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.

The alignment is a very important part of lower limb prosthesis assembly, which influence the acceptance of socket and the　experience of the patients. With the development of science and technology, more and more high-tech sensors were used into the existing　prosthetic assembly technology. This article introduced a kind of lower limb prosthesis intelligent alignment system.

Objective To investigate the postoperative joint not?reset therapeutic effects in the commi?nuted double ankle fracture. Methods From August 2012 to February 2015 in Dongfeng Hospital Affiliated to Hubei Medical College,72 comminuted double ankle fracture postoperative joint not?reset patients were selected as the study subjects,and according to the order of admission were equally divided into the treatment group and the control group,36 patients of each group. The treatment group were treated with closed reduction internal fixa?tion,the control group were given the open reduction and internal fixation. The intraoperative and postoperative recovery of both groups were observed. Results All the operation were completed successfully, the operative time,blood loss and postoperative hospital stay in the treatment group were ( 89. 24 ± 10. 34 ) min, ( 67. 24 ±14. 87) ml and (11. 45±2. 34) d respectively,significantly less than the control group((123. 45±11. 98) min,(82. 14±13. 45) ml and (14. 98±2. 47) d),the differences were significant(t=6. 498,4. 988,5. 278,P<0. 05) . The postoperative 3 months ankle function excellent in the treatment group and the control group were 94. 4%(34/36) and 77. 8%(28/36) respectively,the differences was significant(χ2=5. 966,P<0. 05). The postoperative 3 months pain scores in the treatment group and control group were 1. 78 ± 0. 45 points and 2. 60 ±0. 44 points,the differences was significant(t=8. 355,P<0. 05),and significantly lower than the preoperative ((6. 44±0. 67) points, (6. 49±0. 40) points),the differences were significant(t=25. 983,17. 332,P<0. 05) . Conclusion The closed reduction internal fixation for the postoperative joint not?reset therapeutic in the com?minuted double ankle fracture has better minimally invasive,it can promote double ankle function recovery and relieve pain,it is a reliable way of clinical applications.

Objective: To find out the effect of mineralization condition medium on bone marrow stromal cells(MSCs) proliferation,differentiation and the secretion of extracellular matrix. Methods: MSCs of the third passage were induced by minerlization condition medium (?=10%FBS,10 nmol/L dexamethasone,50 mg/L L-vitamin C and 10 mmol/L ?-sodium glycerophosphate in DMEM). The control cells were cultured in DMEM with ?=10% FBS. The cells were observed by inverted microscope. The proliferation status and alkaline phosphatase level of cells were investigated with MTT assay. Mineralization potential was studied by Von-Kossa staining. TypeⅠ,type Ⅲ collagen and BMP synthesis were examined by immunohistochemistry stains. Results:The proliferation of MSCs in mineralization condition medium was decreased, but ALP level was increased(P

Objective To explore the effect of the intestinal ischemia/reperfusion injury on paracrine patterns of BM-MSCs in order to provide evidence for BMSCs repair.Methods BMSCs were isolated,cultured,characterized,and stained.The rat intestine ischemia/reperfusion model (IRI) was established.Intestinal epithelial mucosal extracts were obtained either from IRI rat or normal rat.Those two type extracts were added into the culture medium,and BM-MSCs were cultured with the two conditioned medium respectively.The culture medium was collected at 0 h and 24 h after culturing with intestinal epithelial mucosal extracts.The levels of TGF-ot,VEGF,FGF and IGF-1 in the medium were assayed by ELISA.Results The contents of all the growth factors detected in cultured medium with intestinal extracts from IRI rats were significantly higher than in regular rats (P ＜ 0.05).The levels of TGF-α,VEGF in culture medium containing IRI epithelium extracts were significantly higher than that in the medium containing normal intestinal epithelium extracts (P ＜ 0.05)Conclusion BM-MSCs can secret TGF-α,VEGF,FGF,and IGF-1 in the presence of intestinal extracts from IRI rat in the culture.These factors might stimulate the differentiation and proliferation of intestinal epithelial cells through paracrine mechanism.

Objective To analyze the genetic characterization(evolution, antigenicity, enzyme activity sites and glycosylation sites)of the neuraminidase(NA)gene of the novel influenza virus A/H1N1 in 2009 pandemic in Guangdong Province. Methods The viral RNA was extracted from 69 isolates of influenza virus A/H1N1 from patients in 2009 pandemic in Guangdong Province. NA gene fragments were amplified by reverse transcription polymerase chain reaction (RT-PCR) and sequenced. The other 52 NA gene sequences of influenza virus A in different years and different regions were retrieved from GenBank. The analysis of evolution and amino acid sequences were analyzed by MEGA 4.0 software. Results The homology of 2009 novel H1N1 influenza viruses in Guangdong and avian H5N1 influenza virus strains was high(＞85 % ). The amino acid distributions of potential antigenic sites were identical. The enzyme activity sites of NA genes of all virus strains were strictly conserved, which had eight glycosylation sites. But there were amino acid substitutions in 5 glycosylation sites, while it was identical with the 2001 avian H5N1 influenza virus. Conclusion The NA genes of 2009 novel H1N1 influenza viruses in Guangdong are high homologous with avian H5N1 influenza virus and the viral specific binding sites of neuraminidase inhibitor are not changed.

Objective To demonstrate the spectrum of multi-detector spiral CT (MSCT) findings of drug-induced liver injury (DILI). Methods From May 2008 to January 2010, DILI was identified in 10 cases based on their clinical and pathological results. The spectrum of CT findings was analyzed retrospectively. Results According to the CT features, DILI were divided into three types. ( 1 ) Two cases presented diffuse hepatic injury, which appeared as homogeneous hypo-attenuation in precontrast CT scan and mild enhancement after contrast injection. The histopathological findings of the involved 1ivers include hepatocellular steatosis, neutrophil and eosinophil infiltration, punctiform necrosis and canalicular cholestasis. (2) Six cases presented focal hepatic injury, including massive wedge-shaped necrosis in 4,multiple small necroses in 1 and multiple regenerated nodules in 1. In precontrast CT scan, hepatic necroses were seen as inhomogeneous hypo-attenuation areas, which turned to hyper-attenuation after contrast injection and presented "flip-flop" sign between precontrast CT scan and portal venous phase scan. In the case with regenerated nodules, slight hyper-attenuation lesions were detected with diffuse distribution in liver in precontrast CT scan, which showed enhancement in hepatic arterial phase and turned to iso-attenuation in portal venous phase and equilibrium phase. The histopathological changes included massive necrosis or bridging necrosis with abundant neutrophil and eosinophil infiltration in 5 cases, nodular regeneration with cholestasis and feathery degeneratin in 1 case. (3) Two cases presented liver cirrhosis. CT displayed obvious nodularity of liver, which complicated with splenomegaly, ascites and collateral veins. The histopathological changes of these two cases included punctiform necrosis, canalicular cholestasis and pseudolobular formation. Conclusion CT signs of DILl have certain characteristics, which may help in detecting and determining the severity of liver damage.

Objective To observe the effect of MG-132 on NF-κB signal path of cartilage and synovium in a rat model of knee osteoarthritis.Methods The rat models of knee osteoarthritis were established by performing anterior cruciate ligament amputation and partial medial meniscectomy.Totally 144 adult SD rats were randomly divided into 4 groups:MG-132 group,100 ml 0.007 g/L MG-132 solution was injected in to the knee joints of rat model 24 h after surgery; DMSO group,100 ml 0.1％ DMSO solution was injected 24 h after surgery; sham surgery group,merely the knee capsulotomy was performed and no solution was injected;control group,100 ml 0.007 g/L MG-132 solution was injected into the knee joints.The cartilage and synovium specimens were obtained at 2,4,12 weeks postoperatively.Pathomorphological observation was taken.The levels of NF-κB p65,I-κB,TNF-α and IL-1β at mRNA were detected by real-time PCR,and the activityof 20S proteasome was measured by fluorospectrophotometry.Resnlts The Mankin score of MG-132 groupwas lower than that of DMSO group.The Mankin scores of sham surgery and control groups were lower thanthose of MG-132 and DMSO groups with significant difference.The mRNA levels of NF-κB p65,IL-1 β,TNF-α of cartilage and synovium in MG-132 group were lower than those of DMSO group with significant differenceexcept for NF-κB p65 of synovium at 2 weeks and IL-1β of cartilage at 12 weeks.The mRNA levels of I-κB of cartilage at 2 weeks and I-κB of synovium at 4 weeks in MG-132 group were higher than those in DMSO group with statistical significance.Conclusion MG-132,the proteasome inhibitor,could postpone the progress of osteoarthritis through alleviating synovial inflammation and defending the articular cartilage.

Objective To understand the genetic characteristics of Enterovirus 71 ( EVT1 ) circu-lating strains of Guangdong province in 2008. Methods We isolated an EV71 strain from the fatal case of the hand, foot and mouth disease during an epidemic of Guangdong in 2008. Its complete genome was se-quenced and analyzed comparatively. Results The results showed that the full length of EV71 GDFS-3 ge-nome( not including poly A tail ) is 7405 bp. No insertion or deletion is detected in the coding region. There are several insertions and deletions in 5'and 3'UTR. Phylogenetic analysis of GDFS-3 and reference strains showed GDFS-3 strain shares the highest nueleotide homology with TW984 strain(96.0% ) but low homology with SIN5865, MS and BrCr( about 81.0% ). GDFS-3 strain also shares the highest amino acid homology with TW984 strain(99.0% ). It clustered with reference strains of CA subgenotype in the phylogenetie tree. The nucleotide identity with CA reference strains is 91.0% -95.0%. Conclusion The phylogenetic analysis based on the entire genome demonstrates that GDFS-3 strain has the nearest genetic relationship with TW984 strains ( isolated in 2004). GDFS-3 may belong to the same subgenogroup ( CA ) with Taiwan predominant strains. Otherwise,Some mutations in 5'UTR of EV71 may play the very important role in heightened viru-lence.

Objective To investigate the surgical methods and clinical effect of repairing forefoot soft tissue defects with free peroneal artery perforator flap in elderly patients.Methods From June,2011 to April,2015,17 cases of forefoot soft tissue defects repaired with free peroneal artery perforator flap in elderly patients.There were 10 cases of male and female in 7 cases with an average age of 65.8 years old ranging from 60 to 74 years.Causes of injury:traffic accident in 7 cases,heavy crushing in 9 cases,electrical bums in 1 case.Injury part:6 cases on the left side and 11 cases on the right side.Metatarsus and phalanges fracture in 9 cases,tendon injury in 5 cases.Defect area:3.0 cm × 4.0 cm-6.3 cm × 11.2 cm.Results All flaps survived.All wounds were primary healing.Skin graft survived for the foot flap donor site,and no complicated with infection.All patients were followed up from 8 to 36 months with an average of 17.6 months.The appearance of flaps were good,slight bloated.The texture and color of the flaps were close to the recipient site.Flap feel were good.Accortling to (AOFAS)criteria system,the AOFAS score of last follow-up was (77.5±13.2).Excellent in 6 cases,good in 9 cases,fair in 2 cases.VAS score was (2.6±0.4).Conclusion The free peroneal artery perforator flap with the advantages of vascular anatomy constant,blood supply is reliable,thickness moderate,etc.It is a useful clinical method to repair forefoot soft tissue defects in elderly patients.