Objective To explore the correlation between plasma T cell subsets,serum interleukin-6(IL-6)levels and CT imaging characteristics in children with mycoplasma pneumoniae pneumonia(MPP),as well as its predictive value for clinical prognosis.Methods A total of 98 children with MPP were selected as the research subjects and divided into the good prognosis group(n=62)and the poor prognosis group(n=36)according to the clinical prognosis.The correlations between plasma T cell subsets,IL-6 levels,CT imaging characteristics and prognosis were analyzed.The predictive efficacy of plasma T cell subsets and IL-6 levels for poor progno-sis was analyzed.Results The levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),IL-6,CD8+and CD19+in the poor prognosis group were significantly higher than those in the good prognosis group,while the levels of CD3+,CD4+,CD4+/CD8+and CD16+/CD56+were significantly lower than those in the good prognosis group(P＜0.05).The statistical conditions of CT ima-ging characteristics such as pulmonary consolidation,ground-glass change,involvement of lung lobes ≥ 2,patchy consolidation shad-ows,grid nodular shadows,bronchial wall thickening,hilar lymph node enlargement,pleural effusion,and atelectasis in the poor prognosis group were significantly higher than those in the good prognosis group(P＜0.05).CD3+,CD4+,CD8+,CD4+/CD8+,CD19+,CD16+/CD56+and IL-6 had independent correlations with the above CT imaging characteristics.IL-6,CD8+and CD19+were positively correlated with the risk of poor prognosis,while CD3+,CD4+,CD4+/CD8+and CD16+/CD56+were negatively correlated with the risk of poor prognosis(P＜0.05).Individual detection of CD3+,CD4+,CD8+,CD4+/CD8+,CD19+,CD16+/CD56+,IL-6 and the combined detection of the seven indicators had certain predictive value for the occurrence of poor prognosis in patients[area under the curve(AUC)＞0.7].Conclusion Plasma T cell subsets and serum IL-6 levels are important factors influencing the prognosis of children with MPP and are independently related to the CT imaging characteristics.

Objective To explore the correlation between plasma T cell subsets,serum interleukin-6(IL-6)levels and CT imaging characteristics in children with mycoplasma pneumoniae pneumonia(MPP),as well as its predictive value for clinical prognosis.Methods A total of 98 children with MPP were selected as the research subjects and divided into the good prognosis group(n=62)and the poor prognosis group(n=36)according to the clinical prognosis.The correlations between plasma T cell subsets,IL-6 levels,CT imaging characteristics and prognosis were analyzed.The predictive efficacy of plasma T cell subsets and IL-6 levels for poor progno-sis was analyzed.Results The levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),IL-6,CD8+and CD19+in the poor prognosis group were significantly higher than those in the good prognosis group,while the levels of CD3+,CD4+,CD4+/CD8+and CD16+/CD56+were significantly lower than those in the good prognosis group(P＜0.05).The statistical conditions of CT ima-ging characteristics such as pulmonary consolidation,ground-glass change,involvement of lung lobes ≥ 2,patchy consolidation shad-ows,grid nodular shadows,bronchial wall thickening,hilar lymph node enlargement,pleural effusion,and atelectasis in the poor prognosis group were significantly higher than those in the good prognosis group(P＜0.05).CD3+,CD4+,CD8+,CD4+/CD8+,CD19+,CD16+/CD56+and IL-6 had independent correlations with the above CT imaging characteristics.IL-6,CD8+and CD19+were positively correlated with the risk of poor prognosis,while CD3+,CD4+,CD4+/CD8+and CD16+/CD56+were negatively correlated with the risk of poor prognosis(P＜0.05).Individual detection of CD3+,CD4+,CD8+,CD4+/CD8+,CD19+,CD16+/CD56+,IL-6 and the combined detection of the seven indicators had certain predictive value for the occurrence of poor prognosis in patients[area under the curve(AUC)＞0.7].Conclusion Plasma T cell subsets and serum IL-6 levels are important factors influencing the prognosis of children with MPP and are independently related to the CT imaging characteristics.

In order to improve the professional competence of in-service general practitioners and improve the effectiveness of standardized residency training, it is necessary to carry out training with the specific problems encountered in the practice. Taking Gaobeidian Community Health Service Center as an example, the characteristics, process and precautions of the general practice case discussion model based on the real scene of the community health institutions are introduced in the article. It would provide reference for improving the teaching effectiveness and efficiency in the training base of general practice.

Objective: To explore early diagnostic and resent prognostic assessment value of serum levels of ischemia-modified albumin (IMA) and cardiac troponin I (cTnI) for acute coronary syndrome (ACS).Methods: A total of 175 ACS patients were selected, including 73 cases with unstable angina pectoris (UAP), 61 cases with non-ST elevation myocardial infarction (NSTEMI) and 41 cases with ST elevation myocardial infarction (STEMI).According to chest pain-to-visit time, ACS patients were divided into <3h group (n=112) and 3~6h group (n=63);another 40 healthy subjects were selected simultaneously as healthy control group.Serum IMA and cTnI levels were compared among above groups and between patients suffering from major adverse cardiovascular events (MACE) within 30d or not in <3h group.Risk factors for MACE in <3h patients within 30d were screened.Results: Compared with healthy control group and UAP group, there were significant rise in serum levels of IMA[(16.78±4.25) μg/L, (35.16±8.32) μg/L vs.(49.76±9.29) μg/L, (52.07±11.34) μg/L], cTnI[(0.17±0.06) ng/ml, (0.15±0.06) ng/ml vs.(7.65±1.29) ng/ml, (8.83±1.40) ng/ml]in NSTEMI group and STEMI group, and IMA level in STEMI group was significantly higher than that of NSTEMI group, that of UAP group was significantly higher than that of healthy control group (P<0.05 or <0.01);serum IMA level of <3h group was significantly higher than those of 3~6h group and healthy control group, and cTnI level of <3h group was significantly lower than that of 3~6h group (P<0.01 all);serum levels of cTnI and IMA in patients suffering from MACE in <3h group were significantly higher than those of patients without MACE (P<0.01 both);multi-factor Logistic regression analysis indicated that elevated serum IMA level was an independent risk factor for MACE within 30d in ACS patients[OR=2.757,95%CI(2.084~4.705), P=0.001].Conclusion: The levels of cTnI and IMA significantly rise in ACS patients.IMA level possesses early diagnosis and recent prognosis evaluation value.

Objective To explore the application value of D-dimmer(DD),hs-CRP and homocysteine(Hcy) in postoperative condition monitoring in the patients with femoral neck fracture.Methods Forty cases of femoral neck fracture treated in our hospital were selected as the observation group and 40 patients with other fractures were selected as the control group.The observation group were given the surgical treatment,while the control group adopted the corresponding measures for conducting intervention according to the fracture situation.The DD,hs-CRP and Hcy levels were detected in the two groups.Then the detection results were compared between the two groups.Results The various indexes before treatment in the observation group were slightly higher than those in the control group without statistical difference(P>0.05).The levels of various indicators at postoperative 24,48 h in the observation group were significantly elevated,moreover the increase range at postoperative 24 h in the observation group was maximal,which was significantly higher than that in the control group(P<0.05).The positive rates of hs CRP,Hcy and DD in the observation group were 75.00%,77.50% and 60.00% respectively,while which in the control group were 0.00%,2.50% and 0.00%,the observation group was significantly higher than the control group (P<0.05).Conclusion Hs CRP,Hcy and DD can be used as the important indicators of condition monitoring for femoral neck fracture.

Objective To investigate the prevalence and resistance mechanisms of Proteus mirabilis in the ward of neurology de‐partment of our hospital .Methods For a total of 20 clinic isolates of Proteus mirabilis ,PCR were used for the detection of AmpC , ESBLs ,KPC and MBLs and then DNA sequencing was performed .The integrons were also detected by using PCR and then sequen‐cing was carried out .The genetic relationship between isolates were detected and analysed by pulsed‐field gel electrophoresis(PF‐GE) .The results of drug sensitivity tests were analysed .Results TEM‐1 and CTX‐M‐14 gene were found in all the 20 isolates ,the 10 isolates of Proteus mirabilis were also found carrying CMY‐2 gene .Class Ⅰ integrons were amplified from 19 strains carrying gene cassettes aacA4+cmlA1,dfrA12+orfF+aadA2and dfrA32+ereA+aadA2 respectively .PFGE analysis revealed that the 20 isolates were grouped into 11 PFGE types P1-P11 ,the 12 isolates of P1-P3 were same clones .The sensitive rates of the i‐solates to Meropenem ,Amikacin ,Aztreonam ,Ceftazidime and Tazocin were high .Conclusion Nosocomial transmission of the same clone of Proteus mirabilis was appeared in the ward of neurology department of our hospital .The predominance drug‐resistance genes were CTX‐M‐14 andCMY‐2 .The incidence of carrying class Ⅰ integrons was high ,and the major gene cassettes wereaacA4+cmlA1and dfrA12+orfF+aadA2.The 20 isolates were all sensitive to Meropenem ,Amikacin and Aztreonam .Other Clinical departments should also pay attention to the nosocomial infection caused by Proteus mirabilis and strengthen the infection control measures .

Objective To study the clinicopathological characteristics of complicated Kaposi's sarcoma after renal transplantation.Methods Five cases of complicated Kaposi's sarcoma after kidney transplantation were studied by histopathological immunohistochemical and ultrastructural observations.Results Of the 5 Kaposi's sarcoma patients,2 had multiple amaranthine dermal plaques starting on the legs,one had lymph node hypertrophy all over the body,and others had inguinal lymph node and adenoid hypertrophy. Histopathologically,these angiomatous lesions had characteristic areas of spindle cells within which erythrocytes were enmeshed.Admixed in these lesions were hyaline bodies and hemosider-laden,phagocytic cells.Immunohistochemical and ultrastructural studies revealed that this tumor was derived from vasofomative mesenchyme with multipotential capabilities.It was found that the epithelia and spindle cells were positive for Vimentin,CD-31,CD-34 and Ⅷ-RAg.Conclusion Complicated Kaposi's sarcoma after kidney transplantation can be diagnosed by combination of clinical manifestations and histopathological examinations with immunohistochemical and ultrastructural observations.