Mycoplasma pneumoniae pneumonia (MPP) accounted for 10%-40% of pediatric community-acquired pneumonia. The clinical manifestations of MPP were complex and varied. In addition to pulmonary inflammation, , the complications with lungs and other organs had been widely reported in MPP. Although the MPP complicated with thrombus in lung, other organs and limbs was rare reported, it was serious and life threatening once thromboembolism happens,. Clinicians should pay great attention to improve the ability of early identiifcation, diagnosis, and treatment. This paper will focus on the mechanism, early identiifcation, early diagnosis and treatment of MPP complicated with thrombosis.

The ketogenic diet (KD) is a special diet with high-fat, low-carbohydrate and moderate amount of protein. The KD therapy is a safe, potentially effective and important treatment of refractory childhood epilepsy in recent years. It has con-ifrmed clinical efifcacy and a generally good prognosis. The adverse reactions of KD treatment are normally less and transient. In this paper, the effective rate, patient compliance, adverse reactions and their causes of KD in treating children with refractory epilepsy were reviewed.

Objective To summarise the experience of surgical treatment of invasive pulmonary fungal infection in patients with hematologic malignancies.Methods From Jan.2000 to Dec.2012,78 hematologic patients with invasive pulmonary fungal infections,including 49 males and 29 females with average age of 29.6 years,underwent surgical treatment.Preoperatively,all patients with 1 to 3 courses of chemotherapy had received average 4 weeks antifungal treatment.There were 58 cases received conventional open thoracic surgery and 20 cases received VATS including lobectomy,segmentectomy,wedgectomy.Results The procedures were successful,the average operation time w as(125.3 ± 35.7) min and intraoperative blood loss was(253.1 ± 42.8) nl.There were no severe postoperative complications.The main complications were excessive effusion (10.2％) and persistence airleak (7.7％).The hospital days was(7.8 ± 2.5) days,no reoperation and death case in 30 days after operation.The follow-up was from 6 to 24 months,38 cases(48.7％) received prophylaetic antifungal treatment,no ease with fungi spread and recurrence.Conclusion The surgical treatment is safe and useful for the hematologic patients with invasive pulmonary fungal infections,when internal medicine conservative treatment is invalid.

It is well known that Tn5B1-4(commercially known as the High Five)cell line is highly susceptible to baculovirus and provides superior production of recombinant proteins when compared to other insect cell lines.But the characteristics of the cell line do not always remain stable and may change upon continuous passage.Recently an alphanodavirus,named Tn5 Cell Line Virus(or TNCL Virus),was identified in High Five cells in particular. Therefore,we established a new cell line,QB-Tn9-4s,from Trichoplusia ni,which was determined to be free of TNCL virus by RT-PCR analysis. In this paper,we describe the development of a novel cell clone,QB-CL-B,from a low passage QB-Tn9-4s cell line and report its susceptibility to ACMNPV,and the level of recombinant protein production. This cell clone was similar to its parental cells QB-Tn9-4s and Tn5B 1-4 cells in morphology and growth rate;although it also showed approximately the same responses to AcMNPV infection and production of occlusion bodies,there were higher levels of recombinant protein production in comparison to QB-Tn9-4s(parental cells)and High5 cells.

Objective To explore the significance of mediastinum drainage tube in prevention and treatment of intrathoracic anastomotic leak after esophagectomy. Methods The morbidity and prognosis of intrathoracic anas-tomotic leak after esophagectomy in 180 patients with esophageal or cardia carcinoma (group A) who used mediasti-num drainage tube in operation from 2006 to 2008 was studied retrospectively,and were compare with 154 patients (group B) without mediastinum drainage tube from 2004 to 2006. Results The morbidity of intrathoracic anasto-motic leak after esophagectomy was 1.67% (3/180) in group A,and 4.55% (7/154) in group B,but no difference between them(χ2=1.4807, P>0.05) were found. Compared to group B, the final diagnosis of anastomotic leak in group A was early [(6.7±0.6) vs (10.0±2.1) days after operation (t=2.62, P<0.05)] and the duration of fe-ver was short [(5.3±1.5)vs (43.0±20.9) hours (t=4.39, P<0.01)]. The prognosis of 3 cases in group A was well, who all recovered without operation and had shorten hospital days than group B [(23.7±5.9)d vs (45.3± 5.0)d,t=4.86,P<0.01)]. In 7 cases of group B,there were 5 cases underwent second operation,but only 3 cases recovered, the case fatality rate was 2.60% (4/154), higher than in group A (0, Fisher, P<0.05). Conclusions Although the mediastinum drainage tube used or not used in esophagectomy is unrelated with the occurrence of anas-tomotic leak, and the significance to use it is that it can help to discover anastomotic leak early, and control mediasti-num infection effectively without reoperation,and improve patients' prognosis.

Objective The regulation of ornithine decarboxylase (ODC) gene expression and enzyme activity by corticosterone, the main glucocorticoid in rat, during rat liver regeneration induced by partial hepatectomy (PH) was evaluated.Methods Bilateral adrenaleetomies (ADX) and sham-ADX were performed on ether-anesthetized rats 3 days before PH.Corticosterone in sesame oil was injected subcutaneously to adrenalectomied rats. ODC mRNA, ODC protein and enzyme activity were detected by RT-PCR, Western blotting and high performance liquid chromatography (HPLC), respectively. Results The ODC mRNA levels, protein accumulation and enzyme activity were lower in the intact liver compared to the regenerating liver.After PH, mRNA levels were remarkably enhanced in all groups (n=6 in each group) and peaked at 5 hours post-PH. Till 7 hours, the contents in all groups from high to low were ADX group,control group (Sham-ADX group), ADX treated with 10mg/kg and 40mg/kg body weight corticosterone group, respectively. ODC protein accumulation in ADX rats was higher than that in control rats (n=13, the same below), but it decreasod in corticosterone-treated (10mg/kg) rats until 24 hours post-PH, with a strong decline seen in 40mg/kg corticosterone-treated rats. ODC activity was rapidly promoted, and the highest levels were observed at 6 hours after PH in all groups (n=6 in each group). After corticosterone treatment, the activities declined significantly at 6 hours post-PH, with the lowest value found in the 40mg/kg group. Conclusion Corticosterone treatment results in dose-dependent decreases in ODC mRNA and enzyme protein both in the intact liver and the regenerating liver. The change in ODC activity is partially related to alterations of ODC mRNA and protein accumulation.

Objective To evaluate the effects of gender on the pharmacokinetics of propofol in patients.Methods Twenty ASA physical status Ⅰ or Ⅱ patients of both sexes (10 male,10 female),aged 42-59 yr,weighing 46-76 kg,scheduled for elective surgery for gastrointestinal cancer,were randomly divided into 2 gender groups (n =10 each):male group and female group.Combined intravenous-inhalational anesthesia was performed during surgery.Anesthesia was induced with iv injection of 2％ propofol 2 mg/kg,remifentanil 1.5 μg/kg,and suxamethonium chloride 1.5 mg/kg.The patients were tracheally intubated and mechanically ventilated.Anesthesia was maintained with inhalation of the mixture of 1％-2 ％ isoflurane and nitrous oxide (N2 O ∶ O2 =1 ∶ 1.),iv infusion of remifentanil 0.2-0.3 μg/kg and intermittent iv boluses of atracurium.Blood samples were taken from the central vein before propofol administration,and at 1,2,3,4,6,10,15,30,45,60,90,120,180,240,360 and 720 min after propofol administration for determination of the plasma concentration of propofol by high-performance liquid chromatography.The blood concentration-time curve of propofol was drawn and the pharmacokinetic parameters were calculated.Results The blood concentrations of propofol were significantly lower at each time points within 10 rmin after administration of the single bolus of propofol in female group than in male group (P ＜0.05).The blood concentration-time curves of propofol were fitted to a three-compartment open model in the 2 groups.The central volume of distribution and clearance rate were significantly larger in female patients than in male patients (P ＜ 0.05).Conclusion After iv injection of propofol,the blood concentration of propofol is lower,and the central volume of distribution and clearance rate are larger in female than in male,suggesting that gender has significant effect on pharmacokinetics of propofol.

Objective To compare the hypnotic effect of propofol administered by target-controlled infusion (TCI) during day-time and night-time,in order to explore the effect of circadian rhythms on the sedative effect of propofol.Methods Sixty-five male ASA Ⅰ or Ⅱ patients aged 18-55 yr undergoing emergency minor hand surgery were divided into 2 gorups according to the time of the day when they received propofol TCI:day-time group (from 7:01 to 19:00) and night-time group (from 19:01 to 7:00).The pharmacokinetic parameters proposed by Schnider which predict effect-site concentration (Ce) were used.Four effect-site concentrations of propofol were set:0.8,1.2,2.0 and 4.0 μg/ml.Ce was increased step by step and each Ce was maintained for 5 min.The level of sedation at each Ce was assessed by BIS and OAA/S scores.BIS value and Ce of propofol were recorded and compared between the 2 groups when the patients lost consciousness (OAA/S score =2).Results There was 28 and 30 patients in day-time and nighet-time groups respectively.When Ce =1.2 and 2.0 μg/ml,the BIS values were significantly lower in night-time group than in day-time group.There was no significant difference in BIS value between the 2 groups when Ce =0.8 and 4.0 μg/ml.When the patients lost consciousness (OAA/S =2),the BIS value was comparable between the 2 groups,but Ce was significantly lower in night-time group than that in daytime group.Conclusion The hypnotic effect of propofol is greater during night-time than during day-time.

Humans ; Microvascular Decompression Surgery ; Neuralgia ; surgery

Objective To compare the hypnotic effects of propofol administered by target-controlled infusion (TCI in daytime and nighttime,in order to explore the effect of circadian rhythm on the sedative effect of propofol.Methods Sixty-five male ASA Ⅰ or Ⅱ patients,aged 18-55 years,with the body mass index (BMI) of 18.5-24.9 kg/m2,undergoing emergency minor hand surgery were divided into two groups according to the time of the day when they received TCI of propofol:daytime group (from 07:01 to 19:00) and nighttime group (from 19:01 to 07:00).The pharmacokinetic parameters proposed by Schnider et al.which suggested the effect-site concentration (Ce) was used.Four Ces of propofol were set at 0.8,1.2,2.0 and 4.0 μg/ml,respectively.Ce was increased step by step and each Ce was maintained for 5 minutes.The level of sedation at each Ce was assessed by bispectral index (BIS) and observer's assessment of alertness/sedation (OAA/S) scores.BIS values and Ces of propofol were recorded and compared between the two groups when the patients lost consciousness (OAA/S score =2).Results There were 28 and 30 patients in daytime and nighttime groups,respectively.When Ces were 1.2 and 2.0 μg/ml,the BIS values were significantly lower in the nighttime group than in the daytime group.There was no significant difference in BIS values between the two groups when Ces were 0.8 and 4.0 μg/ml.When the patients lost consciousness (OAA/S =2),the BIS value was comparable between the two groups,but Ce was significantly lower in the nighttime group than in the daytime group.Conclusion The hypnotic effect of propofol is greater during night time than during day time.