Objective To investigate the changes of the hemostatie coagulation markers in pregnancy induced hypertension (PIH)and significance.Methods The blood samples were collected from 70 normal pregnant women (control group) and 66 pregnant women with PIH (PIH group).Platelet count (PC), mean platelet volume ( MPV ), prothrombin lime (PT), partial thromboplastin time (AFIT), fibrinogen (FIB),D-dimmer (D-D)were measured.Results Compared with the control group,the level of PC,PT, APTT in the PIH group were significantly decreased [(178.32±51.08) × 10~9/L vs (186.17±40.02) × 10~9/L, (10.54±0.34) s vs(11.07±0.49) s, (26.23±3.12) s vs(28.08±4.31) s](P<0.05 or <0.01), while those of FIB,MPV,D-D were significantly increased [(5.34±0.68) g/L vs (4.02±0.73) g/L, (11.10 ± 2.31 ) fl vs (8.95 ± 1.37) fl, (0.46 ± 0.27) mg/L vs (0.18 ± 0.19) mg/L](P < 0.01 ).The levels of FIB and D-D were significantly increased in severe preeclampsia (34 cases) than those in mild preeclampsia (32 cases) (P < 0.01 ).The level of PT was lower and FIB, D-D were increased in early onset preeclampsia ( 31 cases ) than those in late onset preeclampsia (35 cases) (P < 0.05 or < 0.01 ).Conclusions There is hypercoagulative state in pregnant women with PIH.The disorders of coagulation function may be more severe in early onset preeelampsia than those in late onset preeclampsia.

Objective To estimate the effect of tretinoin gel sheeting on early-stage hyperplastic scars in rabbit ears,and to evaluate the feasibility to prevent and treat hyperplastic scars with it.Methods The ears of 24 rabbits were used to establish a model of hyperplastic scar according to previously reported methods.Then,the rabbit ears were randomly divided into four groups:control group receiving no treatment,gel sheeting group treated with the vehicle of the tretinoin gel sheeting,0.05％ tretinoin group treated with 0.05％ tretinoin gel sheeting,0.1％ tretinoin group treated with 0.1％ tretinoin gel sheeting.All the gel sheetings were topically used twice daily for six consecutive weeks.During the treatment,the size,thickness,color and texture of scars were estimated.After six weeks of treatment,all the scar tissues were resected from the rabbit ears and subjected to hematoxylin and eosin (HE) staining and van Gieson (VG) staining.Statistical analysis was carried out by analysis of variance and rank sum test.Results The scars were deeply colored,thickened,hard and elevated with an uneven surface in the control group,but lightly colored,thinned and soft with the presence of small subcutaneous nodules in the other three groups.The surface of scars in the two tretinoin groups was similar to that of adjacent normal skin,and scaling was observed on the scar surface in the 0.1％ tretinoin group.HE and VG staining showed a disarrangement of collagen fibers with the formation of vortex-like structures in the control group.A significant decrease was noted in the number of fibroblasts and microvessels as well as amount of collagen deposition per unit cross-sectional area in the two tretinoin groups compared with the control group and gel sheeting group.Additionally,the collagen fibers were regularly arranged and parallel to the long axis of scars in the two tretinoin groups.The scar hyperplasia index (HI) was 3.173 ± 0.26,2.465 ± 0.19,1.906 ± 0.21 and 1.903 ± 0.23 in the control group,gel sheeting group,0.05％ tretinoin group and 0.1％ tretinoin group respectively,the fibroblast density (NA) was 5836.7 ± 527.03,4128.73 ± 387.66,3207.59 ± 439.17 and 3200.28 ± 421.48 respectively,and the area density of collagen fiber (AA) was 45.38 ± 5.83,36.57 ± 6.84,28.09 ± 3.82 and 28.07 ± 3.47 respectively.As far as HI,NA and AA were concerned,the control group differed significantly from the other three groups (all P ＜ 0.01),and the gel sheeting group from the two tretinoin groups (all P ＜ 0.01),but no significant difference was observed between the two tretinoin groups (all P ＞ 0.05).Conclusions Topical tretinoin gel sheeting can inhibit scar proliferation at early stage in rabbit ears,and may provide a new choice for the prevention and treatment of hyperplastic scars.

Objective To explore the aursing points for patients with acute pancreatitia.Methods Retrospectively summarized the nursing courses among 65 patients with acute pancreatitis.Results Among the 65 patients with acute pancreatitis,there were 10 patients receiving operation,there were 55 patients receiving conservative treatment.5 cases died,and the others rccoverd.Conclusion The key nursing points for patients with acute pancreatitis are careful observation,systematic nursing intervention according to the conditions of patients and preventing complications.

Objective To investigate of mental health level and coping style in emergency nurses. Methods Investigations were conducted in 78 emergency nurses who had been m the emergency department over one year from 4 general hospitals in Huizhou using general condition questionnaire, symptom checklist 90 (SCL-90) and simple coping style questionnaire, the results underwent analysis. Results The subfactor score of SCL- 90 was significantly higher than that of Chinese norm. Emergency nurses adopted positive coping style more then conunon adillt group. The positive coping style of nurses was negatively correlated with the total score of SCL-90, somatization, interpersonal relationship, depression and anxiety factor of SCL-90. The negative coping style was positively correlated with the total score, sornatization, depression and anxiety factor of SCL-90.Conchusions Emergency nurses have poor mental health. We must adopt effective means to improve theirs mental health level.

Objective To investigate the expression of XIAP and survivin and its significance in diffuse large B-cell lymphoma. Methods The expression of XIAP and survivin were detected by immunohistochemistry in 49 patients with diffuse large B-cell lymphomas. Results The positive rate of XIAP and survivin in cases of DLBCL were 40.8%(20/49) and 44.9%(22/49) respectively, which was higher than that of benign lymph node pathological changes (P ＜0.05). The expression of XIAP in DLBCL positively correlated with the expression of surviving (r =0.382, P =0.01). Moreover, the mean survival period in DLBCL expressing XIAP was shorter than the XIAP-negative group. Conclusion The up-regulation of expression of XIAP may play an important role in the development of DLBCL, and may cooperate with the expression of survivin in apoptosis pathway. Furthermore, the expression of XIAP might be a new unfavorable prognosis factor of DLBCL.

Objective To investigate the expression of NF-κB/p65 in nasal NK/T cell lymphomas. Methods Immunohistochemis-try and TUNEL were used to study the expression of NF-KB/p65 and cell apoptosis in 23 nasal NK/T cell lymphoma samples and 14 benign lymph node lesions. Results The NF-KB/p65 positive rates were 43.5% (10/23). The expression of NF-κB/p65 was negative correlated with apoptotic index among 23 nasal NK/T cell lymphomas(P <0. 05). The mean survival period in patients expressed NF-KB/p65 was sig-nificantly shorter than that in negative group(P <0. 05). Conclusions Apoptosis inhibited by overexpression of NF-κB/p65 might be in-volved in the development of nasal NK/T cell lymphoma. NF-κB/p65 expression may be an unfavorable prognostic factor of nasal NK/T cell lymphoma.

Dental Pulp Cavity ; Humans ; Molar ; Tooth Root

Objective To investigate the expression of IgG4 in liver tissues of patients with type Ⅰ autoimmune hepatitis (AIH) and to analyze the clinical manifestation,biochemical indexes,immunological genetic features,pathological characteristics and the effects of immunosuppressive therapy.Methods From March 2012 to July 2013,45 patients diagnosed as type Ⅰ AIH were enrolled.Immunostaining of CD38,IgG and IgG4 in liver tissue slices was performed,inflammation grade G and fibrosis stage S were determined.At the same time,serological indexes (alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),IgG,antinuclear antibody (ANA) titer,antibodies to asialoglycoprotein receptor (ASGPRAb)) of the patients were collected,serum IgG4 was tested and the response to immunosuppressive therapy was observed.Wilcoxon rank sum test and t test were performed for quantitative data comparison.Spearman correlation coefficient was used for correlation analysis.Results Among 45 patients with type Ⅰ AIH,five patients (11.1％) were IgG4 associated AIH (IgG4-AIH group).There were no significant differences in age,gender,biochemical indexes (serum levels of ALT,AST,ALP),immunity indexes (serum levels of IgG,ANA titer,ASGPRAb) and degree of liver fibrosis between patients with IgG4-associated AIH and classical AIH (40 cases) (all P＞ 0.05).Compared with classical AIH group (18.3(6.7) mg/L).The serum level of IgG4 of IgG4 AIH group was 25.8(9.2) mg/L,which significantly increased (Z=-2.041,P＜0.05).However,there was no significant difference in serum level of IgG4 between the two groups (P＞0.05).There was no correlation between the number of infiltrated IgG4 positive plasma cells and the serum level of IgG4 (r=0.311,P=0.279).The inflammation in the liver tissues of IgG4-AIH group was more significant compared with that of classic AIH group (H=4.120,P＜0.05).The number of CD38' or IgG+ plasma cells was larger compared with that of classical AIH (CD38(39.3(13.5)/high power field (HPF) vs (21.3(8.8))/HPF,IgG(39.3 (14.0))/HPFvs (18.5(8.9))/HPF;Z ＝-3.561 and-3.584,both P＜0.01).The number of IgG4+ plasma cells in liver tissues was positively correlated with the number of CD38+ or IgG+ plasma cells (r=0.884 and 0.791,both P＜0.01).Conclusions Among patients with type Ⅰ AIH,the incidence of IgG4-associated AIH was not high.The serum level of IgG4 did not significantly increase in these patients.However,the histological inflammation activity was significant along with many CD38+ or IgG+ plasma cells infiltration.

Objective To investigate the influence of ropivacaine with isodosage on heart rate variability (HRV ) following interscalene brachial plexus block under ultrasound guidance. Methods Forty-five ASA grade Ⅰ patients (28 males,1 7 females,aged 18-50 years)scheduled for upper limb fracture internal fixation removal were randomized into group R1 (0.375% ropivacaine 40ml),group R2(0.5% ropivacaine 30ml)and group R3 (0.75% ropivacaine 20 ml),1 5 in each group.Changes in HRV,such as LF,HF,LF/HF,SDNN,RMSSD,PNN50% were evaluated with dynamic electrocardiogram.The degree and duration of sensory and motor block were recorded 30 min after drug injection.Results The anesthetic effect and maintaining time had no significant difference among the groups.The incidence rate of Horner syndrome had no significant difference among groups,group R1 was 26.7%,group R2 20% and group R3 20%.LF(30 min after drug injection)in both group R2 and group R3 were significantly decreased compared with that before drug injection, and the decreased degree of LF had significant difference among the three groups.SDNN(30 min after drug injection)in group R2 and PNN50% in group R3 were significantly decreased compared with that before drug injection.The time required for LF,the most obvious changeable HRV parameter, returning to the pre injection level was (876.2 +43.7)min for group R1,(798.8 + 61.5 )min for group R2, group R3 (712.2 + 45.7 ) min, the difference between the three groups was not statistically significant.Conclusion ISBPB can affect the stability of the cardiovascular autonomic ac-tivities by reducing the cardiac sympathetic nerve function and increasing parasympathetic nerve func-tion,possibly through blockade of stellate ganglion or branches of vagus nerve.Along with the in-crease of the dose of anesthetic,the influence on HRV is greater.

Objective To discuss the clinical characteristics and treatment methods of lumbar disc herniation in adolescent and to in-crease the awareness of lumbar disc herniation among orthopedists.Methods Retrospectively reviewed the clinical data of 201 adolescent pa-tients(aged 20 years or less)with lumbar disc herniation who were admitted in General Hospital of Shenyang Military Area Command from January 2001 to December 2010.Analyzed the clinical characteristics and treatment methods,and compared the VAS score and ODI score be-fore operation,one week after operation and at the last follow up.Meanwhile,the complications were observed and compared.Results Among the 201 patients,187 patients(93.0%)presented with low back pain with or without radiating pain,20 patients(10.0%)presented with leg pain for the first symptom.There were only 97 patients(48.3%)were diagnosed with lumbar disc herniation for their first diagnosis in other hospital.Totally 70 patients(34.8%)had a history of trauma before the onset.The most common segments were L4 /L5 (101 cases,50.2%) and L5 /S1 (70 cases,34.8%).There were 140 patients treated by microendoscopy discectomy(MED),25 patients treated by percutaneous endoscopic lumbar discectomy(PELD),and 36 patients treated by open lumbar discectomy(OLD).All the patients were followed up for more than 12 months with averagely followed up for(22.9 ±11.7)months.There was significant improvement one week after operation and at the last follow up compared with the preoperative VAS score and ODI score,and the differences were statistically significant(P <0.05).The rate of postoperative complications was 3.6%,4.0%,8.3% in patients with MED,PELD and OLD respectively.Conclusion Diagnosis of LDH in adolescent is usually delayed.Increase the awareness of lumbar disc herniation could help orthopedists to get a exact medical history,per-form a directed physical examination,and order appropriate imaging studies.Minimally invasive surgery is an effective method to treat lumbar disc herniation in adolescent.