卡培他滨联合铂剂治疗晚期消化道恶性肿瘤的临床疗效观察

目的探讨卡培他滨联合铂剂治疗晚期消化道恶性肿瘤的临床疗效。方法选取72例2003年8月～2010年4月入本院治疗且确诊为晚期消化道恶性肿瘤的患者为研究对象,将其随机分为两组,每组36例,即卡培他滨与铂剂合用的联合治疗组和卡培他滨单用的单纯治疗组,通过口服分两次给予卡培他滨2500mg/(m.2d),连续使用两周,顺铂60～80mg.m-2,分三天静滴,对腹盆腔转移和肝转移的患者,一次性给予DDP腹腔灌注(与顺铂相同的用法,草酸铂130mg.m-2,卡铂300mg.m-2,一次性静滴),一个治疗周期约21～28天,持续化疗两个周期后评价两组患者的治疗疗效及不良反应的发生情况。结果联合治疗组治疗有效率为72.2%,而顺铂治疗组治疗有效率为52.7%,联合治疗组治疗有效率显著高于顺铂治疗组(P<0.05);联合治疗组生活质量的改善率为69.4%,显著高于顺铂治疗组(44.4%,P<0.05);此外,联合治疗组恶心呕吐、腹泻、黏膜炎、手足综合症不良反应的发生率均显著低于顺铂治疗组(P<0.05)。结论卡培他滨联合铂剂治疗晚期消化道恶性肿瘤的临床效果较单用顺铂好,且不良反应的发生率更低,值得在晚期消化道恶性肿瘤的治疗中推广和应用。     

基于互联网药品零售的优势与问题分析

目的 揭示网上购药的消费心理和用药误区,并提出可行性建议.方法 通过访问多家网上药店,与传统购药行为比较,总结归纳出网上药品使用的新特点.结果 网上药店改变了公众谨慎的药品消费习惯,存在用药风险和用药误区.结论 我国网上药品交易市场潜力巨大,售药网站鱼龙混杂,应采取疏堵结合、监管与引导并重的策略,借助互联网优势让正确的医药信息成为网络主导.     

Cytotoxicity evaluation of sodium alendronate on cultured human periodontal ligament fibroblasts

Abstract –  External root resorption processes are usually associated with dental trauma, mainly avulsion and intrusion. In such cases endodontic therapy aims to prevent this process by using medications that can inhibit osteoclastic activity, such as bisphosphonates. However, these drugs must be biocompatible to the periapical tissues. The aim of this study was to analyze the cytotoxicity of a bisphosphonate (sodium alendronate) on human periodontal ligament fibroblasts (PDL cells). Cells were plated in a density of 1 × 10³ cells per dish. The experimental groups were GI (control) no sodium alendronate, and GII, GIII, and GIV with sodium alendronate at the concentrations of 10⁻⁵, 10⁻⁶, and 10⁻⁷ M, respectively. The experimental times were 1, 6, 12, and 24 h (short-term) for viability and 2, 4, 6, and 8 days (long-term) for cell survival. Data in triplicate were statistically analyzed. Cultures treated with the highest alendronate concentration (GII) showed cell viability percentages significantly lower ( P  < 0.01) than those of the other groups (GI, GIII, and GIV), at 12 and 24 h. Cell growth on GII and GIII groups was similar. GII presented smaller growth than the other groups ( P  < 0.05). We concluded that sodium alendronate, on direct contact with human periodontal ligament fibroblasts, is cytotoxic in concentrations higher than of 10⁻⁶ M.     

Combined Effect of a Mixture of Silver Nanoparticles and Calcium Hydroxide against Enterococcus faecalis Biofilm

IntroductionThe aim of this study was to evaluate the antibiofilm effectiveness of calcium hydroxide (Ca[OH]₂) mixed with 0.02% silver nanoparticles (AgNPs) in comparison with 1 mg/mL triple antibiotic paste (TAP), Ca(OH)₂, and 0.02% AgNPs against Enterococcus faecalis using confocal laser scanning microscopy.MethodsNinety dentin disks were prepared, sterilized, and inoculated with E. faecalis to establish a 3-week-old biofilm model. The samples received 1 mg/mL TAP, a mixture of Ca(OH)₂ + 0.02% AgNPs, Ca(OH)₂, or 0.02% AgNPs (n = 20/group). Specimens in each group were equally subdivided into 2 groups and incubated for 2 and 4 weeks. Untreated dentin disks (n = 10) were exposed to sterile saline solution and acted as a positive control. Sterile dentin disks (n = 10) were incubated anaerobically in brain-heart infusion broth and served as a negative control. At the end of each observation period, the specimens were stained with LIVE/DEAD BacLight dye (Molecular Probes, Eugene, OR) and analyzed with confocal laser scanning microscopy to determine the proportion of dead cells in the biofilm. Statistical analysis was performed using the generalized linear model repeated measure and Tukey tests (P < .05).ResultsA significantly greater proportion of dead cells was observed in the samples treated with 1 mg/mL TAP (90.39% and 99.41%) and a mixture of Ca(OH)₂ + AgNPs (90.85% and 98.49%) than those in the samples treated with Ca(OH)₂ (76.14% and 91.71%) and AgNPs (62.83% and 88.07%) at 2 and 4 weeks, respectively. A significant difference in the antibiofilm effectiveness was observed among the groups (P < .05), except for 1 mg/mL TAP and the mixture of Ca(OH)₂ + AgNPs (P > .05). All medicaments showed a significant difference in antibiofilm efficacy at the 2 time points.ConclusionsThe mixture of Ca(OH)₂ + AgNPs showed a high antibiofilm effect and was not significantly different from 1 mg/mL TAP. Furthermore, long-term contact between intracanal medicaments and bacterial cells achieved significant antibiofilm efficacy.     

Do Contaminating Substances Influence the Rheological Properties of Root Canal Sealers?

IntroductionThis study evaluated the effect of residual substances derived from irrigant solutions and intracanal medications on the rheological properties of a silicone, gutta-percha, and bioactive glass–based sealer in comparison with an epoxy resin–based sealer.MethodsThin films of contaminants (0.5 μL) (3% sodium hypochlorite [NaOCl], chlorhexidine digluconate [CHX], 17% EDTA, calcium hydroxide, 40% citric acid, or distilled water [DW]) were applied along with freshly mixed GuttaFlow Bioseal (GFB; Coltene/Whaledent, Langenau, Germany) or AH Plus Jet (Dentsply DeTrey, Konstanz, Germany) on the lower plate of a dynamic rheometer. Rheological measurements were performed in oscillating mode at the strain amplitude, angular frequency, and constant temperature of 0.01%, 10 rad/s, and 37°C, respectively. Samples without contaminants served as controls. All measurements were performed 5 times. The Kolmogorov-Smirnov test and 1-way analysis of variance followed by the Student-Newman-Keuls test were performed to analyze the results (P < .05).ResultsThe contaminants did not alter the setting time of GFB compared with the controls; however, CHX and calcium hydroxide decreased its complex viscosity (ƞ*) (P < .05). The setting time of AH Plus Jet was increased by DW, CHX, citric acid, and EDTA (P < .05). All contaminants decreased its ƞ* at the setting point (P < .05). NaOCl led to the greatest alteration of its rheological parameters.ConclusionsIrrigant solutions and intracanal medications adversely affected at least 1 of the tested rheological properties of both sealers, except for DW and 3% NaOCl, which did not alter any rheological property of GFB.     

妊娠期补充钙剂的疗效观察

目的　探讨孕期补充钙剂的效果以及对妊娠的影响。方法　将 186例 2 0～ 34周的孕妇随机分为补钙组 98例 ,服用迪巧维D钙片 ;对照组 98例 ,分别于服药前查血钙、尿蛋白。观察期间每 4周复查 1次血钙及尿蛋白 ,每周复查 1次血压、宫高、腹围。结果　妊娠期血钙低于正常非孕期 ,随妊娠进展下降更明显 (P <0 0 5 ) ,补钙组血钙较对照组明显升高 (P <0 0 5 )。补钙组的临床缺钙症状明显低于对照组且妊高征、胎儿宫内发育迟缓发生率明显低于对照组 (P <0 0 1)。结论　孕期补充钙剂有益于降低缺钙症状的发生 ,降低妊高征、胎儿宫内发育迟缓发生率 ,对母婴都是非常有益的。     

儿科低年资护士用药知识掌握情况及对策

通过对1995－2001年32名儿科低年资护士的考核，发现儿科低年资护士药理知识掌握程度较低，对临床以商品名使用的药物归类不清楚，计算方法及实际操作不够熟练。为提高儿科低年资护士用药知识，采取提高思想认识，提高安全用药意识，正确掌握计算方法和正规操作方法，坚持不断学习等措施，取得了较满意的效果。     

反复发作性根尖周炎根管消毒处理

目的 观察短期内反复发作性根尖周炎的不同根管消毒封药的临床疗效。方法 选择116例多次根管治疗无效的根尖周炎病例，根据治疗前封药次数及其他相关因素，分为根管内封药为樟脑酚(A)组、丁香油酚(B)组、干棉絮(C)组进行临床疗效观察。结果 A组有效率94．12％，B组有效率98．48％，C组有效率93．74％，减少了封药次数，仅需1～2次复诊即能达到满意疗效。结论 本文强调使用根管消毒药物前应分析每个病例使用后的临床效果。     

椎管内扩大术治疗腰椎椎管狭窄症

目的：探讨腰椎椎管狭窄的治疗方法。方法：采用作者设计的“半椎板切除行椎管内扩大术”治疗腰椎管狭窄３５例。其中侧隐窝型２例，马尾神经型１１例，混合型２２例。经３９～９６个月的长期随访。结果：疗效优２７例（７７．１％），良８例（２２．９％），优良率１００％，结论：认为采用文中介绍的手术能最大限度地保持脊柱的稳定性，同时椎管减压彻底，神经组织粘连较少，近远期疗效满意