Mycoplasma pneumoniae(MP) is a common pathogen found in respiratory tract infections of children and is susceptible to macrolides, tetracycline, aminogly-cosides, and quinoloines . Of all these antibiotics, macrolides is the frist choice for children. However,in recent years, strains which are resistant to common drugs have been selected in vitro and isolated from patients Point mutation at antibitics target site of these 8trains is one of the molecular mechanisms.The study of MP resistance can provide theoretical guidance for rational choice of antibiotics and application.

Objective:To design a new automatic cap opening device consists of holding mechanism, open mechanism, improve mechanism, rotating mechanism and recycling mechanism in order to resolve the poor adaptability, complex structure and lower liability problem for specimen container in the biological specimen pretreatment system.Methods: This paper designed a automatic equipment to remove the rubber cap and screw cap. This equipment is compatible with the different specification specimen containers and the container cap, and the specimen container cap was stepped up and rotated with same power component.Results: The application of equipment has reduced the manufacturing cost and maintenance cost for specimen container, improved the system reliability, solved the current technical problems of the equipment, such as poor adaptability and lower liability. Conclusion: The design of equipment mainly adapts to CS-6400 series of automatic biochemical analyzer, and it can improve the detection efficiency of biological specimen, reduce the cross contamination and satisfy the practice necessity for clinical detection.

Aimed at the decontamination of protective clothes used for high level biosafety laboratory,infectious sickroom and field sampling,a kind of chemical spray sterilization device adopting PLC and touch screen technology is developed,which has the advantages of being safe,reliable,easy to operate and adjustable for parameters.The experimental results show that the decontamination effect of the device is reliable,and the device runs stable and highly-automatized,and the effect of the spray is satisfactory.The device has great practical value in the areas of biosafety,inspection & quarantine and medical facility.

Objective To investigate the effect of the rehabilitative therapy on functional recovery of patients with cervical cord injury.Methods 92 cases with spinal cord injury(SCI),including cervical,thoracic and lumbar cord injury,accepted normal rehabilitation.They were assessed with the Barthel Index and Functional Independence Measure(FIM)before and after treatment.Results After rehabilitation of 60~426 d,the scores of the Barthel Index and FIM were significantly improved(P<0.001)in all the patients,but it was the worst in the cervical cord injured ones,and the best in lumbar ones(P<0.05).Conclusion Rehabilitation can promote the functional recovery of patients with cervical spinal cord injury,but it is not as effective as on the thoracic and lumbar cord injury.

Objective To investigate strategies of diagnosis and treatment of ureter endometriosis. Methods From 1983 to 2010, the cases registered in Peking Union Medical College Hospital and confirmed as ureter endometriosis by surgery were enrolled in this study. Clinical manifestatios, preoperative examinations, surgical categories and routes, surgical and pathological findings, post-operative medical treatment, relapse and relating factors were collected and studied. Results Totally 46 patieuts with ureter endometriosis underwent one or two surgeries. Forty-eight per cent (22/46) of patients were not be diagnosed with ureter endometriosis pre-operatively, and 46% (21/46) only presented dysmenorrhea or even no symptoms. Ureterolysis (72%, 33/46) and laparotomy (63%, 29/46 ) were the most common surgical category and surgical approach. There were 64% (25/39) of patients had left ureter involved and 80% (37/46) had extrinsic ureter endometriosis. Fifteen per cent (7/46) of patients had relapsed disease with median recurrent time of 24 months (13 -49 months), and they all received second surgeries. Logistic regression analysis showed that only gonadotropin releasing hormone analogue agents were related with recurrence when compared with those patients without medical treatment post-operatively significantly ( OR =23.2, 95% CI:2. 4 -221.7, P =0. 002). Conclusions Ureter endometriosis was related with reproductive tract endometriosis. It has insidious process resulting in difficulty for early diagnosis. It's important to treat pelvic deep infiltrating endometriosis and ovarian endometrioma to prevent ureter from further involvement. Post-operative treatment of pelvic endometriosis is the key point of preventing relapse of ureter endometriosis.

Objective To evaluate the usefulness of serum galactemannan(GM) for the diagnosis of invasive pulmonary aspergillosis (IPA) in critically ill patients. Methods Study was conducted between February 2007 and July 2008. Included patients on admission ICU who suffer from suspected IPA. GM test and culture were collected 2 weekly. Chnical feature, mycological evidence and optical density index (ODI) were noted. Clinically invasive fungal infection(IFI) were defined proven, probable and possible. The patients were classified into neutropenia, non-neutropenia and treated with immunosuppressive agents, non-neutropenia and non-immunosuppressive agents. To compared of the sensitivity and specificity of GM in different patients. Results 94 patients were included, 4 patients were proven, 29 patients were probable, 34 patients were possible IFI, 27 patients were non-IPA. The positive rate of the GM was 31.9% (30/94). The sensitivity and specificity of GM in proven cases and probable cases are 66.7% and 92.6%. GM assay tended to become positive earlier than the culture 2-10(5.33±2.17)d. We found that differences in patient diagnosis and selection might account for the disparities seen for positive rate for the GM test. There was positive in three of the four patients with proven, the positive rate of GM was 65.5% for probable cases, for possible cases was 17.6%, for non-IPA cases was 7.4% (P=0.001). For patient with neutropenia , treated with immunosuppressive agents and without immunosuppressive agents, the positive rate of GM was 52.9%vs 41.7% vs 34. 6% (P=0.015) ;the sensitivity was 80.0% vs 70. 0% vs 53.8% (P=0.011), the ODI was 1.365 (0.582-6.736) vs 1. 123 (0. 623-6.868) vs 0.554 (0.522-0.823), P=0. 005, respectively. Conclusion These results show that GM test is useful for early diagnosis IPA in critically ill patients. Differences in patient selection and diagnosis might account for the disparities seen for positive rate and sensitivity for the GM test. It has been higher sensitivity and ODI in the patient treated by immunosuppressive agents.

Objective To investigate the clinical role of central venous pressure(CVP) to evaluate fluid responsiveness in septic shock patients. Methods 66 septic shock patients were studied, every patient was administered a volume challenge, before and after it, CVP, intrathoracic blood volume index (ITBVI),global end-diastolic volume index(GEDVI), cardiac index(CI), stroke volume index(SVI) were measured by PiCCO method. All the obtained values were analyzed by statistics method. Results Initial CVP in responders is significantly different from that in nonresponders; △ITBVI, △GEDVI, △CI, △SVI, △HR (△:changes) before and after volume challenge in responders were significantly different from those in nonresponders; the significance of △ITBVI, AGEDVI to predict volume responsiveness was strong indicated by high values of areas under the receiver operating characteristic curves (0.674 and 0.700, respectively).If patients were regrouped by CVP≤11 mm Hg(1 mm Hg=0.133 kPa) and CVP > 11 mm Hg, initial ITBVI and GEDVI in responders were not significantly different from that in nonresponders; △ITBVI,△GEDVI, △CI, △SVI before and after volume challenge in responders were significantly different from those in nom'esponders. Conclusion In septic shock patients, CVP play a guidance role to predict and evaluate volume responsiveness and when CVP was > 11 nun Hg, a positive response will be less likely. Initial volumetric parameters(intrathoracic blood volume and global end-diastolic volume) play a questionable role in predicting and evaluating volume responsiveness, changes before and after volume challenge maybe helpful.

Objectlve To research and analyze the hemod)rnamic status of refractory septic shock associated cardiac dysfunction.Methods 70 refractory septic shock patients were studied.In the duration of pulmonary artery catheter(PAC)-directed hemodynamic optimization,the patients were divided into a cardiac dysfunction group and a control group.Hemodynamic parameters,arterial blood lactate concentration and APACHE II scores were obtained instantly after the placement of a PAC,then lactate clearance in 24 hours was surveyed and calculated.Subsequently the two groups of patients were regrouped by nonsurvivor and survivors respectively.All the obtained values were analyzed with statistic methods.Results 37% of the refractory septic shock patients was complicated with cardiac dysfunction.The age of the patients complicated with cardiac dysfunction was significantly higher than that of the patients of the control group.Central venous pressure(CVP),pulmonary artery obstruction pressure(PAOP),pulmonary artery pressure (PAP),systemic vascular resistance index(SVRI),pulmonary vascular resistance index(PVRI)and oxygen extraction ratio(O2ext)in the cardiac dysfunction group were significantly different from those in the control group.Cardiac output(CO),cardiac index(CI),oxygen delivery index(DO2I)and mixed venous oxygensaturation(S-v O2)were significantly lower than those of the patients in the control group.S -v O2 had a strong correlation witIl CI.If the patients were regrouped by nonsurvivors and survivors.in the patients complicated with cardiac dysfunction APACHE II scores were significantly higher in the nonsurvivors than survivors:the lactate clearance in 24 hours(median-25%)of the nonsurvivors was significantly lower than that of nonresponders(median 22%),P＜0.05.Conclusion (1)In refractory septic shock patients,cardiac dysfunction maybe the main reason leading to bad outcome.(2)Higher CVP and PAOP and lower S -v O2 indicate the onset of cardiac dysfunction.(3)The patients with significantly high initial arterial blood lactate level and the low lactate clearance in 24 hours had bad outcome.

OBJECTIVEThe purpose of this study was to observe the healing process of palate wound with denuded bone restored with transplanted buccal or palatal mucosa and to elucidate the mechanism of maxillary growth inhibition following palate repair.

METHODS32 Japan white rabbits, 5 weeks old, were selected as the subjects for this study. They were divided into 4 groups at random. The rabbits in group I was the control without receiving any treatment. The rabbits in group II, III, IV was surgically denuded the bone of palate, and afterwards, the rabbits in group II were not received further restoration, but rabbits in group III and IV were restored with transplanted buccal and palatal mucosa respectively. From 2 to 14 weeks after surgery, at regular intervals, palatal wounds were observed by using a light microscope. Histological changes were also compared among different groups.

RESULTSIt was found in group II that dense connective tissue was formed 2 weeks after the surgery, and Sharpey's fibers was formed between the scar and bone tissue 4 weeks after the surgery. However, no Sharpey's fiber was found in group III and group IV, and in the latter two groups, the histological character of tissue was similar to that of the control.

CONCLUSIONPrevention of the attachment of Sharpey's fibers to the palatal bone could be effectively accomplished by covering the denuded palatal bone with the transplanted buccal or palatal mucosa.

Animals ; Cleft Palate ; pathology ; surgery ; Female ; Mouth Mucosa ; transplantation ; Palate, Hard ; pathology ; surgery ; Rabbits ; Random Allocation ; Surgical Flaps ; Wound Healing

Military pilot selection is an effective way to lower the training cost, ensure the safety of pilots and aircraft, and improve the military efficiency, which involves a comprehensive evaluation of medical fitness, psychology and flying aptitude of a pilot candidate.The concept and classification of comprehensive evaluation methods were introduced in this paper.Comprehensive evaluation methods used in domestic and overseas military pilot selection were reviewed.Finally, suggestions on the research and application of the military pilot selection system in China were raised.