133 teeth in 34 children aged 4 to 8 year-old were recruited for the treatment of bilateral maxillary primary canines or primary molars with deep caries,chronic pulpitis or chronic periapical periodontitis under local anesthesia.Buccal infiltration(BI)with conventional syringe(CS)was used for one quadrant,anterior middle superior alveolar anesthesia(AMSA)with computer-controlled local anesthesia de-livery system(C-CLADS)on the contralateral side.The injection duration(s)of CS and C-CLADS was 63.6 ±22.6 and 136.6 ±12.4 re-spectively(P =0.000).The pain perception of C-CLADS injection was significantly lower than that of CS(P <0.05),that during operation was not statistically different(P >0.05).55.9% children preferred C-CLADS anesthesia.

Objective To investigate the expression and significance of Maspin and IKKα in nasosinusoidal mucosa of rats with fungal rhinosinusitis (FRS).Methods A total of 40 SD rats were used to establish the FRS model, and randomly divided into nasal obstruction group, FRS group, immunosuppressive group and invasive FRS group, 10 rats in each group.Another 10 normal rats were used as control group.Mice in the control group were fed with normal diet.In the nasal obstruction group, the mice had only hemostatic cotton stuffed in the nasal cavity and injection of 0.9% NaCl in the abdominal and nasal cavities.In the FRS group, the mice were injected Aspergillus fumigatus spore suspension into the nasal cavity and 0.9% NaCl i.p.The mice of the immunosuppressive group were given cyclophosphamide i.p.and 0.9% NaCl injection into the nasal cavity.The invasive FRS group was injected with cyclophosphamide i.p.and Aspergillus fumigatus spore suspension into the nasal cavity.The serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured by enzyme-linked immunosorbent assay (ELISA).The expression of Maspin and IKKα in nasosinusoidal mucosa was detected by immunohistochemical staining.The expression of Maspin mRNA and IKKα mRNA in the nasosinusoidal mucosa was detected by fluorescence quantitative PCR.Results The serum levels of IL-6 and TNF-α in different groups were significantly different (P< 0.05).The level of IL-6 in the FRS group was (69.3 ± 10.9) ng/L, significantly higher than those in the control group, nasal obstruction group, immunosuppressive group and invasive FRS group [(45.2 ± 7.1)ng/L, (46.4 ± 6.7) ng/L, (21.3 ± 4.5) ng/L, and (20.9 ± 4.3 ng/L)] (P < 0.05).The level of TNF-α in the FRS group was (30.4 ± 4.8) ng/L, significantly higher than those in the control group, nasal obstruction group, immunosuppressive group and invasive FRS group [(14.8 ± 2.7) ng/L, (13.9 ± 1.4) ng/L, (7.9 ± 0.6) ng/L, and (7.8 ± 0.4 ng/L)] (P < 0.05).The levels of IL-6 and TNF-α in the control group were significantly higher than those in the immunosuppressive group and invasive FRS group (P< 0.05).There was no significant difference between the immunosuppressive group and the invasive group (P> 0.05).Theresult of immunohistochemical staining showed that the protein expression of Maspin in the FRS group and invasive FRS group was significantly lower than that in the control group, nasal obstruction group and immunosuppressive group, while the expression of IKKα protein was significantly higher than that of control group, nasal obstruction group and immunosuppressive group (P< 0.05).The protein expression of Maspin in the invasive FRS group was significantly lower than that in the FRS group, by contrast, the expression of IKKα protein was significantly higher (P< 0.05).The PCRresult revealed that the expression levels of Maspin and IKKα mRNA were (0.217 ± 0.013) and (0.193 ± 0.012), significantly lower than that in the control, obstruction and immunosuppressive groups [(0.309 ± 0.021), (0.302 ± 0.017), and (0.293 ± 0.02)] (P< 0.05), while the expressions level of IKKα mRNA were significantly higher [(0.319 ± 0.043), (0.384 ± 0.048) vs (0.169 ± 0.015), (0.171 ± 0.018), and (0.175 ± 0.019)] (P< 0.05).Conclusions Down-regulation of Maspin expression after IKKα activation is the main cause of the onset of FRS, which may also be one of the mechanisms of invasive FRS.

ObjectiveTo investigate the teaching effect of problem-based learning(PBL) in clinical probation of gynecology and obstetrics.Methods48 students who majored in obstetrics and took internship in Xiamen Maternity and Child Care Hospital were selected as study subjects and were randomly assigned to control group and observation group.Traditional teaching pattern and PBL were performed in the above-mentioned groups respectively.The score of final test on maternity nursing and self-evaluation on capacity advancement were compared between two groups.ResultsThe score of observation group were significantly higher than control group (P＜0.05); Similarly,the self-evaluation of observation group after internship was also elevated with significance (P＜0.05) when being compared with control group.ConclusionEvidence showed that PBL was capable of improving the knowledge of maternity nursing,and it was also been proved effective in fostering the ability of self-learning,communication,and solving problem.Therefore,the PBL was appropriate to be promoted in the internship of nursing education.

OBJECTIVETo establish a RP-HPLC-PDA method for determination of five triterpenic acids (pomolic acid, hawthorn acid, corosolic acid, oleanolic acid and ursolic acid) in different parts of Salvia chinensis.

METHODThe isocratic elution and separation was achieved on a Kromasil C18 column (4.6 mm x 250 mm, 5 microm), using acetonitrile-water (90:10) as the mobile phase at a flow rate of 0.8 mL x min(-1). The detection wavelength and column temperature were set at 205 nm and 28 degrees C, respectively.

RESULTThe calibration curves of pomolic acid, hawthorn acid, corosolic acid, oleanolic acid and ursolic acid were linear over the ranges of 0.096 0-2.400, 0.1230-3.075, 0.2420-6.050, 0.2830-7.075 and 0.2730-6.825 microg (r = 0.9998, 0.9997, 0.9999, 0.9995, 0.9999), respectively. The average recoveries were 98.43%, 98.13%, 100.6%, 98.19% and 99.15%%, respectively, with RSD (n=6) being 1.3%, 0.67%, 1.2%, 0.87% and 0.43%.

CONCLUSIONThe proposed method is so simple and highly reproducible that it promises to be applicable for determination of major triterpenic acids in S. chinensis.

Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; Plants, Medicinal ; chemistry ; Salvia ; chemistry ; Triterpenes ; chemistry

BACKGROUND: Psychological behaviors play an important role in children accidental injury, and children with a tendency of accidental injury display specific psychological properties in characters and behaviors.OBJECTIVE: To investigate the difference of personality and behavioral characters between normal children and children with a tendency of accidental injury.DESIGN: Case controlled analysis based on suffered children and normal hildren.SETTING: Department of pediatric in a civic hospital.PARTICIPANTS: Totally 131 accidental injured children aged from 7 to 11 years were admitted at Tengzhou Civic center hospital between January and December 2001. Those with congenital intellectual disturbance and brain trauma were excluded and the rest 89 cases were asked to fill questionnaire, 8 were removed from the study due to unintegrated data and 81pieces of integral data were collected (reclaiming rate of 91.01%), including 50 males and 31 females with the mean age of (8.59±1.86) years, the intelligence quotient was(96±15) determined by Peabody picture vocabulary test(PPVT); and 81 children in control group matched in age and sex were selected from healthy children of school age without injury history and similar in some aspects, such as parents' culture degree, economic condition, educational state and the economic and culture state of inhabitancy with control group, including 45 males and 36 females with the mean age of (8.92±1.73) years, the intelligence quotient was(98±18) by PPVT. Two groups were matched in sex, age and IQ(P＞0.05).METHODS: Eysenck personality questionnaire and Achenback children behavioral rating scale(parents rating scale) were used.RESULTS: Data of two groups with 81 questionnaires in each entered into the final analysis without loss. ① Scores for psychoticisim, introverted and extroverted character and neurological quality in Esonk personality question naire were(50. 01±10.58, 55.19±12.1, 57.35±10.12) in injury group, higher than corresponding(45.63±13.81, 48.09±6.49, 50. 01±10.39)in control group( t = 2. 27-4.65, P＜0.05) . Scores for modified rating scale was(49.42±10.42) in control group, higher than(39.65±13.03)in injury group( P＜0.001); ② The median was found higher in hyperactivity, aggression, violation of discipline, bad communication, split anxiety,depression and physical complaint in boys of injury group; as well as in hyperactivity, cruelty, aggression, depression, physical complaint, social retreat, violation of law in girls of injury group, comparing to control group(P＜0.001); ③ Positive behavioral detecting rate of injury group was 32.09% (26/81), higher than 11.11% (9/81) of control group(P ＜0.001), OR was 3.78, and 95% CI was 1.66-8.59. Behavioral factors was proved of lower sensitivity(32. 1% ) with specificity of 88.9% and higher prognostic value of 74. 3%; ④ The mean score for Achenback children behavioral rating scale was(39. 84±10. 99) in boy which was obviously higher than(34.26 ± 10.43) in girls of injury group( P ＜0.05). The edian for violation of discipline and aggression in boys and depression in girls were significantly higher than the opposite sex group(P＜0.05 or 0.01) . The mean score for Achenback children behavioral rating scale was (37.62±11.03) in injury group, which were obviously higher than (17.77±12.12) of control group( P＜0.01) . ⑤Results of multiple factors Logistic analysis revealed that the risk factors for accidental injury included: aggression, hyperactivity and iolation of discipline in boys and aggression, violation of discipline and depression in girls.CONCLUSION: Children with a tendency of accidental injury has obvious ehavioral problems, behavioral factors were proved of lower sensitivity, but of igher specific positive prognostic value. Both boys and girls displayed speific characters in aggression and violation of discipline, and lack of pretendng capability comparing to normal children, thereby liable to response in on-rational manner.

OBJECTIVE: To discuss the mode of grading pharmaceutical care on patients with asthma and chronic obstructive pulmonary disease (COPD). METHODS: Combined with guidelines on patients with asthma and COPD,, the standards for grading pharmaceutical services were formulated. Two hundred and fifth-six patients are divided into intervention group and control group. And patients were given different levels of pharmaceutical services with grading standard. Before the intervention, 3 months and 6 months after intervention, grading score, medication compliance and lung function index (FEV1/FVC, FEV1% value) were expected to make the comparison between the two groups. The incidence of adverse reactions, the number of exacerbations greater than or equal to 2 times and clinical control rate were observed. RESULTS: Compared with control group, 6 months after intervention, the proportion of first intervention decreased by 25%, the incidence of adverse reactions decreased by 7.82%, the number of exacerbations greater than or equal to 2 times was reduced by 7.81%, the rate of clinical effective increased by 23.43%, FEV1/FVC, FEV1% value and medication adherence has improved significantly (P<0.05). CONCLUSION: The grading pharmaceutical care for patients with asthma and COPD, can help pharmacists find the crucial guardianship objects in the shortest time, and improve the quality of pharmaceutical care and clinical effect.

BACKGROUND: There are many drawbacks with hormone replacement therapy for menopausal syndrome. The blood levels of 5-HT and norepinephrine are lower. Fluoxetine hydrochlorde(ProzacR) is a selective serotonin reuptake inhibitor which is widely used in treating anxiety and depression,OBJECTIVE: To evaluate the effect of combined antidepressant and estrogen therapy compared to estrogen alone in the treatment of perimenopausal syndrome in this prospective open study.DESIGN: Randomized comparative study.SETTING: Department of Obstetrics and Gynecology of the First Affiliated Hospital of Chongqing Medical University PARTICIPANTS: From November 2003 to December 2004, 60 female patients with diagnosed menopausal syndrome of 3-12 month duration, aged (46±3) years, from Department of Obstetrics and Gynecology of the First Affiliated Hospital of Chongqing Medical University were enrolled into the study after giving their informed consents. The patients were randomly divided into two equal groups with Group 1 (n=30) receiving a combination of antidepressant + estrogen and Group 2 (n=30) receiving estrogen only.METHODS: Patients in Grgup 1 received fluoxetine hydrochloride (ProzacR) 20 mg orally every morning plus oral estradiol 1 mg once every two weeks for 2 months. Patients in Group 2 received only oral estradiol 1 mg once every two weeks for two months. Patients were not taking any other drug during the treatment period. At the end of two month treatment all patients were evaluated with the following 3 assessment tools: ①female menopausal symptom evaluation with the following 4 categories: Complete symptom relief, markedly improved, improved and no effect. Overall efficacy was defined as 50% symptom improvement. ② Hamilton Depression Scale which reflects energy level and psychosomatic factor of sleep and anxiety. ③Menopause index: Which are description of clinical evaluation and adverse effects; this would help to assess the safety of using both drugs in treating the menopausal syndrome.MAIN OUTCOME MEASURES: female menopausal symptom assessment, hamilton depression scale, and menopause index.RESULTS: ① In female menopausal symptom assessment group 1 showed better results in the complete relief and markedly improved scores. ②Hamilton Depression Scale group 1 also showed better scores than Group2(In Groupl, the scores at week 1 to 8 were 25,18,15,10,8,5,5,4 respectively ,in Group 2, the scores at week 1 to 8 were 25,17,15,14,13,12,13,13 respectively). ③ Group 3 showed a significant better score in the menopausal index with improvement in sleep disorder, anxiety and depression than Group 2 (In Group 1 the scores at week 1-8 were 32,22.5,15,15,14,15,15,14 respectively,In group 2, the scores at week 1 to 8were 33,21,16,14,13,12,13,13 respectively) ,there was no significant difference of incidence of adverse events as compared with Group 3 .CONCLUSION: Combined therapy of fluoxetire hydrochlarde(PROZAC)plus estrogen showed better efficacy in the treatment of menopausal syndrome than estrogen alone.

Objective To identify the differentially expressed genes in Uigur and Kazak patients with and without type 2 diabetes mellitus.Methods The differentially expressed cDNA bands were isolated by fluorescent mRNA differential display from peripheral blood leucocyte of the Uigur and Kazak patients with type 2 diabetes mellitus and the normal controls. After being cloned, all cDNA fragments were sequenced, then underwent sequence analysis, homogenous comparison,and Northern blot analysis. Results Z5、Z8、Z15 differentially expressed cDNA fragments were found.They were over-expressed in the normal controls and were lower or scarced in the Uigur and Kazak patients with type 2 diabetes mellitus. They were selected for sequencing and hybridization. Z5、Z8 showed highly homologous to cellular repressor of E1A-stimulated genes,Z15 are unknown. Conclusion Three differentially expressed genes may have a potential relation with type 2 diabetes mellitus.

It remains controversial whether tumor necrosis factor (TNF)-α antagonism is effective for asthma. This meta-analysis was performed to evaluate efficacy of TNF-α antagonism in treatment of patients with asthma. MEDLINE, EMBASE, LILACS, and CINAHL databases were searched for English-language studies published through January 3, 2010. Randomized-controlled trials comparing TNF-α antagonism with control therapy were selected. For each report, data were extracted in relation to the outcomes analyzed: asthma exacerbation, asthma quality of life questionnaire scores, and forced expiratory volume in 1 second. Four assessable trials were identified including 641 patients with asthma. TNF-α antagonism therapy was superior to control therapy in preventing exacerbations in asthmatics [pooled odds ratio 0.52 (95% confidence interval 0.29-0.88), P=0.02]; however, there was a nonsignificant reduction in asthma quality of life questionnaire scores [0.23 (0 to 0.47), P=0.05], forced expiratory volume in 1 second [0.03, (-0.14 to 0.10), P=0.74] when analyzed using standardized mean differences. TNF-α antagonism was superior to control chemotherapy in terms of asthma exacerbation, but not asthma quality of life questionnaire scores or forced expiratory volume in 1 second.

Objective To systematically evaluate the effectiveness and safety of resuscitation-inducing acupuncture for post-stroke dysphasia. Methods The randomized controlled trials ( RCTs) of resuscitation-inducing acupuncture for post-stroke dysphasia were searched in the domestic and overseas databases such as CBM, CNKI, Weipu VIP, Wanfang Data, PubMed, Web of Science, EMbase and the Cochrane Library ( from the founded date to December of 2014) . Literature screening, information extracting and literature quality assessment were done by 2 reviewers independently. RevMan5.3.0 software was used for Meta analysis. Results A total of 8 RCTs were included into the analysis, involving in 766 cases. The results of Meta analysis showed:( 1) for patients in the recovery stage of stroke, 4-week resuscitation-inducing acupuncture combined with routine treatment including internal medicine plus swallowing function training or not had better efficiency than the control group without resuscitation-inducing acupuncture (P<0.001) ; (2) for patients in the acute stage, the difference of efficiency between the combination group and the control group was insignificant (P=0.05); (3) The efficiency of resuscitation-inducing acupuncture combined with routine treatment for the complication of pulmonary infection stayed uncertain. Conclusion Resuscitation-inducing acupuncture combined with routine treatment is recommended to the patients with dysphasia in the recovery stage of recovery. But the cure time window, treatment course and effectiveness evaluation still need to be confirmed by more large-scale, high-quality randomized controlled trials.