谢晶日以土木升降相因理论治疗胆石症经验

[目的] 探究谢晶日教授治疗胆石症的临床经验。[方法] 通过门诊跟师学习,收集整理医案,对谢师治疗胆石症的理论基础、辨证特点和用药经验的独特之处进行总结,并附验案一则加以佐证。[结果] 谢师认为,胆石症的病机以肝郁脾虚为本,湿热互结为因,胆腑瘀阻为标,并首次提出了“土木升降相因”理论,主张升发肝脾之气,和降胆胃之气,脾胃肝胆升降有序,则气机运转通畅,中焦生机不息,结石无由以生。临证时以升发肝脾、和降胆胃为纲,标本兼治,以复土木之升降;针对兼症,灵活采用利湿、化瘀等法。所举医案患者症状反复发作,为胆胀肝郁气滞兼相火炽盛证,治以疏肝行气、利胆通腑之法,临床症状好转,复查超声结石基本消失。[结论] 谢师治疗胆石症注重肝脾同调,遣方用药灵活多变,疗效显著,其经验值得学习和推广。     

多次法根管治疗与一次性根管治疗在治疗牙体牙髓病患者中的应用效果及对咀嚼功能的影响

目的分析多次法根管治疗与一次性根管治疗在治疗牙体牙髓病患者中的应用效果及对咀嚼功能的影响。方法选取2019年8月至2020年9月本院接收的牙体牙髓病患者78例作为研究对象,按照治疗方案的不同分为对照组(采取多次法根管治疗)与观察组(采取一次性根管治疗),每组39例,比较两组咀嚼功能、治疗效果及不良反应发生率。结果观察组咀嚼效率高于对照组(P<0.05);观察组治疗总有效率高于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05)。结论与多次法根管治疗相比,一次性根管治疗在治疗牙体牙髓病患者中的效果更优,更利于促进患者症状的改善及咀嚼功能的恢复,且可降低不良反应发生率。     

根管治疗失败患者感染微生态研究

目的观察未治疗和根管治疗失败慢性根尖周炎患者根尖周病损组织菌群构成和根管内壁及根外生物膜超微结构,为治疗提供理论依据。方法选取2018年4月至2019年4月本院牙体牙髓科收治的未经治疗和根管治疗失败的慢性根尖周炎患者40例,分为未经治疗组和治疗失败组,各20例。采集两组患者牙窝内根尖周病损组织,提取细菌DNA,构建16S rDNA克隆文库,采用高通量测序法分析根尖周病损组织中菌群构成。取两组患者根尖部位,劈开后经扫描电镜观察根管内壁及根外生物膜超微结构。结果两组根尖周病损组织G;菌检出率和克隆比均高于G;菌(P<0.05);未经治疗组根尖周病损组织中具有较高检出率的菌种从高到低依次为具核梭杆菌(Fusobaeterium nueleatum)、隐蔽小杆菌(Dialister invisus)、纤细弯曲杆菌(Campylobacter gracilis)、轻型链球菌(Streptococcus mitis);治疗失败组根尖周病损组织中具有较高检出率的菌种从高到低依次为粪肠球菌(Enterococcus faecalis)、惰性嗜血杆菌(Haemophilus segnis)、纤细弯曲杆菌(Campylobacter gracilis)、具核梭杆菌(Fusobaeterium nueleatum)、隐蔽小杆菌(Dialister invisus);未经治疗组中,有4例根尖孔周围见骨质陷窝,陷窝内有根管生物膜存在,主要由球菌组成,其他16例仅有少量牙骨质吸收,未见根管生物膜形成;治疗失败组中牙根尖外表面均可见不同程度的牙骨质吸收,根管内壁有呈间断岛状或分布连续片状分布的根管生物膜存在,主要由球菌或杆菌组成。结论以粪肠球菌为主的细菌定植和根尖外表面根管生物膜的形成可能是导致根管治疗失败的主要原因。     

Licorice root extract and magnesium isoglycyrrhizinate protect against triptolide-induced hepatotoxicity via up-regulation of the Nrf2 pathway

Triptolide, the predominant biologically active component of the Chinese herb Tripterygium wilfordii Hook f., possesses numerous pharmacological activities, including anti-inflammatory, anti-fertility, anti-neoplastic, and immunosuppressive effects. However, toxicity and severe adverse effects, particularly hepatotoxicity, limit the clinical application of triptolide. Licorice root extract contains various bioactive compounds and is potent hepatoprotective. Magnesium isoglycyrrhizinate, a magnesium salt of the 18α-glycyrrhizic acid stereoisomer of glycyrrhizic acid, is used clinically in China to treat chronic viral hepatitis and acute drug-induced liver injury. The aim of this study was to investigate the role of the factor erythroid 2-related factor 2 pathway in the protective effects of LE and MIG against triptolide-induced hepatotoxicity. Hepatotoxicity models were established in L-02 cells and rats using triptolide, and the protective effects of LE and MIG were investigated in vitro and in vivo, respectively. LE and MIG significantly protected against triptolide-induced cytotoxicity. Additionally, triptolide decreased the mRNA and protein levels of Nrf2 and down-regulated Nrf2 target genes, including UGT1A, BSEP, and MRP2, while pretreatment with LE and MIG reversed these effects. Finally, Nrf2-involved antioxidant responses were activated in the presence of LE and MIG.     

阿霉素减轻坐骨神经慢性缩窄性损伤大鼠的神经病理性疼痛及其机制

目的观察阿霉素(DOX)对坐骨神经慢性缩窄性损伤(CCI)模型大鼠的镇痛作用,并从形态学及组织凋亡蛋白的角度对其机制进行分析。方法将SD大鼠随机分为4组:假手术组(Sham)、CCI模型组(Model)、假手术+阿霉素5 mg·kg^-1组(Sham+DOX)、CCI模型+阿霉素5 mg·kg^-1组(Model+DOX)。造模成功后,各组采用尾静脉注射的方式给药,Sham组和Model组给予等量生理盐水,检测各组大鼠机械痛阈值和热痛阈值。在行为学检测结束后,即手术后d 15取大鼠右侧L4-5DRG,观察DRG细胞形态、超微结构及DOX的分布情况,采用Western blot法测定DRG组织中Bax、Bcl-2、PKCɑ、PKCδ及PKCε的蛋白表达。结果静脉注射DOX可在DRG组织检测到其自发荧光表达。与Sham组相比,Sham+DOX组痛阈值在整个观察期未见差别,而Model组在术后d 7痛阈值明显降低。与Model组相比,Model+DOX组的痛阈值在给药后明显回升,并表现出DRG细胞明显损伤,Bax/Bcl-2升高以及PKCδ、PKCε的蛋白表达量降低等现象。结论 DOX静脉注射可以到达并蓄积于DRG组织,明显减轻CCI大鼠的疼痛反应,这一作用与其降低PKCδ和PKCε的蛋白表达,诱导DRG的凋亡有关。     

Sustained Release of Minocycline From Minocycline-Calcium-Dextran Sulfate Complex Microparticles for Periodontitis Treatment

It is important to address the periodontitis-associated bacteria in the residual subgingival plaque after scaling and root planing to successfully treat periodontitis. In this study, we explored the possibility of exploiting the ion pairing/complexation of minocycline, Ca²⁺, and sulfate/sulfonate-bearing biopolymers to develop an intrapocket delivery system of minocycline as an adjunct to scaling and root planing. Minocycline-calcium-dextran sulfate complex microparticles were synthesized from minocycline, CaCl₂, and dextran sulfate. They were characterized using Fourier-transform infrared spectroscopy, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. An in vitro release study was conducted to evaluate the release kinetics of minocycline from these microparticles. Agar disk diffusion assays and biofilm-grown bacteria assays were used to assess antibacterial capability. High loading efficiency (96.98% ± 0.12%) and high loading content (44.69% ± 0.03%) for minocycline were observed for these complex microparticles. Mino-Ca-DS microparticles achieved sustained release of minocycline for at least 9 days at pH 7.4 and 18 days at pH 6.4 in phosphate-buffered saline, respectively. They also demonstrated potent antimicrobial effects against Streptococcus mutans and Aggregatibacter actinomycetemcomitans in agar disk diffusion and biofilm assays. These results suggested that the ion pairing/complexation of minocycline, Ca²⁺, and sulfonate/sulfate-bearing biopolymers can be exploited to develop complex microparticles as local delivery systems for periodontitis treatment.     

薏苡根中多糖含量提取及抗氧化活性研究

目的研究薏苡根中多糖含量适宜的提取工艺,并对其进行抗氧化活性评估。方法薏苡根用95%乙醇醇沉,并依次用无水乙醇、丙酮、乙醚充分洗涤提取后,考察料液比、浸提时间、浸提温度对提取物含量的影响,在单因素实验的基础上做L_9(3~4)正交实验化提取工艺参数。通过测定薏苡根中多糖的还原能力,对清除1,1-二苯基-2-三硝基苯肼(DPPH)、羟基、超氧阴离子自由基的能力来评价其抗氧化活性。结果薏苡根中多糖适宜的提取工艺参数:浸提温度90℃、浸提时间2. 50 h、料液比1∶40。在此条件下薏苡根多糖含量5. 80%。薏苡根多糖具有较好的还原能力,DPPH、羟基、超氧阴离子自由基IC50分别为2. 51,2. 60,7. 96 mg·mL^-1。结论在条件为料液比1∶40、浸提时间2. 50 h、浸提温度90℃下,从薏苡根中提取多糖的含量最高,且其多糖具有一定的抗氧化活性。     

Butterbur root extract and music therapy in the prevention of childhood migraine: An explorative study

Background: Migraine is very common in school‐aged children, but despite a number of pharmacological and non‐pharmacological options for prophylaxis, randomized controlled evidence in children is small. Evidence‐based prophylactic drugs may have considerable side effects. Objective: This study was to assess efficacy of a butterbur root extract (Petadolex®) and music therapy in primary school children with migraine. Design: Prospective, randomized, partly double‐blind, placebo‐controlled, parallel‐group trial. Methods: Following a 8‐week baseline patients were randomized and received either butterbur root extract (n=19), music therapy (n=20) or placebo (n=19) over 12 weeks. All participants received additionally headache education (“treatment as usual”) from the baseline onwards. Reduction of headache frequency after treatment (8‐week post‐treatment) as well as 6 months later (8‐week follow‐up) was the efficacy variable. Results: Data analysis of subjects completing the respective study phase showed that during post‐treatment, only music therapy was superior to placebo (p=0.005), whereas in the follow‐up period both music therapy and butterbur root extract were superior to placebo (p=0.018 and p=0.044, respectively). All groups showed a substantial reduction of attack frequency already during baseline. Conclusion: Butterbur root extract and music therapy might be superior to placebo and may represent promising treatment approaches in the prophylaxis of paediatric migraine.     

腰神经根慢性损伤后背根神经节电生理与细胞内钙离子浓度变化的研究

目的　探讨受损背根神经节 (DRG)神经元异位自发放电与细胞内Ca2 浓度改变的关系。方法　纯种成年新西兰大白兔 3 2只 ,随机分为正常组、损伤 10d组、损伤 3 0d组、损伤 90d组 ,建立模拟腰椎间盘突出的兔腰神经根慢性损伤模型 ,于损伤后 10d、3 0d、90d应用在体电生理技术记录损伤DRG异位电活动的改变 ,应用激光共聚焦扫描显微镜技术结合荧光染色法检测受损DRG神经元细胞内Ca2 荧光强度变化。结果　①兔腰神经根慢性损伤后 ,受损DRG神经元异位自发放电频率和幅度随损伤时间延长而逐渐下降 ,损伤各组与正常组相比 ,DRG放电频率、放电幅度均显著增高 (P <0 .0 5 ) ;②兔腰神经根慢性损伤后受损DRG细胞内Ca2 浓度呈现不同程度的增高 ,随着损伤时间的延长 ,Ca2 浓度有下降趋势。结论　Ca2 与受损神经元的异位电活动的发生及变化相关 ,Ca2 浓度升高可导致受损神经元异位电活动的发生及传播。