Dental anxiety (DA) is the psychology obstacle of the dental patients in the dental treatment. Recently, dental anxiety becomes prevalent in the world and it greatly impacts physical health and the quality of life. The text discussed the relationship between doctors and patients in the treatment of DA

Objective To investigate the effect of community nursing intervention on hypertension combined with diabetes in elderly patients.Methods Five hundred and twenty elderly hypertensive patients with diabetes aged over 60 years in 10 communities of Shenzhen were randomly divided into a control group and a study group,260 cases in each group.All the patients in the two groups were given regular follow-ups in community clinics after discharge.Then the control group received instructions on relevant knowledge by the nurses in the community clinics,while the study group received nursing intervention by phone calls or visits by professional nurses once a month.The two groups were compared in terms of blood pressure,blood sugar and blood lipids 12 months after intervention.Results There were no significant differences in blood pressure,blood sugar and blood lipids between the two groups before the intervention(all P>0.05).After intervention,however,the differences were significant(all P<0.05).Conclusion Community nursing intervention may effectively improve hypertension and diabetes in the elderly patients by improving the levels of blood pressure,blood glucose and blood lipid,thereby reducing the incidence of cardiovascular and cerebrovascular events.

Objective To sdudy the effects of Melatonin(MT)on cognition and tau hyperphosphorylation in hippocampus of Alzheimer's disease(AD)model rats.Methods A?25-35 was injected into the hippocampus to make AD model rat.MT was injected intraperitoneully into rats of MT group 7 days before and 19 days after modeling.Normal saline(NS)was injected intraperitoneully into rats of AD group after modeling.The cognition was tested by Morris water maze.The pathological changes of hippocampus was observed by Bielschowsky staining and the tau hyperphosphorylation was detected by immunohistochemistry staining.The results were compared with normal control group.Results In MT group,the results of Morris water maze were significant better than those in AD group(all P

Objective To understand the status and pathogenic characteristics of healthcare-associated infection (HAI)in cardiovascular surgical intensive care unit (ICU)patients undergoing heart transplantation.Methods Pa-tients who underwent heart transplantation in a hospital between July 1 ,2013 and June 30,2014 were performed targeted monitoring.Results Of 66 patients undergoing heart transplantation,16 developed 18 times of HAI,inci-dence of HAI was 24.24%.Incidence of HAI and ventilator-associated pneumonia(VAP)in patients undergoing heart transplantation were both higher than non-transplantation patients (24.24% vs 6.24%,χ2 =33.718;7.58%vs 1 .72%,χ2 =12.199,respectively,both P <0.001 ).The infection tyes were as follows:lower respiratory tract infection(n=7),VAP (n=6),bacteremia (n=3),superficial incision infection (n =1 ),as well as skin and soft tissue infection (n = 1 ). The isolated pathogens were fungus (n = 8 ),Klebsiella pneumoniae (n = 3 ), Staphylococcus aureus (n=2),Acinetobacter baumannii (n=2),Enterobacter cloacae (n=1 ),Acinetobacter hae-molyticus (n=1 ),and Citrobacter freundii (n =1 ).Conclusion Incidence of HAI is high in patients undergoing heart transplantation,the main infection type is lower respiratory tract infection,the major pathogen is fungus.

Objective To investigate the anti-inflammatory impacts of in the progression of Alzheimer' s disease (AD) in the rat model induced by β-amyloid 1-42 (Aβ1-42 ). Methods Sixty healthy male Wistar rats (weight 250--300 g) were randomly divided into 4 groups: control group, model group, statins control group and statins treatment group, 15 in each group. Rats model were established via intracerebroventricular injection of A13, and then atorvastatin (5 mg·kg-1·d-1) were given to the treatment group for 3 weeks, saline to the control group. Water Maze was used to observe learning and memory ability changes in rats, and expression of inflammatory eytokines IL-1β, IL-6 and TNF-α in the hippocampus were repectively detected by immunohistochemical technique. Furthermore, HE staining patterns, hippoeampns neurons and glial cells in the small ultra structural changes were observed under light microscope and electron microscope respectively. Results The model rats resulted in decreased learning and memory abihties ( the escaping latency: 12. 0 ± 1.2, 41.3 ± 3.4, t = 18. 0363, P < 0. 01 ) and increased secretion of the brain inflammatory factor compared with the controls with statistically significant difference (IL-1β:53.5 ± 2.4, 101.0 ± 3. 8, t = 23. 8246, P < 0. 01 ). Atorvastatin treatment group improved learning and memory performance ( the escaping latency: 25. 7 ± 1.6, 41.3 ± 3.4, t = 9. 1076, P < 0. 01 ), reduced the secretion of inflammatory factors in the hippocampus, compared with the model rats (IL-1β:60.0±3.4,101.0±3.8, t = 18.0231, P <0.01). There were less injured nerve cells and proliferated glial cells in the atorvastatin treatment group than in the model group. Conclusions Atorvastatin plays an anti-inflammatory role in the progression of Alzheimer's disease, reducing the nerve cell damage and improving learning and memory ability.

Objective To investigate the performance of surgical management in facial skin malignancies.Methods From January 2000 to December 2006,65 patients with facial skin malignancies,including47 cases of basal cell carcinoma.10 cases of squamous cell carcinoma,3 cases of dermatofibrosarocoma protuberans,2 cases of malignant melanomas,and one case of malignant acanthoma,hemangioendotheliosar-coma and sebaceous carcinoma,respectively,were collected and managed with wide resection followed by reconstruction.In order to achieve a thorough resection,frozen sections were prepared and subjected to pathological examination during the operation process to ensure the margins of resection were free of malignancy.Reconstruction was carried out by direct closure,or with local random flaps,extended flaps,free skin grafts.Resuits All defects were managed by one-stage reconstruction.The survival rate of skin flaps/grafts was 100%,and a satisfactory appearance and function was achieved.During the follow-up from 6 months to 5 years,local relapse was observed in one patient with basal cell carcinoma and one with squamous eell carcinoma,lymphatic metastasis in one with squamous cell carcinoma.Distant metastasis occurred in a patient with malignant melanoma.who died consequently.Conclusions Thorough resection is the key to prevent relapse of facial skin malignancies after surgery.Appropriate reconstruction may favor the restoration of facial appearance,and local random flaps appear to be the best reconstruction strategy.

Objective To investigate the perinatal outcome for pregnancies complicated with chronic renal diseases,and the risk factors for the adverse outcome.Methods Retrospectively analyze the clinical data of 48 patients with chronic renal diseases complicating pregnancy admitted in Peking University People's Hospital between January 1998 and August 2010,record the pregnancy outcome and explore the risk factors for the poor outcome using multivariate regression analysis.Results Thirty-eight patients had known chronic renal disease before conception,and ten were diagnosed during pregnancy.Seven patients (15％,7/48 ) presented with obvious renal impairment [ serum creatinine (sCr) ≥ 125 μmol/L] prepregnancy,and nine (19％,9/48 ) were recorded with chronic hypertension.Thirty-three patients received regular prenatal care.Twenty-one cases ( 44％,21/48 ) developed preeclampsia.During the gestation,normal renal function (defined as sCr ＜71 μmol/L) was seen in nineteen cases (40％,19/48),mild dysfunction (sCr ranged 71 - 132 μmol/L) in twenty (42％,20/48) and moderate to severe dysfunction ( sCr ≥ 132 μmol/L) in nine cases ( 19％,9/48 ).Twenty patients had negative or mild proteinuria (24 hour urine protein ＜2000 mg),19 had moderate (24 hour urine protein ranged 2000 -5000 mg) and nine had severe proteinuria (24 hour urine protein ≥ 5000 mg).The gestational age at delivery ranged from 24 to 41 weeks and the neonatal birth weight ranged from 890 to 4150 g.A total of twenty patients (42％,20/48 ) suffered adverse perinatal outcome,including one case with late spontaneous abortion,fifteen with preterm delivery,eleven with small for gestational age,two with neonatal respiratory distress syndrome and four with perinatal death.Declined maternal renal function was seen in eight patients,and two patients progressed toward the end-stage renal failure ( the stage of uremia).Multivariate regression analysis identified that preeclampsia (OR =24.72, P =0.002 ) and the degree of proteinuria ( OR =4.24,P =0.032) were the independent risk factors for the adverse perinatal outcome. Conclusions Pregnancies complicated with chronic renal diseases have significantly high incidence of preeclampsia and adverse perinatal outcome.Preeclampsia and the degree of proteinuria are perhaps the independent risk factors for the adverse outcome.

Aim To investigate the effect of pioglitazone on the AdipoR1 and AdipoR2 expression of HU-VECs induced by intermittent high glucose.Methods After exposed to intermittent high glucose for 5 d,HUVECs were incubated with pioglitazone(10,1 or 0.1 ?mol?L-1) for 24 hours.The AdipoR1 and AdipoR2 mRNA expression levels in HUVECs were also determined by real-time PCR.Results After exposed to intermittent high glucose for 5 days,HUVECs were treated with pioglitazone(10,1 or 0.1 ?mol?L-1) for 24 h.10,1?mol?L-1 of pioglitazone treatment enhanced AdipoR1 mRNA level(both P

Objective To investigate the incidence and risk factors of acute kidney injury (AKI) in patients with multiple soft tissue contusion.Methods A total of 513 patients diagnosed as multiple soft tissue contusion in the First Affiliated Hospital of Xinjiang Medical University from January 1,2008 to January 1,2013 were retrospectively analyzed.Demographics,clinical data and laboratory examinations before and after AKI were collected and analyzed.Results The age of all subjects was 31.30 (12-78) years old with the male to female ratio of 2.1∶ 1.AKI occurred in 74 cases with an incidence rate of 14.4％.No AKI was observed in patients with assault injuries,while AKI was found in 27 cases (36.5％) with car accident injuries and 4 cases (5.4％) with other injuries.AKI showed in 1 case(1.4％) with damaged area under 1％,in 4 cases(5.4％) with damaged area ranged from 1％ to ＜ 3％,10 cases (13.5％) with damaged area ranged from 3％ to 5％ and 19 cases (25.7％) with damaged area over 5％ with significant difference among the groups (P ＜ 0.01).Incidence rate of AKI was significantly higher in patients with chronic kidney disease (CKD) than those without CKD (54.5％ vs 20.3％,P ＜ 0.01).Two of the AKI cases died,with a mortality rate of 2.7％.Multivariate logistic regression analysis showed that the followings were the independent risk factors for the occurrence of AKI in patients with multiple soft tissue injuries:age (OR =1.996),basic serum creatinine (OR =0.976),basic evaluated GFR (eGFR) (OR =0.964),serum potassium (OR =2.117),myoglobin (OR =0.950) and damaged area (OR =1.811).Conclusions Incidence rate of AKI is quite high in multiple soft tissue contusion.Age,basic serum creatinine,basic eGFR,serum potassium,myoglobin and damaged area are the independent risk factors for the occurrence of AKI in patients with multiple soft tissue injury.

Objective To investigate the clinical and pathological characteristics of carcinoid tumor in rectum and its treatment. Methods The clinical and pathological data of 38 rectal carcinoid patients from Wuhan Center Hospital and Wuhan the Eighth Hospital from January 2005 to December 2009 and reviewed were analyzed retrospectively. Results All 38 cases were typical carcinoid, located in the rectum within 10 centimeters to the lower border of the anal canal.The classic characters were submuscosal tumor with yellow color and rigid or tough texture and always were lack of mobility. Carcinoid tumor of rectum often expressed markers of neuroendocrine differentiation on immunohistochemical staining.Among 38 cases, 34 cases were less than or equal to 2.0 cm in diameter and located in lamina propria (n=30) or invased submucosal layer (n=4), these patients were cured by endoscopic mucosal resection (EMR).Four cases were larger than 2.0 cm in diameter with muscularis externa invasion, treated by curative resection.All tumors <2.0 cm in diameter had a very lower Ki-67 labeling index (<3% ).34 patients survived at the latest follow-up. Conclusions The diagnosis of rectal carcinoid relies on histopathology and immunohistochemistry. The behavior of the rectal carcinoid shows low degree of malignant potentia. They rarely invade the muscularis externa or metastases. Most of them can be cured by endoscopic mucosal resection(EMR).