had the characteristics of mild symptoms, severe pulmonary signs, few pulmonary complications, light systemic inlfammations and mild radiological changes.

[Objective]To appraise the clinical effect of the cervical interbody fusion with PEEK cages after anterior decompression through disc space.[Method]Forty-five patients with cervical spondylosis or disc herniation were treated by using PEEK cages after anterior decompression.X-ray films were taken after operation to observe the stability,fusion rate and intervertebral disc height of the segments.The neural function was evaluated by JOA scoring system.[Result]All patients were followed up from 6 to 12 months.The operated segments were stable and height of disc space was reconstructed.Solid fusion was observed 6 months after operation.The improvement rate of neural function was 45%~100%,with an average of 84%.[Conclusion]The PEEK cage has the advantages of excellent biocompatibility,lower elastic modulus and radiolucence,which helps to reconstruct and maintain the intervertebral disc height and cervical lordosis effectively with satisfactory fusion rate.

[Objective]To assess the accuracies and feasibility of computer assisted navigation technique in scoliosis surgery.[Method]In clinical study,5 cases of scoliosis operations assisted by computer navigation technique(Group 1)and 5 cases of scoliosis operations assisted by anatomy and X-ray fluoroscopy(Group 2)were reviewed.The accuracies of screw placement were evaluated by postoperative CT scan.[Result]There were altogether 114 screws inserted in 10 cases.49 screws inserted with CTbased computer assisted navigation system,91.8% excellent,8.2% good.42 screws inserted with anatomy and X ray fluoroscopy,57.1% excellent,23.8 % good,19.1% bad.[Conclusion]CT-based computer assisted navigation system enhances accuracies and further improves the safety of adolescent scoliosis surgery,CT-based navigation method is better than the anatomy and X-ray fluoroscopy methods.

[Objective]To discuss the diagnosis,treatments and the outcome of anterior spinal artery syndrome induced by cervical disc herniation.[Methods]Eighteen patients(male 13,female 5,average age 35.6 years old) were diagnozed to experience cervical disc herniation by MRI scans.All the patients presented with severe motor paralysis with loss of sensation to pain and temperature but sparing of proprioceptive sensation,which was just like the clinical features of anterior spinal artery syndrome.The average preoperative JOA score was 7.6 points,ranged from 4 to 10.Anterior cervical decompression with fusion was performed on 17 patients within 15 days.Spinal canal occupation was found in 1 case.Posterior approach treatment was not effective and anterior approach decompression was performed 1 year later.[Results]All these patients were followed up for an average of 15 months(12 to 24 months).Seventeen patients had a good outcome.The postoperative JOA score ranged from 7 to 15 points(13.4 in average) and the mean JOA recovery ratio was 61.7%.All the patients recovered with no complication.[Conclusion]A herniated cervical disc can compress the spinal anterior artery and involve with anterior spinal artery syndrome.It can be final diagnozed with clinical features and MRI scans.The outcome is satisfactory when an early and complete anterior decompression with fusion is performed.

BACKGROUND:With increased age,bone marrow mesenchymal stem cells(BMSCs)are influenced with regard to quantity and quality,which will induce great damages to the donors.Many studies have focused on seeking substitute MSC source.In contrast it remains controversial whether umbilical cord blood contains MSCs.OBJECTIVE:To isolate MSCs from human umbilical cord blood,and to detect their biological properties.METHODS:Umbilical cord blood samples were sterilely isolated using Percoll density gradient centrifugation to harvest intermediate layer cells.DMEM medium containing fetal bovine serum,penicillin,streptomycin and L-glutamine was added.Following several adherences and purification,the floating cells were discarded.Thus,many adherent cells with a confluence were collected.When cells were 60% 80% confluent,cells were digested by trypsin for subculture.Cells at passages,1,5 and 9 were obtained and their morphological changes were observed.Cell surface antigens were measured using flow cytometry.Growth curves were drawn,and cell viability was determined utilizing MTT.RESULTS AND CONCLUSION:Isolated umbilical cord blood MSCs presented an even size,showing spindle or star-shape fibroblasts-like cells.Umbilical cord blood MSCs at 1,5,9 passages were greatly positive for CD29,CD105 and CD166,but weakly positive for CD34 and CD45.Following 5 days of incubation,cells entered logarithmic growth phase.The number was decreased at day 9.Population doubling time was(53.5±8.32)hours.Cells grew well.Cells at 1-7 passages showed similar viability(P ＞ 0.05).Till passage 9,cell proliferation viability was decreased,but no significant difference was determined(P ＞0.05).Results verified that MSCs can be successfully isolated from umbilical cord blood in vitro.Cells at passages 1-9 presented a good reproductive activity.

Objective To extract breathing pattern parameters during sleep and get the varying law of NREM and REM sleep stages. Method A newly designed respiratory inductive plethysmography (RIP) and a polysomnography (PSG) are utilized to record whole-night-sleep data simultaneously. The breathing pattern parameters obtained by RIP are dealt with according to the results of sleep stages and sleep apnea by PSG. Then the rule found out and summarized from the experiment is applied to distinguish REM sleep. Conclusion RC/VT can be used as an effective parameter to differentiate NREM and REM sleep. Using this parameter, the results of RIP totally accord with the results of PSG.

The protective effect of niacinamide on interleukin-1beta (IL-1beta)-induced annulus fibrosus (AF) type II collagen degeneration in vitro and the mechanism were investigated. Chiba's intervertebral disc (IVD) culture models in rabbits were established and 48 IVDs from 12 adult Japanese white rabbits were randomly divided into 4 groups: normal control group, niacinamide-treated group, type II collagen degneration group (IL-1beta) and treatment group (niacinamide+IL-1beta). After culture for one week, AFs were collected for inducible nitric oxide synthase (iNOS), cysteine containing aspartate specific protease-3 (Caspase-3) and type II collagen immunohistochemical examination, and type II collagen reverse transcription polymerase chain reaction (RT-PCR). The results showed that rate of iNOS positive staining AF cells in the 4 groups was 17.6%, 10.9%, 73.9% and 19.3% respectively. The positive rate in treatment group was significantly lower than in the type II collagen degeneration group (P<0.01). Rate of Caspase-3 positive staining AF cells in the 4 groups was 3.4%, 4.2%, 17.6% and 10.3% respectively. The positive rate in treatment group was lower than in the type II collagen degeneration group (P<0.01). Type II collagen staining demonstrated that lamellar structure and continuity of collagen in treatment group was better reversed than in the degeneration group. RT-PCR revealed that the expression of type II collagen in treatment group was significantly stronger than that in type II collagen degeneration group (P<0.01). It was concluded that niacinamide could effectively inhibit IL-1beta stimulated increase of iNOS and Caspase-3 in AF, and alleviate IL-1beta-caused destruction and synthesis inhibition of type II collagen. Niacinamide is of potential for clinical treatment of IVD degeneration.

Objective:To research the curative effect of moxifloxacin solution atomization inhalation in the treatment of chronic obstructive pulmonary disease (COPD) combined with respiratory failure.Methods:94 cases of COPD patients combined with respiratory failure from May 2014 to May 2016 were selected and divided into the control group(n=47) and the research group (n=47) acording to the lottery method,the control group received routine treatment,while the research group was treated based on the control group with moxifloxacin solution inhalation treatment.The curative effect,serum tumor necrosis factor-α(TNF-α),c-reactive protein (CRP) and interleukin 10 (IL-10),creatine phosphokinase (CK),aspertate aminotransferase (AST) levels,the blood oxygen partial pressure (PaO2),CO2 partial pressure (PaCO2),APACHE Ⅱ score and occurrence of adverse reactions were compared between two groups.Results:After treatment,the total effective rate of research group was higher than that of the control group (P＜0.05).The serum levels of TNF alpha,CRP,PaCO2,CK,AST,APACHE Ⅱ score of research group were evidently lower than those of the control group (P＜0.05).The serum levels ofIL-10,PaO2 of research group were evident higher than those of the control group (P＜0.05).The occurrence of adverse reactions showed no differences between the two groups (P＞0.05).Conclusion:Moxifloxacin solution atomization inhalation was effective in the treatment of COPD combined with respiratory failure,which might be related to the inhibition of inflammatory response,and improvment of breath.

Objective To discuss the effect of competency based education practice teaching model on vocational nursing students with ability training.Methods Totally 96 vocational nursing students were divided into control group from July 2014 to May 2015,receiving routine mentoring teaching mode and totally 99 vocational nursing students were divided into learning group from July 2015 to May 2016,receiving competency based education practice teaching model.Theoretical examination and clinical operation skill test as well as self evaluation of caring ability and transitional nursing ability were conducted to both groups after the course to compare the test scores and the change of their caring ability and transitional nursing ability.SPSS 19.0 was used for statistical analysis,and independent samples t test was used between the two groups.Results The theoretical scores of the nursing students in the experimental group ([93.70 ± 4.27) vs.(88.00 ± 4.83)] and skill test [[95.70 ± 2.49] vs.(91.40 ± 2.87)] were higher than those of the control group;caring ability score [(189.3 ± 13.5) vs.(179.4 ± 10.4)],with the average score of cognitive dimension (51.6 ± 9.8) vs.(50.2 ± 10.3)],the dimension of courage (70.2 ± 6.5) [vs.(65.7 ± 8.4)],average patient dimension (63.4 ± 4.8) vs.5.4)];transitional nursing ability score [(124.95 ± 24.06) vs.(118.18 ± 20.41)],the dimension of knowledge sharing [(38.43 ± 8.22) vs.(36.08 ± 7.23)],average score of attitude dimension [(54.08 ± 10.66)vs.(51.02 ± 9.16)],average score of behavior dimension [(32.43 ± 6.25) vs.(32.43 ± 6.25)],which were all increased compared with the control group,and the difference was statistically significant.Conclusion Competency based education practice teaching mode achieves good teaching effect and it is worth recommending in clinical teaching.

Community-based rehabilitation (CBR) is positioned to provide various strategies for people with disabilities for achieving the embracing development of the community. CBR is also the terminal of the three-level rehabilitation service system. This paper analyzed the status of domestic community-based rehabilitation based on the document, discussed the possible problems referred to the international concepts about CBR, and suggested a new service pattern of CBR based on the internet and information technology.