BACKGROUND:Matrix metal oproteinases and their inhibitors are proteolytic enzymes contaning Zn+, and involved in extracel ular matrix degradation and tissue remodeling of a variety of tissues. OBJECTIVE:To observe the effects of matrix metal oproteinases in the proliferation of MC3T3-E1 cel s induced by lipopolysaccharide. METHODS:MC3T3-E1 cel line was divided into four groups randomly:control group, low-dose lipopolysaccharide group (1μmol/L), moderate-dose lipopolysaccharide group (10μmol/L), and high-dose lipopolysaccharide group (100μmol/L). The proliferation rate in each group was analyzed. Matrix metal oproteinase 2, 3, 9 and matrix metal oproteinase inhibitor 1 and 2 expressions were detected. RESULTS AND CONCLUSION:The proliferation rate was increased greatly after medication of lipopolysaccharide in time-dependent and concentration-dependent manners. Moreover, the expressions of matrix metal oproteinases and their inhibitors were apparently enhanced, and showed significant differences. Results indicate that the enhanced expressions of matrix metal oproteinases participated in the proliferation of MC3T3-E1 cel s induced by lipopolysaccharide.

Objective To explore the clinical features of female diagnosed recurrent major depression (MD) comorbidity with general anxiety disorder (GAD).Methods 301 females patients with recurrent major depression were interviewed by specially trained interviewers with using computer evaluation system and divided into comorbidity group and non-comorbidity group according to whether comorbid MD with GAD or without GAD.The comparison between the two groups included items of demographic,clinical data,assessment of psychopathology,Eysenck neuroticism questionnaire (EPQ),stressful life events,parental bonding instrument.Results 25.2％ of patients of MD coexistence GAD.There was no significant difference in sociodemographic data between the two groups.Significant differences among total number of depression symptoms(OR=1.439,95％ CI =1.049-1.975,P =0.024),duration of illness(OR=1.253,95％ CI =1.010-1.475,P=0.048),psychomotor agitation(OR=2.031,95％ CI =1.123-3.676,P=0.019),suicidal thought(OR=2.228,95％ CI =1.010-4.912,P=0.047),anxiety(OR =5.547,95％ CI =1.935-15.896,P=0.001),irritable(OR=1.956,95％ CI =1.081-3.542,P=0.027) were identified between the two group.In the comorbidity group,the score of nenroticism dimention derived from EPQ was also higher(OR=2.287,95％ CI =1.674-3.124,P=2.287× 10-7) than that of non-comorbidity group.There was no significant difference of stressful life events between two groups(OR=1.118,95％ CI =0.913-1.368,P=0.280).Conclusion This study suggests the phenomena that female patients of recurrent depression disorder comorbidity with general anxiety disorders is common in clinical.The patients comorbid MD and GAD have more symptoms,neuroticism and be worse in severity.

ObjectiveTo investigate the effect and outcome of critically illness with acute kidney injury (AKI) treated with continuous veno-venous hemodiafiltration (CVVHDF) in children.Methods Twenty-four cases of critically illness with AKI were treated with CVVHDF in our pediatric intensive care unit from Jan 2008 to Dec 2010.The levels of creatinine (Cr),blood urea nitrogen (BUN),K +,Na + and HCO3- were observed before CVVHDF and 6,12,24,48,72 h after CVVHDF.ResultsCatheter was successfully established for CVVHDF in 24 cases of AKI.The average duration of CVVHDF was 46 h ( 16 ～142 h).The blood levels of Cr and BUN were significantly decreased at 6 h after CVVHDF [ ( 196.3 ±112.4) μmol/L,( 13.3 ± 8.5 ) mmol/L] and 12 h after CVVHDF [ ( 106.1 ± 84.2) μ mol/L,( 10.2 ± 9.7 )mmol/L] as compared to those before treatment [ (340.6 ±298.2) μmol/L,(31.6 ± 11.3) mmol/L] (P ＜0.05,P ＜ 0.01 ).After 48 h of CVVHDF,the Cr,BUN returned to normal range.The imbalance of blood K +,Na +,and HCO3- improved at 6 h after CVVHDF and returned to nomal levels at 24 h.Total 28 d fatality rate was 29.2％ (7/24),and all death cases were complicated with multiple organ dysfunction syndrome.ConclusionCVVHDF therapy for AKI can quickly clear Cr,BUN and excess water,correct electrolyte disorders,improve kidney function in children.

Objective To explore the clinical features of female recurrent major depression(MD) patients with and without suicidal ideation.Methods 301 female recurrent major depression patients were interviewed by specially trained interviewers using computer evaluation system and divided into suicidal ideation group and non-suicidal ideation group according to suicidal ideation.The comparisons between the two groups were investigated on items of demographic, clinical data, assessment of psychopathology, Eysenck neuroticism questionnaire, stressful life events.Results 66.4％ of MD patients have suicidal ideation.Compared with non-suicidal ideation group, there were more total number of MD symptoms (8.58±0.77, OR=2.476, P=1.154× 10-9) and melancholia symptoms (6.74±1.07, OR=1.546, P=0.001) and it was more common in the factors of less appetite (OR=2.201, P=0.011), lose weight (OR=2.030, P=0.004), early morning awakening (OR=1.774, P=0.045), worthless (OR =2.352, P=0.014), impaired decision-making (OR=2.044, P=0.018), hopelessness (OR=7.130, P=6.651 × 10-9) ,helpless (OR=2.046, P=0.049) in suicidal ideation group.Also in suicidal ideation group the scores of neuroticism dimension (OR=1.631, P=0.024) were higher, and they were more suffered from stressful life events (OR=1.302, P=0.008).Binary logistic regression analysis indicated that total number of MD symptoms (OR=4.840, P=1.154×10-8) ,stressful life events (OR=1.392, P=0.014) and hopelessness (OR=3.528, P=0.008)were significantly associated with suicidal ideation.Conclusion Specific clinical features are associated with suicidal ideation among female patients of recurrent depression disorder.Hopelessness, stressful life events are risk factors of suicide ideation in female recurrent major depression patients.Integrated clinical assessment should be taken for recurrent major depression patients with suicidal ideation.

Objective To explore the effect and application of the clinical teaching method of stage-separated to targeted management in the comprehensive ICU. Methods ICU rotation learning plans were developed for 113 probationers and rotating physicians,who were given the training of stage-separated to targeted teaching. The program was divided into three stages based on corresponding teaching objective and comprehensive examination and assessment with combination the dynamic and static evaluation were carried out to three parts. Results The probationers and rotating physicians had significant improvement in the familiarity and mastery of ICU specialist knowledge and skills through the systematic training. Conclusion Such training program can effectively improve the ICU specialized quality and comprehensive ability of the probationers and rotating physicians and bring about better clinical teaching effect.

As reported by the world health organization, about 650 thousand people die of liver failure, liver cirrhosis, and hepatocellular carcinoma caused by hepatitis B virus (HBV) infection every year. Although to a certain extent, the application of interferon and nucleos(t)ide analogues reduces the adverse outcome of chronic hepatitis B (CHB), so far no effective therapeutic method can eliminate HBV. HBV carriers have a significantly lower incidence rate of adverse outcome than active CHB patients, but they still have the risk of progression to liver cirrhosis and liver cancer. This article discusses the clinical identification and management of HBV carriers, so as to further clarify the features of chronic HBV carriers and related treatment measures in clinical practice.

Dental operating microscope is recommended to complicated root canal therapy, for it could provide increased lighting and superior magnification, so that the survival rate of tooth is highly increased. More refined access of cavity preparation, canal cleaning, shaping and obturating are realized under microscope. This article combined literature reviews with the writers’ clinical experience, and it aims at helping clinicians to improve their ability to more accurately performance and minimally invasive endodontic procedures, such as locating hidden canals obstructed by calcifications, canals reduced in size, removing materials, reducing ledge formation, apical transportation, and repairing perforations.

Objective To evaluate the impact of the intrauterine device (IUD) insertion on the mental state of women.Methods From Jan.2009 to Jun.2010,a multi-center clinical observational study was performed.Totally 641 women were selected in the six provinces' 18 family planning service stations and hospitals for IUD insertion surgery study.Analysis of the change of women's mental state which was evaluated by symptom checklist-90 (SCL-90) scale before and after IUD insertion surgery.Results Before and after IUD insertion surgery,10 factors' scores in SCL-90 of the observed objects were between 1.1 to 1.2,total scores were 107 ± 27 and 105 ± 25,respectively.Before and after surgery,total average score both were 1.2,the average score of positive items both were 2.1.The difference of the above results were not statistically significance (all P ＞0.05).Preoperative and postoperative,the rate of positive items was 9.2％-19.6％ and 7.7％-17.6％,respectively.In addition to anxiety and fear,the rate of other factors' positive items postoperative was significantly lower than those in the preoperative (all P ＜ 0.05).The incidence of the observed objects postoperative of each factor score,deteriorated was in the range of 4.9％ to 23.0％,improved was in the range of 26.3％-50.1％.The incidence of total scores,deterioration was 28.8％ (166/575),improved was 45.6％ (262/575).The incidence of the average score of positive items,deterioration was 3.7％ (21/575),improved was 52.3％ (301/575).Logistic analysis showed that,in addition to unit level,there were no other significant influencing factors for women' mental state of postoperative (all P ＞ 0.05).Conclusion IUD insertion surgery has no adverse effect on women's mental state.

Objective To discuss the diagnosis and management of pheochromocytoma in pregnancy. Methods Three cases of pheochromocytoma in pregnancy were managed from 2007- 2009.Case 1, a 41-year-old woman presented with paroxysmal hypertension during 27+1 weeks' gestation.The accompanied symptoms included dizziness, palpitation and sweating. Both B ultrasound and MRI revealed a right adrenal tumor about 7 cm in diameter. The 24-hour catecholamine was higher than normal. A diagnosis of right adrenal pheochromocytoma was made. Case 2, a 28-year-old woman presented with hypertension during 12+4 weeks' gestation. B ultrasound showed a right adrenal tumor about 5 cm in diameter. The 24-hour catecholamine was higher than normal. Case 3, a 32-year-old woman presented with hypertension during 14+3 weeks' gestation. B ultrasound revealed bilateral adrenal tumors. The 24-hour catecholamine was higher than normal. The diagnosis of bilateral adrenal pheochromocytomas was made. Results The first patient delivered a healthy female infant through cesarean section at 32 weeks' gestation. Laparoscopic resection of right adrenal pheochromocytoma was successfully performed at the same time. Both the second and third patients had elective abortion for fear of fetotoxicity. Case 2 accepted laparoscopic resection of right adrenal pheochromocytoma after 4 weeks' medical preparation. Case 3 rejected surgery. The histopathological findings proved pheochromocytoma in case 1 and case 2. Conclusions Pheochromocytoma should be included in the defferential diagnosis in hypertension occurring during pregnancy especially in the following situations:hypertension during early pregnancy; paroxymal hypertension accompanied by headache, palpitation and sweating; hypertension does not relieve after delivery. Early diagnosis and management with medical treatment followed by surgical removal usually results in good maternal and fetal outcomes. The second trimester is good timing of surgical management. Laparoscopic removal of pheochromocytoma is safe in pregnancy.

Objective To investigate the correlation between the CD40 gene( - 1 C/T)single nucleotide polymorphism(SNP) and acute coronary syndromes(ACS), and the expression of CD40 on platelets. Method A total of 562 patients with ACS canfirmed by coronary angiography were divided into 3 groups according to the clinical characteristics, namely ACS patients( n = 210), stable angina(SA) patients( n = 189) and control group( n = 163).ACS was defined as ischemic chest pain at rest resulting in admission to hospital and > 50% stenosis in a major coronary artery with or without a rise in troponin Ⅰ. SA was defined as stable effort-related angina without change in angina pattern in 3 months. Patients with infection, tumor, or liver or kidney disease were excluded The gene polymorphism was measured by the polymerase chain reaction and restriction fragment length polymorphism(PCR-RFIP) and identiffed by sequencing. The expression of CD40 on platelets was detected by flow cytometry. The frequency, distribution of genotypes was compared using cross-tabulation and standard X~2 test. Result The CC genotype(31% ) and C allele of frequency(57.9%)of CD40 gene in ACS patients were significantly higher than those in SA(15.9%, 43.1% ) and control groups( 16.1%, 42.6% ). No significant difference of the genotypes or allele frequencies was found between SA and control group(X~2 = 0.053, P = 0.974;X~2 = 0.017, P = 0.897). 1he expression of CD40 on platelets in patients with C alleles carries was significandy higher than that of T allele carries in each group( P <0.0001). Conclusions CD40- 1C/T polymorphism was associated with ACS in Chinese Han nationallity.