Mycoplasma pneumonia (MP) is one of common pathogens of community-acquired pneumonia in children. In recent years, the incidence of MP pneumonia (MPP) shows a trend of increasing. The report of severe refractory MPP was more and more. Glucocorticoids has anti-inlfammatory, anti-allergic and restraining immune response pharmacological effects and is the most effective anti-inlfammatory drug currently. In this paper, pathogenesis of the lower respiratory infection by MP and the therapeutic effects of glucocorticoid were reviewed.

Objective To solve the problems of Information Island and Repeated Construction in hospital information construction. Methods Some solutions of application system integration were discussed and architecture systems were proposed. Results Integration mode was adopted according to the condition of the hospital. Conclusion References are provided for the integration of hospital information system.

BACKGROUND:Erythropoietin and bone marrow mesenchymal stem cells have been shown to affect myocardial apoptosis. However, few studies concerned their combined application to sepsis-related myocardial injury. OBJECTIVE:To observe the effects of the combination of erythropoietin and bone marrow mesenchymal stem cells on pathology and apoptosis of sepsis rat cardiomyocytes. METHODS:A total of 50 Sprague-Dawley rats were randomly selected and assigned to five groups (n=10). Sepsis models were established by cecal ligation perforation method. Rat models in the bone marrow mesenchymal stem cellgroup, erythropoietin group and erythropoietin+bone marrow mesenchymal stem cellgroup were respectively treated with bone marrow mesenchymal stem cells, erythropoietin and erythropoietin+bone marrow mesenchymal stem cells immediately after model induction via intraperitoneal injection or caudal vein. Model group received cecum ligation and puncture. Control group did not undergo any treatment after the abdomen was opened. Model and control groups were infused with an equal volume of physiological saline via caudal vein. At 24 hours, experimental animals were sacrificed by anesthesia. Myocardial specimens were col ected. Myocardial appearance was observed using hematoxylin-eosin staining. Bax, Caspase-3 and Bcl-2 were tested by western blot assay. RESULTS AND CONCLUSION:Hematoxylin-eosin staining:cardiomyocytes were regularly arranged, showing integrated structure in the control group. Extensive myocardial fiber breakage, disordered arrangement, cardiomyocyte swel ing or shrinkage, and vacuolar degeneration were observed in the model group. Moreover, myocardial interstitial vascular congestion, edema, and inflammatory cellinfiltration were visible. Myocardial tissue was similar between erythropoietin and bone marrow mesenchymal stem cellgroups, with the presence of mild inflammatory cellinfiltration and scattered normal cardiomyocytes. In the erythropoietin+bone marrow mesenchymal stem cellgroup, cardiomyocytes were slightly damaged. Interstitial vascular congestion was not apparent, and a few inflammatory cells infiltrated. Western blot assay results demonstrated that Bcl-2 protein expression was significantly higher (P<0.01), but Bax and Caspase-3 protein expression was lower (P<0.05) in the erythropoietin+bone marrow mesenchymal stem cellgroup than in the erythropoietin, model and control groups. The combination of erythropoietin and bone marrow mesenchymal stem cells in treatment of sepsis-related myocardial injury could lessen myocardial pathological changes, and inhibit cardiomyocyte apoptosis. The mechanisms maybe exert by upregulating anti-apoptotic protein expression and downregulating apoptotic protein expression.

Objective To study clinical outcomes of cross-leg fibula flap for difficult reconstruction of an extensive injury in the lower extremity,which included large soft-tissue defects and long infected bone and tibia defects combined with vascular injury.Methods From September 2004 to September 2008,8 cases with an extensive injury in the lower extremity,which included large soft-tissue defects and long infected bone and tibia defects with vascular injury,were retrospectively analyzed,including 6 males and 2 females with an average age of 36 years (range,19-55 years).The course of disease ranged from 2 weeks to 3 months (average,2 months).The bone defect length ranged from 8 to 20 cm (average,13 cm),and the skin defect area varied from 10 cm×7 cm to 22 cm×12 cm.After thorough debridement,cross-leg fibula flap was used to repair the tibial defect and concomitant soft tissue defect.The pedicles were divided at 4-6 weeks after the initial surgery.The important technical considerations were outlined.Results All 8 patients were followed up for 6 to 36 months (average,24 months).The flaps survived in all 8 patients,and no infection and osteomyelitis happened.The flap transplantations healed at two weeks after operation with good shape.The fractures healed in all of patients with an average period of 11 months (range,6-15 months).All of patients recovered to walk without aid.According to Edwards classification of tibial fractures,4 cases were classified as good,2 as acceptable,and 2 as poor.Conclusion The cross-leg fibula flap is relatively simple,liable for the treatment of an extensive injury in the lower extremity.

Objective The anterior-lateral defect of foot that lost one of the three supporting point of foot can lead to collapse of the lateral longitudinal arch, overload of the first metatarsal heads, and painful callus formation. It is meaningful to investigate the effect of reconstructing the lateral forefoot defect with pedical fibular osteoseptocutaneous flap. Methods From March 1989 to June 2008, there were 38 patients with anterior-lateral defect of foot were constructed. The supporting point with the local distal based pedical fibular osteoseptocutaneous flap was constracted. Results All the 38 flaps survived. All 38 patients had been followed up from 6 months to 10 years (mean 23.5 months) postoperatively. The constructed supporting point of the foot was functional. The patients could walk freely with no pain, and was satisfied with the operation. Assessed with the rating system for foot and ankle established by the American Orthopaedic Foot And Anke Society, 8 patients got a score above 85, 23 patients between 75 to 85, 7 patients between 60 to 75. Conclusion It is effective that transferring local distal based pedical fibular osteoseptocutaneous flap to repair the anterior-lateral defect of foot.

Objective To explore the characteristics and clinical significance of lung function in children with mycoplasma pneumoniae pneumonia. Methods The pulmonary ventilation function of 60 cases of mycoplasma pneumoniae pneumonia was tested in the acute stage and 2 weeks after treatment by the pneumatometer made by JAEGER company in Germany. FVC, FEV1, PEF, FEF25,FEF50、FEF75 and MMEF75/25 was detected. Results In acute phase, lung function indexs (FVC, FEV1, PEF, FEF25, FEF50, FEF75, MMEF75/25) of 60 children with MPP were less than expected:(1.56 ± 0.53) L vs.(1.99 ± 0.69) L, (1.37 ± 0.47) L vs. (1.68 ± 0.57) L, (2.90 ± 0.86) L/s vs. (3.95 ± 1.08) L/s, (2.48 ± 0.67) L/s vs. (3.56 ± 0.89) L/s, (1.42 ± 0.41) L/s vs. (2.51 ± 0.64) L/s, (0.65 ± 0.20) L/s vs. (1.28 ± 0.33) L/s, (1.22 ± 0.77) L/s vs.(2.18 ± 0.61) L/s], and there were significant difference (P<0.01). In recovery period, the level of FVC, FEV1, PEF, FEF25, FEF50, FEF75, MMEF75/25 was significantly better than that in acute phase: (98.80 ± 9.34)% vs.(79.14 ± 6.28)%, (98.67 ± 8.28)% vs. (81.63 ± 6.56)%, (86.23 ± 6.86)% vs.(73.17 ± 6.21)%, (85.17 ± 7.86)% vs. (69.79 ± 8.16)%, (79.08 ± 7.99)% vs. (56.57 ± 8.77)%, (70.85 ± 7.48)% vs. (50.66 ± 9.86)%, (77.35 ± 6.81)% vs. (56.19 ± 9.61)%, P<0.01. Conclusions In the acute stage, the pulmonary function of children with MPP shows hybrid ventilation dysfunction. In the recovery period, pulmonary function index improves significantly, but there are still abnormal small airway indicators.

Objective:To review the treatment of life threatening head and neck space infection.Methods:Retrospective was con-ducted to analyse the patient characterization,signs and symptoms at the time of presentation,presence of concomitant systemic co-morbidities,treatment,prognosis and bacteriology.Results:32 patients from 2007.01 to 2013.01(mean age was 57.71 years)were included.The cases were increased year by year.1 1 (34.37%)patients had breathing difficulty requiring tracheostomy and 19 (59.3%)had concomitant systemic comorbidities.23 cases recovered completely,8 with severe mediastinal infection were trans-ferred to the department of thoracic surgery or the department of respiratory medicine.1 patient died.Pus submission rate was 96.87%,the bacteria detection rate was 37.50%.Pus culture showed mixed infection dominated by streptococci.Staphylococcus au-reus,pseudomonas aeruginosa,enterococcus faecalis,prevotella and neisseria were detected.Conclusion:Annually incidence of life threatening head and neck space infection is increasing.Treatment of the infection should include:①Ensuring the airway patency;②Surgical incision and drainage as early as possible;③ Hypoglycemic control,maintenance of hemodynamic,nutritional support,and multi-disciplinary approach are the key points in the management of such infections;④ Systemic antibiotics.

Objective To investigate the correlation between large platelet ratio (P-LCR) and stroke in patients with atrial fibrillation. Methods 152 consecutive patients with atrial fibrillation were selected and divided into two groups according to whether accompanying stoke or not. Clinical features of patients and blood test indicator P-LCR were analyzed by Logistic regression analysis. Results In total, 152 subjects, including 47 patients with stoke and 105 patients without stoke,were included in the study. Univariate analysis showed that the difference in age, diabetes, hypertension, lipid-lowering therapy and P-LCR between two groups was statistically significant (P < 0.05). Logistic regression analysis showed that age, diabetes and P-LCR were independent risk factors of stroke in patients with atrial fibrillation. Conclusions Age, diabetes and P-LCR are independent risk factors of stroke in patients with atrial fibrillation.

Objective To discuss the feasibility of single hole thoracoscopy of pleural fibreboard endarterectomy surgical treatment on chronic tuberculous empyema. Methods Retrospective analysis of minimally invasive treatment of 52 cases of chronic tuberculous empyema form January 2013 to May 2016, 50 cases applied single hole thoracoscopy surgery, video-assisted mini-thoracoscopy for another 2 cases. Results There was no death, operation time 60 ~ 240 min, average 160 min, bleeding 150 ~ 2000 ml, average 350 ml, postoperative chest tube drainage time 3 ~ 21 d, average 7 d, postoperative persistent leakage in 3 patients, 3 cases of atelectasis, incisional infection in 1 case, pleural effusion in 1 case, 3 cases of arrhythmia. All the cured patients are received the corresponding treatment, the follow-up of 3 ~ 36 m, the chest CT scan show no atelectasis. Conclusion Under the condition of strict selection of indication, single hole thoracoscopy of pleural fibreboard endarterectomy in treatment of chronic tuberculous empyema is safe and feasible, so it is worthy of making further clinical promotion and application.

PURPOSE: Studies have found that long noncoding RNA HEIH (lncRNA-HEIH) is upregulated and facilitates hepatocellular carcinoma tumor growth. However, its clinical significances, roles, and action mechanism in colorectal cancer (CRC) remains unidentified. MATERIALS AND METHODS: lncRNA-HEIH expression in CRC tissues and cell lines was measured by quantitative real-time polymerase chain reaction. Cell CountingKit-8, ethynyl deoxyuridine incorporation assay, terminal deoxynucleotidyl transferase dUTP nick end labeling staining, and nude mice xenografts assays were performed to investigate the roles of lncRNA-HEIH. RNA pull-down, RNA immunoprecipitation, chromatin immunoprecipitation, and luciferase reporter assays were performed to investigate the action mechanisms of lncRNA-HEIH. RESULTS: In this study, we found that lncRNA-HEIH is significantly increased in CRC tissues and cell lines. lncRNA-HEIH expression is positively associated with tumor size, invasion depth, and poor prognosis of CRC patients. Enhanced expression of lncRNA-HEIH promotes CRC cell proliferation and decreases apoptosis in vitro, and promotes CRC tumor growth in vivo. Whereas knockdown of lncRNA-HEIH inhibits CRC cell proliferation and induces apoptosis in vitro, and suppresses CRC tumor growth in vivo. Mechanistically, lncRNA-HEIH physically binds to miR-939. The interaction between lncRNA-HEIH and miR-939 damages the binding between miR-939 and nuclear factor κB (NF-κB), increases the binding of NF-κB to Bcl-xL promoter, and promotes the transcription and expression of Bcl-xL. Moreover, Bcl-xL expression is positively associatedwith lncRNA-HEIH in CRC tissues. Blocking the interaction between lncRNA-HEIH and miR-939 abolishes the effects of lncRNA-HEIH on CRC tumorigenesis. CONCLUSION: This study demonstrated that lncRNA-HEIH promotes CRC tumorigenesis through counteracting miR-939-mediated transcriptional repression of Bcl-xL, and suggested that lncRNA-HEIH may serve as a prognostic biomarker and therapeutic target for CRC.
Animals ; Apoptosis ; Carcinogenesis* ; Carcinoma, Hepatocellular ; Cell Line ; Cell Proliferation ; Chromatin Immunoprecipitation ; Colorectal Neoplasms* ; Deoxyuridine ; DNA Nucleotidylexotransferase ; Heterografts ; Humans ; Immunoprecipitation ; In Vitro Techniques ; Luciferases ; Mice ; Mice, Nude ; Prognosis ; Real-Time Polymerase Chain Reaction ; Repression, Psychology* ; RNA ; RNA, Long Noncoding*