Adult ; Anti-Bacterial Agents ; administration & dosage ; Humans ; Male ; Periodontal Diseases ; therapy ; Subgingival Curettage ; Treatment Outcome

Objective To investigate the feasibility and superiority of combined spinal epidural anesthesia incesarean section.Methods 100 lying-in women who experienced cesarean section were collected and divided into combined spinal epidural anesthesia group(CSEA,n=50)and continuous epidural anesthesia group(CEA,n=50).The change of heart rate(HR),blood pressure(BP)and saturation of peripheral oxygen(SpO2),HR and BP of lyingin womeu in pre-anesthesia,5min,15min post-anesthesia and the time of taking effect,time between beginning of anesthesia and laboar of newborn were observed.The side effects of surgical anesthesia and Apgar score of newborn were compared between the two groups.Results There were no difference in clinical data,change of HR,BP and spO2 between two groups.The anaesthetic time of taking effect and the time between beginning of anesthesia and labour of newborn in group CSEA were shorter than in group CEA(all P＜0.05).Conclusion The combined CSEA and CEA was safe and efficient in cesarean section,and CSEA had greater efficacy than CEA in cesarean section.

[Objective]To study the best time for infusing antibiotics as prophylaxis against infection in hip arthroplasty.[Method]Ninty cases of hip arthroplasty were divided into 6 groups randomly with 15 cases each.Ampicillin(UNASYN,1.5g) and cefuroxime axetil(Zinacef, 2.0g) was administered by intravenous infusion respectively one day or one hour before operation or 30 minutes after the operation began.Blood samples from peripheral vein,cancellous bone of acetabulum when reaming,medullary canal of femur when rasping and catheter right after the operation were harvested.Serum Bactericidal Activities(SBAs) were determined by minim dilution technique and were compared between the groups.[Result]SBAs of UNASYN and Zinacef are similar to the bacteria most commonly causing infection after prosthesis implantation such as staphylococcus.Percentage at SBA≥1:8 of UNASYN and Zinacef is significantly more at the beginning of operation and when reaming acetabulum than the other groups(P

Objective To acknowledge the value of interventional therapy in gastrointestinal massive bleeding after abdominal surgery. Methods Retrospectively analyzed 11 patients with acute gastrointestinal bleeding after abdominal surgery, failure to conservative treatment and then undergone emergency angiography or interventional therapy. The correlative evaluation of DSA and interventional therapy was summarized. Results All together 11 case of abdominal postoperative massive gastrointestinal bleeding were undertaken DSA, revealing the bleeding sites as follows: the left gastric artery in 1 case, the gastroduodenal artery pseudoaneurysm in 4, hepatic artery pseudoaneurysm in 2, splenic artery pseudoaneurysm in 1, infected pseudoaneruysm of the branches of the inferior mesenteric artery in 1 and small branches of the superior mesenteric artery in 2 cases. Conclusion Interventional therapy in the treatment of gastrointestinal massive hemorrhage after abdominal surgery is effective.

OBJECTIVE:To promote effective development of services in the intravenous drugs allocation centre and to bring the pharmacists'function into full play in the hospital pharmacy.METHODS:Information concerning services in the intravenous drugs allocation centre of our hospital and experiences from which was introduced,some problems and difficulties in the pharmacy services were analyzed.RESULTS&CONCLUSION:The centralized allocation and management of intra-venous drugs have ensured the safety and effectiveness of the clinical intravenous drug use and which have become the essential part of the pharmaceutical care with a core of rational drug use.

Objective To analyze the clinical effects of individualized comprehensive physiotherapy interventions for temporomandibular disorders (TMD).Methods Data of 307 patients with TMD treated between April 2011 and March 2012 in the authors' department were collected and reviewed.All the patients were treated with individualized comprehensive physiotherapy approach based on the patient's category in research diagnostic criteria for TMD (RDC/TMD),such as patient education,ultrashort-wave diathermy,ultrasound therapy,soft tissue massage,joint mobilization and stabilization exercise.The treatment was administered for 3 weeks.The baseline and endpoint outcome assessment measures were maximum active mouth opening (mm),visual analogue scale (VAS) score and joint clicking (100％ before treatment).Results At the end of treatment,the patient's maximum active mouth opening [(36.95 ± 6.59) mm],VAS score (1.21 ± 0.62) and joint clicking [(29 ± 17) ％] improved significantly (P ＜ 0.05) compared to baseline.Conclusions Individualized comprehensive physiotherapy interventions can improve symptoms of TMD,such as joint clicking,pain,limited mouth opening.

Objective To explore the non-bacteria etiology of pneumonia in children under 12 years old in southwest Shanghai,and investigate clinical characteristic of pneumonia caused by different pathogens.Methods The serum of 187 children with pneumonia from July 2002 to December 2004 in hospital were investigated for respiratory syncytial virus(RSV),adenovirus 3 influenza viruses(IFV) A and B,parainfluenza viruses(PIV)type 1,2,3,4 and coxsackievirus A 1.7,echovirus 7 by employing the indirect immunofluorescence assay(IFA)for the identification of nearly 8 different viruses,and 3 different enteroviruses.Based on the principle that sensitized particles were agglutinated by the pressence of antibodies to mycoplasma pneumonia in human serum.Results Examination for 8 kinds of conventional respiratory virus infected,a total of 90 positive results in 187 cases(48.13%),Firstly was RSV(19.79%),(secondly) was IFV B(16.58%).Out of these 1084 children,154 cases(14.21%)showed positive in anti-mycoplasma pneumonia.Conclusions RSV is still the leading cause of pneumonia in children during winter and spring in southwest in Shanghai.Mycoplasma pneumonia is having been the major pathogens of the school-aged children with pneumonia.

Objective To study the effect of compound hypertonic saline solution (HSD) on sepsis.Methods 133 male Wistar rats were divided into four groups,sham operation group (n =15),cecal ligation and puncture (CLP)group (n =45),CLP plus normal saline (NS) group (n =45),and CLP plus HSD group (n =28).A rat model of sepsis was reproduced by CLP,and the rats in sham operation group received celiotomy without ligation and puncture.All rats in four groups received subcutaneous injection of 30 mL/kg 0.9％ sodium chloride after laparotomy.The rats in CLP plus NS group and CLP plus HSD group received infusion of 5 mL/kg 0.9％ sodium chloride or 7.5％ sodium chloride/6％ dextran post CLP via jugular vein for 3 hours,with the infusion rate of 0.4 mL·kg-1·min-1.The survival rate of each group was observed 9 hours and 18 hours after laparotomy.Mean arterial pressure (MAP) at 0,9,18 hours were monitored.Blood specimens were collected from all rats 0,9 and 18 hours after laparotomy,respectively,for measurement of the plasma levels of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1β),and procalcitonin (PCT).The rats were all sacrificed,and their lung tissues were harvested for the neutrophil count in bronchoalveolar lavage fluid (BALF),myeloperoxidase (MPO) activity in lung tissue,wet/dry weight ratio (W/D) of lung,and pathological changes in lung tissue.Results There was no death in the sham operation group.The survival rates at 9 hours and 18 hours were 62.2％ and 31.1％ in the CLP group,57.8％ and 35.6％ in the CLP plus NS group,85.7％ and 64.3％ in the CLP plus HSD group,and they were all significantly higher compared with those of the CLP group and the CLP plus NS group (P ＜ 0.05 or P ＜ 0.01).MAP levels in the CLP group and the CLP plus NS group were significantly lower than those in sham operation group,and the plasma levels of TNF-α,IL-1β and PCT were significantly higher compared with those of sham operation group,while there was no difference between CLP group and the CLP plus NS group.MAP and the plasma levels of TNF-α,IL-1β and PCT in the CLP plus HSD group were significantly improved compared with those of the CLP plus NS group at 9 hours and 18 hours [MAP (mmHg,1 mmHg =0.133 kPa) at 9 hours:102±5 vs.94±6,18 hours:90±2 vs.72±3; TNF-α (ng/L) at 9 hours:284.19±57.18 vs.329.67±45.79,18 hours:263.46±42.58 vs.349.68±52.40; IL-1β (ng/L) at 9 hours:219.28±39.21 vs.263.47±32.36,18 hours:195.98±39.06 vs.250.10±41.57; PCT (μg/L) at 9 hours:2.32±0.37 vs.4.52±0.75,18 hours:2.89±0.62 vs.5.02±0.84; P ＜ 0.05 or P ＜ 0.01].The ratio of neutrophils in BALF,MPO activity and lung W/D at 18 hours in the CLP group and the CLP plus NS group were significantly higher than those of the sham operation group,while they were all significantly lower in the CLP plus HSD group than those of the CLP group and the CLP plus NS group [ratio of neutrophils in BALF:0.094±0.019 vs.0.148±0.062,0.151 ±0.055; MPO (U/g):1.19±0.45 vs.2.31 ±0.79,2.64±0.69; lung W/D ratio:4.02 ± 0.63 vs.5.14 ± 0.59,5.12 ± 0.83,all P ＜ 0.05].Under light microscope,no pathobiological changes were found in sham operation group.The lung tissues in the CLP group and the CLP plus NS group showed congestion,edema,infiltrating inflammatory changes,while the inflammatory changes in the lung tissue in the CLP plus HSD group were significantly alleviated.Conclusion HSD can obviously ameliorate the circulatory failure in septic rats,alleviate immune disturbance and acute lung injury,and improve the survival rate of rats with sepsis.

ObjectiveTo assess the effects of constraint-induced movement therapy(CIMT) on sub-acute stroke patients with upper extremity motor dysfunction.Methods63 patients with hemiplegia after stroke were divided into two groups: control group(31 cases) and CIMT group(32 casese). The two groups received the regular rehabilitation training for 14 d. Then the control group went on the the regular rehabilitation training, while the CIMT group received CIMT for 14 d. All patients were assessed by the Action Research Arm Test(ARAT) and Fugl-Meyer(FMA) on the first day, the 15th day and the 30th day after the treatment.ResultsARAT score and FMA scores were higher in CIMT group than in the control group 30 d after the treatment and in CIMT group 15 days after the treatment(P<0.001).ConclusionCIMT is more effective to improve the upper limb motor function of the sub-acute stroke patients than the regular rehabilitation training.

Objective This study aimed to investigate whether the copy numbers of the CCL3L1 (Chemokine C-C-Motif Ligand 3 Like Protein 1) gene were associated with susceptibility to ankylosing spondylitis (AS). Methods A total of 806 Chinese individuals including 405 AS patients and 401 healthy controls were enrolled. The CCL3L1 gene copy number was measured by a custom-by-design Multiplex AccuCopyTM Kit based on a multiplex fluorescence competitive polymerase chain reaction (PCR) principle, and 50 samples were randomly selected using the fluorescent quantitative PCR method to verify copy number. Main statistical method was t test, chi-square test and logistic regression model. Results There were no statistically significant differences between the case group and control group in age and gender ( t=1.77, P=0.076, χ2=1.14, P=0.289). The copy number of CCL3L1 gene ranged from 0 to 13 in both AS patients and the controls. After copy numbers were classified into 3 categories by 3, we did not find significant difference between the two groups ( χ2=0.591, P=0.669). And regression analyses also did not support the hypothesis that CCL3L1 gene copy number variation (CNV) could be an impact factor to the severity or function indexes of AS patients ( χ2=0.341, P=0.804 and χ2=0.472, P=0.774, respectively). Conclusion We suggest that the copy number of the CCL3L1 gene does not have a role in the susceptibility and the severity or function to AS.