Objective To probe into the effect of early psychological care on negative emotions and sleep of elderly patients with chronic heart failure. Methods 96 patients elderly patients with chronic heart failure were selected from June 2009 to June 2010, and were randomly divided into the study group and the control group with 48 patients in each group. Two groups of elderly patients were given traditional routine care after diagnosis, and elderly patients in the study group were given early comprehensive psychological nursing intervention additionally. Clinical index such as negative mood and sleep were analyzed. Results Compared with the control group, anxiety and depression scores of the study group were significantly decreased, somatization, obsessive-compulsive symptoms, depression and anxiety were significantly decreased, awakening time, and arousals were significantly lower, and sleep efficiency and sleep maintenance rate was significantly increased, there were significant differences. Conclusions Early psychological care for elderly patients with chronic heart failure is very important to improve negative mood and sleep quality for them, and is worth further clinical promotion and application.

Objective To compare the effects of ephedrine and dopamine in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery.Methods Fifty ASAⅠorⅡ patients undergoing elective cesarean delivery were randomly divided into the two groups,Ephedrine group (n=5 1 ):intrave-nous injection of 10mg ephedrine before anesthesia;Dopamine group(n=52):continuous intravenous infusion at the speed of 5μg·kg-1 ·min-1 .During the whole process,we investigated the incidence rate of adverse effects,com-pared the Apgar score of neonate and analyzed blood gas of umbilical artery and vein.Results Compare to the dopa-mine group,the incidence rate of hypotension was lower in the ephedrine group (43.1% vs 69.2%,χ2 =7.06,P=0.00).The pH value of umbilical artery and 1 min Apgar score of neonate in the ephedrine group was lower compare with that in the dopamine group[(7.22 ±0.03)vs (7.27 ±0.06),t=0.62,P=0.02],there are no significant difference of 5 min Apgar score in the two groups.Conclusion Compared with dopamine,ephedrine is a useful drug in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery and there are no significant differences of adverse effects of dopamine and ephedrine.Ephedrine has transient effect on the neonate,while the effect of dopamine is minor.

Objective To evaluate stepping DSA technology in lower extremity artey disease. Methods 12 cases performed with stepping DSA in lower extremity artery were examined with TOSHIBA Infinixi digital subtraction angiography system, of which, 8 ones were also examined with conventional DSA. Results Stepping DSA technology could decrease the dosage of contrast agent and the examination.

Objective To evaluate the application of 3D DSA in diagnosis of intracranial aneurysm. Methods Conventional DSA and 3D DSA were performed in 15 cases with subarachnoid hemorrhage. Results Of 15 cases, by 3D DSA, 12 ones were diagnosed as intracranial aneurysm, and the remaining 3 ones were suspected, while 7 ones could be diagnosed by conventional DSA. Conclusion 3D DSA can improve the diagnosis of intracranial aneurysm.

Objective To evaluate angiography and interventional embolization in diagnosis and treatment of massive hemobilia.Methods During 10 years,9 patients with massive hemobilia underwent emergency selective hepatic artery angiography to find the bleeding points,and then embolized the feeding branches.Results All cases demonstrated clearly on angiography about the arterial hemorrhage,and extravasation of contrast-medium.Hemorrhage was stanched immediately after embolization of the feeding branches of the hepatic artery.Conclusion Selective hepatic angiography and interventional embolization for massive hemobilia is a safe and efficient diagnostic and therapeutic method.(J Intervent Radiol,2006,15:213-214)

Objective To detect the expressions of Six1 ,TGF‐βand their common induced VEGF‐C in human laryngeal squa‐mous cell carcinoma ,and to explore their significance in the occurrence ,development ,metastasis and prognosis of laryngeal squa‐mous cell carcinoma .Methods The clinical data and preserved paraffin samples of 96 patients with laryngeal squamous cell carci‐noma confirmed by postoperative pathology were collected .The protein expression of Six1 ,TGF‐βand VEGF‐C was determined by adopting immunohistochemistry and Western blotting .Results The positive expression rates of Six1 ,TGF‐β and VEGF‐C in the laryngel squamous cell carcinoma tissue samples were 84 .4% (81/96) ,89 .6% (86/96)and 91 .7% (88/96)respectively .The positive expression rate of Six1 was significantly higher in the patients with poor differentiation and lymph node metastasis ;the positive ex‐pression rate of TGF‐βwas significantly higher in the patients with lymph node metastasis and had no relationship with the degree of differentiation ;the positive expression rate of VEGF‐C was significantly higher in the patients with poor differentiation and lymph node metastasis ;there was a positive correlation between expression of Six 1 and VEGF‐C in the laryngel squamous cell canc‐er tissue .Conclusion The high expression of Six1 ,TGF‐βand VEGF‐C may promote lymphatic metastasis of laryngeal squamous cell carcinoma .Six1 expression may be one of the important influencing factors of the expression change of VEGF‐C .The combined detection of Six1 ,TGF‐βand VEGF‐C has an important clinical significance for judging the metastasis and prognosis of LSCC .

BACKGROUND:Studies have reported that the superfamily of transforming growth factors exert a role in the mineralization of various stem cells, but the combination effects of transforming growth factorβ3 and heparin on proliferation and mineralization ability of stem cells from human exfoliated deciduous teeth remains to be studied. OBJECTIVE:To explore the effect of transforming growth factorβ3 on odontoblast-like differentiation of stem cells from human exfoliated deciduous teeth. METHODS:Human deciduous teeth were col ected using enzyme digestion. The 3rd cells were incubated with 25μg/L recombinant human transforming growth factorβ3, 10 U/mL heparin or their combination. The dentin sialophosphoprotein mRNA and dentinsialoprotein expressions were detected by Q-PCR and western blot assay. Alkaline phosphatase activity was determined using alkaline phosphatase kit. RESULTS AND CONCLUSION:Stem cells from human exfoliated deciduous teeth grew wel after induction. The activity of alkaline phosphatase in the combination group was significantly higher than that in the transforming growth factorβ3, heparin and control groups (P<0.01). After combination induction, the cells were strongly positive for alizarin red staining. Results fromα-PCR and western blot assay showed that the expressions of dentin sialophosphoprotein were both remarkably increased at mRNA and protein levels. In summary, stem cells from human exfoliated deciduous teeth can differentiate into odontoblast-like cells under the induction of transforming growth factorβ3 plus heparin.

BACKGROUND:The role of transforming growth factorβsuperfamily has been reported in bone mineralization of various types of stem cells, but the effects of transforming growth factorβ3 (TGF-β3) combined with heparin on proliferation and mineralization of dental pulp stem cells from human deciduous teeth remains to be studied. OBJECTIVE:To evaluate the effects of TGF-β3 on the proliferation and mineralization of dental pulp stem cells from human deciduous teeth. METHODS:The enzyme digestion method was utilized to separately culture dental pulp stem cells from human deciduous teeth. The cellcolony forming efficiency was determined. Flow cytometry was utilized to identify cellsurface marker CD146. Immunochemistry for Vimentin and STRO1 was performed to measure dental pulp stem cells from human deciduous teeth. The third passage dental pulp stem cells from human deciduous teeth cultured in vitro were intervened with heparin and TGF-β3 of 1, 5, 25μg/L mass concentration. The MTS method was applied to measure cellgrowth curves. Alizarin red staining was carried out. The changes in alkaline phosphatase activity were determined with alkaline phosphatase kit. RESULTS AND CONCLUSION:The cellcolony forming efficiency was high. cells were positive for CD146, and strongly positive for Vimentin and STRO1. Dental pulp stem cells from human deciduous teeth were identified. MTS assay indicated that there was no obvious effect on promoting proliferation of dental pulp stem cells from human deciduous teeth after stimulation of TGF-β3. Detection results of alkaline phosphatase activity demonstrated that the combination of TGF-β3 and heparin could strengthen the alkaline phosphatase activity of dental pulp stem cells from human deciduous teeth with increased concentration. Alkaline phosphatase activities were significantly higher in the TGF-β3+heparin group, TGF-β3 group and heparin group than in the control group (P<0.01). Alizarin red staining was positive in the TGF-β3+heparin group, and the staining was strongest in the 5μg/L TGF-β3+heparin group. Results indicated that TGF-β3 combined with heparin promoted mineralization of dental pulp stem cells from human deciduous teeth.

Objective To analyze the clinical characteristics of pneumomediastinum in patients with dermatomyositis and polymyositis for demonstrating its pathogenesis and for predicting its prognosis. Methods The clinical records of 96 patients with PM/DM were reviewed, focusing on for perdicting its pneumomediastinum. Five patients with pneumomediastinum are described in detail. Case reports of pneumomediastinum in PM/DM in English publications are reviewed. Results Five DM cases complicated by pneumomediastinum all had lung infections. Twenty-nine cases (including our five cases) of DM/PM with pneumomediastinum have taken methylprednisolone, four cases alive, and six died. Nine cases have taken CsA,seven cases alive and two died. Conclusion The infections was strongly suspected as being responsible for the pneumomediastinum. Methylprednisolone has poor effect. CsA can be an effective therapeutic agent in PM/DM.

Objective To investigate the analgesic effect and adverse reactions of patient-controlled intravenous analgesia (PCIA) in breast cancer patients with radical mastectomy.Methods A total of 210 breast cancer patients who underwent radical mastectomy was randomly divided into two groups,experimental (group A) and control (group B) groups (n =105 cases per group).Patients in group A was used PCIA for 48 hours analgesia,while group B weas applied routine intramuscular injections of pethidine.Visual analogue score (VAS) at 4,8,12,24,and 48 hours after operation were recorded.Pulse,respiration,and blood pressure were monitored and side effects e.g.existed skin itching,nausea,vomiting,and respiratory repression were observed.Results The VAS of group A patients on 4,8,12,24,and 48 hours were2.02 ± 1.47,1.73 ± 1.38,1.68 ± 0.91,1.44 ± 0.65,and 1.21 ± 0.61,respectively;and the VAS of group B patients were 6.95 ± 1.96,6.42 ± 1.57,5.63 ± 1.66,4.99 ± 1.62,and 3.72 ± 1.46,respectively.The VAS was significantly lower in group A patients than in group B (P ＜ 0.05).The incidence of skin itching,nausea,vomiting,and respiratory repression was also distinctly decreased in group A than in group B (P ＜0.05).The overall satisfaction of patients in group A (96.2％) was remarkably higher than in group B (67.6％) (P ＜0.01).Conclusions Patient-controlled intravenous analgesia pump can more effectively alleviate the degree of pain,reduce the incidence of skin itching,nausea,vomiting and respiratory repression,improve the satisfactory degree for analgesia in breast cancer patients with radical mastectomy compared to traditional intramuscular way.