慢性根尖周炎患牙根尖外表面的细菌生物膜

目的：对慢性根尖周炎患牙根尖外表面的生物膜进行细菌学研究和形态学观察,了解生物膜中细菌的种类、组成及其超微结构。方法：选择临床诊断为慢性根尖周炎且不能保留的患牙10例,包括未经治疗及根管治疗失败的患牙各5例,同时将5例因正畸减数拔除的健康前磨牙作为对照组。所有样本的牙冠部无菌消毒后进行根管内取样、接种、厌氧培养后检测根管内的细菌种类。患牙拔除即刻3%（体积分数）戊二醛固定,取距根尖5 mm的牙根经梯度脱水、临界点干燥、喷金处理后进行扫描电镜观察。结果：10例慢性根尖周炎患牙拔除前根管内细菌培养均为阳性,其中微小消化链球菌和具核梭杆菌检出率较高。在5例未治疗的慢性根尖周炎患牙中仅有1例根尖外表面存在生物膜结构,主要由球菌组成;而在5例根管治疗失败的根尖周炎患牙的根尖外表面均可观察到浓密的细菌膜状结构,由球菌、杆菌及/或丝状菌组成,并且在超填的牙胶尖表面还观察到由球菌和丝状菌组成的典型的“玉米棒芯”样结构。对照组中则未有细菌存在。结论：慢性根尖周炎患牙的根尖外表面存在细菌生物膜结构,该生物膜的存在与临床上难治性慢性根尖周炎密切相关。     

感染根管内细菌定植状态的观察

目的：了解慢性根尖周炎患牙根管内的细菌感染状态,以指导临床治疗和评估预后。方法： 采用组织学与扫描电镜相结合的方法对临床不能保留的7例慢性根尖周炎患根进行超微结构观察,将新鲜拔除的患根沿牙长轴近、远、中向劈为两半,一半做组织学切片,采用Brown&Brenn染色观察,另一半做扫描电镜观察。结果：组织学切片细菌特染显示,大量细菌附着于根管壁表面并定植于根管壁牙本质小管深部,用测微尺测量细菌侵入深度为140～1 000 μm,根尖1/3段感染较重。扫描电镜结果显示,根管壁表面可见到致密、半封闭状态的网状细菌膜结构,大量球菌、杆菌和/或丝状菌镶嵌于无定形的基质中,集中于根尖1/3段。结论：慢性根尖周炎的根管内细菌以生物膜形式定植在根尖1/3区,并侵入牙本质小管深部,形成感染难以清除的区域。     

根管治疗失败患者感染微生态研究

目的 观察未治疗和根管治疗失败慢性根尖周炎患者根尖周病损组织菌群构成和根管内壁及根外生物膜超微结构,为治疗提供理论依据.方法 选取2018年4月至2019年4月本院牙体牙髓科收治的未经治疗和根管治疗失败的慢性根尖周炎患者40例,分为未经治疗组和治疗失败组,各20例.采集两组患者牙窝内根尖周病损组织,提取细菌DNA,构建...     

粪肠球菌再感染根尖周炎病程进展分析

目的构建粪肠球菌(Enterococcus faecalis,E.faecalis)再感染大鼠根尖周炎模型,通过观察实验牙根尖区骨质破坏面积、根尖区炎症状态及TNF-α表达,分析E.faecalis再感染大鼠根尖周炎的病程进展。方法 SD大鼠30只,采用双侧上颌第一磨牙开髓后置入细菌内毒素脂多糖并自然暴露于口腔正常菌群4周的方法建立混合菌初次感染慢性根尖周炎模型,建模成功后对实验牙行根管预备、封药消毒2周,其后去除填充物,根管内注入E.faecalis菌悬液,封闭洞口1周建立E.faecalis再感染大鼠根尖周炎模型,之后连续观察3周。E.faecalis再感染根尖周炎组大鼠在建模成功后1周、2周、3周时,以及混合菌初次感染慢性根尖周炎组正常培养6周后、慢性根尖周炎氢氧化钙治疗组经氢氧化钙治疗6周后,各组随机处死6只大鼠,通过X线测量法、H-E染色和免疫组化染色分别检测实验牙根尖周区骨质破坏面积、根尖周区炎症状态及炎症因子TNF-α的表达量。结果 (1)E.faecalis再感染大鼠根尖周炎建模成功后连续观察3周发现根尖周骨质破坏面积持续增加,骨破坏边界仍不清晰,而根尖周炎症1～2周时达重度炎症,在3周时已转为慢性炎症状态,TNF-α表达量在2周后下降。(2)混合菌初次感染慢性根尖周炎组根尖周骨质破坏面积较小,骨破坏边缘清晰,根尖炎症程度低,TNF-α表达量少。(3)慢性根尖周炎氢氧化钙治疗组根尖周骨质破坏面积最小,炎症消退,可见根尖周牙骨质和牙槽骨新生明显,TNF-α极少量表达。结论 E.faecalis具有较强的破坏根尖周组织的能力,在慢性炎症时,根尖周组织仍有进行性溶骨破坏的现象。     

血链菌生物膜中死菌/活菌的空间分布

目的研究血链菌生物膜形成中死菌/活菌的空间分布.方法在模拟人口腔环境的简易人工口腔模型内,形成血链菌生物膜,应用激光共聚焦扫描显微镜和死菌/活菌荧光染色方法,对血链菌生物膜形成中死菌/活菌的空间分布进行观察.结果生物膜底部的活菌百分比为20%;随着生物膜厚度的增加,活菌百分比达到70%,其间存在许多黑色气泡样的间隙;随后活菌百分比逐渐减少,至生物膜顶部时几乎全部为死菌.结论生物膜的底部和顶部主要由死细菌组成,而中间层主要是由围绕在黑色气泡样孔和通道周围的活细菌组成.     

口腔精密附着体生物膜中死菌/活菌的空间分布

目的 研究口腔精密附着体生物膜形成中死菌/活菌的空间分布. 方法 采集20例磁性附着体组织面菌斑生物膜,应用激光共聚焦扫描显微镜和死菌/活菌荧光染色方法 ,对生物膜形成中死菌/活菌的空间分布进行观察. 结果 生物膜底部的活菌百分比为12%;随着生物膜厚度的增加,活菌百分比达到74 %,其间存在许多黑色气泡样的间隙;随后活菌百分比逐渐减少,至生物膜顶部时几乎全部为死菌.结论 口腔精密附着体生物膜的底部和顶部主要由死细菌组成,而中间层主要是由围绕在黑色气泡样孔和通道周围的活细菌组成.     

血链菌生物膜中死菌/活菌的空间分布

目的 研究血链菌生物膜形成中死菌／活菌的空间分布。方法在模拟人口腔环境的简易人工口腔模型内，形成血链菌生物膜，应用激光共聚焦扫描显微镜和死菌／活菌荧光染色方法，对血链菌生物膜形成中死菌／活菌的空间分布进行观察。结果生物膜底部的活菌百分比为20％；随着生物膜厚度的增加，活菌百分比达到70％，其间存在许多黑色气泡样的间隙；随后活菌百分比逐渐减少，至生物膜顶部时几乎全部为死菌。结论生物膜的底部和顶部主要由死细菌组成，而中间层主要是由围绕在黑色气泡样孔和通道周围的活细菌组成。     

瘘型慢性根尖周炎206例的临床分析

目的 探讨常规根管治疗及根管外科手术对有瘘型慢性根尖周炎恒前牙的临床治疗效果。方法 分析我科2001—2005年的206例恒前牙有瘘型慢性根尖周炎患牙的临床特点、治疗方法及结果。结果 173例有瘘型慢性根尖周炎患牙通过常规根管治疗治愈而保存患牙,26例辅以根管外科手术——根尖切除术或根尖刮治术治愈,7例不能治愈而拔除。结论 常规根管治疗瘘口不能闭合的患牙在完成常规根管充填后,需辅以根管外科手术——根尖切除术或根尖刮治术,如还不能治愈应拔除惠牙。     

牙髓治疗失败行一次性根充再治疗的临床观察

目的应用甲硝唑、强的松、碘仿、根管充填剂配成糊剂 ,观察治疗慢性牙髓炎及根尖周炎的效果.方法对80例100颗牙髓治疗失败的患牙均采用一次性根充.结果 80例100颗牙治疗失败的病例中,9颗牙因牙冠劈裂拔除,7颗牙因原症状不能消除,X线片显示根尖区暗影扩大.结论应用配制根管充填剂一次性根充对牙髓治疗失败患者再治疗是可行的.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.