20 children aged 3 years ±3 months with dental caries were randomly divided into 2 groups(n =1 0).The caries tissue was re-moved by conventional bur and Er:YAG laser respectively without the use of mouth speculum,mouth gag and binding belts.In laser group the success rate of treatment at first visit and return visit was higher(P <0.05)and children's dental anxiety grad was lower(P <0.05).The Er:YAG laser is more effective in easing children's dental anxiety and in the dental treatment.

Accessory pathway-induced dilated cardiomyopathy is a new diagnosis proposed recently.Pre-excitation of part of the myocardium may mediate electrical and mechanical dyssynchrony,which will result in decreased left ventricular systolic function and increased diameter of left ventricle in patients with right-sided overt accessory pathways (type B ventricular preexcitation).Its features are listed as follows:(1) Incessant and prolonged tachyarrhythmia never happened.Tachycardiomyopathy and other causes of dilated cardiomyopathy are excluded.(2) Right-sided overt accessory pathways are shown by electrocardiogram.(3)Echocardiography indicates dyssynchronous left ventricle contraction,decreased left ventricular systolic function and increased diameter of left ventricle.Normal interventricular septal motion,recovered left ventricular and reversed left ventricular remodeling can be realized by radiofrequency ablation with a good prognosis.To infant patients,taking anti arrhythmia drugs to inhibit the conduction of the accessory pathway was recommended.

AIM：To investigate the roles of nitric oxide (NO) and endothelin-1(ET-1) in regulation of coronary vascular reserve (CVR) during hypoxia.METHODS： CVR were measured with 99m TC radiolabelled frog RBC, the changes of NO-2，ET-1 contents， nitric oxide synthase(NOS) activity and the myocardial morphometry were observed. RESULTS： (1) Acute hypoxia caused an increase in left and right ventricular myocardial blood flow，myocardial NO-2，ET-1 contents，NOS activity，but CVR in the left and right ventricle were decreased compared with the control group.(2) Intermittent hypobaric hypoxia for 90 days did not lead to significant change in left ventricular CVR，myocardial ET-1/NO-2 ratio. However, right ventricular myocardial ET-1 contents，ET-1/ NO-2 ratio were increased，right ventricular CVR and myocardial NO-2 contents were decreased. We also observed that perivascular collagen，arterial wall thickness in right ventricle， hematocrit，RV weight index were augmented. CONCLUSION： Rest myocardial blood flow was increased，CVR was decreased；The decreased coronary vascular reserve during chronic hypoxia might be resulted from the increased hematocrit，arterial wall thickness，perivascular collagen，ET-1 content, the decreased NO content and right ventricular hypertrophy

Objective To understand the distribution and antimicrobial resistance of pathogens isolated from blood culture in a hospital in Sanya city.Methods Blood culture specimens and antimicrobial susceptibility testing results in this hospital from January 2013 to December 2015 were analyzed retrospectively.Results A total of 356 isolates of pathogenic bacteria were isolated from 3 195 blood culture specimens,the positive rate was 11.14％,including 215(60.39％)gram-negative bacterial strains,122(34.27％) gram positive bacterial strains,and 19(5.34％) fungi strains.The top 3 gram negative bacteria were Escherichia coli (n =90,25.28％),Klebsiella pneumoniae (n =60,16.85％),and Burkholderia pseudomallei (n =24,6.74％);the most common gram positive bacteria were Staphylococcus aureus (n =42,11.80 ％),coagulase-negative staphylococcus (n =38,10.67 ％),and Streptococcus spp.(n =33,9.27 ％).Resistance rates of Escherichia coli and Klebsiella pneumoniae to cefoperazone/sulbactam,amikacin,and carbapenems were all lower than 10.00％;resistance rates of Burkholderia pseudomallei to most antimicrobial agents were lower than 10.00％.There were no strains of main gram-positive bacteria that were found to be resistant to linezolid and vancomycin.Conclusion Gram-negative bacteria are the main pathogens causing bloodstream infection in this hospital in recent years,especially the isolation rate of Burkholderia pseudomallei is higher,which should arouse more attention in clinic.

AIM:To investigate the roles of nitric oxide (NO) and endothelin-1(ET-1) in regulation of coronary vascular reserve (CVR) during hypoxia.METHODS: CVR were measured with 99m TC radiolabelled frog RBC, the changes of NO - 2,ET-1 contents, nitric oxide synthase(NOS) activity and the myocardial morphometry were observed. RESULTS: (1) Acute hypoxia caused an increase in left and right ventricular myocardial blood flow,myocardial NO - 2,ET-1 contents,NOS activity,but CVR in the left and right ventricle were decreased compared with the control group.(2) Intermittent hypobaric hypoxia for 90 days did not lead to significant change in left ventricular CVR,myocardial ET-1/NO - 2 ratio. However, right ventricular myocardial ET-1 contents,ET-1/ NO - 2 ratio were increased,right ventricular CVR and myocardial NO - 2 contents were decreased. We also observed that perivascular collagen,arterial wall thickness in right ventricle, hematocrit,RV weight index were augmented. CONCLUSION: Rest myocardial blood flow was increased,CVR was decreased;The decreased coronary vascular reserve during chronic hypoxia might be resulted from the increased hematocrit,arterial wall thickness,perivascular collagen,ET-1 content, the decreased NO content and right ventricular hypertrophy.

Objective To explore the influence of OPN in eutopic glandular epithelial cells of endometriosis on the NF-κBp65 expression and its relationship with the cell invasion .Methods The eutopic primary glandular epithelial cells in 12 cases of endome-triosis were performed the primary isolation and culture .The cells were collected after 24 h OPN siRNA intervention .Western blot and RT-PCR methods were adopted to detect the expressions of OPN ,NF-κBp65 protein and its mRNA before and after interven-tion .The Transwell experiment was used to detect the change of cell invasiveness before and after intervention .Results The ex-pression of OPN protein and mRNA after interfering primary glandular epithelial cells by OPN siRNA was significantly decreased , and the difference was statistically significant (t1 =7 .92 ,t2 =9 .87 ,P<0 .05) .the expression of NF-κB p65 protein and mRNA after OPN siRNA interfering primary glandular epithelial cells was obviously weakened ,the difference was statistical significant (t=2 .38 ,P<0 .05) .the invasiveness of primary glandular epithelial cells after OPN siRNA intervention was significantly decreased ,the difference was statistically significant(t=2 .38 ,P<0 .05) .The expression of OPN and NF-κBp65 had a significantly positive corre-lation in eutopic endometrial glandular epithelial cells (r=0 .87) .Conclusion The expression of OPN and NF-κBp65 is significantly decreased after OPN siRNA interfering eutopic endometrial glandular epithelial cells ,therefore OPN most likely lead to the occur-rence and development of endometriosis via the NF-κB pathway .

Objective:To estimate the remineralization of enamel of primary teeth with early caries protreated by NaF-chitosan gel.Methods:Early stage caries was created on anterior primary teeth.The samples were divided into 4 groups randomly (n =6),and treated by NaF-chitosan gel,chitosan gel,duraphat and non-treatment(the control) respectively.Then all samples were underwent a 7days pH cycle.Then samples were tested with SEM and EDS.Data were analyzed with SPSS 19.Results:The SEM data showed that chitosan gel protected the enamel surface from being mined by erosion.NaF-chitosan gel group showed more mineral crystal formation on the enamel surface.The NaF-chitosan gel group showed more Ca remineralized on the enamel surface.Conclusion:NaF-chitosan gel can increase the remineraliztion of on the anterior primary teeth with early stage caries.

Objective To investigate the efficacy of combining ultrasonic with three-dimensional imaging guided microwave ablation in treating large hepatocellular carcinoma.Method The clinical data of 262 patients with large unresectable liver cancer who were admitted to the Air Force General Hospital from Jan 2011 to Jun 2014 were retrospectively analyzed.Of these patients,136 underwent transcatheter arterial chemoembolization (TACE),and the remaining 126 patients underwent combined ultrasonic with three-dimensional imaging guided microwave ablation (MWA).The AFP levels,tumor ablation rate,postoperative complication rates and survival rates between the two groups were compared.Result There were significant differences in the AFP levels in the two groups before and after surgery (P ＜0.05),but no significant differences were found between the 2 groups (P ＞ 0.05).A significant difference was also observed on tumor ablation rate.In the MWA group,11 patients (8.73％) developed complications,while 21 patients (15.44％) in the TACE group developed complications,(P ＜ 0.05).The 3-month,9-month,1-year,2-year and 3-year survival rates were 99％,95％,81％,70％ and 57％ in the MWA group,and 98％,94％,63％,36％ and 28％ in the TACE group.There were significant differences in the 1-year,2-year and 3-year survival rates,but no significant difference were observed in the 3-month and 9-month survival rates.Conclnsion Combined ultrasonic with three-dimensional imaging guided microwave ablation increased the rate of tumor ablation and prolonged the survival time of patients with large hepatocellular carcinoma.

Objective To investigate the drug resistance,source and molecular epidemiology of methicillin-resistant Staphyloccus aureus(MRSA)causing nosocomial infection. Methods Fifty-seven pathogenic MRSA strains were isolated from Beijing Tongren Hospital during 2007 and 2008.K-B method,MIC assay,multiple PCR,automatic repetitive element sequence-based PCR(REP-PCR)typing platform and DL MRSA Library were used to identify the resistant phenotypes,Panton-Valentine leukocidin gene (pvl)and REP-PCR types of the MRSA.Results All strains were classified as 6 antibiotic resistant phenotypes(a-f)based on the resistance to rifampin,clindamycin,levofloxacin and cotrimoxazole.The MRSAs with Staphylococcal cassette chromosome mec(SCCmec)Ⅲ and SCCmec Ⅱ accounted for 91.23% (52/57)and 5.26%(3/57)of all strains,respectively.Only one strain was pvl positive.All strains were typed as REP-A-F(6 types)and three single clones by automatic REP-PCR typing platform,in which REP-C was predominant(30/57,52.63%).Three out of 6 REP-D strains were from laryngology wards.The REP-C-SCCmec Ⅲ were genetically most close to the Brazilian clone-SCCmec Ⅲ in DL MRSA Library.Conclusion s REP-C-SCCmec Ⅲ-a type are the major epidemic hospital-associated MRSA and the REP-D-SCCmec Ⅲ-d is usually isolated from patients received laryngeal surgery. Automatic REP-PCR typingplatform combined with DL MRSA Library database is an effective approach to study the nosocomial infection.

Objective To observe the clinical efficacy of ulinastatin(UT) conjoined to high flow continuous blood purification( CBP) in the critical patients with multiple organ dysfunction syndrome(MODS). To evaluate the therapeutic potential of UT and CBP in systemic inflammatory response syndrome (SIRS) , severe sepsis( SS) , acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Method A total of 122 cases of emergency and critical patients with a score of more than 15 counted up from APACHE H (acute physiology and chronic health evaluation 11 ) were randomly divided into Ulinastatin treatment group (UT group, n = 35) .continuous blood pu-rification(CBP group, n = 31),UT plus CBP (combine group, n = 30) and routine treatment group (control group, n =26). Routine treatment was given to patients of all groups, and patients of UT group had Ulinastatin 0.4 MIU given intravenously every 8 hours for 7 days in addition. Patients of CBP group were managed with continuous blood purification round the clock for 7 days and those of combine group were treated with UT plus CBP for 7 days.The efficacy of the treatment in four groups was assessed,and serum high sensivity reactive protein(hs-CRP) and IL-6 levels were measured on admission and comparison was made between values of biomarkers taken before and 1 d,3 d,and 7 d after treatment in four groups. The changes in WBCs,arterial gas analysis and the oxygena-tion index PaO2/FiO2 were checked, and at the same time, the APACHE II values and the incidence of MODS were compared within four groups. Results (1)One, three and seven days after treatment the plasma hs-CRP and IL-6 levels in UT and CBP groups were reduced significantly more than those in control group ( P < 0. 05), and in combine groups those were more dramatically lowered ( P < 0.05, P < 0.01). Before treatment there was no significance diffience in those values between groups, and there was on diffience in those values between 3 rd day and 7 th day after treatment ( P > 0.05). (2) The 1 st,3 rd and 7 th day after treatment the arterial gas PaO2/FiO2 index in UT and CBP groups was improved more than that in control group ( P < 0.05) , and it in combine group was most significant improved (P < 0.05,P < 0.01). The ALT and creatinine were lower than those in control group ( P < 0.05), and there were no significant differences in ALT and creatinine between groups before treatment (P > 0.05). (3) The 1 st,3 rd and 7th day afer treatment,the APACHE II values in UT and CBP groups were decreased more than those in control group ( P < 0. 05) , and therefore, the incidence of MODS was lower ( P < 0.05). Conclusions Ulinastatin could significantly inhibit the production of inflammatory cytokines and CBP could effectively eliminate inflammatory factors from blood, and the combination of these two approaches produce a more effective therapeutic potential for preventing MODS development.