精细化护理干预措施对鼻咽癌患者化疗后唾液pH值、口腔感染的影响

目的 研究循证护理干预在鼻咽癌患者化疗后对唾液pH值及口腔感染的影响.方法 选取2017年1月至2019年1月在该院行化疗治疗的鼻咽癌患者126例为研究对象,依据随机数表法分对照组、研究组,各63例.对照组患者在化疗期间接受口腔评估护理等常规护理,研究组患者在对照组常规护理基础上实施循证护理干预.比较两组护理前后唾液p...     

唾液钠、钾离子浓度和单位时间的总量及Ph值变化与Sj(o)gren综合征的关系

[目的]测定舍格伦综合征(Sjö     

揉按颊车穴与叩齿对于健康人唾液分泌的影响研究

目的 探讨颊车穴揉按与叩齿法对健康人唾液流率以及口腔湿润主观评分的影响,为临床口腔干燥症患者的中医护理提供前期研究基础。方法 采用随机对照试验,纳入135名符合标准受试者。采用信封法,随机分为颊车穴揉按组、叩齿组以及空白组,每组45名。分别记录受试者揉按穴位后、叩齿后以及未干预情况下后的唾液流率和口腔湿润主观评分。结果 穴位揉按组、叩齿组和空白组的唾液流率差异有统计学意义（P<0.001）,叩齿组最高。颊车穴揉按组、叩齿组口腔湿润主观评分高于空白组,差异有统计学意义（P<0.001）。结论 颊车穴揉按和叩齿法均能有效刺激唾液分泌,有效滋润口腔黏膜。     

腹腔镜手术应激对唾液皮质醇及分泌型免疫球蛋白A的影响

[目的]探讨腹腔镜手术应激对病人唾液皮质醇和分泌型免疫球蛋白A(SIgA)的影响.[方法]采用状态焦虑量表,于病人入院时、手术前对27例全身麻醉腹腔镜手术病人进行测试,并留取唾液标本检测唾液皮质醇和SIgA.[结果]状态焦虑手术前较入院时升高了13.81%,但其差异无统计学意义(P=0.090);唾液皮质醇和SIgA手术前较入院时显著升高(P<0.05).经Spearman相关分析,唾液皮质醇的升高幅度与状态焦虑的升高程度呈中度线性相关.[结论]腹腔镜手术作为心理应激源,调动机体的应对机制,使唾液皮质醇和SIgA升高,机体免疫功能增强.     

腹腔镜手术应激对唾液皮质醇及分泌型免疫球蛋白A的影响

[目的]探讨腹腔镜手术应激对病人唾液皮质醇和分泌型免疫球蛋白A（SIgA）的影响。[方法]采用状态焦虑量表,于病人入院时、手术前对27例全身麻醉腹腔镜手术病人进行测试,并留取唾液标本检测唾液皮质醇和SIgA。[结果]状态焦虑手术前较入院时升高了13．81％,但其差异无统计学意义（P=0．090）;唾液皮质醇和SIgA手术前较入院时显著升高（P〈0．05）。经Spearman相关分析,唾液皮质醇的升高幅度与状态焦虑的升高程度呈中度线性相关。[结论]腹腔镜手术作为心理应激源,调动机体的应对机制,使唾液皮质醇和SIgA升高,机体免疫功能增强。     

急性牙髓炎疼痛对唾液皮质醇及分泌型免疫球蛋白A水平的影响

目的:探讨急性牙髓炎患者治疗前后唾液中皮质醇(cortisol)及分泌型免疫球蛋白A(secretory immunoglobulin A,s Ig A)的变化和临床意义。方法:选择21例急性牙髓炎并自愿参加该实验的患者作为受试者。使用疼痛分级语言评估量表(verbal rating scale,VRS)记录患者牙髓炎急性疼痛发作时和治疗2周后的疼痛指数及不适指数,同时测量脉搏及血压等生理指标。使用无菌唾液收集管留取患者牙髓炎急性发作时和治疗后自然分泌的唾液,经离心机离心后,使用ELISA酶联免疫试剂盒对唾液cortisol及s Ig A进行测定,记录检测结果并进行统计学分析。结果:急性牙髓炎患者治疗后同治疗前相比较,疼痛指数及不适指数显著降低(P<0.05),收缩压、舒张压均降低,统计学差异有显著性(P<0.05),脉搏虽有降低但统计学差异无显著性,cortisol显著降低,差异有统计学意义(P<0.05),而s Ig A虽呈下降趋势但差异无统计学意义。结论:急性牙髓炎疼痛可引起机体唾液中cortisol水平的显著升高,唾液中cortisol水平可反映急性牙髓炎的病情及治疗效果。     

不同液体pH值、加药时间对胰岛素浓度的影响

静脉输注胰岛素是临床治疗糖尿病的常用方法。通过实验观察不同液体对胰岛素作用的影响以及液体加入药物后 ,ｐＨ值在 5 .0～ 8.0、室温为 10℃的环境下 ,放置时间与胰岛素浓度的关系 ,以指导临床医疗和护理工作。1　材料和方法1.1　材料　胰岛素 (ＲＩ) :诺和灵Ｒ (为基因重组人正规胰岛素 ) ,0 .9%氯化钠溶液 5 0 0ｍｌ和 5 %葡萄糖溶液 5 0 0ｍｌ ,聚苯乙烯管 ,胰岛素测定试剂盒 ,Ｈ -10 0尿液分析仪 (吉林迪瑞公司生产 )用以测定液体 ｐＨ值 ,5 %碳酸氢钠 ,维生素Ｃ。1.2　方法1.2 .1　实验分组　根据不同液体分为 0 .9%氯化钠和 5 %葡…     

3种方法对酸刺激前后唾液淀粉酶活性及其活性比值检测的影响

目的：比较碘‐淀粉法、Bernfeld 法和 EPS‐G7速率法3种方法检测酸刺激前后唾液淀粉酶（sAA）活性及其活性比值的差异,探讨3种方法检测 sAA 活性之间的相关性。方法采集5例健康志愿者柠檬酸刺激前后的唾液标本各5份,分别用3种方法3次重复检测每份唾液标本的 sAA 活性,计算 sAA 活性及其活性比值的变异系数,并对3种方法检测的 sAA 活性的相关性进行分析。结果3种方法检测的 sAA 活性及其总变异系数差异有统计学意义（P ＜0．05）,其中以 EPS‐G7速率法检测 sAA活性和总变异系数最小;3种方法检测的 sAA 活性比值及其比值的变异系数差异无统计学意义（P＞0．05）;3种方法中的任意2种方法检测的 sAA 活性都有显著相关（P＜0．05）,相关系数都在0．96以上。结论3种方法检测的 sAA 活性可以通过回归方程进行相互转换,检测精度以 EPS‐G7速率法的最高,而且 sAA 活性比值的数据处理方式可以减少3种方法之间变异系数的差异。     

几种因素对氧氯灵杀芽胞效果影响的研究

以类炭疽杆菌芽胞为试验菌测定作用时间、浓度、温度、有机物与pH对氧氯灵(含二氧化氯消毒剂)杀菌作用的影响。其n值为1.25,QC_(10)值为2.32;氧氯灵-1500的D值为3.55分钟,Q_(10)值为-2.10。结果表明氧氯灵-1500为一快速灭菌剂,但杀菌作用的浓度与温度效应较明显。在试验条件下,有机物对杀菌作用影响不大。药液pH值超过3时,杀菌效果明显下降。     

不同pH值对大环内酯类药物抗肺炎支原体活性的影响

目的 研究肺炎支原体(Mp)对大环内酯类药物的敏感性和耐药性以及不同pH值对大环内酯类药物最低抑菌浓度(MIC)的影响.方法 在pH 7.0、7.3、7.6、7.9条件下.采用微量肉汤稀释法检测红霉素、阿奇霉素、交沙霉素、克拉霉索对40株Mp的MIC,并统计分析.结果 在同-pH值条件下,克拉霉素抗Mp活性最强;其次是阿奇霉素和交沙霉素;红霉素最差,且Mp对红霉素的耐药率大于12.5%(5/40).当pH值由7.0升到7.9时,4种大环内酯类药物的MIC都逐渐降低(p<0.05).MIC50:红霉素降低8倍,克拉霉素16倍.阿奇霉素31倍,交沙霉索8倍:MIC90:红霉素降低至少4倍.克拉霉索16倍,阿奇霉素16倍,交沙霉素8倍.结论 同-pH值条件下,抗Mp活性由强至弱排列依次为克拉霉素、阿奇霉素、交沙霉素和红霉素.Mp对红霉素存在一定程度的耐药现象.4种大环内酯类的MIC随培养基pH值升高而显著降低,即在一定pH值范围内,大环内酯类药物的抗菌活性随着pH的升高而增强.     

梯度柠檬酸咳嗽反射试验在脑卒中误吸筛查中的临床价值

目的:采用不同浓度梯度的柠檬酸进行咳嗽反射试验(CRT),评估脑卒中后吞咽障碍患者的误吸风险,并与金标准对比探讨其诊断价值,为探索新的误吸筛查方法提供循证依据。方法:62例康复期脑卒中后吞咽障碍患者分别接受4种不同浓度梯度柠檬酸(0.2mol/L,0.4mol/L,0.6mol/L,0.8mol/L)以及电视透视检查吞咽评估(VFSS)或纤维光学内窥镜吞咽评估(FEES)。以VFSS/FEES为金标准,计算不同浓度梯度柠檬酸咳嗽反射试验对于误吸和隐匿性误吸诊断的敏感度、特异性和约登指数等。结果:随着柠檬酸浓度的升高,误吸筛查的敏感性降低而特异性升高。0.4mol/L柠檬酸CRT对于卒中后误吸筛查具有较高的敏感性76.9%和特异性69.4%,约登指数0.46。同样浓度对于隐匿性误吸的敏感性达80%,特异性55.8%,约登指数为0.36;而0.6mol/L柠檬酸CRT对SA的敏感性为66.7%,特异性71.2%,约登指数0.38。结论:柠檬酸CRT是脑卒中误吸评估中有价值的筛查工具,其中较低浓度柠檬酸CRT对误吸和隐匿性误吸诊断价值最大。     

Therapeutic effects of isoflavones on impaired salivary secretion

Dry mouth, which is characterized by decreased salivation, has a number of causes; the involvement of estrogen has been suggested as symptoms typically develop in middle-aged females. However, there is a lack of consensus regarding the treatment of this condition. Soy isoflavones, a subgroup of flavonoids, are abundantly found in the soy germ. They are thought to exert a number of effects by specifically binding to estrogen receptors due to their structural similarity to estrogen. Recently, soy isoflavones have been found to exert antioxidant effects, ameliorating disorders caused by reactive oxygen/free radicals. Based on these observations, the effects of soybean isoflavones on impaired salivary secretion were studied in patients with dry mouth. Soy isoflavone aglycones were administered at 25 mg per day to 15 subjects with an average age of 67.9 ± 8.0 years for 2 months, and salivary secretion was analyzed. The results showed a significant improvement based on the saliva flow rate and self-completed questionnaire, thus suggesting the usefulness of isoflavones in improving the symptoms of salivary gland hypofunction.     

Protective effects of curcumin on radioiodine‐induced salivary gland dysfunction in mice

Radioiodine (RI) treatment is widely used in patients with differentiated thyroid cancer. However, RI exposure often induces salivary gland (SG) dysfunction. In this study, we investigated the effect of curcumin on RI‐induced SG dysfunction in mice. Mice were assigned to one of four groups (n = 6 per group) as follows: normal control, RI only, RI + curcumin, and RI + amifostine group. Salivary flow rate, lag time, and changes in ^99mTc (technetium)‐pertechnetate uptake and excretion were measured, and changes in SG morphology and histology were analysed. Salivary epidermal growth factor content, amylase, and superoxide dismutase (SOD) activities were also measured. A terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) was performed to assess SG apoptosis, and the expression of apoptosis‐related protein was determined by western blotting. The reduced salivary flow rate and prolonged lag time in the RI group was restored by treatment with curcumin or amifostine. In the histological analysis, compared with the RI group, RI + curcumin and RI + amifostine groups had more mucin‐rich acini and less periductal fibrosis. Compared with the RI group, RI + curcumin and RI + amifostine groups showed evidence of tissue remodelling, with a greater number of salivary epithelial cells (AQP‐5‐positive), SG ductal cells (CK18‐positive), endothelial cells (CD31‐positive), and myoepithelial cells (α‐SMA‐positive). RI + curcumin and RI + amifostine groups alleviated RI‐induced cell death, demonstrating antiapoptotic effect, compared with the RI group. Both SOD activity and the protein expression levels of SOD2 were higher in the RI + curcumin and RI + amifostine groups than in the RI group. Our results demonstrate that curcumin ameliorates RI‐induced SG dysfunction in mice.     

乌梅含漱液与喷雾剂对健康人唾液腺分泌影响的对比分析

[目的]观察乌梅含漱液与喷雾剂对健康人唾液腺分泌的影响,并分别与基础唾液量对比其作用效果。[方法]随机选择120例符合纳入标准的受试者分别进行三次唾液腺分泌测量,依次为基础唾液量、乌梅喷雾后及乌梅含漱后唾液量,每次测量间隔1h。所得三组指标采用自身对照法比较。[结果]乌梅含漱组、乌梅喷雾组和基础对照组的唾液量,分别为4.60mg±1.53mg、4.21mg±1.39mg和2.94mg±1.40mg,三组组间差异有统计学意义（P〈0.05）,且三组组间两两比较差异均有统计学意义（P〈0.05）。受试者使用两种乌梅制剂干预后口渴感、唇舌口腔黏膜滋润情况的得分,两组差异有统计学意义（P〈0.05）。[结论]乌梅含漱组和乌梅喷雾组唾液量明显多于基础对照组的唾液量,且乌梅含漱组唾液量多于乌梅喷雾组唾液量。对比乌梅喷雾剂,乌梅含漱液能更有效地刺激口腔唾液腺分泌,增加唾液分泌量,滋润唇舌口腔黏膜,减轻口渴感,为缓解各种原因引起的口干症提供新的理论依据。     

糖负荷后血尿酸与胰岛素分泌及胰岛素敏感性/抵抗的相关性分析

目的研究不同糖负荷人群血尿酸(SUA)水平与胰岛素分泌及胰岛素抵抗的关系。方法 389例符合要求的研究对象行口服糖耐量试验(OGTT),测量空腹SUA,OGTT 0、30、60、120min血糖(GLU)和胰岛素(INS)水平,按照OGTT结果将研究对象分为糖耐量正常组(NGT组,n=88)、糖尿病前期组(preDM,n=119)、糖尿病组(DM,n=182),计算研究对象的胰岛素分泌指数(IGI)、120min胰岛素分泌指数(AUC INS_(120)/AUC GLU_(120))、胰岛素抵抗指数(HOMA-IR)、及Matsuda指数;将SUA按四分位水平分组,比较各糖负荷组不同SUA水平胰岛素分泌及胰岛素抵抗差异;计算SUA与胰岛素分泌及HOMA-IR的直线回归方程。结果 DM组SUA水平低于PreDM组[(346.66±90.60)mmol/Lvs.(367.36±92.34)mmol/L],但是略高于NGT组(339.34±89.51)mmol/L,差异有统计学意义(P0.01);DM组IGI指数、AUC INS_(120)/AUC GLU_(120)指数随着SUA升高有降低趋势(P0.01),Matsuda指数随着SUA水平升高有降低趋势(P0.05)。SUA与IGI、AUC INS_(120)/AUC GLU_(120)、HOMAIR、Matsuda指数的二元一次方程分别是Y=4.050+0.144 X,Y=2.343+0.206 X,Y=1.288+0.176 X,Y=129.373-0.202 X。结论 SUA与胰岛素分泌及胰岛素敏感性显著相关,DM组胰岛素分泌随着SUA水平升高而升高,胰岛素敏感性随着SUA水平升高而降低。SUA与胰岛素分泌及胰岛素敏感性的二元一次方程可大概评估胰岛素功能。     

Comparative study of total protein,and total and lipid-associated serum sialic acid levels in patients with type 2 diabetes mellitus

The aim of the present study was to investigate the serum total protein (TP), total sialic acid (TSA), lipid-associated sialic acid (LSA), LSA/TP, and LSA/TP values in type 2 diabetes mellitus (DM) patients. Two study groups (healthy controls and type 2 DM subjects) were examined. For the type 2 DM group, 120 patients (60 females and 60 males) who had been diagnosed and treated for type 2 DM in the Yuzuncu Yil University Hospital, Van, Turkey, were selected consecutively. Forty healthy individuals (20 females and 20 males) were selected from hospital staff and other outpatient clinics to serve as the control group. They were matched for age, sex, body mass index, and smoking status. None of the participants had taken vitamin or mineral supplements for at least 2 weeks before sampling. To determine serum glucose, TP, TSA, and LSA levels, blood samples were drawn after all of the subjects fasted overnight. It was found that diabetics had higher TSA, LSA, TSA/TP, and LSA/TP levels than controls. However, the TP levels were not significantly different between the groups. Our results showed that TSA, LSA, TSA/TP, and LSA/TP have interactive connections with DM. These parameters can be used as a diagnostic index for patients with DM.     

单侧肺滴入酸后急性肺损伤的研究

目的：观察酸滴入侧的急性肺损伤（ＡＬＩ）的形成及对测肺有无损伤形成。方法：１８只新西兰兔随机分为生理盐水（ＮＳ）滴入对照组和盐酸入损伤组。以向右肺内滴入ＮＳ或ＨＣｌ后的血气、气道压力、动静态顺应性、肺湿／干比（Ｗ／Ｄ）和支气管肺泡灌洗液（ＢＡＬＦ）中总蛋白（ＴＰ）、总磷脂（ＴＰＬ）、饱和磷脂占总磷脂比（ＤＳＰＣ／ＴＰＬ）及肺组织形态学来判断有无ＡＬＩ及其严重程度。结果：损伤组在酸滴入后ＰａＯ２较基     

己酮可可碱对盐酸诱导的兔急性肺损伤的治疗作用

目的观察盐酸吸入性肺损伤家兔肺组织和相关指标的变化,探讨己酮可可碱(PTX)对盐酸吸入性兔急性肺损伤的治疗作用。方法健康家兔30只随机分为3组:盐酸模型组(n=10),PTX治疗组(n=10)和生理盐水对照组(n=10)。实验通过气管内滴入盐酸诱导家兔急性肺损伤模型形成,待盐酸滴入后7 h处死家兔,进行肺泡灌洗液(BALF)蛋白浓度、细胞总数,肺湿/干比测定,肺组织形态学观察等,对比3组间各项指标的变化和差异。结果治疗组与模型组相比,PaO2和pH值显著升高,PaCO2则显著降低(P<0.01);BALF中蛋白浓度、细胞总数比例均显著降低(P<0.05);病理学检查发现组织病变也较模型组轻。结论PTX对于盐酸诱导后的家兔急性肺损伤有显著的抑制作用,在ALI发生发展过程中对家兔肺组织具有一定的保护作用。