对内科治疗无效慢性胃炎的临床探讨

目的探讨内科治疗无效慢性胃炎的临床特征及有效治疗方案。方法将64例内科治疗无效的慢性胃炎设定为研究组与48例内科治疗有效的慢性胃炎设定为对照组,并对两组进行EPQ、HAMD、HAMA分值、治疗6周时IL-6、TNF—α测定对照,抑郁、焦虑分值与慢性胃炎症状严重度相关分析。同时再将研究组随机分为A、B两组,每组各32例,A组给予抗抑郁抗焦虑治疗,B组给予抗抑郁抗焦虑药物联合非典型抗精神病药物治疗。对A、B两组治疗前后进行SCL-90测定。结果研究组存在明显的神经质性人格,多为内向不稳定型,并伴有明显的焦虑抑郁情绪,抑郁焦虑分值与慢性胃炎症状的严重度呈正相关（r=0．59,F=54．98;r=0．86,F=339．98）,治疗6周时两组IL-6、TNF—α比较具有显著差异,A、B两组治疗前后SCL-90的躯体化、焦虑、抑郁、恐怖因子分自身对照均有显著性差异,但两组比较则无显著差异。A组治疗前后偏执因子分无显著差异,而B组比较则有显著差异（2．24±0．81,1．15±0．61）。结论慢性胃炎的症状与人格、抑郁焦虑情绪、免疫功能密切相关,抗抑郁抗焦虑药物及其联合非典型抗精神病药物治疗均可改善慢性胃炎症状,但后者可改变患者的优势观念。     

Effects of Calcium Hydroxide Paste in Different Vehicles on Bacterial Reduction during Treatment of Teeth with Apical Periodontitis

IntroductionThis clinical study evaluated the antibacterial effects of calcium hydroxide associated with different vehicles during the treatment of infected teeth with apical periodontitis.MethodsBacteriologic samples were taken from 90 necrotic root canals of teeth with apical periodontitis before (S1) and after preparation with a rotary nickel-titanium instrument system and 2.5% sodium hypochlorite irrigation (S2). The teeth were distributed in 3 groups according to the intracanal medication used, which consisted of a calcium hydroxide paste in glycerin, camphorated paramonochlorophenol/glycerin (CHPG), or 2% chlorhexidine for 1 week, and then another sample was taken (S3). The frequency of bacteria-positive cases and the reduction of bacterial counts were evaluated by quantitative real-time polymerase chain reaction.ResultsSubstantial intracanal bacterial reduction was observed after preparation in the 3 groups (P < .001). After calcium hydroxide paste in glycerin medication, the number of bacteria-positive cases decreased from 20/29 (69%) to 17/29 (59%); however, the mean bacterial counts increased 8.4% from S2 to S3. Medication with CHPG reduced the number of bacteria-positive cases from 17/29 (59%) to 15/29 (52%), with a significant mean S2–S3 reduction of 71% (P < .05). In the chlorhexidine group, the number of bacteria-positive cases decreased from 21/30 (70%) to 17/30 (57%) after medication, with a mean S2–S3 reduction of 55%, which, however, was not statistically significant (P > .05). Intergroup comparisons showed no significant differences (P > .05).ConclusionComparison between the 3 calcium hydroxide pastes showed no significant differences in antibacterial effectiveness in the main root canal. However, only the CHPG paste showed a significant reduction in bacterial counts when postpreparation and postmedication samples were compared.     

Effectiveness of propolis and calcium hydroxide as a short‐term intracanal medicament against Enterococcus faecalis: A laboratory study

The aim of this study was to investigate the antimicrobial activity of propolis‐based intracanal medicament against Enterococcus faecalis using infected dentine models, and to compare its antimicrobial efficacy with that of the non‐setting calcium hydroxide paste when used as a short‐term medication for 1 and 2 days. A total of 50 dentine discs of 7‐mm length was obtained from extracted human teeth. Five dentine discs were kept sterile to serve as a negative control. The remaining 45 were contaminated with E. faecalis and divided into two groups (n = 20) in addition to five discs that served as a positive control. The discs were treated as follow: 20 discs were filled with propolis, while the other 20 discs were filled with non‐setting calcium hydroxide. Microbiological sampling was performed utilising sterile paper point, headstrom file and disc immersion. Results showed that propolis was significantly more effective than non‐setting calcium hydroxide against E. faecalis after short‐term application, which made comparison from this prospect unlevelled. The most effective microbiological sampling technique was abrading the lumen with headstrom file. Propolis is very effective as intracanal medicament in rapidly eliminating E. faecalis ex vivo.     

对氢氧化钙根管消毒作用的再认识

氢氧化钙是临床上常用的根管消毒药物之一,其消毒效果得到广泛认同.但近年来的研究表明,氢氧化钙的抗菌作用并非全能,特别是对于一些难治性根尖周病的病原菌抗菌效果不佳,其药物剂型和临床操作也存在着一定的局限性.本文就氢氧化钙的抗菌作用、临床操作等作一综述.     

尼泊金乙酯与其它抗角膜常见致病真菌药物的抑菌对比实验研究

通过实验研究,表明尼泊金乙酯是一种抗角膜常见致病性真菌的扰菌剂,与其它药物对比,抗真菌作用强,抑菌谱广。经动物实验及临床观察无副作用,且疗效较满意。此药药源广,价低廉,因此可作为治疗真菌性角膜溃疡病的首选药物。     

药物渗透治疗仪治疗重度冻伤对血液的影响

目的：观察低频超声药物渗透治疗仪(简称治疗仪)治疗兔足重度冻伤对血液有形成分的影响，探讨重度冻伤的治疗机理。方法：制备兔足重度冻伤模型，采用治疗仪治疗，于冻前和冻后24h、48h、72h，1W、2W、3W、4W、6W分别采血，进行血液有形成分8项指标的测定。结果：经治疗仪或治疗仪综合治疗，WBC数量分别于冻后2W或1W达正常水平，RBC数量、HCT分别于冻后2W或48h恢复正常，PLT数量分别于冻后72h或48h恢复正常。结论：治疗仪和治疗仪综合疗法可明显地改善血液循环，有效抗感染，促进冻伤病理改变的恢复，治疗仪综合疗法的效果更好。     

药物利用研究与合理用药

药物是治病防病的重要物质。药物的合理利用与人们的健康水平密切相关，也是医院现代化管理的重要组成部分。药物利用研究是解决合理用药的有力工具之一，目的在于建立用药的合理性、安全性和有效性的质量保证体系。近年来，药物利用研究在医院逐步展开，它是医院了解药品使用规律的重要手段之一。本文阐述了药物利用的概念、发展、作用及意义，合理用药的现代涵义。论证了医院开展药物利用研究是合理用药的根本，是医院可持续发展的保障。     

Effect of electrophoretically activated calcium hydroxide on bacterial viability in dentinal tubules –in vitro

Abstract –  To evaluate the ability of electrophoretically activated calcium hydroxide (CH) to eliminate bacteria in dentinal tubules. In an in vitro model of dentinal tubule infection, 18 cylindrical root specimens prepared from freshly extracted bovine teeth were used. After removal of the smear layer, intracanal dentinal tubules were infected with Enterococcus faecalis for 21 days. In 12 specimens, CH paste was placed in the root canals for 7 days. In six of these, an electrophoretic current (10 mA per 10 min), using two electrodes, was applied after placing the medicament in the canal. Powder dentin samples obtained from within the canal lumina using ISO 025, 027, 029, 031 and 033 burs were examined for the presence of vital bacteria by inoculating agar plates and counting colony forming units. anova with repeated measures was used to analyze results. A significant difference was found between experimental groups and the positive control group. CH and electrophoretically activated CH significantly ( P  < 0.001) reduced bacterial viabilities in dentinal tubules to a depth of 200  μ m. Treatment with electrophoresis was significantly ( P  < 0.001) more effective than pure CH in depths of 200–500  μ m. Specimens treated with electrophoretically activated CH showed no viable bacteria in dentinal tubules to a depth of 500  μ m from the root canal space within 7 days. The time required for treatment of pulpal infection root resorption may be decreased, thus minimizing the risk of coronal fractures in young patients with traumatized teeth.     

Effect of three endodontic materials on the bond strength of two composite core materials to dentin

PURPOSE: This study investigated the effect of dentin treatment with iodine potassium iodide, calcium hydroxide or a biphenol-A- diglycidylether epoxy resin sealer on the dentin bond strength of titanium-reinforced Bis-GMA and urethane dimethacrylate composite materials. MATERIALS AND METHODS: Dentin was exposed in four groups of extracted teeth (20 specimens each). Three groups were treated with one of the contaminants and the fourth group was left uncovered and served as the control group. All specimens were stored for 1 week at 37 degrees C and 100% humidity. The dentin surfaces were cleaned with pumice slurry using a prophylaxis rubber cup, rinsed and dried. Then the dentin surfaces were treated using the conditioner and the primer of the GLUMA adhesive system followed by placement of composite core materials. After 20 minutes, debonding of the core materials was accomplished using a shear-peel test. A two-way analysis of variance and Tukey's multiple range test was performed based upon core type and contaminant type (alpha = 0.05). RESULTS: Titanium-reinforced Bis-GMA composite showed significantly greater bond strength values than the urethane dimethacrylate composite material (p < 0.0001). The mean bond strength values in megapascals for the Bis-GMA resin ranged from 8.47 +/-1.52 for the calcium hydroxide group to 9.81 +/-0.94 for the control group. Mean bond strengths for the urethane dimethacrylate resin ranged from 3.35 +/-0.90 for calcium hydroxide to 3.99 +/-0.88 for iodine potassium iodide groups. Within each core group, no difference in bond strengths were noted compared to the uncontaminated control. CONCLUSION: Pretreatment of the dentin with iodine potassium iodide, calcium hydroxide, or epoxy resin followed by pumicing and using the GLUMA system conditioner and primer had no effect on the bond strength of the two resin composite core materials. However, the titanium reinforced Bis-GMA composite exhibited significantly greater bond strength to dentin than the urethane dimethacrylate based composite.