NO含量用于评价瓷融附金属修复后牙龈改变的研究

目的：研究NO含量用于评价瓷融附金属（PFM）修复后牙龈组织的病理改变，为PFM修复适应症的选择提供依据。方法：选取PFM修复后局部牙龈增生需行牙龈切除术的19例患者的牙龈组织为实验组，另取10例因正畸需要行拔牙术发生牙龈撕裂的健康牙龈组织为对照组，利用透射电子显微镜和NO含量测定法进行对比分析。结果：电镜下PFM修复后的牙龈组织出现炎性细胞浸润和细胞变性、坏死改变，且NO含量随PFM修复时间的延长而增加。结论：PFM修复后牙龈组织存在明显的炎症反应，且与修复时间呈正相关，NO含量检测技术对评价PFM修复后牙龈组织的病理改变具有良好的准确性、可重复性和对不同人群之间的分辨能力，值得推广应用。     

不同金属烤瓷冠修复患者龈沟液中IL-6浓度测定及Ni 离子对牙龈的影响

目的：通过龈沟液(GCF)中白细胞介素6(IL-6)浓度的测定,评价不同金属烤瓷冠(PFM)对牙龈组织的刺激性。 方法：欲行PFM修复的牙列缺失患者60例分别采用镍铬合金、镍铬合金镀金及金合金进行修复,每组20例,以修复对侧同名牙或对牙合同名牙为各自对照组。PFM修复6个月后,采集并定量GCF,采用酶联免疫吸附法测定GCF中IL-6的浓度。结果：金合金组GCF分泌量与对照组比较差异无显著性（P>0.05）;镍铬合金镀金组及镍铬合金组GCF分泌量显著高于金合金组及对照组（P<0.05）,而镍铬合金镀金组与镍铬合金组比较差异无显著性（P>0.05）。金合金组、镍铬合金镀金组GCF中IL-6浓度与对照组比较差异无显著性（P>0.05）,镍铬合金组GCF中IL-6浓度显著高于对照组（P<0.05）;金合金、镍铬合金镀金组GCF中IL-6浓度显著低于镍铬合金组（P<0.05）,而金合金与镍铬合金镀金组比较差异无显著性（P>0.05）。结论：含镍金属对牙龈刺激最大,金合金烤瓷冠对牙龈组织刺激性最小,GCF中IL-6的浓度可以作为监测PFM修复效果的理论指标。     

丙交酯/乙交酯共聚材料支架的输尿管原位组织相容性

目的：探讨可生物降解材料丙交酯/乙交酯共聚物（PLGA 80∶20）支架的输尿管原位组织相 容性。方法：16只雄性家犬左侧输尿管施以离断吻合术后随机分为2组：实验组（n=8）将PLGA支架植于输尿管吻合局部支撑引流,对照组（n=8）植入UROVISION支架,分别于术后2、4、8及12周取2只犬术侧输尿管行组织病理学切片检查,采用Lumiaho评分法进行组织学反应评价。结果：实验组PLGA材料在植入12周内完全降解,输尿管腔内无材料碎片残留;支架植入2～4周,术侧输尿管局部见移行上皮过度增生、固有层炎症细胞浸润;支架植入8～12周,随PLGA材料降解,术侧输尿管壁炎症消退,仅见极轻微的移行上皮增生。对照组早期病理表现与实验组相似,但局部炎症反应随植入时间延长而逐渐加重,术后12周时输尿管移行上皮增生、固有层炎细胞浸润及组织充血、水肿等反应比实验组明显（P<0.05）。结论：PLGA材料支架植入犬输尿管后发生的输尿管炎症反应是可恢复的,PLGA材料具有很好的组织相容性,是加工可生物降解输尿管支架的理想材料。     

兔下颌前牙即刻种植后种植体周围炎动物模型的构建

目的：构建兔下颌前牙即刻种植后种植体周围炎动物模型。方法：选取12只健康雄性新西兰大白兔,麻醉后拔除兔下颌左侧前牙,在拔牙窝中即刻植入锥柱状纯钛种植体。待种植体植入8周后,随机选择3只实验兔处死,采用Micro-CT观察种植体骨结合状况。剩余实验兔随机分为3组：空白组不加刺激,对照组种植体周围注射磷酸盐缓冲溶液,实验组注射细菌内毒素溶液。加刺激2周后处死实验动物,取含种植体的下颌骨标本,采用Micro-CT观测骨量;取种植体周围牙龈标本,采用HE染色,观察牙龈组织病理学改变。结果：即刻种植8周后,种植体骨结合良好,牙龈健康。加刺激2周后,空白组和对照组牙龈健康呈粉红色,质地坚韧,种植体骨结合良好,种植体顶部骨组织无明显吸收,牙龈组织中见散在炎症细胞;实验组牙龈红肿,质地软,种植体顶部牙槽骨明显吸收,骨密度和骨体积分数显著降低,牙龈组织中见大量炎症细胞弥散性浸润。结论：种植体周围局部注射细菌内毒素可快速构建兔种植体周围炎原位动物模型。     

金属烤瓷修复体毗邻变芭牙龈的超微分析

目的：研究金属烤瓷修复体毗邻变色牙龈组织的超微结构变化,探究牙龈变色的病理生理过程。方法：以金属烤瓷修复6个月以上变色的牙龈组织为实验组,慢性牙龈炎组织为对照组,对其进行超微结构观察和X-ray能级分析。结果：透射电镜下观察到组织中炎症细胞浸润,吞噬细胞增多,其细胞器发生改变及凋亡的早期表现。能级分析未发现镍铬含量异常。结论：金属烤瓷修复体毗邻变色牙龈中存在病理改变及细胞凋亡现象。     

镍铬烤瓷冠修复后牙龈及龈沟液中镍和铬含量的变化

目的:探讨镍铬烤瓷冠修复后牙龈组织和龈沟液中镍和铬含量的变化,为修复材料的选择提供参考.方法:选择镍铬烤瓷修复后牙龈增生并需行牙龈修整术者作为实验组,需要拔除第三磨牙且口内无任何修复体者为对照组,使用Whatman 3号滤纸汲取龈沟液并切取牙龈,运用电感耦合等离子体质谱法测量牙龈组织及龈沟液中镍和铬的含量.结果:实验组...     

同种异体兔骨髓间充质干细胞复合纳米晶胶原基骨修复胫骨缺损的实验研究

目的探讨同种异体兔骨髓间充质干细胞（marrow mensenchymal stem cells，MSCs）与纳米晶胶原基骨（nano—hydroxyapatite／collagen，NHAC）修复材料构建的组织工程骨修复兔胫骨缺损的可行性。方法24只新西兰大白兔胫骨中段形成10mm长的骨缺损，右侧骨缺损处植入组织工程骨作为实验组，左侧骨缺损处植入单纯NHAC作为对照组。术后3、6、9、12wk分批处死动物，行一般情况、缺损区大体观察、X线、组织学染色分析等指标检测，行统计学分析，比较各组修复骨缺损的效果。结果24只新西兰大白兔均进入结果分析。①术后一般情况：各组兔术后恢复及进食均正常，伤口无炎症反应，愈合良好。②大体观察：实验组术后6wk骨缺损部分修复，9、12wk骨缺损完全修复，3、6、9、12wk骨缺损修复情况明显好于对照组。③X线：实验组缺损区术后3wk可见有骨痂生长，9wk骨缺损基本修复，对照组术后12wk缺损区基本修复，各观察时间点实验组骨缺损修复情况明显好于对照组。④组织学染色：实验组缺损区新生类骨样组织、编织骨和板状骨出现的时间较对照组早，并且不经软骨介导即可直接成骨，而对照组以“爬行替代”方式修复骨缺损。结论同种异体兔MSCs复合NHAC修复骨缺损的能力较单纯NHAC强且迅速，能够对大段骨缺损进行快速有效的修复。     

全瓷牙在前牙美容修复中的疗效分析

目的：探讨全瓷牙在前牙美容修复中的临床效果。方法选取前牙美容修复患者72例,随机分为对照组（n=43）和实验组（n=29）。对照组行钴铬烤瓷修复,实验组行全瓷修复,比较2组患者的牙周情况及对美观的满意度。结果实验组牙龈色泽（变深,0.00%）、牙龈指数（1级以上,3.45%）明显低于对照组牙龈色泽（变深,41.86%）、牙龈指数（1级以上,30.23%）,差异有统计学意义(P<0.05)。实验组整体美观（92.47±24.11）、修复体色泽（97.83±29.86）、修复体外形（96.53±24.03）明显高于对照组整体美观（84.34±26.13）、修复体色泽（88.34±28.76）、修复体外形（89.06±24.92）,差异有统计学意义(P<0.05)。结论全瓷牙在前牙修复治疗中,有良好的修复效果,值得临床推广应用。     

M1型巨噬细胞相关因子在重度慢性牙周炎患者牙龈组织中的表达及其意义

目的：探讨M1型巨噬细胞相关因子诱导型一氧化氮合酶（iNOS）和信号传导及转录激活因子1（STAT1）在重度慢性牙周炎患者牙龈组织中的表达情况,阐明M1型巨噬细胞在慢性牙周炎发生发展中的可能作用。方法：选择15例重度慢性牙周炎患者的病损牙龈组织作为实验组,15例需要拔除第三磨牙患者的健康牙龈组织作为对照组。采用RT-PCR法检测2组患者牙龈组织中iNOS和STAT1 mRNA表达水平,Western blotting法检测2组患者牙龈组织中iNOS和STAT1蛋白表达水平。结果：与对照组比较,实验组患者牙龈组织中iNOS和STAT1 mRNA表达水平明显升高（P<0.01）;与对照组比较,实验组患者牙龈组织中iNOS和STAT1蛋白表达水平明显升高（P<0.01）。结论：在重度慢性牙周炎中M1型巨噬细胞介导的免疫应答增强,表明M1型巨噬细胞参与牙周组织的炎症反应和组织损伤。     

根向复位瓣在牙冠延长术中的临床应用

目的：评价根向复位瓣在牙冠延长术后的近期临床疗效。方法：对15例19颗需行牙冠延长术而附着龈宽度不足的患者行根向复位瓣术，观察术后1～6周临床效果。观察指标：①牙龈的色、形、质及断缘暴露是否良好；②茵斑指数（PLI）、出血指数（BI）和松动度（MD）；③牙龈缘的位置与相邻牙龈缘的位置关系（唇颊侧）及牙龈乳头的术后恢复情况；④附着龈宽度的变化。结果：患牙主观感觉良好，牙龈无炎症，牙龈缘高度与邻牙基本协调，术后断缘均暴露于龈上，有利于冠修复。结论：根向复位瓣术的实施，有利于断缘位于龈下方而生物学宽度及附着龈宽度不足的牙齿保存和修复。     

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…