论牙周牙髓综合征的治疗

通过比较牙周牙髓综合征患者的临床疗效。对牙周牙髓综合征患者的患牙分别采用单纯牙周治疗,单纯牙髓治疗及联合治疗并观察疗效。得出牙周牙髓综合征患牙应尽量采用联合治疗。     

牙髓牙周综合征42例治疗体会

牙髓牙周综合征４２例治疗体会李国珍洛阳石化总厂职工医院口腔科洛阳４７１０１２关键词牙髓牙周综合征；根管治疗；干髓术牙髓牙周综合征不是一种独立疾病，而是在牙髓或牙周独立疾病的基础上发展而成。作者对就诊的４２例共４８颗牙给予综合治疗，经观察疗效较满意。现...     

牙周牙髓综合征临床诊疗心得

目的 比较86例牙周牙髓综合征患者的临床疗效.方法 对我院86例牙周牙髓综合征患者的130颗患牙分别采用单纯牙周治疗,单纯牙髓治疗及联合治疗并观察疗效.结果 联合治疗较单纯牙髓或牙周治疗的有效率高.结论 牙周牙髓综合征患牙应尽量采用联合治疗.牙周牙髓综合征同时兼有牙髓炎和牙周炎的症状.临床表现比较复杂,疗程长,原发病变和继发病变往往较难分清,治疗比较复杂,预后也相对较差.     

牙周牙髓综合征118例临床分析

为进一步探讨牙周牙髓综合征治疗效果,本文通过对118例牙周牙髓综合征患者的临床特点、治疗方法等进行临床分析,现报道如下。临床资料1一般资料选择2002~2004年在我院口腔科门诊就医的118例牙周牙髓病变患者,共136个患牙。其中男68例,74个患牙,年龄42~72岁,平均59岁。女50例,62     

牙周-牙髓综合征临床治疗体会

牙周牙髓综合征是有着不同来源，不同预后的一组疾病，同时兼有牙髓和牙周组织的综合症状，临床表现比较复杂且疗程长，其临床治疗的预后相对较差。临床上分为原发性牙髓根尖病继发牙周病变，原发性牙周病变继发牙髓病变，联合性病变3类。在临床上既有牙周病的表现特点，同时也有牙髓病的临床特点，常见于中老年人，在诊疗上有一定的难度，过去一般认为此种患牙不能保留须拔除。作者对116例126个牙周牙髓联合病变的患牙采取了综合治疗，保存了大部分的患牙，取得了比较满意的疗效，结果报告如下。     

Cortisomal糊剂充填根管治疗牙周牙髓联合病变的临床研究

目的对牙周牙髓联合病变患牙，应用Cortisomal糊剂进行根管治疗，并配合牙周治疗，观察临床疗效，同时分析不同类型病变治疗方案的选择对患牙预后的重要性。方法对40例牙周牙髓联合病变牙的临床资料进行分析，应用Cortisomal糊剂根管充填，针对病因采取牙髓牙周综合治疗，观察3、6、12个月疗效。结果Ⅰ型病变不需牙周治疗，预后最好；Ⅱ、Ⅲ型病变预后取决于牙周病变程度，牙髓治疗未显著提高骨缺损的修复。结论Cortisomal糊剂是一种很好的根管封闭材料，不同类型的牙髓牙周联合病变，根据病因采取不同的治疗措施。     

97颗牙周牙髓联合病变牙的临床治疗分析

目的：探讨牙周牙髓联合病变的临床有效治疗方法。方法：对我院2011年7月～2013年3月收治牙周牙髓联合病变患者进行抽样，选取81例患者的97颗患牙作为研究对象，并根据患牙病变的情况给予针对性的治疗，并对比观察其疗效。结果：针对81例患者的97颗患牙进行针对性治疗后，整体有效率高达82．5％。结论：对于牙周牙髓联合病变患者的治疗应考虑其导致病变的主要因素，并选取恰当的治疗方案，以提升临床治疗的有效率。     

Profile机用根管器械治疗磨牙牙周牙髓联合病变的临床效果

目的 探讨牙周牙髓联合病变的牙髓活力状况与牙髓治疗状况对临床治疗效果的影响。方法 选择伴有牙髓病变的牙周炎患牙123个磨莜 ，术前测验牙髓尖力；以Maillefer Profile机用根管器械采用逐步深入法预备根管共60个牙；以Mani Reamers手用根管器械采用逐步后退法预备根管共63个牙；通过术前，术后（3个月，6个月和1年）的X线牙片和临床指标（探诊出血和度，附着丧失和牙动度等）进行对比分析。结果 术前牙髓活力诊断正常的10例术后经为30．0％，敏感的70例为84．3％，迟钝的43例为86．0％，Millefer-Profile镍钛合金机用根管锉根管偏多率和根管治疗临床效果优于Mani Reamers手用根管器械组，治疗后1年的探诊出血指数，6个月及1年的探诊深度，3个月至1年的附着丧失和牙动率，均有明显差异，P＜0．05。结论 牙髓治疗的时机和效果对牙周牙髓联合病变的临床疗效影响明显，Maillefer-Profile镍钛合金机用根管锉的成形作用外，明显提高患者的临床效果。     

牙髓及牙周相瓦关系的临床思考

目的通过对临床工作中遇到的46例典型病例对牙周以及牙髓之间的关系进行分析,以求临床治疗设计上多一些思路,在联合治疗基础上考虑多些个体化治疗。方法将46例患者55颗牙按照相互关系分为五类,每一类根据病因设计不同的治疗方法并观察疗效。结果主要为牙髓病损,单纯采取根管治疗6例,有效率67％;牙髓病合并牙周病变,联合治疗17例,有效率82％;牙周病变牙髓有活力,单纯牙周治疗9例,有效率33％;牙周病变逆行感染牙髓,联合治疗13例,有效率85％;牙周牙髓联合病变,联合治疗10例,有效率70％。结论牙周损害对牙髓的影响并不大,除非牙髓本身原因,所以治疗上要尽可能查清病因。在病因不能确定的情况下,死髓牙先做牙髓治疗,配合牙周治疗;活髓牙则先做系统牙周治疗和调合,若疗效不佳,再视情况行牙髓治疗。     

牙髓及牙周相互关系的临床思考

目的 通过对临床工作中遇到的46例典型病例对牙周以及牙髓之间的关系进行分析,以求临床治疗设计上多一些思路,在联合治疗基础上考虑多些个体化治疗.方法 将46例患者55颗牙按照相互关系分为五类,每一类根据病因设计不同的治疗方法并观察疗效.结果 主要为牙髓病损,单纯采取根管治疗6例,有效率67%;牙髓病合并牙周病变,联合治疗17例,有效率82%;牙周病变牙髓有活力,单纯牙周治疗9例,有效率33%;牙周病变逆行感染牙髓,联合治疗13例,有效率85%;牙周牙髓联合病变,联合治疗10例,有效率70%.结论 牙周损害对牙髓的影响并不大,除非牙髓本身原因,所以治疗上要尽可能查清病因.在病因不能确定的情况下,死髓牙先做牙髓治疗,配合牙周治疗;活髓牙则先做系统牙周治疗和调合,若疗效不佳,再视情况行牙髓治疗.     

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.