Mycoplasma pneumoniae(MP) is the smallest organism that dose not need a host cell for replication.It is one of the most common pathogens of community acquired pneumonia in children.In recent years,the incidence of pneumonia mycoplasma pneumonia increased year by year,and severe pneumonia mycoplasma pneumonia,refractory pneumonia mycoplasma pneumonia cases also increased.MP causes a variety of clinical presentations,in addition to respiratory infections,there are also many extrapulmonary manifestations.Immune response plays a very important part in pathogenesis of MP infection.This article focused on the immune aspects in pathogenesis and extends to some diagnosis and therapeutic implications.

OBJECTIVE:To study the effects of 1,25-droxyvitamin D3 on nitric oxide and nitric oxide synthase in peripheral blood mononuclear cells(PBMC)in patients with spinal tuberculosis and to explore its immunoregulation function.METHODS:Patients' PBMC were assigned to test group in which DHVD3 was added or control group in which culture medium was added,then cultured after BCG vaccine inoculation.Cultured supernatant fluid from isolated PBMC was collected at 0,3,6,9,12 days respectively for measuring of relative optical density(OD)of NO by nitric oxide kit.Total RNA extracted from the PBMC was reverse transcribed to cDNA and amplificated by fluorecent real-time quantitative PCR on the sixth day;mRNA of target gene iNOS and reference gene 3-GAPD were analyzed and compared by relative quantitative method 2-??Ct.RESULTS:OD value of NO and mRNA of iNOS in test group were all higher than in control group(P

Objective To analyze the distribution and content characteristics of highly cited pa pers in Chinese nursing journals,in order to give a reference for nursing researchers to design their studies and to improve more high quality nursing papers.Methods Nursing papers were searched from database of China Academic Journal Network.Papers cited 100 times or more were collected for statistical analysis.Results There were 266 nursing papers cited 100 times or more.They were found in 9 nursing journals,of which Chinese Nursing Journal was 69.1％.The paper most highly cited was 1 298 times.The contents of highly cited papers covered basic nursing (infusion nursing and air way nursing),health education,nursing management (safety management,nursing laws,and nursing profession protection),humanistic care,psychological nursing care,and pressure of nurses.Conclusions In order to produce high quality of nursing paper,nursing researchers should improve their academic sensitivity,pay more attention to the scientific fronts,emphasize basic nursing research and study persistent.

Objective To evaluate the role of contrast enhanced CT (CECT) scanning in the diagnosis and treatment planning of some rare liver tumors. Methods We retrospectively reviewed the CECT imaging features of 10 cases with rare tumors of the liver proved by surgical pathology in 8 cases or by liver biopsy in 2 cases, with correlation of relevant clinical manifestations, laboratory results and surgical findings. Results Three cases were histopathologically proved to be benign, and 7 cases were malignant. On CT images, the liver lesions were mixed cystic solid in 5 cases, totally solid in the other 5. Eight cases demonstrated heterogeneous enhancement, while 2 cases of liver lymphoma had no enhancement. The anatomic relationship of tumors to intrahepatic vasculature, the compression and infiltration of neighboring abdominal structures were accurately delineated by CT as compared with findings at operation. Clinical manifestations and laboratory findings were not useful for the qualitative diagnosis of rare liver tumors, except for hepatocellular carcinoma. Conclusion CECT is very useful for the detection of rare liver tumors and the fine depiction of local extent of these tumors. When correlated with clinical and laboratory information, it helps to differentiate rare liver tumors from hepatocellular carcinoma. But its role in the characterization of rare liver tumors is limited.

Objective To review advance of gabapentin in treatment of refractory chronic cough, and to provide evidence for its clinical usage and further study.The original articles referring to gabapentin’ s effect on sensory neuropathy such as refractory chronic cough, which were retrieved from CNKI, Wanfang Medical Network, as well as PubMed over the last 15 years, were reviewed.The safety, efficacy and its mechanism of gabapentin were sorted, generalized and analyzed.Gabapentin appears to be effective and safe in the treatment of sensory neuropathic disorder such as refractory chronic cough, and its effective treatment results may come ture through improving central sensitization, which indicates the drug has new clinical application value.Relevant clinical trials investigating its efficacy and safety profile in the treatment of cough are limited and further research are needed.

Objective To investigate the changes in the concentration of myocardin in children with lupus nephritis (LN) under different degree of vessel damage.Methods Forty-nine children diagnosed with LN by routine tissue immunolfuorescence, light microscope, and electron microscope were included, and 30 healthy children were included as control group. The pathological classiifcations were performed according to the ISN/RPS 2003 LN pathological classiifcation criterion. According to the Katafuchi evaluation method, the semi quantitative assessment of glomerular and kidney tubule damage was carried out, and the degree of vascular damage was evaluated at the same time. Double antibody sandwich method was used to detect the concentration of serum myocardin.Results The glomerular and kidney tubules damage in children with LN were signiifcantly aggravated with higher pathological classification (P<0.05). Glomerular damage was positively correlated with renal interstitial damage (r=0.96, P<0.01). The degree of vascular damage was related to the degree of glomerular injury and renal interstitial injury, while it was no related with the results of clinical tests. There were different concentrations of myocardin among mild-, moderate-, severe-vessel damage and control groups (F=378.61,P<0.001), and the concentration of myocardin in moderate- and severe-vessel damage groups were obviously lower than those in control group and mild-vessel damage group (P<0.01) while there was no difference between control group and mild-vessel damage group (P>0.05). According to pathological type, there were signiifcant differences in the concentration of myocardial between control group and different pathological types (F=626.793,P<0.01). FromⅡ,Ⅲ,Ⅲ+Ⅴ,Ⅳ toⅣ+Ⅴ, the concentrations of myocardial were decreased systematically, and there were statistic differences between groups (P all<0.05).Conclusion The concentration of myocardin in children with LN can relfect the renal vascular damage to a certain extent. Elevation of myocardin concentration may be helpful for the repair of vascular damage.

BACKGROUND: Glial cell line-derived neurotrophic factor (GDNF) ischaracterized by its trophic function on motor neurons, but there is stilllack of quantitative data concerning the influence of different concentra tions of the neurotrophic factor on the growth of in vitro cultured motorneurons. OBJECTIVE: To observe the influence of GDNF on neuronal growth byobserving fetus rat spinal cord motor neurons cultured in vitro. DESIGN: Verifying observation taking in vitro cultured cells as subjects. SETTING: Neurological Department of the Second Hospital Affiliated toHebei Medical College. MATERIALS: This experiment was conducted in the laboratory of Neu rological Department, the Second Hospital Affiliated to Hebei Medical College, between January 2001 and September 2002. Adult male and female rats were raised together in the same cage, embryonic rats at 15 days of gestation were obtained for spinal cord separation. METHODS: Ventral spinal tissues were obtained from embryonic rats at 15 days of gestation for prinary in vitro culture. They were divided into four groups according to the density of GDNF, namely 1, 10, 50 and 100 μg/L GDNF groups, while the culture medium in control group did not contain GDNF. Neurons were cultured in 8 wells foreach group, which was repeated for two batches. Then the influence of GDNF on spinal cord motor neu rons was observed from the perspective of cell morphology with MTF method. MAIN OUTCOME MEASURES: The survival rate of motor neurons andthe length of cell processes. RESULTS: ① The length of spinal cord motor neuronal processes: It was found obviously longer in GDNF 1 μg/L group, 10 μg/L group, 50 μg/L group and 100 μg/L group than in control group [(107.4±35.406 8,160.5±38.564 9, 450.5±60.640 3, 293.5±67.381 4, 82.8±7.972 5) μm, t=2.610-2.647, P ＜ 0.01]. ② Cell survival rate: It was higher in GDNF 1 μg/L group, 10 μg/L group, 50 μg/L group and 100 μ g/L group than in control group [(13.9±0.899 9, 16.1±0.668 0, 20.1±0.667 9, 26.0±0.603 0,10.5±0.782 0) μm, t=2.211-2.312, P ＜ 0.05]. ③ MTT colorimetric analy sis: It was obviously higher in GDNF 1 μg/L group, 10 μg/L group, 50 μg/Lgroup and 100 μ g/L group than in control group [(0.350±0.059 8, 0.366 7±0.071 9, 0.381 9±0.063 8, 0.395 3±0.060 5, 0.285 8±0.032 5) μm,t=2.259-2.577, P ＜ 0.05]. CONCLUSION: GDNF of different concentrations exerts different effects on in vitro cultured embryonic spinal cord motor neurons.

Objective:To study the effect of different substrates coated on the cell survival and neurite outgrowth of spinal motor neurons (SMN) from embryonic rat cultured in vitro.Methods:The ventral spinal tissue was isolated from embryonic rats and digested into dissociated cell suspention for culture,then the cells were identified as SMN by immunohistochemistry stain.Poly-L-lysine(PLL) was dissolved into distilled water,phosphate-buffered saline solution,boric acid at 0.1 and 0.01 mol/L concentration respectively.The different substrates include PLL,collagen Ⅰ,laminin and PLL combined with laminin.Distilled water was used as control.The neuron survival numbers and the mean length of the neurites were measured and compared.Results:The cells on the PLL dissolved into boric acid at 0.01 mol/L concentration survived well.The SMNs grown on the PLL combined with laminin were in dispersed disitribution with high survival rate.Conclusion:PLL combined with laminin is the best for the study of the motor neuron including both soma and neurite.

Objective To study the effects of serum from a patient with acute motor axonal neuropathy (AMAN) on the sensory and motor neurons culture in vitro from embryonic rats. Methods Dorsal root ganglions and spinal ventral tissue were isolated from embryonic rats and digested into dissociated cell suspenstion for culture. The cells were identified by immunohistochemistry stain. When culturing for a week, AMAN serum was exposed in a 25% concentration, with normal human serum as control group. The AMAN serum was tested by anti-Penner O∶19 campylobacter jejuni lipopolysaccharide antibody positive. The changes of motor and sensory neurons were observed and the neurons were stained by using Guillery Shirra and Webster method which was sensitive to degeneration of nerve fiber. Results After normal serum exposure, neurons and their neurites were normal and stained in yellow color without silver granular deposition by using Guillery Shirra and Webster method. While after AMAN serum exposure, the axon from motor neuron became degenerating and stained in brown-black color increased silver-phile property. Conclusion The serum of AMAN patient might be specifically toxic to the neurites of motor neuron and might cause the degeneration of axon following soma changes. The damage of axon might be the response of campylobacter jejuni lipopolysaccharide antibody without participation of macrophage and complements.

Objective To compare the effects of intraoperative anesthetic management on im-mune function between enhanced recovery after surgery (ERAS)and traditional approach in laparo-scopic rectal surgery.Methods Clinical data of 90 laparoscopic rectal surgery in Shanxi Provincial People’s Hospital from January 2013 to January 201 5 were prospectively analyzed.90 cases (male 5 1 cases,female 39 cases,aged 48-70 years,ASA grade Ⅰ-Ⅲ)were randomly divided into two groups (n = 45 each)using a random number table:ERAS group (group A,n = 45 )and control group (group B,n = 45 ).In group A patients were treated with epidural general anesthesia,maintaining perioperative normothermia,perioperative goal-directed fluid therapy and patient controlled epidural analgesia,while in group B routine anesthetic management and patient controlled intravenous analgesia were used.The levels of blood CRP and IL-6,CD3 + ,CD4 + ,CD8 + ,CD4 +/CD8 + on the first day before operation,the first day and the third day after operation were recorded.Results The blood CRP and IL-6 levels in two groups were increased on the third day after operation(P <0.05), however the increase was more significantly in group A than in group B (P <0.05).Compared with the first day before operation,CD3 + ,CD4 + ,CD8 + and CD4 +/CD8 + levels in two groups were de-creased on the third day after operation(P <0.05),on the third day group A decreased significantly, which was more than that in group B(P <0.05).Conclusion In the relief of operative stress and the protection of immune function through enhanced recovery after surgery in anesthetic management.