盐酸米诺环素治疗重度慢性牙周炎临床观察

目的评价盐酸米诺环素辅助治疗重度慢性牙周炎的临床疗效。方法20例重度慢性牙周炎患者，以超声洁治后1周为基线。同一患者的一侧牙随机设置为实验组，另一侧为对照组。实验组患牙超声龈下刮治和手工根面平整术后，牙周袋内放药，每周一次，共四次。对照组患牙仅超声龈下刮治和手工根面平整术。基线、治疗后2个月和4个月测量：牙龈出血指数（BI）、牙周探诊深度（PD）和附着丧失（AL）。结果治疗后2个月和4个月实验组与对照纽的BLPD和AL与基线比较均有明显下降，当基线PD≥6mm时，治疗后2个月和4个月实验组的临床指标改善优于对照组。结论盐酸米诺环素辅助超声龈下刮治和手工根面平整术可以提高治疗重度慢性牙周炎的疗效。     

盐酸米诺环素辅助超声龈下刮治联合手工根面平整术治疗慢性牙周炎的疗效观察

目的比较局部使用盐酸米诺环素辅助超声龈下刮治联合手工根面平整术与单纯超声龈下刮治联合手工根面平整术治疗慢性牙周炎的临床疗效。方法共纳入15例慢性牙周炎患者,以超声洁治后1周作为基线。采用分口设计方案,按照随机原则,一侧(实验侧)行超声龈下刮治联合手工根面平整术后局部使用盐酸米诺环素,之后每周上药1次,共使用4次;另一侧(对照侧)则仅进行超声龈下刮治和手工根面平整术。基线和治疗后(从超声龈下刮治联合手工根面平整术后开始计)2、6个月测量如下指标:菌斑指数(plaque index,PLI)、牙龈出血指数(bleedingin-dex,BI)、探诊深度(probing depth,PD)和附着丧失(attachment loss,AL)。结果实验组和对照组患牙在治疗前各项牙周临床指标无显著性差异;两组治疗后2个月和6个月时PLI、BI、PD和AL与基线比较均有明显下降;治疗后2个月,两组之间临床指标BI、PD和AL的变化有显著性差异;治疗后6个月,两组之间临床指标PD和AL的变化有显著性差异。结论盐酸米诺环素辅助超声龈下刮治联合手工根面平整术可以提高对中度慢性牙周炎的治疗效果。     

龈下超声联合龈下喷砂在慢性牙周炎治疗中的作用

目的观察探讨龈下超声联合龈下喷砂在慢性牙周炎治疗中的效果。方法选择2016年1月~12月在我院口腔科接受治疗的30例慢性牙周炎患者进行研究,所有患牙采用超声治疗仪进行龈下刮治和根面平整治疗,其中观察组患牙联合龈下喷砂治疗,对照组患牙在喷砂时仅喷气和水。比较两组患牙治疗前、治疗后3个月的牙周临床指标(牙菌斑指数PLI、探诊深度PD、出血指数BI、附着丧失AL)和治疗过程中患牙疼痛程度。结果治疗后3个月两组患牙的牙周临床指标均明显改善,PLI、AL、PD、BI均明显低于治疗前,且观察组治疗后明显优于对照组(P<0.05);且观察组治疗时VAS疼痛评分及治疗后的VAS敏感评分均明显低于对照组(P<0.05);治疗前后PD≥6mm位点的对照组和观察组PD差值明显大于PD4~5mm位点和根分叉位点(P<0.05)。结论在龈下超声治疗的基础上对慢性牙周炎患者联合龈下喷砂治疗可显著提高超声龈下洁治疗的效果,更有利于改善患者牙周临床指标,且能有效降低患者的不适感,可作为一种有效的维护治疗手段推广应用。     

超声龈下刮治联合同步1%聚维酮碘液龈下冲洗治疗牙周炎的效果分析

目的探讨超声龈下刮治联合同步1%聚维酮碘液龈下冲洗治疗牙周炎的临床疗效。方法回顾性分析本院2011—2013年口腔科收治的164例牙周炎患者的资料,将患者随机分为观察组和对照组,各82例。两组患者均进行全口洁治、龈下超声刮治及根面平整,观察组患者同步1%聚维酮碘液龈下冲洗治疗,对照组患者用0.9%氯化钠溶液冲洗,比较两组患者治疗后3、6个月牙周袋探诊深度（PD）、龈沟出血指数（SBI）、菌斑指数（PLI）,黑色素类杆菌量和厌氧菌总数。结果两组患者治疗前、后PD、PLI、SBI比较,差异均有统计学意义（P〈0.05）;治疗后观察组PD、PLI、SBI、黑色素类杆菌量和厌氧菌总数与对照组比较,差异有统计学意义（P〈0.05）。结论超声龈下刮治联合同步1%聚维酮碘液龈下冲洗治疗牙周炎,能较长时间控制龈下菌斑,改善牙周炎症情况,疗效满意,值得在临床推广。     

龈下刮治和根面平整术对慢性牙周炎龈沟液中OPG和RANKL水平的影响

目的研究龈下刮治和根面平整术对慢性牙周炎患者龈沟液(GCF)中骨保护素(OPG)和核因子кB受体活化子配体(RANKL)水平的影响。方法选择60例慢性牙周炎患者作为观察组,60例健康者作为对照组。观察组采用龈下刮治和根面平整进行治疗。两组研究对象分别在基线、治疗后4周测量牙周指标和GCF中OPG和RANKL水平。结果基线、治疗后4周观察组患者菌斑指数(PI)、探诊出血(BOP)、探诊深度(PD)及附着丧失(AL)等牙周指标和GCF中RANKL/OPG比值均高于对照组,差异有统计学意义(P<0.05)。治疗后4周观察组患者牙周指标和GCF中RANKL/OPG比值均低于基线,OPG高于基线,差异有统计学意义(P<0.05)。结论龈下刮治和根面平整术能改善慢性牙周炎患者的牙周状况,使GCF中OPG增加,RANKL水平降低。     

米诺环素软膏辅助治疗慢性牙周炎42例

目的探讨米诺环素软膏辅助治疗慢性牙周炎疗效及安全性。方法将慢性牙周炎患者80例分为观察组42例和对照组38例。两组患者均予以龈上洁治、龈下刮治术及根面平整术等基础治疗。观察组在此基础上将米诺环素软膏注满牙周袋内,2%碘甘油放置牙周袋内,每周1次,连用4周。观察两组患者治疗4周后菌斑指数(PLI)、龈沟出血指数(SBI)和牙周袋探诊深度(PD)的变化,以及临床疗效和不良反应。结果治疗4周后,两组患者的PLI,SBI和PD均较治疗前明显改善(P<0.05或P<0.01),且观察组改善更明显(P<0.05);观察组的临床总有效率明显优于对照组(χ2=7.82,P<0.01)。两组患者治疗期间均未见明显药品不良反应。结论米诺环素软膏辅助治疗慢性牙周炎的疗效确切,能有效改善患者的临床症状,安全性较好。     

局部应用2%米诺环素软膏治疗慢性牙周炎的有效性及安全性

目的 探讨2%盐酸米诺环素软膏局部应用治疗慢性牙周炎的疗效、安全性及给药方法.方法 将60例（118颗牙）中重度慢性牙周炎患者随机分为治疗组和对照组,两组均给予全口洁治、根面平整等基础治疗,在此基础上治疗组30例（60颗牙）给予2%盐酸米诺环素软膏于牙周炎袋内置药,对照组30例（58颗牙）给予碘甘油于牙周炎袋内置药.治疗前、治疗后4周、8周检测菌斑指数（PLI）、龈沟出血指数（SBI）和牙周袋探诊深度（PD）并比较,同时观察不良反应.结果 与治疗前比较,两组治疗后4周、8周PLI、SBI、PD均有改善（均P〈0.05）,治疗组改善情况优于对照组（均P〈0.05）.结论 盐酸米诺环素软膏于牙周炎袋内置药治疗慢性牙周炎安全、有效.     

局部应用2%米诺环素软膏治疗慢性牙周炎的有效性及安全性

目的 探讨2%盐酸米诺环素软膏局部应用治疗慢性牙周炎的疗效、安全性及给药方法.方法 将60例(118颗牙)中重度慢性牙周炎患者随机分为治疗组和对照组,两组均给予全口洁治、根面平整等基础治疗,在此基础上治疗组30例(60颗牙)给予2%盐酸米诺环素软膏于牙周炎袋内置药,对照组30例(58颗牙)给予碘甘油于牙周炎袋内置药.治疗前、治疗后4周、8周检测菌斑指数(PLI)、龈沟出血指数(SBI)和牙周袋探诊深度(PD)并比较,同时观察不良反应.结果 与治疗前比较,两组治疗后4周、8周PLI、SBI、PD均有改善(均P<0.05),治疗组改善情况优于对照组(均P<0.05).结论 盐酸米诺环素软膏于牙周炎袋内置药治疗慢性牙周炎安全、有效.     

光动力疗法联合龈下刮治和根面平整术治疗重度慢性牙周炎的疗效观察

目的 比较光动力疗法（photodynamic therapy,PDT）辅助龈下刮治术及根面平整术（scaling and root planing,SRP）和单独使用SRP治疗重度慢性牙周炎的临床疗效.方法 对34例重度慢性牙周炎患者做自身对照,每个病人选取PD≥7 mm的位点,一共300个,随机分为实验组（SRP/PDT）和对照组（SRP）.实验组在龈下刮治术及根面平整术后做一次光动力治疗（光敏剂为26.7 mmol·L-1亚甲基蓝,660 nm激光）,对照组仅行SRP.术前、术后1个月、3个月检查实验组及对照组的牙周探诊深度（probing depth,PD）和探诊出血（bleeding on probing,BOP）.结果 实验组和对照组术前PD和BOP差异无统计学意义（P〉0.05）,术后1个月和3个月的结果显示,两组PD和BOP较术前均有改善,且实验组的PD和BOP改善效果均优于对照组,差异具有统计学意义（P〈0.05）.结论 对重度慢性牙周炎患者应用PDT辅助SRP治疗较单独使用SRP效果更佳.     

脉冲Nd:YAG激光与手工龈下刮治术联合应用治疗慢性牙周炎的临床效果观察

目的 评价脉冲Nd:YAG激光与手工龈下刮治术联合应用治疗慢性牙周炎的临床疗效.方法 选择于北京朝阳医院口腔科就诊的慢性牙周炎患者8例,对所有患牙均进行常规的洁治和抛光治疗,并在1周后对牙周探诊深度(PD)、附着丧失(AL)、出血指数(BI)进行基线检查.共选取患牙PD在4～7 mm的76个位点并完全随机分为2组,对照组(32个位点)行单纯手工牙龈下刮治术,观察组(44个位点)行Nd:YAG激光(波长:1064 nm,50 Hz,6W,400 rnJ)辅助手工牙龈下刮治术.治疗3个月后再次对所有牙周位点进行上述牙周指标的检查.结果 观察组和对照组位点的PD、AL、BI较治疗前均有明显改善(P＜0.05),且观察组位点的改善程度明显高于对照组.观察组和对照组的改善程度比较分别为PD:(3.0±1.2)mm比(2.5±1.0)mm,P =0.03;AL:(2.5±1.3)mm比(1.9±1.5)mm,P =0.04;BI:l.5±0.9比1.1±0.6,P=0.02.结论 脉冲Nd:YAG激光可作为传统龈下刮治术辅助手段治疗慢性牙周炎.     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

Self-stimulation and amphetamine: Tolerance to d and l isomers and cross tolerance to cocaine and methylphenidate

The effects of the d and l isomers of amphetamine on self-stimulation responding were tested following acute and chronic administration. Tolerance and post-drug depression of responding occurred in tests with both isomers, indicating no role for p-hydroxynorephedrine (PHN) which is one of the metabolites of d-amphetamine. In the second experiment, d-amphetamine, methylphenidate and cocaine all produced quantitatively and qualitatively similar effects on self-stimulation responding following acute administration. Following chronic administration of d-amphetamine, animals showed tolerance to all three drugs, indicating cross-tolerance among them. These data are consistent with an hypothesis that tolerance and post-drug depression following chronic amphetamine treatment are the result of decreases in postsynaptic receptor sensitivity, which would lead to a decreased effectiveness of all three drugs, regardless of their pre-synaptic mechanisms.     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Acamprosate and naltrexone treatment effects on ethanol and sucrose seeking and intake in ethanol-dependent and nondependent rats

Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

Alprazolam and lorazepam single and multiple-dose effects on psychomotor skills and sleep

Summary The effects of alprazolam 0.5 mg and lorazepam 2 mg on cognitive and psychomotor skills were assessed in twelve normal volunteer subjects in a randomised, double-blind, crossover design. Single and multiple dose effects were monitored using a battery of tests comprising critical flicker fusion threshold (CFFT), choice reaction time (CRT), simulated car tracking, and subjective ratings of perceived sedation (LARS) and of sleep behaviour (LSEQ). Compared with placebo baseline scores, treatment with lorazepam 2 mg (both single and multiple doses) resulted in a widespread impairment of CRT, tracking accuracy, and CFFT. Single doses of alprazolam 0.5 mg reduced CFFT with respect to the placebo baseline. Single and multiple dose treatment with both drugs resulted in subjective reports of sedation, a reduction of sleep onset latency, and improved sleep quality. Only lorazepam 2 mg significantly disrupted the integrity of behaviour on waking from sleep. These results suggest important pharmacodynamic differences between the two drugs in the doses used.