Exercise therapy technology is a main course of rehabilitation therapy specialty in middle medcial school. The paper discussed several problems needing attention in teaching in order to improve the teaching quality.

Objective To study the mutations of Pseudomonas aeruginosa oprD gene in Imipenem-resistant clinical isolates. Methods Random amplified polymorphic DNA typing(RAPD) was carried out to analyse the homology in 10 Imipenem-resistant clinical isolates. Pseudomonas aeruginosa oprD gene in 10 Imipenem-resistant clinical isolates were amplified by polymerase chain reaction and sequenced. Results Ten Imipenem-resistant clinical isolates were divided into four different clones which can not produce metallo ?-lactamase. As compared with sequence X63152, oprD gene of Pseudomonas aeruginosa varied greatly. The aberration rates exceed 50%. There were multiple point mutations within 276～387 bp coding region of 30, 11, 9, 20, 31 strains. Due to the mutations of 308 bp G→C and 344 bp C→A, threonine and diaminocaproic acid were replaced by serine and threonine respectively. The DNA deletion of 393～412 bp in oprD gene contributes to the frame shift mutation in the following nucleotide sequence. The deletion of 264～273 bp in the coding region of oprD gene in 13 and 21 clone strains leads to frame shift mutations forming terminal codon TAA(319～321 bp).Base substitutions and multiple point mutations were obvious in the coding regions of 1 and 22 clone strains. Their aberration rates were 54.03% and 74.89% respectively. Conclusions The mutations of Pseudomonas aeruginosa oprD gene in Imipenem-resistant clinical isolates are various.

Objective To explore the effect of miniAd-ATP7B-GFP on the copper metabolism of skin fibroblasts of Wilson′s disease ( WD ) patients under high concentration copper medium.Methods Firstly, mini-adenovirus carrier containing human ATP7B gene was built and the mutations of 8 WD patients were detected.Fibroblasts from primary culture of skin of WD patients and normal human were cultivated 72 h in basic medium and medium with the copper concentration of C1(22.3μmol/L), C2(89.2μmol/L), C3 (156.1 μmol/L), C4 (245.3 μmol/L).Then the concentration of copper and protein was detected and copper/protein ratio was calculated.Secondly, miniAd-GFP ( miniAd-GFP group) and miniAd-ATP7B-GFP ( miniAd-ATP7B-GFP group ) were added into WD patients skin fibroblasts respectively, Wilson non-transfection group and normal group were set up as control, and C4 medium was used to culture the cells of four groups for 72 h and 96 h.Then the concentration of copper and protein was detected and copper/protein ratio was calculated.Results Five kinds of mutations were detected from 8 WD patients.The copper/protein ratio of WD patients and normal human in basic medium and the C1 -C3 groups had no statistically significant difference, but in C4 group (WD (1 871.6 ±209.2) ng/mg, normal group (1 267.2 ±188.3) ng/mg) the difference was statistically significant (t=6.075, P<0.01).C3((816.3 ±113.9) ng/mg) and C4 groups had statistically significant difference compared with the basic medium group ( ( 159.2 ± 38.6) ng/mg;WD:χ2 =31.493, normal group:χ2 =30.708, both P<0.01).The copper/protein ratio of 96 h group was higher than 72 h group.Compared with WD non-transfection (96 h:(2 731.2 ±188.7) ng/mg,72 h:(1 901.7 ±219.5) ng/mg) and normal groups, miniAd-ATP7B-GFP group had statistically significant difference both in 96 h ( ( 2 071.0 ±171.8 ) ng/mg ) and 72 h groups ( ( 1 495.5 ±161.4 ) ng/mg;72 h:F=20.130, 96 h: F=51.496,P<0.01).Conclusion MiniAd-ATP7B-GFP has partial improvement on copper metabolism of skin fibroblasts of WD patients under high concentration copper medium.

Chemokine CCL5 and its receptor CCR5,as one of the chemokine family,are involved in the processes of many diseases and especially play an important role in breast cancer.Recent researches show that chemokine CCL5 and its receptor CCR5 have an obvious impact on the tumorigenesis,invasion,metastasis,therapy and prognosis of breast cancer.

Objective To determine the ESBLs of Klebsiella pneumoniae and ESBL typing by molecular genetic procedures. Methods MIC test and ESBLs confirmation test were taken by agar dilution method in 80 strains of Klebsiella pneumoniae isolated in Beijing area from July 1999 to December 1999. To the 20 ESBLs positive conjugates isoelectric focusing was given. And nucleotide sequencing was analysed to conjugate strain CK23. Results 28 (35%) of the 80 strains of Klebsiella pneumoniae produced ESBLs. In the 28 strains, 20 were successfully done with conjugation of resistant plasmid. Isoelectric focusing results revealed that 13 (65%) of the 20 strains produced an ESBLs protein with a pI of 8.8 with or without additional pI 7.6 and pI 5.4. These ? lactamases were all inhibited by clavulanite acid. The strains with pI=8.8 protein were highly resistant to cefotaxime and ceftriaxone but were susceptible or intermediate to ceftazidime. We picked CK23 strain out from 13 conjugates for gene cloning by the primers designed for bla CTX M and nucleotide sequencing. The results showed that the ESBLs gene in CK23 was CTX M, highly similar to CTX M 3 but had 3 amino acids, which were Glu39Gly, Leu122Pro, Asp278His. Conclusions 28 (35%) of the 80 strains of Klebsiella pneumoniae produced ESBLs. Resistant plasmid successfully conjugated in 20 of the 28 ESBLs producing strains. 13 of the 20 (65%) conjugates pruduced a pI =8.8 ESBLs,which was CTX M ESBLs,with only 3 amino acids different from CTX M 3. This paper indicated that a type of CTX M ESBLs existed in Klebsiella pneumoniae in Beijing, which specifically confers resistance to cefotaxime.

Objective: To examine the temperament of childhood epilepsy. Methods:Subjects were 84 children with epilepsy diagnosed by criteria of ILAE (international league of anti-epilepsy) 1981 and 168 normal children. Their temperament was assessed with Carey's temperament questionnaires (for parents).Results:Children with epilepsy had higher scores on activity level (3.4?0.6/3.1?0.7,t=5.38,P

Objective To study the effect of different concentration of tumor necrosis factor-? (TNF-?) on expression of the receptor activator of nuclear factor-kappa B ligand (RANKL) and osteoprotegerin (OPG) mRNA on human dental follicle cells in vitro, and investigate the role of TNF-? in osteoclast formation during tooth eruption. Methods The 5th passage of primary cultured human dental follicle cells were treated with 0 (control group), 5, 10, 25, 50 and 100ng/ml TNF-?, respectively, for 6 hours. Total RNA was then isolated from human dental follicle cells and subjected to RANKL and OPG mRNA assay by reverse transcription-polymerase chain reaction (RT-PCR) technique. The relative expression levels of RANKL and OPG mRNA were normalized to ?-actin gene expression. Results The mRNA expression of OPG in human dental follicle cells with 5ng/ml TNF-? treatment was down regulated significantly compared with that in control group (P

ObjectiveTo explore the efficacy of 131 Ⅰ treatment in Graves' disease,and to analyze the related factors.MethodIn 87 patients with Graves' disease,thyroid uptake ratio( TUR ) and its effective half-life(EHL) were compared before and after 131 Ⅰ treatment.The weight of thyroid gland was evaluated with radio-imaging and type B ultrasonography.ResultThe dose of 131 Ⅰ was ( 185.2 ± 148.0 ) MBq.The TUR of tracer dose and therapeutic 131 Ⅰ dose were 76.5 ％ ±8.2％ and 73.3 ％ ±9.0％ ( t =2.451,P =0.008 ).The EHL were ( 5.2±0.7 ) and ( 5.0 ±0.8 )days,respectively ( t =1.998,P =0.023 ).After followe-up of ( 57.0 ±26.3 ) months,49 patients ( 56.3 ％ ) became euthyroid,14 ( 16.1％ )manifested delayed hypothyroidism,and 24 (27.6％)remained in hyperthyroidism.Thyroid autoantibodies were found in 34.5％ patients,of whom,the incidence of hypothyroidism was higher in patients with positive autoantibodies than those with negative ones (30.0％ vs 8.8％,x2 =6.560,P =0.009 ).ConclusionBoth TUR and EHL of therapeutic doses of 131 Ⅰ are lower than the tracer doses.Positive thyroid autoantibodies may affect the outcome of the 131 Ⅰ treatment.

Objective To guide the implementation of home enteral nutrition (EN) for outpatients with Crohn's disease, and to observe its effect.Methods In this observational study, 26 patients at active period of Crohn's disease were collected between April 2014 and June 2015 in the clinic of Clinical Nutrition Center of Nanjing General Hospital of Nanjing Military Command.Home EN combined with medication was administered.The nutritional status, Crohn's Disease Activity Index (CDAI), and quality of life before and after EN were compared.Results After home EN therapy, body mass index (BMI) of the patients increased from (17.7 ± 2.1) kg/m2 to (19.8 ± 2.0) kg/m2 (P ＜ 0.001), proportion of lymphocytes from (0.216 ± 0.066) to (0.305 ± 0.106) (P =0.007), albumin level from (40.3 ± 5.9) g/L to (43.7 ± 5.4) g/L (P =0.038), prealbumin from (233.1 ± 71.5) mg/L to (306.0 ± 72.1) mg/L (P =0.009), and transferrin from (2.7 ± 0.6) g/L to (3.1 ±0.7) g/L (P =0.038).In the indicators reflecting the activity of Crohn's disease, CDAI declined from 197.0 ±55.8 to 113.2 ±33.4 (P ＜0.001) after EN, C-reactive protein from 28.50 (18.00-32.80) mg/L to 2.00 (0.58-6.33) mg/L (P ＜0.001), erythrocyte sedimentation rate from (29.6 ± 9.9) mm/h to (9.4 ± 7.6) mm/h (P ＜ 0.001).The patient's disease activity scores and inflammatory reaction indexes all reached the normal levels after EN, show that the patients were in remission stage.In inflammatory bowel disease quality of life score, the score of intestinal symptoms rose from 41.2 ± 13.3 to 57.0 ±9.6 (P ＜ 0.001), the score of systemic symptom from 20.7 ± 5.5 to 28.9 ± 4.2 (P ＜ 0.001), emotional ability from 43.6±16.1 to 61.0 ± 15.9 (P=0.002), and social ability from 20.6 ±4.9 to 28.4 ±5.6 (P＜0.001), all showing statistical significance.Conclusions Standardized home enteral nutrition in patients at active period of Crohn's disease, when implemented under professional guidance of nutritional support team and well followed up, may improve nutritional status, induce remission, and improved quality of life.

Objective Three-dimensional(3D) automated ultrasonic volume measurement is becoming favorable in clinical application and turns to be an important direction .The article was to evaluate the consistency of two-dimensional (2D) and three-di-mensional ultrasonography in the diameter measurement of single follicle . Methods 438 single folliculars were respectively meas-ured by the same sonographer in 2D and 3D ultrasonic measurement.2D diameter, 3D mean diameter and 3D virtual ball diameter of every single follicle were recorded , and Bland-Altman method were used to evaluate the consistency of the results by these two meth-ods. Results In the consistency analysis on the diameter measurement of single follicle by 2D and 3D mean diameter measurment methods, d equaled -1.06 mm, and 95% LoA range covered the range of -4.82 mm to 2.70 mm.95% CI of 95% LoA range,-5.21 mm to 3.08 mm, was beyond the settings of clinical acceptable error limit range , -3.56 mm to 1.44 mm, showing poor consis-tency.Likewise, in the research of the consistency in the measurement of 2D diameter and 3D virtual ball diameter in the diameter measurement of single follicle , d equaled -0.07 mm , and 95%LoA range covered the range of -3.11 mm to 2.98 mm.95%CI of 95%LoA range, -3.43 mm to 3.29 mm, was beyond the settings of clinical acceptable error limit range , -2.57 mm to 2.43 mm, showing poor consistency . Conclusion 2D and 3D ultrasound measurements in the diameter measurement of single follicle are not consistent.However, considering the objectivity and accuracy of the results , 3D ultrasonography still has an advantage over 2D ultra-sonography , which can provide more acurate aid for assisted reproductive technology .