A case of Mycoplasma pneumoniae (MP) pleural effusion in the Department of Pediatrics, the Second Hospital of Tianjin Medical University at May 2019 was analyzed retrospectively.The female child was 12 years old, with abdominal pain as the onset of symptoms, accompanied by fever." Gastrointestinal tract infection" symptomatic treatment did not relieve it.Before being admitted to the hospital for dyspnea, combined with physical examination, imaging studies revealed pleural effusion.Laboratory tests supported MP infection, and the course of the disease always lacked obvious manifestations of pulmonary infection.The combination of Azithromycin and Meloxicillin/Sulbactam anti-infective treatment was ineffective, and the temperature was stable after changing to oral Moxifloxacin, and the pleural effusion was rapidly absorbed after oral glucocorticosteroids, without recurrence after 6 months of follow-up. It is suggested that MP infection in children can lead to pleurisy and unilateral pleural effusion, which can have abdominal pain and fever as the main symptoms, and can be changed to quinolones according to individual condition when conventional macrolides are resistant.

Humans ; Medicine, Chinese Traditional ; Nephrotic Syndrome ; diagnosis ; therapy

Objective:To enhance the ability of organizing, commanding, decision-making and contingency-meeting of campaign medical support commanding officers so as to qualify them for their positions by simulation training. Methods: Based on the decision support theory, modern medical support theory, health service optimized decision support system and medical support command simulation training system, we designed and constructed a simulation training platform for medical support decision optimization. Results: A network-based simulation training platform was successfully constructed, which gives a strong support to the simulation training in medical support decision optimization under the network circumstance. Conclusion: The application of the simulation training platform has enriched the content and renewed the pattern of training in decision optimization for campaign medical support commanding officers.

Factor Analysis, Statistical ; Health Policy ; Leadership ; Occupational Health Services ; organization & administration

Objective To explore the characteristics of sleep disturbance and its related factors in patients with rheumatoid arthritis (RA).Methods A total of 71 patients with RA in Department of Rheumatology Huaxi Hospital have completed the following questionnaires, including Pittsburgh sleeping quality index (PSQI), visual analogue scale (VAS), disease activity score in 28 joints (DAS28), health assessment questionnaire (HAQ), hospital anxiety and depression scale (HADS), fatigue severity scale (FSS) and a self-designed general status questionnaire.Results The prevalence of sleep disturbance was 42.3％ (30/71) in rheumatoid arthritis patients (68.4％).The scores of DAS28, VAS, PSQI, HAQ, FSS and HADS in patients with sleep disturbance were significantly higher than those in patients with good sleep, which were respectively 3.90 ± 1.12 vs 2.92 ± 1.92, (5.03 ± 2.63) scores vs (2.41 ± 1.84) scores, (10.87 ± 2.42) scores vs (4.29 ± 1.85) scores, 3.0 (0.0, 7.0) scores vs 2.0 (0.5,4.0) scores, (39.17 ±14.02) scores vs (29.63 ± 16.12) scores, (14.50 ±7.77) scores vs (9.49 ±6.57) scores (P ＜ 0.05 in all scales).According to the results of Pearson correlation analysis, PSQI had significantly positive correlation with DAS28 (r =0.462, P ＜ 0.01), VAS (r =0.556, P ＜ 0.01), HAQ (r =0.360, P ＜ 0.01), FSS(r =0.420, P ＜ 0.01) and HADS (r =0.447, P ＜ 0.01) respectively.The logistic regression analysis indicated that VAS was a predictor for poor sleep quality (P ＜ 0.01).The patients receiving biological agents had significantly (P ＜ 0.05) lower scores of DAS28 (2.86±1.39 vs 3.52 ± 1.1 0), PSQI [(5.90 ± 4.24) scores vs (8.53 ± 3.78) scores], VAS(2.15 ± 2.30 vs 4.05 ± 2.46), HAQ [0.0 (0.0, 2.0) scores vs 3.0(0.0,6.0) scores] compared to those taking oral drugs.Conclusion High prevalence of sleep disturbance in patients with RA is noted, which indirectly influences the activity of disease, quality of life, depression, fatigue and other physical and mental health.Biological agents can partly improve the sleep disturbance and functional status.

[Abstract ] Enhanced recovery after surgery (ERAS) is a kind of multi-discipline technology which is based on evidence-based medicine and aims to optimize the current peri-operative management, reduce the stress and complications during the periopera-tive period and enhance recovery aftery surgery.The introduction and successful practice and generalization of ERAS promote the trans-formation of medical quality management thought, innovation of the clinical technologies and patients'rehabilitation process.In the era of ERAS, we should make efforts to promote the medical quality management by fully using new technologies from the aspects of impro-ving the understanding, strengthening team work and optimizaing information support.

Objective To investigate the effects of long term exposure of 18F-FDG-PET/CT X-rays on rabbit immune system.Methods The rabbits were irradiated with 18F-FDG-PET/CT every day and this irradiation treatment continued for 3 months.At each month,the total number of white blood cells,thymus index and spleen index,phagocytic index,immune globulins,TNF-α and IL-1 in peripheral blood and serum were detected.Results After long-term 18F-FDG-PET/CT irradiation,the total number of white blood cells increased,the thymus and spleen index decreased (t =3.144-72.903,P ＜ 0.05),the phagocytic index and phagocytic percentage decreased after 1 or 2 months(t =2.719-11.859,P ＜ 0.05),and the number of immune cells marked with CD4 + increased but CD8 + decreased(t =6.433-29.877,P ＜ 0.05).In addition,the level of immune globulin in the serum decreased,but the expressions of TNF-α and IL-1β increased (t =2.720-28.775,P ＜ 0.05).Conclusions 18F-FDG-PET/CT has some damage effects on the immune system of male Japanese big ear rabbit,suggesting that the negative effects of PET-CT should be paid close attention to during clinical application.

Objective To investigate the regulatory effect of insulin-like growth factor binding protein 7 (IGFBP7) on the synthesis and secretion of fibronection and the inhibiting effect of anti-IGFBP7 antibody on apop-tosis of hepatic stellate cell-T6 (HSC-T6). Methods HSC-T6 cultured in vitro were divided into blank control group, IGFBP7 20 μg/L group, anti-IGFBP7 antibody 0.25 mg/L group, anti-IGFBP7 antibody 0.50 mg/L group and anti-IGFBP7 antibody 1.00 mg/L group. HSC-T6 were treated by IGFBP7 for 24 hours, then the expression of fibronectin was detected by Western blot and the content of fibronectin by ELISA. After incubating HSC-T6 with anti-IGFBP7 antibody for 14 hours, the inhibiting effect of anti-IGFBP7 antibody on HST-T6 was evaluated by MTT assay, and the effect of anti-IGFBP7 on the apoptosis of HST-T6 was detected by flow cytometry. All data were analyzed by one-way ANOVA, t test and SNK-q test. Results The content and expression of fibronection in IGFBP7 20 mg/L group were significantly higher than those in the blank control group (t = 22.06, 7.43, P < 0.05). Anti-IGFBP7 antibody had an obvious inhibiting effect on the proliferation of HSC-T6 (F=14. 70, P < 0.05), and it also enhanced the ratio of apoptosis of HSC-T6 (F = 63.79, P < 0.05). Conclusions IGFBP7 can increase the synthesis and secretion of fibronectin which is the principal component of extracellular matrix. Anti-IGFBP7 antibody can inhibit the proliferation and promote the apoptosis of HSC-T6.

Objective To explore the procedures of breast repair and reconstruction after mastectomy with three methods for optimal appearances of the breast.Methods Three methods were adopted in this study:(1)Two-stage breast reconstruction operation with ampliate latissimus dorsi myocutaneous flap after mastectomy;(2)One stage breast reconstruction operation with transverse rectus adbominis myocutaneous(TRAM)flap after mastectomy;and(3)Two-stage breast reconstruction and nipple repair operation with tissue expander/implant after mastectomy preserving pectoralis major museulus or implants along under pectoralis major musculus.Results All of the flaps survived well and were well-shaped in total 10 patients(10 breasts)with a flap breast reconstruetion,in which the superior ratios were 83.33%.The appearance and volume were not satisfactory in 1 patiant treated with the method of tissue expander/implant,because the volume of tissue inflation was smaller than another one and 100 ml implant was applied.The partial flap necrosis occurred in 1 case with the method of TRAM flap.Conclusions With the development of plastic surgery technique,the appearances and shapes of reconstructed breast achieve the satisfactory effects.After the ampliate latissimus dorsi myocutaneous flap is applied,the appearance and volume of reconstructed breast are similar to the healthy one.The two-stage nipple repair operation is applied with breast reconstruction operation by the tissue expander/implant after mastectomy preserving pectoralis major musculus.According to the different methods of mastectomy to choose suitable procedures of breast reconstruction,the satisfactory appearances and psychotherapy will be achieved.

Objective To summarize the clinical experience of fat granule injection for auto-trans-plantation in the treatment of concave temporal area. Methods The fat granule was extracted with injec-tor and injected into temporal area after washing and purging, but it might be necessany for patient to be injected extra 20 % fat autograft due to his absorptive effect. Results Satisfactory results were obtained in all patients. Transplantation was carried out one time in 139 cases, two times in 9 cases, and three times in 4 cases. 6 - 28 ml fat granule was injected in one site at each time. Conclusion Fat granule injec-tion for auto-transplantation is a safe and ideal method to treat concave temporal area.