Objective To dieuss clinical manifestations of the organs damage out of lung caused by my-coplasma pneumonia(MP) infection in children. Methods Clinical date of 383 children with mycoplasma pneumonia infection were retrospectively reviewed. Results Among 383 cases, a total of 81 cases(21.25 %) were accompanied by organs damage out of lung. Conclusion The organs damage out of lung were observed in many system, the rate of organs damage out of respiratory tract is high in children. Mistake may occur easily in diagnosis if the symptoms out of lung appear first.

Objective To explore the effects of subchronic arsenic exposure through drinking water on glutamate-glutamine cycle in the brain of mice. Methods The female Kunming mice were exposed to arsenite ( iAsⅢ ) by drinking water at the levels of 25, 50 and 100 mg/L respectively for 6 consecutive weeks. The blood and brain were taken, the concentration of inorganic arsenic (iAs), monomethylarsenic acid (MMA), dimethylarsenic acid (DMA) and the activity of glutamine synthetase (GS), phosphate activated glutaminase (PAG), superoxide dimutase (SOD) and the concentrations of glutamate (Glu), lipidperoxide(LPO) were determined. Results The concentrations of iAs, MMA and DMA in the blood and brains increased as the iAsⅢ concentrations in drinking water increased. The activity of GS, PAG and the concentrations of Glu in the arsenic exposed mice increased compared with the control. The activity of GS in 50 mg/L group, the activity of PAG in 25 and 50 mg/L groups, the concentration of Glu in 100 mg/L group showed a significant difference compared with the control. The activity of PAG in 25 mg/L group was significantly higher than that in 100 mg/L group. The activity of SOD in exposed groups was higher than that in the control, the concentration of LPO in exposed groups did not show a significant difference compared with the control. Conclusion Arsenic can enter the brain and organic arsenic is dominant both in the blood and brain, however, the composition of arsenic speciation is different in the blood and brain. DMA, as a main arsenide, distributed in the brain. Arsenic exposure can change the activity of GS and PAG which can influence the concentration of Glu. Moreover, arsenic exposure can increase the superoxide anion and make the activity of SOD increase compensatively.

Objective To analyse the distribution characteristics of negative pattern of hepatitis B virus Markers (HBV‐M ) in healthy population in Hangzhou district in 2014 ,and provide strategy for the prevention and control of HBV infection in HBV‐M negative population .Methods The HBV‐M (HBsAg ,HBsAb ,HBeAg ,HBeAb and HBcAb) in blood specimens of health examina‐tion population were tested by using ELISA .For 300 cases preserved HBV‐M negative specimens ,HBsAg and HBsAb were detec‐ted by using chemiluminescence immunoassay and HBV‐DNA was detected by using PROCLEIX ULTRIO? Assay .The viral load of HBV‐DNA reactive sample was quantitatively determined .Results Among 9 143 blood samples ,2 213 samples were HBV‐M negative ,and the negative rate was 24 .20% .The negative rate of male to female was 1∶1 .21 .Using chemiluminescence immunoas‐says and PROCLEIX ULTRIO? Assay simultaneously ,we found one case of low concentration of HBsAg(both HBsAb and HBV DNA nonreactive) ,four cases of low concentration of HBsAb(both HBsAg and HBV DNA nonreactive) ,two cases of HBV‐DNA reactive(HBV‐M negative) .One HBV‐DNA reactive sample could be quantified as 560 IU/mL .Conclusion In HBV‐M (ELISA) negative population of health examination of Hangzhou district ,a few subjects had low concentrations of HBsAg or HBsAb or HBV‐DNA .For HBV‐M negative population ,quantitative detection of HBV‐M and HBV‐DNA before HBV vaccination is recom‐mended to determine w hether they need HBV vaccine and the HBV vaccination plan .

Objective To discuss the relationship between serum uric acid (SUA) and the metabolic components in metabolic syndrome(MS) .Methods 147 female cases of MS aged >60 year old were divided into MS Ⅰ group ,MSⅡ group and MS Ⅲgroup according to numbers of metabolic components ,and the levels of SUA were compared among the three groups .These patients were also subdivided into 4 groups according to the SUA levels by the quartile division ,and the differences of the metabolic compo-nents were compared among the 4 groups .The relationship between SUA and various metabolic components of MS was analyzed by Logistic regression analysis .Results The SUA level had statistical difference among the MS Ⅰ group ,MSⅡ group and MS Ⅲgroup(P<0 .05);the four SUA intervals of q25(< 44 .31 mg/L) ,q50(44 .31 -53 .24 mg/L) ,q75(>53 .24 -62 .68 mg/L) and q100(>62 .68 mg/L) showed significant differences in waistline ,SBP ,DBP ,TG ,HDL-C and FPG(P<0 .05) .Compared with the SUA interval of <44 .31 mg/L ,the occurrence risk of MS in the SUA intervals of (44 .31-53 .24) ,> (53 .24-62 .68) and >62 .68 mg/L were 1 .87(95% CI1 .35-2 .59) ,2 .71(95% CI 1 .88 -3 .91) and 4 .88(95% CI 3 .12 -7 .63) ,respectively .Waistline(OR=2 .56 ,95% CI 1 .52-4 .31) ,TG(OR=2 .21 ,95% CI 1 .63-3 .00) ,SBP(OR=1 .68 ,95% CI 1 .33-2 .12) ,DBP(OR=1 .84 ,95% CI 1 .41-2 .40) ,FPG(OR=2 .16 ,95% CI 1 .68-2 .78) and numbers of metabolic components (OR=2 .87 ,95% CI 1 .89-4 .36) were the risk factors for SUA ,and the HDL-C was the protective factor(OR=0 .48 ,95% CI 0 .29-0 .79) .Conclusion There may be in-teraction between SUA and the metabolic components of MS .

Objective To explore change of diaphragm electromyograms in patients with obstructive sleep apnea-hypoventilation syndrome (OSAHS) before and after nocturnal sleep, as well as effective nasal continuous positive airway pressure (n-CPAP) ventilation treatment for more than two months. Methods Diaphragm electromyogram was recorded with chest surface electrodes in 22 patients with moderate and severe OSAHS and 24 normal people, and phrenic nerve conduction time (PNCT) and diaphragm compound muscle action potential (CMAP) provoked by unilateral magnetic stimulation (UMS) were measured for them before and after sleep. Measurements were repeated for five patients with severe OSAHS after effective OSAHS patients before and after nocturnal sleep than that in normal people bilaterally, (8.4±0. 6)ms and (8.4±0. 9)ms vs (7. 3±0. 8)ms and (7. 3±0. 8) ms for the left side; and (8.4±1.3) ms and (8. 9 ± 0. 8) ms vs (7.2 ± 0. 8) ms and (7.2 ± 0. 8 ) ms for the right side ( P < 0. 01 ), respectively ; and amplitude of CMAP was significantly lower in OSAHS patients, (0. 60±0. 20)mV and (0. 64±0. 29)mV vs (0. 98 ± 0. 28)mV and (0. 97±0. 27)mV for the left side; and (0. 53±0. 23)mV and (0. 56±0. 26)mV vs (0. 93 ±0. 29) mV and ( 0. 94 ± 0. 29 ) mV for the right side, respectively ( P < 0. 01 ) ; but no significant significantly shortened bilaterally in five patients with severe OSAHS after effective n-CPAP ventilation treatment for more than two months, (8.6±0. 7)ms vs (7.4±0. 5)ms for the lfet side and (7. 8±0. 6)ms vs (6.4 ± 0. 6) ms for the fight side ( P < 0. 05 ), respectively. Conclusions Both phrenic nerve conduction and diaphragm muscle function are weakened in patients with OSAHA, which may be related to hypoxia and/ or disturbance of sleep structure at night.

Objective:To explore the relationship between TK gene expression regulated by enhanced suicide gene vector and telomerase activity in nasopharyngeal carcinoma cells.Method:The reformed reconstructed enhanced vector, pGL3-basic-EGFP-TK-hTRETp-CMV enhancer, and hTERT mono-promoter vector, pGL3-basic-EGFP-TK-hTRETp(as controls), were transfected into telomerase(+) nasopharyngeal carcinoma 5-8F cell lines,telomerase(+) human breast cancer MCF-7 cell lines and telomerase(-) normal vascular endothelium cell lines respectively. TK gene green fluorescent protein was observed by fluorescence microscope. The expression of TK gene mRNA was measured by the real-time fluorescent quantified PCR and the telomerase activity was determined by the method of TRAP argentation in maligment tumour cells pre- and post-transfected by enhanced vector . Meanwhile the relationship beteewn TK and telomerase was analyzed.Result:①A strong TK gene fluorescent show and TK mRNA expression were displayed after the enhanced suicide gene vector was transfected into nasopharyngeal carcinoma 5-8F cell lines and human breast cancer MCF-7 cell line, which were more stronger than those of mono-promoter group,pGL3-basic-EGFP-TK-hTRETp,and ECV cells transfected by enhanced suicide gene vector. Meanwhile,real-time fluorescent quantified PCR showed that the A value of enhanced vector group was higher than that of controls. ②Telomerase activity after transfection of enhanced vector and GCV was lower than those before by the method of TRAP argentation in nasopharyngeal carcinoma cell lines,but no change in normal control cells after transfection of enhanced vector and GCV.③ After adding GCV, the obvious inhibitory effect of tumour cells growth induced by pGL3-basic-EGFP-TK-hTRETp-CMV enhancer were observed in nasopharyngeal carcinoma 5-8F cell lines and human breast cancer MCF-7 cell line, which was higher than those of mono-promoter, pGL3-basic-EGFP-TK-hTRETp,pGL3-basic-EGFP3 and blank controls, but without inhibitory effect in ECV cells transfected by enhanced vector. Conclusion:TK gene expression is regulated by hTERT promoter and CMV enhancer, and then the telomerase activity is reduced and the cancer cells are specifically killed.But it is unclear how the telomerase are down-regulated by TK gene.

Objective To explore the effect of evidence-based medicine combined withcase based learning(CBL) in pediatric residency training.Methods Totally 52 residents were equally divided into two groups:experiment group and control group.Method of CBL combined with the evidencebased medicine (Taking two residents as one group,firstly teacher posed the questions and then residents searched for references when off duty and made evidence-based case presentation at fixed time when doing teaching ward around,after wards all personnel in the department made case discussion,finally teacher made the summary) was used in experimental group while traditional teaching method (teacher guided the residents to analyze the case by clinical experiences,residents took notes and sometimes asked questions,teacher directly gave the answers)was used in control group.The teaching effect is evaluated by questionnaire,theory test and clinical skills assessment.Statistical analysis was carried out on appraisal results with SPSS 16.0 software,test results and appraisal results were expressed as ((x-) ±s) and t test was performed,P ＜ 0.05 was taken as statistically significant.Results Residents in experimental group had more advantages in self-study ability,literature retrieval ability,physician teamwork spirit,clinical thinking,PowerPoint making and language expression after receiving CBL combined with evidence-based medicine.Theory examination showed that average score of experimental group was better than that of control group (75.46 ± 6.646) vs.(71.38 ±4.758),with statistically significantly differences (P =0.014),especially in subjective items.Clinical skills assessment showed that experimental group was better than control group in writing medical records and doing clinical thinking.Conclusions Teaching method of evidence-based medicine combined with CBL is significantly better than traditional indoctrination teaching in improving the abilities of self-study,cultivating clinical thinking,literature retrieval,language performance and other skills.This teaching method is more suitable for pediatric residency training.

OBJECTIVE To analyze the clinical cases of fungal infections and drug resistance to provide a basis for the treatment of mycotic infection.METHODS A total of 215 cases of fungal strains were identified by API 20C AUX.Drug susceptibility was determined by Rosco slip diffusion.RESULTS In 215 fungal strains of specimens,Candida accounted for 87.9%,of which C.albicans accounted for 37.2%.The yeast-like fungi sensitivity rate to amphotericin B,nystatin and ketoconazole respectively was 100.0%,97.9% and 93.5%.CONCLUSIONS Candida are the most common pathogens in the 215 fungal stains.Yeast-like fungi is sensitive to amphotericin B,nystatin and ketoconazole.

AIM: To examine COX-2 expression in esophageal carcinoma,and to study relationships between COX-2 expression and clinicopathological features and prognosis of esophageal carcinoma patients.METHODS: 89 paraffin-embedded tissue samples from patients with esophageal carcinoma were collected,its clinicopathological features such as tumour differentiation,depth of invasion,length and site of the tumor,regional lymph node metastases,distant metastasis were recorded.Survival time of 81 cases were also recorded.By SP immunohistochemistry method,the expression of COX-2 in tumor samples was examined.RESULTS: COX-2 expression in esophageal carcinoma was markedly higher than that in nomal esophagus,the expression was higher in less differentiated and deeper invaded cases(P0.05).Cases of esophageal carcinoma with lower COX-2 expression had longer survival time than those with higher COX-2 expression(P

Objective To investigate the clinical characteristics and prognosis of patients with systemic lupus erythematosus (SLE) complicated with acute pancreatitis (AP) .Methods From January 1999 to December 2013 ,the clinical data of 16 patients with SLE complicated with AP among the total 2 526 cases of SLE was collected .A retrospective analysis was performed and the clinical data of patients was classified and documented ,which included general information ,past history ,clinical symptoms , laboratory findings ,imaging findings ,treatment and outcome .The rank sum test was performed for analysis of non‐normal distributed measurement data ,and the Fisher′s exact test was used for count data analysis .Results The incidence of SLE complicated with AP was 0 .63% (16/2 526) .Among them ,ten patients were mild acute pancreatitis (MAP) and six patients were severe acute pancreatitis (SAP) .All patients were treated with fasting ,gastrointestinal decompression ,nutritional support ,anti‐acid ,anti‐inflammatory ,glucocorticoid and somatostatin and so on . Six patients were cured , seven patients improved and three patients died (two SLE complicated with SAP ,one SLE complicated with MAP) . Compared with the SLE patients complicated with SAP ,the SLE patients complicated with MAP were more easily to have lupus nephritis(6/6 versus 5/10 ,Fisher′s exact test) ,hematological system injuries (6/6 versus 5/10 ,Fisher′s exact test) ,liver injuries (5/6 versus 0/10 ,Fisher′s exact test) ,more organs involved (mean 7 versus 3 ,Z= -3 .225) and higher SLE disease active indexes (DAI) score (mean 13 .5 versus 6 .5 ,Z= -2 .876);the differences were statistically significant (all P<0 .05) .Compared with the cured and improved SLE patients complicated with AP ,lupus encephalopathy (2/3 versus 1/13 ,Fisher′s exact test) ,more organs involved (mean 7 versus 5 ,Z= -2 .276) and higher SLE DAI score (mean 21 versus 12 ,Z= -2 .195) was more common in dead SLE patients complicated with AP;the differences were statistically significant (all P< 0 .05) .Conclusions SLE patients complicated with SAP are more easily to get lupus nephritis ,hematological system injuries ,liver injuries ,activity of SLE and multiple‐organ systems involved . The prognosis of SLE patients complicated with AP was poor in those with activity of SLE ,multiple‐organ involved and lupus encephalopathy .