Objective To observe the clinical effectiveness of calcium sodium phosphosilicate desensitizer for the treatment of root-dentin hypersensitivity.Methods This was a randomized,single-blind,placebo controlled pilot study.135 subjects,a total of 215 teeth with a confirmed diagnosis of root-dentin hypersensitivity were randomly divided into three groups:group 1 (patients treated with 100％ calcium sodium phosphosilicate powder with 7％ calcium sodium phosphosilicate toothpaste),group 2 (patients treated with a placebo powder with 7 ％ calcium sodium phosphosilicate toothpaste),group 3 (patients treated with a placebo powder vith 0.11％ NaF toothpaste).Two standard test stimuli,cool air and cold water,were applied to sensitive root surfaces.Subjects recorded the intensity of sensitivity in response to each stimulus on a visual analogue scale (VAS) at baseline,immediately after powder application and after 2,4 and 6 weeks of twice-daily product use.Results The VAS values stimulated by cool air immediately,and 2,4 and 6 weeks after the treatment were [[(4.87±1.98),(3.85±1.09),(2.03±1.16),(0.59±0.51),respectivly] in Group 1; [(6.35±1.84),(4.83±0.75),(3.17±1.12),(1.45±0.91),respectively] in Group 2; [(6.83±0.78),(6.73±1.54),(5.441.58),(4.18±0.98),respectively] in Group 3.The VAS values stimulated by cold water immediately,and after 2,4 and 6 of treatment were [(6.43±1.01),(4.95±1.21),(3.06±0.86),(1.38±0.92),respectively] in Group 1; [(7.72±0.56),(5.65±0.69),(3.81±0.41),(2.17±0.58),respectively] inGroup2; [(8.380.89),(8.17±1.02),(7.99±0.74),(6.46±0.77),respectively] in Group 3.Compared with before treatment,there were significant differences in VAS values stimulated by the two tests at all time points in Group 1,and after 2,4 and 6 weeks of treatment in Group 2 (all P ＜0.05).Group 3 had significant differences in VAS values stimulated by cool air after 4 and 6 weeks of treatment,and had a significant difference in VAS values stimulated by cold water after 6 weeks of treatment (all P＜0.05).There were significant differences between group 1 and group 2 in the hypersensitivity reduction over baseline by two stimuli at all time point.Conclusions The 7％ calcium sodium phosphosilicate toothpaste shows a good performance in relieving the root dentin hypersensitivity.Moreover,the 100％ calcium sodium phosphosilicate powder can enhance the effectiveness of the 7％ calcium sodium phosphosilicate toothpaste.

Objective To analyze the causes of inappropriate discharge of implantable cardioverter defibrillator (ICD) in elderly patients and to discuss the corresponding solutions.Methods Totally 95 elderly patients with ICD were collected.They were followed up and the inappropriate ICD discharges were recorded and analyzed.Results All patients were followed up for 235 times/year totally.There were 16 patients with inappropriate ICD discharges.The causes of inappropriate ICD discharges included ventricular oversensing in 7 patients (43.7％),supraventricular tachycardia misclassified into ventricular tachycardia in 4 patients (25.0％),electrode fracture in 2 patients (12.5％),and electromyogram (EMG) interference,electromagnetic interference and electrode fracture with EMG interference in 1 patients respectively (6.3％ each).11 inappropriate ICD discharges were reduced and avoided by reprogrammed and noninvasive treatment in 16 patients.1 patient with the underdetected ventricular fibrillation after reprogramming and the problem was solved by external defibrillation.The other 5 patients got better by the invasive treatment.Conclusions Different causes account for inappropriate discharges in patients with ICD.Reprogramming the corresponding parameters in different ICD can reduce or avoid inappropriate discharges without affecting the sensitivity of ICD.

Objective To investigate the molecular mechanisms of protective effects of thioredoxin (Trx) on human vascular endothelial cells in atherosclerosis.Methods The cell models of Trx-overexpressing cells (Ad Trx) and the control cells (Ad-con) were established by adenovirus vector gene transfer technology in human umbilical vein endothelial cells (HUVECs).The oxidized low density lipoprotein,a risk factor of atherosclerosis,was used as a stimulator.Western blot and indirect immunofluorescence were used to detect the protein expression levels and the cellular localization of Trx,adhesion molecules (ICAM-1,VCAM-1) and the upstream signal pathways.Trx activity was detected by insulin disulfide reduction assay,and cellular reactive oxygen species (ROS)production was detected by fluorescent probe DCFH-DA.Results As compared with control group,Trx protein expression level was enhanced in Ad-trx group and the Trx activity in Ad-Trx group was upregulated by (26.2 ±3.3)％.The result of ROS detection showed that overexpression of Trx significantly inhibited the cellular ROS generation.As compared with control group,overexpression of Trx obviously inhibited the adhesion molecules expression but markedly promoted the phosphorylation of Smad3 in endothelial cells with or without oxLDL stimulation (P＜0.05).Pretreatment of cells with SIS3,a specific inhibitor of Smad3 phosphorylation,reversed Trx-induced inhibition of adhesion molecules expression.Further studies showed that pretreatment of cells with SIS3 enhanced oxLDL-induced AP-1 subunit c-fos nuclear expression.Conclusions The enhancement of Smad3 phosphorylation and c-Fos nuclear expression are mainly responsible for the Trx-induced downregulation of adhesion molecules.

Objective To investigate the correlations of plasma B-type natriuretic peptide (BNP) and carbohydrate antigen 125 (CA125) levels in elderly patients with chronic heart failure (CHF) and to evaluate the clinical value.Methods A total of 124 elderly patients diagnosed as chronic heart failure were recruited.Patients with CHF were divided into the stage Ⅱ group,stage Ⅲ group and stage Ⅳ group according to the New York Heart Association (NYHA) classification.35 health subjects were randomly enrolled as the control group.The plasma levels of BNP and CA125 between different groups were compared.The correlations of the plasma BNP and CA125 levels with chronic heart failure were analyzed.60 cases with clinical improvement by aggressive treatment were followed up and the plasma levels of CA125 and BNP in them were tested.The changes in heart failure indicators were analyzed before and after treatment.Results The plasma BNP and CA125 levels were higher in patients with CHF than in control subjects (all P＜0.01).The plasma BNP and CA125 levels were gradually increased in the stage Ⅱ,Ⅲ and Ⅳ group (all P＜0.01).The plasma levels of BNP and CA125 were negatively correlated with left ventricular ejection fraction and positively correlated with left ventricular end-diastolic diameter (r=-0.75,-0.73,0.72,0.63,respectively,both P＜0.01).There were no significant differences in the plasma levels of BNP and CA125 between patients with or without atrial fibrillation (both P ＞0.05).Conclusions Plasma BNP and CA125 levels are correlated with NYHA classification in CHF,which can be used as indexes for the diagnosis,treatment and prognosis of CHF.

Objective To investigate the association between CYP2C19 polymorphisms and efficacy of clopidogrel in Chinese Han patients with coronary atherosclerotic heart disease.Methods A total of 176 Chinese Han patients who underwent percutaneous coronary intervention and were treated with dual antiplatelet therapy with aspirin and clopidogrel were enrolled.Polymorphisms of CYP2C19 * 2,* 3 were measured by PCR-restriction fragment length polymorphism (PCR RFLP).The correlation between the genetic variants and cardiovascular events was analyzed.Results In the 176 patients,the allele frequencies of CYP2C19 * 2 and * 3 were 34.38％ and 5.97％ respectively,the percent of patients with poor metabolizer genotypes (* 2/* 2,* 2/* 3,* 3/* 3) was 14.20％.Among the 176 patients,11 patients reoccured acute coronary syndrome,1 patient suffered from stroke,and 4 patients had stent thrombosis.The incidence of cardiovascular events was 9.09 ％.Thecumulative incidence of cardiovascular events had no significant differences between poor metabolizer genotype carriers and extensive and intermediate metabolizer genotype carriers (16.00％ vs.7.95％,x2 =1.683,P=0.195).Conclusions The frequencies of CYP2C19 poor metabolizer genotypes are higher in Chinese Han population than in Caucasians,but the incidence of cardiovascular events in Chinese Han population is not increased.

Objective To explore the correlation between prethrombotic state (PTS)and chronic atrial fibrillation in elderly patients,and to analyze the risk factors.Methods A total of 142 elderly patients with chronic atrial fibrillation from May 2009 to May 2011 were selected.Patients were divided into the PTS group (n =90) and no-PTS group (n =52) by transesophageal echocardiography (TEE).The left atrial diameter (LAD),left ventricular ejection fraction (LVEF),levels of high-sensitivity c reactive protein (hs-CRP),D-Dimer (D-D),β-platelet globulin (β-TG),B type brain natriuretic peptide (BNP),P-select element (PS),endothelial damage/dysfunction mark (vWF) and platelet aggregation rate-AA (PAR-AA)were determined.The related factors of prethrombotic state in elderly patients with chronic atrial fibrillation were analyzed by the multiple regression analysis.Results There were significant differences in the time of atrial fibrillation,frequency of patients with mitral regurgitation,levels of hs-CRP,D-D,β-TG,BNP,PS,vWF and PAR-AA between the PTS group and the non-PTS group [(6.9±1.8)years vs.(4.7±1.3)years,39 cases (43.3％)vs.11 cases (21.2％),(7.8±1.0)mg/L vs.(2.7±0.4)mg/L,(706.6±38.1)μg/L vs.(270.4±28.5)μg/L,(147.2± 21.3) μg/L vs.(117.7±17.1)μg/L,(1075.4±31.2)ng/L vs.(222.6±26.0)ng/L,(88.5±13.9)μg/Lvs.(37.4±11.2)μg/L,(36.1±11.2) ×10-3U/L vs.(26.4±9.9)×10-3U/L,(27.4±12.6)％ vs.(19.7±5.7)％,t=4.52,11.18,15.31,31.20,4.89,166.46,22.59,14.06,5.45,respectively,all P＜0.01].Multivariate logistic regression analysis showed that the time of chronic atrial fibrillation,mitral regurgitation,levels of hs CRP,PS,vWF and PAR-AA were independent risk factors for PTS in elderly patients with atrial fibrillation (OR=3.57,2.19,2.91,3.28,2.37,1.98,respectively,all P＜0.05).Conclusions The time of atrial fibrillation,mitral regurgitation,levels of hsCRP,PS,vWf and PAR-AA are independent risk factors for PTS in elderly patients with chronic atrial fibrillation.

Objective To evaluate the feasibility of community treatment and management mode in elderly patients with hypertension.Methods A total of 286 elderly patients with hypertension were treated with community therapy and management for 6 months.The improvements in life style and hypertension control were observed before and after the community treatment and management.Results There were significant differences in systolic blood pressure and diastolic blood pressure in the elderly patients before and after the treatment and management [(158.4± 11.3) mm Hg vs.(131.3±5.9) mm Hg,(99.6±8.9) mm Hg vs.(81.5±5.6) mm Hg,respectively,both P＜0.05].Compared with pretreatment,the blood pressure control rate,the awareness rate of diagnostic criteria and the drug compliance were significantly increased after the treatment and management [38.5％ (110/286) vs.96.9％ (277/286),66.4％ (190/286) vs.100％ (286/286),49％ (140/286)vs.91.3％ (261/286),x2 =98.87,115.36,122.13,respectively,all P＜0.01].Conclusions The community treatment and management can increase the blood pressure control rate and improve the quality of life in elderly patients with hypertension.It is a feasible method to comprehensively prevent and control hypertension.

Objective To explore the relationship of glucagon in many phases with insulin and blood glucose in patients with insulin resistance syndrome,and to provide theory and practice support for the treatment of insulin resistance syndrome.Methods Totally 93 patients with insulin resistance syndrome (observation group),107 patients with type 2 diabetes (diabetes group) and 80 patients without diabetes (non-diabetes group) in our hospital from July 2008 to October 2011 were selected.The general information were collected.Patients with stable blood glucose stopped taking anti-diabetic drug for 10 hours.The fasting blood glucose,fasting insulin,and fasting glucagon were tested.Then patients took 75 g glucose,blood glucose,insulin and glucagon were respectively tested after 30 and 120 minutes.Data were processed by SPSS 17.0 software,and P＜0.05 was considered as being statistically significant.Results The levels of fasting glucose,early phase glucose and late phase glucose were lower in observation group than in diabetes group,but higher than in non-diabetic group,and the differences were statistically significant (all P＜0.05).The levels of fasting insulin,the early phase insulin,and late phase insulin were higher in observation group than in diabetes group and non-diabetic group,and the differences were statistically significant (both P＜0.05).The insulin levels in observation group and diabetes group were lowest after fasting and were highest at 120 minutes after the oral glucose load,but the insulin levels were highest at 30 minutes and decreased at 120 minutes after the oral glucose load in non diabetic group.The differences in fasting glucagon,early phase glucagon and late phase glucagon among three groups were statistically significant (all P＜0.05).The glucagon levels in observation group and diabetes group were lowest after fasting and highest at 120 minutes after the oral glucose load,but the glucagon levels in non-diabetic group were highest after fasting and were lowest at 120 minutes after the oral glucose load.There were positive correlations between glucagon and glucose in 3 phases in observation group (r=0.65,0.63,0.67,respectively,all P＜0.05).Conclusions Glucagon and glucose in different phases are positively correlated in patients with insulin resistance syndrome,and blood glucose can be controlled by improving glucagon secretion.

Objective To study the relationship between insulin resistance and carotid atherosclerosis in elderly patients with type 2 diabetes.Methods A total of 63 elderly patients with type 2 diabetes were divided into 2 groups:group A (HbA1c≤7％,n=30),group B (HbA1c＞7％,n=33); and 30 healthy people were as controls.Fasting blood sugar(FBS),fasting insulin (FINS),glycated hemoglobin (HbA1c) and carotid intima-media thickness (IMT) were measured,atherosclerotic plaques were counted,and insulin resistance was calculated by homeostatic model assessment (HOMA-IR).Results The IMT,number of atherosclerotic plaques and incidence of carotid atherosclerosis were all higher in the two diabetic groups than in controls (P＜0.05).The levels of FINS,HbA1c and HOMA-IR were all higher in group A and group B than in controls (P＜0.05 and P＜0.01),which had a significant difference between group A and group B [(9.7± 2.1)mU/L vs.(13.6±2.0) mU/L; (6.5±0.4)％ vs.(8.2±0.6)％; (3.5±0.4) vs.(6.1±0.5); all P＜0.05].Pearson correlation analysis showed that IMT was positively correlated with FBS and HOMA-IR in group A and group B (r=0.62 and r=0.46,respectively,P＜0.05).Conclusions There is a positive correlation between insulin resistance and carotid atherosclerosis in elderly patients with type 2 diabetes.

Objective To study the roles of the contact heat evoked potential (CHEP) in evaluating the small nerve fibers of cranial and spinal in elderly diabetic patients,and to analyze the feature of the small fibers in order to provide scientific foundations for early diagnosis of diabetic neuropathy (DN).Methods Totally 50 diabetic patients and 40 healthy subjects were included in this study.The diabetic patients were divided into the normal nerve conduction group (n=17) and the abnormal nerve conduction group (n=33).CHEP was determined and thermal stimuli was given to the area of eyelid,forearm and peroneal.Sensory and motor nerve conduction velocity in the upper and lower limbs were tested in all diabetic patients.Results Compared with the healthy group,the N wave latencies were prolonged and the N-P amplitudes were reduced in the area of eyelid,forearm and peroneal in diabetic patients (all P＜0.01).Compared with the healthy group,the logarithm of N-P amplitudes were reduced in areas of forearm and peroneal [(1.70±0.10) vs.(1.60±0.14),(1.65±0.078) vs.(1.54±0.15),both P＜0.05] and N wave latencies were prolonged in eyelid area [(343.1±18.2) ms vs.(385.4±26.5) ms,P＜0.05] in normal nerve conduction group.Compared to group with normal nerve conduction velocity,the logarithm of N-P amplitudes was reduced in peroneal area [(1.54±0.15) vs.(1.44±0.15),P＜0.05] in abnormal nerve conduction group.Conclusions CHEP can detect the early impairment of the small fibers in elderly diabetic patients.The early smallfiber impairments in diabetic neuropathy may be axon-oriented in spinal nerves and myelin-oriented in cranial nerves.