Objective To explore the clinical therapy for cyclosporine A(CsA)-induced gingival overgrowth (GO) and the pathological changes in gingival overgrowth tissues.Methods Nine cases of CsA-induced GO after renal transplantation were subjected to periodontal non-surgical treatment and surgical treatment.Under light and electron microscopy,the pathological changes in CO tissues were observed.Results The bleeding index(BI) and the plaque index(PLI) of patients were declined after periodontal treatment.GO recurred in 2 patients 6 months later and happened to recur in all 9 patients 12 months later(GOD≤1).At 18th month after transplantation,an obvioUS GO(GOD≥2)occurred in one patient,and re-operation was done to cut hyperplastic gingiva.At 48th month during the observation period,GO existed continuously but no more than 2 in GOD.There were 3 other patients who had their GO(GOD≥2)at 24th month after peridental treatment and re-operation was carried out to remove the hyperplasic gingivaL Under a light microscope,epithelial pegs constituted of basal cells and prickle cells elongated and presented as cancellation structure;spinus layer thickened:hyperkeratosis or parakeratosis occurred in cuticular layer where inflammatory cells infiltrated:collagen increased in proper layer.Under the transmission electron microscopy,the volume of fibroblasts in hyperplastic gingival tissues was increased,rough endoplansmic reticula in the intracytoplasm were abundant and expanded slightly,and there were a few of the apoptotic fibroblasts in the early stage.Conclusion BI and PLl were declined in patients taking CyA for a long-term who were subjected to periodontal and surgical treatments.GO recurred in some patients.The proliferation and differentiation of fibroblasts was not observed in hyperplastic gingival tissues.

Objective To investigate effect of Xiaoyao pill on superoxide dismutase (SOD), malondialdehyde (MDA), interleukin family and clinical efficacy in patients with pelvic inflammation.Methods 75 cases with pelvic inflammation were selected and divided into experimental group and control group randomly according to random number table method.37 cases in control group were treated with conventional anti-inflammatory and Qianjin pill, 38 cases in experimental group were treated with conventional anti-inflammatory and Xiaoyao pill, 14 days for a course.SOD, MDA and interleukin family were compared and the effective rate and adverse reaction rate were compared.Results Compared with control group post-treatment, SOD in serum in experimental group was higher(P<0.05),MDA in serum was lower(P<0.05);IL-1 and IL-8 were lower(P<0.05);IL-4 and IL-10 were higher(P<0.05).The total efficiency of experimental group was significantly higher than that of control group, the adverse reactions were lower (P<0.05).Conclusion Xiaoyao pill has good curative effect on the patients with pelvic inflammatory disease,the mechanism may be related to the elevation of serum SOD,IL-4, IL-10 levels and reduce the levels of MDA,IL-1,IL-8.

Objective To analyze the detection rate of neonatal congenital malformation,and to explore the risk factors for neonatal malformation.Methods A total of 29 831 infants born in Shenzhen People's Hospital from January 2011 to December 2015 were analyzed retrospectively,the detection rate of congenital malformations was calculated,381 infants with congenital malformation were selected as malformation group,and 381 healthy infants were selected as healthy control group,and the risk factors of congenital malformation were analyzed.Results A total of 381 infants with congenital malformation were screened out,the incidence rate of congenital malformation being was 12.77‰(381/ 29 831 cases).The incidence rates of multi-finger or multi-toe,cleft lip,congenital heart disease were the high,which were 18.64％ (71/381 cases),17.32％ (66/381 cases) and 16.80％ (64/381 cases),respectively.The multiple Logistic analysis showed that birth children with low weight newborns (＜ 2 500 g),multiple births,preterm birth (＜ 37 weeks),pregnancies ＞ 1,low literacy levels of mothers,living in towns,late childbirth (≥ 35 years of age),pregnancy syndrome,viral infection during early pregnancy,medication history during pregnancy,rubella unvaccinated,exposure to harmful substance,smoking and alcohol during pregnancy and paternal smoking,chronic diseases,total 16 items were related risk factors for neonatal congenital malformations (all P ＜ 0.05).Among them,the impact of viral infection during early pregnancy,alcohol,smoking,pregnancy syndrome,exposure to harmful substance,medication history during pregnancy on the incidence of malformations in neonates was relatively serious.Conclusions The incidence rate of congenital malformations among neonates conforms to the present situations in China,which was closely correlated with genetic and environmental factors.Health education targeting pregnant women and the women of childbearing age should be carried cut to reduce the birth of neonatal congenital malformations.

Objective To study the effect of smoking on oxidized low-density lipoprotein ox-LDL lag time in patients with cerebral infarction. Methods Plasma samples were obtained from 67 patients with cerebral infarc-tion. 30 acute cerebral infarction patients without history of smoking were chosen to be as control group; meanwhile, 37 acute cerebral infarction patients with history of smoking were chosen to be as smoking group. There was no statis-tical difference in age,gender,blood pressure,lipid level and location and level of the cerebral focus between the two groups (P > 0.05). The ox-LDL lag time and lipid levels of low-density lipoproteins (LDL), including total choles-terol (TC) ,triglyceride (TG) and free cholesterol were measured. Results The ox-LDL lag time of the patients with history of smoking was significantly shorter than that in the control group[(77.21 ± 9.1) min vs. (59.95 ± 8.7)min,P <0.001]. There were no significant differences in LDL- TC,LDL- TG and LDL-free cholesterol level[(5.12±0.61) vs. (4.63±0.62) mmol/L; (0.89±0.07) mmol/L vs. (0.85±0.04) mmol/L; (1.71±0.43) vs. (1.74±0.91) mmol/L, P > 0.05 respectively] between the two groups. Conclusion Smoking shorts the ox-LDL lag time in patients with cerebral infarction, and decrease the anti-oxidization and increase the stress of oxidization.

Objective:To describe the imaging findings of primary brain lymphoma in immunologically normal patients.Methods:The clinical manifestations and imaging findings of 5 patients operated with pathological proved primary brain lymphoma were reviewed.Results:In 5 cases,4 patients were men and one was woman.The median age was 47(range 34 to 63 years).Pathological diagnosis was compatible with primary non-Hodgkins lymphoma of brain for all five patients.Primary brain lymphoma may be soiltary or mutiple and locate at supratentorial or infratentorial.Lesions presented as an isodense to hyperdense on CT scan,hypointense on T1-weighted images and isointense or hyperintense to gray matter on T2-weighted images.Most lesions showed dense homogenous enhancement on CT and MR.Tumors associated with different degrees of mass effect.One patient received whole-body 18 FDG PET examination that presented as an intracranial hypermetabolic lesion.Conclusion:Primary brain lymphoma is a rare tumor that imaging findings overlap with those of other intracranial mass lesions,we can only make a suggestive diagnosis of primary brain lymphoma and pathological confirmation is meeded.

Objective To investigate the influencing factors of in-stent restenosis (ISR) following stenting for vertebral artery ostium stenosis (VAOS). Methods From January 2013 to December 2014, a total of 325 patients receiving stenting for severe vertebral artery stenosis (≥70%).which was diagnosed with color Doppler ultrasonography (CDUS) and confirmed by digital subtraction angiography (DSA) were retrospectively recruited. All patients were divided into the ISR group (116 cases) and the non-ISR group (209 cases). CDUS was utilized for periodical follow-up after the procedure. All vascular structure characteristics and related clinical information of the target vertebral artery were recorded. The Kaplan-Meier was used to calculate the accumulative ISR incidence and generate the survival curves. The Log-rank test (χ2 test or Fisher exact test) was used to compare the discrepancy in survival curves. Cox proportional risk regression model was used to analyze the possible influencing factors. Results (1) All patients were followed up for a median of 14 (6, 38) months. There was no significant difference between the two groups in age, gender, side of severe stenosis, diabetes mellitus, hypertension, smoking history, symptoms of posterior circulation and posterior circulation cerebral infarction (all P>0.05). (2) There was significant difference in stent type using of drug eluting stent (DES) or bare metal stent (BMS) between the two groups(48/68 vs. 125/84 , χ2 =10. 18, P = 0. 001). The stent diameter in the ISR group was significantly larger than that in the non-ISR group ([4. 5 ±0. 7]mm vs. [4. 3 ±0. 8]mm, t = -2. 52, P =0. 010). There was no significant difference in stent length between the two groups (P > 0. 05). (3) Compared with the non-ISR group, the ISR group had more prevalent tortuosity of vertebral artery (42. 2% [49/116] us. 26. 8% [56/209] , χ2 = 8.14) and larger original diameter of the vertebral artery before stenting ([3.5 ± 0. 6]mm vs. [3. 3 ± 0. 5]mm, t = - 2. 74). The differences were significantly (P < 0. 05). There was no significant difference in other structural characteristics of vertebral artery between the two groups (P > 0. 05). (4) Further analyzed by Cox step-wise regression, DES (HR, 0. 58, 95 % CI 0. 39 -0. 86, P = 0. 01) and tortuosity of the target vertebral artery (HR, 1. 52, 95% CI 1. 02 -2. 28, P =0. 04) were influencing factors for ISR after VAOS stenting. While the ratio of postoperative diameter to preoperative original diameter was not significantly correlated with the occurrence of ISR (P >0. 05). (5) Kaplan-Meier survival curve analysis was performed on the cumulative incidence of ISR in patients with vascular tortuosity. There was no statistically significant difference in the cumulative incidence of ISR in patients with vertebral artery tortuosity using BMS (Log-rank χ2 = 1. 72, P = 0. 19), but DES (Log-rank χ2 = 8. 62, P = 0. 003). Conclusion DES could effectively reduce the incidence of ISR. Tortuosity of the target vertebral artery was a risk factor for ISR after stent implantation, especially when using DES.

Objective To apply the health education intervention based on protection motivation theory in community female patients with stress urinary incontinence,in order to establish a health behavior and to control urinary incontinence.Methods 96 female patients with stress urinary incontinence were randomly divided into the control group and the experimental group by random number table method,the control group received routine health education,the experimental group received health education based on protection motivation theory.The ICI-Q-SF score,pelvic muscle exercise compliance scale score,urinary incontinence coping efficacy score were compared between the control group and the experimental group.Results The ICI-Q-SF score of the experimental group after the intervention was 5.43 ± 1.77,which was significant lower than that in the control group,7.96±2.98,t=4.88,P＜0.01.The urinary incontinence coping efficacy scores of experiment groups after the intervention was 17.63±1.85,which was higher than that in the control group,13.49±2.46,t=-9.09,P＜0.01.There were 29 cases accounted for 63.04％ with good compliance and 17 cases accounted for 36.96％ with poor compliance in experimental group after intervention,14 cases accounted for 31.11％ with good compliance and 31 cases accounted for 68.89％ with poor compliance in control group after intervention,the difference was statistically significant,x2=9.306,P＜0.05.Conclusions Health education based on protection motivation theory can promote the coping efficacy and health behavior of community female patients with stress urinary incontinence and can effectively control urinary incontinence symptom.

Objective To explore the application of transitional care based on the Omaha system in postoperative rehabilitation of patients with breast cancer.Methods Seventy-two patients after radical mastectomy were assigned into two groups according to admission time,patients from June to December 2011 were set as the control group,patients from February to December 2012 were assigned to the intervention group,each group contained 36 patients.The patients in the control group received routine nursing,while patients in the intervention group were implemented transitional care program with Omaha system as framework from before discharge to 6-week follow-up after discharge from hospital.Nursing effect was compared between two groups from three aspects such as cognition,behavior and status.Results Twenty-three problems were found in the 6-week follow-up for the intervention group,including environmental domain,psychosocial domain,physiological domain and health-related behavior domain.Knowledge,behavior and status scores of the intervention group 6 weeks after discharge were significantly higher than those of the control group [(3.92 ± 0.48) scores vs.(2.41 ± 0.17) scores,(4.11 ± 0.49) scores vs.(2.83 ± 0.25) scores,(3.09 ±0.52) scores vs.(2.32 ±0.39) scores,t=14.81,15.36,9.42,P＜0.01 or 0.05].Conclusions Transitional care based on the Omaha system shows common problems in rehabilitation of patients with breast cancer after operation,and provides standardized program for rehabilitation nursing.It can achieve better nursing effect.

Objective To investigate the clinical efficacy and psychological status of three kinds of drug therapy in patients with generalized anxiety disorder. Methods 90 patients with generalized anxiety disorder in our hospital from January 2015 to December 2016 were selected,and according to the different treatment methods divided into the observation group A, observation group B and observation group C,45 cases in each groups. The observation group A with venlafaxine treatment, observation group B with tandospirone treatment, observation group C treated with Laura Si; comprehensive observation of 3 groups of patients with clinical treatment, improve psychological status and the incidence of adverse reactions, drug compliance, strict record the relevant data and comparative analysis. Results 3 groups of patients with clinical curative effect, no significant difference ; observation group A patients psychological status were better than those observed in B and C group. The incidence of adverse reaction was lower than observed in B and C group, medication compliance was higher than B, C group, the difference was statistically significant (P<0.05). Conclusion The patients with generalized anxiety disorder can choose Vin Rafa Sin, tandospirone, Laura Si treatment, but Vin Rafa Sin on the psychological status of patients with improvement is more significant, less adverse reactions, medication compliance of patients, is worthy of clinical application.

Objective To analyze the correlations of vascular structure, hemodynamic changes and surgical recanalization of carotid endarterectomy ( CEA) for the treatment of subtotal or complete occlusion of carotid artery. Methods A total of 107 patients with carotid artery occlusive disease diagnosed at Beijing Xuanwu Hospital,Capital Medical University received CEA therapy from January 2005 to January 2014 and were enrolled retrospectively. According to the findings of introperative ultrasound,they were divided into either a recanalization group (n=86) or a non-recanalization group (n=21). Preoperative and intraoperative carotid artery diameter and blood flow velocity were compared and analyzed with carotid ultrasonography. Intraoperative detected vascular abnormalities, residual vascular stenosis rate, blood flow velocity and pulsatility index of the ipsilateral middle cerebral artery ( MCA) were documented. Results (1) The peak systolic velocity (PSV) (82 ± 32 cm/s and 60 ± 17 cm/s),mean velocity (MV) (50 ± 19 cm/s and 42 ±13cm/s),and pulsatility index (PI) (0. 97 ± 0. 25 and 0. 67 ± 0. 14) on the ipsilateral MCA in patients of carotid artery recanalization before and after procedure were significantly higher than those during the procedure. There were significant differences (all P=0. 000). In patients failed to recanalize,the intraoperative and preoperative PSV,EDV,and MV of MCA were 46 ± 20 cm/s and. 63 ± 21 cm/s,24 ± 13 cm/s and 34 ± 12 cm/s, and 32 ± 16 cm/s and 44 ± 15 cm/s,respectively. They were reduced more significantly during the procedure than those after procedure. There were significant differences ( all P=0. 000 ) . But there was no significant difference in PI (0. 70 ± 0. 18 and 0. 67 ± 0. 15) compared with that before procedure (P=0. 317). (2) The diseased vascular diameter of the recanalization group was significantly widened (0. 6 ± 0. 4 mm vs. 3. 4 ± 0. 9 mm,P=0. 000) compared with before procedure. The overall recanalization rate was 80. 4% (86/107). Intraoperative ultrasound revealed that 13 patients had mild abnormal vascular structures among the recanalized patients. The non-recanalized patients had significantly abnormal vascular structure. Conclusion Intraoperative carotid ultrasound in combination with transcranial Doppler (TCD) for monitoring cerebral blood flow may effectively identify the carotid structure and the degree of cerebral hemodynamic improvement,and timely guide the secondary repair.