上颌神经诱发三叉神经皮层电位的研究

目的　探讨三叉神经的分支上颌神经皮层诱发电位的特点及与三叉神经其他分支皮层诱发电位的差异。方法　通过刺激 10名健康成人的眶下神经 ,收集刺激对侧的三叉神经诱发电位 (TSEP)。结果　①刺激发生 2 0ms左右出现P1,其后N1～N5等 9个波峰依次出现 ;②P3、N3、P4潜伏期稳定 ,N3～N4振幅高且图形规律 ;③上颌神经皮层诱发电位与下颌神经皮层诱发电位无明显差异。结论　上颌神经TSEP中高峰电位出现于 110ms的N3P4波 ,波幅 >10 μV ,其潜伏期相对稳定 ,形成上颌神经TSEP的特点 ,早期的P1～N2波幅较低 ,但可以因周围神经的改变而有较大的变化 ;正常上颌神经的TSEP各波潜伏期、图形特点、峰峰电位差与下颌神经TSEP差异不明显。根据图形特点、参数可以作为临床三叉神经上颌支功能状态和病理改变的判定指标     

Er, Cr: YSGG激光与氟化物联合应用对牙体硬组织脱矿的影响

目的：体外研究Er，Cr：YSGG激光与氟化物联合应用对牙体硬组织抗酸性的影响。方法：标本随机分成4组，分别为对照组，激光组，氟处理组，激光＋氟组，进行不同处理后，0．1mol／L乳酸（pH4．8）脱矿24h，原子吸收分光光度计检测脱矿液中溶解的钙离子浓度，能谱分析仪进行氟原子含量分析，扫描电镜观察牙釉质和牙本质表面超微结构的变化。结果：激光组、氟处理组、激光＋氟组溶解的钙离子浓度都明显降低，与对照组有显著性差异（P〈0．05），但是激光＋氟组钙离子浓度仅略低于激光组、氟处理组，与其无显著性差异（P〉0．05）；氟含量的测定仅在氟处理组牙釉质和牙本质标本有氟峰出现；扫描电镜观察见，激光组：表面不平呈鳞片状、峭壁状，无玷污层，釉质结构清晰可见，牙本质小管开放，无熔融、炭化等热损伤的表现；氟化钠组：表面有大量玷污层和碎屑，并可见到许多小颗粒沉积在牙釉质和牙本质表面；激光＋氟组：表面结构与激光组相似，未见颗粒沉积。结论：Er，Cr：YSGG激光与氟化物无联合效应，其机制仍需进一步的研究与探讨。     

Molecular mediators of Porphyromonas gingivalis‐induced T‐cell apoptosis

Porphyromonas gingivalis produces virulence factors which can modify the molecular and cellular components of the host immune response. In the present work we investigated the role of specific virulence factors from P. gingivalis in the induction of apoptosis in Jurkat T cells. P. gingivalis culture supernatants mimicked the effect of butyric acid on T‐cell apoptosis and this effect was associated with an increase in histone H4 acetylation. A role for proteases was excluded in experiments which demonstrated that neither protease inhibitors nor use of P. gingivalis mutants defective in protease synthesis had any effect on the stimulation of T‐cell apoptosis in this system.     

Creating an effective PBL case in oral and maxillofacial surgery at a Chinese dental school: a dental education primer

Problem-based learning (PBL) is a widely accepted educational method centered on the discussion and learning that emerge from a clinically based problem; however, little has been reported on the details of PBL case-writing in the dental education literature. This article outlines some principles of writing a PBL case as it is practiced at a Chinese dental school and presents, as an example, an actual case based on a clinical problem (ameloblastoma of the jaw) intended to provide a learning focus for predoctoral dental students. A good PBL case should allow for progressive, interdependent actions to be taken in the evaluation and overall management of the patient in context and should trigger inquiry and discussion among students in both the basic sciences (anatomy, physiology, biochemistry, pharmacology, pathophysiology, etc.) and related clinical sciences. The epidemiological, sociological, and ethical considerations related to each problem should also be emphasized as an essential component of effective health care provision.     

末端种植体倾斜状况的应力研究——向舌侧倾斜

目的：研究下颌种植体舌倾斜时末端种植体应力分布情况。方法：下颌５个种植体，除左侧末端种植体舌倾斜１５°外余为垂直状态。以１００Ｎ分别垂直加载于距末端种植体０、１０、２０ｍｍ的悬臂梁上，在微机上用ＳＡＰ８４软件分析种植体周围应力分布。结果：加载于距末端种植体２０ｍｍ时其种植周围应力均比加载于悬臂梁０、１０ｍｍ时为大。种植体舌侧倾斜时，在近中和舌侧骨界面应力亦较远中和颊侧骨界面的应力大。结论：种植义齿设计时应考虑种植体舌侧倾斜时骨界面舌侧和近中应力状况     

学习贯彻基层指南,加强慢性乙型肝炎基层防治

近年来,我国在慢性乙型肝炎防治研究领域取得了巨大进步,基层医生也逐渐参与到慢性乙型肝炎的预防、诊断及治疗中,中华医学会组织肝病、感染专家和全科专家共同制订了《慢性乙型肝炎基层诊疗指南(2020年)》,现对该指南的特点作一简述。     

158例糖尿病足病原菌分布与创面特点的关系

目的 分析糖尿病足住院患者创面的病原菌分布、药敏情况及其与创面特点之间的关系.方法 选取2017年1月至2019年12月该院急诊外科糖尿病足住院患者158例作为观察对象,取足部创面深部组织,行微生物培养及药敏试验.结果 糖尿病足患者Wagner2、3级创面革兰阳性菌菌株(2级22株,3级30株)多于革兰阴性菌菌株及真菌,Wagner4级创面革兰阴性菌菌株(44株)多于革兰阳性菌菌株及真菌,Wagner 5级共培养细菌2株均为革兰阴性菌.革兰阳性菌对万古霉素、替考拉林、利奈唑胺、替甲环素的敏感度为100％,革兰阴性菌对亚胺培南、美罗培南、庆大霉素、氨基糖苷类的敏感度较高.结论 糖尿病足患者创面病原菌以革兰阳性菌为主,糖尿病足Wagner分级越高,革兰阴性细菌、真菌感染率逐渐升高.     

Effect of Electro-acupuncture on Expression of IRS-1/PI3K/GLUT4 Pathway in Ovarian Granulosa Cells of Infertile Patients with Polycystic Ovary Syndrome-Insulin Resistance of Phlegm-Dampness Syndrome

Objective: To evaluate the effect of electro-acupuncture (EA) in infertile patients with phlegm dampness polycystic ovary syndrome-insulin resistance (PCOS-IR). Methods: Seventy-six PCOS-IR patients who underwnet in vitro fertilization and embryo transfer (IVF-ET) were equally assigned to two groups according to a random digital table: the EA group and the control group, with 38 cases in each group. Before undergoing IVF, the two groups were treated with EA or pseudo-acupuncture, respectively, for 3 menstrual cycles. The intervention was 25 min twice a week until the day of oocyte collection. The selected acupoints were Zhongwan (RN 12), Tianshu (ST 25), Daheng (SP 15), Daimai (GB 26), Qihai (CV 6), Guanyuan (CV 4), and bilateral points including Xuehai (SP 10), Fenglong (ST 40), Zusanli (ST 36), and Yinlingquan (SP 9). Evaluation of phlegm-dampness syndrome score and IR score were carried out before and after treatment. Additionally, the number of oocytes retrieved, transplantable embryo rate, high-quality embryo rate, clinical pregnancy rate and live birth rate were compared between the two groups. Real-time polymerase chain reaction analysis was used to monitor the mRNA expression of the insulin receptor substrate (IRS-1), phosphatidylinositiol 3-kinase (PI3K) and glucose transport factor 4 (GLUT4) in ovarian granulosa cells. Results: EA treatment reduced the phlegm-dampness syndrome score as well as the IR scores compared with the control group (P<0.05). No significant differences in the number of oocytes retrieved and clinical pregnancy rate between the two groups (P>0.05). Moreover, the transplantable embryo rate [49.0% (284/580) vs. 41.9% (273/652)], high-quality embryo rate [36.6% (104/284) vs. 27.8% (76/273)], and live birth rate [50% (19/38) vs. 26.3% (10/38)] in the EA group were significantly higher than in the control group (P<0.05). Gene expression analyses revealed significantly elevated IRS-1, PI3K and GLUT4 mRNA in ovarian granulosa cells of the EA group compared with the control group (P<0.05). Conclusions: EA may ameliorate the effects of phlegm-dampness syndrome and ovarian IR in PCOS-IR patients. Mechanistically, this effect might be through an upregulation of the IRS-1/PI3K/GLUT4 signaling pathway, which may result in improved oocyte quality and embryonic development potential. (Registration No. ChiCTR1800015453)     

新型冠状病毒肺炎防控期间居家隔离人群心理健康状况调查及影响因素分析

目的 了解新型冠状病毒肺炎防控期间居家隔离人群心理健康状况并分析其影响因素,为进一步做好疫情防控工作,疏导不良情绪及心理恐慌提供依据.方法 选取2020年2月15 17日本研究团队7名研究生居住地为调查单位,采用自制一般情况调查表及12项一般健康问卷(GHQ-12)量表调查居家隔离的380人的心理健康状况.根据GHQ-12评分,将调查对象分为GHQ-12≥3分为阳性组(n=212)和GHQ-12＜3分为阴性组(n=168).采用Logistic回归模型分析居家隔离人群心理健康状况的影响因素.结果 两组在年龄、性别、是否独生子女、经济收入方面比较,差异无统计学意义(P＞0.05);而在居住地、婚姻状况、生育情况、担心感染、文化程度、职业方面差异有统计学意义(P＜0.05).多因素Logistic回归分析结果显示,居住地农村、初中及以下文化程度、已婚、学生、外出务工人员、担心感染是居家隔离人群心理健康的危险因素,年龄是其保护因素.结论 新型冠状病毒肺炎防控期间,居家隔离人群存在一定心理健康问题,其受多种因素影响.医院或社区卫生中心应针对不同人群进行心理疏导,改善其身心健康.