Objective:To investigate the clinical efficacy of azithromycin combined with methylprednisolone in the treatment of severe mycoplasma pneumonia in children.Methods:A total of 200 children patients with severe mycoplasma pneumonia who received treatment in Putuo District People's Hospital of Zhoushan, China from January 2015 to December 2018 were included in this study. They were randomly assigned to receive treatment with azithromycin (control group, n = 100) or azithromycin combined with methylprednisolone (observation group, n = 100) for 7 successive days. Time to improvement of signs and symptoms, total effective rate, inflammatory factors, incidence of adverse reactions, and length of hospital stay were compared between the control and observation groups. Results:Fever subsidence time, cough disappearance time, lung rale disappearance time and length of hospital stay in the observation group were (6.30 ± 2.16) d, (10.05 ± 2.36) d, (7.06 ± 1.95) d, (11.06 ± 2.07) d, which were significantly shorter than those in the control group [(7.75 ± 2.84) d, (12.37 ± 3.10) d, (12.30 ± 2.2) d, (14.78 ± 2.61) d, t = 4.064, 5.955, 17.734, 11.167, all P < 0.05). Total effective rate in the observation group was significantly higher than that in the control group [97.0% (97/100) vs. 85.0% (85/100), χ2 = 8.791, P < 0.05]. After treatment, C-reactive protein, interleukin-6, interleukin-10 and tumor necrosis factor levels in the observation group were (8.72 ± 2.19) mg/L, (13.50 ± 3.65) ng/L, (6.06 ± 1.25) ng/L, (16.28 ± 5.09) ng/L, which were significantly lower than those in the control group [(16.11 ± 3.73) mg/L, (25.13 ± 4.86) ng/L, (8.42 ± 1.74) ng/L, (36.20 ± 6.41) ng/L, t = 17.085, 19.135, 11.015, 24.337, all P < 0.05]. There was no significant difference in the incidence of adverse reactions between the observation and control groups ( P > 0.05). Conclusion:Azithromycin combined with methylprednisolone is highly effective and safe for the treatment of severe mycoplasma pneumonia in children. This treatment method can improve clinical symptoms and reduce inflammatory reactions in children with severe mycoplasma pneumonia.

[ ABSTRACT] AIM:To construct a prokaryotic expression plasmid to produce recombinant human tumor necrosis factor-related apoptosis-inducing ligand ( TRAIL) and to verify the biological activity of TRAIL.METHODS: The pro-karyotic expression plasmid pET-28a (+)-TRAIL114-281 was constructed.Human soluble TRAIL was obtained through opti-mized inducing protein expression and purification conditions.The biological activity of TRAIL was verified by CCK-8 as-say.The apoptosis-inducing effect of TRAIL alone and/or in combination with proteasome inhibitor bortezomib ( Velcade, PS-341) on the tumor cell lines H460 ( TRAIL-sensitive) and K562 ( TRAIL-resistance) for 24 h was determined.The ap-optotic rates of the cells were analyzed by flow cytometry with Annexin V-FITC/PI staining.The activities of caspase-8,-9 and -3 in the cells were detected by colorimetric method.The protein expression of Bax, Bcl-2 and cFLIP was measured by Western blot.The expression of DR4 and DR5 in the H460 cells and K562 cells after treated with bortezomib for 24 h was detected by flow cytometry.RESULTS:The recombinant human soluble TRAIL protein with stable bioactivity was success-fully acquired, which induced apoptosis in H460 cells and K562 cells.After treatment with different concentrations of TRAIL, the apoptotic rate of H460 cells was significantly increased with the increase in the concentration of TRAIL ( P<0.05), but the apoptotic rate of K562 cells was not affected by the increasing TRAIL concentration.Apoptotic rate in com-bination group was obviously higher than that in single group ( P<0.05 ) .In the process of apoptosis, the activities of caspase-8,-9 and -3 in H460 cells and K562 cells were both increased.The expression of Bcl-2 and cFLIP in treatment groups ( especially the combination group) was decreased compared with control group.No significant change of the Bax expression level was observed.The expression of DR4 and DR5 in the H460 cells and K562 cells was significantly up-regu-lated after treated with bortezomib ( P<0.05 ) .CONCLUSION: Bortezomib combined with recombinant human soluble TRAIL synergistically induces apoptosis in tumor cell lines H460 and K562 through initiating intrinsic apoptotic pathways by up-regulating death receptors DR4 and DR5, and reducing the expression of antiapoptotic proteins Bcl-2 and cFLIP.

Objective To explore electrophysiological features of infantile spinal muscular atrophy (SMA), and to evaluate diagnostic value of electrophysiological examinations in patients with SMA.Methods Tweenty-seven SMA children from Jan 2011 to Nov 2015 diagnosed in Wuxi People''s Hospital were enralled.All patients had neurogenic changes by EMG and finally confirmed by genetic test as SMA.Basic clinical data were retrospectively analyzed.Nerve conduction velocity was tested in each patient;While EMG was performed in no less than six muscles in each patient.Results All these patients were characterized by progressive flaccid paralysis in limbs.In all cases, amplitude of CMAP in median nerve was significantly decreased, apparent decreased in ulnar nerve and peroneal nerve;while mild decrease of MCV was appeared in ulnar nerve.Nothing abnormal were detected in sensory nerve conduction.EMG demonstrated neurogenic damage.Conclusion Typical clinical symptoms of infantile SMA are progressive symmetrical loss of muscle control and atrophy in limbs, and specificity electrophysiological representation provides very important basis for the diagnosis.

RASSF1,a putative tumor suppressor gene identified at 3p21.3 has been frequently observed.Many reports suggested that those was no RASSF1 expression or was at abnormally low level in many carcinomas.It is possible that aberrant DNA methylation and loss of heterozygosity might be involved in the loss of RASSF1 expression.Other results demonstrate a relationship between EBV infection and aberrant methylation.

OBJECTIVEThis study aims to analyze the long-term stability of the anterior teeth and hard tissue of skeletal class III malocclusion after a three-year orthodontic surgery by systematic review.

METHODSAll studies about skeletal class III malocclusion with orthodontic-surgery were searched by computer-based retrieval and manual retrieval; the deadline is December 2013. The literature, filtered according to the inclusion criteria and exclusion criteria, was performed with quality. assessment. The same indicators of the anterior location and hard tissue stability were combined and evaluated with metaanalysis and descriptive analysis by Rev Man5.2.

RESULTSFour before-and-after comparison study articles with 180 cases were included. The grades of the four literature evaluation were A. The meta-analysis results showed that comparing the three-year post-orthodontic-surgery and post-orthodontic-surgery, the total weighted mean difference (WMD) of Ul-SN was 4.29 (P<0.05); the WMD of Ll-MP, OB, OJ, SNA, SNB, ANB, and MP-SN were -1.58, 0, -0.41, -0.58, 0.25, -0.70, and 0.39, respectively (P>0.05). The measurement methods of A and B point position were different, hence the qualitative description were as follows: point A remained at a relatively stable position, and point B had some replacement compared with post-operative (P<0.05).

CONCLUSIONTo the skeletal class III malocclusion after three-year orthodontic-surgery, the position of the lower anterior teeth could be kept stable, as well as the overbite and the overjet of the anterior teeth; only the upper inci- sor has a lip-inclined relapse. The maxillary could also be kept stable, and the mandibular had a little relapse.

OBJECTIVE: To estimate the prevalence of allergic rhinitis (AR) in a community center in Beijing. METHOD: We randomly investigated a community with 13 900 inhabitents in Beijing by means of questionnaire survey. RESULT: A total of 2000 questionnaires was send out, and 1988 of them were collected, which included 952 males and 1036 females (age: 1 to 96 years old, 128 cases are younger than 14 years old. Among of them, 194 cases (9.76%) were diagnosed as having AR according to epidemiologic definition, including 14 children. The prevalence of AR was 9.68% in adults, with male 10.21% and female 9.18%, 10.94% in children. The prevalence in male are slightly higher than in female both with adults and children but without statistic significance. CONCLUSION The survey showed the incidence of AR in Beijing are 9.76% in population, adults 9.68%, children (younger than 12) 10.94%. AR patients are more likely to have other allergic diseases.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Cities ; epidemiology ; Female ; Humans ; Hypersensitivity ; epidemiology ; Incidence ; Infant ; Male ; Middle Aged ; Prevalence ; Rhinitis, Allergic ; epidemiology ; Sex Distribution ; Surveys and Questionnaires

Objective To evaluate the prognostic value of MTV measured by pretreatment 18F-FDG PET/CT imaging in patients with pancreatic cancer (PC).Methods The clinical data of 52 patients (31 males,21 females,median age 58.5 years) with pathologically or clinically proved PC from January 2011 to October 2014 were retrospectively analyzed.Serum CA19-9 was measured within 1 week before PET/CT examination.SUVmax and MTV were measured respectively,and PET/CT staging was obtained simultaneously.All patients were followed up until January 2015.The CA19-9,MTV,SUVmax,PET/CT staging and clinical factors(age,gender,treatment methods) were assessed by ROC curve analysis,Kaplan-Meier analysis and multivariate Cox model.Results The median survival time of 52 patients was (11.20±7.25) months.ROC curve analysis showed that the AUC of MTV,SUVmax and CA19-9 were 0.735,0.614 and 0.527 respectively.Kaplan-Meier survival analysis manifested that the survival times were significantly different between patients with different MTV (＜ 12.14 cm3 vs ≥ 12.14 cm3),different SUVmax (＜ 8.95 vs ≥ 8.95),different PET/CT staging and different treatment methods (x2 =4.272-11.693,all P＜0.05).The survival time of patients with MTV ＜ 12.14 cm3 and that of patients with MTV ≥ 12.14 cm3 were (13.44±8.40) and (7.00± 4.82) months,respectively.Cox single-factor analyses indicated that MTV,PET/CT staging and SUVmax were risk factors of survival,the hazard ratios (HR) were 0.393,0.503,0.547 respectively (P=0.002,0.020,0.027).Cox multi-factor analyses indicated that MTV and PET/CT staging were independent risk predictors of survival.Conclusion MTV and PET/CT staging are significant factors in prognosis prediction of patients with PC,which would be helpful to make individual treatment for patients with high risks.

Objectives To investigate the associations of serum superoxide dismutase ( SOD) , malondialdehyde (MDA), and uric acid (UA) with blood pressure and the prevalence of hypertension in a Chinese population. Methods We measured serum superoxide dismutase (SOD), malondialdehyde (MDA) and uric acid (UA) in 506 randomly selected participants. For database management and statistical analysis, we used the SAS 9.13 Software. Results Compared with normotensive participants, hypertensive patients had significantly lower serum levels of superoxide dismutase activity ( =0.0002), and higher serum levels of malondialdehyde and uric acid ( <0.05) .Univariate analysis indicated that serum superoxide dismutase activity was negatively associated with blood pressure, and serum levels of uric acid (P 0.0001);while serum levels of malondialdehyde was positively associated with blood pressure, and serum levels of uric acid (P 0.05) . There was significant difference in systolic (Ptrend=0.02) and diastolic blood pressure (Ptrend=0.04) between three groups defined by tertiles of serum levels of superoxide dismutase, with a lower blood pressure in the highest tertile than in the lowest tertile. Furthermore, the systolic (Ptrend=0.01) and diastolic blood pressure (Ptrend=0.003) in the highest tertile, which defied by the serum levels of malondialdehyde, were significantly higher than those in the lowest tertile. Conclusions Hypertensive patients have a disturbed oxidative and anti-oxidative balance. Oxidative stress may play a role in the pathogenesis of hypertension in Chinese.

BACKGROUND: Neurotrophin-3 (NT3) and neurotrophin-4 (NT4) play an important role in the growth, survival and functions of neurons in vivo or in vitro. However, it has not been reported whether they can protect and repair neurons of spinal cord after crushed spinal cord injury (cSCI).OBJECTIVE: To explore the expression of NT3 and NT4 in ventral and dorsal horns of spinal cord at various time points after cSCI and analyze the pattern of expression changes.DESIGN: Randomized controlled study and single analysis of variance.SETTING: Continuing Education College of Beijing Union University;Department of Anatomy, Kunming Medical College.MATERIALS: The experiment was conducted in the Institute of Neuroscience of Kunming Medical College from January to March 2003.Totally 24 adult SD rats were divided randomly into 4 groups: control group, 24-hour cSCI group, 7-day cSCI group, and 21-day cSCI group with 6 rats in each group.METHODS: After anesthesia, rats in each cSCI group were dissected at vertebra T11 and crushed at spinal cord T13. After 24 hours, 7 days and 21days, the rats were killed respectively by cutting their heads off, and spinal cord L1-L3 was taken out to make frozen transactional slices of 20 μm.Rats in control group received no treatment and were killed at the same time point as those in 24-hour cSCI group, and the process of slice making was the same as mentioned above. The distribution of NT3 and NT4 positive cells in the spinal cord ventral and dorsal horns of adult rats was observed, and NT3 and NT4 positive nucleus in the ventral and dorsal horns of the same areas were counted.neurons in the rats' spinal cord ventral and dorsal horns.products were mainly stained in nucleus while NT4 was stained in horns of spinal cord in each group: The number of positive neurons in the ventral horn was significantly greater in 7-day and 21-day cSCI groups than in control and 24-hour cSCI groups (10.2±1.1, 11.4±3.2, 6.2±1.8, 7.4±2.4, P＜0.01). The number of positive neurons in the dorsal horn in 21day group was significantly greater than that in control group (86.4±9.8,71.3±8.3, P＜0.01); however, it was remarkably lower in 24-hour and 7day cSCI groups than in control group (48.5± 5.1, 41.5±3.7, 71.3± 8, P cord in each group: The number of positive neurons in the ventral horn was significantly higher in 24-hour, 7-day and 21-day cSCI groups than in control group (9.4±2.8, 10.8±2.7, 15.1±4.0, P＜0.05); and it assumed an increasing tendency as time went by (P＜0.05). By contrast, the number of positive neurons in the dorsal horn in 7-day and 21-day groups was significantly higher than in control and 24-hour groups (28.1±3.1,35.1±4.4, 23.3±2.3, 24.1±1.8, P＜0.01), and it would increase with time following cSCI (P＜0.01).CONCLUSION: The number of NT3 and NT4 positive neurons increases in spinal cord ventral and dorsal horns after cSCI, suggesting that endogenous NT3 and NT4 have effect at different time on sensory and motor neurons in the repair of spinal cord injury.

In the clinical practice,critically ill patients are in great risk of delirium because of the impact of psychological,surroundings,illness,and medications,with the incidence rate as high as 45％-87％.Delirium could result in bad prognosis and clinical consequences of cognitive function in late stage.Dexmedetomidine (DEX) is a novel and highly selective 2-adrenoceptor agonist.It offers beneficial pharmacological properties and has been widely used in intensive care unit (ICU).In order to provide scientific and effective references for clinical practice,this paper reviewed the development of DEX intervention for the prevention of delirium in ICU both in China and abroad refereed to the pharmacological characteristics and the efficiency in clinic and the influence factors ofthe efficiency;and also discussed the possible mechanisms,such as modulating the neurotransmitters,and attenuating stress response and inflammation.