Objective To evaluate the value of polymerase chain reaction (PCR) combined with probe detection method in diagnosis of Mycoplasma pneumonia (MP) pneumonia (MPP) in children and to analyze the factors influencing the diagnostic accuracy,and to identify the rate of MP mutation for drug resistance and the involving factors.Methods Two hundred and twenty-five children with MPP hospitalized in the Department of Respiratory Medicine,Beijing Children's Hospital,Capital Medical University between June 2015 and March 2016 were enrolled in this study.Nasopharyngeal swab samples from the participants within 24 hours of admission were detected by using PCR combined with fluorescence probes for MP-DNA and macrolide-resistant mutations.The information of age,sex,clinical symptoms,course of disease,duration by admission,the history of macrolide treatment and the increase or decrease of quadruple or more serum MP antibody titer were extracted from medical records within 4 weeks of treatment,which received further correlation analysis with the detection rate of MP-DNA and the drug resistance mutation.Results The sensitivity of the MPP by using the method of PCR combined with fluorescence probes was 80.4％ (181/225 cases),while the specificity was 98.0％ (99/101 cases).The MP-DNA positive rate for patients with double MP antibody 4 times increased during treatment was 88.8％ (71/80 cases),which was significantly higher than that of patients with antibody titer ≥1 ∶ 160 [75.9％ (110/145 cases)],and the difference was sigmficant(x =5.443,P =0.020).The positive rate of MP-DNA of patients had no obvious association with gender,age,and disease duration and macrolide treatment history before admission.Macrolide-resistant mutation rate of MP-DNA was 85.1％ (154/181 cases),macrolide-resistant mutation rate of MP for patients finishing one course of macrolide treatment when admission(89.6％)was higher than that of the patients without using macrolide and the patients treated with macrolide but not finishing one course of treatment (71.9％ and 86.6％),and the significant difference among the three groups was observed(x2 =4.454,P =0.035).Conclusions PCR combined with fluorescence probe for MP-DNA detection has a high accuracy for the diagnosis of MPP,and the overall mutation rate is high,suggesting that the clinical treatment of MPP needs to be adjusted according to drug resistance in children.

Objective: To describe the patients situation and correlation Health Empowerment ability and the quality of life of patients with coronary heart disease. Methods: A Random sampling from December 2016 to August 2017 was preformed. The patients with coronary heart disease were recruited and assessed for socio-demographic, medical data with self-made general information questionnaire, the scales of Chinese version of Patient perception of empowerment scale (PPES) and the MOS item short from health survey (SF-36). Results: The patients with coronary heart disease Healthy empowerment cognition score was (45.17±5.72) and the Healthy empowerment cognition was positively correlated with Quality of life (r=0.109-0.371, P<0.05). Conclusion The Healthy empowerment cognition and Quality of life of mild-to- moderate generally in patients with coronary heart disease. It is suggested that improving the healthy empowerment ability of patients with coronary heart disease can indirectly improve the quality of life of the patients.

Objective To assess the characteristic of normal tension glaucoma (NTG) patients with mild cogni?tive impairment (MCI). Methods This study included twenty-six cases of normal tension glaucoma patients who were diagnosed at ophthalmology department of Peking University Third Hospital. All the participants were examined by us?ing the scales of Montreal Cognitive Assessment (MoCA), mini-mental state examination(MMSE), clinical dementia rat?ing (CDR), activities of daily living (ADL), Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), Pitts?burgh Sleep Quality Index (PSQI) and polysomnography (PSG). The patients were then divided into Group with MCI (16 cases) and Group without MCI (19 cases). Results There was no difference between the two groups in gender, age, edu?cation, depression, anxiety and body mass index (BMI) (P>0.05), but significant difference in MoCA scores (P<0.05). The incidence rate of sleep disorder of PSQI in was 28.6%(10/35 patients) of total NTG patients, 43.8%(7/16 patients) in Group with MCI, and 15.8% (3/19 patients) in Group without MCI, respectively. The PSQI score was higher in Group with MCI than in Group without MCI (P<0.05). Sleep efficiency was higher in Group without MCI than in Group with MCI (P<0.05), but no difference was found between the two groups in six other indexes of PSQI (P>0.05). The in?cidence rate of sleep structure disorder of PSG in all the NTG patients was 85.7%(30/35 patients), 87.5%(14/16 pa?tients) in Group with MCI, and 84.2%(16/19 patients) in Group without MCI. Sleep time of NREM-N3 was significant?ly shorter in Group with MCI than in Group without MCI (P<0.05), but no difference was found between those groups in total sleep time, sleep efficiency, sleep latency and REM time (P>0.05). Conclusion NTG patients with mild cogni?tive impairment are more prone to sleep disorders, especially sleep structure disturbance and short NREM-N3 time may affect cognitive function.

Objective To study the use of preoperative indocyanine green retention test at 15 minutes (ICG R15) in the prediction of liver functional reserve in patients with hilar cholangiocarcinoma (HCCA).Methods The clinical data of 62 patients with HCCA treated in our department from March 2016 to March 2018 was reviewed.The relationship between preoperative ICG R15 and postoperative hepatic insufficiency was analyzed.The relationship between preoperative ICG R15 and Child-Pugh scoring was also studied.Univariate analysis was used to evaluate the risk factors of postoperative liver dysfunction.Logistic regression was used to assess the independent risk factors of postoperative liver dysfunction.The regression equation between independent risk factors and postoperative liver dysfunction was established.Results Among the 62 patients,ICG R15 was less than 10.0％ in 26 patients,between 10.0％ and 19.0％ in 17 patients,between 20.0％ and 29.0％ in 9 patients,between 30.0％ and 39.0％ in 5 patients,and over 40.0％ in 5 patients.There were 29 patients with a Child-Pugh A grading and 33 patients with a Child-Pugh B grading in the preoperative evaluation of liver function.The Wilcoxon W rank sum test was used to compare the preoperative ICG R15 in patients with Child-Pugh grading A and B separately.The ICG R15 in Child-Pugh grading A patients was significantly lower than those in Child-Pugh B grading patients (P ＜0.05).There were no significant differences in age,gender,history of previous liver diseases,duration of operation,and intraoperative blood loss (P ＞ 0.05) between the normal liver function group and the liver dysfunction group.However,there was a significant difference in the preoperative ICG R15 and preoperative bilirubin levels (P ＜ 0.05) between the two groups.The preoperative ICG R15 and preoperative bilirubin levels were significant risk factors of postoperative hepatic insufficiency.Regression analysis suggested that preoperative ICG R15 level was an independent risk factor of postoperative hepatic insufficiency (P ＜ 0.05).A regression equation:logit(P) =0.185 × preoperative ICG R15-3.152 could be constructed.Conclusions ICG R15 is an ideal clinical indicator for evaluation of preoperative liver functional reserve in patients with HCCA.It predicted the recovery of postoperative liver function.

Tuberculosis (TB) is a serious threat to children′s health.The world health organization (WHO) reported that there were almost 1 million TB patients and 230 000 deaths among children globally in 2017.In order to control the prevalence of childhood TB, WHO put forward a blueprint of " towards zero death for childhood TB" . However, due to the difficulty in obtaining specimens, the lack of typical symptoms and the insufficient of existing diagnostic methods for children, it is hard to achieve the goal of zero death.The summary of the TB diagnosis status will promote to solve the current problems in children.

Tuberculosis(TB) is a serious threat to children′s health.The World Health Organization reported that there were almost 10 million new TB cases(including 1.12 million pediatric patients) and 1 240 000 deaths(173 000 were children) globally in 2018." Find.Treat.All.#End TB" points out that an effective vaccination is the most effective method for the control of infectious diseases.It is difficult to diagnose TB in children in the early stage due to atypical clinical symptoms of TB, leading to treatment delay.Therefore, vaccination is essential for the prevention of pediatric TB.However, the problems of limited immune duration, unclear protective effect and increasing the risk of BCG disease existing in Bacillus Calmette-Guerin(BCG), the only TB vaccine widely used in the world, necessitate the development of new vaccines.The progress in and challenges of research on TB vaccines were reviewed in this article, which helps provide reference for the development of new vaccines and seeking solutions of above problems.

Objective:To investigate epidemiological characteristics and macrolide-resistance of hospitalized children with Mycoplasma pneumoniae (MP) infections in Beijing from 2016 to 2019, so as to provide basis for the prevention and treatment of pediatric Mycoplasma pneumoniae pneumonia (MPP).Methods:The clinical data were analyzed retrospectively from 8 691 children hospitalized with community acquired pneumonia in Beijing Children′s Hospital between January 2016 and September 2019.MP RNA was detected by simultaneous amplification and testing (SAT), and macrolide resistance of MP was examined by MP and macrolide-resistant isolate diagnostic kit (PCR with fluorescence probes). Chi- square test was used for categorical analysis. Results:Among 8 691 cases detected by SAT, the overall detection rate of MP was 28.10% (2 442/8 691 cases). The detection rates of MP from 2016 to 2019 were 26.23%, 31.36%, 27.84 % and 26.57%, respectively.The detection rate of MP in 2017 was significantly higher than that in other years ( χ2=16.11, P<0.05). The detection rate of MP in females was 29.65%(1 107/3 733 cases), which was evidently higher than that in males 26.93%(1 335/4 958 cases) ( χ2=7.85, P<0.05). The positive rates of MP in summer[32.21% (726/2 254 cases)] and autumn[39.76%(852/2 143 cases)] were significantly higher than those in spring[17.00% (327/1 924 cases)] and winter[22.66%(537/2 370 cases)] ( χ2=315.15, P<0.001). The percentages of MP were 35.06%(732/2 088 cases) in preschoolers and 37.71%(1 160/3 076 cases) in school-age children, which were significantly higher than 11.20%(232/2 072 cases) in infants and 22.01% (318/1 445 cases) in toddlers ( χ2=509.89, P<0.001). Macrolide resistance detection was conducted in 1 524 patients by fluorescent PCR.Among them, 1 386 patients were positive for drug resistance, and the positive rate was 90.94%.The prevalence of macrolide-resistant MP from 2016 to 2019 were 88.19%, 90.93%, 90.56% and 92.90%, respectively.Macrolide-resistant rates were not related with gender, age and season. Conclusions:MP can be detected in all seasons, but most prevalently in summer and autumn.Girls are more prone to MP infections than boys.The detection rate of MP increases with age, and the positive rate is higher in preschoolers and school-age children.During the 4-year study period, the drug resistant rate of MP remain high.