used at the primary-care settings in China to assess asthma control.

Objective To study the correlation of heart rate variability(HRV) and autonomic nervous function in patients with anxiety neurosis, and provide evidence for prevention and treatment of anxiety disorder. Methods 90 patients with generalized anxiety disorder(GAD) and panic disorder(PD) and 90 healthy persons were tested by psychological questionnaire,the anxiety and depression were assessed by HAMA and HAMD. The average heart rate and HRV index were monitored by 24-hour ambulatory ECG. Results The average heart rate of the anxiety group was higher than the control group, compared with the control group the difference was significant ( P < 0. 05 ); The HRV parameters of the anxiety group were lower than the control group, compared with the control group the difference was significant( P < 0. 05 ) ;The HRV parameters of the GAD group were lower than the control group, the HRV parameters of the PD group were lower than the GAD group, the difference was significant ( P < 0. 05 ). Conclusion The patients with anxiety neurosis had high sympathetic nerve activity function and autonomic dysfunction, the PD patients had higher sympathetic nerve activity function and autonomic dysfunction than the GAD patients.

Objective:To determine the effects of TGF-?1 on the cytoskeleton in cultured human dental pulp cells(HPCs).Methods:Human dental pulp cells were cultured from dental pulp tissue explants digested with collagenase I. Semi-confluent cultures of the cells maintained under serum deprivation were treated with 20 ng/ml of TGF-?1 for 30 min, 1, 6 and 24 h respectively.Then cells were processed for BODYPY-phalloidin direct fluorescence examination of the actin filaments,DAPI direct fluorescence of the nucleus and Rhodamine Red(TM) indirect immunofluorescence of tubulin-?. Confocal laser scanning microscopy was used to investigate the changes of actin filaments and microtubules.Results:Disintegration and reorganization of actin filaments were observed in human dental pulp cells treated by TGF-?1 at 20 ng/ml. Actin filaments assembly was found near the cell membrane,specially after 30 min exposure.Disintegration of actin filaments was most obvious after 6 h treatment.Actin filaments were reorganized after 24 h exposure.Microtubules mainly remained intact in the cells during TGF-?1 treatment.Conclusion:TGF-?1 at 20 ng/ml may induce actin cytoskeletal reorganization in human dental pulp cells.

Objective To compare the inspiratory cycling-off synchronization with expiratory trigger sensitivity (ETS) setting during noninvasive pressure support ventilation (PSV) under the different conditions of respiratory mechanics. Methods Bi-level pressure ventilator was connected to a lung model (Hans Rudolph Series1101 simulator). And its mechanics was set to normal, obstructive and restrictive ventilation dysfunction. Tests were performed with pressure support levels of 10 (in normal condition, 1 cmH2O = 0.098 kPa) and 15 cmH2O, 5 cmH2O positive end-expiratory pressure (PEEP). The data including cycling delay time (Td), tidal volume (TV) and airflow were collected in the presence of air leaks (24-28 L/min). Results Significant performance on airflow was observed in various respiratory mechanics conditions. The peak inspiratory flow (PIF) and peak expiratory flow (PEF) were different, and the tidal volume, PEF and inspiratory time were increased after decreasing the ETS level. Premature cycling occurred frequently in normal and restrictive model. Delay cycling was found only when the ETS setting was at the lowest level (about 5% of PIF), at which Td were (15.20 ± 0.43) ms and (105.00 ± 15.82) ms. In obstructive model, PIF and PEF were significantly decreased, and delay cycling was always present. Td were increased after the ETS setting was changed from the most sensitive level to moderate level:(51.30 ± 12.63) ms vs. (162.40 ± 15.59) ms, as cycling-off criteria were reduced from (34.52 ± 3.36)% to (16.04 ± 2.58)% of PIF, and there were statistical differences (P<0.05). Severe delay cycling was found when the ETS level was at the lowest level. Conclusions There are significant differences in performances and cycling-off synchrony in various respiratory mechanics models during PSV. For Curative Flexo ST30 bi-level pressure ventilator, its flow cycling-off criteria range is about 5%-35%of PIF. The higher ETS level might be beneficial to improve patient-ventilator synchrony in patients with obstructive airway diseases, which could result in premature cycling in patients with restrictive disease.

Objective To observe the benefits and safety of low-dose azithromycin maintenance treatment on pulmonary function and quality of life in patients with bronchiectasis. Methods Thirty-seven adult bronchiectasis patients accompanied with chronic purulent respiratory tract symptoms were selected, and all the patients were given azithromycin 250 mg oral, once/d for 12 months. The respiratory symptoms, pulmonary function and quality of life before treatment and 16, 52 weeks after treatment were observed. Results Among 37 patients with bronchiectasis, 3 cases were lost, 1 case was in the follow-up of the 16th week, and 2 cases exited because of acute exacerbation. There were no statistical differences in body mass index (BMI) and inspiratory capacity percentage of estimated value (IC%Pred) before treatment, 16 and 52 weeks after treatment (P>0.05). The C-reactive protein (CRP), forced expiratory volume in 1 second (FEV1)/ forced ventilatory capacity (FVC), forced expiratory flow between 25% and 75% of vital capacity percentage of estimated value (FEF25-75%Pred), modified British medical research council dyspnea scale (mMRC) score 16 and 52 weeks after treatment were significantly better than those before treatment:(15.33 ± 4.00) and (9.21 ± 3.04) mg/L vs. (25.59 ± 9.82) mg/L, (75.94 ± 5.59)%and (75.52 ± 7.06)% vs. (72.14 ± 5.62)%, (60.22 ± 10.90)% and (63.73 ± 6.54)% vs. (55.44 ± 9.16)%, (1.75 ± 0.69) and (1.41 ± 0.56) scores vs. (2.19 ± 0.74) scores;the low respiratory tract infection visual analog scale (LRTI- VAS) score, FEV1 percentage of estimated value (FEV1% Pred) and chronic obstructive pulmonary disease assessment test (CAT) score 52 weeks after treatment were significantly better than those before treatment: (17.74 ± 3.76) scores vs. (21.57 ± 4.47) scores, (70.31 ± 4.07)% vs. (66.95 ± 5.48)%and (18.06 ± 3.32) scores vs. (21.54 ± 4.89) scores, and there were statistical differences (P<0.05). In the course of treatment, 5 cases might be associated with the drug adverse reactions, but the symptoms were mild. No patients exited because of adverse reaction. Five patients had 7 episodes of acute exacerbation, among whom 2 cases exited and the other 3 cases did not interrupt azithromycin treatment during acute exacerbation. Conclusions For adult patients with bronchiectasis, the long-term treatment of low-dose azithromycin (250 mg/d) can improve the respiratory symptoms and quality of life, and reduce the airflow limitation of peripheral airway.

Aim To investigate the proliferative effect and the apoptosis of human hepatoma SMMC-7721 cells induced by gallic acid ( GA ) , and its underlying mechanism. Methods SMMC-7721 cells were cul-tured in vitro. MTT assay was used to observe the pro-liferation of SMMC-7721 cells induced on GA 24 , 48 , 72 h. The morphological and ultra structural changes of the SMMC-7721 cells were observed by inverted micro-scope and transmission electron microscope respective-ly. Annexin V-FITC/PI staining was used to quantify the percentages of apoptosis in the total cell popula-tion. The expression of p53 mRNA was investigated by RT-PCR. Western blot was used to determine the pro-tein expression of p53. Results GA(6. 25~50 μmol ·L-1 ) markedly inhibited the activity of proliferation and induced apoptosis of SMMC-7721 cells after 48 h in a dose-dependent manner. GA significantly induced cell nuclear condensation and fragmentation. RT-PCR and Western blot results showed that GA could improve the expression of p53 mRNA and protein. Conclusion GA can inhibit the proliferation of human hepatoma SMMC-7721 cells and induce cells apoptosis. The mechanism may be associated with improving tumor suppressor gene p53 expression.

AIM:To observe the changes in heme oxygenase-1(HO-1) expression in the lung after ischmia-reperfusion of hind limbs in rats.METHODS:Hind limbs ischemia was made by clamping infrarenal aorta with a microvascular clip and lung injury was made by following reperfusion. Lung tissue was obtained from the animals subjected to sham operation, 4 h ischemia without reperfusion and 4 h, 8 h, 16 h, 24 h, 48 h reperfusion following 4 h ischemia. The levels of HO-1 mRNA and protein were measured at different times by Northern blot and Western blot. Immunohistochemistry technique was used to determine the cell types responsible for limb ischemic reperfusion induced HO-1 expression. RESULTS:After ischemia-reperfusion of limbs, HO-1 mRNA increased by 4 h, reached a peak at 16 h, and returned toward baseline at 24-48 h. This time course correlated with increased HO-1 protein. Immunohistochemical studies showed HO-1expressed in a variety of cell types, including the airway epithelium, alveolar macrophages and vascular smooth muscular cells. There were no positive signals in sham group and ischemia group both in mRNA levels and protein levels. CONCLUSION:The expression of HO-1 in the lung is not induced by limb ischemia or sham operation, but induced by limb reperfusion after ischemia in rats.

Objective To investigate the effectiveness and safety of low-intensity warfarin anticoagulation in over 80-year-old patients with nonvascular atrial fibrillation (NVAF). Methods The 180 NVAF patients aged over 80 years were randomly assigned into 2 groups: 90 patients in lowintensity warfarin anticoagulation group (target value of INR 1.6-2.0), the other 90 patients in standard-intensity warfarin anticoagulation group (target value of INR 2. 0-3.0). All patients were followed up in outpatient-department for one year. Main outcome measures included the incidence rates of bleeding and thromboembolic events, and secondary outcome measures included the warfarin dosage and times of INR＞3.0. Results The incidence rate of thromboembolic events was 4.4% (4/90) in low-intensity group and 3.3% (3/90) in standard-intensity group with no statistically significant difference between these two groups (P＞0. 05). However, the incidence rate of hemorrhage was significantly lower in low-intensity group than in standard-intensity group [5.6% (5/90) vs. 16.7%(15/90), P＜0. 05]. Meanwhile the warfarin dosage was significantly lower in low-intensity group than in standard-intensity group [(1. 55±0. 63) mg vs. (2.31±0.57) mg, P＜0.05]. The times of INR＞3.0 were less in low-intensity group than in standard-intensity group (P＜0. 05). Conclusions Therapy with low-intensity warfarin anticoagulation in NVAF patients aged over 80 years may be equally effective as, but safer than that with standard-intensity warfarin.

Aim To study proliferation capacity of cell and the target relationship between microRNA and Runx2 after effect of puerarin on osteoblasts MC3 T3-E1 . Methods The proliferation capacity of cell was detected by MTT after effect of puerarin on osteoblasts MC3 T3-E1 . The vitality of osteoblasts was detected by activity of alkaline phosphatase. The expression level of mRNA and protein of Runx2 were detected by real-time quantitative PCR and Western blot. The result of miRNA expression spectrum was compared with the predicted result to determine the Runx2-targeting miR-NAs. The expression levels of miRNAs possiby targeted to Runx2 were detected by real-time quantitative PCR. The RhoE 3′UTR vector and RhoE mut 3′UTR vector were constructed. miRNA-204 mimics and miRNA-204 NC were synthetised. The target genes were verified by dual luciferase report gene assay. Results After osteo-blasts treated with puerarin, proliferation capacity and activity of cells were enhanced , expression levels of mRNA and protein of Runx2 were both increased , the expression levels of miRNA-204 and miRNA-344 f-5 p were declined, the expression levels of miRNA-2861 was increased,the expression levels of miRNA-23a-5p, miRNA-770-5 p and miRNA-871-5 p showed no obvious change. According to the results of dual luciferase re-porter gene method after cell transfection of 48 h, only set of 3′UTR Runx2+mimics the miRNA-204 of fluo-rescein protein expression level decreased significantly, showing only the miRNA-204 inhibits Runx2 3′UTR report gene expression. Conclusion Puerarin pro-motes the proliferation of osteoblasts and regulates the miRNAs which possibly target to Runx2 .

Objective To explore the causes,clinical characteristics and prognosis of children′s completely at-rioventricular block(CAVB).Methods The clinical data of 73 patients with CAVB were analyzed retrospectively from January 2004 to December 201 3 at the Cardiology Department,Nanjing Children′s Hospital Affiliated to Nanjing Medi-cal University.Within those 73 patients,34 patients were male and the others were female,from 3 months old to 1 2.5 years old,the mean age of 6 years.Results There were 21 congenital CAVB patients and 52 acquired CAVB patients with myocarditis undergoing ventricular septal defect (VSD)closure operation.All congenital CAVB patients were re-fractory to drug therapy.Electrocardiogram and echocardiogram were performed in 1 9 cases without clinical symptoms during follow -up,but 2 cases had permanent pacemaker implanted.Among 27 fulminant myocarditis,Adams -Stokes attacks were found in 1 5 cases,3 cases had Adams -Stokes attack in 1 5 cases with sequelae of myocarditis,and 2 out of 6 cases undergoing VSD closure operation had Adams -Stokes attack,and other 4 cases without clinical symptoms were followed up periodically.The acquired CAVB patients were given energy composition and intravenous megavitamin C. The cases with fulminant myocarditis were given adrenal cortical hormone and intravenous gamma globulins simulta-neously.A total of 27 acquired CAVB patients were implanted temporary pacemaker and 5 with permanent pacemaker. Among 52 acquired CAVB patients,31 cases were cured,9 cases were improved,1 1 cases were ineffective,and 1 case died.Conclusions Most congenital CAVB children without clinical symptoms need clinical follow -ups.Myocarditis is a major cause of acquired CAVB.The CAVB prognosis caused by fulminant myocarditis may be related to antimely im-planting the temporary pacemaker timely.Permanent pacemaker should be implanted in patients who have no response to drug therapy with frequent Adams -Stokes or heart failure.