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.

A rapid method has been developed based on the sample preparation procedure named as QuEChERS (Quick,Easy,Cheap,Effective,Rugged and Safe),combined with reversed-phase high performance liquid chromatography with fluorescence detector and C18 column after precolumn derivatization using o-phthalaldehyde and 2-mercaptoethanol to determine dopamine in porcine muscle.Methanol and deionized water (0.1％ acetic acid,v/v) with a ratio of 60∶40 was used as mobile phase.The flow rate was 0.8 mL/min and dopamine was eluted within 15 min.The linearity range was 0.003-8 μg/mL with r=0.9992.The detection limit for dopamine was 4 μg/kg and the quantification limit was 9 μg/kg.Recovery studies were carried out at 0.1,0.5 and 1.0 mg/kg fortification levels and the average recoveries obtained ranged from 90.4％ to 98.2％ with relative standard deviations between 3.5％ and 8.1％.The method was found to be suitable for detection of dopamine in animal product tissues at the maximum residue level.

A rapid method has been developed based on the sample preparation procedure named as QuEChERS （Quick, Easy, Cheap, Effective, Rugged and Safe）, combined with reversed-phase high performance liquid chromatography with fluorescence detector and C18 column after precolumn derivatization using o-phthalaldehyde and 2-mercaptoethanol to determine dopamine in porcine muscle. Methanol and deionized water （0.1% acetic acid, v/v） with a ratio of 60：40 was used as mobile phase. The flow rate was 0.8 mL/min and dopamine was eluted within 15 min. The linearity range was 0.003-8 μg/mL with r=0.9992. The detection limit for dopamine was 4 μg/kg and the quantification limit was 9 μg/kg. Recovery studies were carried out at 0.1, 0.5 and 1.0 mg/kg fortification levels and the average recoveries obtained ranged from 90.4% to 98.2% with relative standard deviations between 3.5% and 8.1%. The method was found to be suitable for detection of dopamine in animal product tissues at the maximum residue level.

Objective To investigate the organophosphorus pesticide residues in vegetables and fruits in Shnxi area so as to take preventive measures to minimize food contamination. Methods A total of 140 samples of vegetables and fruits were obtained randomly from the local market in Shnxi area. Eight organophosphorus pesticides were analyzed by gas-chromatographic method. Results The incidence of organophosphorus pesticide residues in vegetables and fruits were 20% and 1.7%, respectively. The mean level of parathion in vegetables and dimethoate in fruits were 6.22?g/kg and 3.02?g/kg, exceeding their MRLs. Conclusion There is a misuse of organophosphorus pesticides in Shnxi area and routine monitoring is necessary to reduce food contamination before entering market.

Aim To investigate the effects of Ginkgo biloba extract(EGB)on tumor necrosis factor-alpha(TNF-?)in TNBS-induced colitis in rats and its mechanisms.Methods Colitis in rats was induced by colonic administration with 2,4,6-trinitrobenzene sulfonic acid(TNBS).Wistar rats were randomly divided into four groups,10 in each:normal group,model group,5-aminosalicylic acid(5-ASA group)and Ginkgo biloba extract group(EGB group).The levels of nitric oxide(NO),and glutathion peroxide(GSH-Px)were measured by biochemical methods.The expressions of TNF-? and nuclear factor kappaBp65(NF-?Bp65)in the colon tissues of colitis rats were detected by means of immunohistochemistry.The expressions of induce nitric oxide synthase(iNOS)in the colon tissues of colitis rats were detected by reverse transcription polymerase chain reaction(RT-PCR).The effects of EGB on colonic inflammation and macroscopic and histological damage were evaluated as well.Results Compared with the model group,treatment with EGB for 4 weeks significantly reduced colon macroscopic and histological damage,elevated the activities of GSH-Px and reduced the contents of NO,inhibited the protein expressions of TNF-? andNF-?Bp65,and decreased the mRNA levels of iNOS in the colon tissues of experimental colitis.Conclusions The probable mechanisms of EGB was that it ameliorated inflammatory injury in TNBS-induced colitis in rats by its reduction of TNF-?,NF-?Bp65 and iNOS levels.Then EGB could curb the inflammatory cascade effects of inflammatory mediators to protect ulcerative colitis.

Objective:To explore protective effect of atorvastatin on blood vessels in early stage of atherosclerosis (AS).Methods:A total of 120 patients without AS plaques,who had >2 cardiovascular risk factors and received control cardiovascular risk factors therapy,were randomly divided into four groups:control group (did not receive atorvastatin),atorvastatin 5mg group,10mg group and 20mg group (received corresponding dose of atorvastatin). All patients were followed up for six months,changes of thromboxane B2 (TXB2),6-Keto-prostaglandin F1α (6-Keto-PGF1α),brachial-ankle pulse wave velocity (baPWV),ankle brachial index (ABI)and intima-media thickness (IMT)were observed.Results:There were no significant changes in ABI and IMT between before and after treat-ment among four groups (P >0.05 all).Compared with baseline,TXB2、baPWV levels significantly rose,6-Keto-PGF1αlevel significantly decreased after treatment in control group and 5mg group;in contrast,TXB2、baPWV lev-els significantly decreased,6-Keto-PGF1αlevel significantly rose after treatment in 10mg group and 20mg group(P <0.05~ < 0.01).After treatment six-month,compared with control group and 5mg group,the TXB2 [(148.3 ± 29.2)pg/ml,(142.3±30.6)pg/ml vs.(111.5±22.8)pg/ml,(104.9 ± 17.4)pg/ml]、baPWV[(1621.1 ± 136.1) cm/s,(1597.7±125.3)cm/s vs.(1232.9±132.3)cm/s,(1178.2±155.1)cm/s]levels significantly decreased,6-Keto-PGF1α[(104.7±66.1)pg/ml,(102.2±70.3)pg/ml vs.(132.8±48.3)pg/ml,(139.1±66.3)pg/ml]level significantly rose(P <0.05~<0.01)in 10 mg group and 20 mg group.Conclusion:Atorvastatin has protective effect on blood vessels in early stage of atherosclerosis,and 10mg atorvastatin may be the minimum effective dosage to protect blood vessels.

Objective To compare the differences between two statistical methods for evaluating non-sensitivity of pathogenic bacteria to antimicrobial agents,and explore effect of non-consideration of clinical background on evalua-ting extent of bacterial resistance.Methods Data of Staphylococcus aureus and Acinetobacter spp .in a hospital in the first half year of 2008,2010 and 2013 were collected and conducted statistical analysis with two methods (me-thod 1 :based on all clinically isolated bacteria;method 2 :based on infection-related non-repetitive bacteria),two methods for evaluating bacterial non-sensitive rates to antimicrobial agents were compared.Results The non-sensi-tive rates of Acinetobacter spp .to various antimicrobial agents :statistical results by using method 1 were generally higher than those using method 2,absolute difference between two statistical methods was 10.46%-33.77%;the non-sensitive rates of Staphylococcus aureus to various antimicrobial agents :except compound sulfamethoxazole in 2010 and 2013(difference were 6.17% and 10.21 % respectively),penicillin G (difference was 3.86%),erythromy-cin (difference was 2.71 %),and azithromycin in 2013 (difference was 2.43%),statistical results by using method 1 were generally higher than those using method 2,absolute difference between two statistical methods was 0-18.04%.Conclusion There are deviation in the non-sensitive rates of bacterial strains to antimicrobial agents by using two different statistical methods,deviation is larger in Acinetobacter spp ..The resistance level might be incorrectly higher when evaluating the resistance status without considering clinical background of bacteria.

Objective To investigate the significance of resistant gene detection combined with adenosine triphosphate-tumor chemosensitivity assay (ATP-TCA) in the second-line chemotherapy of lung squamous cell cancer, and to provide a reference for clinical treatment. Methods 150 patients with lung squamous cell cancer diagnosed by histopathology or cytology and with the disease progressed after NP regime chemotherapy were enrolled. The mRNA expressions of excision repair cross complementation 1 (ERCC1) and ribonucleotide reductase M1 (RRM1) were detected by RT-PCR, and ATP-TCA was carried out. After detected by RT-PCR and ATP-TCA, the patients who were sensitive to gemcitabine plus cisplatin (GP) accepted the second-line systemic chemotherapy with GP regimen, and the others who were not sensitive to GP regimen or whose results of gene detection and ATP-TCA were on the contrary took the second-line chemotherapy regimens with docetaxel plus cisplatin (DP). Both groups accepted 2-4 cycles of systemic chemotherapy. The chest CT was followed up, and the response rate (RR), progression-free survival (PFS) and median survival time (MST) were investigated. Results The RR of GP group was 36.2 % (17/47), while the DP group was 28.1 % (26/92), and the difference was statistically significant (χ2= 4.274, P< 0.05). The media PFS of GP group and DP group were 4.2 months (95%CI 3.485-5.348 months) and 3.6 months (95 %CI 2.685-4.648 months), respectively, and the difference was statistically significant (P<0.05). The MST of GP group and DP group were 9.6 months (95 %CI 8.283-10.637 months) and 8.9 months (95 %CI 7.384-9.648 months), respectively, and there was no statistically significant difference (P> 0.05). Conclusion The resistance gene detection combined with ATP-TCA have certain guiding significance on the second-line chemotherapy for advanced lung squamous cell cancer.

Objective To investigate the predictive value of fluid overload for mortality in children with severe sepsis.Methods In this retrospective study,the children with severe sepsis who were admitted to the Pediatric Intensive Care Unit (PICU),Children's Hospital of Soochow University between January 2011 and March 2015.Fluid accumulation was calculated in the first 72 hours after admission.Pediatric index of mortality Ⅱ (PIM2) score was calculated during the first 1 hour after admission.Multivariate Logistic regression analysis assessed the relationship between fluid overload and mortality after adjustment for confounding factors.The predictive value of fluid overload for mortality was assessed by the receiver operating characteristic curve and au area under the receiver-operating-characteristic curve (AUC).Results Of the 199 children admitted,62 cases (31.2％) died during PICU stay.Among the children,133 cases (66.8％) had fluid overload of＜5％,55 cases (27.6％)had fluid overload of≥5％-10％,and 11 cases (5.6％) had fluid overload of≥ 10％.Multivariate regression analysis showed that a high fluid overload percent (OR =1.263,95 ％ CI:1.113-1.434,P ＜ 0.001),a high PIM2 score (OR =1.028,95 ％ CI:1.012-1.043,P ＜ 0.001) and multiple organ dysfunction syndrome(OR =4.160,95％ CI:1.728-10.012,P =0.001) were independent risk factors for mortality in children with severe sepsis.The fluid overload was significantly associated with mortality (OR =1.309,95％ CI:1.158-1.480,P ＜0.001),even after adjustment for age and illness severity assessed by PIM2 scores.Fluid overload achieved AUC of 0.741 (95％ CI:0.661-0.820,P ＜ 0.001) for predicting mortality in children with severe sepsis.Conclusion Fluid overload developed during the first 72 hours after admission is independently associated with and predictive of PICU mortality in children with severe sepsis.