Objective:To explore the relationship between 23S rRNA domain V locus mutations in mycoplasma pneumoniae (MP) and the clinical characteristics plus macrolide resistance in pediatric MP pneumonia.Methods:A retrospective analysis was conducted on 220 children with MP pneumonia admitted to the Xi′an Central Hospital from January 2021 to June 2024. Patients were divided into a mutation group and a non-mutation group according to the presence or absence of point mutations at positions 2063, 2064, 2067 and 2617 within the 23S rRNA domain V. General data, clinical features [disease course, fever duration, length of hospital stay, time to resolution of chest X-ray infiltrates, pleural effusion, pulmonary parenchymal lesions, white blood cell count (WBC), lactate dehydrogenase (LDH), MP-DNA load] and macrolide resistance were compared between the two groups.Results:Among the 220 enrolled patients, 114 were assigned to the mutation group and 106 to the non-mutation group. Mutations detected in the 23S rRNA domain V were A2063 ( n=107), C2617 ( n=2), A2064 ( n=2) and A2067 ( n=0); three patients had combined A2063+ A2064 mutations. The proportion of severe pneumonia was higher in the mutation group ( P<0.05). Compared with the non-mutation group, the mutation group exhibited longer disease course, fever duration, hospital stay and time to resolution of chest X-ray infiltrates; higher rates of pleural effusion; and higher LDH levels and MP-DNA loads (all P<0.05). Both groups showed the highest resistance to first-generation macrolides (erythromycin, erythromycin ethylsuccinate, erythromycin stearate) and the highest sensitivity to third-generation macrolides (telithromycin, josamycin). Resistance rates to first-and second-generation macrolides were significantly higher in the mutation group (all P<0.05). Conclusions:Mutations in the 23S rRNA domain V of MP are closely associated with clinical severity in pediatric MP pneumonia, and patients harboring these mutations display higher rates of macrolide resistance.

Objective:To explore the relationship between 23S rRNA domain V locus mutations in mycoplasma pneumoniae (MP) and the clinical characteristics plus macrolide resistance in pediatric MP pneumonia.Methods:A retrospective analysis was conducted on 220 children with MP pneumonia admitted to the Xi′an Central Hospital from January 2021 to June 2024. Patients were divided into a mutation group and a non-mutation group according to the presence or absence of point mutations at positions 2063, 2064, 2067 and 2617 within the 23S rRNA domain V. General data, clinical features [disease course, fever duration, length of hospital stay, time to resolution of chest X-ray infiltrates, pleural effusion, pulmonary parenchymal lesions, white blood cell count (WBC), lactate dehydrogenase (LDH), MP-DNA load] and macrolide resistance were compared between the two groups.Results:Among the 220 enrolled patients, 114 were assigned to the mutation group and 106 to the non-mutation group. Mutations detected in the 23S rRNA domain V were A2063 ( n=107), C2617 ( n=2), A2064 ( n=2) and A2067 ( n=0); three patients had combined A2063+ A2064 mutations. The proportion of severe pneumonia was higher in the mutation group ( P<0.05). Compared with the non-mutation group, the mutation group exhibited longer disease course, fever duration, hospital stay and time to resolution of chest X-ray infiltrates; higher rates of pleural effusion; and higher LDH levels and MP-DNA loads (all P<0.05). Both groups showed the highest resistance to first-generation macrolides (erythromycin, erythromycin ethylsuccinate, erythromycin stearate) and the highest sensitivity to third-generation macrolides (telithromycin, josamycin). Resistance rates to first-and second-generation macrolides were significantly higher in the mutation group (all P<0.05). Conclusions:Mutations in the 23S rRNA domain V of MP are closely associated with clinical severity in pediatric MP pneumonia, and patients harboring these mutations display higher rates of macrolide resistance.

Objective To compare the clinical effect and safety evaluation of three different dose regimens for treating children with viral encephalitis.Methods Totally 126 cases treated in Xi'an Central Hospital from January 2010 to December 2015 were randomly divided into observation group 1 (ganciclovir combined with gangliosides,42 cases),observation group 2 (ganciclovir combined with gamma globulin,43 cases),and control group (39 cases).The clinical effect and levels of NSE,inflammatory cytokine were compared in the three groups.Results The total effective rate in observation group 1 was 95.24％ and that of observation group 2 was 93.02％,which were significantly higher than that of control group (79.48％).The disappearance time of headache,fever,convulsions,clouding of consciousness,meningeal irritation sign,cerebrospinal fluid abnormalities,and length of stay in observation groups (both 1 and 2)were significantly shorter than those in control group (P ＜ 0.05);After therapy,the levels of NSE in three groups were obviously decreased compared with those before therapy (P ＜ 0.05),and those in observation group were significantly lower than the control group (P ＜ 0.05);the levels of inflammatory cytokine in all three groups were obviously decreased compared with those before therapy (P ＜ 0.05),and that of observation group 1 had no statistical difference with the normal group,whereas that in control group was significantly higher than the normal group (P ＜ 0.05).Conclusion Ganciclovir combined with gangliosides as well as ganciclovir combined with gamma globulin were both effective methods in treating children with viral encephalitis and could decrease levels of inflammatory cytokine.Ganciclovir combined with gangliosides could effectively repair nerve damage,which deserves clinical expansion.

Objective:To compare the clinical effect and safety of three different regimens treating children with severe pneumonia.Methods:120 cases treated in our hospital from January,2012 to January,2016 were randomly divided into the observation group 1 (dopamine combined with dobutamine,42 cases),observation group 2 (dopamine combined with phentolamine,40 cases),control group (38 cases).The clinical effect and levels of inflammatory cytokine were compared between the three groups.Results:The total effective rate in the observation group 1 was 90.48％ and that of observation group 2 was 87.5％,which were significantly higher than that of the control group (63.16％).The disappearance time of pulmonary rales,cough,dyspnea,pyretolysis and length of stay in the observation group (both 1,2) were significantly shorter than those of the control group (p ＜0.05).After therapy,the level of serum IL-6,IL-8,CRP and TNF-α in all the three groups were obviously decreased compared with those of before therapy (p＜0.05),and those of the observation group were significantly lower than the control group (p ＜ 0.05).Conclusion:Dopamine combined with dobutamine as well as dopamine combined with phentolamine were both effective methods in treating children with severe pneumonia,which were significantly better than conventional therapy.