Objective To study the distribution and antimicrobial susceptibilities of anaerobic bacteria from periodontal pockets of patients with chronic periodontitis, so as to guide the anti-infection therapy. Methods Eighty-four patients with chronic periodontitis were enrolled in this study. The anaerobes were isolated from periodontal pockets of patients with chronic periodontitis. Antimicrobial susceptibility of the anaerobes to seven kinds of antibiotics (like metronidazole, penicillin, cefmetazole, etc.) was tested with the agar dilution technique. Results A total of 305 cultivable anaerobes were isolated from periodontal pockets of 84 patients with chronic periodontitis. All patients were infected by anaerobes. 59.34%of cultivable anaerobes were gram-positive anaerobes, and 40.66%were gram-negative anaerobes. The P.melanin ogenica and P.gingivalis were the most common among the cultivable anaerobes, accounting for 51.19% and 55.95%, followed by P.intermedia (36.90%), P.micros (35.71%), F.mucleatum (33.33%), Capnocytophaga ssp (27.38%), Actinomyces ssp (10.71%), and so on. Most isolated anaerobes were sensitive to seven antibiotics. All isolated anaerobes were susceptible to Chloromycetin and Imipenem. 98.03%of isolated anaerobes were susceptible to Amoxicillin. Approximately 76%to 88%of isolated anaerobes were susceptible to Cefmetazole and Metronidazole. Susceptibility to Clindamycinum and Penicillin were 65.91%and 55.73%. Conclusions There is a close relationship between chronic periodontitis and anaerobes. P.melanin ogenica and P.gingivalis are the most frequently isolated anaerobes from periodontal pockets of patients with chronic periodontitis. Chloromycetin and Imipenem can be used for the treatment of anaerobes infected chronic periodontitis.

Objective:To improve the recognition of bleeding risk in the anticoagulant process by analyzing one case of senior patient with deep vein thrombosis occurred severe bleeding during the anticoagulant therapy.Methods:The possible causes of hemorrhage were analyzed after the brief introduction of medical history,lab test report and treatment process of the patient.Results:The reasons of hemorrhage might be as follows:① the combination of warfarin and dalteparin induced the adverse drug reaction;② albumin decreased during the treatment process resulting in the effect enhancement of warfarin;③ the clearance of warfarin decreased resulting from the low creatinine clearance of the elderly patient.Conclusion:Clinical anticoagulant practice should be more careful in senior patients.The frequency of related laboratory tests should be increased in order to find potential risks timely.

Objective To explore the effect of controlled premature delivery and its termination method of pregnancy.Methods The clinical data of 151 cascs of controlled premature delivery were retrospectively analyzed.Results The incidence of premature delivery was 7.5% and the incidence of controlled premature delivery was 44.8%.The cesaran section rate of controlled premature delivery Was 93.4%.Pregnancy induced hypertension(PIH)was the first place reason of controlled premature delivery.The second was antepartum hemorrhage,intrauterine fatal diatress and placenta previa,pregnancy associated with cardiac disease.The complications and mortality of premature infants were reduced if antenatal care is regularly and glucocorticoids could be used.Conclusion Antenatal care and proper treatment can increase the survival rate of premature infants in the inevitable controlled delivery.

Relationship between the doctors and patients is the most important and basic interpersonal relationship in the medical practice and it is also the ability for interns to be strengthened.During the process of clinical practice teaching in children's department of stomatology,we demand that demonstration teachers deal with the relationship between the teaching and patients.Interns should skillfully grasp the psychological behavior of children,learn the skills of communicating and disposaling interpersonal relationship,and cultivate the consciousness of satisfactory medical ethics,laws and legislation.

Objective To explore the effect of pre-treatment of subcutaneous injection of ketamine on remifentanil induced hyperalgesia and K+/Cl-cotransporter 2,KCC2) expression on spinal cord of rats.Methods60 male adult SD rats were randomly divided into five groups(n=12 in each group):control group (group C),the incision group(group I),the incision plus remifentanil group(group I+R),the incision plus ketamine group(group I+K) and the incision plus remifentanil and ketamine group(group I+R+K).Mechanical withdrawal threshold (MWT) was evaluated at 24 hours before incision(T0),2 hours,6 hours,24 hours and 48 hours after incision(T1~T4).The lumbar spinal cords of rats were taken out at T4 time point and the KCC2 detected was detected by immunofluorescence analysis and western blot analysis.ResultsCompared with group C(T1(14.5±1.7)g,T2(14.2±1.1)g,T3(13.9±1.8)g,T4(14.2±1.1)g),MWT of other groups at T1 (I(5.6±0.8)g,I+R(3.2±1.0)g,I+K(6.8±1.7)g,I+R+K(5.1±1.6)g),T2 (I(6.9±1.0)g,I+R(4.3±1.2)g,I+K(8.0±1.4)g,I+R+K(6.2±1.5)g),T3 (I(7.6±0.9)g,I+R(5.4±1.1)g,I+K(10.3±1.2)g,I+R+K(7.1±1.1)g),T4 (I(8.9±1.1)g,I+R(7.5±1.4)g,I+K(11.3±1.2)g,I+R+K(8.3±1.2)g)and the expression of KCC2 at T4 decreased (P<0.05).Compared with group I(T1(5.6±0.8)g,T2(6.9±1.0)g,T3(7.6±0.9)g,T4(8.9±1.1)g),MWT of group I+R (T1(3.2±1.0)g,T2(4.3±1.2)g,T3(5.4±1.1)g,T4(7.5±1.4)g) decreased at all time points after incision (T1~T4)(P<0.05) and the expression of KCC2 at T4 decreased significantly (P<0.05).Compared with group I(T1(5.6±0.8)g,T2(6.9±1.0)g,T3(7.6±0.9)g,T4(8.9±1.1)g),MWT of group I+K (T1(6.8±1.7)g,T2(8.0±1.4)g,T3(10.3±1.2)g,T4(11.3±1.2)g) increased at all time points after incision (T1~T4)(P<0.05) and the expression of KCC2 at T4 increased (P<0.05).Compared with group I+R(T1(3.2±1.0)g,T2(4.3±1.2)g,T3(5.4±1.1)g,T4(7.5±1.4)g),MWT of group I+R+K (T1(5.1±1.6)g,T2(6.2±1.5)g,T3(7.1±1.1)g,T4(8.3±1.2)g) increased at all time points after incision (T1~T4)(P<0.05) and the expression of KCC2 at T4 increased (P<0.05).ConclusionPre-treatment of subcutaneous injection of ketamine can reduce the hyperalgesia of rats induced by remifentanil and reduce the inhibition of KCC2 expression on dorsal horn of spinal cord.

Objective To study the effects of different hypertonic saline (4.5%and 7.5%) in fluid resuscitation on hemodynamics in traumatic rabbits with hemorrhagic shock.Methods Thirty-two healthy rabbits ( male or female, 2.0-3.0 kg body weight) were divided into 4 groups randomly:SHAM group, SWT group ( shock without treatment) , 4.5%group (resuscitation with 4.5% hypertonic saline), and 7.5% group ( resuscitation with 7.5% hypertonic saline), 8 rabbits in each group.The rabbit model of uncontrolled hemorrhagic shock was established after anesthesia.The fluid used in the two methods of fluid resuscitation was infused into the rabbits at designed times.The hemodynamic data including the left intraventricular systolic pressure ( LVSP) and maximal change rate of left intraventricular pressure ( ±dp/dtmax) were determined at 0 min, 30 min, 60 min, and 90 min.Results (1) The rabbit models of uncontrolled hemorrhagic shock were generated successfully.At 30 min, data of SWT in the 4.5%and 7.5%groups had no significant difference through pairwise comparison (P>0.05).(2) The hemodynamic parameters changed similarly during the experiment.At 60 min, the values of the 7.5%group ( LVSP=115.00 ±8.37 mmHg, +dp/dtmax=4.29 ±0.50 mmHg/ms, -dp/dtmax=-3.25 ±0.25 mmHg/ms) were significantly higher than those in the 4.5%group ( ( LVSP=104.14 ±7.73 mmHg, +dp/dtmax=3.35 ±0.39 mmHg/ms, -dp/dtmax=-2.27 ±0.12 mmHg/ms) (P<0.05).At 90 min, the data of the 7.5%group were higher, but statistically not significantly different ( P>0.05 ) .Conclusions Fluid resuscitation can improve the hemodynamic function in traumatic rabbits with uncontrolled hemorrhagic shock.Comparing with the 4.5%hypertonic saline, 7.5% hypertonic saline can improve the hemodynamic function more apparently.Our results may provide an experimental support for the treatment of clinical patients with uncontrolled hemorrhagic shock.

OBJECTIVE:To provide reference for the exploration of training model of clinical pharmacist in according with special condition of our country.METHODS:The manner of clinical pharmacist training and pharmaceutical care in the training base of our hospital were analyzed,and training contents and pattern were summarized.RESULTS&CONCLUSIONS:It needs to improve the capacity of students during clinical pharmacist training in respect of theory and practice.Moreover,strict access system and examination should be strengthened,teaching and studying should complement each other.

OBJECTIVE: The purpose of this article is to discuss the clinical value of central neck lymph node dissection in papillary thyroid carcinoma, especially in thyroid papillary microcarcinoma (PTMC). Also this article wants to evaluate the diagnostic significance of preoperative ultrasonography of central neck metastasis lymph nodes and the clinical significance of preoperative ultrasonography in central neck lymph node dissection. METHOD: Collected and analyzed 121 cases from September 2012 to December 2013. All of them had done the central neck lymph node dissection with the same standard by the same surgeon in our department. Evaluate the value of preoperative ultrasound diagnostic in thyroid microcarcinoma and non-microcarcinoma. RESULT: In the 121 patients, The 62 patients were diagnosed with PTMC (primary lesion d≤1. 0 cm). Accuracy rate of ultrasound diagnostic was 74. 2% (46/62), the rate of missed diagnosis was 61. 9% (13/21), the rate of misdiagnosis was 7. 3 % (3/41), sensitivity was 38. 1% (8/21), specificity was 92.7% (38/41), positive predictive value was 72. 7% (8/11), negative predictive value was 74. 5% (38/51) and the value of Kappa was 0. 3485. The other 59 patients was diagnosed with thyroid papillary non-microcarcinoma (primary lesion d>1. 0 cm). The accuracy rate was 55. 9% (33/ 59), the rate of missed diagnosis was 58. 3% (21/36), the rate of misdiagnosis was 21. 7% (5/23), sensitivity was 41. 7% (15/36), specificity was 78. 3% (18/23), positive predictive value was 75. 0% (15/20), negative predictive value was 46. 2% (18/39) and the value of Kappa was 0. 1757. CONCLUSION Cervical central lymph node dissection was necessary when the ultrasound diagnosis of cervical central lymph node-positive was prompted suspiciously in the thyroid papillary microcarcinoma. However, when it prompted negative, we could recommend patients to do the prophylactic central lymph node dissection in conjunction with the risk factors. Whether the ultrasound diagnosis of central lymph node was prompted suspiciously or not in the thyroid papillary microcarcinoma and non-microcarcinoma, the central lymph nodes dissection is necessary.
Carcinoma ; diagnostic imaging ; Carcinoma, Papillary ; diagnostic imaging ; Diagnostic Errors ; Humans ; Lymph Node Excision ; Lymph Nodes ; diagnostic imaging ; Lymphatic Metastasis ; diagnostic imaging ; Neck ; Risk Factors ; Sensitivity and Specificity ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; diagnostic imaging ; Ultrasonography

ObjectiveTo investigate the effects of Akt3 gene knockout on neuropathic pain behaviors induced by chronic constriction injury of sciatic nerve (CCI).MethodsExperiment was divided into two groups:Akt3 knockout group (Akt3-/-,n =12),wild type group (WT,n =12 ).Randomly numbered,the right sciatic nerve of mice were received the operation of chronic constriction injury.Paw withdrawal mechanical threshold (PWMT)and paw withdrawal thermal latency (PWTL) were tested on day 1 before operation and day 1,3,5,7,10,14,17,21 afterCCI.ResultsThe basic values of PWMT(right:(1.09±0.20)g,(1.17±0.22)g;left:(1.17±0.15)g,(1.22±0.23)g,P＞0.05) andPWTL(right:(6.18±1.11)s,(6.20±1.25)s;left:(5.82±0.91)s,(5.92± 1.71 ) s,P ＞ 0.05 ) had no statistically significant differences between two groups.On day 1 after operation,compared with basic values,the PWMT and PWTL of the right paw in both Akt3-/- group and WT group decreased significantly (P ＜ 0.05 ),and at least lasted up to day 21.The PWMT( 3d:(0.42 ± 0.22 ) g,(0.72 ± 0.36) g ; 17d:(0.29 ±0.15)g,(0.49 ±0.19) g;21d:(0.27 ±0.18)g,(0.56 ±0.15)g,P＜0.05) and PWTL(5d:(2.43 ±0.68)s,(3.13±0.52)s;17d:(2.43±1.26)s,(3.84±1.29)s ;21d:(2.14±1.23)s,(4.07±1.26)s,P＜0.05 ) of the right paw in Akt3-/- group was significantly lower than those in WT group.The PWMT and PWTL of the left paw in Akt3-/- group and WT group had no obvious differences (P ＞ 0.05 ). However.compared to left paw,the PWMT and PWTL of the right paw of the two groups were obviously lower (P ＜ 0.05 ).ConclusionThe neuropathic pain induced by CCI increased in Akt3 gene knockout mice.

BACKGROUND: Neuron-specific enolase, γtype isoenzyme that is specially present in the cytoplasm of neurons and neuroendocrine cells, is considered as a sensitive predictor for neuronal damage.OBJECTIVE: To observe the changes of serum neuron-specific enolase in patients with transient brain ischemic attack, so as to explore its relationship with the degree of neuronal damage.DESIGN: Case-control observation.SETTING: Department of Neurology, Jinan No. 4 People's Hospital.PARTICIPANTS: A total of 29 patients who were hospitalized in the Department of Neurology, Jinan No. 4 People's Hospital, due to transient brain ischemic attack (all called for emergent medical treatment within the onset of 6 hours) between March 2002 and May 2004 were enrolled in this study. There were 18 males and 11 females with the average age of(60.36t11.67) years. According to the duration of neural functional deficits, all subjects were divided into two groups, namely, transient-symptom group (≤ 6 hours) of 19 cases and lasting-symptom group (＞ 6 hours)of 10 cases. At the same time, 25 healthy controls, 15 males and 10 females with the average age of (62.34±9.65) years, rere selected from those who came for routine health examination.METHODS: Fasting elbow venous blood of 1 mL was collected only once from the subjects in control group; the same amount of blood was collected from the patients in transient ischemic attack group immediately after hospitalization, and at days 2, 3, 4 and 5. Roche Elecsys 2010 automatic analyzer was used to detect serum neuron-specific enolase. Neuronal damage was assessed with neurological deficit scale (defined as practical recovery if scores were reduced by 90%-100%; remarkable improvement if scores were reduced by 46%-89%; improvement if scores were reduced by 18%-45%; ineffective if scores were reduced by less than 17% or even the disease aggravated).MAIN OUTCOME MEASURES: The daily changes of serum neuronspecific enolase.RESULTS: All the54 subjects remained in the final result analysis. [1]Comparison of neuron-specific enolase density: It was significantly higher in transient brain ischemic attack group than in control group [(23.53±12.35) vs(14.29±6.83) μg/L, t=2.678, P ＜ 0.01]. [2] Curve of neuron-specific enolase changes during the acute stage: It began to increase at the early stage,reached the peak level on the next day, and gradually declined to the normal level in 4-5 days. [3] The level of serum neuron-specific enolase in the two groups with various durations of neurological deficit symptoms: It was obviously higher in transient-symptom group than in control group [(19.24±8.95)vs (14.29±6.83) μg/L, t=1.893, P ＜ 0.05], and higher in lasting-symptom group than in control group [(28.87±13.15) vs (14.29±6.83) μg/L, t=4.367,P ＜ 0.001]. [4] The level of neuron-specific enolase was positively correlated with the duration of neuronal damage (r=0.815, P＜0.01).CONCLUSION: Serum neuron-specific enolase increases within a short term after transient brain ischemic attack and reaches the peak level at around 24-36 hours, suggesting that the detection of serum neuron-specific enolase has a guiding value in assessing the severity of transient brain ischemic attack.