Abstract: Objective To explore the risk factors for macrolide unresponsive mycoplasma pneumoniae pneumonia (MUMPP) in children and to develop a model for predicting the risk of MUMPP. Methods Children with mycoplasma pneumoniae pneumonia admitted to the Pediatric Department of Leshan People's Hospital who met the inclusion criteria from March 1, 2023, to December 1, 2023, were retrospectively selected and divided into the responsive group and unresponsive group according to their reactions to macrolides. General patient data, laboratory tests, and imaging findings were collected and compared. Logistic regression analysis was used to analyze the risk factors of the Macrolide unresponsive mycoplasma pneumoniae pneumonia, and R language (R4.2.3) to establish the nomogram model. The goodness of fit, discriminative ability, calibration, and clinical utility of the model were assessed using the Hosmer-Lemeshow goodness of fit test, receiver operating characteristic (ROC) curve analysis, calibration curve analysis, and decision curve analysis, respectively. Results A total of 224 patients were included in the analysis of children. Among them, 156 (70%) were randomly selected as the training set, and the remaining 68 cases (30%) were used as the validation set. Logistic regression analysis revealed that pleural effusion (OR=6.986, 95%CI 1.362-35.847), highest temperature before admission (OR=3.095, 95%CI 1.487-6.439), neutrophil count (OR=1.294, 95%CI:1.103-1.519), C-reactive protein (OR=1.030, 95%CI 1.002-1.058), and procalcitonin (OR=2.899, 95%CI:1.353-6.214) were independent risk factors for MUMPP in children (all P<0.05). A nomogram was established using R software. The Hosmer-Lemeshow goodness of fit tests for the training set and the validation set were χ2=4.018 and χ2=4.657 (all P>0.05), indicating a good fit of the model. The AUC values for the training set and validation were 0.825 (95%CI: 0.755-0.894) and 0.828 (95%CI 0.729-0.928), respectively, suggesting good discriminative ability of the model. Calibration curve analysis suggested that the model had good predictive performance, while decision curve analysis indicated a high clinical application value of the predictive model. Conclusions Pleural effusion, highest body temperature before admission, neutrophil count, C-reactive protein, and procalcitonin are independent risk factors for MUMPP in children. The prediction model constructed based on the above variables has high predictive efficacy and clinical application value.

BACKGROUND: Common complication of traditional joint replacement is hip joint dislocation and large head joint implant can effectively solve this problem. OBJECTIVE: To investigate the preliminary efficacy of large head metal-on-metal implants for patients undergoing total hip arthroplasty. DESIGN, TIME AND SETTING: Prospective cohort study. The patients were selected from Department of Joint Surgery, Xinjiang Hospital of Traditional Chinese Medicine between February 2007 and January 2008. PARTICIPANTS: A total of 65 patients (71 hips) undergoing large head metal-on-metal implantation in Xinjiang Hospital of Traditional Chinese Medicine were selected, including 21 females and 44 males with an average age of 54.6 years (ranging 19 to 77 years). Of them, there were 28 cases of necrosis of the femoral head, 24 of hip osteoarthritis, 9 of femoral neck fracture and 4 of acetabular dysplasia. METHODS: According to age, sex, cause of disease and preoperative joint function, the patients were divided into traditional prosthesis (n=30, 33 hips, metal-on-polyethylene implant) and large head M-O-M group (n=35, 38 hips, ASR/XL prosthesis, DePuy, Motech, Warsaw, IN, USA). MAIN OUTCOME MEASURES: The pre and postoperative Harris scores for the hip, range of motion, periprosthetic radiolucency, leg-length inequality and complications were recorded and compared. RESULTS: All patients were followed-up. The traditional group was followed up for 20 months (ranging 13-28 months), and the large head M-O-M group was followed up for 17 months (ranging 10-26 months). The mean Harris score was 89 points (ranging 59-98) in traditional group, and 94 points (ranging 71-100) in large head M-O-M group (P=0.014). The range of motion of hip was improved, and the large head M-O-M group (34?) was superior to traditional group (26?, P=0.004) at 6 months after surgery; the range of motion was improved 27? in traditional group and 37? in large head M-O-M group (P=0.009) over 1 year of follow up. The leg-length inequality was 4 mm (2-11 mm) in large head M-O-M group and 7 mm (5-16 mm) in traditional group (P=0.005). Both groups exhibited periprosthetic radiolucency (≤1 mm, 2 cases in traditional group and 3 cases in large head M-O-M group). One patient in the traditional group suffered dislocation. CONCLUSION: The large head M-on-M implants in total hip arthroplasty has excellent short-term effects on patients compared with traditional prosthesis. They offer the more stability and better restoration of hip articulation function and biomechanical reconstruction.

Objective To investigate the pharmaeokinetics of levofloxacin in rat's pancreatic tissue. Methods Pancreatic tissue and blood were sampled in vivo by microdialysis simultaneously. The concentrations of levofloxacin in beth blood and tissues were measured by high performance liquid chromatography. All date were analyzed by WinNonlin software. Results The maximum concentration of free levofloxacin in blood and pancreatic tissue were (65.23 ± 12.9) μg/ml at 10min and (30.56±3.22) μg/ml at 20 min, respectively, then beth continuously decreased. Concentration of free levofloxacin in pancreatic tissue was higher than that in blood from 20min to 100min, then returned to similar level. The area under the concentration curve(AUC)of unbound levofloxacin was(2465.11±258.56)min·μg~(-1)·ml~(-1) in pancreas,and (2914.38±205.73)min·μg~(-1)·ml~(-1) in blood.Conclusions Microdialysis with reversed phase high performance liquid chromatography established in this essay could be used to determine the pharmacokinetics of levofloxacin objectively. High concentration of levofloxacin in pancreatic tissue and blood was observed.

Objective To analyze the expression characteristics of SRPK2 ( serine /arginine-rich protein specific kinase 2 mRNA and its encoded protein products in mouse testis, and to reveal its molecular role during spermatogenesis. Methods Using semi-quantitative reverse transcription polymerase chain reaction ( RT-PCR) and Western blotting to an-alyze the expression of SRPK2 mRNA and its protein products in several mouse tissues.The stage-specific expression pat-tern of SRPK2 mRNA in mouse testis was examined by real-time quantitative PCR.Immunohistochemical staining was ap-plied to identify the SRPK2 protein distribution in mouse testicular seminiferous tubules and indirect immunofluorescence staining was used to detect the subcellular localization of SRPK2 protein in spermatic cells.Results Semi-quantitative RT-PCR and Western blotting analysis revealed that SRPK2 was highly expressed in mice testis.Real-time quantitative PCR analysis showed that SRPK2 mRNA was expressed abundantly at the stage of 5-and 8-week old mouse testes, suggesting that SRPK2 gene has stage-specific expression patterns during mouse spermatogenesis.Immunohistochemical and indirect immu-nofluorescence staining demonstrated that SRPK2 protein was located around the surface of elongated sperm nucleus. Conclusions SRPK2 is highly expressed in mouse testis and has significant stage-specific expression characteristics with distinct nuclear localization.These results indicate that SRPK2 may participate in precursor mRNA splicing during mouse spermiogenesis.The molecular mechanism of SRPK2 is yet to be further studied.

Objective To explore the clinical application value of neutrophil gelatinase-associated lipocalin(NGAL)which were tested by immunity transmission turbidity in early kidney injury after elective percutaneous coronary intervention.Methods A case-control study was conducted.All 201 stable angina pectoris and acute coronary syndrome patients undergone percutaneous coronary intervention in TEDA International Cardiovascular Hospital,during April to August 2013,were enrolled in this study.Before and 2 h,4 h,8 h,24 h,48 h after the operation,the plasma creatinine of the patient samples were tested by enzymic method.Before and 2 h,4 h,8 h,24 h after the operation,the plasma NGAL was tested by immunity transmission turbidity method.Before and 8 h,24 h after the operation,the urinary NGAL was tested by immunoturdimetric method.The data were compared between contrast induced nephrpathy (CIN) and non-CIN groups.For normal distribution of quantitative data,t test were used and for non-normal distribution of quantitative data,nonparametric rank and inspection were used.Results CIN occurred in 8 of 201 enrolled patients,the incidence was 3.98％.Receiver operating characteristic curve (ROC) analysis confirmed the diagnostic accuracy of the plasma NGAL in CIN,and the area under the curve(AUC) of 2 h plasma NGAL was 0.928,95％ CI 0.800-0.985,with the cut-off value NGAL as 109 ng/ml,the diagnostic sensitivity and specificity for CIN were 87.5％ and 100％ ;the AUC of 8 h plasma NGAL was 0.945,95％ CI 0.824-0.992,with the cut-off value NGAL as 96 ng/ml,the diagnostic sensitivity and specificity for CIN were 87.5％ and 87.5％ ;the AUC of 8 h urinary NGAL was 0.969,95％ CI 0.859-0.999,with the cutoff value NGAL as 91 ng/ml,the diagnostic sensitivity and specificity for CIN were 87.5％ and 100％.Conclusions The change of plasma and urinary NGAL is earlier to that of serum creatinine for the early diagnosis of CIN.It can be used as the predictor of early renal damage after elective coronary artery interventional.

From August 2011 to March 2012,5 241 type 2 diabetic patients with body mass index ≥ 24kg/m2 were enrolled from 60 hospitals in Guangdong Province.According to estimated glomerular filtration rate (eGFR),a total of 2 631 subjects with norml urine microalbumin level (＜30 ng/L) were divided into normal eGRF group and decreased eGRF group.Binary logistic regression was used to analyze the associations between eGFR and its related risk factors.The results showed that age,blood uric acid,blood urea nitrogen,history of hypertension and coronary heart disease,family history of diabetes,and hyperuricemia were positively related to lowering of eGFR (P＜ 0.05 or P＜0.01).HbA1C＜7％,regular glucose monitoring,and regular physical activity were negatively related to eGFR decrease (all P＜ 0.01).These results suggest that urine microalbumin and eGFR should be applied to overweight or obese patients with type 2 diabetes in order to screen diabetic nephropathy.Furthermore,intensive control of blood glucose,uric acid,and blood pressure is beneficial to lowering the risk of diabetic nephropathy.

OBJECTIVETo investigate the clinical effect and safety of chiropractic in treating cervicogenic sudden hearing loss.

METHODSFrom January 2011 to October 2013, 90 patients with cervicogenic sudden hearing loss were randomly divided into treatment group and control group according to the random number table produced by SPSS 19.0 software. In the treatment group, there were 17 males and 28 females, aged from 31 to 62 years old with an average of (47.57±9.43) years; course of disease was from 1 to 3 days with an average of (1.43±0.68) days; pure-tone audiometry score was from 46.5 to 77.8 dB with the mean of (61.20±9.83) dB; Northwick Park Neck Pain Questionnaire (NPQ) score was from 17 to 31 scores with an average of (23.46±7.18) scores. In the control group, there were 15 males and 30 females, aged from 28 to 64 years old with an average of (45.77±6.99) years; course of disease was from 1 to 3 days with an average of (1.50±0.73) days; pure-tone audiometry score was from 48.1 to 75.0 dB with the mean of (63.91±8.05) dB; Northwick Park Neck Pain Questionnaire (NPQ) score was from 20 to 29 scores with an average of (25.61±10.43) scores. The patients of control group were treated with dexamethasone intravenous drip of 10 mg, 3 days later, decreased to 5 mg, 3 days again. And with the methycobal intravenous drip of 500 μg, treatment continued for 10 days. The patients of treatment group were treated with chiropractic additionally except for the therapeutic methods of control group. Chiropractic included local muscle loosening, attacking point, bilateral pulling atlanto-axial joint, and continuous treatment for 10 days. The pure-tone audiometry score and NPQ score were compared between two groups after treatment.

RESULTSAfter the treatment, pure-tone audiometry score and NPQ score in treatment group improved to (40.23± 8.14) dB and (12.70±8.29) scores respectively, which were obviously better than that of control group's (37.70±10.61) dB and (21.24±11.13) scores (P<0.05).

CONCLUSIONCompared with routine method for cervicogenic sudden hearing loss, additional chiropractic can improve hearing and relieve neck pain effectively.

Cervical Vertebrae ; Female ; Hearing Loss, Sudden ; therapy ; Humans ; Male ; Manipulation, Chiropractic ; methods ; Medicine, Chinese Traditional ; Middle Aged

The usage of pesticides can enhance the production of crops,but their overuses may be hazardous to both people health and the environment.Thus,it is of great significance to develop effective methods to detect pesticides.Metal nanoclusters(MNCs)have become increasingly popular in analytical sensing areas because of their miniscule size,high stability,ease of manufacturing and good biocompatibility.They have exhibited great potential in the field of pesticides detection.In this paper,the detection methods of pesticides by using MNCs and their development in detection of organophosphorus pesticides,organic nitrogen pesticides,organochlorine pesticides and other types of pesticides were reviewed.Finally,the development prospects were discussed.

Objective To investigate the internal quality control ( IQC ) on clinical chemistry , clinical immunology and clinical hematology in mutual recognition laboratories in medical institutions in Beijing.Methods By means of questionnaire survey and on -site investigation, fresh frozen serum and whole blood samples with assigned values by reference method were measured to investigate the status of IQC on clinical chemistry , clinical immunology and clinical hematology in 142 mutual recognition laboratories in medical institutions of Beijing,and results were analyzed.Results 142 copies of questionnaireson clinical chemistry, clinical immunology and clinical hematology were send out and 120, 97, and 101 laboratories returned the questionnaires respectively .The information feedback rate was 84.5%, 68.3% and 71.1%respectively .All the questionnaires were effective .Questionnaires survey results showed that more than 50%laboratories set up quality control goals and the most of the goals were probability for error detection ( Ped) 95%, probability for false rejection(Pfr)5%;About 70% laboratories usecd the same quality control plan for different tests ;The most frequently used quality control rules are 12s/13s/22s.On-site investigation showed that ,take the results of clinical chemistry for example , based on the desirable biological variation and WS/T 403 -2012 , most of the tests can't meet the quality control goalsunder the existing quality controlcondition.Conclusion Clinical laboratories should consider their actual situations , assess their own qualitylevels that they can reach , set reasonable quality standards for themselves , and make appropriateindividualized quality control plan.