Objective To investigate the diagnosis and treatment of refractory Mycoplasma pneumoniae pneumonia (RMPP).Methods The clinical manifestations,diagnosis and treatment of 30 children with RMPP from January 2009 to December 2013 were analyzed retrospectively.Results Thirty children were accompanied by fever and intractable cough,fever type of relapsing fever,18 cases of elevated C-reactive protein (22-100 mg/L),1 case had sputum culture of Klebsiella pneumoniae,8 cases showed lower lung wild large patchy shadows,3 cases of pleural effusion,2 cases of pulmonary atelectasis,1 case had a pericardial effusion.Three cases of electrocardiogram abnormalities,3 cases of elevated creatine kinase isoenzyme-MB,2 cases of abnormal liver function,1 case of elevated troponin.Thirty cases cured completely,the smallest course was 12 d,the longest course was 4 months.There was 1 case of bronchiolitis obliterans caused by poor results.Conclusion RMPP should be given early diagnosis and analysis of its causes,on the basis of erythromycin infusion therapy,glucocorticoid and human immunoglobulin treatment should be carried out in a timely manner.

OBJECTIVE:To establish a method for the simultaneous determination of paeoniflorin,baicalin and imperatorin in Urticaria pill. METHODS:HPLC was performed on the column of Alltima C18 with mobile phase of methanol-water-Phosphoric ac-id(55∶45∶0.2,V/V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 230 nm for paeoniflorin,280 nm for baicalin and 300 nm for imperatorin,column temperature was 30 ℃,and the volume injection was 10 μl. RESULTS:The linear range was 5.40-54.0 μg/ml for paeoniflorin(r=0.999 8),11.29-112.9 μg/ml for baicalin(r=0.999 7)and 24.95-249.5 μg/ml for imperatorin (r=0.999 9),respectively;the linit of quantitation were 5.4、11.2、30.0 ng,the lirnit of detection were 1.8、2.8、7.5 ng;RSDs of pre-cision, stability and reproducibility tests were lower than 2%;recoveries were 95.88%-98.33%(RSD=0.95%,n=6), 96.86%-99.96%(RSD=1.20%,n=6)and 98.07%-100.55%(RSD=0.92%,n=6),respectively. CONCLUSIONS:The method is simple and accurate with strong specificity and good reproducibility,and can be used for the simultaneous determination of paeoni-florin,baicalin and imperatorin in Urticaria pill.

Objective: To explore the effect of acute hypoxia on the appetite and expression of neuropeptide Y (NPY) in rat hypothalamus. Methods: Wistar rats were randomly divided into control group, 3 000 m group, 4 000 m group , 5 000 m group and 6 000 m group for different times (1d, 2d and 3d respectively) . The change of appetite was observed and the expression of NPY in hypothalamus of rats was measured by immunohistochemical method. Results: (1) After acute hypoxia, the appetite of rats decreased. (2) The expression of NPY of the test groups and the normal group was decreased in arcuatus, paraventricular and dorsal median nucleus of the hypothalamus after acute hypoxia. Conclusion: Acute hypoxia might inhibit feed intake of rats, and decreased expression of NPY in hypothalamus, which may be one of the important reasons for loss of appetite.

Objective To explore the effects of acute hypoxia on the expression of neuropeptide Y (NPY) mRNA in the rat hypothalamus. Methods A total of 78 Wistar rats were randomly divided into 13 groups ( n =6 in each group): control group and 12 experimental groups. Rats in the experimental groups were exposed to hypoxia in the hypobaric chamber simulating the altitudes of 3 000, 4 000, 5 000, and 6 000 m for 1, 2, and 3 d, respectively. The expression of NPY mRNA in the rat hypothalamus under the condition of acute hypoxia was detected by semi quantitative reverse transcription polymerase chain reaction (RT PCR). Results ① Expression of NPY mRNA was detected in the rat hypothalamus in the experimental groups and the control group. ② Under the condition of acute hypoxia for the same time, the expression of NPY mRNA in the rat hypothalamus showed the tendency of decrease at increasing altitudes; ③ At the same altitude, expression of NPY mRNA in the rat hypothalamus decreased gradually with the increasing time for acute hypoxia. Conclusion Acute hypoxia can decrease the expression of NPY mRNA in the rat hypothalamus.

Objective To investigate the protective effects of kaempferol against the fatty acid-induced islet microvessel endothelial function injury and the role of poly (ADP-ribose) polymerases-1 (PARP-1). Methods Mouse islet microvessel endothelial MS-1 cells were divided into normal control group, solvent (DMSO) group, fatty acid group (0. 25 mmol/L palmitic acid+0. 5 mmol/L oleic acid), kaempferol group (50 µmol/L), fatty acid + kaempferol group, PARP-1 inhibitor (8 µmol/L BYK204165)+fatty acid group and PARP-1 inhibitors+fatty acidVkaempferol group. The changes of cell viability, apoptosis, nitric oxide (NO), nitric oxide synthase (NOS) and oxidative stress related indicators were examined in each group. Results After treatment with fatty acid, the survival rate of MS-1 cells was significantly decreased and the apoptosis rate was significantly increased (P<0. 05); meanwhile, fatty acids also increased NO production and promoted the activities of the total NOS (tNOS), inducible NOS (iNOS) and constitutive NOS (cNOS) in the MS-1 cells (P<0. 05). Treatment with fatty acid also significantly increased the lipid peroxidation products-malondialdehyde (MDA), while significantly decreased the levels of antioxidants, glutathione (GSH) and superoxide dismutase (SOD) (P<0. 05); and t also increased the mRNA and protein expression of PARP-1, iNOS and cNOS (P <0. 05). Kaempferol significantly attenuated the toxic effects of fatty acidsconcerning all the detected indicators (P<0. 05). Moreover, pretreatment with PARP-1 inhibitor (BYK204165) for 1 h markedly enhanced the protective effects of kaempferol, and all the detected parameters were similar to those of the control group(P<0. 05). Conclusion Fatty acid can directly trigger islet microvessel endothelial function injury, and kaempferol shows a protective effect against the toxicity of fatty acid. Inhibition of PARP-1 can significantly promote the protective effects of kaempferol.

Objective To investigate the role of Shh-PARP-1 signaling pathway in the protective effects of tea polyphenols against the fatty acid-induced islet microvessel endothelial function injury. Methods Mouse islet microvessel endothelial MS-1 cells were used in this study, and the cells were divided into normal control group, solvent group, fatty acid group (0. 25 mmol/L palmitic acid + 0. 5 mmol/L oleic acid), tea polyphenols group (25 μmol/L), fatty acid + tea polyphenols group, PARP-1 inhibitor (8 μmol/L BYK204165) + fatty acid group, PARP-1 inhibitor + fatty acid + tea polyphenols group, Shh inhibitor (2. 5 μmol/L cyclopamine) + fatty acid group, Shh inhibitor + fatty acid + tea polyphenols group and inhibitors of Shh and PARP-1 + fatty acid +tea polyphenols group. The changes of cell viability, apoptosis, nitric oxide (NO) synthesis and oxidative stress related indicators were examined in each group. Results After fatty acid treatment, the survival rate ofMS-1 cells was decreased, and the level of apoptosis was significantly increased (P<0. 05); meanwhile, fatty acid treatment also significantly increased the content of NO, and the activities of total nitric oxide synthase (tNOS), inducible NOS (NOS) and constitutive NOS (cNOS) in the cells (P<0. 05). Moreover, the lipid peroxidation product, malondialdehyde (MMDA) was remarkably elevated and the levels of antioxidants, glutathione (GSH) and superoxide dismutase (SOD), were significantly decreased in response to fatty acid (P<0. 05); the expression of PARP-1 and phosphorylated Shh (pShh) was significantly increased (P<0. 05). Tea polyphenols could significantly attenuate the toxic effects of fatty acids concerning all the detected indicators (P<0. 05). Moreover, after pretreatment with Shh-PARP-1 inhibitors BYK204165 and cyclopamine for 1 h, the protective effects of tea polyphenols were markedly enhanced. There were no significant difference in the detected indicators as compared with controls (P!>0. 05). Conclusion Fatty acid can directly trigger islet microvessel endothelial function injury, and tea polyphenols shows a protective effect against the toxicity of fatty acid, which can be enhanced by inhibiting Shh-PARP-1 signal pathway.

Objective:To observe the changes of serum progastrin-releasing peptide (Pro-GRP) and neuron specific enolase (NSE) levels in patients with small cell lung cancer (SCLC) in the concurrent chemoradiotherapy and their significances.Methods:The data of 80 patients with SCLC who were admitted to Shanxi Provincial Cancer Hospital from June 2018 to December 2019 were retrospectively analyzed, and the patients were divided into the concurrent chemoradiotherapy group (26 cases) and chemotherapy alone group (54 cases). Enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence method were used to detect serum Pro-GRP and NSE levels before and after treatment; and the association of Pro-GRP and NSE levels with patients' condition, treatment method, treatment stage and treatment efficacy was analyzed.Results:Among 80 patients with SCLC, Pro-GRP level of patients with limited-stage [127.43 pg/ml (17.61- 1 547.30 pg/ml)] was lower than that of patients with extensive-stage [547.87 pg/ml (20.20-2 111.00 pg/ml)], and the difference was statistically significant ( U = 312.65, P < 0.01). NSE level of patients with limited-stage [25.02 μg/L (4.72-64.64 μg/L)] was also lower than that of patients with extensive-stage [88.08 μg/L (5.52-104.64 μg/L)], and the difference was statistically significant ( U = 203.14, P < 0.01). The levels of Pro-GRP and NSE in the concurrent chemoradiotherapy group and the chemotherapy alone group were decreased after 2 and 4 cycles of chemotherapy compared with those before treatment, and the differences were statistically significant (all P < 0.01); the decrease range in the concurrent chemoradiotherapy group was more than that in the chemotherapy alone group, but the differences between the two groups were not statistically significant (all P > 0.05). The objective response rate in the concurrent chemoradiotherapy group was 96.15% (25/26), which was higher than that in the chemotherapy alone group [70.37% (38/54)], and the difference was statistically significant ( χ2 = 6.972, P = 0.008). Conclusions:The serum levels of Pro-GRP and NSE for patients with SCLC in the concurrent chemoradiotherapy can reflect the changes of the condition of SCLC patients. Concurrent chemoradiotherapy is more effective compared with the chemotherapy alone in the treatment of SCLC.

ObjectiveTo investigate the safety and clinical value of treadmill exercise testing for the patients with acute myocardial infarction in the early recovery. Methods36 patients with acute myocardial infarction performed treadmill exercise testing with Bruce protocol 15～57 d after infarction. ResultsThe outcome of 19 cases was positive, and the outcome of other 16 cases was negative. 1 case couldn't finish the testing, whose outcome could not be analyzed because his exercise time was too short. The average cardic fuction was (5.42±3.12) METs. ConclusionIt is safe that the patients with acute myocardial infarction performed treadmill exercise testing early.

This paper presents the general principles and usual problems involved in the development of Institutional Review Board in research institutions. And suggestions are made in this regard. Meanwhile, it discusses two common difficult issues involved in ethical review.

Aim To obtain high pure hPPAR?1LBD fusion protein.Methods A cDNA encoding ligand binding domain(LBD)of PPAR?1 was amplified by RT-PCR from human fatty tissue and the product was inserted into the downstream of the malE gene in the vector pMAL-p2X,which encoded maltose-binding protein(MBP).The recombinant plasmid containing MBP-PPAR?1 gene was transformed into E.coli.TB1 and the expression conditions of the recombinant strain were optimized.Results The DNA strap of MW(909 bp) was presented after re-combinant plasmid was digested by Hind Ⅲ and BamH Ⅰ.The high efficient expression of MBP-PPAR?1 fusion protein in TB1 cells was observed with 38.54% product of the total cytoplasm proteins when 0.4 mmol?L-1 IPTG and 6 h incubation were taken at 30℃.Conclusion The recombinant vector was successfully constructed.It could high efficiently express hPPAR?1LBD fusion protein in TB1 cells and obtain the hPPAR?1LBD fusion protein with high bioactivity.