Aimed to cure dental anxiety,we summarized its clinical features,and also analyzed the etiological factors from therapeutic tools,medical treatment and patients.We adopted kinds of mental interventions,such as promoting patients' vulnerable mental state,eliminating their anxiety,providing therapeutic information,raising their confidence in recovery.By the above countermeasures,we have got satisfactory therapeutic effects in clinical practice.

From the view of medical ethics,the importance of the communication between intern and patient are illustrated.The author holds that the intern should develop the communication consciousness,realize the patient's expectation,and satisfy the patient's desire with humanism consciousness and role-switch consciousness.

ABSTRACT:Objective To investigate the effects of phenytoin (PHT)on the secretion of vascular endothelial growth factor (VEGF)and stem cell factor (SCF)based on the establishment of indirect co-culture system of rat bone marrow mesenchymal stem cells (BMSCs)and vascular endothelial cells (VECs).Methods Indirect co-culture model of rat BMSCs and VECs was established.Experimental groups:indirect co-culture groups (PHT concentrations were 0,20 and 40 μg/mL);the control group:BMSCs culture group and VECs culture group (PHT concentrations were 0,20 and 40μg/mL).The contents of VEGF and SCF in the culture supernatant were measured using double antibody sandwich ABC-ELISA method on cultivation days 2,4,6.Results ELISA assay of the rBMSCs and rVECs in indirect co-culture supernatants,collected on culture days 2,4 and 6 showed that:① VEGF:On culture day 2,VEGF level in the co-culture groups was significantly higher than those in BMSCs group (P <0.05)and rVECs group (P <0.001).As culture time prolonged and PHT concentration increased to 20 μg/mL and 40 μg/mL,VEGF level increased too (P <0.001,P <0.05 ).② SCF testing results showed that the secretion of SCF in co-culture groups was higher than that in the control groups.When PHT was 20 μg/mL,the secretion of
SCF increased as the incubation time increased;but as the incubation time increased, PHT concentration of 40 μg/mL made SCF content decrease.Each group did not significantly differ (P > 0.05 ).Conclusion PHT promotes the secretion of VEGF and may reduce the secretion of SCF.

Objective: To investigate and analyze the KAP situation for Uv occupational injuries in Xi′an physical education teachers and provide scientific basis for the protection .Methods:Scale and questionnaire are used to survey 1200 people , using a questionnaire method to Xi′an sports teachers′occupational injuries is ultravio-let ray KAP investigation.Results:Respondents had a history of sunburn (21.5%), worked as a certified check the skin accounts for 5.1%;Think long-term outdoor ultraviolet harm to the skin (34.1%), 58.9%take protec-tive measures, can correct understanding on the Uv 3.2%; The purpose of protective measures , 43.9% of re-spondents take measures the purpose is to prevent tanning rather than prevent sunburn .Conclusions:Physical edu-cation teachers as a special outdoor work group , the overall Uv occupational injuries protection knowledge was low , from the perspective of the biopsychosocial medical model should be based on the principle of health ethics , it should strengthen the propaganda of knowledge of Uv occupational injury protection , and actively take appropriate intervention measures .

Objective To explore clinical effect of repairing soft tissue defect in forearm, hand and foot with free super-thin anterolateral thigh perforator flaps. Methods At first the site of perforator vessels were determined by Doppler, then the flaps were designed and harvested with the site as center; the fascia lata and subcutaneous fat were removed by sandhill-likely only the 4.0 cm × 3.0 cm - 3.0 cm×2.5 cm disc-like fascia lata and dermis layer were reserved. 15 traumatic soft tissue defects including forearm, hand and foot were repaired with the ree super-thin antemlateral thigh perforator flaps. Results No vascular crisis happened and all skin grafts survived in donor sites. 2.0 cm×1.2 cm of the distal of flap was necrosis in 1 case and it was healed by dress changing. 15 cases were followed up 3 months-2 years and the average is 6 months. The contour and texture of all flaps were good and two point discrimination (2-PD) was about 8-10 mm of. Conclusions The contour and texture of free super-thin anterolateral thigh perforator flap are good, the feeling of recipient site recovered well, it's less injury for donor site and there is no reshaping for flap. It is a fineness donor site for repairing soft tissue defects in hand and foot.

AIM: To investigate the effects of insulin on aortic constriction caused by endothelin-1(ET-1) in normal and hyperglycemic rats. METHODS: Hyperglycemic rat models were prepared. Two aortic rings were immersed in the Krebs-Hensleit fluid with and without insulin (40 mIU/L) and the responses of rings to 10 -9 mol/L ET-1 were observed. RESULTS:ET-1 induced more obvious aortic ring constriction in normal rats than those in hyperglycemic rats ( P

To elucidate the molecular characteristics of the hemagglutinin (HA) genes of H5N1 subtype of avian influenza viruses in the boundary region of Yunnan province. Of 420 samples were collected from the foreign poultry in boundary region of Yunnan province during 2003 to 2008 and these samples were subjected to screening by H5/N1 subtype-specific and multiplex RT-PCR. testing. The HA genes of H5N1 viruses from positive samples were amplified by RT-PCR and cloned into vector pMD18 T for subsequent sequencing. The alignment with sequences of the known reference strains and phylogenetic analysis were then performed. The genes from 21 representative positive samples with 4 different sequences at the cleavage site were obtained and all of them possessed the molecular characteristic of highly pathogenic avian influenza virus. The mutation of key amino acids had been found among receptor-binding sites, potential glycosylation sites and neutralizing epitopes.-Phylogenetic analysis showed those positive samples could be divided into 5 distinct clades, including clade 1, 2.4. 2.3.2, 2.3.4 and 7. It is evident that H5N1 viruses from the foreign boundary region of Yunnan province in 2003 to 2008 show genetic divergence and clade 2,3,4 is the dominant clade in this region.

Serum p-amyloid peptide(Aβ)40 and Ap42 levels in patients with type 2 diabetes mellitus (T2DM)and atherosclerosis(AS)were detected by ELISA.The results showed that serum Ap40 level in T2DM group was significantly higher than that in the control group[(274.70±159.51 vs 162.63±87.58)pg/ml,P<0.05],especially in the diabetic patients accompanied with AS[(616.95±195.13)pg/m],P<0.01].Serum Ap40 level in simple AS group was also higher than that in control group[(318.52± 188.65)pg/ml,P<0.05].These results suggest that Ap40 is a risk factor of T2DM complicated with AS.However,there was no difference in serum Ap42 levels among various groups.

Objective To explore the curative effect of percutaneous cavity injection for the treatment of drug resistant pulmonary tuberculosis guided by color Doppler ultrasound.Methods Ninety-six bacterial culture positive patients with drug resistant pulmonary tuberculosis were randomly divided into treatment group(n =48) and control group (n =48).Patients in both groupswere given systemic anti tuberculosis therapy,and those who in the treatment group were given extra percutaneous cavity injection guided by color Doppler ultrasound.Results After 3 months of treatment,the sputum negative conversation rate,X-ray absorption rate,cavity closure rate,and cavity efficiency rate of the treatment group were 56.3％ (27/48),81.3％ (39/48),58.3％ (28/48) and 75.0％ (36/48) respectively,higher than those of the control group 35.4％ (17/48),62.5％ (30/48),37.5％ (18/48) and 50.0％ (24/48) respectively),and the differences were statistically significant(x2 =4.20,P =0.02 4 ; x2 =4.17,P =0.041; x2 =9.58,P =0.004 ; x2 =6.40,P=0.020).After 12 months of treatment,the sputum negative conversation rate,cavity closure rate,cavity efficiency rate of the treatment group were 93.8％ (45/48),83.3％ (40/48),95.8％ (46/48) respectively,higher than those of control group(77.1％ (37/48),62.5％ (30/48) and 81.3％ (39/48)),and there were significant differences between two groups (x2 =5.35,5.27,5.03 ; P =0.040,0.038,0.025) ; the X-ray absorption rate of the treatment group was 93.8％ (45/48),higher than that of ciontrol group (83.3％ (40/48)),but there was no significant difference between two groups(x2 =2.56,P =0.199).Conclusion It is very effective to treat drug resistant pulmonary tuberculosis using percutaneous cavity injection guided by Color Doppler Ultrasound.No obvious complications or adverse reactions have been observed so far.

Objective To evaluate the feasibility of an in-room automated volumetric arc therapy (VMAT) planning engine based on dose volume histogram (DVH) prediction model in RayStation treatment planning system.Methods A total of 4,0 VMAT plans of cervix cancer,planned by experts,were chosen to build DVH estimation model by principal component regression analytic method.An in-room automated VMAT planning program based on IroPython scripting language combined with DVH prediction model was performed in RayStation treatment planning system.The DVH estimation model was applied to Another 10 testing cases of cervical cancer and the feasibility was evaluated by comparing the automatic plans with manual plans.Results The predicted DVH of organs at risk showed a good fit with real DVH in the ten testing cases.There were no statistically significant differences between manual and automatic plans in PTV conformal index (CI) and homogeneity index (HI) (P ＞ O.05).V40 and V50 of bladder were significantly decreased by 4.3％ and 1.6％ in automatic plans (t =2.75,5.26,P ＜ 0.05).V30,V40 and Vs0 of rectum were also decreased by 6.8％,5.8 ％ and 2.1％ (t =2.26,3.55,5.19,P ＜ 0.05).Both left and right femoral heads were better spared in automatic plans with average doses decreased by 380 and 322 cGy(t =5.55,7.25,P ＜ 0.05).The time of creating a treatment plan was 36 min for automatic plan and 53 min for manual plan.Conclusions The fully automated VMAT treatment plan program can create a VMAT plan of cervix cancer with high efficiency and good quality.