Carotid stenting has become one of the effective ways in the treatment of carotid artery stenosis.In-stent restenosis is one of the major causes impacting long-term effects following carotid stenting.It is also an important factor for impacting the prognosis of patients.The monitoring,prevention and treatment of in-stent restenosis have been a major clinical chanllege.This article reviews the progress in research on the in-stent restenosis in recent years.

Systemic lupus erythematosus ( SLE) is a chronic multisystem relapsing-remitting autoimmune disease, which affects human health seriously.There are numerous animal models that have long been employed in an effort to un-derstand the mechanism and treatment of SLE.Animal models of SLE were reviewed and compared in this paper, to provide references for the researchers to choose appropriate models for studying specific pathogenic mechanism and diagnostic crite-ria, searching for targeted treatment interventions and developing potential therapeutic drugs.

Objective To shorten the average length of stay for single disease entities and enhance the hospitals competitiveness through hospitalization process recombination while guaranteeing the quality of its medical service. Method The method of "systematic reintegration" from the theory of operation process recombination was adopted to recombine the hospitalization process for common disease entities in general surgery. Result After the recombination, the number of discharged patients with disease entities covered by the year 2000 research increased by 14.78%, the average length of stay was shortened by 3.83 days, a reduction of 21.58%, the average hospitalization fees incurred on the patients were reduced by 108 yuan, a reduction of 1.18%, and the business income increased by 13.43%, as compared with 1999, when recombination was not yet initiated. Conclusion Hospitalization process recombination can improve the quality and efficiency of a hospitals medical service and increase its business income while its medical service resources remain unchanged.

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.

Microthrombosis may be involved in the pathogenesis of cardiac microangiopathy due to diabetes. Recent studies have shown that fibrinogen-like protein 2 (fgl2) plays a pivotal role in microthrombosis in viral hepatitis, acute vascular xenograft rejection and cytokine-induced fetal loss syndrome. The current study was designed to examine the expression of fgl2 in microvascular endothelial cells and investigate the effects of microthrombi due to fgl2 on cardiac function and structure in rats with type 2 diabetes. Following induction of type 2 diabetes, 24 rats were observed dynamically. Fgl2 expression and related cardiac microthrombosis were examined. Local or circulating TNF-α was measured. Coronary flow (CF) per min was calculated as an index of cardiac microcirculation. Cardiac function and morphology were evaluated. It was found that Fgl2 was highly expressed in cardiac microvascular endothelial cells of rats with type 2 diabetes, which was promoted by local or circulating TNF-α. The Fgl2 expression was associated with cardiac hyaline microthrombosis. In parallel with the fgl2 expression, CF per min, cardiac diastolic or systolic function and cardiac morphology were aggravated to some extent. It was concluded that in rats with type 2 diabetes, microthrombosis due to fgl2 contributes to the impairment of cardiac diastolic or systolic function and morphological changes.

Objective To investigate the prevalence of plasmid-mediated quinolone resistance (PMQR) genes among clinical isolates of Klebsiella pneumoniae (K.pneumoniae) in pediatrics.MethodsA total of 131 non-duplicate clinical isolates of K.pneumoniae were collected in the Affiliated Children′s Hospital of Capital Institute of Pediatrics from 2010 to 2012.PMQR genes [qnrA, qnrB, qnrS, aac(6′)-Ⅰb-cr and qepA], mutations in the quinolone resistance-determining region (QRDR) and extended spectrum β-lactamases (ESBLs) genes in those strains were analyzed by PCR.Minimum inhibitory concentrations (MIC) of different antibiotics against those K.pneumoniae strains were determined by broth microdilution method and E-test according to the guidelines issued by the Clinical and Laboratory Standards Institute (CLSI).Transferability of the PMQR genes was examined by conjugation test with the sodiumazide-resistant Escherichia coli J53.Results Among the 131 isolates, 9.92% were resistant to quinolone and 30.5% were positive for PMQR genes, including 6.87% harboring qnrB gene, 22.9% harboring qnrS gene and 4.58% harboring aac(6′)-Ⅰb-cr gene.Neither qnrA-positive nor qepA-positive strain was detected.Among these PMQR genes-positive isolates, 90% were ESBLs-producing strains and two presented mutations in gyrA and parC genes.Conjugation test showed that these PMQR genes could be transferred horizontally and the ciprofloxacin resistance increased 2 to 32 folds in transconjugants.Conclusion This study indicates that the PMQR gene-carrying rate is high in K.pneumoniae strains isolated in paediatrics in China.Most of the PMQR gene-positive strains are also ESBLs-producing strains.The PMQR genes could be transferred horizontally in bacteria.

Objective To detect eight kinds of clinical common pathogenic bacteria by DNA microarray.Methods Eight kinds of common pathogenic bacteria,including Staphylococcus aureus,Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Proteus mirabilis,Enterobacter aerogenes,Pseudomonas fluorescens,Shigella sonnei were collected.Universal primers were designed to amplify 16S rRNA gene fragment from the genomic DNA of the eight bacteria,and probes were designed in the highly variable regions.DNA microarray detection system was established and used for detection of colleted bacteria.A total of 50 samples were collected from the Zhongnan Hospital of Wuhan University,including 6 blood samples,32 sputum samples,9 feces samples and 3 bronchoscope lavage samples.DNA were extracted and detected by the established DNA microarray system.Results The desired fragments were well amplified by the self-designed universal primers.The selected probes had good detection results according to repeated detection.Of the 50 samples detected,pathgenic bacteria were accurately detected in 47 samples.Other three samples were not detected as those bacteria were not included in the chip.By optimizing the detection process,the results could be reported within 8 hours.Observation of probe signal attenuation indicated that even attenuated after 60 days,but the attenuation did not affect the results.Conclusion A microarray system was established for detection of clinical common bacteria accurately and quickly,which provided foundation for its clinical application.

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.

This study is to investigate the effect of the effective components group of Xiaoshuantongluo (XECG) on neuronal injury induced by oxygen-glucose deprivation (OGD) in primary cortical cultures isolated from SD rat cortex at day 3 and the possible mechanism. Cells were divided into control group, OGD model group and XECG group (1, 3 and 10 mg x L(-1)). The cell viability was assessed with MTT assay and the LDH release rate was measured by enzyme label kit. The cell apoptosis was analyzed using Hoechst staining. RT-PCR was applied to detect the mRNA levels of JAK2 and STAT3. Western blotting was used to detect the expressions of Bcl-2, Bax, p-JAK2 and p-STAT3 proteins. Results showed that XECG resulted in an obvious resistance to oxygen-glucose deprivation-induced cell apoptosis and decrement of cell viability, decrease the cell LDH release rate. XECG could adjust the expression of Bcl-2 and Bax proteins and increase Bcl-2/Bax ratio, up-regulate the expression of p-JAK2 and p-STAT3. In conclusion, XECG could protect against the neuronal injury cells exposed to OGD, which may be relevant to the promotion of JAK2/STAT3 signaling pathway, and impact the expression of Bax and Bcl-2.

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.