Objective To investigate the clinical characteristics of children with refractory Mycoplasma pneumoniae pneumonia (RMPP),and to analyze the related risk factors. Methods Clinical manifestations,laboratory indexes and image features of 628 children with Mycoplasma pneumoniae pneumonia (MPP) from January 2012 to October 2016 were retrospectively analyzed, and stepwise logistic regression analysis was performed for risk factors of RMPP. ROC curve was mapped to analyze the predictive value of independent risk factors in RMPP. Results Compared with 486 cases of general Mycoplasma pneumoniae pneumonia (GMPP), 142 cases of refractory MPP was older, and durations of fever and hospitalization, azithromycin treatment days were longer, pulmonary complications, lesions in the right lobe and right upper lobe, pleural effusion, lobar atelectasis, pulmonary consolidations, and pleural thickening ratio were higher, the percentage of neutrophil, CRP, LDH, CK-MB, IL-6, IL-10, IFN-γ and IgA levels were also higher (all P<0.05). Stepwise logistic regression analysis showed that CRP, LDH, IL-6, IL-10, IFN-γ were the independent risk factors of RMPP. ROC curve analysis showed that CRP, LDH, IL-6, IL-10 and IFN-γ has a good value for identification of children with RMPP and GMPP, the best threshold value of 15.3 mg/L, 402 IU/L, 13.82 pg/mL, 5.07 pg/mL, and 13.84 pg/mL, respectively. Conclusions The clinical symptoms and imaging findings of the lung are severer,and the levels of serum CRP, LDH, IL-6, IL-10, and IFN-γ are significantly increased, which is helpful for the early identification of RMPP.

ObjectiveTo investigate the clinical effect of pendulum and straight wire technology in patients with fully erupted second molar.MethodsPatients with Angle class Ⅱ malocclusion were chosen.Control group included patients without erupted second molar.Experimental group included patients with completely erupted second molar.Pendulums were used in two groups to distalize maxillary molars.Then straight wire orthodontic treatment had been performed until treatment was over.Cephalograms of each stage were analyzed.ResultsIn the experimental group,mesiobuccal cusp of first molar was distalized for 4.62 mm,geometric center was distalized for 3.75 mm,about 81 percent of the movement of mesiobuccal cusp.In control group,mesiobuccal cusp of first molar was dis talized for 5.78 mm,geometric center was distalized for 3.20 mm,about 55 percent of the movement of mesiobuccal cusp.It turned out first molar was distalized in both groups,but more rotation took place in control group than that in the experimental group.ConclusionsPendulum can distalize maxillary first and second molars in patients with completely erupted second molar.The pendulum and straight wire technology can treat these patients successfully.

Objective To study the clinical effect of orthopedic-orthodontic treatment in crossbite in deciduous dentition through cephalmetric analysis. Methods 12 children with crossbite in deciduous dentition were enrolled in treatment group. Control group included 8 patients with normal deciduous dentition. Modified reverse headgear was used in each patient in the treatment group. Orthodontic force was a-bout 2. 94-4. 90 N (300-500 g) , and the direction of force was under occlusion plane for 37 degree. Each patient wore reverse headgear for 10 hour per day. Orthodontic treatment lasted for 6 months, and then orthodontic treatment began at once. Orthodontic treatment was not over until crossbite was corrected. The cephalmetric change was compared between two groups before treatment (T1) , after orthopedic treatment (T2)and after orthodontic treatment (T3). The effect of orthopedic-orthodontic treatment was analyzed in two group. Results Crossbite was corrected successfully in all patients in the treatment group. After treatment, A point moved forward by 2. 8mm, Is-FHp increased 8. 38 mm, ＜SNA increased 2. 65, incisors in mandible moved backward a little bit. All these changes were statistical different as compared with those in the control group. Conclusion Skeletal and dental deformity are improved progressively after combined orthopedic-orthodontic treatment. It is recommended to perform orthopedic-orthodontic therapy in skeletal crossbite in deciduous dentition.

OBJECTIVETo Verify the safety and reliability of one-stage repair of complete cleft Lip and palate in infancy and to obtain the primary result.

METHODSThe simultaneous repair of complete cleft Lip and palate in infants 3 to 12 months of age were performed in 271 cases. The deformities include 185 cases of typical complete unilateral clefts and 75 cases of complete bilateral clefts, and other 11 atypical cleft infants. The preoperative orthopedic treatment for wide alveolar cleft was undertaken in 24 infants and the lip appearance and speech outcome were evaluated in 116 children by 1 to 4 years' postoperative follow-up.

RESULTSAll infants, except for dyspnea in 2 babies, palatal fistula formation in 6 cases and temporary wound hemorrhage in 5 infants, were recovered without complications. After orthopedic treatment, the width of the alveolar cleft was reduced 6.1 mm in average. The evaluation showed that 93.1% of children had got good or excellent lip appearance. And the acceptable or excellent speech was found in 94.8% children.

CONCLUSIONSSimultaneous repair of complete cleft lip and palate in infancy is safety and reliable. The preoperative orthopedic procedure is able to reduce the wide alveolar cleft and to achieve alignment of alveolar segments. The acceptable and or excellent lip appearance and speech function could be obtained in this one-stage operative procedure in infants.

Cleft Lip ; surgery ; Cleft Palate ; surgery ; Female ; Humans ; Infant ; Male ; Treatment Outcome

Objective:To investigate the prognostic value and related factors of heart-type fatty acid binding protein (H-FABP) in patients with heart failure.Methods:A total of 877 consecutive patients who were admitted to heart failure care unit of Fuwai hospital and diagnosed as heart failure from July 2015 to July 2017 were enrolled in this study. Baseline serum H-FABP concentration was measured by fluorescence lateral flow immunoassay. According to serum H-FABP levels, patients were divided into three groups: low H-FABP group (H-FABP≤4.04 ng/ml, n=292), middle H-FABP group (H-FABP 4.04-7.02 ng/ml, n=292) and high H-FABP group (H-FABP≥7.02 ng/ml, n=293). The general clinical characteristics were collected and compared among the three groups. According to whether heart failure was caused by coronary artery disease or not, patients with heart failure were divided into ischemic heart failure and non-ischemic heart failure. Multivariate linear regression analysis was performed to explore the independent risk factors of H-FABP. The primary endpoint events were the composite of all-cause death or heart transplantation. Multivariate Cox regression analyses, receiver operating characteristic (ROC) curves, risk prediction tests with multivariate Cox regression model and Kaplan-Meier analyses were conducted to investigate the relationship between H-FABP and the prognosis of heart failure. Results:Multivariate linear regression analysis showed that age, coronary artery disease, alanine aminotransferase, uric acid and N-terminal pro-B type natriuretic peptide (NT-proBNP) were positively associated with H-FABP (β=0.012, 0.238, 0.001, 0.345 and 0.063 respectively,all P<0.05), while female, hemoglobin, albumin, sodium, and estimated glomerular filtration rate (eGFR) were negatively associated with H-FABP (β=-0.184, -0.006, -0.016, -0.034 and -0.006 respectively, all P<0.05). One hundred and nineteen patients (13.6%) lost to follow-up, and 246 patients (32.5%) suffered from all-cause death or heart transplantation during the median follow-up duration of 931 (412-1 185) days. Multivariate Cox regression analysis showed that baseline H-FABP (log 2H-FABP) level was the independent predictor of all-cause death or heart transplantation in patients with heart failure ( HR=1.39, P<0.001). ROC curves showed that baseline H-FABP was a predictor of all-cause death or heart transplantation in patients with heart failure within 3 months, 1 year and 2 years (areas under the curves were 0.69, 0.69 and 0.71 respectively), and the best cut-off values were 5.85 ng/ml, 6.54 ng/ml and 6.54 ng/ml respectively. Risk prediction test with multivariate Cox regression model showed that baseline H-FABP could provide additional prognostic value in predicting all-cause death or heart transplantation for patients with heart failure on top of basic model and baseline NT-proBNP ( P<0.001). Taking 6.54 ng/ml and trisected levels of H-FABP as cut-off values respectively, Kaplan-Meier analyses showed that the survival rates were significantly different among the two or three groups ( P<0.001). Subgroup analyses showed that baseline H-FABP (log 2H-FABP) level was an independent predictor of all-cause death or heart transplantation in patients with ischemic heart failure ( HR=1.74, P<0.001), as well as in patients with non-ischemic heart failure ( HR=1.28, P=0.027). Conclusions:Age, sex, coronary artery disease, hemoglobin, albumin, alanine aminotransferase, sodium, eGFR, uric acid and NT-proBNP are associated with H-FABP level. Baseline H-FABP level is an independent predictor of all-cause death or heart transplantation in patients with heart failure. On top of basic model and baseline NT-proBNP, baseline H-FABP could provide additional prognostic value in predicting adverse events for patients with heart failure.

Nucleic acid aptamer is an oligonucleotide sequence screened by the exponential enrichment ligand system evolution technology (SELEX). Previous studies have shown that nucleic acid aptamer has a good application prospect in tumor diagnosis and treatment. Therefore, we reviewed the selection and identification of nucleic acid aptamer of lung cancer cells in recent years, and discussed the effect of aptamer as targeting drugs and targeting vectors on the diagnosis of tumors, which provide a new idea for early diagnosis and treatment of tumor.