Objective To explore the clinical features of children infected with macrolide-resistant (MR) Mycoplasma pneumonia(MP) isolates and genetic typing of all isolates.Methods Polymerase chain reaction(PCR) of MP positive in 96 nasopharyngeal or bronchoalveolar lavage fluid (BALF) samples were collected from patients diagnosed as MP pneumonia in the Affiliated Children's Hospital of the Capital Institute of Pediatrics from January 2013 to October 2015.Fifty-five cases were male,41 cases were female;19 cases (19.8％) were 1 to 3 years old,18 cases (18.7％) were more than 3 to 5 years old,59 cases(61.5％) were more than 5 to 13 years and 2 months old.These samples were tested for MR associated mutations in the 23S rRNA of MP,and were divided into the MR group and the macrolide-sensitive (MS) group.Furthermore,the genotype of all the isolates were performed by conducting P1-restriction fragment length polymorphism(P1-RFLP) analysis and multiple-locus variable-number tandem-repeat analysis (MLVA) method.The clinical characteristics including the age,gender,hospitalization duration,symptoms,signs,fever duration,fever duration after macrolide therapy,white blood cell count,C-reactive protein (CRP),chest X-ray and/or chest computed tomography,which were compared between different groups.SPSS 11.5 software was used to analyze the statistical data.Statistical significance was determined at the 0.05 level of a two-tailed test.Results MR mutations were identified in the 23S rRNA gene in 81 specimens (84％),and the 96 specimens were divided into MR group(81 cases) and MS group (15 cases).There were statistical differences in fever duration,hospitalization duration,the incidence of complications and CRP level between the MR group and MS group (t =2.061,Z =-3.368,x2 =5.856,Z =-2.165,all P ＜ 0.05).There were no statistical differences in age,white blood cell count,consolidation percentage on chest radiography and fever duration after macrolide therapy(all P ＞ 0.05).All the 96 isolates were performed by adopting P1-RFLP typing,but 5 isolates were not typed successfully,while 81 cases (89.0％) isolates were typed as P1-Ⅰ and 10 isolates(11％) were typed as P1-Ⅱ c.The hospitalization duration and the fever duration after macrolide therapy in the P1-Ⅰ were longer than the P1-Ⅱ c group,and the difference was statistically significant (Z =-2.197,2.237,all P ＜ 0.05).There were no statistical differences in age,fever duration,white blood cell count,CRP level,consolidation percentage on chest radiography and the incidence of complications (all P ＞ 0.05).Seventy-three cases (90％) of P1-Ⅰ group were MR isolates,8 cases (10％) were MS isolates;3 cases (30％) of the P1-]Ⅱ c group were MR isolates,7 cases (70％) were MS isolates.The MR isolates in P1-Ⅰ group were much more than P1-Ⅱ c group.There was obvious statistical difference in the proportion of MR isolates between 2 groups (x2 =19.209,P ＜ 0.01).All the 96 isolates were performed by modified MLVA typing,82 cases(85.5％) were typed as M4-5-7-2,11 cases(11.5％) were typed as M3-5-6-2,1 case (1.0％) was typed as M4-5-5-2,and 2 cases (2.0％) were typed as M4-5-6-2.Because there were less cases of the M4-5-5-2 and M4-5-6-2 type,only the clinical data of M4-5-7-2 and M3-5-6-2 group were compared.The hospitalization duration and the fever duration after macrolide therapy in the M4-5-7-2 group were longer than the M3-5-6-2 group,and the difference was statistically significant(Z =-2.406,-4.472,all P ＜ 0.05).There were no statistical differences in age,fever duration,white blood cell count,CRP level,consolidation percentage on chest radiography and the incidence of complications(all P ＞ 0.05).Seventy-four cases (90％) of the M4-5-7-2 group were MR isolates,8 cases (10％) were MS isolates;4 cases (36％) of the M3-5-6-2 group were MR isolates,7 cases (64％) were MS isolates.The MR isolates in M4-5-7-2 group were much more than M3-5-6-2 group.There was obviously statistical difference in the proportion of MR isolates between 2 groups (x2 =17.022,P ＜ 0.01).Conclusions In the MR group,the children had longer fever duration and hospitalization duration,higher incidence of complications and higher CRP level than those in the MS group.The MR rates of MP in China was high.P1-Ⅰ and M4-5-7-2 are the predominate genotypes.There may be a correlation between genotype and MR.

Objective To determine the feasibility and accuracy of velocity propagation within main pulmonary artery(VP)from color M-mode Doppler imaging using custom software on a personal computer for noninvasive estimation of PVR.Methods Color M-mode imaging of pulmonary flow was obtained and then transferred to computer,the velocity propagation of pulmonary flow was automatically obtained.Comparative studies among Doppler echocardiography,personal computer and cardiac catheterization for predicting PVR had been done in 20 children with congenital heart disease and 20 normal children.Results Velocity propagations of children with congenital heart disease were significant lower than those of normal children obtained by color Mmode echocardiography[(38.38±18.89)cm/s VS(80.34±15.65)cms,P＜0.01),and correlated well with invasive PVR measurements(r=-0.69,P＜0.01).The correlation and repeatability of VP obtained by the custom software were better than VP obtained by Doppler echocardiography(r=-0.78,P＜0.01).A VP cutoff value obtained by the custom software of 35.910 had a sensitivity of 92.9% and a specificity of 100% to within pulmonary artery obtained by color M-mode echocardiography using custom software on a personal computer.

OBJECTIVETo study the prevalence and the epidemiological feature of hepatitis B in the population of Zaozhuang and the seroepidemiology of hepatitis B virus infection.

METHODSHBsAg, anti-HBs and anti-HBc were detected in 963 sera collected from 312 families by RIA, which were selected by multistage and stratified cluster sampling.

RESULTSThe results indicated that the standardized positive rates of HBsAg, anti-HBs and anti-HBc were 7.08%, 37.56% and 41.35%, respectively and the standardized prevalence rate of hepatitis B virus infection was 44.37%. The positive rate of HBsAg was higher in male subjects and in the urban area groups than those in female subjects (P<0.05) and in rural area groups (P<0.01), respectively. There was no significant difference in the positive rate of HBsAg among all age groups and occupation groups (P>0.05). The positive rates of anti-HBs and anti-HBc and infective rate of hepatitis B virus increased with age. The infective rate of hepatitis B virus was higher in male subjects and in rural area groups than those in female subjects (P<0.05) and in urban area groups (P<0.05), respectively.

CONCLUSIONSThe HBV infective rate of population was higher in Zaozhuang city; measures of prevention and control should be taken actively and effectively.

Adolescent ; Adult ; Age Distribution ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Hepatitis B, Chronic ; epidemiology ; Humans ; Infant ; Male ; Middle Aged ; Rural Population ; Seroepidemiologic Studies ; Sex Distribution ; Urban Population

Objective:To investigate the value of superb micro-vascular imaging (SMI) in evaluating carotid neovascularization in patients with Takayasu arteritis (TA).Methods:SMI was used to analyze the wall thickness and neovascularization in a total of 38 common carotid arteries in 23 patients with TA diagnosed in Shengjing Hospital of China Medical University, and the results were compared with contrast-enhanced ultrasound (CEUS).Results:SMI could clearly show the thickening wall of the common carotid artery in TA patients, and could show very tiny blood flow channels in the thickening wall. Neovascularization was detected in a total of 34 common carotid arteries by SMI, 23 of which showed 1 point of score with scattered low-velocity blood flow and the rest of which showed 2 points of score with diffused spots or strips with low-velocity blood flow. Correspondingly, neovascularization was detected in a total of 34 common carotid artery by CEUS, 22 of which showed 1 point of score and the rest of which showed 2 points of score. The scores of the two groups were consistent ( Kappa=0.641, P<0.01). Conclusions:SMI can be used as one of the important screening methods for neovascularization assessment in thickened carotid wall in patients with TA, which shows potential application value in the diagnosis, treatment and follow-up for TA patients.

Objective To analyze the application of intelligent speech follow-up system in sec-ondary prevention of ischemic stroke(IS).Methods A total of 842 IS patients who received intra-venous thrombolysis were randomly divided into intelligent group and artificial group.In the artificial group,corresponding intelligent follow-up templates were developed for the main risk factors affecting the occurrence of IS.The intelligent follow-up system determined the follow-up time and period ac-cording to the reserved information of patients when they were discharged,automatically called out the patients'home conditions for follow-up,and converted the response contents into text mode for out-put.The artificial group was followed up by professionally trained nursing staff,and the follow-up con-tent was the same as that of the intelligent group.Call out,hypertension,diabetes,medication,exer-cise,average call time and satisfaction of follow-up in the two groups were collected.Results The tel-ephone connection rates showed no statistical significances between two groups(P＞0.05).During the follow-up calls,the correct recognition rate of follow-up contents in the intelligent group was low-er,and therateof unwillingness to cooperate and call interruption rate were higher than those in the control group(P＜0.05).There were no statistically significant differences in the percentages of au-tomatic message leaving,inconvenient answering,resident death,family members unable to answer and number error between the two groups(P＞0.05),and there was no statistical significance in the distribution of disconnected calls between the two groups(P＞0.05).In the effective follow-up calls,there was no statistical significance in the answers to questions related to hypertension and diabetes,compliance and exercise between the two groups(P＞0.05).The average call duration in the intel-ligent group was significantly shorter,and follow-up satisfaction was lower than that in the control group(P＜0.05).Conclusion Intelligent voice follow-up system can replace manual telephone follow-up to a certain extent,and help medical staff understand the compliance of home blood pres-sure,blood sugar,medication,exercise and secondary prevention in IS patients,and can save fol-low-up time and improve follow-up efficiency compared with manual follow-up,but its language rec-ognition and improvement of cooperation rate still need to be optimized.

Objective To analyze the application of intelligent speech follow-up system in sec-ondary prevention of ischemic stroke(IS).Methods A total of 842 IS patients who received intra-venous thrombolysis were randomly divided into intelligent group and artificial group.In the artificial group,corresponding intelligent follow-up templates were developed for the main risk factors affecting the occurrence of IS.The intelligent follow-up system determined the follow-up time and period ac-cording to the reserved information of patients when they were discharged,automatically called out the patients'home conditions for follow-up,and converted the response contents into text mode for out-put.The artificial group was followed up by professionally trained nursing staff,and the follow-up con-tent was the same as that of the intelligent group.Call out,hypertension,diabetes,medication,exer-cise,average call time and satisfaction of follow-up in the two groups were collected.Results The tel-ephone connection rates showed no statistical significances between two groups(P＞0.05).During the follow-up calls,the correct recognition rate of follow-up contents in the intelligent group was low-er,and therateof unwillingness to cooperate and call interruption rate were higher than those in the control group(P＜0.05).There were no statistically significant differences in the percentages of au-tomatic message leaving,inconvenient answering,resident death,family members unable to answer and number error between the two groups(P＞0.05),and there was no statistical significance in the distribution of disconnected calls between the two groups(P＞0.05).In the effective follow-up calls,there was no statistical significance in the answers to questions related to hypertension and diabetes,compliance and exercise between the two groups(P＞0.05).The average call duration in the intel-ligent group was significantly shorter,and follow-up satisfaction was lower than that in the control group(P＜0.05).Conclusion Intelligent voice follow-up system can replace manual telephone follow-up to a certain extent,and help medical staff understand the compliance of home blood pres-sure,blood sugar,medication,exercise and secondary prevention in IS patients,and can save fol-low-up time and improve follow-up efficiency compared with manual follow-up,but its language rec-ognition and improvement of cooperation rate still need to be optimized.

Objective: To investigate the epidemiology and associated factors of deciduous dental caries in 3-5 years old children in Henan Province, and to provide a epidemiological reference for prevention work of deciduous dental caries among children. Methods: According to the basic methods of the Fourth National Oral Health Survey, 12 kindergartens were randomly selected from 2 counties and 2 districts in Henan Province and a total of 1 296 children aged 3-5 years old were randomly selected with stratified multi-stage random sampling method. The deciduous teeth of these children were examined for caries and their guardians were surveyed with questionnaires regarding oral health behavior, knowledge and attitude. Results: Deciduous dental caries occurred in 755 children, accounting for 58.3% and the average decay-missing-filled teeth (dmft) was 2.83. The differences of prevalence of dental caries of boys and girls (60.5%, 56.0%) and mean dmft index (2.88, 2.78) were of no statistical significance(χ2/F=2.64, 0.22, P>0.05). The prevalence of dental caries and mean dmft index for 3, 4 and 5-year-old group was 46.7%, 2.02 and 60.9%, 2.85 and 67.5%, 3.64, respectively. There was statistical significance among three age groups(χ2/F=40.00, 21.68, P<0.01). No significant difference was found in the dental caries prevalence and mean dmft index between urban (58.9%, 2.87) and rural area (57.7%, 2.79)(χ2/F=0.20, 0.16, P>0.05). Multivariate logistic regression showed that age, feeding pattern within the first six months after birth, dental care experience and self-perceived oral health status associated with deciduous caries in 3-5 year-old children in Henan Province(P<0.05). Conclusion Dental caries prevalence is highly prevalent among preschool children in Henan Province. Effective caries precaution measures should be taken to improve oral health level of these children.

Objective: To explore the characteristics of thrombelastogaphy (TEG) in term neonates, and to evaluate their correlation with traditional coagulation tests. Methods: A total of 52 term neonates were enrolled as neonatal group and 34 adults undergoing elective surgery as adult control group in Jiangmen Central Hospital from January to December 2017.TEG, plasma coagulation test and platelet counts (PLT) were performed and the corresponding ana-lysis was conducted. Results: TEG parameters in term neonates: response time(R)(4.18±1.08)min, clot kinetics(K)(1.21±0.45) min, α angle (Angle)(73.08±5.74)°, maximum amplitude(MA)(65.68±7.13)mm.Compared with adult control group, neonatal group exhibited shorter R and K(t=3.764, P<0.001; t=4.888, P<0.001), higher Angle, MA(t=5.539, P<0.001; t=2.873, P=0.001). In traditional coagulation, compared with adult control group, neonatal group showed longer prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT) (t=5.449, P<0.001; t=13.134, P<0.001; t=3.575, P=0.001), lower fibrinogen(Fib) (t=4.164, P<0.001), and higher PLT (t=4.230, P<0.001). In addition, K was negatively correlated with Fib(r=-0.374, P=0.004), while Angle and MA were positively correlated with Fib(r=0.354, P=0.007; r=0.630, P<0.001); K was negatively correlated with PLT(r=-0.430, P=0.001), but Angle and MA were positively correlated with PLT (r=0.427, P=0.001; r=0.586, P<0.001); K was positively correlated with APTT(r=0.285, P=0.035), and MA was negatively correlated with APTT(r=-0.324, P=0.017). There was no significant correlation between R and traditional coagulation test.K, MA and Angle were not significantly correlated with PT (all P>0.05), and Angle and APTT were not significantly correlated (all P>0.05). Conclusions The reference interval of TEG in term neonates is different from adults.And the parameters of TEG in term neonates are partly related to the traditional coagulation tests.

Objective:To evaluate the immunogenicity of a novel influenza virus mRNA vaccine based on conserved antigens delivered by lipopolyplex (LPP) platform in a mouse model.Methods:Four copies of genes coding for extracellular domain of matrix 2 protein (M2e) and nucleoprotein (NP) of influenza A virus were synthetized after codon optimization. The fusion antigens were transcribed in vitro and delivered by LPP platform, named as LPP-4M2eNP. Expression of M2e and NP in eukaryotic cells was detected by immunofluorescence assay (IFA). BALB/c mice were inoculated intramuscularly twice with 10 μg or 30 μg LPP-4M2eNP vaccine at an interval of four weeks. Antibody response was detected by ELISA and cellular-mediated immunity (CMI) was detected by enzyme-linked immunospot assay (ELISPOT). Results:IFA showed that NP and M2e were expressed correctly in eukaryotic cells. Single dose immunization could induce significant antigen (NP, M2e)-specific CMI and antigen (NP, M2e)-specific antibody response was induced in mice with Th1 type bias after boost immunization. Moreover, NP-specific CMI was increased significantly after the second immunization, while no significant change in M2e-specific CMI was observed.Conclusions:Stronger CMI was triggered in mice by single dose of LPP-4M2eNP vaccine. Furthermore, robust humoral and cellular immune responses were induced after boost immunization. This study suggested that LPP-4M2eNP vaccine, which based on conserved antigen of influenza A and delivered by LPP platform, had great potential for development and application.

Objective:To construct a novel respiratory syncytial virus (RSV) vaccine based on a recombinant influenza virus vector and evaluate its immune protective effects in mice.Methods:A recombinant H1N1 influenza A virus (IAV) expressing the extracellular domain (Gecto) of RSV A2 G protein was constructed and rescued, named as PR8NAGecto/WSN. After in vitro verification of the Gecto expression and PR8NAGecto/WSN growth kinetics, a single dose of PR8NAGecto/WSN was used to immunize BALB/c mice through intranasal administration to evaluate the efficacy of PR8NAGecto/WSN by assessing humoral (IgG, neutralizing antibody), mucosal (IgA) and cellular immunity (IFN-γ ELISPOT). Four weeks after immunization, the mice were challenged with RSV A2 or RSV B9320 to evaluate the protective effects of PR8NAGecto/WSN by analyzing mouse body weight changes, lung tissue virus titers and pathological changes. Results:A single-dose intranasal immunization with PR8NAGecto/WSN induced robust humoral, mucosal and cellular immunity in mice. Moreover, the mice in the immunized group had lower lung virus loads and mild lung pathological damages following the challenge with RSV A or RSV B subtype as compared with the control group.Conclusions:A single-dose intranasal immunization with PR8NAGecto/WSN induces robust immunity and provide protection against RSV A and B challenges in mice. This study provides new ideas and reference for the development of novel mucosal vaccines against RSV.