Objective:To analyse the salivary cortisol changes in patients with temporomandibular disorders(TMD)after electrical stimulation,and the relationship between cortisol and pain catastrophizing.Methods:1 1 TMD and 1 1 healthy subjects were evoked by electrical stimulation.The saliva samples were collested before test,50 s and 1 00 s of stimulation after test seperately.Salivary cortisol was analysed by ELISA kit.The pain catastrophizing scale(PCS)was answered by all the subjects before stimulation.Data were statis-tically analysed.Results:The salivary cortisol concentration in TMD patients was higher than that in the controls(P <0.05).After stimulation,it showed a downward trend.No interaction between time and groups.The total scores of PCS including three indexes(ru-mination,magnification,helpless)were positively correlated with salivary cortisol concentration.Conclusion:The unpredictable stress causes high level of cortisol.which is related to pain catastrophizing.

Objective To study the relationship between the positive expression of human leukocyte antigen B27 (HLA-B27) in different age groups and genders in Uygur and Han nationality in Xinjiang,and explore the clinical value of HLA-B27 in different ethnic groups.Methods From January 2013 to November 2016,1 416 cases of Uygur and Han patients with positive expression of HLA-B27 were detected by flow cytometry.There were 369 cases of Uygur and 1 047 cases of Han.Results Independent samples t-test showed that the positive expression of HLA-B27 in Uygur and Han population was statistically significant (165.22±8.262 vs 163.99±8.113,t=2.479,P=0.013).In male,there was a significant difference in the positive expression of HLA-B27 between Uygur and Han population (165.40 ± 8.237 vs 163.99 ± 8.164,t =2.187,P =0.029).In the age of 41～60 years old and ＞60 years old,the positive expression of HLA-B27 in Uygur was higher than that in Han nationality (166.18 ± 7.650 vs 164.53 ± 8.018,t =2.215,P =0.027;171.63 ± 8.134 vs 167.40 ± 9.469,t =2.126,P=0.035).There was no significant difference in the positive expression of HLA-B27 between Uygur and Han nationality in women,as well as in the age of 20 years and 21～40 years (t=-0.029～1.257,all P＞0.05).Conclusion The investigation showed that the positive expression of HLA-B27 in Uygur was higher than that in Han nationality.The content of HLA-B27 positive expression has racial difference.

Objective To explore the effect of aerobic exercise on platelet function in elderly patients with hypertension and type 2 diabetes.Methods81 elderly patients with hypertension and type 2 diabetes were divided into the routine treatment group (group A, n=41) and regular exercise group (group B, n=40). All patients of two groups were treated with routine treatment. The exercise with moderate intensity was performed in the group B for 3 months besides routine treatment. The platelet membrane glycoprotein CD62P, CD61 (Ⅲa) were detected by flow cytometric analysis and platelet aggregating ratio was measured before and after regular aerobic exercise.ResultsAfter three months, the systolic blood pressures were 166±3.6 mm Hg (group A) and 152±3.5 mm Hg (group B); the diastolic blood pressures were 93±4.2 mm Hg (group A) and 83±4.3 mm Hg (group B); the contents of blood glucose were 7.4±2.4 mmol/L (group A) and 6.3±1.9 mmol/L (group B); the positive percents of platelet membrane glycoproten CD62P were 27.3±2.2% (group A) and 21.5±3.3% (group B), CD61(Ⅲa) were 26.3±2.3% (group A) and 20.2±2.9% (group B) and platelet aggregation rates were 78.4±4.5% (group A) and 69.7±5.4% (group B), there was a significant difference between two groups ( P<0.05～0.01).ConclusionRegular aerobic exercise can decrease the positive percent of platelet membrane glycoprotein and platelet aggregation rate in elderly patients with hypertension and type 2 diabetes.

Multiple organ dysfunction syndrome (MODS) is one of the leading causes of death in ICU patients.However,there have been few studies on the role of MODS as a cause of death in patients with acute myocardial infarction (AMI),particularly in those at advanced age.Our study aimed to investigate the incidence and to identify the predicting factors of MODS in elderly patients with AMI.Methods We identified consecutive patients with AMI who were discharged from the Chinese PLA General Hospital between January 1993 to June 2006.Medical records of 800 consecutive patients aged 60 years or over were analyzed retrospectively.Multivariate logistic regression was used to determine factors predicting in-hospital development of MODS.Results Twenty-seven (3.4%) patients developed MODS within 30 days after AMI.Compared with patients without MODS,patients with MODS had higher in-hospital mortality rates (55.6% vs 11.6%,P＜0.001 ) and more frequent complications of cardiogenic shock (25.9% vs 6.2%,P＜0.001),heart failure (HF) (59.3% vs 18.2%,P＜0.001 ),cardiac arrhythmia (44.4% vs 26.4%,P＜0.05) and pneumonia (55.6% vs 16.3%,P＜0.001).Multivariate logistic regression analysis showed the major predictors for the occurrence of MODS secondary to AMI were advanced age (≥ 75 years,odds ratio 2.64,95% confidence interval [CI] 1.13 to 6.61),heart rate/＞ 100 bpm on admission (odds ratio 1.74,[CI] 1.14 to 2.64),in-hospital complication of HF (odds ratio 3.03,[CI] 1.26 to 7.26) and pneumonia (odds ratio 2.82,[CI] 1.18 to 6.77).Conclusions MODS is not the uncommon complication in elderly patients with AMI and is associated with poor prognosis.Advanced age,heart failure and pneumonia are predictors of the development of MODS in patients with AMI.(J Geriatr Cardiol 2008;5:199-202)

Objective To investigate the sonographic features of follicular variant of papillary thyroid carcinoma (FV-PTC) and to decrease misdiagnosis rate. Methods Thirty-one patients with 35 FV-PTCs and 66 patients with 75 conventional PTCs (C-PTCs) were enrolled in this study. The sonographic features were reviewed retrospectively between the two groups with universally accepted standards. Results The sonographic features of 35 FV-PTCs included irregular shapes (6/35), anteroposterior to transverse diameter ratio A/T > 1 (7/35), spiculated margins (25/35), marked hypoechogenicity (0/35), hypoechogenicity (18/35), isoechogenicity (16/35), no calcification (15/35), microcalcifications (11/35), macrocalcification (9/35), color Doppler lfow patternⅠ(20/35), color Doppler lfow patternⅡ(10/35), color Doppler lfow patternⅢ(5/35). Irregular shapes, A/T>1, spiculated margins, marked hypoechogenicity, microcalciifcations, and color type Ⅱ were rarer in FV-PTCs than in C-PTCs, while isoechogenicity, no calciifcation, macrocalciifcation, and color type Ⅲwere more frequent in FV-PTCs than in C-PTCs. The differences of the above features were statistically significant [χ2=4.276, P=0.039; χ2=8.125, P=0.004; P=0.009 (Fisher′ s exact test); χ2=8.548, P=0.003;χ2=4.898, P=0.027,χ2=7.796, P=0.005;χ2=5.462, P=0.019;P=0.001 (Fisher′s exact test)] . During the preoperative ultrasonography, 20 of 35 FV-PTCs were diagnosed as malignancy, and others were misdiagnosed as benign nodules (misdiagnosis rate was 43%). The lymphatic metastasis rate of FV-PTCs was 29%(9/31), significantly lower than C-PTCs [62%(41/66),χ2=9.246, P=0.002]. In terms of the sonographic features of metastatic lymph nodes, there was no marked difference between FV-PTCs and C-PTCs. Conclusions Some FV-PTCs are lack of malignant features, and tend to be misdiagnosed frequently when coexisting with benign thyroid nodules. Observing the echogenicity, color lfow characteristics and other features of each thyroid nodule and cervical lymph node with multiple views may decrease the misdiagnosis rate.

AIM: To investigate the role of autophagy in the apoptosis of human pulmonary artery endothelial cells (HPAECs) induced by cigarette smoke extract (CSE).METHODS: HPAECs were cultured routinely.HPAECs were treated with CSE at different concentrations, and the cell viability was detected by MTT assay.HPAECs were divided into control group, CSE group, 3-methyladenine (3-MA) group and 3-MA+CSE group.The autophagy was observed under fluorescence microscope with monodansylcadaverine (MDC) staining.Annexin V/propidium iodide staining and Hoechst 33342 staining were employed to detect apoptosis.In addition, the protein levels of LC3, beclin-1 and cleaved caspase-3 were determined by Western blot.RESULTS: MDC staining showed the increased production of autophagic vacuoles was observed in CSE group.The results of Western blot showed that the expression levels of autophagy-related proteins LC3 and beclin-1 were increased, while 3-MA pretreatment inhibited the expression of these proteins and the production of autophagic vacuoles.Observation with Annexin V/propidium iodide staining and Hoechst 33342 staining showed that the apoptotic rate in CSE group was significantly higher than that in control group, and pretreatment with 3-MA induced further increase in the cell apoptosis.The protein level of cleaved caspase-3 in CSE group was significantly higher than that in control group (P<0.05), and 3-MA+CSE treatment induced the further increase in the protein level of cleaved caspase-3.CONCLUSION: CSE induces autophagy and apoptosis in the HPAECs.Inhibition of autophagy promotes the apoptosis induced by CSE in HPAECs, which can be achieved through activation of caspase-3.

Objective To explore the way of contrast-enhanced ultrasound(CEUS)and quantitative analysis technology to assess testicular microvascular ischemia-reperfusion inj ury.Methods Twenty-four healthy adult rabbits were randomly divided into the control group and the microvascular mild,moderate, serve ischemic inj ury group (group Ⅰ,including group Ⅰ1 ,Ⅰ2 ,Ⅰ3 ).The spermatic cord of the control group were threaded but not ligated.The group Ⅰ1 ,Ⅰ2 ,Ⅰ3 were reperfused 2 h after 2 h,4 h,6 h complete testicular ischemia respectively.The ultrasound contrast angiographic parameters of each group were analyzed by the quantitative analysis techniques,including peak intensity(PI),time to peak(TP),slope,mean transmit time(MTT),DT/2 and area.The levels of plasma vWF,NO and ET-1 were tested after the CEUS. The pathological changes of the ipsilateral testicular were observed by the HE and immunohistochemical staining.Statistical analysis was performed by SPSS 13.0 software.Results Preoperativeiy,each parameter of the experimental group and the control group showed no statistical significance (P > 0.05 ). Postoperatively,the PI,slope,area of the group Ⅰ1 increased significantly,while the TP,MTT were prolonged(P <0.05).Contrast time-intensity curve was significantly higher peak and retrusion.The groupⅠ2's PI,slope,area increased further,DT/2 was significantly prolonged,but TP significantly reduced (P <0.05).The contrast curve significantly increased,forward and decreased slowly.The contrast curves of the group Ⅰ3 was approximate a straight line.The vWF,NO,ET-1 levels of each experimental group were significantly higher than those in control group (P <0.05),among them,the levels of group Ⅰ2 were the highest (P <0.05 ).With the aggravation of ischemia,the testicular capillaries expansion,erythrocyte sedimentation,leakage,infiltration of inflammatory cells,MMP-9 expression in vascular basement membrane gradually increased.Conclusions The CEUS and quantitative analysis techniques can effectively evaluate testicular microvascular inj ury.

Overt gastrointestinal bleeding (GIB) is one of the noncardiac complications in patients with acute myocardial infarction (AMI).Identification of patients at increased risk of overt GIB could aid in targeting more aggressive treatment,and lead to improved outcomes.The aim of this study is to determine the frequency,risk factors,and prognostic significance of overt GIB in patients with AMI.Methods A retrospective review of the medical records of 1443 patients admitted to the Chinese PLA General Hospital with AMI was conducted.Charts were reviewed for clinical characteristics,possible precipitating factors and complications.Patients were categorized as having or not having overt GIB(GIB associated with hemodynamic changes or the need for transfusions).Results Twenty nine (2.0%) patients developed overt GIB within 30 days after AMI.Patients with overt GIB had higher 30-day mortality rate than those without (44.8% vs.9.9%,P ＜ 0.001).Multivariate logistic regression analysis showed major determinants of in-hospital overt GIB secondary to AMI were gender of female (odds ratio 2.41,95% confidence interval [CI] 1.08 to 5.37),age=75 years (odds ratio 1.58,95% CI 1.13 to 2.20),prior history of AMI (odds ratio 2.28,95% CI 1.17 to 4.88),pneumonia (odds ratio 3.47,95% CI 1.50 to 8.03) and anemia at admission (odds ratio 2.37,95% CI 1.04 to 5.37).Conclusions In patients with AMI,overt GIB is associated with higher in-hospital mortality,and female sex,older age,prior AMI,pneumonia and anemia at admission are predictors of overt GIB during hospitalization.(J Geriatr Cardiol 2008;5:195-198)

14 aged patients received radiofrequency current ablation(RFCA)to treat drug-refractory tachycardia. The success rate was 97%(13/14).In conjunction with the charcteristicaof aged patients often with long clinical history and apt to be complicated,the paper especially discussed the distinctive feature of application of RFCA to aged patients.

Background and objective Fast track surgery (FTS) can accelerate rehabilitation and reduce postop-erative hospital stay. It has been effectively applied to several surgical diseases. However, the safety and effectiveness of FTS for patients with lung cancer in China is unclear. hTismeta-analysis aimed to evaluate the effect of FTS undergoing lung cancer surgery in China.Methods Using home and abroad databases to search all documents required. hTe deadline of retrieval was January 31, 2016. hTen the studies were screened according to the inclusion and exclusion criteria. Data were analyzed by RevMan 5.3 sotfware.Results 8 randomized controlled trials (RCTs) and 5 clinical controlled trials (CCTs) with 1,241 pa-tients were eligible for analysis. Compared with control group, FTS group can signiifcantly shorten postoperative hospital time (MD=-3.61, 95%CI: -5.05--2.16,P<0.000,01) and chest tube duration (MD=-2.62, 95%CI: -3.07-2.17,P<0.000,01), reduce incidence of postoperative complications (OR=0.30, 95%CI: 0.19-0.47,P<0.000,01) and hospitalization costs (MD=-0.92, 95%CI: -1.19--0.65,P<0.000,01).Conclusion FTS can safely and effectively accelerate the recovery of patients with lung can-cer in China, it exhibits important clinical values.