0.05) in GCF. Conclusion:, The change PGE 2 and ALP in GCF of periodontitis tooth was similar to that of normal tooth during orthodontic therapy.

Objective:To analyze the effects of mutiparity on the pelvic floor muscle and the best time of postpartum for pelvic floor rehabilitation intervention.Methods:By questionnaire survey and pelvic floor functional checking on women with 42 days postpartum clinic routine health checking,and following up pelvic floor muscles force exam in postpartum 3 months,6 months and 1 year,426 cases were included in the puerpera group,including primipara 325 cases as primiparous group,two birth multipara 101 cases as multiparous group,the damage of pelvic floor muscles(≤level Ⅱ) was compared between the two groups,the difference between multiparity and primiparity were compared.Results:①In postpartum 42 days,type Ⅰ muscle fiber damage rate was lower in multiparous group than that in primiparous group(P ＜0.05),there was no significant difference on the muscle fiber damage ratio (muscles force below Ⅲ) between the two groups (P ＞ 0.05).②)In postpartum 3 months,6 months,1 year there was no significant difference in proportion of muscle damage between the two groups (P ＞ 0.05).③Multiparous group pelvic floor muscle damage ratio decreased slowly and gradually in the four periods,there was no statistical difference between adjacent period (P ＞ 0.05),the pelvic muscle damage ratio appeared significant statistical difference between postpartum 6 months and postpartum 42 days(P ＜ 0.01).④In primiparous group,pelvic floor muscle damage ratio decreased significantly in postpartum 6 months,postpartum 42 days、3 months,6 months,the differces were statistically significant among the three times(P ＜ 0.05),there was no statistical difference between postpartum 6 months and 1 year(P＞0.05).Conclusions:Type Ⅰ muscle fibers suffer injury more in Primipara than that in multipara,multiparous pelvic floor muscle recovery process is more slowly than primipara's,we should pay attention to pelvic muscle recovery within 6 months after delivery.

0.05). But there was more BMP in the treated group of periodontitis than the other groups(P

Objective To look for an appropriate dietary pattern of early nutritional intervention, which does not only meet the need of catch-up growth but also avoids or reduces the incidence of insulin resistance (IR) in adulthood of rats born with intrauterine growth retardation (IUGR). Methods The model of IUGR in rats was established by maternal nutrition restriction. Sixty newborn female rats with IUGR were randomly divided into 5 groups: (1) IUGR control group fed with common diet. (2) IUGR high-carbohydrate diet group. (3) IUGR high-fat diet group. (4) IUGR high-protein diet group. (5) IUGR low-protein diet group. The IUGR newborn rats were breast-fed for 3 weeks, while the mother rats were fed with the above different diets with the same caloric amount. Twelve normal newborn female rats served as a normal control group and were fed with common diet. All newborn rats were fed routine diet starting from the 4th week of experiment. The body weight, perirenal fat weight and the serum leptin, blood glucose, insulin concentration were measured and the insulin sensitive index (ISI) were calculated at the 4th week and the 12th week of life. Results The IUGR rats fed with high-protein diet showed a catch-up growth without the increase of perirenal fat at the 4th week, a normal level of perirenal fat, leptin and ISI at the 12th week compared with the normal control group, and did not show IR. The groups fed with high carbohydrate diet and high fat diet also showed a catch-up growth, but did the same as the IUGR control group in other aspects, they all showed increased perirenal fat, higher levels of leptin, lower ISI and IR at adulthood. The group fed with low protein diet did not show IR, but kept a small body size with increased perirenal fats. The serum leptin level of rats was positively correlated to body weight at the 4th week of life and was positively correlated to the weight of perirenal fat and negatively correlated to ISI at the 12th week of life. Conclusion High protein diet is an appropriate early nutritional intervention for rats with IUGR. The serum leptin level at the 12th week of life seems to be an index of IR in adult rats with IUGR.

Objective To study the image examination of renal injuries and discuss renal explorative indications so as to spare the kidney or nephron as much as possible and improve curative rate of diagnosis and treatment. Methods An analysis was done on 286 cases that included 231 cases with close injury, 54 with open injuries, one with iatrogenic injury and 91 with combined injuries. Of all, 212 cases were examined by B-ultrasonography, 163 by CT and 132 by intravenous urography(IVU) and 6 by digital subtraction angiography(DSA); 202 cases were treated with conservative treatment and 84 with operation. Results The diagnostic positive rates of IVU, B-ultrasonography and CT were 67.4%, 72.2% and 87.7%, respectively. Among the operation cases, 42 cases were treated by renal repair, 12 by partial nephrectomy and 30 by nephrectomy. The operation rate was 29.4% and the nephrectomy rate 35.5%. Interventional treatment of the kidney was carried out in three cases. Conclusions For renal injury cases, the first and most important step is to evaluate the injury condition so as to correctly determine whether an operation exploration is needed. The injury conditions and severity are mainly determined by the image examinations that change according to injury cause, injury type and clinical symptoms. Renal exploration or not, and the operation time exert great influence on renal reservation rate and complication rate.

Objective To study the characteristics of neonatal sepsis caused by gram positive (G +) bacteria,gram negative (G+) bacteria and fungi.Method Clinical data of 202 neonates with sepsis hospitalized from Jan.2012 to May.2015 were studied.According to the different pathogens,202 neonates were divided into gram positive bacteria group,gram negative bacteria group and fungi group.The general information,clinical manifestation,laboratory examination and treatment outcome of the three groups were analysed with Chi square analysis,LSD,Fisher exact probability tests.Result A total of 202 cases of neonatal sepsis were recruited.The detection rate of gram positive bacteria,gram negative bacteria and fungi was 35.2％ (71 cases),56.4％ (114 cases) and 8.4％ (17 cases),respectively.Comparing with gram negative group and fungi group,gram positive group had older gestational age (36.0 ± 3.8 w,compared with gram negative 33.0 ± 3.9 w,fungi group 31.2 ± 3.2 w,P ＜ 0.05),larger birth weight (2 620 ± 925 g compared with gram negative group 1 999 ± 849 g,fungi group 1 595 ± 666 g,P ＜ 0.05),lower nosocomial infection rate (29.6％ compared with gram negative group 70.2％,fungi group 94.1％,P ＜0.05),lower rate of shock,blood glucose disturbance and thrombocytopenia (P ＜ 0.05).There was no statistics difference between the gram negative group and fungi group.Comparing with the other two groups,fungi group was older [20.0 (11.5,39.5) d compared with gram positive group 7.0 (2.0,17.0) d,and gram negative 10.0 (6.0,18.2) d,P ＜ 0.05].The rate of deep venous catheterization in fungi group was higher than that in gram positive group and gram negative group (88.2％ compared with gram positive group 25.4％,gram negative group 40.4％,P ＜0.05).The treatment course of fungi group was longer than that of the gram positive group and gram negative group [22.0 (12.0,37.5) d compared with the gram positive group 14.0 (10.0,17.0) d,gram negative group 14.0 (11.0,18.0) d,P ＜0.05].The incidence of apnea in the gram negative group was higher than that in gram positive group and fungi group (P ＜ 0.05).The rate of leukocytosis,leukocytopenia and elevated CRP were higher in gram negative and gram positive group (P ＜ 0.05).Conclusion The clinical manifestations and laboratory examinations in neonatal sepsis caused by different pathogens were different,which can help to early identification of different pathogenic infections.However,there is no specific indicators to differentiate neonatal sepsis caused by different pathogens.Early identification of the pathogen needs clinical acumen.

Objective To observe the inhibition of amikacin in vitro on platelet aggregation and blood coagulation tests, and to study its effects on hemostasis and the related mechanisms.Methods Plateletrich plasma and platelet-poor plasma from donors were mixed with different concentration of amikacin, which was divided into four groups:0 mg/L, 30 mg/L, 91 mg/L and 910 mg/L group.The maximial ratio of platelet aggregation induced by ADP were measured with Platelet Aggregation Analyzer.The expression levels of P-selectin, GP Ⅱ b/Ⅲ a and Fg-R were determined with Flow Cytometer.The PT, APTT, TT and Fg of platelet-poor plasma were detected with Blood Coagulation Analyzer. The four concentration of amikacin mentioned above and two anticoagulants (62.5 U/ml of sodium heparin and 109 mmol/L of sodium citrate)were interacted with fresh whole blood, in which the blood CT and plasma Ca2+ were detected. Blood samples were collected from 10 patients with acute lower respiratory tract infection before and 30 minutes after routine amikcin treatment respectively.The maximial ratio of platelet aggregation, the expression levels of P-selectin, GPⅡ b/Ⅲa and Fg-R induced by ADP were measured; while PT, APTT, CT and plasma Ca2+ were determined.Results At 30 mg/L of amikacin group, the maximal ratios of platelet aggregation (65.8±3.9)%, the expression levels of P-selectin (9.2 ± 1.0)% and Fg-R (12.6 ± 1.7)% were statistically lower than those [(88.0 ±4.6%, (16.1 ± 1.3)% and (31.0 ±2.5)%]at 0 mg/L of amikacin group ( t = 9.442,8.432,9.993,P ＜ 0.01 ).At 30 mg/L of amikacin group, the APTT (80.5 ±6.8) s and CT ( 857 ± 66) s were significantly higher than those [(33.0 ± 3.6) s and (447 ± 35 ) s] at 0 mg/L of amikacin group ( t = 11.312, 13.211, P ＜ 0.01 ). There was a negative correlation between amikacin concentration and maximial ratio of platelet aggregation ( r = - 0.832, P ＜ 0.05 ), but a positive correlation between amikacin concentration and inhibitory rates of platelet aggregation ( r = 0.939, P ＜0.05) was observed, as well as APTT (r ＞0.870, P＜0.05).At 30 mg/L, 91 mg/L, and 910 mg/L of amikacin groups, the P-selectin and Fg-R expression were remarkably inhibited with a dose-dependent manner, the CT was notably enhanced [Fwithin subjects =21.44, 26.24, ( ＞29.81 ), P ＜0.01].At 0 mg/L,30 mg/L, 91 mg/L and 910 mg/L of amikacin groups, the PT values were ( 14.7 ± 1.9) s, ( 15.2 ± 1.7) s,(15.6±1.5) s and (22.1 ±2.1) s, respectively (F=8.21,P＜0.05), but there was no markeddifference for the levels of GP Ⅱ b/Ⅲ a, TT, Fg and plasma Ca2+ among the four groups ( P ＞ 0.05 ).After 30 minutes of amikacin treatment, the maximial ratio of platelet aggregation (51.6 ± 10.1)%, the expression levels of P-selectin (6.8 ± 1.8) % and Fg-R ( 20.1 ± 5.8 ) % were significantly lower than those [(66.8 ± 11.4)%, ( 10.9 ±3.1 )% and (28.5 ±7.4)%] before amikacin treatment, but APTT (49.8 ±5.9) s and CT (660 ±59) s were remarkably higher than those [(26.9 ±3.8) s and (410 ±45) s] before amikacin treatment, respectively ( t = 5.456,8.875,7.423,10.012,11.322, P ＜ 0.01 ), while the GP Ⅱ b/Ⅲ a expression, PT and Ca2+ concentration had no significant changes ( P ＞ 0.05).Conclusions There are inhibitory effects of amikacin on platelet aggregation mainly through the inhibition of both fibrinogen receptor activation and secretion reaction of activated platelet. Amikacin may also inhibit pathway of coagulation system factor to prevent blood coagulation.Therefore, risk of hemorrhage may be investigated in the patients with amikacin for anti-infection treatment.

Objective To compare the dose distribution of the three-dimensional conformal radiotherapy(3D-CRT)and 5-field or 7-field intensity modulated radiation therapy(IMRT), and to explore the value of IMRT in preoperative radiotherapy for rectal cancer.Methods Ten rectal cancer patients treated with preoperative combination radiotherapy and chemotherapy were enrolled in this study. 3D-CRT plan and the 5.field or 7-field IMRT plans were performed for each patient.The conformal index (CI),heterogeneity index(HI)of the planning target volume(PTV)and the dose of normal organs of 3D-CRT plan(3D-CRTp)and the 5-field or 7-field IMRT plans(IMRT5fp or IMRT7fp)were analyzed with the dose-volume histogram.Results The CI values of PTV were 0.91,0.87 and 0.78 in IMRT7fpIMRT5fp and 3D- CRT but with IMRT7fp>IMRT5fp>3D-CRTp(t=-5.69、-8.91,P<0.01),respectively.The HI values of PrV were 1.09,1.08 and 1.05 in IMRT5fp,IMRT7fp and 3D- CRTp but with IMRT5fp >IMRT7fp>3D- CRTp(t=3.41、-6.89,P<0.01),respectively.The ratio of dose volume were 0.08,0.10 and 0.19(t=2.79、3.52,P<0.05)in IMRT7fp,IMRT5fp and 3D- CRTp on the small intestine V50,with 0.07,0.10 and 0.19(t=2.58、3.40,P<0.05)in IMRT7fp,IMRT5fp and 3D-CRTp on the bladder V50 and 0.01,0.01 and 0.05(t=3.00、3.17,P<0.01)in IMRT7fp,IMRT5fp and 3D- CRTp on the fomoral head V45.The ratio of dose volume were 0.31 and 0.38(t=3.91,P<0.01)in IMRT7fp and IMRT5fp on the bone marrow V50,with 0.07 and 0.10 in IMRT7fp and IMRT5fp on bladder V45.Conclusions IMRT plan is superior to 3 D- CRT plan in dose conformal degrees of PTV with preoperative radiotherapy of rectal cancer and can significantly protect the normal tissues.The 7-field IMRT plan might be the optimal plan for dose conformal degree and dose uniformity compared with 5-field IMRT.

Objective To evaluate the role of chemokine CXC ligand 13 (CXCL13) in spinal cord in neuropathic pain (NP) in rats.Methods One hundred and eight male Sprague-Dawley rats,weighing 150-200 g,were randomly divided into 4 groups (n =27 each):sham operation group (group S),group NP,small interference RNA (siRNA) negative control group (group NS) and CXCL13-siRNA group (group CS).The animals were anesthetized with intraperitoneal ketamine 50 mg/kg.NP was induced by ligation of L5 spinal nerve (SNL) in groups NP,NS and CS.L5 spinal nerve was only exposed but not occluded in group S.CXCL13-siRNA lentivirus and siRNA negative control lentivirus were injected intrathecally in groups CS and NS,respectively.Mechanical pain threshold was measured at 3,7 and 14 days after SNL.Then the rats were sacrificed and L4-6 segments of the spinal cord were obtained for determination of coexpression of CXCL13 and Neun (by immunofluorescence),activation of astrocytes,and expression of CXCL13 and glial fibrillary acidic protein (GFAP) protein (by Western blot) and mRNA (by RT-PCR) in spinal cord tissues.Results Compared with group S,mechanical pain threshold was significantly decreased and the expression of CXCL13 and GFAP protein and mRNA was up-regulated at each time point after operation in groups NP,NS and CS (P ＜ 0.05).Compared with group NP,mechanical pain threshold was significantly increased and the expression of CXCL13 and GFAP protein and mRNA was down-regulated at each time point after operation in group CS (P ＜ 0.05).There was no significant difference in the indexes mentioned above at each time point after operation between groups NP and NS (P ＞ 0.05).Conclusion CXCL13 is involved in the development and maintenance of NP in rats via activation of astrocytes.

Objective To evaluate the value of CT perfusion imaging (CTPI) in the diagnosis of hepatocellular carcinoma (HCC). Method CTPI was carried out on 21 patients with 26 lesions to obtain the following perfusion parameters: hepatic blood flow (HBF), hepatic blood volume (HBV),mean transit time (MTT), permeability surface area product (PS), and hepatic arterial fraction (HAF). The parameters from the lesion and non-lesion areas were compared. In addition, serum AFP was measured in the HCC patients and a linear correlation analysis between the alpha-fetoprotein (AFP) level and the CTPI parameters was performed. Result CTPI failed in 3 patients with 3 lesions and was successful in 18 patients with 23 lesions which included 18 HCC, 4 hemangioma of the liver,and 1 hepatic focal nodular hyperplasia (FNH). On comparison of the HCC parameters in the lesion and non-lesion areas, significant differences were found in the HAF which was 4.11 times higher in the lesion than the non-lesion areas, while the MTT and PS were significantly lower. There was no significant difference in the HBF and HBV. Correlation between the serum AFP level and the CTPI parameters of the HCC lesion was insignificant. The differences of all the parameters between the lesion and the non-lesion in hemangioma were similar to those in HCC, except for a higher HBF in the lesion than in HCC. There was no significant difference between the parameters of FNH and the non-nodular part of the liver. Conclusion CTPI played an important role in the diagnosis and differential diagnosis of HCC, especially when the AFP was negative and/or the imaging manifestation was atypical on contrast CT.