Objective　To explore the effect of the psychological intervention on the treatment of dental anxiety (DA).Methods Measured with Corah's dental anxiety scale , 316DA patients were selected from department of dentistry and were divided into two groups: the intervention group and the control group . The psychological intervention as well as regular dental therapeutics were applied to the patients in the intervention group , whereas only regular dental therapeutics were used to those in the control group.Results　The patients had a lower clinical dental anxiety in the intervention group , significantly different from that of the control group ( P＜ 0.01). After the treatment , more patients in the intervention group had a slower pulse than those in the control group and fewer had a faster pulse .The results also showed that the psychological intervention had a better curative effect on male patients than female ( P＜0.05). Conclusion　The psychological intervention was efficient to patients with dental anxiety.

BACKGROUND:Great saphenous vein is the most common vascular material in coronary artery bypass grafting, however, the graft neointimal hyperplasia and subsequent atherosclerosis result in angiostegnosis, which affect the long-term efficacy. OBJECTIVE: To analyze the pathophysiology and mechanism of the angiostenosis, additionally, to construct smooth muscle cell specific SM22a promoter and SMHC enhancer. METHODS: The database of PubMed, HighWire and CNKI were retrieved with key words of "SM22α promoter, SMHC enhancer, stenosis, Pi3k and RNAi/RNA interference". The language was confined to English and Chinese. The literatures correlated with angiostenosis, VSMC-specific SM22α promoter and enhancer were selected. The reviews and overlapped researches were excluded. In vascular smooth muscle cell proliferation and apoptosis of graft neointimal hyperplasia, as well as the extent of graft thrombosis were considered as evaluation index. RESULTS AND CONCLUSION: More than 8 730 literatures were searched by the computer. According to inclusion and exclusion criteria, the SM22α promoter and angiostenosis were analyzed. The neointimal hyperplasia and thrombosis had a strong impact on prospective efficacy after coronary artery bypass grafting. The PI3K-Akt-mTOR pathway was a crucial signal passage which regulated cell proliferation and migration. RNA interference targeting Pik3cb can efficiently suppress the neointimal hyperplasia through down regulating the PI3K-Akt-mTOR pathway. The shRNA eukaryon expression plasmid vectors targeting rat Pik3cb were constructed using VSMC-specific SM22α promoter. On the one hand, it can suppress the neointimal hyperplasia, and on the other, it can prevent the occurrence of thrombosis.SM22a is a specific gene in vascular smooth muscle cell. The studies that applied VSMC-specific SM22α promoter/enhancer to vascular grafting provide a new strategy to prevent angiostenosis and thrombosis.

Objective To demonstrate clinical value of surgical repair combined with collateral embolization for tetralogy of Fallot with major aortopulmonary collateral arteries (MAPCAs).Methods The clinical catheterization and surgical data of 8 such patients from October 2004 to May 2008 were analyzed retrospectively.All 8 patients underwent completely surgical repair combined with MAPCAs occlusion.Of 25 collateral arteries,20 were occluded before surgical procedure and 5 small ones were left.Corrective repairs were accomplished under moderate hypothermic cardiopulmonary bypass.Ventricular septal defect was closed with Dacron patch,and all patients underwent non-valved autologous right ventricular outflow tract reconstruction.Results No complications were observed,only 1 patient got hypoxemia.Blood returned to left atrium from lung was decreased.During 6 months follow-up,7 cases were in NYHA class Ⅰ,another was in NYHA class Ⅱ.Conclusions In selective patients with dual pulmonary blood supply by both MAPCAs and native pulmonary arteries,this combined therapy of collateral embolization and surgical repair simplifies copmpleling surgical procedure,improves surgical results and achieves higher rate of one-stage repair.

The hTERT gene promoter is a tumor-specific promoter, regulated by a number of factors.Modulation of the chromatin structure via DNA methylation or histone acetylation plays an important role in regulating the hTERT promoter. Recent study also found that glycogen synthase kinase -3 cytokines, macrophage colony-stimulating factor receptor 1, bone inducing factor -7, transcription factors c-myc inhibitor, transforming growth factor β, cyclopentenone prostaglandin regulate the activity of hTERT through various pathways. Telomelysin, the telomerase-specific replication competent oncolytic adenovirus, has been used in clinical settings.Various gene therapies based on hTERT are current under-way.

Objective To explore the effect of three shifts on sleep status of nurses in order to supply evidence for improving the nurses' sleeping quality. Methods 111 three shifts nurses and 117 traditional shifts nurses of 3 grade three A hospitals in Guangzhou were investigated for their sleep condition with self-rating scale of sleep (SRSS), and later the results underwentχ2 test and t test. Results There were 55 three shifts nurses with sleeping factor scores of SRSS≥23 (49.5 %), while there were 72 traditional shifts nurses with sleeping factor scores of SRSS≥23 (61.5 %). Compared with traditional shifts nurses, the total mean scores and factor score of three shifts nurses were better except sleeping time and lack of awakening. It is discovered that great sleeping status differences were found among three shifts nurses and traditional shifts nurses between the age of 20 to 30. Conclusions Three shifts can release the pressure of nurses and can improve the nurses' sleeping status to some degree, especially to the juniority nurses' sleeping status,then the nursing safety can be insured.

The paper investigates 31 foreign representative clinical knowledge base,analyzes development status including the establishment and maintenance institutions,user version control,localization application,clinical evidence resources,clinical specific content representation,evidence quality evaluation criteria and so on,summarizes revelation for domestic clinical knowledge base construction.

OBJECTIVE:To explore the effects of xingnaojing combined with naloxone on related indexes of patients with he-patic encephalopathy. METHODS:In retrospective analysis,76 patients with hepatic encephalopathy were divided into control group(40 cases)and observation group(36 cases)according to drug use. Based on routine treatment,control group was additional-ly given Naloxone injection 1 mg added into 10% Glucose solution 100 mL intravenously twice a day. Observation group was addi-tionally given Xingnaojing injection 20 mL added into 0.9% Sodium chloride injection 250 mL intravenously once a day on the ba-sis of control group. Treatment courses of 2 groups lasted for 2 weeks. HDS score,MMSE score,the levels of blood ammonia,β-endorphin,CRP,IL-6 and TNF-α,the occurrence of ADR were observed in 2 groups before and after treatment. RESULTS:Af-ter treatment,HDS score and MMSE score of 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group;the levels of blood ammonia,β-endorphin,IL-6,CRP and TNF-α in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statis-tical significance(P<0.05). There was no statistical significance in the level of IL-10 between 2 groups before and after treatment (P>0.05). There was no statistical significantly in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Based on routine treatment,Xingnaojing combined with naloxone can significantly improve cognitive function for patients with hepatic en-cephalopathy and reduce peripheral blood neurotoxin and inflammatory factor,moreover,do not increase the incidence of ADR.

To evaluate APTT for monitoring heparin neutralization and rebound following CPB. Method: Twenty patients undergoing cardiac valve replacement were randomly selected, APTT and activated clotting time (ACT) were measured 10 minutes following protamine in 0.5:1,0.7:1and 1:1 ratio to total heparin administered, and 3 and 6 hours after 1:1 ratio. Result: After the neutralization of the heparin/protamine at ratio of 0.5:1, the further doses of protamine (0.7: 1,1:1)decreased APTT markedly (P0.05). APTT with 0.5:1 or 0.7:1 ratio neutralization decreased significantly after in vitro protamine titration (P0.05). Conclusion= APTT is a better assay for monitoring both inadequate reversa. of heparin and heparin rebound,and is more sensitive to minimal dose heparin than ACT. The dose ratio of protamine to heparin at 1:1 may reverse heparin effect completely.

Objective:To explore the differences of depressive emotion among youth, middle age and the senile depressive cancer patients. Methods:96 depressive cancer patients were assessed with a self-developed data-collecting form, Beck Depression Inventory (BDI), Simplified Coping Style Questionnaire (CPS) and Dysfunctional Attitude Scale(DAS).Results:There were differences in the total scores of BDI and the factor scores of depression, feeling of failure, dissatisfaction, self-feeling of guilty, self-dislike, intention of suicide, irritability, hypoactivity, hyposexuality, feeling of being punished, self-blame, crying, pessimism preoccupied viewpoint and body-image disturbance among the three groups. Conclusion:There are differences among depressive cancer patients of different age periods.

Diabetic peripheral neuropathy( DPN) is one of the most common chronic complications and the disabling one, which is related to chronic hyperglycemia and microvascular changes. Currently, the treatments of diabetic peripheral neuropathy contains glu-cose control,pain management,etiological treatment,prevention and remove risk factors. So we make a review on the progress on the treatment of DPN by now , providing a scientific basis to a advanced and effective program.