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??Objective To compare pbp2b??ply and lytA genes PCR with cerebral spinal fluid culture in diagnosis of Streptococcus pneumoniae meningitis and prediction of its susceptibility. Methods A nested PCR targeting pbp2b and another two S.pneumoniae specific PCR targeting the genes of pneumolysin??ply?? and autolysin??lytA?? were developed for detection of S.pneumoniae in cerebral spinal fluid from bacterial meningitis patients. The three PCR results and culture were compared. The consistency of penicillin susceptibility PCR ??using resistant and susceptible primers respectively????sequencing and culture-based phenotypic penicillin resistant results were compared. Results Of the 161 specimens studied??there were 25 cases of S.pneumoniae infection confirmed by different methods??16 by pbp2b PCR??16 by lytA PCR??14 by ply PCR and 9 by cerebrospinal fluid culture??. Of the 16 pbp2b positive specimens??penicillin sensitive and resistant sequence types accounted for half??respectively. Four of the 16 pbp2b positive specimens had culture-based phenotypic penicillin-resistant result. Three of 4 were consistent with penicillin susceptibility PCR result. The results of susceptibility PCR targeting pbp2b was consistent with sequencing result. New sequence types were found but there were no new point mutations in these strains when compared with GenBank ??http??//blast.ncbi.nlm.nih.gov/Blast.cgi??. Penicillin resistance in pneumococcal meningitis was 66.67%??6/9?? by culture phenotype and 50%??8/16?? by PCR and sequencing when culture was negative. Conclusion Pbp2b can serve as a good target gene to detect S.pneumoniae and predict its penicillin susceptibility??which is especially important when culture is negative.     

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??Inhaled corticosteroids??ICS?? are the most effective medicine for chronic airway inflammation nowdays. Atomization inhalation has been widely applied in clinics because of its efficacy??fewer side-effects and convenience. Here??we focused on some points which should be paid attention to??including how to choose appropriate patients??how to ensure the effectiveness of inhaled steroids and how to reduce possible side-effects.     

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??With the increasing prevalence of childhood overweight/obesity in the worldwide??obesity-related glomerulopathy??ORG?? has become a growing concern among pediatricians. Clinical and pathologic characteristics ofORG are proteinuria??glomerulomegaly??progressive glomerulosclerosis and renal function decline. If not intervened in time??the disease may slowly progress??some of which end in end-stage renal disease. Here we review the recent advances in the pathogenesis and clinical features of ORG??as well as diagnosis and differential diagnosis and potential therapeutic targets.     

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??Objective To detect the value of 3D T1W-WATS sequence on cartilage display of hemophilic arthropathy using quantitative and qualitative assessment. Methods Totally 16 joints including 8 knees and 8 ankles ??13 joints with hemosiderin deposition?? from 16 hemophilia patients were scanned on a 3.0 T MR ??Achieva TX??Philips Health care??Best??The Netherlands?? with sagittal 3D T1W-WATS sequence and 2D T2*W sequence. Signal to noise ratio ??SNR?? of cartilage and relative contrast between cartilage and surrounding tissues were employed to measure the performance of two sequences quantitatively??SNRcartilage= SIcartilage/standard deviationnoise?? relative contrast=??SIcartilage-SIsurrounding tissues??/??SIcartilage+SIsurrounding tissues??. Cartilage of 13 joints were divided into 142 subareas according to the literature. The impact of hemosiderin deposition was evaluated by counting the number of subareas where the display of cartilage was affected qualitatively. Results SNR of 3D T1W-WATS sequence was??53.93±18.80????and SNR of 2D T2*W sequence was??52.96±24.32??. There was no statistical difference for SNR between two sequences??P??0.05????3D T1W-WATS sequence exhibited better relative contrast between cartilage and bone marrow?? cartilage and fat?? cartilage and fluid than 2D T2*W sequence??P??0.05????42 of 142 subareas of cartilage were covered with hemosiderin partially or completely in 2D T2*W sequence??while the number was only 16 in 3D T1W-WATS sequence??there being statistical difference ??P??0.05??. Conclusion 3D T1W-WATS sequence is superior in the evaluation of cartilage display for hemophiliac joints with better relative contrast and immunity to hemosiderin deposition?? compared with 2D T2*W sequence.     

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??Abstract?? Objective To study the influence factors?? clinical features??and prognosis of antitubercular agent-induced hepatotoxicity in children. Methods The clinical data of 194 patients with hepatotoxicity caused by anti-tuberculosis agent??from 1691 patients with various types of tuberculosis as the research object?? were analyzed retrospectively. Results The incidence of agent-induced hepatotoxicity was 8.8??. The patients aged ≤1 took the lead??with 61 cases ??31.44%????53.54% of agent-induce hepatotoxicity occurred in 6 ~ 10 days after medication.There were 63.31% patients with symptoms??and anorexia??nausea?? vomiting??jaundice??bellyache??bloating and rash were the most frequently observed symptoms. Liver disfunction in patients with clinical manifestations was significantly more than those without clinical manifestations??P??0.05??. There was no statistical difference in liver disfunction between patients with multi-system damage and single damage??P??0.05??. As for those patients whose liver disfunction would be high??the difference in the use time of liver protectant was not statistically significant??P??0.05??. Conclusion The incidence of antitubercular agent-induced hepatotoxicity is higher in the infancy. The non-specificity in clinical manifestations of antitubercular agent-induced hepatotoxicity in children??and the degree of hepatotoxicity are more serious in patients with clinical manifestation. The patients with the hematogenous disseminated tuberculosis may be easy to develop to hepatotoxicity. No correlation the use time of liver protectant and degree of hepatotoxicity.