BACKGROUND:Previous studies have found that cyclic tensile stress can induce the proliferation of human periodontal ligament fibroblasts in a certain time. OBJECTIVE: To observe the effect of cyclic tensile stress on the expression of connective tissue growth factor in human periodontal ligament fibroblasts, and to clarify the role of JNK, p38MAPK, PI3K pathway in the cyclic tensile stress-induced expression of connective tissue growth factor in human periodontal ligament fibroblasts. METHODS:Human periodontal ligament fibroblasts culturedin vitro were given stimulation of cyclic tensile stress in vitro for 1, 6, 12, 24 hours using multi-channel cel stretch stress loading system (experimental group). Control group was set up and not given any stimulation at the same time. The cels under stress application for 12 hours were given specific inhibitors of JNK, p38MAPK, PI3K respectively at the beginning, and were compared with those with no inhibitors. The concentrations of connective tissue growth factor in the culture supernatant were measured by ELISA. The mRNA expression of connective tissue growth factor in human periodontal ligament fibroblasts was detected by real-time RT-PCR. RESULTS AND CONCLUSION:Compared with the control group, the expression of connective tissue growthfactor in human periodontal ligament fibroblasts under cyclic tensile stress began to increase at 1 hour, increased manifestly at 6 hours, reached the peak at 12 hours, and then decreased at 24 hours. The expression of connective tissue growth factor was reduced by the specific inhibitors of JNK, while the specific inhibitors of p38 MAPK, PI3K had not the same effect. In a certain time, the cyclic tensile stress can induce a time-dependent increase in mRNA and protein levels of connective tissue growth factor. Along with the extending of time, the expression of connective tissue growth factor begins to decrease. Cyclic tensile stress can regulate expression of connective tissue growth factor in human periodontal ligament fibroblasts via the JNK pathway.

Objective To analyze the diagnostic value of diffusion tensor imaging(DTI)and diffusion tensor tractography(DTT) in viral encephalitis at 3.0T magneton. Methods 25 patients with viral encephalitis confirmed by clinic and 25 age-match healthy patients were examined by conventional MRI and DTI. The average diffusion coefficient (ADC) map, fractional anisotropy (FA) map and diffusion tensor tractography (DTT) was acquired through image post processing technique. The ADC value, FA value of lesions and normal tissues were measured by region of interest (ROI) with the same standard and the results were statistically analyzed.Results In the acute stage of viral encephalitis: The ADC values were significantly lower than that in normal tissues of control group (P<0.01), FA values of lesions were higher than that of control group and had no statistical significance (P＞0.05). In the subacute and chronic stage of viral encephalitis: The ADC values were higher than that of control group and had statistical significance(P＜0.01), FA values of lesions were significantly lower than that of control group(P<0.05). DTT imaging showed infiltrative changes of white matter fibers in the lesion areas.Conclusion DTI and DTT technique may provide some complementally informations and clinical diagnostic value for viral encephalitis.

ObjectiveTo discuss the clinical diagnosis and treatment of multiple endocrine neoplasia ( MEN ) 2A, and report the mutation of the RET proto-oncogene in a pedigree of three patients with MEN 2A.MethodsBilateral adrenalectomy was performed on two of the three patients with hypertension and bilateral adrenal-conserving adrenal pheochromocytoma resection was performed on the other patient. All three patients were treated by total thyroidectomy and neck lymphadenectomy. Twelve family members were recruited to the study. Peripheral blood was collected and total genomic DNA was prepared for polymerase chain reaction (PCR). PCR products of exon 10 and exon 11 of the RET proto-oncogene were purified and a direct DNA sequence analysis was performed.ResultsThe pathological diagnosis of the specimens was bilateral adrenal pheochromocytoma and medullary thyroid carcinoma in all the three patients. There was no tumor recurrence or distant metastasis after 1.5 - 5 years of follow-up. A missense mutation of TGC (Cys)to CGC (Arg) at codon 634 in exon 11 of the RET proto-oncogene was detected in all three patients. Genetic screening identified two mutation carriers in the other members of this pedigree.ConclusionGenetic mutation screening and surgical intervention may be helpful to the members of high-risk families.

Objective To investigate the electrocardiogram analysis of electronic colonoscopy on patients with coronary artery heart disease,and to evaluate the safety of colonoscopy on patients with coronary artery heart disease.Methods Sixty patients who underwent colonoscopy from Jun.2012 to Jun.2013 were divided into experimental group (patients with coronary artery heart disease,Heart function class Ⅰ-Ⅲ) and control group (patients without coronary artery heart disease).The changes of electrocardiography during colonoscopy and before performance were compared between two groups through dynamic electrocardiogram.Results Heart rate of the two groups were no statistically significant difference before colonoscopy process (t =0.537,P ＞ 0.05).During the inspection process,there was heart rate increase at different degree in two groups.The heart rate in patients of experiments group was increased from (73.20 ± 7.91) times/min to (88.67 ± 7.79) times/min,which waas more than that in control group (from (73.40 ±6.44) times/min to (74.88 ±7.82) times/min),and the difference between the two groups was significant(t =4.462,P ＜ 0.05).During colonoscopy inspection,the arrhythmia rate arrhythmia in experiment and control group were 46.67％ (14/30),20.00％ (6/30),and the difference was statistically significant (x2 =4.8,P ＜0.05).Meanwhile,ST-T change rates in experimental group and control group were 26.7％ (8/30) and 10.0％ (3/30) (x2 =45.72,P ＜ 0.05).The rate of subjective discomfort the two groups were 40％,30％ (x2 =0.659,P ＞ 0.05).Conclusion During the inspection process of colonoscopy,patients with coronary heart disease are more susceptible to increase heart rate,cardiac arrhythmia,ST-T change than those without coronary heart disease.However,no serious electrocardiographic changes.It is relatively safe to get colonoscopy in patients with coronary heart disease.

Objective To investigate the sleep condition and its influence factors in old patients with hypertension. Methods A total of 100 old patients with hypertension were investigated by Pitts-burgh sleep quality index (PSQI) and serf-designed questionnaire of influence factors. Results 76 per-cents of the old patients with hypertension had sleep disorders.The total score of PSQI,sleep quality,time take to fall asleep,hours of sleep,sleep effficiency,sleep disorders,hypnotic drugs and every score of daytime dysfunction were significantly higher than domestic norm(P<0.01).Surroundings(strange circumstances or noisiness), physio-pathology (disease distress or high frequency of going to toilet during nighttime),psycho-logical situations(the fear to the disease or worrying about medical fees) and drags(use of diuretics or the adverse effects of some antihypertensive agents) were the important factors affecting sleep quality. Con-clusions Old patients with hypertension have poor sleep quality,which relates with multiple factors.Valid nursing interventions should be adopted in order to control the various factors which affect sleep quality to improve patients' sleep quality.

Objective To detecte the expression of COX-2,VEGF-C and lymphatic vessel density (LVD)in pancreatic cancerous and paracancerous tissues,and investigate their correlation.Methods The expression of COX-2.VEGF-C and LVD in 40 cases of pancreatic cancer tissues and paracancerous tissues and 12 cases of normal pancreas was detected by tissue chip and immunohistochemical assays,and the relationship between them and the cljnicopathological parameters was analyzed. Results The expression of COX-2,VEGF-C in pancreatic cancer tissues were 70.0%(28/40)and 67.5%(27/40),respectively,which were significantly higher than that in paracancerous tissues(42.5%,17/40)and(35.0%,14/40),and that in normal pancreas(8.3%,1/12)and(25.0%,3/12).The LVD in pancreatic cancerous,paracancerous and normal pancreatic tissues were 4.75±2.77,15.2 ±4.70 and 1.67±1.15,respectively.The expression of COX-2 in cancerous tissues and LVD in paracancerous tissues was correlated with tumor differentiation and lymph metastasis;the expression of VEGF-C Was correlated with lymph metastasis.LVD in paracancerous tissues was correlated with the expression of COX-2 and VEGF-C.Conclusions Pancreatic cancer lymphangiogenesis mainly existed in paracancerous tissues,COX-2 and VEGF-C may play an important role in the lymphangiogenesis.

Objective To evaluate the value of the Bedside Index for Severity in Acute Pancreatitis (BISAP) in diagnosing severe acute pancreatitis. Methods Sixty-eight patients with suspected diagnosis of severe acute pancreatitis were collected and were scored by BISAP, APACHE Ⅱ , Ranson and CTSI scoring systems, respectively. BISAP scoring system included the blood urea nitrogen, impaired mental status,systemic inflammatory response syndrome, age, and pleural effusion. The diagnosis criteria of severe acute pancreatitis was BISAP ≥ 3 points or APACHE IⅡ ≥ 8 points, Ranson ≥ 3 points, CTSI ≥ 3 points. The diagnostic accuracy of SAP of these scoring systems was calculated. Results Among these 68 cases, 63.2％(43/68) were graded ≥ 3 points in BISAP scoring system;60.3％ (41/68) were marked ≥8 points in APACHE Ⅱ scoring system; 60.3％ (41/68) were scored ≥ 3 points in Ranson scoring system; and 67.6％(46/68) were scored ≥3 points in CTSI scoring system. There was no statistical difference between BISAP scoring system and other three scoring systems in diagnosing severe acute pancreatitis. Conclusions As a new and simple scoring system, BISAP scoring system can be widely used in the diagnosis of severe acute pancreatitis.

Objective To investigate the blood fatty levels in different genotypes of matrix metalloproteinases (MMP) and the carotid atherosclerosis (CAS) in patients with essential hypertension (EH).Methods Four hundred and eighty-eight cases of Han and Uygur in patients with EH were selected,and MMP-2-735 C/T and MMP-3-1171 5A/6A polymorphism was measured by polymerase chain reactionrestriction fragment length polymorphism.They were divided into two groups:EH with CAS group (CAS group,293 cases,Han 171 cases,Uygur 122 cases) and EH without CAS group (NS group,195 cases,Han 105 cases,Uygur 90 cases).Blood fatty factors were analyzed according to the different MMP genotypes.Results According to MMP-2 genotypes,in Hart CAS group,the low density lipoprotein cholesterol (LDL-C) levels in MMP-2 CT+TT genotypes were significantly higher than those in CC genotype(P ＜ 0.05),and high density lipoprotein cholesterol levels were significantly lower than those in CC genotype(P ＜ 0.05); In Uygur CAS group,the triglyceride levels in MMP-2 CT+TT genotypes were significantly higher than those in CC genotype(P ＜ 0.05).According to MMP-3 genotypes in Han NS group,the total cholesterol and LDL-C levels in 6A/6A genotype were significantly higher than those in 5A/5A+5A/6A genotypes (P ＜ 0.05).Conclusion The blood fatty levels are different in patients with different MMP genotypes,which may probably influence the CAS.

Objective To investigate the expression of BAMBI in pancreatic carcinoma tissue and its clinical value.Methods Expression of BAMBI was detected by immunohistochemistry in 69 cases of pancreatic cancer and 15 normal pancreatic samples.The survival and its association with clinicopathologic parameters were analyzed.Results The expression of BAMBI in the cancer tissue was much higher than that in the normal tissues (56.5％ vs 16.7％,P ＜0.01).The expression of BAMBI was not associated with age,sex and tumor size,differentiation,but expression of BAMBI in patient with lymph node metastasis was higher than that in patient without lymph node metastasis (67.4％ vs 38.5％,P =0.019),the expression of BAMBI in TNM stage Ⅲ was higher than that in stage Ⅰ + Ⅱ (75.0％ vs 31.0％,P =0.001).The median survival of BAMBI-positive group (6 months) was lower than that of BAMBI-negative group (10 months).Conclusions BAMBI is over-expressed in pancreatic carcinoma,and its expression is associated with lymph node metastasis,TNM staging,differentiation and prognosis.

Objective To explore the effect of support with total parenteral nutrition(TPN)or early enteral and parenteral nutrition(EN+PN)on immune function of critically ill neurosurgical patients.Methods In this prospective control study,patients were divided inte TPN group and EN+PN group based on the timing of admission.The changes of immunological indicators including CD3,CD4,CD8,CD4/CD8,CD3/CD25,IgA,IgG,IgM,and serum protein before and after nutritional support were compared.Results The percentage of T lymphocyte subsets CD3,CD4,and CD8,the ratio of CD3+/CD25+,the plasma leveh of IgA,IgM,and IgG,and the serum protein were significantly increased after nutrifional supports(P<0.05,P<0.01).However,compared with the TPN group,the percentages of T lymphocyte subsets(CD3,CD4,and CD8),the ratio of CD4+/CD8+,the plasma levels of IgA,IgM,and IgG,and the serum protein were significantly higher in EN+PN group(P<0.05,P<0.01).Conclusions Both TPN and EN+PN can promote the recovery of immune function,while EN+PN is superior to TPN.Early nutritional support should be provided to critically ill neurosurgical patients.