特殊颌关系患者种植修复的临床进展

种植义齿设计中，修复体的排列关系和咬合关系是考虑的重点。但对于上下颌关系失调的患者，种植体的位置和基台的结构常与咬合关系相抵触。本文就种植义齿修复中遇到的颌关系不调的分类及其临床处理方法作一综述。     

上颌斜面导板在增强支抗和调整咬合中的应用

目的探讨上颌斜面导板在加强下前牙支抗及治疗末期调整后牙尖窝关系中的作用。方法选择需下颌后牙前移而下前牙不能过多后移或治疗后期后牙尖窝关系不理想的患者62例,其中29例戴用上颌斜面导板加强下前牙支抗或治疗末期调整后牙尖窝关系,33例未戴用上颌斜面导板,对两组治疗前后的头颅侧位片进行测量并对组内和组间的差异进行统计学分析。结果上颌斜面导板能增强下前牙支抗,在关闭下前牙或下后牙间隙时,斜面导板阻挡下前牙,防止下前牙舌倾及后移,保证前牙覆牙合、覆盖正常。上颌斜面导板还可打开后牙咬合,使上下颌后牙脱离锁结,便于后牙前移及后牙尖窝关系的调整。结论上颌斜面导板能缩短治疗时间,使治疗效果更理想。     

Serum Ferritin and the Risk of Metabolic Syndrome: A Systematic Review and Dose-Response Meta-Analysis of Cross-sectional Studies

Objective This study aims to assess the dose-response relationship between serum ferritin (SF) and metabolic syndrome (MetS) in the two sexes.Methods We searched for articles on PubMed, the Cochrane Library, EMBASE, and the Web of Science databases that were published from 1950 to 2020. The summary odds ratio (OR) and 95％ confidence interval (CI) of the association between SF and MetS were estimated using a random-effects model through a meta-analysis. Based on the methods described by Greenland and Longnecker, we explored the dose-response relationship between the two sexes. Results This study included 14 studies and 74,710 samples. The results of the classical meta-analysis showed that SF was positively associated with MetS (OR = 1.77, 95％ CI: 1.59–1.98). Regarding the components of MetS (8 studies included), the results showed that SF was positively associated with abdominal obesity (OR = 1.42, 95％ CI: 1.24–1.62), elevated fasting plasma glucose (OR = 1.84, 95％ CI:1.50–2.25), elevated blood pressure (OR = 1.17, 95％ CI: 1.08–1.26), elevated triglycerides (OR = 2.09, 95％ CI: 1.72–2.54), and reduced high-density lipoprotein cholesterol (OR = 1.33, 95％ CI: 1.19–1.49). In the linear dose-response meta-analysis, the ORs of males, females, and postmenopausal females were 1.14 (95％ CI: 1.13–1.16), 1.32 (95％ CI: 1.26–1.39), and 1.34 (95％ CI: 1.22–1.47), respectively.Conclusions Our study shows that SF is significantly and positively associated with MetS, and the risk in the male population is higher than that in the female population. This finding also supports the recommendation of using SF as an early warning marker of MetS.     

安氏Ⅱ类1分类拔牙病例正畸治疗后后牙关系的稳定性研究

目的　探讨安氏Ⅱ类1分类患者正畸治疗前、后后牙关系的变化趋势,分析可能影响后牙关系复发的因素。方法　选取采用拔牙治疗的安氏Ⅱ类1分类患者29例,其中男12例,女17例。根据ANB角进一步分为牙性Ⅱ类14例,骨性Ⅱ类15例。分别对其正畸治疗前、后进行模型测量和X线头影测量。结果　所有患者的Ⅱ类磨牙关系在治疗后均得到明显改善,随访时仅有少量复发。牙性Ⅱ类患者治疗后下磨牙近中移动量(4·52±2·15) mm,大于上磨牙移动量(3·62±2·62)mm,而骨性Ⅱ类患者上下磨牙近中移动量相似,但ANB角由治疗前的(6·27± 1·08)°明显减小为(4·64±1·17)°。随访时两类错患者上下颌磨牙均近中移动,且上颌磨牙移动量大于下颌磨牙。多元回归分析提示下颌骨水平向生长和上前牙不齐指数与磨牙关系复发有关。结论　Ⅱ类错患者正畸治疗后磨牙关系较为稳定。牙性Ⅱ类错磨牙关系的解除有赖于上下颌磨牙相对移动调整,骨性Ⅱ类错则依靠上下颌骨间位置关系的改变。有利的下颌生长型和上颌前牙不齐程度等与磨牙关系的保持有密切关系。     

盐炙对广西余甘子清除2种自由基作用的谱效关系影响

目的:分析盐炙对广西余甘子清除2种自由基作用的谱效关系影响。方法:通过HPLC法建立了13批广西不同产地余甘子盐炙前后的指纹图谱,并测定清除DPPH自由基和ABTS⁺自由基作用,采用改进的灰色关联度分析法分析谱效关系。结果:盐炙后,清除DPPH自由基新增了11个特征共有峰,清除ABTS⁺自由基新增了12个特征共有峰,清除这2种自由基的作用增强,特征共有峰34(诃子联苯酸)、峰42(鞣花酸)等盐炙后峰面积均增大。结论:清除这2种自由基作用的增强,是广西余甘子盐炙后新产生和含量增加的化学成分组成的化学组分群共同作用的结果,为阐明广西余甘子盐炙后抗氧化活性的物质基础提供了实验依据和新的思路,也为日后其盐炙品的质量评价提供了参考。     

Synthesis,molecular structure and urease inhibitory activity of novel bis-Schiff bases of benzyl phenyl ketone: A combined theoretical and experimental approach

BackgroundUrease belongs to the family of amid hydrolases with two nickel atoms in their core structure. On the basis of literature survey, this research work is mainly focused on the study of bis-Schiff base derivatives of benzyl phenyl ketone nucleus.ObjectiveSynthesis of benzyl phenyl ketone based bis-Schiff bases in search of potent urease inhibitors.MethodIn the current work, bis-Schiff bases were synthesized through two steps reaction by reacting benzyl phenyl ketone with excess of hydrazine hydrate in ethanol solvent in the first step to get the desired hydrazone. In last, different substituted aromatic aldehydes were refluxed in catalytic amount of acetic acid with the desired hydrazone to obtain bis-Schiff base derivatives in tremendous yields. Using various spectroscopic techniques including FTIR, HR-ESI-MS, and ¹H NMR spectroscopy were used to clarify the structures of the created bis-Schiff base derivatives.ResultsThe prepared compounds were finally screened for their in-vitro urease inhibition activity. All the synthesized derivatives (3–9) showed excellent to less inhibitory activity when compared with standard thiourea (IC₅₀ = 21.15 ± 0.32 µM). Compounds 3 (IC₅₀ = 22.21 ± 0.42 µM), 4 (IC₅₀ = 26.11 ± 0.22 µM) and 6 (IC₅₀ = 28.11 ± 0.22 µM) were found the most active urease inhibitors near to standard thiourea among the synthesized series. Similarly, compound 5 having IC₅₀ value of 34.32 ± 0.65 µM showed significant inhibitory activity against urease enzyme. Furthermore, three compounds 7, 8, and 9 exhibited less activity with IC₅₀ values of 45.91 ± 0.14, 47.91 ± 0.14, and 48.33 ± 0.72 µM respectively. DFT used to calculate frontier molecular orbitals including; HOMO and LUMO to indicate the charge transfer from molecule to biological transfer, and MEP map to indicate the chemically reactive zone suitable for drug action. The electron localization function (ELF), non-bonding orbitals, AIM charges are also calculated. The docking study contributed to the analysis of urease protein binding.     

不同剂量右美托咪定对舒芬太尼抑制老年患者气管插管心血管反应的半数有效剂量的影响

目的 观察复合不同剂量右美托咪定时对舒芬太尼抑制老年患者气管插管的半数有效剂量（ED50）的影响。方法 选择全身麻醉下行腹部手术的老年患者96例,ASA分级Ⅰ~Ⅱ级,将患者分为4组：对照组（C组,麻醉诱导前输注10 mL生理盐水）和右美托咪定组（D1、D2、D3组,分别于麻醉诱导前静脉泵注右美托咪啶0.1、0.3、0.5 μg/kg,泵注时间5~15 min）。所有患者均采用丙泊酚靶控浓度2.5 μg/mL及预设靶浓度的舒芬太尼全凭静脉麻醉。气管插管时采用序贯法测定舒芬太尼目标靶控浓度,记录所有患者插管前出现窦性心动过缓、低血压、呛咳的例数,并记录在PACU期间躁动、疼痛例数及术后2小时的镇静评分。结果 全麻诱导前静脉给予不同剂量右美托咪定且丙泊酚效应室浓度2.5 μg/mL下舒芬太尼抑制老年人气管插管心血管反应的EC50分别是：C组：0.246 ng/mL,D1组0.238 ng/mL,D2组0.215 ng/mL,D3组0.199 ng/mL。与C组相比,D3组气管插管前出现心动过缓的发生率较高,D2、D3组拔管期间患者躁动发生率较低,差异有统计学意义（P<0.05）。各组患者气管插管前出现低血压、呛咳的发生率及拔管期间疼痛的发生率以及术后2小时Ramsay评分差异均无统计学意义（P>0.05）。结论 随着右美托咪定的剂量增加,老年患者气管插管所需的舒芬太尼目标靶控浓度呈剂量依赖性下降,且全身麻醉诱导前静脉滴注0.3 μg/kg和0.5 μg/kg右美托咪定能够降低老年患者PACU期间的躁动发生情况。     

骨质疏松症与甲状腺功能亢进的关系

目的 基于临床试验结合生物信息学分析骨质疏松症与甲亢的相互关系。方法 ①选取40例甲亢女性患者（观察组）及40例甲功正常女性（对照组）为研究对象,比较其T值及骨密度;②分别以骨质疏松及甲亢在相关人类疾病数据库中筛选靶基因,整合后映射得出交集靶点,通过STRING v11.0平台得出PPI网络并筛选出核心靶点,通过Metascape数据库进行GO富集分析及KEGG通路分析。结果 观察组的T值及骨密度均低于对照组（P<0.01）,骨质疏松与甲亢的核心交集靶点为IL6、TNF、INS、IL1B、ALB、IL10、LEP等,核心靶点集中作用于细胞因子-细胞因子受体的相互作用、Jak-STAT通路、I型糖尿病、HIF-1通路、PI3K-Akt通路、脂肪细胞因子通路等。结论 骨质疏松症与甲亢在复杂基因网络背景下存在一些高度重合的基因表达,所涉及的信号通路能够同时对两种疾病产生干预作用,这提示两种疾病的分子机制存在密切联系,可能为药物同时调控两种疾病提示潜在靶点。在临床试验的基础上应用生物信息学具有较高的置信度和参考价值,为探索疾病间关系提供了新方向与新思路。     

抑郁症与老年性骨质疏松之间的相关性

抑郁症与骨质疏松症是严重影响老年群体身心健康的常见疾病,随着人口老龄化趋势的加剧,二者的发病率逐年增长。老年人各组织器官开始衰老、功能逐渐退化,机体内环境发生改变,各种不良因素的交互叠加,导致骨代谢紊乱,骨吸收大于骨形成,造成骨量丢失。抑郁症属于精神心理系统疾患,近年来随着研究的不断深入,发现与骨质疏松症的发生密切相关。本文通过总结分析近几年国内外在这方面取得的最新研究进展,就抑郁症与老年性骨质疏松症之间的相关性展开综述,从而有针对性地对这两种疾病进行早期干预,对降低不良事件的发生,改善老年患者临床症状,提高晚年生活质量具有积极意义。     

线叶菊抗耐药性细菌感染有效部位的抗菌活性谱效关系

目的:建立线叶菊指纹图谱,阐明共有峰所代表的化学成分对抗菌药效贡献的大小,揭示其药效物质基础。方法:采用HPLC建立线叶菊的指纹图谱,流动相乙腈-PBS(0.1 mol·L~(-1)磷酸二氢钠与2%冰乙酸1∶1混合)梯度洗脱,检测波长360 nm。通过线叶菊不同批次样品对金黄色葡萄球菌、大肠埃希菌、白色葡萄球菌、副乙型伤寒杆菌和耐药金黄色葡萄球菌的抑制作用来反映其抗菌活性,利用多元线性回归与灰色关联分析方法建立谱效关系。结果:多元线性回归法可知对耐药性金黄色葡萄球菌、大肠埃希菌、金黄色葡萄球菌、白色葡萄球菌和副乙型伤寒杆菌有作用的峰共有9个。灰关联度分析得出异鼠李素3-O-芸香糖苷、异荭草素、异杜荆苷与耐药金黄色葡萄球菌相关;异鼠李素3-O-β-D-葡萄糖苷、东莨菪内酯、杨梅素、木犀草苷、圣次草苷、异槲皮苷与大肠埃希菌和金黄色葡萄球菌相关;木犀草素和槲皮素3-O-芸香糖基-7-O-葡萄糖苷与白色葡萄球菌相关;圣次草苷、芒果苷、杨梅素、芦丁、东莨菪内酯、异鼠李素3-O-β-D-葡萄糖苷与副乙型伤寒杆菌相关,上述抑菌关联度均达到了0.8以上。结论:所建立的HPLC指纹图谱方法简便、重复性良好。