Objective To observe the effect of the emodin thermosensitive hydrogel on collagenase in gingival crevicular fluid of patients with chronic periodontitis and to evaluate the clinical efficacy.Methods Forty patients with chronic periodontitis were selected.For each patient after scaring and root planning,the one teeth on one side in a person was assigned at the test group and treated with the emodin thermosensitive hydrogel in the pocket once a week for four weeks.The teeth on the other side were assigned as the control group,just with the primary periodontal treatment.The PLI、SBI、PD、AL、MD and content of collagenase in gingival crevicular fluid were examined at baseline,before administration and after administration four weeks.The COL-II level in GCF was detected using ELISA method.Results There were no significant differences in PLI、SBI、PD、AL、MD and content of collagenase in gingival crevicular fluid before the treatment(P ＞ 0.05).While there are some evidences that periodontal indexes dropped down and the type Ⅱ collagenase level in gingival crevicular fluid also declined after using the emodin thermosensitive hydrogel than the control group(t =3.46,4.02,4.18,3.03,2.79,4.29,all P ＜ 0.05).Conclusion Ultrasonic scaling using the emodin thermosensitive hydrogelas was more effective in reducing the type Ⅱ collagenase level in gingival crevicular fluid.And improving clinical parameters associated with periodontal health in patients with chronic periodontitis.

Experiments were carried on cultured neonatal myocardial cells of rat to study the effects of angiotensin Ⅰ(AngⅠ) and Ⅱ (AngⅡ) on the synthesis of DNA, RNA, protein and on the cardiac hypertrophy. It was shown that the incorporation of both ~3H-TdR and ~(14)C-uR increased over a set of time periods after addition of AngⅠ and AngⅡ to the medium. The mean protein content of the single myocardial cell was also enhanced, and the volume of myocardial cell was increased significantly after a continuous stimulation of AngⅠ and AngⅡ for 7 days. No stimulation effect was observed either in the synthesis of DNA, RNA, and protein or in the volume of myocardial cells after addition of AngⅠ together with the angiotensin converting enzyme inhibitor(ACEI, captopril). These results indicated that: (1). AngⅠ acts as a regulator by its indirect stimulation effect on the synthesis of DNA, RNA and protein of myocardial cells, since it must be changed into AngⅡ by the ACE present in myocardial cells. The ACE can be inhibited by the ACEI: (2) The hypertrophy of cultured neonatal myocardial cells may induced by a continuous stimulation of AngⅠ and AngⅡ.

Objective To evaluate the efficacy of dexmedetomidine used to supplement lumbar plexus combined with sciatic nerve block for total hip arthroplasty in the elderly patients.Methods Fifty ASA Ⅱ or Ⅲ patients,aged 80-93 yr,with a body mass index of 17-25 kg/m2,scheduled for unilateral total hip arthroplasty,were randomly divided into 2 groups (n =25 each):normal saline group (group NS) and dexmedetomidine group (group D).Lumbar plexus combined with sciatic nerve block was performed guided by a nerve stimulator in both groups.After a loading dose of dexmedetomidine 0.5 μg/kg was infused over 10 min starting from 20 min after the block,dexmedetomidine was infused at 0.2 μg· kg-1 · h-1 until the end of surgery.While the equal volume of normal saline was given instead of dexmedetomidine in group C.Propofol 20 mg or ketamine 10 mg was infused intravenously when the efficacy of the block was inadequate.The mean arterial pressure (MAP),heart rate (HR),pulse oxygen saturation (SpO2),respiratory rate (RR),side effects during operation,requirement for propofol or ketamine and doctor' s satisfaction were recorded after admission to the operating room,immediately after iv administration,at 0,10 and 30 min after the beginning of surgery,and at the end of surgery (T0-5).Results Compared with the baseline value at T0,MAP and HR were significantly increased at T2-5 in group C (P ＜ 0.05),and no significant change was found in the hemodynamic parameters at each time point in group D (P ＞ 0.05).Compared with group C,the MAP,HR,incidences of respiratory depression and agitation and requirement for propofol or ketamine were significantly decreased,and the doctor's satisfaction was significantly increased (P ＜ 0.05).Conclusion Dexmedetomidine can increase the efficacy of lumbar plexus combined with sciatic nerve block when used for supplementation of total hip arthroplasty in the elderly patients,the hemodynamics is stable and side effects are fewer.

Objective To observe the influence of insulin resistance(IR) and isosorbide mononitrate(ISMN) on myocardial cellular apoptosis in spontaneously hypertensive rats (SHR) .Methods Forty male 14‐week old Wistar(W) rats and SHR(S) each were respectively or jointly fed with normal diet (ND) ,high fat and high glucose(HFHG) diet ,normal saline(NS)and ISMN by ga‐vage .Then they were randomly divided into the normal and NS group (normal W and normal S ) ,HFHG and NS group(HFHG W and HFHG S) ,normal and ISMN group(ISMN W and ISMN S) ,HFHG and ISMN group(HI W and HI S) ,with 10 rats in each group .After 12‐week feeding ,carotid arterial blood was collected for detecting blood glucose concentration and insulin level and cal‐culating insulin resistance index (HOMA‐IR);4 myocardial tissue samples were taken for respectively observing the morphology under microscope ,and detecting the NO level ,myocardial Bcl‐2 ,Bax gene and their protein expression levels in myocardial tissue . Results Myocardial NO level ,Bax gene mRNA and related protein levels in the HFHG and ISMN intervention groups were higher than those in the normal group ,while the bcl‐2 gene mRNA and related protein expression were on the contrary ;myocardial tissue NO level ,Bax gene mRNA and related protein expression in the S groups were increased compared with the corresponding W groups ,while the bcl‐2 gene mRNA and related protein expression were on the contrary ;in the HFHG W group ,the myocardial tis‐sue NO level had significantly positive correlation with HOMA‐IR ,and in the ISMN W group ,HOMA‐IR was positively correlated with the NO level in the myocardial tissue .Conclusion Myocardial cellular apoptosis of SHR is increased compared with Wistar rats ;both IR and ISMN can aggravate the apoptosis of SHR myocardial cells ,moreover IR has a mutual induction and reciprocal causation with ISMN .

Objective To investigate the clinical effects of laparoscopic repair of esophageal hiatal hernia using Bard CruraSoft PTFE/ePTFE Mesh combined with Toupet partial fundoplication.Methods From August 2006 to April 2007,13 patients with esophageal hiatal hernia(typeⅠin 6 and type Ⅲ in 7)were treated by laparoscopy in our hospital.Under a laparoscope,esophageal hiatal hernia was separated by ultrasonic scalpel,and then repaired using Bard CruraSoft PTFE/ePTFE Mesh with Ethicon Endopath Multifieed Stapler.Afterwards,Toupet partial fundoplication was performed.Results The operation was completed in all the cases without converting to open surgery.The mean operation time was 142 min(115-185 min);mean intraoperative blood loss was 75 ml(25-120 ml);mean time to the first flatus and oral feeding was 32 h(26-37 h);and mean postoperative hospital stay was 4 d(3-6 d).The patients were followed up for 4-11 mon(mean 6.5 mon).The symptoms disappeared in 1 month.Three months after the operation,barium examination found no recurrence of the hernia in the 13 cases.Conclusions Laparoscopic repair of esophageal hiatal hernia with mesh combined with Toupet partial fundoplication is a safe and minimally invasive operation.The method is worth being widely used.

Objective To assess the association of obesity, serum lipid levels and insulin resistance with leptin in Nanjing population. Methods One hundred and eighty eight subjects aged 22～81 years in Nanjing were divided into three groups according to BMI and dignosis criteria of diabetes: normal group, obese group and diabetes group. Their weight, height, waist, abdomen and hip circumferences were measured. Total cholesterol, triglycerides, low density lipoprotein cholesterol, high density lipoprotein cholesterol, apoA, apoB, fasting plasma glucose (FPG), true insulin (TI), immunoreactive insulin (IRI) and leptin were also measured. ISI 1=1/(FPG?TI) and ISI 2=1/(FPG?IRI) as insulin sensitivity indexes were used to analyse the relation between leptin and insulin resistance. Results Fasting serum leptin level was associated with sex (four fold as high in women as that in men). BMI was the second strongest determinant of leptin. Leptin was positively correlated with TI (r=0.32, P

Objective To investigate effects of laparoscopic repair of abdominal wall incisional hernia using polypropylene and expanded polytetrafluoroethylene(e-PTFE) composite mesh. Methods Forty-one patients with abdominal wall incisional hernia(4~25 cm in length and 3~18 cm in width) were treated in this hospital from October 2004 to August 2005. The patients received laparoscopic mesh herniorrhaphy after complete dissection of adhesion using an ultrasonic scalpel.A polypropylene and(e-PTFE) composite mesh(Bard Composite Mesh) was used and fixed using the Ethicon Endopath Multifeed Stapler(EMS).Results The laparoscopic mesh herniorrhaphy was successfully completed in all the 41 patients without conversions to open surgery.The operative time was 60~182 min(mean,85 min).Postoperatively,the patients felt slight pain and began to take food on the second day.The time to first passing flatus was 25~41 hours(mean,32 hours).The postoperative hospital stay was 5~7 days(mean,6 days).No recurrence occurred during a follow-up period of 6~16 months(mean,9 months) in the 41 patients. Conclusions The laparoscopic incisional hernia repair using the Bard Composite Mesh is a safe and effective method.

Objective To investigate the clinical effect of Exelon and the high pressure oxygen uniting to treat the old-age period of dementia and influence of Exelon on plasma transforming growth factor ?(TGF-?), insulin-like growth factor 1(IGF-1)and intercellular adhesion molecule-1(ICAM-1) in patients with elderly dementia.Methods 172 cases with ?lzheimer's diseases (AD) and 202 cases with vascular dementia (VD) were randomly divided into Exelon group, high pressure oxygen group, uniting group (taking Exelon and doing the high pressure oxygen together) and piracetam group. The MMSE scores were graded before and after treatment. TGF-?, IGF-1 and ICAM-1 were detected in Exelon group before and after treatment.Results MMSE scores had improved in Exelon group, high pressure oxygen group and uniting group after the treatment in AD group and VD group (all P

Objective To evaluate the predictive value of serum presepsin (sCD14-ST) for septic myocardial depression (SMD) in patients with severe sepsis or septic shock.Methods This was a prospective cohort study.A total of 84 patients with severe sepsis or septic shock were monitored by pulse indicator continuous cardiac output (PiCCO) system and divided into myocardial depression group (cardiac function index [CFI]<4.1 L/min, n=37) and non-myocardial depression group (CFI≥4.1 L/min, n=47) according to cardiac function index (CFI).Left ventricular ejection fraction (LVEF) was measured by doppler echocardiography at admission.The patients were divided into survival group (n=40) and non-survival group (n=44) based on 28-day mortality.Serum sCD14-ST,B-type natriuretic peptide(BNP), tumor necrosis factor-α(TNF-α), cardiac troponin Ⅰ (cTnⅠ) levels and hemodynamic parameters were observed dynamically at day 1,3,5 after admission.Quantitative data with normal distribution were analyzed using t-test and abnormal distribution data were analyzed using Mann-Whitney U test.Categorical data were analyzed using χ2 test.Results The serum levels of cardiac index (CI), global ejection fraction (GEF) and left ventricular contractility index (dPmax) in myocardial depression group were all significantly lower than those in non-depression group at day 1 after admission (all P<0.01).The serum levels of sCD14-ST, TNF-α and BNP in myocardial depression group were all significantly higher than those in non-depression group (all P<0.01).Serum sCD14-ST levels in 84 septic patients were positively correlated with both BNP and TNF-α (r=0.204, P<0.05 and r=0.516, P<0.01, respectively).The area under the receiver operating characteristics curve (AUC) of sCD14-ST was 0.782 for myocardial depression in patients with sepsis, with a sensitivity of 89.2% and a specificity of 78.0% at the cut-off point of 988 mg/mL.The predictive value of sCD14-ST was inferior to BNP and TNF-α (both P<0.05).The combination of sCD14-ST, TNF-α and BNP could provide better prediction value in septic myocardial depression.Logistic regression analysis showed that serum sCD14-ST was not the in dependent predictor for septic myocardial depression (P>0.05).There were 24 cases died in myocardial depression group.The mortality of myocardial depression group was significantly higher than that of non-depression group (64.9% vs 42.6%, χ2=4.132, P =0.042).The serum levels of sCD14-ST at day 1 and day 3 in myocardial depression group were significantly higher than those in non-myocardial depression group (both P<0.01).sCD14-ST levels in both groups showed downtrend.The serum level of sCD14-ST in non-survival group was significantly higher than that in survival group (P<0.01).Conclusions Myocardial depression is common in patients with severe sepsis and septic shock.High serum level of sCD14-ST is correlated with myocardial depression to some extent, but not an independent predictor.The combination of sCD4-ST, BNP and TNF-α can improve the predictive value for myocardial depression.

Objective To explore the value of color Doppler ultrasonography and plasma D-dimer in diagnosis of lower limb deep venous thrombosis (DVT).Methods The clinical data of 70 cases of patients with lower limb DVT diagnosed clinically were retrospectively studied.The lower limb venous of each patient was examined by color Doppler ultrasonography and the plasma level of D-dimer were measured,furthermore the plasma levels of D-dimer in different phase and different type of thrombosis were compared.Results The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of plasma D-dimer and ultrasonography examination in lower limb DVT were 100%,66.7%,97.0%,100%,and 97.1%,and 98.4%,83.3%,98.4%,83.3%,and 97.1%,respectively.The plasma D-dimer in acute phase 〔(6 451?4 012.22) ?g/L〕 and subacute phase 〔(2 063?1831.35) ?g/L〕 of lower limb venous thrombosis were significantly higher than that in normal control group 〔(310?66.70) ?g/L〕,P