牙周炎及吸烟对种植体周围边缘骨吸收的影响

选取我院2010年8月~2014年5月收治的58例后牙缺失拟行种植修复患者。58例患者均存在牙周炎,其中28例合并吸烟,即观察组,30例为非吸烟患者为对照组。观察组患者36颗种植体存留率83.33%(30/36),对照组40颗种植体存留率为100.00%(40/40),观察组患者平均边缘骨吸收量为1.05±0.13mm,对照组为0.79±0.11mm,两组的存留率及骨吸收量均存在显著差异,具有统计学意义(P0.05);负载1年后,观察组m PLI与对照组相比无明显差异(P0.05);观察组患者m SBI与对照组相比具有显著差异(P0.05)。牙周炎合并吸烟的患者种植体边缘骨吸收明显,且更易发生牙周探针出血,因此,对于患有牙周炎并进行种植修复的吸烟患者,为了种植体的更好修复,应及早戒烟。     

骨质疏松模型大鼠骨量及血脂的变化

目的 观察大鼠去卵巢30，60，90d后骨量及血脂的变化，验证雌激素变化与骨代谢及血脂代谢的时间、变化速度具有相关性的假设成立。方法 42只大鼠单纯随机分为两组：假手术组和去卵巢组。分别在实验30，60，90d后处死，取血清及胫骨。观测骨密度(BMD)的变化并检测高密度脂蛋白胆固醇(HDL-C)，低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG)。结果 大鼠去卵巢后体重增加的速度较快，60d后显著增加，平均为39．5g，比同期假手术组增加19．1g，90d后，同组比较，增加21．1g。去卵巢后，同期去卵巢组BMD均比假手术组减少(P&;lt;0．01，t=3．89，9．92，9．52)，具有显著性差异，90d同30d相比，BMD从0．287g／cm^2下降到0．245g／cm^2，仍具有显著性(P&;lt;0．01，t=10．38)。30，60d后去卵巢组比同期假手术组LDL-C水平升高(P&;lt;0．05，t=2．57，2．46)，90d组比较两组无显著性变化。HDL-C在整个实验过程中变化不大。30d组TC，TG水平均显著增加(P&;lt;0．01，t=3．48，3、10)；60d组同期去卵巢组TC比假手术组增加7.3％(P&;lt;0．05，t=2.90)，TG增加45．6％(P&;lt;0．01，t=3．05)；90d组同期去卵巢组TC比假手术组增加6．1％，无统计学意义，TG增加45．6％，各假手术组的TC，TG，LDL-C水平随着时间的增加虽然有所增加，但不具有统计学意义。结论 30d去卵巢大鼠已出现典型的骨质疏松表现，伴有血脂紊乱。60，90d后逐渐趋于相对稳定期。     

雌激素与辛伐他汀序贯疗法对去势大鼠种植体骨愈合影响的骨计量学研究

目的：观察序贯应用雌激素（骨吸收抑制剂）和辛伐他汀（骨形成刺激剂）对去势骨质疏松大鼠种植体骨愈合骨计量的影响。方法：选用32周龄雌性SD大鼠40只,并随机分为正常对照组（A组）和去势组。去势组切除双侧卵巢,正常对照组只进行耻区皮肤单纯切开术。卵巢切除12周后于大鼠胫骨近骺端植入纯钛螺纹状种植体并将去势组随机分为4组：雌激素组（B组）、辛伐他汀组（C组）、序贯组（D组）和去势对照组（E组）。雌激素组：皮下注射苯甲酸雌二醇0.1 mg/kg,3 d给药1次;辛伐他汀组：5 mg/kg,1 d灌胃1次;序贯组：皮下注射苯甲酸雌二醇0.1 mg/kg,3 d给药1次,2周后,灌胃给予辛伐他汀5 mg.kg-1.d-12周,停药5周,再应用辛伐他汀5 mg.kg-1.d-1灌胃3周;去势对照组：单纯饲料喂养,无药物干预。种植术后12周全部处死,摘取胫骨。标本制作带种植体的不脱钙切片,行骨计量学观察。结果：比较结合骨板宽度,骨小梁直径,松质骨区种植体-骨接触率及松质骨区骨量,D组与A,B,C,E组差异有显著性（P〈0.05）。结论：实验性骨质疏松可阻碍种植体和骨组织的结合,使种植体周围骨小梁减少,结合骨板和骨小梁变得菲薄,序贯疗法可有效促进骨形成,从而提高骨组织对种植体的支持。     

辛伐他汀对骨质疏松微种植体稳定性影响的研究

目的 观察辛伐他汀对骨质疏松微种植体稳定性的影响。方法 采用21只体重为2kg左右,5月龄的雌性新西兰大白兔。随机分为假手术组、去势组、去势加辛伐他汀组,每组7只。首先制作去势新西兰大白兔模型(骨质疏松模型),植入微种植体,并加载100 g力值。同时去势加辛伐他汀组给予辛伐他汀[10 mg/(kg·d)]灌胃9周。标本制作不脱钙硬组织切片,行骨计量学测量分析。结果 去势加辛伐他汀组微种植体移动距离(0.416 ±0.091)mm较去势组(1.040 ±0.182)mm降低,差异有统计学意义(t =2.886,P＜0.05);骨密度去势加辛伐他汀组(0.310±0.016)％较去势组(0.248±0.014)％增加,差异有统计学意义(t=3.367,P＜0.01)。微种植体周围去势加辛伐他汀组松质区骨量(27.30±2.31)％、松质骨骨结合率(28.57±2.44)％较去势组松质区骨量(18.62±2.24)％、松质骨骨结合率(16.23±3.30)％高(P均＜0.05)。结论 辛伐他汀可以对抗骨质疏松对微种植体的不良影响。     

雌激素对去卵巢大鼠骨形成的影响

目的：观察大鼠去卵巢后椎体骨丢失的组织学改变，椎体骨密度和生物力学性能变化，了解激素复合药物对椎体骨丢失的影响。方法：选用40只6月龄雌性SD大鼠，随机分为4组，每组10只，包括非手术组，假手术组，去卵巢组和去卵巢后药物治疗组，治疗组为去卵巢后3周给予盖福润（gevrine)0.8mg/kg，羟乙膦酸钠35mg/kg,1次／d，术后12周处死各组大鼠，进行骨形态计量学，骨密度及生物力学检测，结果：与假手术组相比，去卵巢组的骨小梁体积占海绵骨体积百分比明显降低（P＜0．01），椎体骨密度显降低（P＜0．01），骨的力学强度降低（P＜0．05），与去卵骨组相比，治疗组骨小梁体积占骨体积百分比明显增加（P＜0．05），椎体骨密度明显增加（P＜0．05），骨的力学强度增加（P＜0．05），结论：雌激素复合药物盖福润和羟乙膦酸钠能抑制骨丢失，促进骨形成，对大鼠脊柱骨质疏松有明显的防治作用。     

被动吸烟对大鼠种植体周围组织中OPG和RANKL表达的影响

目的：探讨被动吸烟对大鼠种植体周围骨沉积的影响。方法全麻下在20只Wistar大鼠右侧胫骨内植入纯钛螺纹状种植体,根据是否被动吸烟将大鼠随机分为对照组和被动吸烟组。3个月后,处死动物获取胫骨标本,扫描电镜观察各组种植体周围骨结合情况,采用免疫组织化学方法检测各组种植体周围骨组织中骨保护素（OPG）和核因子κB受体活化因子配体（RANKL）表达水平。结果被动吸烟持续组界面骨表面吸收陷窝增多、增深,骨质沉积降低;RANKL的表达强,范围广泛,颜色深,光密度值（IOD）显著高于对照组（P＜0.05）。OPG的表达弱,均散且染色淡,IOD值明显低于对照组（P＜0.05）。结论被动吸烟可减少大鼠种植体骨界面的骨沉积,机制涉及RANKL的表达水平的升高和OPG表达水平的降低。     

磷酸钙修饰钛植入物结合富血小板血浆促进骨质疏松大鼠种植体骨结合的实验研究

目的 探讨磷酸钙修饰钛植入物结合富血小板血浆促进骨质疏松大鼠种植体骨结合的效果。方法 32只11周龄雌性Sprague-Dawley大鼠,依据随机数字表法分为以下4组：假手术组(腹部切开并去除等量的脂肪,n=8);OVX组(骨质疏松模型,n=8);OVX+植入物组(骨质疏松模型+磷酸钙修饰钛植入物,n=8);OVX+植入物+血小板组(骨质疏松模型+磷酸钙修饰钛植入物+PRP,n=8)。检测并分析4组新骨形成、组织形态学、血管内皮生长因子(VEGF)、IGF-1、转化生长因子β1(TGF-β1)及骨细胞标志物基因蛋白表达。结果 与假手术组相比,OVX组BV/TV和BMD降低,Tb.Sp升高;与OVX组相比,OVX+植入物组和OVX+植入物+血小板组BV/TV和BMD升高,Tb.Sp降低;OVX+植入物+血小板组较OVX+植入物组BV/TV和BMD升高,Tb.Sp降低,差异均有统计学意义(P<0.05)。与假手术组相比,OVX组绿色荧光面积和矿物沉积率降低;与OVX组相比,OVX+植入物组和OVX+植入物+血小板组绿色荧光面积和矿物沉积率增加;OVX+植入物+血小板组较OVX+植入物...     

应用骨量及骨强度变化评估壁虎提取物改善骨质疏松大鼠的生物效应

目的:通过观察骨量及生物力学指标,探讨中药壁虎提取物对影响骨组织构建正常结构骨质疏松的效应。方法:实验于2005-08/2006-07在解放军第四军医大学放射医学教研室完成。实验材料:健康8周龄雌性SD大鼠24只,体质量(220±15)g。壁虎提取物由解放军第四军医大学制备。实验分组:大鼠按体质量大小随机分为4组,即假手术组、模型组、预防组和治疗组,每组6只。实验干预:假手术组大鼠仅游离卵巢后关腹,其余各组大鼠均切除双侧卵巢。预防组大鼠术后6d开始灌胃用药,治疗组大鼠术后3个月开始灌胃用药,两组均按每日0.2g/kg体质量给予壁虎提取物1mL;假手术组和模型组大鼠术后6d给予等量注射用水灌胃。实验评估:术后6个月取各组大鼠骨组织,进行骨组织骨密度值、骨钙含量、最大应力、最大应变、弹性模量、骨皮质厚度等指标检测。结果:24只大鼠均进入结果分析。①骨密度和骨钙含量变化:假手术组与模型组相比各指标均有明显差异,表明骨质疏松动物模型制备是成功的。预防组和治疗组的全身骨密度值、腰椎骨密度值和骨钙含量均高于模型组大鼠(P<0.01)。②生物力学变化:预防组和治疗组的骨组织最大应力、最大应变及弹性模量高于模型组(P<0.01),但未能恢复到假手术组水平。③几何结构参数:预防组和治疗组的骨皮质厚度均较模型组增厚[(0.784±0.081),(0.686±0.077),(0.506±0.091)mm,P<0.01],两组的骨髓腔直径均较模型组降低[(1.993±0.149),(1.975±0.087),(2.120±0.098)mm,P<0.01和P<0.05]。结论:壁虎提取物可改善实验动物骨皮质厚度和髓腔径,增加骨量和骨强度,对骨组织构建影响因素骨质疏松有一定的防治作用。     

自体骨髓浓缩物修复种植体周围的骨缺损

背景：目前,自体骨髓浓缩物主要应用于骨科、重症肢体缺血患者,其在口腔颌面外科尤其是种植外科应用较少,在种植体周围促进新骨再生的效果也有待研究。目的：评价自体骨髓浓缩物在种植体周围骨缺损修复中的作用。方法：于实验犬髂后上棘处抽取骨髓5 mL,对浓缩前后的骨髓进行细胞计数。在实验犬的双侧下颌前磨牙区植入种植体,并于近中制作4 mm×4 mm×4 mm的骨缺损,随机植入骨髓浓缩物混合明胶海绵、自体骨、明胶海绵。术后4,12周对骨缺损标本进行组织学观察分析,并计算新骨生成率和新骨密度。结果与结论：骨髓细胞平均浓缩倍数为（2.78±177;0.22）倍。浓缩骨髓中,可观察到更多和更大的克隆单位。组织学分析发现,4周时骨髓浓缩物明胶海绵组的新骨生成率和密度均明显高于自体骨组和明胶海绵组（P＜0.05）,12周时骨髓浓缩物明胶海绵组新骨生成率明显低于自体骨组,但高于明胶海绵组（P＜0.05）,3组新骨密度差异无显著性意义（P＜0.05）。结果显示自体骨髓浓缩物能够显著提高种植体周围骨缺损内早期新生骨的质量。     

微种植体支抗负载对妊娠大鼠雌激素和孕激素的影响

目的建立妊娠大鼠模型,探讨正畸微种植体支抗负载对妊娠大鼠孕激素、雌激素的影响。方法 30只雌性大鼠分为正常组、妊娠组、妊娠加力组,左侧胫骨植入微种植体2枚,腹主动脉采血检测孕激素、雌激素,同时检测右侧胫骨骨密度。结果妊娠组、妊娠加力组大鼠雌激素水平高于正常组,差异有统计学意义(P0.05);孕激素水平高于正常组,差异有统计学意义(P0.05);妊娠组大鼠骨密度低于正常组,差异有统计学意义(P0.05)。结论妊娠阶段施加60g正畸轻力时大鼠雌激素、孕激素会稍有下降,妊娠阶段骨密度下降。     

Effects of chronic cigarette smoke inhalation on the development of senile lung in senescence-accelerated mouse

The senescence-accelerated mouse (SAM) manifests most of the features of function and morphology in the senile lung with aging. However, little is known about the effects of age and cigarette smoke on alterations of the lung in SAM. In the present study, we examined the effects of chronic cigarette smoke inhalation and age on the function and morphology of lungs in two strains of SAM, SAMP2 (senescence-prone strain) and SAMR1 (senescence-resistant strain), from 6 months of age (young) and 18 months of age (aged). After 4 weeks of cigarette smoke inhalation, a small but significant airspace along with a leftward shift of the pressure-volume (P-V) curve was observed in young SAMP2, but not in SAMR1. However, the airspace size of young SAMP2 with cigarette inhalation was smaller than that in aged SAM with air inhalation, suggesting that the effect of age may be greater than that of the small burder of tobacco smoke on the lung alterations in SAMP2. In the aged SAM, there were no differences in function and structure between tobacco-exposed and air-exposed mice. Because the changes in the lungs of young SAMP2 exposed to cigarette smoke were partly simulated with age-related alterations in human lung, and because age-dependent changes of lungs were clearly investigated in SAMP2, this strain may be an interesting animal model for investigating the effects of age and/or cigarette smoke on alterations in lung structure and function.     

Human cigarette smoking: effects of puff and inhalation parameters on smoke exposure

This study determined effects of three smoking behavior components: puff volume, inhalation volume and lung exposure duration on biological measures of smoke exposure. A microcomputer-based auditory feedback system allowed subjects (N = 9 or 10 per experiment) to control puff and inhalation parameters as they smoked usual brand cigarettes. In each of four experiments, one smoking parameter was manipulated across sessions while two other parameters were held constant. Biological samples were obtained before and after each 8-puff smoking session conducted under a given set of behavioral parameters for analysis of plasma nicotine and expired air carbon monoxide (CO) levels. In Experiment I, both nicotine and CO levels were influenced systematically as puff volume was varied from 15 to 60 ml (inhalation volume = 50% of vital capacity, lung exposure time = about 9 sec). Nicotine boost (post- minus presession levels) increased 4-fold and CO boost increased 9-fold over this range of puff volume values. In Experiment II, nicotine levels were unaffected when average lung exposure times varied from 5 to 21 sec (puff volume = 50 ml, inhalation volume = 50% of vital capacity), suggesting that all the nicotine available may be absorbed during a normal smoking inhalation cycle with no breathholding. CO levels increased systematically with longer breathholds. In Experiments III and IV, inhalation volumes from 10% and 20% to 60% of vital capacity had no effect on either nicotine or CO levels, and this was true whether lung exposure time was about 8 sec (Experiment III) or about 4 sec (Experiment IV). This series of studies has shown that puff volume is an important determinant of tobacco smoke exposure, but that inhalation components of smoking behavior, at least within the range of parameters tested, have no effect on nicotine exposure levels.     

Sensory mechanisms in the upper respiratory tract affect the inhalation of cigarette smoke in man

Cigarette puffing parameters (puff volume, puff duration, number of puffs, total smoking time) and inhaled smoke volume (by a radiotracer technique) have been measured in a group of 11 asymptomatic smokers, once after topical anaesthesia of the upper airways and once without anaesthesia. Topical anaesthesia significantly reduced the mean inhaled smoke volume per puff for the group from 41.1 ml to 30.6 ml (P less than 0.05) and the total inhaled smoke volume from 575 ml to 528 ml (P = 0.05), but cigarette puffing parameters were unchanged. It is concluded that stimulation of upper airway sensory receptors, probably sensitive to nicotine, may be an important mechanism in determining the amount of cigarette smoke inhaled by smokers.     

十一酸睾酮对雄性骨质疏松大鼠骨代谢的影响

目的:研究十一酸睾酮替代治疗对雄性去势骨质疏松大鼠骨代谢的影响,以期为男性骨质疏松症的预防提供思路。方法:实验选用15周龄雄性SD大鼠32只去睾后作为动物模型,随机分为对照组11只、模型组11只、治疗组10只,28周后行血尿生化、骨密度检查。结果:模型组大鼠全身骨密度、股骨中点骨密度、睾酮水平犤(0.351±0.012),(0.357±0.007)g/cm2,(0.01±0.02)nmol/L犦明显低于对照组犤(0.366±0.021),(0.366±0.012)g/cm2,(1.82±0.02)nmol/L犦(P<0.05～0.01)。治疗组大鼠全身骨密度、股骨中点骨密度、睾酮水平、雌二醇水平明显高于模型组(P<0.05～0.01)。模型组大鼠尿钙/肌酐、尿磷/肌酐、尿羟脯氨酸/肌酐水平明显高于对照组(P<0.05～0.01)。治疗组大鼠血碱性磷酸酶水平明显高于模型组(P<0.05)。结论:早期应用十一酸睾酮替代治疗可逆转雄性大鼠去睾28周后骨质疏松的发生。     

Vitamin C modifies the cardiovascular and microvascular responses to cigarette smoke inhalation in man

Both neutrophil margination and increases in the non-invasively assessed parameter, isovolumetric venous congestion cuff pressure (Pv(i)), are symptomatic of some inflammatory diseases. Neutrophil margination occurs primarily, though not exclusively, at the post-capillary endothelial surface. The local haemodynamic changes resulting from margination may be responsible for the observed increases in Pv(i). Smoke inhalation has been shown in animal studies to cause an increase in post-capillary neutrophil margination by mechanisms that can be blocked by oral vitamin C administration. We looked for indices of a relationship between margination and Pv(i) in man, using cigarette smoke inhalation as a pathophysiological challenge. We also examined the effect of prophylactic vitamin C on the response. Smoke inhalation was associated with highly significant increases in both Pv(i) and heart rate. After vitamin C pre-treatment, no increase in Pv(i) was observed in response to the smoke inhalation; however, whilst heart rate still increased significantly, the duration of this response was attenuated. The results suggest that vitamin C affords protection against some of the cardiovascular and microvascular changes associated with cigarette smoke inhalation in man. They also support the notion that non-invasive assessment of changes in Pv(i) may provide a measurable index of systemic changes in inflammatory conditions.     

阿托伐他汀钙对糖尿病骨质疏松大鼠骨代谢的影响

目的观察糖尿病大鼠应用他汀类药物阿托伐他汀钙(商品名立普妥Lipitor)治疗后骨组织形态学改变以及血中Ⅰ型胶原氨基端肽(PINP)水平变化,为骨质疏松的防治提供依据。方法3月龄雄性SD大鼠30只,单纯随机分为糖尿病组(D)、立普妥治疗组(L),空白对照组(C),每组10只。D组和L组大鼠经鼠尾静脉注射链尿佐菌素造成糖尿病大鼠模型,C组大鼠注射生理盐水。L组大鼠予立普妥灌胃。9周及14周分别处死大鼠,取骨与血行骨组织形态计量法分析及应用放免方法检测PINP水平。结果9周末,D组和L组光镜下见骨质疏松表现,PINP水平:C组(63±7)μg/L,D组(67±3)μg/L,L组(100±11)μg/L,D组和C组无差异,L组明显增高(P<0.05)。14周末D组仍见骨质疏松征象,而L组微观结构较9周末明显改善;PINP水平:C组(60±11)μg/L,D组(62±8)μg/L,L组(92±6)μg/L,D组与C组无差异,L组显著增高(P<0.01)。结论立普妥可以促进糖尿病大鼠骨质的形成,抑制糖尿病大鼠骨质疏松的发生发展。     

不同强度跑台运动与雌激素联合作用对实验性骨质疏松大鼠骨量的影响

目的 :将成年SD大鼠去卵巢建立骨质疏松模型 ,探讨不同强度运动与雌激素联合作用对骨质疏松大鼠骨量的影响。方法 :实验动物分基础对照组、正常对照组、阳性对照组、雌激素对照组、中等强度运动组、大强度运动组、中等强度运动 雌激素组和大强度运动 雌激素组。用骨形态计量学方法 ,研究了 8周的不同强度跑台运动 ,以及运动和雌激素结合对大鼠胫骨松质骨骨量的影响。结果 :中等强度运动组骨高转换受到抑制 ,骨量丢失减缓。大强度运动仍为高转换型骨代谢 ,且骨量低于中等强度运动组。两个运动加雌激素组明显抑制了去卵巢后的高骨转换 ,骨量较两个单纯运动组和雌激素对照组增多。结论 :雌激素和运动的结合比单纯用药和单纯运动能起到更好的预防骨丢失的作用