In a rapidly aging society, many patients will have multiple medical co-morbidities and on polypharmacy. Dental patients rarely have medical emergencies during their treatment and it is because of this rarity, that theodd emergency that presents can overwhelm the dentist’s ability to cope despite their theoretical knowledge. The authors discuss how to adapt the clinic facilities for managing an emergency and provide an overview of management of common emergencies that dentists may encounter.

Purpose:To study analgesia effect and adverse reaction of diclofenac sodium extended release capsule for cancer pain in senile patients. Methods:20 senile patients with light or moderate cancer pain were selected.The analgesia effect and adverse reaction were observed after diclofenac sodium extended release capsule 100 mg qn po.Results:The treatment of cancer pain with diclofenac sodium extended release capsule in senile patients had obvious analgesia effect without obvious adverse reaction. Conclusions:Diclofenac sodium extended release capsule 100 mg qn po is a safe,effective and simple way to relieve cancer pain in senile patients with light or moderate cancer pain.

Objective:To study the efficacy of social skill-training on the positive symptoms, negative symptoms and cognitive function of patients with chronic schizophrenia.Method:100 subjects who met with the criteria of Chinese Classification and Diagnostic Criteria of Schizophrenia were randomly assigned to the skill-training group (50 patients) and the control group (50 patients). Under the condition of stable antipsychotic medication, the skill-training group received the skill-training course offered by Liberman RP for 12 weeks. BPRS and SANS were used to evaluate every four weeks; WCST and SDSI were evaluated before and after the treatment.Result:(1) 45 patients of skill-training group and 46 patients of control group completed the study. (2) There were significant differences between skill-training group and control group in total score, anxiety depression and lacking active factor of BPRS (P

Objective To investigate the effects of allogenic intra-bone marrow bone marrow transplantation (IBM-BMT) on re-establishing hematopoiesis in mice. Methods Bone marrow mononuclear cells (BMNCs) from BALB/ c mice were transplanted into the C57BL/6 mice treated with a lethal dose of ~(60)Coγ-ray radiation through intra-bone marrow injection or intravenous injection. Sixty of the C57BL/6 mice were randomly divided into three groups as higher dose intra-bone marrow injection group (IBM1 group), lower dose intra-bone marrow injection group (IBM2 group) and intravenous injection group (IV group). The nucleated cell numbers of whole bone marrow from the tibia of each recipient mouse were counted respectively at the day 1, day 3, day 6 and day 9 after the transplantation. The donor-derived total nucleated cells and myeloid cells were quantified by flow cytometry. Results At 6th day after transplantation, more total bone marrow nucleated cells, total donor-derived nucleated cells and donor-derived myeloid cells in the tibia of injected side in both IBM1 group and IBM2 group were found than that in IV group (P<0.05 or P<0.01). Conclusion Compared with traditional bone marrow transplantation (IV-BMT),IBM-BMT improves the bone marrow hematopoiesis in the early hematopoietic re-establishing stage in allogenic bone marrow transplantation.

ObjectiveTo study the effects of the Behavior Therapy on outpatient with schizophrenics in relieving symptoms, insight, and attitude to treatment. Methods96 outpatients with schizophrenia were randomly assigned to the Behavior Therapy group and the control group. The Behavior Therapy courses were given to the Behavior Therapy group for six months. All the subjects were evaluated with Positive and Negative Syndrome Scale(PANSS) and Insight and Therapeutic Attitude questionaire(ITAQ). Results94 cases completed the trial. The scores of PANSS, the Negative Subscale, the General Psychopathology Subscale of the Behavior Therapy group decreased significantly after treatment(P<0.01). The score of ITAQ of the Behavior Therapy group increased significantly after treatment(P<0.01).The reductions of PANSS, the Positive Subscale, the Negative Subscale, the General Psychopathology Subscale and ITAQ between two groups were significant different(P<0.05-P<0.01). Conclusions The Behavior Therapy may play an important role in augmenting optimal pharmacotherapy for outpatients with schizophrenia and it is effective in improving symptoms, insight and therapeutic attitude.

Objective To evaluate diagnostic value of plasma D-dimer (D-D),fibrinogen (Fg) and Ddimer/fibrinogen (D/F) ratio in acute lower extremity deep vein thrombosis (DVT) after artificial joint replacement.Methods From August 2009 to December 2011,273 patients who had undergone total hip arthroplasty (THA) or total knee arthroplasty (TKA) underwent venography of lower extremity deep vein at 35 days postoperatively.According to results of angiography,all patients were divided into DVT group including 66 patients (15 males and 51 females,median age 66 years) and non-DVT group including 207 patients (70 males and 137 females,median age 63 years).Plasma levels of D-D and Fg were measured by immunoturbidimetry and solidification methods respectively preoperatively and at 3-5 days postoperatively.The differences of plasma levels of D-D and Fg and D/F ratio between the two groups were analyzed with statistical method.Furthermore,diagnostic value of postoperative plasma D-D and D/F ratio in acute DVT was assessed using a receiver operating characteristic (ROC) curve.Results There was no statistical significance in preoperative plasma levels of D-D and Fg,and postoperative plasma levels of Fg between two groups.However,the postoperative plasma levels of D-D and D/F ratio were higher in the DVT group than those in the nonDVT group,and there was significant difference between two groups.In addition,the ROC curve analysis showed that the area under curve of postoperative plasma D-D and D/F ratio was 0.688 and 0.684,respectively,but this difference did not reach statistical significance.Conclusion Plasma Fg may be meaningless for the diagnosis of acute DVT after artificial joint replacement.Although plasma D-D and D/F ratio may be useful for diagnosing acute DVT,the diagnostic accuracy is low.

Objective To explore the operative method of open distal tibial pilon fractures, and to evaluate the outcome of ankle joint function postoperatively. Methods From March 2003 to March 2007, 24 patients with open Pilon fractures were treated with one-stage open reduction and internal fixation (18 males and 6 females) . The average age was 37. 6 years (14 ～ 53 years) . All 24 patients had open fracture, 12 of whom combined fibular fracture. According to AO comprehensive classification system, the fractures was classified as C1 in 4, C2 in 9, and C3 in 11. According to Gustilo-Anderson classification method, the fracture was classified as Type Ⅰ in 3, Type Ⅱ in 5, Type Ⅲ A in 4, Type Ⅲ B in 10, and Type Ⅲ C in 2. All tibial pilon fractures were treated by radical debridement, one - stage open reduction and internal fixation. Soft tissue defection was covered by a vascularized flap and continually washed by pipes under the flap. Results All patients were followed-up at an average of 2. 3 years(1～3.8 years) after the surgery. All the fractures healed at an average of 22. 3 weeks (16 ～54 wk) postoperatively. According to the scoring system of Con-roy, 17 were excellent (62. 5%), 4 good (25%), and 3 poor (12.5%), The excellence rate was 87.5% . According to the ankle score of Teeny and Wiss, there were 11 excellent (37. 5%), 7 good (37.5%), 3 fair (16.7%), and 3 poor (8.3%) and the excellence rate was 75% . Conclusion One-stage management for open Pilon fracture has the advantages of fewer complications, lower infectious rate, and better ankle joint function.

We summarized the epidemiological investigation results of the first case of human infection with avian influenza A(H9N2) virus in Chengdu,China,in order to provide references for dealing with similar diseases scientifically in the future.The methods of field epidemiology and laboratory testing were used to collect the H9N2 case's clinical and epidemiological data,as well as collect and test the samples of the H9N2 case and the relevant environment,so that the possible sources of infection,the epidemiological characteristics and clinical features could be analyzed.Results showed that the H9N2 case contacted with poultry within 10 days before the onset of illness and the H9N2 virus nucleic acid was detected in the patient's specimen by PCR.This case suffered from several chronic diseases for a long time,although active treatments were taken this time,she died soon after onset.Her living environment,the chicken leftovers from cooking,and surrounding poultry markets were polluted by H9 avian influenza virus.Through the investigation,we could deduce that the infection source of this case was the chicken infecting H9N2 viruses from surrounding poultry markets.This would be the first fatality associated with influenza A (H9N2) virus infections in humans.And though avian influenza A(H9N2) virus was low pathogenic,infection could cause severe symptoms or death in people with severe underlying diseases.

On-shore port-based training is important to improve naval submarine rescue and escape capability. It is highly necessary to establish subordinate comprehensive training base for submarine rescue and escape, so as to solve the current problems in on-shore port training. Taking into consideration of the organizational leadership, coordination mechanism, supporting system, operational mode, main function, role design, numbers and location of setting, and supplementary measures, we put forward a general concept for the training base, hoping to provide ideas for innovating the training mechanism and improving the training effectiveness of naval submarine rescue and escape capability.

Objective To investigate the alterations of invariant nature killer T( iNKT) cells in peripheral blood samples from patients with rheumatoid arthritis ( RA) and to clarify the correlation between the percentage of iNKT cells and the ratio of IFN-γ/IL-4 in order to further understand the significance of iNKT cells in the development of RA.Methods Peripheral blood mononuclear cells ( PBMCs) were isola-ted from 70 patients with RA and 40 healthy subjects.Among them, thirty patients in the stage of inactive RA were involved in a follow-up study.Fluorescence activated cell sorting ( FACS) was used to detect the percentage of iNKT cells.PBMCs were cultured in vitro for analysis of cytokine production.The dynamic changes of iNKT cells in percentages were analyzed by FACS.MILLIPLEX MAP Human Cytokine/Chemo-kine kit was used to measure the secretion of IFN-γand IL-4 in serum samples and culture media of PBMCs. The expression of IFN-γand IL-4 in iNKT cells at mRNA level were analyzed by RT-PCR.Results Com-pared with the healthy subjects, the patients with active RA showed the delayed proliferation of iNKT cells and the decreased percentages and proliferation rates of iNKT cells (P<0.05).The percentages and prolif-eration rates of iNKT cells in patients with active RA were significantly lower than those in patients with inac-tive RA (P<0.05).No statistical significant differences with iNKT cells were found between healthy sub-jects and patients with inactive RA (P>0.05).The ratios of IFN-γ/IL-4 in serum samples and culture media of PBMCs were increased in patients with active RA as compared with those in patients with inactive RA and healthy subjects (P<0.05).No statistical significant differences with the ratios of IFN-γ/IL-4 were observed between healthy subjects and patients with inactive RA (P>0.05).Compared with healthy subjects and patients with inactive RA, patients with active RA showed increased transcriptional level of IFN-γand decreased transcriptional level of IL-4.No significant differences with the expression of IFN-γand IL-4 in iNKT cells at mRNA level were observed between healthy subjects and patients with inactive RA.The per-centage of iNKT cells was negatively related to the IFN-γ/IL-4 ratio in patients with RA (P<0.05).Con-clusion Decreased percentage and impaired function of iNKT cells were detected in patients with RA. iNKT cells were closely related to the development and disease activity of RA.