Objective To explore the necessity of inferior vena cava(IVC) filter implantation during catheter directed thrombolysis (CDT) for acute deep vein thrombosis (DVT). Method Ninety-three patients with acute DVT were reviewed from Nov. 2006 to Dec. 2008. There were 35 men and 58 women, age averaging at (60 ±29) year old, treated with CDT followed by percutaneous transluminal angioplasty ( PTA). The course of DVT was from 5 h ～ 15 d (6. 28 ±7.08) d with 80 left lower limbs and 13 right lower limbs involved. Results There were 30 patients with prior IVC filter implanted compared with 63 patients without filters (67. 7% ,63/93). Among the patients without filter, there were 93. 6% (59/63) left lower limbs. DSA was redone after thrombolysis. Seventy-seven iliacfemoral thrombosis was resolved completely and stenosis or occlusion of the iliac vein were found in 90. 9% (70/77) cases. Endovascular treatment was performed in 57 patients. There was no patients suffering from symptomatic pulmonary embolism (PE). PE was found in 3 cases with a filter and 1 case without filter was suspected of PE on pulmonary CTA after treatment. Conclusion It is not necessary to routinely place an IVC filter during CDT for treating DVT on left lower limb when the thrombosis is not involing the IVC.

Experimental studies on the myocardial ischemia and reperfusion injury in 16 anaethetized SDrats,of which,8 animals were pretreated with morphine(5 mg/kg,i.p.)for preventing of arrhyth-mias,were studied immunocytochemically with anti-muscle actin specific monoclonal antibody (HHF_(35)),8 shan-operated rats were used as control.With HHF_(35) ABC immunocytochemical method,the area of myocardial ischemia and reperfusion injury(without morphine)showed decrease or ab-sence of staining,large areas of staining loss were also seen.In the group with morphine,only smallfoci of staining absence were shown.The myocardium in control animals showed evenly positive stain-ing.No change were seen with HE staining in all groups.The results obtained with HHF_(35) stainingsupport its important value in studying on myocardic reperfusion injury,and indicated that the degreeof myocardic damage may be relative to the arrhythmias in myocardial reperfusion injury.

Parkinson′s disease(PD),the second neurodegenerative disease in the world,is characterized by a combination of motor symptoms(rest tremor,bradykinesia,rigidity,postural instability,stooped posture and freezing of gait)and non-motor symp?toms(including psychiatric and cognitive disorders). The core neuropathological features of PD are the loss of dopaminergic neurons in the substantia nigra and the deposition of iron and cytoplasmic protein aggregates(Lewy bodies)inside neurons. Currently,clinical treatment for PD is symptomatic and there is no effective treatment to restore neuronal degeneration. In the PD therapy ,medication re?mains dominant. Anti-PD drugs are mainly based on the critical signal pathways or some specific targets which play a key role in the pathogenesis of PD to relieve the symptoms of PD. Research and development in novel drugs to prevent or treat PD have been a crucial subject,and some novel candidates are under development. In this paper,we summarize and analyze the anti-PD drugs,and make a brief discussion about its pharmacological targets.

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 inspect the source of an outbreak with Mycoplasma pneumoniae (Mp).Methods We carried out real-time PCR to analyze specimens collected from pediatric patients in Beijing during January 2010 to May 2012,diagnosed as pneumonia or a respiratory infection according to clinical symptoms.These positive samples were analyzed by the M-P typing system(M:multiple-locus variable-number tandem-repeat analysis,MLVA; P:P1-restriction fragment length polymorphism analysis,P1-RFLP).Results Sixty-nine specimens were tested positive to Mp by the real-time PCR in 446 specimens from pediatric patients.The infection rate was 11.69％,15.56％ and 20.00％ respectively in 2010,2011 and the first half of 2012.According to the M-P system,11 distinct genotypes were identified from 69 positive specimens,M43562P1 and M53562P1 were the two main genotypes that showed an increasing trend from 2010 to 2011,and M33562P1 and M63562P1 showed an increasing trend from 2011 to 2012 in China.Conclusion During this international Mp epidemic,the infection rate of Mp was also increase in Beijing in 2011,and M43562P1 and M53562P1 were the two main genotypes.Among them,M43562 were consistent with pop genotypes in Europe,and M53562 were consistent with pop genotype in Israel.The M-P system would be valuable to monitor the epidemic of Mp in different countries in the world.

Objective To study the application of P1 adhesin protein epitopes in diagnosis of Mycoplasma pneumoniae(Mp) infected patient. Methods The major epitope(P1-534) of P1 adhesin protein were predicted by ProPred and ANTIGENIC according to its primary structure. The high value fragment was cloned into a constructed recombinant vector. The gene was induced to express fusion protein in E. coli host strain BL21(DE3) and the fusion protein was identified by Western blot. BALB/c mice were immunized with purified protein to test its immunogenicity. Then the purified protein was used as antigen to test the serum of Mp infected patient by ELISA, and compared with the Mp whole cell antigen. Results The P1-534 protein was successfully expressed and purified. ELISA data showed that P1-534 protein could elicit high levels of IgG in immunized mice, the sensitivity and specificity of P1-534 were determined to be 85.00% and 97.67%, while the Mp whole cell antigen were 72.50% and 74.42%. Conclusion The results conformed that the recombinant epitope has certain immunogenicity,and its sensitivity and specificity are better than Mp whole cell antigen. P1-534 protein can be used as an antigen for immunodiagnosis of Mp infection.

Objective To evaluate the efficiency of using nested PCR in restriction fragment length polymorphism analysis (P1-RFLP) for genotyping Mycoplasma pneumonia (M.pneumonia) in clinical specimens.Methods Based on the gene sequence of RepMp4 and RepMp2/3 in P1 gene of reference strains M129 (type 1) and FH (type 2),two sets of inner primers were designed with a HaeⅢ restriction enzyme site (GGCC).The nested PCR was set up to detect the target DNA in clinical specimens.The amplification products were mixed and digested with Hae Ⅲ enzyme.The genotypes were analyzed by comparing with various restriction maps and the results were verified by sequencing analysis.The concentration of DNA extracted from standard and clinical strains were detected by ten-fold dilution to evaluate the sensitivity of nested PCR-P1-RFLP and P1-RFLP.M.pneumonia-positive specimens isolated from Beijing in 2012 were analyzed by the nested PCR-P1-RFLP and the results were compared with those by P1-RFLP analysis.Results The nested PCR-P1-RFLP could effectively genotype M.pneumonia in clinical specimens and the results were consistent with those by sequencing analysis.The sensitivity of new assay was 103 times higher than that of the original P1-RFLP.Of the 115 M.pneumoniae positive clinical specimens,97.4％ (112/115) were type 1 and the rest were type 2.Conclusion The nested PCR-P1-RFLP shows high efficiency for genotyping of M.pneumonia in clinical specimens.It might be useful for the surveillance of M.pneumoniae infection.

Objective To assess the mid-term and long-term efficacy of the permanent inferior vena cava filter in the treatment of deep vein thrombosis of lower limb and discuss the clinical significance of inferior vena cava filter.Methods Retrospectively analyze on the 86 cases with deep vein thrombosis of lower limb (41 males and 45 females,aged 50 to 94 years,mean age was 71.8 years) treated with implantation of permanent inferior vena cava filter in inferior vena cava from Janunary 2010 to October 2015.In these patients,there were 51 cases with embolism in the left leg,25 cases in the right leg,10 cases in both legs and 6 cases were accompanied with pulmonary embolism.The cases without contraindication underwent catheter directed thrombolysis and even percutaneous transluminal angioplasty or stents subsequently if necessary after inferior vena cava filter implantation.All the cases with no contraindication were treated with anticoagulant therapy.Results All the 86 patients were implanted inferior vena cava filter (B.Braun Vena Tech LP 76 and Cordis TrapEase 10)successfully.Sisty-five cases were underwent inferior wena cava filter implantation only,while 21 cases were treated with inferior vena cava filter implantation and catheter directed thrombolysis or even percutaneous transluminal angioplasty and stents.During the follow-up period(12 to 81 months,mean time was 51 months),27 patients died dueing to malignant tumor(17 cases) and other diseases (10 cases) rather than complications caused by inferior vena cava filter.Three patients had recurrence of deep vein thrombosis and 2 patients suffered from the thrombosis induced by stenosis of stents.Inferior vena cava filter appered tilted with angle less than 15 degrees in 6 cases.Three cases suffered from new thrombosis below the filter and 2 cases complained of the filter migration.No case was found with fracture of filter,perforation of the inferior vena cava,bleeding or pulmonary embolism(new onset or recurrent).Conclusions Application of permanent inferior vena cava filter may cause complications,though it is an effective approach to prevent pulmonary embolism in patients with deep vein thrombosis of lower limb.However,permanent inferior vena cava filter may be fit for patients with old age,incurable cancer or limited expected life.

Objective To present clinical results of endovascular treatment of total iliac vein occlusions and to discuss the technique details of this treatment. Methods From Feb 2006 to Aug 2010,15 patients with chronic total occlusive lesions of the iliac vein and adjacent vein segments underwent endovascular treatment. Average age was (62 ±7) years (range 35 to 81 years), the male/female ratio was 12: 3. Clinical score of CEAP was grade 3 in 33. 3%, grade 4 in 40%, grade 5 in 13. 3%, and grade 6 in 13.3%. Venography showed left iliac vein was occluded in all 15 patients, common femoral vein was occluded in 14 patients, and superior femoral vein was occluded in 9 patients, however profounder femoral vein was patent in these patients with superior femoral vein being occluded. Results No postoperative major morbidity or mortality was seen. The technique success rate was 93. 3%. Treatment failure was caused in one case for a wrong selection of the femoral vein approach site. The average length of stent was 18. 4 cm.In 12(80. 0% ) stents crossed the inguinal ligament. The average follow-up time was 11.6 ± 2. 4 months.The primary patency rates of the stents at 6 months were 92. 9%. 10 (66. 7% ) patients were asympotomatic, 3(20% )were improved, 1 (6. 7% ) was unchanged, and 1 (6.7%) was worse, compared to before intervention. Conclusions Endovscular recanalization and stent placement is a safe and effective treatment for chronic total occluded iliac veins, with good patency, significant symptom resolution, and minimal morbidity in the short term follow-up.

Objective To compare the capabilities of culture method, polymerase chain reaction ( PCR) and serological test in identifying Mycoplasma pneumoniae infection in children with confirmed com-munity acquired pneumonia. Methods Bronchoalveolar lavage fluid and serum samples were collected from hospitalized children with community acquired pneumonia in Capital Institute of Pediatrics from March to May in 2016. Three methods, traditional culture method, PCR and serological test, were respectively used to de-tect Mycoplasma pneumoniae infection in those children. Statistical analysis was performed by using SPSS18. 0 software and chi-square test. Results Seventy-nine children with community acquired pneumonia were enrolled in this study. Eight (10. 13%) patients were diagnosed with Mycoplasma pneumoniae infec-tions by the traditional culture method with an average positive culture period of 21 days. Twenty-three (29. 11%) patients showed positive results by using PCR analysis, including the 8 patients identified by the culture method. Forty-one (51. 90%) patients were found to be positive for Mycoplasma pneumoniae infec-tions by the serological test. However, four negative samples identified by the serological test were confirmed to be positive by PCR analysis, including two positive samples confirmed by the culture method. Statistical analysis showed that the differences in positive rates detected by using the three methods were statistically significant. Conclusion It is recommended that both serological test and PCR analysis should be used in combination with clinical symptoms for a comprehensive assessment of Mycoplasma pneumonia infection in children.