[ ABSTRACT] AIM:To investigate the distribution of mast cells ( MCs) and the expression of transforming growth factor-β(TGF-β) on tryptase positive MCs in different types of human periapical diseases.METHODS:Total 78 cases of specimens were involved in this study, including healthy control, periapical cyst and periapical granuloma.The tissue sam-ples were fixed in 10% formalin for at least 48 h, stained with hematoxylin and eosin for histopathological examination, stained with toluidine blue staining for identifying MCs and MCs degranulation, and stained with double immunofluores-cence for identification of tryptase-TGF-βdouble positive MCs.RESULTS:The density of tryptase-TGF-βdouble positive MCs in the periapical lesions was significantly higher than that in the healthy controls ( P<0.01) .The number of TGF-βpositive MCs in the periapical cyst was significantly higher than that in the periapical granuloma ( P<0.01 ) .Compared with toluidine blue staining, the number of MCs with double immunofluorescence staining significantly increased ( P <0.01).CONCLUSION:The TGF-βpositive MCs may play an important role in the pathogenesis of human chronic peria-pical diseases, particularly in the formation of fibrous tissue in periapical cyst.Double immunofluorescence staining is more sensitive than the traditional toluidine blue staining for identifying MCs.

Objective To explore the coping strategies of patients with superficial bladder carcinoma and analyze the influential factors.Method The medical coping modes questionnaire(MCMQ)was used to do the investigation among 146 patients with superficial bladder carcinoma.Results Among the coping strategies,the scores on the factors of facing,avoidance and yielding were 2.42±0.45,2.00±0.45 and 1.52±0.50,respectively.The operative method,education level,sex and stages of chemotherapy were the main factors influencing the coping strategies.Conclusions For the postoperative patients with superficial bladder carcinoma, the coping strategies were influenced by different factors.Therefore,nursing staff should attach their highlights on patients' coping strategies and instruct the patients with active coping strategies based on the their traits.

Objective To explore the incidence,features and outcomes of in-hospital sudden cardiac death (SCD) in order to determine the predictors of survival. Methods The clinical data of 69 patients with cardiac arrest hospitalized from January 2008 through December 2010 were retrospectively analyzed.Information on genders,age,types of arrhythmia was collected and further analyzed to determine these factors associated with the occurrence and outcomes of in-hospital cardiac arrest. Results The overall incidence of SCD was 47.3 / 100 000 per year and 17.4％ of them.survived at discharge.The occurrence rate was higher in male than that in female (66.7％ vs.33.3％,P ＜0.01 ),whereas difference in gender did not affect the discharge rate ( P ＞ 0.05 ). Survivors from in-hospital cardiac arrest were significantly younger than non-survivors (man:62.57 ± 12.83 years vs.75.56 ± 10.55 years; women:60.36 ± 13.24years vs.69.53 ± 11.72 years,P ＜ O.01 ).From 62 ECG records of SCD patients,the incidence of nonshockable rhythms was higher than that of shockable rhythms.Compare to the non-shockable rhythms,the shockable rhythms brought a higher rate of restoration of spontaneous circulation (ROSC) (54.5％ vs.24.5％,P ＜0.05),whereas survival rates at discharge between two groups were not statistically different ( 18.2％ vs.18.4％,P ＞ 0.05 ).Conclusions Non-shockable rhythms were more common in patients suffering from in-hospital cardiac arrest.Although defibrillation treatment contributed benefit to ROSC among patients with ventricular fibrillation or pulseless ventricular tachycardia,high-quality CPR and post-cardiac arrest care may play a more critical role in the outcomes of in-hospital sudden cardiac death.

Objective:To investigate the effect ofLeech Capsule on stability ofcarotid plaque and expression ofplatelet membrane glycoprotein in patients with cerebral arteriosclerosis.Methods:203 patients with cerebral arteriosclerosis which with unstable carotid plaque were divided into two groups.There were 101 patients in observation group which were treated by conventional therapy and Leech Capsule, and 102 patients in control group which were treated only by conventional therapy.Then comparison analysis ofIMT, plaque area, unstable plaque number and positive rates ofPAC-1 and CD62P were made before and after treatment with two groups.Results:After treatment, the IMT, plaque area, unstable plaque number and positive rates ofPAC-1 and CD62P in observation group were significantly lesser than those in control group.In observation group, all parameters after treatment were significantly lesser than those before treatment, but in control group there were no significant difference in IMT and positive rates ofCD62P between after treatment and before treatment.In addition, there were no obvious adverse reactions after treatment by leech capsule.Conclusion:Leech Capsule was an effective drug for stabilizing carotid plaque and depressing the level ofplatelet activation, and it had few adverse reaction.It was worth further spreading.

Objective To investigate the relationship between acute cerebral infarction(CI)and matrix metalloproteinase-9(MMP-9)serum level and polymorphism(C-1562T)in Han population.Methods One hundred and one patients with acute CI from the department of neurology of Taizhou Hospital were included and 114 healthy persons were selected from physical examination as the control group.Serum MMP-9 level was measured by enzyme-linked immunosorbent assay(ELISA).At the same time.genotype was determined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)for the common C-1562T functional promoter polymorphism of the MMP-9 gene.The serum MMP-9 level and genotype frequencies of the MMP-9 gene between the patients and the control group were analyzed.Results The genotype frequencies of the MMP-9 gene C-1562T polymorphism of the two groups were in Hardy-Weinberg equilibrium.The results of individual polymorphisms analysis showed that the frequencies of CT and TT genotypes in the C-1562T polyporphismin were of no significant difference between the patients group with CI(13.9%)and the control group(13.2%).The frequencies of-1562T allele was of no statistical difference between the CI group(6.9%)and the control group(7.5%).But serum levels of MMP-9 in CI patients group((138.9±121.8)ng/ml)were significantly higher than in the control group((18.4±4.6)ng/ml,t=9.93,P=0.00).Conclusions Serum level of MMP-9 obviously is increased after ischemic stroke in 48 hours.But genetic polymorphism in MMP-9 promoter(C-1562T)has no definite relationship with MMP-9 genetic expression and CI in the Han population of China.Therefore,the relationship between genetic polymorphism in MMP-9 promoter(C-1562T)and ischemic stroke needs further investigation.

Objective To investigate the effect of the calmodulin kinase Ⅱ Inhibitor KN-93 on L-typecalcium current(ICa,L)and intracellular calcium concentration([Ca2+]i)in hypertrophic cardiac myocytes.Methods Forty-eight female New Zealand white rabbits were randomized(random number)into four groups(12 animals in each group):the sham operation group(sham group),the left ventricular hypertrophy group(LVH group),the myocardial hypertrophy + KN-93 group(KN-93 group),and the myocardial hypertrophy + KN-92 group(KN-92 group).Myocardial hypertrophy in the rabbits was established by coarctation of the abdominal aorta.In the sham group,the abdominal aorta was dissociated without coarctation.Eight weeks after coarctation,single ventricular myocytes were isolated by enzymaticdissociation,and ICa,L was recorded using perforated-patch recording(PPR)techniques.[Ca2+]i was measured using single-cell calcium imaging with the fluorescence calcium indicator dye fura-2/AM.Results Cardiac hypertrophy was successfully established after 8 weeks of coarctation of the abdominal aorta.The peak ICa,L in the LVH group and the sham group was(1.38 ± 0.3)nA and(0.87 ± 0.1)nA at 0 mV,respectively(P ＜0.01,n =12).There was no significant difference in Ica,L density between the LVH group and the sham group[(6.7 ±1.0)pA/pF vs.(6.3±0.7)pA/pF; P≥0.05,n=12].The addition of either KN-92(0.5 μmol/L)or KN-93(0.5 μmol/L)to the perfusing solution caused a modest steady-state inhibition of peak ICaL(9.4％ ±2.8％,KN-92; 10.5％ ±3％,KN-93)(P≥0.05,n =12)at 0 mV.However,at a higher concentration(1 μmol/L),KN-93 more potently inhibited peak ICa,L(40％±4.9％)compared to KN-92(13.4％ ± 3.7％ ; P ＜ 0.01,n =12).Resting[Ca2+]i levels in fura-2-loaded myocytes isolated from the sham,LVH,KN-92,and KN-93 groups were(98 ± 12.3)nmol/L,(154 ± 26.2)nmol/L,(147 ± 29.6)nmol/L,and(108 ± 21.2)nmol/L,respectively.Conclusions The CaMK Ⅱ specific inhibitor,KN-93,can effectively block ICa,L and reduce intracellular calcium overload in hypertrophic cardiac myocytes.This action may account for the antiarrhythmic effect of KN-93 in hypertrophic ventricular myocardium.

Objective To study the changes in the level of serum IMA in patients with cardiac arrest followed by CPR,and explore the value of serum IMA in predicting prognosis of these patients after CPR.Methods (1) A total of 36 patients (25 men and 11 women) after CPR following cardiac arrest were recruited into experimental group (group C).Of them,15 cases (11 men and 4 women) and 21 cases (14men and 7 women) were assigned into resuscitation group (group R) and non resuscitation group (group NR),respectively,according to the presence or absence of ROSC.Meanwhile,another 60 healthy subjects (39 men and 21 women) matched for age and gender were recruited into healthy control group (group H).(2) The determination of the serum IMA level and comparisons of changes in serum IMA levels among groups were carried out.Results (1) The level of serum IMA in group C was higher than that in group H (P ＜ 0.05) ; The serum IMA level in group R was lower than that in group NR and higher than that in group H (P ＜0.05 for both).(2) The area under the ROC curve for serum IMA in predicting the prognosis of patients treated with CPR after cardiac arrest was 0.73.When the cut off value was 128.25 U/mL,the sensitivity and specificity were 57.1％ and 93.3％ respectively; the positive predictive value and negative predictive value were 92.3％ and 60.9％ ; positive likelihood ratio and negative likelihood ratio were 8.5 and 0.5 ; the correct diagnosis index was 72.2％,and Youden index was 50.5％.Conclusions Serum IMA has a certain value in prediction of prognosis in patients treated with CPR following cardiac arrest.

Objective To analyze the correlation between covalently closed circular DNA (cccDNA) in the peripheral blood mononuclear cells (PBMC) of hepatitis B virus (HBV)-infected patients and serum HBV DNA,hepatitis B surface antigen (HBsAg),hepatitis B e antigen (HBeAg) and liver histology of hepatitis B patients,and to explore the clinical significance of HBV cccDNA detection in PBMC.Methods One hundred and eight patients with chronic HBV infection were involved in this study.PBMC were extracted using density gradient centrifugation.HBV cccDNA in PBMC and serum HBV DNA were detected by real-time fluorescence quantitative polymerase chain reaction.HBsAg and HBeAg were detected by chemiluminescence immunoassay.Liver biopsy was conducted in 59 out of the 108 patients.Chi-square test was used to compare the categorical variables.Correlation analysis was used to compare quantitative variables.Nonparametric test was used to compare the non-normal distribution parameters.Results In the overall population,HBV cccDNA in PBMC was positive in 59 patients (54.6％).Eleven of the 15 patients with liver failure were found to be HBV cccDNA positive,which was significantly higher than that in the acute hepatitis B group (only 2 of the 8 patients were HBV cccDNA positive; x2 =4.960,P＜0.05).One hundred and eight patients were categorized into three groups according to their serum HBV DNA levels,with group A:＞5 lg copy/mL,group B:3-5 lg copy/mL and group C:＜3 lg copy/mL.The proportions of HBV cccDNA positivity in PBMC in three groups were 76.1％ (51/67),5/18 and 13.0％ (3/23),respectively.Comparing with patients with lower HBV DNA (group B and C),the proportion of HBV cccDNA positivity was higher in patients with higher HBV DNA (group A; x2=14.751,P＜0.05 and x2 =28.384,P＜0.05,resepectively).The HBV cccDNA quantitation in PBMC was positively correlated with the serum HBV DNA level and HBsAg quantification (r=0.554,P＜0.05 and r=0.497,P＜0.05,respectively).The proportion of HBV cccDNA positivity in PBMC of patients with liver histology ≥G2 and/or ≥S2 was significantly higher than that in patients with liver histology ＜ G2/S2 (x2 =9.159,P＜0.05).Conclusions HBV cccDNA exists in PBMC of hepatitis B patients.The HBV cccDNA quantitation in PBMC is positively correlated with the serum level of HBV DNA and HBsAg quantification,and is also associated with liver histology injury.

Objective To study the characteristics of epidemiology among the emergency patients with acute drugs poisoning in emergency center of Fujian Province.Methods Retrospective study was used to collect data of patients with acute drugs poisoning from 2004 to 2009,and data of patients 'gender,age,cause of poisoning,poison type,emergency diagnosis,medical treatment,etc.were analyzed.Results The epidemiological reports of 744 cases of acute drugs poisoning patients were collcected from 2004 to 2009,the male-to-female ratio was 1:4.2,the average age was 33.0,high incidence group was at ages 18 ～29 (50.3％ ).The most visiting time was in Spring (April to June).Eighty-eight point three percentage of poisoning was intentional.Central nervous system drugs,in particular sedative/hypnotic drugs (64.5％ )was the most common agents associated with poisoning.The poisoned patients were divided into three groups with mild ( 51.5％ ),moderate ( 33.2％ ) and severe ( 15.3％ ) according to the patient' s condition.Thirty-seven percentage poisoned patients were discharged after treatment followed up for observation,and 28.3％ patients were hospitalized,no patients died.Conclusions The majority of acute drugs poisoning among patients from city were sedative/hypnotic drugs.Reasonable grading and different treatment according to the condition of acute drugs poisoning would be helpful to improve the survival rates of acute poisoning and reduce medical costs.

This article was aimed to study the main effective substances and characteristics of Ke-Luo-Xin (KLX) capsule. HPLC-DAD system was applied in the establishment of HPLC finger prints of serum of rats after taking KLX capsule. And then, serum samples taken KLX capsule, blank blood serum, and single crude drugs were com-pared. Constituents absorbed into the serum were determined by HPLC-DAD system. The results showed that meth-ods for serum HPLC fingerprinting had good precision, reproducibility and stability. A total of 13 constituents migrat-ing to the blood were detected, of which 9 were prototype constituents, 4 were metabolites. Prototype constituents in-cluded aloeemodin and chrysophanic acid. It was concluded that 13 constituents migrating to the blood may be the main effective substances of KLX capsule.