手用ProTaper镍钛器械在磨牙根管治疗中的应用

目的:评价手用ProTaper镍钛器械预备磨牙根管的临床疗效.方法:选取需进行根管治疗的80颗患有牙髓炎或根尖周炎的磨牙,随机分为两组,A组:使用手用ProTaper镍钛器械,以冠根向深入法预备根管;B组:使用手用不锈钢扩大锉(K-file),以逐步后退法预备根管.两组均使用侧压充填法充填根管.记录根管预备时间、器械折断数量及工作长度变化,根据术前、术中、术后的X线片评价根管预备和充填的效果.结果:A组平均单根管预备时间较B组短,两组差异有统计学意义(P＜0.05);A组有一枚S1析断,B组有8枚8#到15#锉尖变形;A组预备根管后工作长度基本无变化,B组平均减少(1.41±0.93)mm(P＜0.01);A组预备后根管锥度,流畅度较好,术后疼痛发生少,且程度轻,差异有显著性(P＜0.05)结论:手用Pro T aper镍钛器械与传统不锈钢K锉相比可明显提高预备质量,尤其适于弯曲根管的预备,是值得推广的新型手用根管预备技术.     

临床应用手用PROTAPER系统与传统倒退扩根法的对比评价

目的:评价手用ProTaper系统预备根管与传统倒退扩根法的临床应用效果.方法:随机选取患有牙髓炎和根尖周炎的患牙58例,随机分试验组和对照组各29例,试验组用手用ProTaper多锥度镍钛器械逐步伸入法预备根管,对照组用K锉,逐步后退法预备根管,两组均用侧向加压充填法充填根管,根据治疗前后的X线片,评价根管预备效果.结果:试验组无根管偏移、根尖阻塞、台阶,且根管壁平滑流畅,无器械折断等并发症发生.对照组有4例台阶形成,器械折断1例,根管偏移4例.试验组操作时间短且术后疼痛轻微.结论:应用手用ProTaper系统预备根管快速、安全,成形效果好,易于根管冲洗消毒及充填.     

镍钛机用器械预备弯曲根管的临床评价

目的评价镍钛机用器械Profile预备弯曲根管的临床疗效。方法选取临床根管治疗的弯曲根管随机分为两组,对照组用不锈钢K锉行根管预备,试验组用镍钛机用器械Profile预备。结果Profile能很好地维持根管的弯曲度和走向,根管的锥度和流畅度极佳,所有患牙均无根管偏移、根管阻塞、台阶形成等并发症,且操作时间短,术后疼痛较少。结论Profile预备弯曲根管快速、高效,成形效果好,临床疗效明显优于手用不锈钢锉。     

机用ProTaper系统结合手用不锈钢K锉预备弯曲细小根管临床评价

目的 评价机用镍钛ProTaper系统结合手用不锈钢K锉预备弯曲细小根管临床疗效.方法 选取有弯曲根管的牙髓炎和根尖周炎患牙60颗,实验组用机用镍钛ProTaper结合手用不锈钢K锉预备根管,对照组手用不锈钢K锉预备根管,两组均用侧向加压法充填根管.根据治疗前、中、后的X线及术后疼痛情况,评价根管预备和充填的效果,并记录器械折断情况及操作时间.结果 实验组无根管偏移、台阶形成、无术后疼痛、无器械折断等并发症发生,对照组出现几例台阶形成和根管偏移及术后疼痛的发生.结论 两种方法联合运用各自优点,缩短操作时间,避免器械折断,可视为临床上预备弯曲根管的有效方法.     

Protaper手动镍钛锉在根管预备中的应用

目的 评价Protaper手动镍钛锉在根管预备中的应用效果.方法 随机选择200例需做根管治疗的患者,分为2组,每组100例,Protaper手动镍钛锉组(PT组)采用冠向下深入法预备根管,手用不锈钢K型锉组(SS组)采用逐步后退法预备根管.记录患者的术后反应和根管充填后的效果、根管的锥度和流畅度.结果 前牙术后根尖急症的发生率PT组与SS组差异无显著意义(P＞0.05);前磨牙、磨牙术后根尖急性反应的发生率PT组少于SS组(P＜0.01).根管充填后的X线片显示中,两组牙根管预备后的流畅度和锥度差异无显著意义(P＞0.05);前磨牙、磨牙,尤其是弯曲根管中PT组根管形态光滑、锥形完美,适充率更高.结论 Protaper手动镍钛锉用于磨牙根管预备有明显优势,可减少根尖急性反应的发生,根管塑形效果好,适充率高.     

机用镍钛器械在乳牙根管治疗中的疗效观察

目的:评价机用镍钛器械与传统手用不锈钢器械在乳牙根管治疗中的临床疗效。方法:符合根管治疗适应证的80颗乳磨牙随机分成A、B两组,每组40颗。A组以手用不锈钢器械行根管预备,B组为机用镍钛器械;根尖定位仪结合X线片法确定根管工作长度,Vitapex充填根管。根据治疗前后的X线片对根管的预备以及充填效果进行评价,并对两组的根管预备时间、患儿对治疗的疼痛反应、根管治疗后的远期疗效进行对比。结果:机用镍钛器械根管预备效果显著优于手用不锈钢器械,包括操作时间、预备后根管的锥度和流畅度、根管充填效果及远期疗效等指标,两组之间的差异有统计学意义(P<0.05)。两组患儿在根管预备过程中以及预备后均偶有疼痛等不适感,组间比较无统计学差异(P>0.05)。结论:机用镍钛器械在乳牙根管预备中可明显节省治疗时间、提高工作效率,并且预备后的根管锥度更有利于充填。     

ProTaper手用镍钛锉用于磨牙根管预备的临床效果分析

目的：评价ProTaper手用镍钛锉预备磨牙根管的临床效果。方法：选取患急、慢性牙髓炎或根尖周炎患者116例116颗磨牙,随机分为实验组和对照组,实验组采用ProTaper手用镍钛锉及冠向下法进行根管预备;对照组采用不锈钢K型锉及逐步后退法进行根管预备。两组均采用侧向加压法充填根管,记录两组根管预备后的反应情况,比较治疗前后的x光片,评价根管预备和充填效果。结果：ProTaper手用镍钛锉预备磨牙根管锥度流畅度好,恰填率高,根管治疗期间急症发生率低。结论：ProTaper手用镍钛锉在磨牙根管预备中有明显的优越性,可减少根尖急性反应,根管塑性效果好,适充率高。     

手用镍钛器械ProTaper与K形锉在根管预备系统的临床效果分析

目的评价手用镍钛器械ProTaper根管预备系统的根管预备效果和近期疗效.方法将60例牙髓病患者随机分为镍钛锉组和K形锉组,每组30例,分别采用手用镍钛器械ProTaper根管预备系统和传统K形锉进行根管预备,采用冷牙胶侧方加压充填技术进行一次性根管充填,临床观察比较2组的根管预备时间、预备质量和近期效果.结果手用镍钛器械ProTaper根管预备系统预备时间平均为2.9min,明显较传统K形锉时间(10.2min)缩短(P<0.05),镍钛锉组与K形锉组术后疼痛发生率分别为6.67%、3.33%,差异无统计学意义(P>0.05).镍钛锉组成功26例,进步4例;K形锉组成功28例,进步2例.结论手用镍钛器械ProTaper根管预备系统可以快速、简例地完成根管预备,临床近期疗效好.     

手用Protaper镍钛锉预备后牙根管的临床疗效分析

目的比较手用Protaper镍钛锉和不锈钢k锉预备后牙根管的临床效果。方法随机选取患牙髓炎或根尖周炎的后牙100颗,分为两组,观察组50例用手用Protaper镍钛锉预备根管,对照组50例用不锈钢k锉预备根管,两组均用侧向加压充填法充填根管。结果与不锈钢k锉相比,手用Protaper镍钛锉预备后牙根管能较好地维持根管的走向和弯曲度,根管的锥度和流畅度好,术后并发症少且程度轻。结论手用Protaper镍钛锉预备后牙根管成型效果好,术后并发症少,值得在基层口腔科推广。     

手用镍钛器械ProTaper根管预备系统的根管预备效果分析

目的：评价手用镍钛器械ProTaper根管预备系统的根管预备效果和近期疗效。方法：将60例牙髓病患者随机分为镍钛锉组与K形锉组,每组30例,分别采用手用镍钛器械ProTaper根管预备系统和传统K形锉进行根管预备,采用冷牙胶侧方加压充填技术进行一次性根管充填,临床观察比较2组的根管预备时间、预备质量和近期效果。结果：手用镍钛器械ProTaper根管预备系统预备时间平均为2.9min,明显较传统K形锉时间（10.2min）缩短（P〈0.05）,镍钛锉组与K形锉组术后疼痛发生率分别为6.67%、3.33%,差异无统计学意义（P〉0.05）。镍钛锉组成功26例,进步4例;K形锉组成功28例,进步2例。结论：手用镍钛器械ProTaper根管预备系统可以快速、简便地完成根管预备,临床近期疗效好。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.