米诺环素治疗急性智齿冠周炎的临床疗效研究

目的观察米诺环素(派力奥)对急性智齿冠周炎的临床治疗效果。方法选择下颌第三磨牙发生冠周炎的患者80例,随机分为治疗组和对照组各40例。治疗组在进行常规盲袋冲洗后以米诺环素糊剂置入盲袋内,观察临床效果;对照组仅进行常规冲洗,局部涂布3%碘甘油。结果与对照组比较,治疗组患者冠周疼痛和肿胀的消退时间明显缩短(P<0.05)。结论应用米诺环素治疗急性冠周炎具有明显效果。     

中西医结合治疗男性不育合并支原体感染的疗效观察

目的观察不同治疗方案治疗男性不育合并支原体感染的疗效,为临床工作提供参考。方法选取我院就诊男性不育合并支原体感染患者392例,随机分为对照组和观察组,每组各196例。全部患者均给予阿奇霉素21d治疗,口服维生素E、叶酸。此外,对照组给予口服乙酰半胱氨酸;观察组给予口服复方玄驹胶囊、前列通瘀胶囊。30d为1个疗程,连续治疗3个疗程,比较两组患者临床疗效和不良反应。结果两组患者总有效率比较,差异无统计学意义(P>0.05)。两组治疗前后精子量、精子密度、精子成活率、精子畸形率比较,均有所改善,但对照组的改善效果较观察组明显(P<0.05),治疗期间两组患者不良反应发生率比较,观察组明显低于对照组,差异有统计学意义(P<0.05)。结论采用复方玄驹胶囊、前列通瘀胶囊治疗男性不育合并支原体感染,可以取得良好的临床疗效,同时不良反应较小,值得推广应用。     

酪氨酸家族激酶在大鼠脊髓背角LTP中的作用及其机制

目的: 探讨酪氨酸家族激酶(SFKs)在大鼠脊髓背角C纤维诱发电位的长时程增强(LTP)中的作用及其机制。 方法: 用在体电生理方法检测SFKs抑制剂对高频刺激坐骨神经诱导的脊髓背角LTP的影响;用Western blotting方法检测高频刺激诱导脊髓LTP的不同时点大鼠脊髓背角磷酸化SFKs的表达情况;用免疫荧光双染方法检测高频刺激诱导脊髓LTP后大鼠脊髓背角磷酸化SFKs表达的细胞学定位。 结果: SFKs的抑制剂(PP2或SU6656)可以完全阻断LTP的诱导,甚至将LTP逆转为长时程抑制(LTD);高频电刺激大鼠坐骨神经诱导脊髓LTP后15 min开始,刺激同侧的脊髓背角中磷酸化SFKs表达明显增加,并且这些高表达的磷酸化SFKs仅仅存在于脊髓小胶质细胞中。 结论: 在脊髓背角,小胶质细胞中的SFKs 是诱导LTP的必要条件,抑制SFKs及其下游分子可能有助于治疗病理性疼痛。     

Altered P-selectin and CD44 expression in the renal tissues and peripheral blood of children with IgA nephropathy

Objective  To understand the role of P-selectin (CD62P) and CD44 in mediating immune inflammation in the nephrotic process of children with IgA nephropathy (IgAN), cooperative expression of CD62P and CD44 in peripheral blood and renal tissues of IgAN children was investigated and its association with changes of histopathologic, serologic, and urinary properties was tested. Material and methods  Forty-six IgAN children were divided into three groups according to pathologic grades and clinical features. Fifteen blood samples from normal children and four normal renal biopsy specimens were used as controls. Plasma level of CD62P was detected by double antibody sandwich immunoradiometric assay; ELISA was used to determine serum level of CD44. Expression of CD62P and CD44 in renal tissues was determined by immunohistochemistry. Results  Cooperative expression of CD62P and CD44 was detected in renal tissues and peripheral blood of IgAN children. Altered expression of CD62P and CD44 in peripheral blood significantly correlated not only with hematuria, proteinuria, serum cholesterol, and albumin, and with urine NAG and β₂-MG, but also with degree of tubulointerstitial injury in IgAN children. Conclusion  The evidence supported CD62P and CD44 as initial and promoting factors mediating immune inflammation in the nephrotic process in IgAN children. The cooperative expression profiles of CD62P and CD44 in renal tissues and peripheral blood combined with serologic and urinary predictors may be important in diagnosis of progression in children with IgAN.     

微创经皮肾取石术治疗先天性异常肾合并结石

目的探讨微创经皮肾镜取石术（minimally invasive percutaneous nephrolithotomy,MPCNL）治疗先天性异常肾合并结石的疗效。方法2000年1月～2007年11月,采用MPCNL治疗异常肾合并结石41例,其中马蹄肾12例,重复肾19例,旋转肾10例。单发上盏结石4例,中盏6例,下盏7例,肾盂结石3例,重复肾上肾结石4例,多发结石12例,鹿角形结石5例。结石最大直径1.0～4.0 cm,平均2.5 cm。13例合并输尿管中上段结石同时取石。结果41例均一次穿刺成功。手术时间45～210 min,平均95 min。术中出血30～150 ml,平均80 ml。一期结石清除率85.4%（35/41）,2例马蹄肾和1例重复肾患者经二次取石取净,2例重复肾和1例旋转肾患者术后配合体外冲击波碎石治疗。1例旋转肾MPCNL术后发生较严重出血（800 ml）,经高选择性动脉栓塞后治愈,其余未见严重并发症发生。41例随访5～12个月,平均6个月,无结石复发。结论MPCNL治疗先天性异常肾合并结石安全、可靠。但仍需强调个体化的原则,根据不同异常肾的类型,结石大小、位置等情况进行操作。     

经骨折椎单节段复位固定治疗创伤性胸腰椎骨折的临床疗效

目的评价经骨折椎单节段椎弓根螺钉复位固定治疗创伤性胸腰椎骨折的临床疗效。方法采用单节段椎弓根螺钉固定治疗创伤性胸腰椎骨折132例。按AO分型,A型117例,B型8例,C型7例。通过测量骨折椎楔变指数（wI）、骨折节段矢状指数（SI）评价影像学效果,并通过Oswestry功能障碍指数评价临床疗效。结果所有患者手术顺利,手术用时平均87min,术中出血量平均136ml。随访128例,平均随访时间30．4个月（11～54个月）,全部骨性融合,除1例出现螺钉松动外,无内固定失败。术前骨折椎WI和S1分别为（42．96±11．51）％和13．06°±4．13°,术后WI和S1分别为（21．78±7．66）％和4．47°±2．28°,与术前比较差异具有统计学意义（P〈0．01）。除2例外,最后一次随访时未见明显矫正丢失（P〈0．05）。Oswestry功能障碍指数较术前获得明显改善（P〈0．05）。结论经骨折椎单节段椎弓根螺钉复位固定融合术具有创伤小、用时短、出血少、脊椎运动功能单位丢失减少等优点,可用于治疗部分创伤性胸腰椎骨折。     

Effects of dermatophagoides pteronyssinus allergen-specific immunotherapy on the serum interleukin-13 and pulmonary functions in asthmatic children

Background Airway remodeling is the specific pathological characteristics of asthma, which is related to the clinical symptoms, pulmonary function, and airway hyperreactivity. This study aimed at exploring the effects of dermatophagoides pteronyssinus allergen-specific immunotherapy （SIT） on the serum interleukin （IL）-13 and pulmonary functions in asthmatic children.
Methods Fifty-eight pediatric asthma patients allergic to dust mite participated in this study. Thirty-five children received SIT with a standardized dermatophgoides pteronyssinus extract for one year （SIT group）, and the other 23 children treated with inhaled corticosteroids （ICS group） according to the Global Initiative for Asthma （GINA） for one year. Serum levels of IL-13, IL-4 and interferon （IFN）-γ were examined and the pulmonary functions were checked before and after the treatment.
Results After the treatment, the number of emergency visiting for asthma attack in SIT group was significantly less than that in ICS group. The serum levels of IL-4 and IL-13 were clearly reduced, IFN-γ and the ratio of IFN-γ/IL-4 were significantly increased, the pulmonary functions （forced vital capacity （FVC）, forced expiratory volume in one second percentage （FEV1%） and peak expiratory flow percentage （PEF%） were significantly improved in the SIT group. Meanwhile, IFN-γ and the ratio of IFN-γ/IL-4 were greatly increased, but serum levels of IL-4 and IL-13 had less changes, the pulmonary functions （FVC, FEV1% and PEF%） were poorly improved in ICS group. The basic pulmonary functions in both groups were at the same level, which had made more improvement in SIT group than in ICS group one year later.
Conclusions One year of dermatophagoides pteronyssinus SIT can significantly reduce the frequencies of emergency visiting for asthma attack and improve the pulmonary functions of children with allergic asthma, and that is attributed to SIT, which can reduce the levels of IL-4 and IL-13 and regulate the imbalance of the Th1/Th2 cells in asthmatic children. All of these might be effective in preventing the asthmatic airway from remodeling.     

和爽在痔瘘术前肠道准备中的应用

目的：探讨和爽清洁肠道与传统灌肠方法进行肠道准备的异同。方法：100例痔瘘手术患者随机分成两组,清洁灌肠组、和爽组各50例,对两组的不良反应、术后并发症、肠腔清洁程度及肠道准备情况进行对比观察。结果：和爽组恶心、饥饿、腹部胀痛、全身乏力和肛门疼痛的发生率明显较清洁灌肠组减少,和爽组、清洁灌肠组肠腔清洁优良率分别为94.5%、92.0%,两组优良率差异无统计学意义（P〉0.05）。与清洁灌肠组比较,和爽组肠道准备时间和饮食限制时间缩短,灌洗量减少,护理程序简单,患者比较容易接受。结论：和爽是一种有效、安全、快速且易被患者接受的肠道准备方法。     

蒙脱石散治疗口腔溃疡临床观察

目的观察蒙脱石散治疗口腔溃疡的有效性与安全性。方法采用开放随机对照试验方法,以仅给常规疗法治疗作为对照组,比较研究蒙脱石散加常规疗法治疗15腔溃疡的临床疗效和安全性。结果蒙脱石散加常规疗法组的痊愈率和总有效率分别为75．5％-90．6％。而仅给常规疗法治疗组的痊愈率和总有效率分别为36．0％和68．0％。两组比较,差异均有统计学意义（均P〈0．05）。结论蒙脱石散治疗口腔溃疡,方便、安全、有效。     

上颌窦外提升及同期牙种植动物模型的建立

目的：建立一种可行上颌窦外提升及同期种植体植入的动物模型。方法：1-1.5岁的成年狗8只为实验对象,其中2只行上颌窦区解剖学观察,另6只拔除双侧上颌第一磨牙,使用上颌窦外提升法提升上颌窦,同期植入种植体及自体骨。术后3月处死动物,观察种植体的大体及新生骨的情况。结果：犬上颌窦有足够的体积行上颌窦外提升术.术后3月种植体稳固,牙槽嵴丰满,种植体顶部有新生骨形成。结论：建立犬上颌窦外提升及同期牙种植动物模型具有一定的可行性。