Objective To compare the clinical effects of vancomycin, linezolid alone, and their separate combination with spleen polypeptide in the treatment of severe community-acquired pneumonia (CAP) in children with a history of recurrent respiratory infections. Methods A total of 296 children with severe CAP and a history of recurrent respiratory infections were selected as study subjects and randomly divided into four groups: vancomycin group (vancomycin alone), linezolid group (linezolid alone), combined group A (vancomycin combined with spleen polypeptide), and combined group B (linezolid combined with spleen polypeptide), with 74 patients in each group. The curative effects, recovery process (time to normalization of body temperature, time to improvement of cough, time to improvement of respiration, length of hospital stay), adverse reactions, and direct medical costs were compared among the four groups. Decision tree models and cost-effectiveness analysis were used to compare the economics of each treatment plan. Results The total effective rates in the linezolid group, combined group A, and combined group B were 83.78%, 86.49%, and 97.30%, respectively, which were all higher than 71.62% in the vancomycin group, and the combined group B had a higher effective rate than the linezolid group and combined group A (P < 0.05). The time to normalization of body temperature, improvement of respiration, improvement of cough, and length of hospital stay were shorter in the linezolid group, combined group A, and combined group B than in the vancomycin group, and were shorter in the combined group B compared to the linezolid group and combined group A (P < 0.05). There was no statistically significant difference in the occurrence of adverse reactions among the four groups (P>0.05). There were no statistically significant differences in treatment costs, examination/testing costs, and hospitalization costs among the four groups (P>0.05). The treatment costs and total costs were higher in the vancomycin group, combined group A, linezolid group, and combined group B in ascending order, with statistically significant between-group difference (P < 0.05). The cost-effectiveness ratios from high to low were combined group A (75.84), vancomycin group (73.22), linezolid group (32.87), and combined group B (32.69). Sensitivity analysis showed that the cost-effectiveness ratio analysis results were stable and reliable. Conclusion Among the four treatment options, the combination of linezolid and spleen polypeptide has the best therapeutic effect in severe CAP children with a history of recurrent respiratory infections, with the most significant clinical benefit and cost-effectiveness advantages.

Objective To study the relationship between in situ telomerase activity and the expressin of bcl-2 and p53 proteins in human ovarian epithelial tumors(OETs), and explore their effect in pathogenesis of ovarian cystadenocarcinoma. Methods The telomerase activity of ovarian epithelial tumors was measured by in situ telomerase activity labeling (ISLT), and bcl-2 and p53 expression was detected by SP immunohistochemical method. Results ⑴The positive rates of telomerase in ovarian cystadenocarcinomas(OCAC), their surrounding ovarian tissues(SOT),borderline cystadenomas(BCA),and cystadenomas(CA)were 92 3%(24/26), 0(0/26), 42 8%(9/21) and 0(0/15) respectively, and the positive rate was significantly higher in OCAC than that in SOT, BCA and CA(P0 05); ⑵The positive rates of Bcl-2 in OCAC, SOT, BCA and CA were 65 38%(17/26), 0(0/26), 52 38%(11/21) and 26 66%(4/15) respectively, which were significantly higher in OCAC and BCA than those in SOT and CA(P0 05). Conclusion The results indicated that overexpression of bcl-2 protein may be related to telomerase activation, the telomerase activation induced by bcl-2 overexpression may result in malignant transformation of ovarian epithelials, and p53 mutation may not affect telomerase activity during ovarian cystadenocarcinogenesis.