温莪术内生真菌的分离及其抗菌活性的初步研究

 目的研究温莪术内生真菌的种群组成及其代谢产物抗菌活性。方法采用内生菌常规分离法对健康温莪术植株体内的内生真菌进行了分离鉴定。以大肠杆菌、金黄色葡萄球菌、链球菌、沙门氏菌、巴氏杆菌为测试菌种,对温莪术根、茎、叶中分离的56株内生真菌进行抗菌活性筛选。结果经初步鉴定,这些内生真菌为5目、6科、24属;抑菌实验表明,56株内生真菌中有39株对5种测试菌均有不同程度的抑制作用。结论温莪术植物含有丰富多样的内生真菌,且多数内生真菌都表现为较高的抑菌活性。     

微酸性次氯酸水用于口腔综合治疗台水路消毒的研究

目的　检测不同浓度微酸性次氯酸水（slightly acidic hypochlorite water,SAHW）应用于口腔综合治疗台水路（dental unit waterlines,DUWLs）的消毒效果。方法    选取32台口腔综合治疗台（dental chair unit,DCU）,随机均分为4组（1个对照组和3个实验组,每组8台DCU）。首先,采集高速手机和三用枪基础水样行细菌培养、菌落计数;然后,实验组分别用有效氯含量8 ~ 12 mg/L（实验1组）、18 ~ 22 mg/L（实验2组）、28 ~ 32 mg/L（实验3组）的SAHW供水DUWLs,连续7 d采集高速手机和三用枪水样行细菌培养、菌落计数。第8 d始改用无菌蒸馏水（distilled water,DW）供水DUWLs后采集水样菌落培养计数;对照组用DW替代消毒水,同样程序流动冲洗DUWLs后收集高速手机和三用枪水样菌培养后菌落计数。数据采用SPSS 20.0软件进行统计分析。结果    与基础水样比较,SAHW消毒1 d,3个实验组的高速手机和三用枪水样菌落计数均显著下降（P < 0.05）;SAHW消毒2 d,实验3组高速手机和三用枪水样菌落计数均小于消毒合格水样上限值（100 CFU/mL）;SAHW消毒3 d开始,实验3组菌落计数为0 CFU/mL,实验1组和2组菌落计数均显著小于100 CFU/mL。更换为DW供水后1 ~ 2 d,3个实验组的高速手机和三用枪水样菌落计数维持小于100 CFU/mL,组间差异无统计学意义（P > 0.05）;3 ~ 7 d,3个实验组的高速手机和三用枪水样菌落计数持续增加（149 ~ 1014 CFU/mL）,实验1、2、3组的组内不同时间点检测数据比较差异均有统计学意义（均P < 0.05）,且均明显大于合格水样上限值（P < 0.05）。结论    高有效氯含量较低有效氯含量的SAHW消毒效果更稳定;低有效氯含量8 ~ 12 mg/L的SAHW持续作用于DUWLs内环境亦可有效控制菌落计数,消毒效果明显。     

颌骨囊肿术后骨形成的影像学评估

手术是颌骨囊肿的主要治疗方法。囊肿刮除术、开窗减压术（袋形术）在临床上广泛应用。术后采用影像学方法观察骨腔的愈合或囊腔的缩小,是术后疗效评估及开窗减压术后选择二期囊肿刮除术时机的必要措施。由于不同的手术方式,上、下颌骨结构的差别,病变类型、大小以及患者年龄等差异,可能影响囊肿术后骨沉积的速率与结果。文章结合文献和笔者的经验,就颌骨囊肿术后骨形成的影像特点与相关因素做一概述。     

家长陪同对口腔门诊患儿七氟烷全身麻醉苏醒期躁动的影响研究

目的　研究家长陪同对口腔门诊患儿七氟烷全身麻醉苏醒期躁动的影响。方法　选取2017年6—12月于重庆医科大学附属口腔医院行七氟烷全身麻醉口腔治疗患儿120例,随机分为陪同组和未陪同组,每组60例。陪同组患儿在治疗前麻醉诱导期及治疗后苏醒期均有家长陪同,未陪同组患儿在麻醉诱导期及苏醒期均无家长陪同。采用小儿麻醉苏醒期躁动量化评分表（pediatric anesthesia emergence delirium scale,PAED）对患儿麻醉苏醒期躁动情况进行评分,并计算躁动发生率。结果　陪同组PAED评分为（9.18 ± 3.41）分,未陪同组PAED评分为（10.57 ± 3.62）分,两组PAED评分比较,差异有统计学意义（t = 2.04,P = 0.03）。陪同组躁动发生率（26.67%）明显低于非陪同组（50.00%）,差异有统计学意义（χ2 = 6.91,P = 0.01）。结论　治疗前麻醉诱导期及治疗后苏醒期有家长陪同,可减少患儿躁动的发生,提高家长对口腔治疗的满意度,促进良好的医患关系。     

Trabecular aspiration in pseudoexfoliative glaucoma--surgery to primarily reduce intraocular pressure

BACKGROUND: Trabecular aspiration has been discussed during the past few years as a new surgical method in the treatment of pseudoexfoliative glaucoma. In this procedure PEX-material, pigment and detritus are aspirated from the trabecular meshwork. Trabecular aspiration has been evaluated mainly in combination with cataract extraction. This study reports on our first experiences concerning the IOP-reducing effect of trabecular aspiration as a primary surgical method in the management of pseudoexfoliative glaucoma. MATERIALS: 17 eyes of 14 patients (7 m, 7 f; 12 OD, 5 OS; age 71 +/- 6 years) with pseudoexfoliative glaucoma were included in this study and operated on by standardised trabecular aspiration (vacuum max. 200 mm Hg, 180 - 270 degrees, 5 min). Therapy success was defined as an IOP reduction by more than 20 % and less than 21 mm Hg. RESULTS: Therapy success was 82 % (14 out of 17) on the first postoperative day, 50 % after 30 days (8 out of 16) and 23 % after 180 days (3 out of 13). IOP was 26.8 +/- 8.5 mm Hg before surgical intervention, 18.1 +/- 11.4 mm Hg after 1 day, 19.1 +/- 7.9 mm Hg after 30 days and 19.2 +/- 5.2 mm Hg after 180 days. Mean quantity of antiglaucomatous eye drops application was 3.1 +/- 0.9 preoperatively, 0.9 +/- 1.6 after 1 day, 0.8 +/- 1.2 after 30 days and 1.0 +/- 1.3 after 180 days. CONCLUSIONS: Trabecular aspiration achieves a good short-term effect in the reduction of IOP in patients with pseudoexfoliative glaucoma. However, this effect was limited to a few weeks in most patients. Trabecular aspiration as a primary surgical method in the management of pseudoexfoliative glaucoma does not appear to be suitable for long-term IOP reduction.     

敲除CIAPIN1基因提高白血病K562细胞对伊马替尼的敏感性

目的： 探讨靶向干扰细胞因子诱导凋亡抑制因子1 （cytokine induced apoptosis inhibitor 1,CIAPIN1）基因表达后慢性 粒细胞性白血病K562细胞对伊马替尼的敏感性。 方法 ：构建靶向CIAPIN1基因的shRNA干扰载体;使用实时定量PCR、West- ern blotting以及免疫荧光评价CIAPIN1-shRNA组（CIAPIN1-shRNA转染）和scramble-shRNA组（scramble-shRNA转染K562细 胞）干扰效率;伊马替尼（imatinib）处理两组K562细胞后,MTT法检测其增殖能力,集落形成实验检测细胞克隆形成能力,流式细 胞术和Western blotting检测细胞周期、凋亡及凋亡相关蛋白的变化。 结果： shRNA干扰可有效抑制CIAPIN1表达,CIAPIN1- shRNA组的CIAPIN1 mRNA表达量为scramble-shRNA组的(29.74±4.03)%、CIAPIN1蛋白表达量前者为后者的(21.57±2.18)%。 CIAPIN1表达下调能显著抑制伊马替尼对K562细胞的增殖和克隆形成,CIAPIN1-shRNA+imatinib组的细胞克隆形成数为 （15.60±1.03）个/视野,克隆半径为（2.63±0.55）μm,均小于scramble-shRNA+imatinib组（P<0.05或P<0.01）。CIAPIN1-shRNA+ imatinib组的细胞G1期细胞比例比scramble-shRNA+imatinib组明显增多,S期细胞比例较scramble-shRNA+imatinib组明显减少 （均P<0.01）。CIAPIN1-shRNA+imatinib组K562细胞凋亡率明显增加（P<0.01）。敲除CIAPIN1能抑制细胞周期相关蛋白Cyclin D1、Bcl-xl、Bcl-2、Mcl-1表达,诱导细胞内细胞凋亡相关蛋白p21、Bid、Bim表达,且与伊马替尼具有协同作用。 结论： CIAPIN1表 达下调可明显提高K562细胞对伊马替尼的敏感性,该作用主要通过阻滞K562细胞周期及诱导凋亡相关蛋白表达实现。     

Addition of a defibrillation electrode in the low right atrium to a right ventricular lead does not reduce ventricular defibrillation thresholds

Transvenous unipolar active can defibrillation systems have proven to be effective in treating ventricular tachyarrhythmias. However, a further reduction of ventricular defibrillation thresholds (V-DFT) would increase the longevity, reduce the size of pulse generators, and help to avoid additional leads in patients with inacceptable high V-DFTs. In a finite difference computer model, the extension of the right ventricular (RV) defibrillation coil into the low right atrium led to a 40% reduction of unipolar V-DFT. To evaluate this finding, we conducted a prospective, randomized study in 11 patients receiving an ICD. Extension of the RV electrode was simulated by adding a second coil placed in the low right atrium with the same polarity. Using a binary search protocol, V-DFT was determined with and without the additional electrode in each patient. Total shock impedance was significantly lower in the two coil (low RA) configuration, compared to the single coil (RV) configuration. Corresponding values were 49.9 +/- 6.7 Ohm and 61.1 +/- 9.3 Ohm, respectively (P < 0.01, paired t-test). However, there was no reduction, but even a nonsignificant increase in V-DFTs. Mean V-DFT in the RV configuration was 12.0 +/- 5.6 J and 16.3 +/- 7.8 J in the low RA configuration (P = 0.09, paired t-test). Despite a reduction in total impedance, the addition of a defibrillation coil in the low right atrium does not reduce ventricular defibrillation thresholds.