两种粘结系统处理牙本质后的磨片观察

[目的] 比较正常牙本质和硬化性牙本质经全酸蚀或自酸蚀粘结处理后的混合层情况.[方法] 选择2008年1月～2008年3月在大连医科大学附属第一医院口腔颌面外科因牙周病须拔除患牙6例患者的后磨牙6颗,颌面具有典型硬化性牙本质,另选择因正畸减数须拔除前磨牙3例患者的6颗前磨牙,根尖孔已形成.每颗牙分成两部分,一部分应用3 M Single Bond全酸蚀系统处理牙本质,另一部分应用SE BOND自酸蚀粘结系统处理牙本质.所有样本树脂包埋,磨片,染色,观察.[结果] 两种粘结系统对正常牙本质与硬化性牙本质处理后混合层均清晰,厚度较均匀,部分切片混合层牙本质侧可见凸凹不平的树脂突.[结论] 3M Single Bond全酸蚀系统处理正常牙本质获得的混合层与硬化性牙本质获得的混合层无明显差别.SE BOND自酸蚀粘结系统处理正常牙本质获得的混合层与硬化性牙本质获得的混合层无明显差别.     

一种新型通用型牙本质粘结剂对牙本质粘结强度的体外评价

目的:评价一种新型通用型牙本质粘结剂(All Bond Universal,ABU)对牙本质的粘结强度,为临床选择合适的粘结剂提供参考依据。方法:选取人体12颗无龋坏磨牙,磨除牙釉质暴露牙本质面,分别用酸蚀-冲洗法和一步自酸蚀法使用All Bond Universal粘结剂,在其上堆砌树脂,并与酸蚀-冲洗粘结剂Prime&Bond NT(PBN)和一步法自酸蚀粘结剂G Bond(GB)进行对照。试样于37℃去离子水储存24 h后,每颗牙齿垂直于粘结面制备出0.81 mm2的树脂/牙本质试件,进行牙本质粘结微拉伸强度(μTBS)测试。结果:通用型牙本质粘结剂All Bond Universal在两种粘结方法下,其粘结力均高于对照组;就All Bond Universal本身而言,酸蚀-冲洗技术可以提高其粘结强度。结论:这种新型牙本质粘结剂具有较高的粘结强度,并且酸蚀-冲洗技术能提高其粘结力。     

全酸蚀粘结技术治疗龋病的临床实验研究

目的 使用全酸蚀粘结技术治疗龋病,选取术后1月内出现冷热刺激痛症状的患牙8颗,通过实验观察牙本质粘结面情况,试图查找牙齿敏感出现的原因以指导正确治疗.方法 在征得患者同意的情况下,临床选取48颗阻生或无对颌智齿,均患龋病达牙本质浅层,制备洞形后使用30%磷酸酸蚀剂酸蚀龋洞壁,充分冲洗龋洞表面后涂布Single Bond(3M),按使用说明充填Filtek Z350前后牙通用型纳米树脂材料.选取术后1月内出现牙齿敏感症的患牙共8例为实验组,另随机选取临床症状正常患牙8例为对照组进行拔除,在扫描电镜下观察牙本质粘结界面的微观形态.结果 出现牙齿敏感症患牙的粘结界面局部区域树脂突未从表面树脂层渗入到下层未脱矿牙本质层中,或局部区域树脂突上未观察到明显侧枝.结论 使用全酸蚀粘结技术治疗龋病造成术后牙齿敏感症出现的原因是树脂深入牙本质不完全,在脱矿牙本质中出现未渗入区域.     

三种粘结系统与牙本质的粘结强度的比较

目的:对比3种不同粘结系统与牙本质之间的粘结强度。方法:选用两步法自酸蚀粘结系统Fluoro-Bond、一步法自酸蚀粘结系统iBond,全酸蚀粘结系统Single bond,按照厂家推荐步骤应用于湿润的样本牙本质表面,用树脂z-350(3M公司)修复至同一高度,测量每个样本粘结面的实际面积,通过微拉伸实验,计算各个样本的微拉伸粘结强度。结果:iBond组的微拉伸粘结强度低于Fluoro-Bond组和SingleBond组,差异有统计学意义(P<0.05),后两者差异无统计学意义(P>0.05)。结论:自酸蚀两步法粘结系统的粘结强度与全酸蚀粘结系统相当,但均高于自酸蚀一步法粘结系统。     

IDS与DDS技术粘结树脂嵌体的微拉伸强度研究

目的评价即刻牙本质封闭（IDS）技术粘结树脂嵌体的微拉伸强度。方法选择新鲜拔除的无龋下颌第3磨牙24颗,随机分为3组,制备近远中临舍面（MOD）嵌体,其中两组分别采用IDS技术及延时牙本质封闭（DDS）技术粘结树脂嵌体。另一组设为对照组,直接酸蚀,树脂修复。所有试件水浴1个月后制备微拉伸试件,测试微拉伸强度并做统计分析。结果采用IDS技术粘结树脂嵌体与直接树脂修复的试件微拉伸强度无差别,而采用DDS技术粘结树脂嵌体的试件微拉伸强度明显低于以上技术方法。结论IDS技术粘结树脂嵌体可获得与直接树脂修复牙体缺损相同的微拉伸强度,明显优于DDS技术粘结树脂嵌体。     

不同粘结条件下健康成人牙本质中MMP-2和MMP-9表达水平及其意义

目的：探讨不同粘结条件下健康成人牙本质中基质金属蛋白酶2（MMP-2）和基质金属蛋白酶9（MMP-9）表达水平,为临床应用基质金属蛋白酶（MMPs）抑制剂提高粘结效果提供依据。方法：收集20颗成人新鲜离体磨牙,液氮冷却条件下将其研磨为牙本质粉;模拟口内条件,对牙本质分别进行自酸蚀粘结（Single Bond Universal）和全酸蚀粘结（35%磷酸凝胶+Adpter Single Bond 2）处理,以不进行任何处理的牙本质作为阴性对照组,10%磷酸溶液（自酸蚀粘结）或10%磷酸溶液+35%磷酸凝胶处理的脱矿牙本质粉（全酸蚀粘结）处理的牙本质作为阳性对照组,只进行Single Bond Universal （自酸蚀粘结）处理和35%磷酸凝胶+Adpter Single Bone2（全酸蚀粘结）处理的牙本质作为空白对照组;在粘结过程中分别使用MMPs抑制剂氯己定（CHX）和米诺环素（MI）预处理,作为CHX预处理组和MI预处理组;采用10%次氯酸钠进行牙本质老化,作为老化组,并在老化组基础上加入CHX和MI作为CHX预处理老化组和MI预处理老化组。采用明胶酶谱法进行聚丙烯酰胺凝胶电泳,孵育染色脱色后,采用凝胶图像分析系统分析条带,计算各组牙本质中MMP-2和MMP-9表达水平。结果：在自酸蚀粘结条件下,与空白对照组比较,CHX预处理组牙本质中MMP-2和MMP-9表达水平降低（P<0.05）,MI预处理组牙本质中MMP-2和MMP-9表达水平降低（P<0.05）;与空白老化对照组比较,CHX预处理老化组牙本质中MMP-2和MMP-9表达水平降低（P<0.05）,MI预处理老化组牙本质中MMP-2和MMP-9表达水平降低（P<0.05）。在全酸蚀粘结条件下,与空白对照组比较,CHX预处理组和MI预处理组牙本质中MMP-2表达水平降低（P<0.05）;与空白老化对照组比较,CHX预处理老化组与MI预处理老化组牙本质中MMP-2表达水平降低（P<0.05）。结论：在牙本质粘结过程中,CHX和MI能够通过降低MMP-2和MMP-9表达水平减缓酶解反应,从而增强粘结强度。     

不同类型牙本质与全酸蚀和自酸蚀粘接系统粘接强度的比较

目的:比较不同类型牙本质与全酸蚀和自酸蚀牙本质粘接系统的粘接强度,从而指导临床选择。方法:选择临床常见3种牙本质:正常牙本质(ND)、龋病影响牙本质(CAD)、颈部非龋性硬化牙本质(CSD);两种全酸蚀系统:All-Bond2、Single Bond和两种自酸蚀系统:Fluoro Bond、XenoⅢ,用微拉伸法测试粘接强度。在体视显微镜下观察断裂界面。结果:牙本质类型和粘接系统对粘接强度都有显著影响。不同牙本质上的微拉伸强度有显著差异(P<0.05);SD上全酸蚀和自酸蚀系统的微拉伸强度差异无显著性,XenoⅢ在CAD上的粘接强度较低,CSD中All-Bond2粘接强度较高;体视显微镜下观察断裂多发生在粘接树脂-牙本质界面。结论:不同类型牙本质与全酸蚀和自酸蚀粘接系统粘接强度不同,临床上应根据不同的牙本质类型及实际情况选择合适的粘接系统。     

同向施压测定自酸蚀与全酸蚀粘接系统粘接强度

目的：比较自酸蚀和全酸蚀粘结系统对牙釉质的剪切粘结强度,为临床选择粘结术式提供依据。方法：取近期拔除人上中切牙10颗,轴向纵切,一分为二,分别进入实验组和对照组。一组用Single Bond^TM 2粘结Filtek^TM Z250树脂;另一组用SE Bond粘结Filtek^TM Z250树脂。所有试件按自切端向颈部施压法测定剪切粘结强度。结果：Single Bond^TM 2对牙釉质的剪切粘结强度大于SE Bond,二者的差异有统计学意义（P＜0.01）。结论：全酸蚀粘结系统对牙釉质的粘结剪切强度大于自酸蚀系统,临床上对牙釉质的粘结应选择全酸蚀技术,采用自切端向颈部的方向施压的原则测定试件的剪切粘结强度更具有科学性。     

牙本质的位置对粘接效果的影响

目的:通过对两步法自酸蚀粘接剂(Clearfil SE Bond)的微拉伸强度及断裂模式分析牙本质的位置对粘接效果的影响。方法:选取60颗新鲜拔除人无龋坏第三磨牙,去掉牙冠,Clearfil SE Bond处理粘接界面,复合树脂堆塑,将粘接好的牙齿标本在实验切片机上垂直于粘接面切成大约1.0mm×1.0mm的粘接试件,试件分成中心牙本质组和外周牙本质组,分别冷热循环0次,2 500次,5 000次,10 000次进行老化后,万能材料试验机测量进行微拉伸计算粘接强度,并对断裂模式进行分析。结果:外周牙本质组的粘接强度均高于中心牙本质组(P<0.05)。结论:对于两步法自酸蚀粘接剂来说,牙本质的位置对粘接效果有明显影响。     

Er:YAG 激光和酸蚀预处理对自粘结树脂水门汀粘结强度的影响

目的:探讨Er:YAG 激光和酸蚀预处理对自粘结树脂水门汀粘结强度的影响?方法:44颗前磨牙根据对牙本质表面预处理方式的不同随机分为4组:对照组?Er:YAG 激光组?酸蚀组(35%磷酸)?Er:YAG 激光+酸蚀组?每组11颗牙中随机选出1颗切取3 mm厚牙本质片,按相应分组要求预处理后进行扫描电镜观察;每组剩余10颗牙制备一致标准牙本质表面后按相应分组要求预处理,用自粘结树脂水门汀RelyXTM Unicem将其与Everest ZS 氧化锆瓷片粘结,24 h后测试各组剪切粘结强度并进行统计分析?结果:扫描电镜观察显示采用不同方式预处理后,牙本质表面形态改变明显;统计分析结果显示剪切粘结强度由高到低为Er:YAG 激光组(7.18 ± 2.54)MPa?Er:YAG 激光+酸蚀组(5.50 ± 2.09)MPa?对照组(4.05 ± 1.04)MPa?酸蚀组(3.61 ± 0.70)MPa;Er:YAG 激光组?Er:YAG 激光+酸蚀组与对照组有显著性差异(P < 0.05),酸蚀组与对照组无显著性差异(P > 0.05)?结论:酸蚀对自粘结树脂粘结强度的改变无明显影响,Er:YAG 激光预处理能有效提高自粘结树脂与牙本质和氧化锆瓷的粘结强度?     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…