Objective To observe the differences in the therapeutic efficacies of macrolides,minocycline,and tosufloxacin against macrolide-resistant Mycoplasma pneumoniae(MRMP).Methods A total of 188 children with M.pneumoniae pneumonia confirmed by culture and PCR were analyzed.Of these,150 patients had a strain with an MR gene and 134 had one with an A-to-G mutation at position 2063 of M.pneumoniae 23S rRNA domain V.Azithromycin(n=27),clarithromycin(n=23),tosufloxacin(n=62),or minocycline(n=38)was used for definitive treatment of patients with MR M.pneumoniae.Among the 188 patients,the other 38 patients with macrolide-sensitive Mycoplasma pneumonia (MSMP)were grouped into azithromycin(n =16)and clarithromycin groups(n =22)for observing whether there is differences with respect to efficacy under parallel treatment between patients with MRMP and MSMP. Results Defervescence within 48 h after the initiation of antibiotic therapy was observed in 41%of the patients in the azithromycin group,48% of those in the clarithromycin group,69% of those in the tosufloxacin group,and 87% of those in the minocycline group.The average number of days of fever after the administration of antibiotic treatment was lower in the minocycline and tosufloxacin groups than in the macrolide groups(azithromycin and clarithromycin groups).The decrease in the M.pneumoniae burden,as estimated by the number of DNA copies,after 48 to 96 h of treatment was more rapid in patients receiving minocycline(P=0.016)than in those receiving tosufloxacin(P=0.049),azithromycin(P=0.273),or clarithromycin(P=0.107).Conclusion We found that the clinical and bacteriological efficacies of macrolides against MR M.pneumoniae pneumonia was low.Our results indicated that minocycline rather than tosufloxacin can be considered the first-choice drug for the treatment of M.pneumoniae pneumonia in children aged >8 years.

Objective To analyze the serological detection results of hemolytic disease of newborns(HDN)in neonatal hyperbil-irubinemia and to explore the relationship between serological results and related factors.Methods The neonatal hemolytic three i-tems test were performed on blood specimens of 796 cases of neonatal hyperbilirubinemia.The relationship between the positive rate of HDN with the related factors such as blood type,specimens collecting time,hemoglobin level and serum total bilirubin value was analyzed.Results Among 796 cases of hyperbilirubinemia,184 cases were HDN(23.12%),in which 796 cases were ABO-HDN and 8 cases were Rh-HDN.The direct free antibody test,antibody release test and direct antiglobulin test were positive in 180 cases (22.61%),184 cases(23.12%)and 140 cases(17.59%)respectively.The HDN positive rate of the newborns with B blood type was higher than that of the newborns with A blood type,the difference between them had statistical significance(χ2 = 10.304,P <0.05).The HDN positive rate was closely related with the specimen collection time,moreover,the greater the day age,the higher the HDN positive rate,the difference showing statistical significance(P <0.05).The hemoglobin level and serum total bilirubin val-ue had statistically significant difference between newborns with HDN and those without HDN(P <0.05).Conclusion The posi-tive rate of HDN is high in newborns with hyperbilirubinemia.The hemolytic three items test should be performed as early as possi-ble.Combining with the hemoglobin level and serum total bilirubin value can increase the HDN detection rate.

Objective To assess the prevalence and risk factors associated with clopidogrel resistance in patients with acute myocardial infarction after primary PCI(percutaneous coronary intervention). Methods Using a retrospective case?control study,210 patients with acute myocardial in?farction who underwent primary PCI in the first hospital affiliated to China Medical University between October 2013 and September 2014 were re?viewed. Patients were divided into the normal group and the resistance group according to the platelet aggregation rate(PAR),and the incidence of clopidogrel resistance was calculated and the correlation between age,gender,smoking,alcohol drinking,blood pressure,blood lipid,glycosylated hemoglobin,and the clopidogrel resistance were analyzed. Results The incidence of clopidogrel resistance in patients underwent primary PCI was 36.67%. Platelet aggregation rates were 62.62 ± 9.23%and 32.71 ± 11.77%respectively in two groups(P<0.001). Multivariate logistic regression analysis found that clopidogrel resistance was positively correlated to high level of glycosylated hemoglobin(P=0.037,OR 1.241,95%CI 1.013?1.519). Conclusion High level of glycosylated hemoglobin was the independent risk factor of clopidogrel resistance. The risk of clopidogrel resis?tance will significantly increase in these diabetic patients who cannot control blood sugar well.

Objective To investigate the growth, development and health management of children with type 1 diabetes, and to provide guidance for the treatment of children with type 1 diabetes. Methods From June 2018 to June 2021, 86 children with type 1 diabetes diagnosed and treated in the Department of Endocrinology of our hospital from January 2000 to December 2002 were selected, including 41 males and 45 females, the onset age of 6-9 years old, all of whom were followed up by telephone. Height, weight, age of onset of youth, age of menarche, blood glucose control and complications were recorded and analyzed from onset to adulthood. Results The initial height of children were lower than those of children of the same age (P<0.05), and there was no difference in height between children of the same age and children of the same age when they reached lifetime height (P>0.05).The median age of initiation of puberty in boys was (12.10±1.50) years later than that in the general population (P<0.05), and the median age of initiation of puberty and menarche in girls were (11.20±1.40) years and (14.90±2.10) years later than that in the general population (P<0.05). 11.63% (10/86) of children HbAl-c <7.0%, 30.23% (26/86) in children with HbAl-c is 7.00% -8.00%, 58.14% (50/86) in children with HbAl-c > 8.0%. There were 1 (1.16%) cases of retinopathy and 4 (4.65%) cases of microalbuminuria. 84 cases (97.67%) were monitored for blood glucose or urine glucose, and only 2 cases were not monitored. Conclusion Due to poor self-control and growth, the blood glucose control of children with type 1 diabetes is often not ideal. Although complications are rare, most blood glucose control is not ideal and blood glucose detection is not enough. Therefore, It is necessary to strengthen the publicity and education of diabetes and regularly monitor blood glucose.