成人下颌第三磨牙先天性缺失的调查与分析

本文对701例成人下颌M_3进行了直观检查,对无M_3者进行了X线拍片。发现M_3先天性缺失者36例,缺失率为5.14％,其中男4.44％,女6.23％,男女间无明显差异(P>0.05),与年龄也无关P>0.05。M_3缺失率山区低于平原P<0.001。 M_3的退化是人类进化过程中的必然。其先天性缺失是下颌骨与牙齿均衡退化的结果,是适应性退化,而阻生是人类进化从有第三磨牙向无第三磨牙演化的过渡阶段。     

前牙与第三磨牙萌出的关系

目的　观察前牙对第三磨牙萌出的影响。方法　根据第三磨牙萌出程度分为正常萌出组 (M1) ,不全萌出组(M2 )及未萌出组 (M3) ,共 2 0 0例 ,测定前牙各种参数。结果　与M1组、M2 组比较 ,M3 组的上下颌牙弓弧长度和牙弓前段弧长度均较长 (P <0 .0 1或P <0 .0 5 ) ,M3 组的上下颌前牙不齐指数和前牙拥挤指数均较小 (P <0 .0 1) ,上下颌各前牙牙冠宽度和前牙牙量三组差别不明显 (P >0 .0 5 )。结论　本研究提示前牙槽长度可影响前牙的排列 ,也影响第三磨牙的萌出。     

脑中风患者彩色多普勒超声特征研究

目的用彩色多普勒超声观察中老年人脑中风患者颅内及颈动脉形态、结构和血流动力学改变. 方法应用2.5MHz探头和10MHz线阵探头分别观察155例不同类型脑中风患者和80例正常人颈动脉内中膜厚度、斑块情况及颅内与颈动脉血流动力学改变情况. 结果 (1)各型脑中风组颈总动脉(CCA)内中膜厚度均较对照组明显增厚,斑块有109例出现(70.3%),而对照组仅4例(5.0%)出现斑块;(2)各型脑中风组颈内动脉时间平均流速(TAVICA)较正常组减低、阻力指数(RI)、搏动指数(PI)较正常组明显升高;(3)脑梗死组大脑中动脉时间平均流速(TAVMCA)较正常组低,脑出血组TAVMCA较正常组明显升高,混合性中风组可出现TAVMCA升高或降低两种情况. 结论中老年人各型脑中风患者颈动脉粥样硬化程度加重,斑块出现率高及斑块所引起的颈动脉狭窄,对脑中风有直接的因果关系,联合检查颅内动脉和颈动脉血流动力学改变可协助诊断不同类型脑中风,对其疗效观察,预防复发有一定的指导作用.     

男性不育患者Y染色体微缺失和生殖激素的相关性研究

目的探讨男性不育患者Y染色体微缺失的分布和生殖激素水平的变化,分析其相关性。方法选取2015年8月-2016年7月就诊于我院生殖医学中心的男性不育患者717例,抽取外周血清,采用荧光定量PCR方法检测Y染色体微缺失,化学发光仪检测生殖激素水平。同时选取80例正常生育男性为对照组。结果 717例男性不育患者中,共有27例出现Y染色体微缺失,缺失率为3.8%(27/717),其中AZFa区缺失1例,缺失率为0.14%(1/717),AZFb区缺失1例,缺失率为0.14%(1/717),AZFc区缺失23例,缺失率为3.2%(23/717),AZFb+c区缺失2例,缺失率为0.28%(2/717)。与无AZF缺失不育组和对照组比较,AZF缺失不育组FSH水平显著升高(P0.05),E2、LH、PRL和T无明显差异(P0.05)。结论 AZFc区缺失是男性不育患者Y染色体微缺失最常见的缺失类型,缺失位点为s Y254和s Y255;FSH水平增高与AZF缺失不育密切相关。     

下颌牙槽对下颌第三磨牙萌出的影响

本文选用国人下颌骨100例,根据其第三磨牙萌出程度分为正常萌出组(M_1组)53例,不全萌出组(M_2组)20例,未萌出组(M_3组)27例.用游标卡尺测量.结果显示:1.磨牙槽长度和第三磨牙槽长度三组间差别明显,而第一、二磨牙槽长度M_1组明显小于M_2组和M_3组;2.下颌牙弓长度、尖牙间距在M_1组和M_2组明显小于M_3组;3.下颌支高度、下颌体弓长度和下颌支体间距各组间变化不明显.本研究提示前牙槽和第一、二磨牙槽的大小对第三磨牙间隙有影响,进而影响第三磨牙的正常萌出.     

胃癌组织中RUNX3与mP53表达的关系及意义

目的观察RUNX3蛋白在正常胃黏膜、癌前病变及胃癌组织中的表达,分析RUNX3与mP53在胃癌中表达的关系,探讨Runx3与胃癌临床病理因素的关系以及二者在胃癌发生发展中的作用和意义。方法采用免疫组化PV9000法检测91例胃癌及配对正常胃黏膜,19例肠上皮化生,5例异型增生中RUNX3和mP53的表达。结果RUNX3在胃癌组织中的阳性表达率(48/91,52.75%,P<0.05)显著低于正常胃黏膜(86/91,94.51%)和肠上皮化生(19/19,100%)。RUNX3与胃癌临床病理因素未见显著相关性。胃癌组织中mP53的阳性表达率随分化程度降低而升高,但无统计学意义。胃癌组织中RUNX3与mP53表达呈负相关(=-0.225,P<0.05)。结论胃癌组织中RUNX3表达缺失与mP53过表达可能参与胃黏膜的癌变和胃癌的发病机制和演进。     

下颌骨观察性状的时代间比较

目的:分析中国现代人群下颌骨几项观察性状的表现及时代变异特点.方法:下颌骨干骨379例,其中新石器时代56例,青铜铁器时代210例,近代113例,将髁突冠突高低,颏孔开口方向,舌骨沟桥,舌骨沟宽,舌骨沟深,下颌前翘,摇椅式下颌等分为几个类型,统计各个类型的主要形态表现、在不同时代间的出现率,比较时代间的差异.结果:冠突主要表现为不低于髁突(85.8％);颏孔的开口主要朝后上(70.9％);舌骨沟桥(明显)的出现率6.2％;舌骨沟宽大多为细(47％)和中(36.1％);下颌前翘的出现率为35.5％,摇椅式下颌的出现率很低(4.6％),以上观察性状无明显时代差异.舌骨沟宽的宽度在“中”以上的比例,在新石器时代、青铜铁器时代和近代,左侧分别为24％、45.8％、59.6％,右侧分别为36.7％、46.8％、55.6％.结论:舌骨沟宽随时代而增宽,可能反映了走行其中的神经、血管随时代而增粗.其他观察性状没有整齐规律性的时代变化.     

下颌第二磨牙后间隙与下颌第三磨牙阻生关系的研究

目的　探讨下颌第三磨牙阻生的机理。方法　将 30 2个下颌骨标本分为正常组、阻生组、无第三磨牙组 ,再分别测量下颌骨斜长 ,下颌第二磨牙后间隙的长度及下颌支喙突内侧面隆嵴与齿槽缘所形成的夹角。结果　男女阻生为 10 0 % ,女性高于男性 (P <0 0 5 )。结论　无第三磨牙可能是人类进化过程中 ,下颌骨与牙齿均衡退化的果结 ,而阻生是人类进化从有第三磨牙向无第三磨牙演化的过渡阶段     

孕期妇女外周血免疫功能与淋巴细胞凋亡的变化

目的 探讨孕期妇女外周血免疫功能与淋巴细胞凋亡的变化。方法 选择孕期妇女48例和正常对照组38例。应用单克隆抗体间接免疫荧光法检测CD^ 3、CD^ 4、CD^ 8。IgA、M、G采用免疫比浊法。外周血成熟淋巴细胞凋亡检测采用吖啶橙-溴化乙锭细胞内染色法。结果 孕期妇女CD^ 4、CD^ 4／CD^ 8、IgG明显降低，IgM、CD^ 8、淋巴细胞凋亡率(PCD)明显升高，与正常组比较有统计学意义。结论 孕期妇女免疫功能降低。外周血淋巴细胞凋亡率升高。     

大学生第三磨牙萌出情况调查

第三磨牙(也称智齿,以下简称M3)是人类恒牙组中萌出最晚的牙齿,又是先天缺失最多的牙[1],其萌出时间约在20岁左右[2],本文以我校2004年录取的四川籍本科生为研究对象,将第三磨牙的萌出情况进行调查,现报道如下。1对象与方法选择我校2004年录取的本科生442名,其中男生234名,女生     

MR横向弛豫时间测定技术对激素诱导兔股骨头缺血坏死模型的定量影像分析

目的 定量研究兔激素性股骨头坏死模型(SANFH)MR横向弛豫时间在造模不同时相的变化规律,探讨所反映的骨髓组分及微结构变化。方法 健康成年纯种新西兰大白兔60只,采用随机区组抽样方法分为空白对照(8只)及造模2、4、6、8周组(各13只)。制作模具小管并行MR T₂ mapping序列MR扫描,评价所得参数即T₂值的稳定性。参照Yamamoto的方法对模型组进行造模处理。造模开始前对空白对照组进行MR扫描,各模型组分别在造模后满2、4、6、8周时行MR扫描,将横向弛豫原始图像数据传至GE AW4.2工作站进行后处理,计算各像素T₂、T₂*值,创建相应参数的彩色编码图,对股骨头区、骺下区及髓腔骺端进行测量域感兴趣区的特征参数值;扫描完成后将实验动物处死,切取股骨头进行组织形态学检查。结果 剔除实验期间死亡动物及无效图像资料,MR检查并获得有效数据的空白对照及造模2、4、6、8周组实际样本量分别为8只(16髋)、10只(20髋)、9只(18髋)、9只(18髋)、10只(20髋)。各模型组及空白对照组T₂值(F=51.601, P＜0.01)、T₂*值(F=36.889, P＜0.01)组间总体差异有统计学意义。造模各组T₂、T₂*值均低于空白对照组,造模早期(2周)出现明显下降,4周降至最低,6、8周出现部分恢复;各解剖区域间T₂(F=86.274, P＜0.01)、T₂*(F=53.172, P＜0.01)值差异有统计学意义;股骨头区T₂、T₂*值高于骺下区及髓腔骺端,骺下区高于髓腔骺端(P值均＜0.05)。组织形态学变化:造模早期表现为骨髓造血细胞减少及脂肪细胞增生,髓内微血管血栓及出血,4周最为显著,之后出现骨组织坏死,骨小梁变细、部分消失,间质反应(充血、水肿、出血)及纤维化。结论 MR横向弛豫时间可敏感地反映SANFH模型骨髓组分及骨小梁微结构特征性改变,为此病早期诊断及病程监控提供了重要的定量影像学方法。     

Methoctramine and hexahydrodifenidol antagonise two muscarinic responses on the rat superior cervical ganglion with opposite selectivity

Two novel muscarinic antagonists, methoctramine and hexahydrodifenidol, have been assessed for their action against two muscarinic agonist-induced responses on the rat superior cervical ganglion in vitro. DC recordings were made between the desheathed ganglion and its internal carotid nerve using the grease-gap technique. Hexahydrodifenidol and methoctramine antagonised the muscarine-induced M₁-mediated depolarisation of this preparation with estimated pA₂ values of 7.5 and 6.5, respectively. In 0.3 μM pirenzepine and 0.1 mM CaCl₂, 1 μM muscarine evoked a hyperpolarisation mediated by cardiac-like M₂ receptors. Hexahydrodifenidol and methoctramine antagonised this response with pIC₅₀ values (−log₁₀IC₅₀) of 5.7 and 7.4, respectively. The selectivity of methoctramine for cardiac-like M₂ receptors over M₁ receptors is therefore confirmed and extended to these two neuronal responses. The selectivity of hexahydrodifenidol was opposite to, and greater than, that seen with methoctramine.     

Lithium discriminates between muscarinic receptor subtypes on guinea pig hippocampal neurons in vitro

In CA3 pyramidal neurons of guinea pig hippocampal slices an outward current activated by the GABA_B agonist, baclofen (0.3 μM, I_bac) was reduced by low concentrations of carbachol (Cch, 0.1–0.3 μM). The effect of Cch desensitized suggesting that the receptor subtype involved in this muscarinic effect of Cch was of the M₁ subtype. The receptor subtype was also characterized by its equilibrium dissociation constant for pirenzepine (10 nM) as an M₁ receptor. Li⁺ applied extracellularly (1 mM) or intracellularly blocked the suppression of I_bac by Cch without affecting the Cch blockade of a current termed I_AHP, which is mediated by M₂ receptors. While the effect of intracellular Li⁺ application was immediate, it developed very slowly with extracellular application. Since Li⁺-salts are used effectively in the treatment of mania and depression, the selective effect of Li⁺ on M₁-mediated muscarinic neurotransmission might be important for the cholinergic hypothesis of affective disorders.     

Muscarinic modulation of acetylcholine release from slices of guinea pig nucleus basalis magnocellularis

Spontaneous and electrically evoked endogenous acetylcholine release and [³H]-choline efflux from slices of guinea pig nucleus basalis magnocellularis (nbM) were studied. Tetrodotoxin reduced the spontaneous endogenous release by 55%, while the Ca²⁺-free medium reduced it by about 30%. Evoked [³H]-choline efflux was Na⁺ and Ca²⁺ dependent and frequency related. Physostigmine, 30 μM, nearly halved the stimulation-evoked efflux; atropine, 0.15 μM, not only antagonized, but even reversed this effect into facilitation. Pirenzepine, 1 μM, and AFDX 116, 1 μM, were less effective than atropine, and reversed the inhibitory effect of physostigmine only when applied together. 4-DAMP, 0.01 μM, was ineffective. These findings indicate that acetylcholine release in guinea pig nbM slices is inhibited by the cooperation of muscarinic autoreceptors, possibly belonging to the M₁ and M₂ subclasses.     

Spinal nerve ligation does not alter the expression or function of GABA(B) receptors in spinal cord and dorsal root ganglia of the rat

Several postmortem and neuroimaging studies suggest that central nicotinic and muscarinic acetylcholine receptors are important in both the pathophysiology and pharmacotherapy of schizophrenia. However, while antipsychotic drugs are routinely used in the therapeutics of schizophrenia, little is known about their effects on the densities of these receptors when they are administered for extended periods of time (a common practice in the clinical setting). In the present study in rats, the residual effects of prior chronic exposure to representative first generation antipsychotics and second generation antipsychotics on the densities of high affinity nicotinic acetylcholine receptors and muscarinic acetylcholine receptor in the brain were investigated. Test subjects were treated with the first generation antipsychotics, haloperidol (2.0 mg/kg/day) or chlorpromazine (10.0 mg/kg/day) or the second generation antipsychotics, risperidone (2.5 mg/kg/day) or olanzapine (10.0 mg/kg/day) in drinking water for periods of 90 or 180 days, given a drug-free washout period (i.e. returned to normal drinking water) for two weeks and then killed. Quantitative receptor autoradiography was subsequently performed using 16 μm sagittal slices of whole brain incubated with [³H]-epibatidine, [³H]-pirenzepine or [³H]-AFDX-384 to measure high affinity nicotinic acetylcholine receptors, M₁ and M₂ muscarinic acetylcholine receptors, respectively. The most notable experimental result was a moderate, but significant (P<0.01) increase in [³H]-AFDX-384 binding sites in a number of brain regions (including cortex, hippocampus, subiculum, substantia innominata, and thalamus) associated with prior exposure to olanzapine for 90, but not 180 days. Olanzapine was also associated with a significantly higher density of [³H]-pirenzepine binding sites in cortex lamina I after 90 days of prior drug exposure. These data indicate that chronic treatment with a commonly used second generation antipsychotic, olanzapine is associated with modest increases in M₂ muscarinic acetylcholine receptors in memory-related brain regions that may eventually abate with longer periods of chronic drug exposure.     

Comparison of pharmacokinetic profiles of a 17β-estradiol gel 0.6 mg/g (Gelestra) with a transdermal delivery system (Estraderm TTS 50) in postmenopausal women at steady state

Objectives: to compare the patterns of a 17β-estradiol (E₂) gel containing 0.6 mg/g (1.5 mg E₂ per day, Gelestra); with the transdermal delivery system (Estraderm TTS 50) applied every 3 days over a 14-day period to women in spontaneous or surgical menopause. Methods: a single centre, open, randomised, parallel-group study was conducted. A total number of 33 postmenopausal women were enrolled. In 23 of them the menopause occurred spontaneously, while 10 women were bilaterally ovariectomized. Randomly, the subjects were treated with Estraderm TTS 50 (no. 8) or with Gelestra (no. 14). The pharmacokinetic study of the drugs was performed at the seventh, ninth and 14th day in Gelestra treated women and at the first, third and second day in Estraderm TTS 50 treated women. In fact, the seventh, ninth and 14th day of percutaneous treatment corresponds to the first, third and second day of application of the transdermal system application. Blood samples were taken by each subject at baseline and 1, 2, 3, 4, 8, 12 and 24 h after the gel or transdermal system application. In almost all samples the level of E₂ and estrone (E₁) were evaluated. Statistical analysis was performed by comparing the two groups of treatment. The following parameters were assessed: mean E₂ and E₁ concentrations, E₂ peak serum concentration within interval from 0 to 72 h (C_max), E₂ trough concentration within interval from 0 to 72 h (C_min), area under the E₂ time concentration curve in the interval from 0 to 72 h (AUC_(0–72)), the average E₂ concentration during the measurement interval, calculated by dividing AUC_(0–72) by 72 h (C_av), E₁/E₂ ratio, and percentage fluctuation (%Fluct) which is equal to 100 (C_max−C_min/C_max). Results: there was no significant difference in E₂ C_av between the two treatments. However, significant differences in favour to the gel on the first day (first h) and on third day (72nd h) and in favour to the patch at the second day (48th h) were detected. C_max, E₁/E₂ ratio and AUC_(0–72) were not statistically different, while a significantly higher C_min for the gel was observed. Furthermore, the 90% confidence interval for AUC_(0–72) ratio (0.83–1.10) was within the commonly applied bioequivalence acceptance range (0.80–1.25). The %Fluct was significantly lower for Gelestra than for Estraderm TTS 50. Conclusions: although the mean E₂ and E₁concentrations, C_max, E₁/E₂ ratio and the AUC_(0–72) did not differ between the two E₂ treatments, the Gelestra treatment showed a lower day-to-day variation over the three day application, than the Estraderm TTS 50.     

涉及C2水平的长节段颈椎后纵韧带骨化症的手术疗效观察

目的 探讨涉及C₂水平的长节段颈椎后纵韧带骨化(OPLL)症的手术方式及疗效。方法 对2011年5月—2014年11月第二军医大学附属长征医院脊柱外科手术治疗的42例涉及C₂水平长节段OPLL症患者的临床资料进行回顾性研究。其中男22例、女20例,平均年龄56.2岁。依术式不同将其分为A、B两组,A组21例行单纯C_3～7后路椎管扩大成形术,B组21例行C_3～7后路椎管扩大成形加C₂椎板下缘减压术,比较两组患者术后JOA评分及评分改善率、颈椎曲度及C_2～3椎体间活动度。结果 42例患者均顺利完成手术。A组中1例术后发生C₅神经根麻痹,A组中1例、B组中2例术后出现轴性疼痛,予相应处理后痊愈。术后随访6个月～4年,平均随访2.1年。术后3个月及末次随访时B组JOA评分及评分改善率均高于A组,差异均有统计学意义(t值分别为7.203、6.644,P值均＜0.01)。术后3个月及末次随访时两组患者颈椎曲度及C_2~3椎体间活动度差异均无统计学意义(P值均＞0.05)。结论 对于涉及C₂水平长节段颈椎OPLL症患者,若K线阳性,行C_3~7后路椎管扩大成形加C₂椎板下缘减压术,可以取得满意疗效。     

DIETARY MAGNESIUM EFFECT ON SWINE CORONARY ATHEROSCLEROSIS INDUCED BY HYPERVITAMINOSIS D

The effects of magnesium (Mg) supplement on coronary arteries of 61 swine, fed various levels of vitamin D₃ (VD₃), were studied by light and electron microscopy. High frequencies of smooth muscle cell degeneration were observed in groups of swine fed various levels of excess VD₃. Swine fed moderately excessive level of VD₃ with a basal level of Mg displayed great incidence and magnitude of intimal thickening, while swine fed the same level of VD₃ with supplementary Mg sustained only mild intimal thickening. In groups of swine fed high levels of VD₃, the prevention of calcification and smooth muscle cell degeneration was observed as a supplementary Mg effect. Plasma analyses indicated that supplementary Mg with excess VD₃ increased cholesterol levels but decreased arterial damage. It is concluded that the dietary Mg supplement prevents coronary atherosclerosis induced by hypervitaminosis D.     

β-Adrenergic and muscarinic receptor mRNA accumulation in the sinoatrial node area of adult and senescent rat hearts

The sinoatrial (SA) node is the cardiac pacemaker and changes in its adrenergic-muscarinic phenotype have been postulated as a determinant of age-associated modifications in heart rate variability. To address this question, right atria were microdissected, the SA node area was identified by acetylcholinesterase staining, and, using a RT-PCR method, the accumulation of mRNA molecules encoding β₁- and β₂-adrenergic (β₁- and β₂-AR) and muscarinic (M₂-R) receptor was quantified to define the proportion between β-AR and M₂-R mRNAs within the sinoatrial area of adult (3 months) and senescent (24 months) individual rat hearts. In adult hearts, the highest M₂-R/β-AR mRNA ratio was observed within the sinoatrial area compared with adjacent atrial myocardium, while in the senescent hearts, no difference was observed between sinoatrial and adjacent areas. This change was specific of the sinoatrial area since adult and senescent whole atrial or ventricular myocardium did not differ in their M₂-R/β-AR mRNA ratio, and was associated with a fragmentation of acetylcholinesterase staining of the senescent SA node. Quantitative changes in the expression of genes encoding proteins involved in heart rate regulation specifically affect the sinoatrial area of the senescent heart.     

Acetylcholine receptors in dissociated nucleus basalis of Meynert neurons of the rat

Electrical and pharmacological properties of acetylcholine (ACh)-induced currents in neurons dissociated from the nucleus basalis of Meynert (nBM) of immature (2-week-old) rats were investigated with the whole-cell mode of the patch-clamp technique. At a holding potential (V_H) of −50 mV, ACh (10⁻⁴M) evoked a transient inward current mimicked by nicotine (I_nACh), followed by a sustained outward current mimicked by carbamylcholine (I_mACh). The K_D values were 1.2 × 10⁻⁴ M for I_nACh) and 8.7 × 10⁻⁷ M for I_mACh. The reversal potenial of I_mACh was close to E_K. The I_mACh was determined to be elicited via the M₂ muscarinic receptor, based on the differences in sensitivity to muscarinic antagonists such as pirenzepine and AF-DX-116.