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.

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.

Objective To analyze the outcome of applying venous flow-through flap in replantation of complex severed finger.Methods From March,2011 to August,2012,15 cases of complex severed fingers were repaired by flow-through flap with two sets of venous system of forearm vein and one stage repair of wound.The time from injury to operation was 1.5-5.5 h (mean 2.5 h).Vascular defect length ranged from 1.5 to 11.0 cm (mean 3.6 cm);and soft tissue defect of 1.5 cm × 3.0 cm to 11.0 cm × 11.0 cm.All digits had severe soft tissue defect and segmental defect of blood vessels.All the finger blood circulation was disorder.Results All flaps and replanted fingers survived completely,except 1 case of postoperative venous crisis occurred which was remission after the vascular transplantation,and 1 case of skin flap necrosis at the distal part which was healed after skin grafting; Fourteen cases were followed-up from 7 to 20 months.At the final followed-up the flaps were of good consistency and appearance.Function of the finger was graded excellent in 7 cases,good in 5 cases,and poor in 2 cases.All flaps and replanted fingers survived completely over a period of 12 to 30 months follow-up.The flaps were of good consistency and appearance.Function of the finger was graded excellent in 7 cases and good in 5 cases.Conclusion With less injury at donor site,and good repair results,venous flow-through flap is well indicated in complex finger replantation with soft tissue defect and vascule defect.

Objective To investigate the clinical effects of large flow-through venous flap for salvaging the limb on the verge of amputation complicated with arterial defect.Methods Between March 2012 and January 2015,large flow-through venous flap was used in 10 patients with upper limb on the verge of amputation to reconstruct artery defect and large-area skin and soft tissue defect,including 6 males and 4 females with a mean age of 27.9 years (range,18 to 41 years).Injury was caused by machine crush in 4 patients,twisting belt pulley in 4,and traffic accident in 2.The dimension of skin defect ranged from 6.5 cm× 10.0 cm to 10.5 cm × 18.0 cm (mean,9.0 cm × 12.0 cm).Vascular defect length ranged from 6.0 to 16.0 cm (mean,12.3 cm).Time from injury to operation was 1.5-5.5 h (mean,3.5 h).After operation,flap survival,appearance,texture and sensation were recorded.Upper limb function was evaluated using the standard set up by hand surgery branch of Chinese Medical Association.Results The flap varied in size from 8.0 cm×12.0 cm-12.0 cm ×20.0 cm (mean,10.0 cm × 13.5 cm).One patient was amputated due to severe postoperative infection,and 9 patients were successfully operated.The flap showed small-area necrosis on the distal end in 2 patients,which was cured after dressing change,while survived completely in 7 patients.The donor wounds healed in one stage.After 12-27 months of follow-up (mean,13.7 months),the thickness,texture and appearance of the flap were close to the surrounding normal tissues and the skin protective sensation was restored.The functional results were excellent in 6 patients,good in 2 and poor in 1,with the excellent and good rate of 89％.Conclusion Large flow-through venous flap can reconstruct upper-limb vascular defect while repairing large-area wound,and has advantages of easy operation,less damage to the donor site and good appearance.

BACKGROUND:Vacuolar proton pump on the cytoplasmic membrane of osteoclasts is an essential enzyme for bone histolysis. Vacuolar proton pump inhibitor can significantly inhibit the in vitro cultured osteoclasts.
OBJECTIVE:To observe the effect of proton pump inhibitor FR167356 on the osseointegration of dental implant of osteoporosis rabbits.
METHODS:A total of 24 female Japanese white rabbits aged 5 months were randomly divided into three groups:ovariectomy (OVX) group, FR167356 group and shamed operation group. Each group contained eight rabbits. Rabbits of OVX group and FR167356 group received a surgical removal of bilateral ovaries, while rabbits of sham operation group had a surgical removal of equivalent adipose tissue beside the ovaries. Two titatium implants (8 mm long, 3.3 mm diameter) were instal ed into bilateral proximal tibias respectively 12 weeks after OVX operation. FR167356 was administrated by muscle injection in FR167356 group;meanwhile equivalent normal saline was administrated in the OVX group and sham operation group. At 4 and 8 weeks after implantation, animals in each group were sacrificed respectively for X-ray imaging, histomorphology, and mechanical test.
RESULTS AND CONCLUSION:X-ray examination showed that at 4 weeks, the implants in the OVX group exhibited a high resistance projective image, low density image of clearance screw thread, and clear boundaries between bone tissue than the other two group. At 12 weeks, the density of the clearance screw thread in sham operation group and FR167356 group was more closer to the surrounding bone tissue when compared with the OVX group, the boundaries between the implant and the surrounding bone tissue disappeared more apparently, and no significant differences were found between the two groups. Histomorphology observation revealed that, at 4 weeks after implantation, new bone with porous and trabecular extended along the implant surface to the root direction in FR167356 and sham operation groups. There were no significant differences in the two groups. At 12 weeks after implantation, the bone mass around implant was increased greatly and the trabecular grew thicker. This phenomenon was not observed in the OVX group. Mechanic test showed that at 4 and 12 weeks after implantation, the maximum pul out force in the OVX group was significantly lower than that in the other two groups. Local application of FR167356 can significantly improve the osseointegration of the implant in osteoporosis rabbits.

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.