In recent years,more and more Macrolide resistance of Mycoplasma pneumoniae becomes a hot research.The current studies suggest that the mechanisms of Macrolide resistance are drug-binding site mutations,ribosome methylation,drug efflux,and drug related fire-fighting,in which the drug target 23srRNA gene 2063,2064 mutation is significant.It has been reported that drug-resistant patients have the poor effect,including the long total febrile days and high dressing.For treatment of drug-resistant patients,most studies still use the macrolide,early use of corticosteroids may be effective.It is uncertain whether the increase in resistant strains is related with the use of macrolide.It is significant to carry out future researches in this area for clinical therapy and put off the prevalence of drug-resistant strains.

Objective To evaluate the effect of meglumine cyclic adenosine (MAC) on heart rate variability (HRV) in aged-patients with coronary heart disease (CHD).MethodsSeventy six aged-patients with CHD were randomly divided into control group (n =36) and treatment group (n =40).The patients in control group were treated with nitrate,ozagrel,calcium antagonist,aspirin enteric-coated tablets,low molecular heparin,angiotensin-converting enzyme inhibitor ( ACEI ) or angiotensin receptor antagonist ( ARB ) and lipidlowering agents according to patients' conditions.Based on this,the patients in treatment group were treated with MAC 90 mg intravenous injection once a day for two weeks.The 24 h dynamic electrocardiogram was recorded.pre-ard post-treatment,and the changes of HRV indexes were observed.Results There was no statistical significance in HRV between the two groups before treatment ( P ＞ 0.05 ).However the HRV in two groups improved significantly after treatment ( P ＜0.01 ).The improvement of HRV was more significant in MAC group than that in control group (P ＜0.01 ).Conclusion MAC can significantly improve HRV in aged-patients with CHD.

Objective To explore the mechanism of shengmai injection on relieving ischemia reperfusion injury and antagonizing systemic inflammatory response syndrome by regulating cytokines when it was applied at the early stage of cardiopulmonary resuscitation(CPR).Methods 40 cases suffering from cardiac arrest and had their heart beat recovered through CPR for more than 24 hours were randomly divided into SMI group and control group(20 cases for each).The patients in the two groups were treated with common therapeutics based on the CPR,but the patients in SMI group were intravenously dropped with SMI in the early period of PLS phase,then the changes of serum concentration of TNF-α and IL-81h,2h,6h,12h and24h after CPR in the two groups was compared.Results The concentrations of serum TNF-α and IL-8 stepped up gradually after resuscitation and the levels of TNF-αand IL-8 in SMI group were lower than that of the control group at 1h,2h,6h,12h and 24h after resuscitation(P＜0.05).Conclusion SMI functions to relieve ischemia reperfusion injury by regulating cytokines and antagonizing systemic inflammatory response syndrome.

Objective To study the characteristic of operation design and analyze curative effect of laser sub-epithelial keratomileusis (LASEK) on low and midrange myopia in aged patients. Method Fiftyeight patients ( 114 eyes) no less than 35 years old were treated with LASEK by monoblepsis. The subjects were examined and analyzed at 3 days, 7 days, 1 month,3 months and 6 months after operation. Results Seventy-one corneas(62.28%) recovered well at 3 days after operation. At 1 month after operation, the acuity of vision of all patients achieved or exceeded corrected vision before operation,and lasted to 6 months after operation. The break up time of 63 eyes were lower than normal at 3 months after operation,but 6 months after operation all of them recovered to normal. The satisfaction of patients raised gradually. Conclusions LASEK is effective for no less than 35 years old myopic patients. Make operation plan refer to monoblepsis and patients' needs can receive more satisfaction.

Objective To explore the best time interval to extubate catheter for the postoperative gastric cancer patients,and provide the basis for early extubation after operation.Methods To collect 108 cases with gastric cancer in Department of Forensic Surgery of Yuncheng Central Hospital from March 2013 to February 2014 with indwelling catheter preoperatively.According to the admission sequence,they were divided into the observation group and the control group with 54 cases in each group,the observation group began clipping catheter in 10-15 hours after operation,extubating catheter within 24 hours after operation;the control group began clipping catheter on the second day after operation,and extubating catheter during 48-72 hours after operation.The time of extubation,urinary tract irritation symptoms,resetting catheters and the incidence of early postoperative ambulation in patients of two groups were observed.Results The incidence of urinary tract irritation was lower in the observation group than that of the control group [3.7％ (2/54) vs 16.7％(9/54)],the difference was statistically significant (x2=4.960,P＜0.05).Early ambulation compliance of the observation group was higher than that of the control group (complete compliance 52 vs.40,partial compliance 2 vs.8,no compliance 0 vs.6),the difference was statistically significant (x2 =10.565,P ＜0.05).Conclusions The method of extubation catheter within 24 hours after gastric canter operation can reduce the incidence of urinary tract irritation and improve early ambulation compliance.

Objective To find a solution to the long-term storage of enormous amount of imaging data in hospital picture archiving communication system (PACS). Methods Medical imaging data collected by devices of Digital Imaging and Communications in Medicine-3 (DICOM3) and non-DICOM3 were transformed into the storage format, metadata instance, and expression pattern of digital images standardized by DICOM3. Based on the requirements of data utilization and storage system and the optimal principle of function and value, the reasonable flow of imaging data in PACS network were scientifically allocated by application of on-line, near-line, and off-line storage patterns and by reasonable allocation of the volume and clusters of storage devices. Results The PACS storage system established by our method, characterized by super capacity of error tolerance, permanent unrestricted storage, quick in retrieval, and quick, convenient and reliable in storage and reading, could meet the requirements of long-term storage and management of enormous amount of medical imaging data. Conclusion Grading storage is the effective method for long-term storage of enormous amount of medical imaging data in PACS.

Objective To investigate the clinical and pathological features of Churge-Strauss syndrome(CSS) combined leukocytoclastic vasculitis.Methods The clinical data of 1 patient with CSS combined leukocytoclastic vasculitis was analyzed retrospectively.Results The main symptoms of the case were peripheral nerve damage,violation of the skin lesions,gastrointestinal tract,lung,and central nervous system;peripheral blood eosinophil count was high.The pathological examine showed vessel wall and skin organizations had a large number of eosinophils infiltration,small vessel walls,as well as granuloma formation around multiple segmental fibrinoid necrotizing vasculitis.Eventually died of multiple organ failure.Conclusion The clinical manifestations of CSS combined leukocytoclastic vasculitis have vasculitis and peripheral neuropathy mainly;the pathological features are that vessel wall and skin organizations have a large number of inflammatory cells infiltration;the late multi-system are involved,and the prognosis is poor.

To assess the clinical effect of HA regimen on newly diagnosed patients in chronic phase of chronic myeloid leukemia (CML). Ninety four cases of CML patients were grouped in accordance with the requirements on the basis of treatment regimens and Sokal risk index, and the clinical effects of HA regimen wer evaluated. We found that HA regimen showed satisfactory immediate effect on CML in chronic phase. CR rates achieved in high risk and medium risk groups(77 4%,20 0%) with HA were higher than that with Hu regimen(35 0%,0%). However, HA regimen was incapable of extending the duration of CML. So HA should not be used as first line treatment in the treatment on newly diagnosed patients in chronic phase of CML, except for high risk group whose symptoms could not be controlled with other regimens.

OBJECTIVEThis study observed the curative effect of sustained negative pressure drainage application on treatment of severe maxillofacial and neck space infection.

METHODSIncision and drainage were performed to treat 18 patients with severe maxillofacial and neck space infection. A small incision was made on the site of the most obvious swelling or fluctuations, and localized negative pressure was applied with a drainage device on the wound during suturing.

RESULTSAmong the 18 patients, 14 were healed, whereas 4 underwent dehiscence of the wound after the operation. Negative pressure was lost as the drainage tubes were removed, and non-negative pressure drainage method was used instead. During the negative pressure treatment, swelling and pain did not increase after the operation. Other complications, such as asphyxia, septic shock, or mediastinal abscess, did not occur. All the patients were healed and eventually discharged from the hospital.

CONCLUSIONSustained negative pressure drainage, which is a modified version of the traditional method of incision and drainage, is an alternative treatment for severe maxillofacial and neck space infection. Such treatment reduces patient pain and eases doctor exertion. Thus, this method provides a new therapeutic strategy for severe maxillofacial and neck space infection.

Objective To determine the correlation between Smad4 mRNA,protein expression,abnormal methylation of CpG islands of Smad4 and colorectal cancer.Methods The expression of Smad4 in 43 cases of colorectal cancer and its adjacent tissue.30 cases of colorectal adenoma and 12 normal colon mucosa were analyzed by RT-PCR,sequencing,semi-quantitative RT-PCR,methylation-specific PCR(MSP)and immunohistochemistry.Results The mRNA expression of Smad4 was detected in 25 cases of colorectal cancer(58.14%),with expression levels at 0.73±0.25,which was significantly lower than those in corresponding adjacent tissues(88.37%,0.95±0.29),eolorectal adenoma(90.63%,1.01±0.37)and normal mucosa(100.00%,1.18 ±0.33)(P＜0.05).The positive rates of Smad4 gone promoter methylation in colorectal caner(60.53%)was significantly higher than that in other tissues(27.03%,25.00%and 16.67%,respectively,P＜0.05).The expression of Smad4 protein was significantly lower in colorectal cancer(44.19%)than that in other tissues(81.40%,87.50%,91.67%,respectively,P＜0.05),which was correlated with tumor invasion and lymph node metastasis.Conclusion Down-regulation of Smad4 expression may be associated with the development,the biological behavior and prognosis of colorectal cancer,and it can be an important biological marker in evaluation of disease progression.