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 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.

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 new ways for treating multiple-ulcer treatment of breast tuberculosis. Methods The clinical data fo 10 cases of muhiple-ulcers summary of TB breast-conserving surgery and breast sur-gery purely traditional procedure were retrospectively analyzed. Results Surgical incision of 10 patients were healed stage Ⅰ, 2 patients experienced abscess drainage before admission to hospital and local incision healing was poor, who were healed through the out-patient dressing, and no skin ischemic necrosis occurred as well as the breast was in good shape. Follow-up lasted 3 to 26 months, during which period there was no recurrence, and patients and their families present with 100% satisfaction. Conclusion Conserving surgery with anti-TB rules is the new way of muhi-ple ulcer type of breast tuberculosis treatment,which is minimally invasive, effective, safe, with less complications and economical and practical advantages.

BACKGROUND: The pain and the unstability of the knee joint are the main clinical manifestation of knee osteoarthritis.OBJECTIVE: To verify the efficacy of ultrasonic drug penetration combiued with quadriceps exercise in treating senile knee osteoarthritis.DESIGN: Randomized controlled study.SETTING: Rehabilitation Department of the Affiliated Hospital of Luzhou Medical College.PARTICIPANTS: Seventy-six in-patient and out-patient cases of the knee osteoarthritis, 28 males and 48 females and total 109 knees, were chosen in the Orthopaedic Department and Rehabilitation Department in the Affiliated Hospital of Luzhou Medical College in theperiod between August,2001 and August, 2004. The cases were randomly divided into the experimental group and the control group with 38 cases each.therapy apparatus made in Mianyang was adopted and the diameter of the handpiece was 3 cm. 10 g/L dichloride sodium emulsion (made by Beijing Nuohua Pharmaceutical co.,Ltd) was taken as the coupling agent to smear around the knee joint about 0.75 -1.25 W/cm2, once a day, and 8-10 minutes per time. Meanwhile the static isometric contraction exercise of the knee joint in the extension position was done. Using the quardriceps isometric exercise apparatus, the Delorme progressive resisThe same ultrasonic therapy was done as the therapy group. The nonthermal and microthermal ultrasonic wave was adopted on the suffered location 10 -15 minutes per time, and the tolerance dose of the mid-frequency current was given 20 minutes per time and once a day using the CM-efficacy was assessed in the two groups 4 weeks after the therapy. During the therapy period the anti-inflammatory and analgesic drugs were not patient's knee joint activities of daily life (0 score signifies no pain, 10 scores severe pain, the pain relief better than 40% that before the therapy means the effectiveness). The lower limb activity of daily life was chosen to evaluate the patient's knee joint activities of daily life (5 items,total 10 scores, high score means good, low score means poor). The maximal loading dose in the extension position of the knee joint was measured on the quadriceps isometric exercise apparatus using the suspension weight method.The maximal loading dose in the extension position of the knee joint in the two groups.result of the walking pain scale in the two groups before and after the therapy: The score of pain evaluation after therapy was significantly lower than that before the therapy (P ＜ 0.01), and there was no significant differs knee joint activities of daily life in the two groups before and after the therapy: the result after the therapy was siguifieantly better than that before the therapy, and the efficacy after the therapy was significantly higher than that before the therapy, the efficacy of the experiment group was better than that of the control group (9.61±1.82, 8.77±2.28), while there was tion results of the maximal loading dose in the extension position of the knee joint in the two groups: the result of the experimental group after the therapy was significantly better than that of the experimental group before the therapy and the control group [ (10.05±2.41) kg vs (7.86±1.98) kg and (8.76±1.65) kg, P ＜ 0.01 ].CONCLUSION: The ultrasonic wave using the dichloride sodium emulsion as the ultrasonic coupling agent in combination with quadriceps strengthening exercise in treating the senile knee osteoarthritis is efficacious in relieving pain and improving the ADL ability of the knee joint, increasing the maximal loading dose in the extension position of the knee joint and the stability of the knee joint. The efficacy of the combination therapy is better than the single ultrasonic therapy.

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.

Objective To investigate the effects of Aktl gene knockout on pain behavior induced by chronic constriction injury model of sciatic nerve (CCI).Methods C57BL/6 male mice were randomly divided into Akt1 knockout group (KO group,n=12),wild type group(WT group,n=12).All mice were made model of CCI in the right sciatic nerve.Each mouse received tests of the paw withdrawal mechanical threshold (PWMT) and the paw withdrawal thermal latency(PWTL) at the times of 1d before and 1 d,3 d,5 d,7 d,10 d,14 d,17 d,21 d after surgery.Results For both KO group and WT group,the basic values of PMWT(right(0.89±0.15)g,(0.87±0.15)g; left(0.97±0.19) g,(1.05±0.14) g,P＞0.05) and PWTL(right (7.64±0.71) s,(7.56±0.68) s ;left: (7.67±0.6) s,(7.64±0.64) s,P＞0.05) showed no significantly statistical difference.Compared with WT group and the basic value,PWMT and PWTL were significantly decreased after surgery in KO group (P＜0.05).The PWMT and P WTL of the left paw in KO group and WT group had no obvious statistical difference (P＞0.05).However,the PWMT and PWTL of the right paw significantly decreased in the two groups compared with left paw.Conclusion h aggravates the neuropathic pain induced by CCI in mice when the Akt1 gene was knocked out.

Objective To explore the training demand among clinical medical postgraduate students.Methods Focus Group Discussions and a research interview,two of the qualitative study methods were applied among medical students of a hospital.Results Different clinical medical postgraduate students need different levels training.The demand status related to the students' training styles.Students had desire to receive kinds of help of hospital administrative authority.Conclusion Training guide is importance during the growth of clinical medical postgraduate students.Hospital administrative authority should afford manifold ways to satisfy the demand of students for their training.

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.

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.