As a common pathogen, pulmonary mycoplasma in children will lead to various clinical manifestations, involving hematologic, alimentary, and central nervous systems injuries except for respiratory system, and develop many kinds of extra-pulmonary complications.Here in some rare complications accompanied by mycoplasma infection will be elucidated to enforce the understanding, early reorganization, then ameliorate the outcomes.

Sepsis is a complex systemic inflammatory response syndrome caused by invasion of a varie-ty of pathogenic bacteria. The disease spectrum includes sepsis, severe sepsis, septic shock and multiple organ failure. Mitochondria are referred to as “power plants”, providing energy for viscera to maintain normal func-tion. Immune disorders,the activation and release of a series of inflammatory factors,anomalies of intracellular signal transmission and oxidative stress in sepsis can induce mitochondrial dysfunction. Recent research suggests that mitochondrial autophagy also plays a certain role in mitochondrial dysfunction. This article reviews the mechanism of mitochondrial functional damage during the pathogenesis of sepsis.

OBJECTIVE:To optimize the extraction technology of Paeonia lactiflora. METHODS:The surface figure made by mixed uniform design combined with the quadratic polynomial stepwise regression equation is adopted to optimize the extraction technology of P. lactiflora by using the content of paeoniflorin as index,with extraction solvent,the amount of extraction solvent, extraction time,extraction times as factors. RESULTS:The optimal extraction technology of P. lactiflora was as follows as 90%ethanol,12-folds extraction solvent,extracting for 150 min,extracting for 2 times. The measured value of 3 validation tests were 2.848 4%,2.795 7%,2.841 9%(RSD=0.82%,n=3),which was close to the predicted value 2.848 4%. CONCLUSIONS:The method is convenient and accurate,and can be used for the extraction of P. lactiflora.

Objective To compare the differences in curative effect between general treatment model and stroke unit model in the treatment of stroke in the elderly inpatients, to explore the standardized management model, for improving efficacy and reducing the degree of invalidity and mortality. Methods A total of 1200 cases with acute cerebrovascular disease were admitted into our department from April 2002 to April 2007. All patients were randomly assigned either into stroke unit or general ward to receive treatment, and the data of two groups were compared. The key indexes included mortality, hospitalization time, Barthel Index (BI), National Institutes of Health Stroke Scale (NIHSS) and Oxford Handicap Scale (OHS). All the patients or their family members were asked to have the Visual Analogue Scales (VAS). The data of cost and effect were analyzed with SPSS software. Results The complication rate and mortality rate were significantly lower in stroke unit group than in general ward group (P＜ 0.01). The scales of BI, NIHSS, OHS and VAS were significantly better in stroke unit group than in general ward group when discharged (P＜0.05). The hospitalization time was shorter in stroke unit group than in general ward group (P＜0.05). There was no significant difference in the costs of hospitalized patients between the two groups (P＞0.05).Conclusions Stroke unit model can improve the physical activity and life quality of patients and reduce disease mortality without increasing the cost of patients.

Objective To develop a kind of patient transferring trolley with special machinery. Methods A bedplate could upturn and slide both sides for more than one breadth. The trolley's bedrail with special design could be kept from capsizing. Results In the practice of patient transferring, the trolley was safe, steady and laboursaving. Conclusion The trolley is useful for transferring severe patients or patients after operation.

Purpose To investigate the effect of small interfering RNA on the increase of myocyte enhancer factor 2A(MEF2A) expression in PC12 cells exposed to hypoxia.Methods PC12 cells were cultured under normal conditions or were exposed to hypoxic conditions.Small interfering RNA targeted MEF2A gene (MEF2A-siRNA) was chemically synthesized. Eukaryocytic expression vector was built and transfected into PC12 cells with liposome. The expression of MEF2A mRNA was detected by real-time PCR. Western blot was used to detect the MEF2A protein.Results Compared with normal control(2~(-△△CT)=1.01±0.02), the mRNA level of MEF2A gene in PC12 cells with the treatment of MEF2A-siRNA was down-regulated significantly by 88%(2~(-△△CT)=0.12±0.03, P＜0.01).The expression of MEF2A protein in hypoxia-treated PC12 cells was markedly higher than that of normal control(98.4±11.7 and 47.5±7.6,P＜0.01).However, MEF2A-siRNA could significantly suppress the increase of MEF2A protein (P＜0.01).Conclusion MEF2A gene silence induced by siRNA might inhibit the increase of MEF2A protein by hypoxia in PC12 cells.

Objective: To analyze the clinical manifestation, imaging characteristics and prevention of medication-related osteonecrosis of the jaw (MRONJ) after intravenous bisphosphonate (BP) for cancer patients with bone metastases. Methods: The clinical data and radiographic findings of 6 primary breast cancer patients with bone metastases diagnosed as MRONJ from January 2014 to April 2018 in Shanxi Dayi Hospital were retrospectively analyzed. Results: All 6 patients were female, with the median age of 65.5 years old. All patients had no history of systemic application of hormone therapy, no history of diabetes, no history of radiation therapy, no history of metastasis of the jaw, and no history of infection. The average usage time of BP was 28 months. MRONJ occurred in 2 cases on maxilla and 4 cases on mandible. There were 2 patients with tooth extractions history in BP treatment. Clinical symptoms included maxillofacial pain, loosened teeth, fistula suppuration, and exposed sequestrum. Radiographic findings included osteolysis and bone sclerosis or the mixed manifestation of both, with or without periosteal reaction. In addition, nonhealing tooth sockets and sequestrum separation imaging were also included. Conclusions Tooth extraction is considered as an increased risk for MRONJ in patients with malignant bone metastases after BP therapy. MRONJ is more likely to appear in the mandible, but it can also appear in the maxilla. Early screening and initiation of appropriate dental care are necessary for the patients before using BP therapy.

Objective To evaluate the clinical efficacy and safety of antofloxacin hydrochloride tablet for the treatment of acute bacterial infections. Methods A multi-center randomized control, double blind and double dummy clinical trial was conducted; levofloxacin tablet was chosed as controlled drug. The duration of treatment was 7-14 days in both groups. Results A total of 719 patients were enrolled in the study, in which 359 patients treated with antofloxacin and 360 patients treated with levofloxacin were included. Three hundred and thirty and 337 patients completed the study and met with all the criteria for perprotocol analysis, respectively. By the end of chemotherapy, the cured rates in per protocol set (PPS)population were 79.7% and 77.4%, the effective rates were 95.2% and 96. 7%, and the bacterial clearance were 96. 7% and 97. 5% for the treating and control group, respectively. The clinical and bacterial efficacy of antofloxacin and levofloxacin was comparable by the analysis of infectious sites. Three hundred and fifty-seven and 356 patients in antofloxacin and levofloxacin groups were evaluated the safety.The drug adverse events occurred both in 10. 1%, and drug adverse reactions accurred in 7. 8% and 7.9%patients in the two groups. The most common drug adverse reactions were mild gastroenteric symptoms. No QTc prologation was detected in all the patients. One patient in each group had mild blood glucose increase at the end of therapy, but the glucose returned to normal level without any intervention. No statistic significant difference between the two groups in clinical efficacy and safety was detected (P＞0.05).Conclusions Antofloxacin hydrochloride tablet was effective and safe for the treatment of acute bacterial infections.

Objective:Topredict the three-dimensional dose distribution of regions of interest (ROI) with brachytherapy for cervical cancer based on U-Net fully convolutional network, and evaluate the accuracy of prediction model.Methods:First, 100 cases of cervical cancer intracavity combined with interstitial implantation were selected as the entire research data set, and divided into the training set ( n=72), validation set ( n=8), and test set ( n=20). Then the U-Net was used to construct two models based on whether the uterine tandem and the implantation needles were included as the distinguishing factors. Finally, dose distribution of 20 cases in the test set were predicted using the trained model, and comparative analysis was performed. The performance of the model was jointly evaluated by , and the mean absolute deviation (MAD). Results:Compared with the model without the uterine tandem and the implantation needles, the of the rectum was increased by (16.83±1.82) cGy ( P<0.05), and the or of the other ROI were not different significantly (all P>0.05). The MAD of the high-risk clinical target volume, rectum, sigmoid, small bowel, and bladder was increased by (11.96±3.78) cGy, (11.43±0.54) cGy, (24.08±1.65) cGy, (17.04±7.17) cGy and (9.52±4.35) cGy, respectively (all P<0.05). The MAD of the intermediate-risk clinical target volume was decreased by (120.85±29.78) cGy ( P<0.05). The mean value of MAD for all ROI was decreased by (7.8±53) cGy ( P<0.05), which was closer to the actual plan. Conclusions:U-Net fully convolutional network can be used to predict three-dimensional dose distribution of patients with cervical cancer undergoing brachytherapy. Combining the uterine tube with the implantation needles as the input parameters yields more accurate predictions than a single use of the ROI structure as the input.

Objective: To study a lung dose prediction method for the early stage non-small cell lung cancer (NSCLC) treated with stereotactic body radiotherapy based on machine learning algorithm, and to evaluate the feasibility of application in planning quality assurance. Methods: A machine learning algorithm was utilized to achieve DVH prediction. First, an expert plan dataset with 125 cases was built, and the geometric features of ROI, beam angle and dose-volume histogram(DVH) parameters in the dataset were extracted. Following a correlation model was established between the features and DVHs. Second, the geometric and beam features from 10 cases outside the training pool were extracted, and the model was adopted to predict the achievable DVHs values of the lung. The predicted DVHs values were compared with the actual planned results. Results: The mean squared errors of external validation for the 10 cases in mean lung dose (MLD)MLD and V₂₀ of the lung were 91.95 cGy and 3.12%, respectively. Two cases whose lung doses were higher than the predicted values were re-planned, and the results showed that the the lung doses were reduced. Conclusion It is feasible to utilize the anatomy and beam angle features to predict the lung DVH parameters for plan evaluation and quality assurance in early stage NSCLC patients treated with stereotactic body radiotherapy