Mycoplasma pneumoniae(MP) is one of the most important pathogens for respiratory tract infections in older children and adults. And it also has a close relationship with the development, acute exacerbation and persistence of chronic difficult-to-control symptoms of asthma.But so far,the mechanisms inducing or causing asthma remain unclear.Possible mechanisms include direct damage of bronchial mucosa, IgE-mediatad immune response, a variety of cytokines and inflammatory mediators releasing and the propensity of host.

ObjectiveTo explore the effect of atopic status on interleukin-4 (IL-4),interferon-γ (IFN-γ) and interleukin-5 (IL-5) levels in serum of children wih mycoplasma pneumoniae (MP) infection,and to investigate the relation between these cytokines and disease severity.MethodsNinety-five children with MP infection were enrolled in our study,which were divided into atopic group and non-atopic group,mild group and severe group,normal-TIgE group and high-TlgE group.Meanwhile,38 normal children were enrolled as normal control group.The serum levels of IL-4,IFN-γ and IL-5 were detected by ELISA method.Results(1) Thelevels of serum IL-4 (pg/ml),IFN-γ (pg/ml) and IL-5 (pg/ml) in MP infection group[2.82(2.12,7.13 ),39.70(18.82,181.42),16.12( 10.35,28.07 ) ] were higher than those in normal control group [ 1.17(1.05,1.60),13.25(8.77,22.56),9.72(6.11,12.39) ] ( P＜0.05 ).(2) Serum IL-5 levels in atopic group [ 15.55 (10.35,22.61 ) ],severe group [ 15.98 ( 11.95,26.58 ) ] and high-TlgE group [ 16.55( 10.35,23.65 ) ] were much higher than those in normal control group( P＜0.05 ).Rather than the serum IL-5 levels of atopic group,mild group and normal TIgE group showed no significant difference compared with the normal control group( P＞0.05 ).(3) No significant differences of serum IL-4,IFN-γ,andIL-4/IFN-γ were found between atopic group and non-atopic group,mild group and severe group,normalTIgE group and high-TIgE ( P＞0.05 ).ConclusionIL-4,IFN-γand IL-5 are involved in the pathogenesis of MP infection,furthermore,atopic status of the host may lead to the increase of serum IL-5,which may enhance the progress of the disease.

Flexible bronchoscopy has become an important method in diagnosis of pediatric respiratory diseases.Here,we introduced some diagnostic techniques such as bronchoalveolar lavage,protected specimen brushing and biopsy techniques including endobronchial biopsy,transbronchial lung biopsy,and transbronchial needle aspiration.Meanwhile,its role in the diagnosis of common diseases and symptoms (abnormality of airways,dyspnea,refractory wheezing,chronic cough,tuberculosis and bronchial foreign bodies)was discussed.

Wheezing is a common problem in early childhood and leads to a diagnostic dilemma.Respiratory endoscopy permits the examination of the morphology and the dynamics of the upper and lower airways.Moreover,it allows additional procedures to be performed.These include bronchoalveolar lavage (BAL) and endobronchial biopsy that help to complete the diagnostic evaluation and complement the findings with information from more peripheral airways.

Objective To investigate clinical characteristics of children infected with Klebsiella pneumonia (KP) in community and nosocomial ,and analysis briefly about their resistance .Methods 79 cases of children with pneumonia identified as KP infection by the method of sputum bacterial culture were collected and divided into nosocomial infection group (11 cases) and community in-fection group(68 cases) from January 2009 to December 2012 .The clinical information were recorded ,sputum bacterial susceptibili-ty and extended-spectrum β-lactamase enzyme were tested .Results 10 cases and 12 cases of extended-spectrumβ-lactamase enzyme strains were detected from nosocomial infection group and community infection group ,respectively .The children infected KP had a high degree of resistance to cefazolin ,ampicillin/sulbactam ,head penicillin ,ceftriaxone ,aztreonam ,cefepime and ceftazidime ,while sensitive to ciprofloxacin ,cefotetan and piperacillin/tazobactam in the nosocomial infection group .12 cases in community infection group produce highly resistant to penicillin-type drugs ,but were not obvious resistance to other types of antibiotics .Conclusion Multi-drug resistance problems are serious in the pneumonia children who infected KP and the extended-spectrum β-lactamase en-zyme is positive .Infected children should be treated differently in the selection of antibiotics in the treatment of infection in commu-nity and nosocomial .

The function of hepatic stellate cell (HSC)in liver fibrosis has been well recognized.In recent years,the role of HSC in the liver tumor microenvironment have been paid increasing attention.Platelet derived growth factor (PDGF) is the most important mitogen of hepatic stellate cell,and plays an important role in the activation of hepatic stellate cell.Hepatic stellate cell is not only the target cells of PDGF,but also PDGF-secreting cells.Thus a bi-directional cycle mode of PDGF activating hepatic stellate cell has been established.The signaling pathways of HSC activation include MAPK,PI-3K,Ca2+ and JAK pathways.To explore PDGF activating hepatic stellate cell in liver tumor microenvironment and to find the new methods of targeting PDGF and hepatic stellate cell,may help us find a new direction for the treatment of hepatocellular carcinoma.

Objective To evaluate therapeutic effects of radiofrequency ablation for thyroid benign nodules . Methods By using the radiofrequency electrode (18G ×7 cm, working segment length =1 cm), a total of 61 patients with 87 thyroid benign nodules underwent ultrasound-guided radiofrequency ablation in our department from February 2013 to May 2014.The maximum diameter , volume, and volume-reduction ratio (VRR) were measured by ultrasound at 1, 3, 6, and 12 months after operation. Results The 61 patients with 87 thyroid benign nodules were successfully treated with radiofrequency ablation , including 3 cases receiving secondary ablation after 1 month.The maximum diameter of thyroid nodules was (2.24 ±0.63) cm preoperatively, and (1.82 ±0.81) cm, (1.52 ±0.72) cm, (1.03 ±0.43) cm, and (0.56 ±0.36) cm at 1, 3, 6, and 12 months after ablation, respectively.The maximun volume was (5.37 ±1.85) ml preoperatively, and (4.41 ±2.16) ml, (3.19 ±1.92) ml, (1.34 ±0.61) ml, and (0.69 ±0.41) ml at 1, 3, 6, and 12 months after ablation, respectively.The VRR were (20.7 ±13.2)%, (48.6 ±16.1)%, (77.3 ±4.7)%and (88.7 ±5.6)%, respectively at 1,3,6, and 12 months after ablation.At the final follow-up, 51 (58.6%) nodules disappeared completely. Conclusion Ultrasound guided radiofrequency ablation for thyroid benign nodules is safe and effective .

[Objective]To analyze the relative factors of reoperation to lumbar disc herniation(LDH)and to discuss the three methods for reoperation.[Method]By retrospectively studying and analyzing etiopathogenisis in 102 cases,who were made at least one reoperation,and other(1 327) LDH patients underwent an initial standard discectomy in our department from 1999 to 2004.Then studied several relative factors,such as age,interval time between the initial operation to the first reoperation,was made stastistic analysises.Combined with the statistic results,the clinical outcomes of patients who underwent three different reoperative methods were evaluated.[Result]A total of 102 cases underwent at least one reoperadon,11 of them had multiple(two or more)reoperations.Among these patients 58 cases suffered from recurrent LDH,40 suferred from postoperative stenosis or instability and 4 had postoperative intervertebral-space-infection.Forty-eight cases(47.06%)were performed single discectomies again,20(19.61%)undergone decompressions by laminectomy and 34(33.33%)had decompressions,bone-grafting and fixed with spinal instrumentations.There were 16 patients in all interbody-fusion surgeries and the number increasd year by year.Higher reoperation rate was seen in patients with the initial operation taking place less than 1 year comparing,more than those with the initial operation performing more than 1 year ago(P

[Objective]To approach clinical outcomes and experiences of low-grade spondylolistbesis patients treated with posterior lumbar interbody fusion(PLIF)and transpedicular instrumentation.[Method]Consecutive 53 cases suffered from low-grade spondylolisthesis were analyzed retrospectively.All patients were treated by posterior lumbar ioterbody fusion and transpedicular instrumentation.Pre-operative and post-operative Boxall index,angle of slipping,intervertebral height were oberserved in all patients.Curative effects,fusion fate,operation-methold and complications were analyzed in all patients.[Result]All patients were followed up from 9 to 21 months with an average of 16 months.Forty-nine(92.5%)patients were assessed to bony fusion postoperatively.Comparement about preoperative and postoperative Boxall index,angle of slipping and intervertebral height were observed in all patients.There were great changes in all these indexes(P

Objective To study the correlativity of laser-induced fluorescence (LIF) spectrum on the same specimen of colorectal carcinoma both in vivo and in vitro and to obtain the best diagnostic parameter in detecting colorectal carcinoma. Methods LIF spectra were analyzed from 10 patients with colorectal carcinoma during colonoscopy, and then analyzed again after resection. The cancer foci and normal mucosa more than 5 cm apart from the foci were excited by a nitrogen laser (337 nm)using a quartz optical fiber in gentle contact with the area of interest, and then the fluorescence emission was collected by the same quartz optical fiber. The LIF spectrum was analyzed using an optical multichannel analyzer (OMAⅢ). Results (1)The LIF spectrum from cancer tissues was same as that of normal tissues, both showed the main and the second peak respectively located at about 460 nm and 390 nm in vivo and in vitro. The main peak intensities in vivo from both cancer and normal tissue were significantly lower than these in vitro. The main peak intensities in vivo and in vitro from cancer tissue were decreased about 1 time to those from normal tissue.(2) The integrated spectral intensity in vivo and in vitro of cancer tissue from each patient was significantly lower than that from the corresponding normal tissue respectively, P