Objective To compare the therapeutic effect of azithromycin and erythromycin in the treatment of children with Mycoplasma pneumoniae infection complicated with central nervous system involvement.Methods Mycoplasma pneumoniae infection in children with central nervous system damage treated in our hospital from March 2014 to June 2015 were selected as the observation object.According to the treatment method,it was divided into treatment group(45 cases)and control group(50 cases),the control group was given erythromycin tablets,the treatment group given azithromycin.To observe the therapeutic effect of two groups,compared the cerebrospinal fluid inflammatory cytokine levels and lung function of the two groups before and after treatment.Results The effective rate of treatment group was significantly higher than that of control group,and the difference was statistically significant(P<0.05); After treatment,the indexes of lung function in patients of the two groups were increased before treatment,and the treatment group increased more significantly(P<0.05); The level of hs-CRP,IL-6 and other inflammatory cytokine of the two groups of patients before treatment had no significantly difference,after treatment,the two groups of patients with the above indicators were lower than before treatment,and the treatment group decreased more significantly(P<0.05).Conclusion Azithromycin and erythromycin in children with Mycoplasma pneumoniae infection complicated with central nervous system involvement have better treatment effect,and the effect of azithromycin is better,has a high clinical value.

Objective:To evaluate left lateral position I-scope tracheal intubation for optimizing anesthesia time during the patient′s general anesthesia before endoscopic submucosal dissection.Methods:A total of 150 patients with early upper gastrointestinal cancer were enrolled in the study for endoscopic submucosal dissection in Beijing Friendship Hospital, Capital Medical University from March to December 2018. Patients were randomly divided into three groups with 50 patients in each group. The SL group underwent I-scope tracheal intubation in the left lateral position, SS group underwent I-scope tracheal intubation in the supine position, and MS group underwent Macintosh laryngoscope tracheal intubation in the supine position. Preoperative non-essential anesthesia time (the time between successful intubation and operation), attempts for tracheal intubation and complications related to intubation were analyzed.Results:The preoperative non-essential anesthesia time was 8.55±2.16 min in SL group, 10.44±2.43 min in SS group, and 10.56±3.20 min in MS group, with significant difference among three groups ( F=9.08, P<0.001), and the time in SL group was shorter than that in SS group ( P<0.001) and MS group ( P<0.001). However, there was no statistical difference in non-essential anesthesia time between the SS group and MS group ( P=0.819). The success rate of first attempt intubation was 96.0% (48/50) in SL group, 90.0% (45/50) in SS group, and 92.0% (46/50) in MS group, with no significant differences among three groups ( χ2=2.601, P=0.627). The incidences of cough and expectoration, dry mouth and mucosal injury showed no statistical differences among three groups during transference to the ward after tracheal catheter removal (all P>0.05). The incidence of sore throat in MS group (38.0%, 19/50) was higher than that in SL group (18.0%, 9/50, P<0.05) and SS group (18.0%, 9/50, P<0.05), while the difference was not statistically significant between SL group and SS group ( P>0.05). Conclusion:I-scope tracheal intubation in the left lateral position may shorten the preoperative anesthesia time in patients undergoing general anesthesia for the operation in the left lateral position, and optimize overall anesthesia time.

Objective:To investigate the relationship between monocyte/high-density lipoprotein ratio (MHR) and clinical parameters and the prognosis of patients with chronic kidney disease (CKD).Methods:Clinical data were collected of CKD patients who were diagnosed and followed up regularly in Henan Provincial People's Hospital from January 1, 2017 to June 30, 2020. According to the median baseline MHR of the selected patients, they were divided into two groups: low-level MHR group (MHR≤0.347 8) and high-level MHR group (MHR>0.347 8). The patients were regularly followed up for 3-42 months, the renal adverse prognostic events were defined as serum creatinine doubled, estimated glomerular filtration rate (eGFR) reduced to at least 50% of the original, new entry into end-stage renal disease (ESRD), starting renal replacement therapy, death due to renal or cardiovascular events. The Kaplan-Meier method was used to compare the differences in survival rates between the two groups, and Cox regression analysis method was used to explore the influencing factors of renal adverse prognosis in CKD patients. Stratified analysis was used to find special factors that might affect the relationship between MHR and renal adverse prognosis in CKD patients.Results:A total of 405 patients were included in this study. Their age was (49.77±14.82) years old. Body mass index was (25.18±4.22) kg/m 2. Women accounted for 30.62%(124/405). The proportion of patients with smoking, drinking, hypertension and diabetes was 39.51%(160/405), 35.06%(142/405), 73.33%(297/405) and 38.27%(155/405), respectively. Compared with the low-level MHR group ( n=202), the high-level MHR group ( n=203) had more people in late CKD, males, and hypertension (all P<0.01), and body mass index, white blood cells, monocytes, serum creatinine, serum uric acid, serum urea nitrogen, retinol binding protein, cystatin C, blood phosphorus were higher (all P<0.05), while hemoglobin, high density lipoprotein and eGFR were lower (all P<0.05). Spearman rank correlation results show that MHR level was positively correlated with white blood cells, serum creatinine, serum uric acid, serum urea nitrogen, retinol-binding protein, cystatin C, serum phosphorus (all P<0.01), and negatively correlated with hemoglobin and eGFR (both P<0.01). The median follow-up time was 8(4, 16) months. To the end of the follow-up, 113 patients (27.90%) had renal adverse prognostic events. Kaplan-Meier survival analysis results showed that the renal cumulative survival rate of the high-level MHR group was lower than that of the low-level MHR group ( χ2=8.277, P=0.004). Multivariate Cox regression analysis showed that high MHR level was an independent influencing factor for poor renal prognosis in CKD patients ( HR=1.628, 95% CI 1.050-2.523, P=0.029). Stratified analysis showed that, without hypertension, MHR had a more significant effect on the prognosis of the kidneys ( HR=3.414, 95% CI 1.091-10.686, P for interaction=0.001). Conclusions:The level of MHR is related to the severity and poor renal prognosis of CKD, and the high MHR level is an independent predictor for poor renal prognosis in CKD patients.

Objective To discuss the quality control measures of the thermoluminescent dosimetry system and to verify its propriety of when used in environmental radiation monitoring. Methods The quality control measures included the stability test, the dispersibility screening and the uncertainty evaluation of measurement results of the TLD reader and TLD detector, in addition, the environmental radiation accumulated dose monitoring results obtained by the high pressure ionization chamber were compared with those by the thermoluminescent dosimetry system. Results The variation range of TLD reader’s light source coefficient is within 0.070 ～ 0.073 during the preheating and measuring process, which meets the requirements of stability; The χ² value of the TLD detector is 2.088, which obeys the normal distribution; The thermoluminescent dosimetry system’s nonlinear response, coefficient of variation and energy response meet the measurement requirements; There is a deviation of −6.58% the largest between the cumulative dose obtained by TLD and the high pressure ionization chamber. Conclusion The quality control measures discussed in this paper can be used as a reference for similar thermoluminescent dosimetry system. Our system has passed all the tests and can meet the environmental radiation cumulative dose monitoring requirements.

Objective:To observe the clinical efficacy of angiotensin-receptor neprilysin inhibitors (ARNI) in the treatment of maintenance hemodialysis (MHD) with heart failure.Methods:The clinical data of heart failure patients who accepted MHD in Central China Fuwai Hospital were retrospectively collected. All patients accepted regular treatments of heart failure, and then the treatment group was treated with ARNI, while the control group was treated with valsartan. The treatment course was 6 months. The cardiac parameters: left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic dimension (LVESD), pulmonary artery pressure, right ventricular end-diastolic dimension (RVED), right atrial end-diastolic dimension (RAED), N-terminal pro-B-type natriuretic peptide (NT-pro BNP), and serum potassium were collected and compared between the two groups. Multivariate ordered logistic regression analysis was adopted to analyze the influencing factors of treatment effect.Results:A total of 60 MHD patients with heart failure were enrolled with age of (53.92±11.88) years old, 37 males (61.7%), dialysis age of (27.83±12.92) months, and blood pressure of (154.22±15.27) mmHg/(85.43±12.31) mmHg. (1) There was no significant difference of the clinical data and cardiac parameters between the treatment group ( n=30) and the control group ( n=30) before treatment (all P>0.05); (2) After treatment of 6 months, the total effective rate [28/30(93.3%)] in the treatment group was significantly higher than that in the control group [20/30(66.7%)] and the rehospitalization rate [2/30(6.7%)] in the treatment group was significantly lower than that in the control group [10/30(33.3%)] (both P<0.05); (3) After treatment of 6 months, LVEF, LVEDD, LVESD, pulmonary artery pressure, RVED, RAED, NT-pro BNP, and blood pressure were all improved significantly compared with the baseline in both groups (all P<0.05) and there was no significant difference of serum potassium and body weight before and after treatment in the two groups (all P>0.05); (4) After treatment of 6 months, LVEF in the treatment group was higher than that in the control group and LVEDD, LVESD, pulmonary artery pressure, NT-pro BNP, and blood pressure in the treatment group were lower than those in the control group (all P<0.05). There was no significant difference of RVED, RAED, serum potassium and body weight between the two groups after treatment (all P>0.05); (5)The difference values before and after treatment of LVEF, LVEDD, LVESD, NT-pro BNP, body weight, systolic blood pressure, and diastolic blood pressure were different between the two groups (all P<0.05); (6)Therapy method ( β=-1.863, 95% CI -2.948-0.777, P=0.001) and residual urine ( β=-1.686, 95% CI -3.079- -0.293, P=0.018) were independent influencing factors of treatment effect (the treatment effect of ARNI was better than that of valsartan; the treatment effect of patients with normal urine volume was better than that of patients with oliguria and anuria). Conclusions:ARNI can effectively improve cardiac function in MHD patients with heart failure, inhibit ventricular remodeling, and improve disease prognosis.

Objective:To evaluate the diagnostic performance and clinical significance of SLE-DAS in the disease activity of SLE patients in China.Methods:The clinical data of 134 patients with SLE were collected. The disease activity was evaluated by SLE-DAS, SLEDAI-2000, BILAG-2004 and PGA scoring tools. Pearson test and Spearman test were used to analyze the correlation. The receiver operating characteristic curve (ROC curve) was used to evaluate SLE-DAS, and Kappa consistency test was adapted to assess the consistency of the two scoring methods.Results:One hundred and thirty-four patients with SLE, including 7 males and 127 females, aged 13-77 years, with an average of (35±13) years were included. Among them, renal involvement was 38.1%, skin mucosal involvement was 11.2%, musculoskeletal involvement was 8.2%, blood system involvement was 13.4%, heart and lung involvement was 2.2%, neuropsychiatric involvement was 1.5%, and multisystem involvement was 3.0%. SLE-DAS was positively correlated with CRP, ESR, anti-dsDNA antibody, urinary protein (24 h) level, SLEDAI-2000, BILAG-2004 and PGA ( r=0.25, 0.34, 0.47, 0.77, 0.93, 0.94, 0.95, P<0.01); SLE-DAS was negatively correlated with PLT, Hb, C3 and C4 ( r=-0.29, -0.43, -0.41, -0.32, P<0.01). When SLEDAI-2000>5 was used as a cut point for analyzing SLE-DAS, the results showed that the area under the curve (AUC) 95% CI of SLE-DAS was 0.961 (0.927,0.995), the Yoden index was 0.845. When the cut-off value was set up to 4.65( P<0.001), the sensitivity was 98.11%, the specificity was 86.42%, and the accuracy was 91.04%. Kappa consistency test showed that kappa value was 0.819( P<0.001). Conclusions:SLE-DAS can be used to evaluate the disease activity of SLE patients and can be used as the evidence to guide treatment plan in clinical practice.