陈祥主任治疗生殖器疱疹临床经验总结

生殖器疱疹是一种慢性终生性病毒感染性疾病。患者感染此类病毒后,机体不能将病毒完全清除。如何预防感染及复发是本病诊治的关键。陈祥主任医师是中华医学会河南省男科专业委员会常委,师从中国工程院院士郭应禄院士,从事男科临床、教学、科研工作30余年,常年工作于临床一线,临床经验丰富,遣方用药灵活多变,尤其在治疗前列腺、性传播疾病方面颇有造诣,对生殖器疱疹诊治颇有心得体会。     

女贞子-枸杞子对去势雌鼠血清中IL-10、IL-17水平的影响

目的:观察"女贞子-枸杞子"对去卵巢骨质疏松症大鼠血清中IL-10、IL-17水平的影响,探讨补阴药防治绝经后骨质疏松症的作用机制。方法:3月龄SD雌性大鼠60只,分为假手术组、模型组、阳性对照组、壮骨止痛胶囊组、女贞子-枸杞子组,对除假手术组外的其余组大鼠去卵巢3个月,制备绝经后骨质疏松症病理模型,手术后1周灌胃给药,连续13周。检测比较各组大鼠血清IL-10、IL-17水平。结果:与模型组比较,壮骨止痛胶囊组、女贞子-枸杞子组血清IL-10水平均明显升高,差异有统计学意义(P0.05);各给药组IL-17水平均有明显降低趋势,但与模型组差异无统计学意义(P0.05)。结论:女贞子-枸杞子能明显升高骨质疏松模型雌鼠血清IL-10水平,且能小幅度提高其IL-17水平,从而达到抗绝经后骨质疏松的目的。     

扶正抗癌方通过PTEN/PI3K/Bad通路调控肺癌A549细胞增殖与凋亡

目的:观察扶正抗癌(FZKA)方对肺癌细胞A549增殖的调控作用,探讨其作用的分子机制。方法:以非小细胞肺癌细胞A549为研究对象,以FAKA方0.8,1.2,1.6,2.0,2.4,2.8,3.2 g·L~(-1)干预,空白组,分别孵育24,48,72 h后,设立采用噻唑蓝(MTT)比色法检测FZKA方对A549细胞活力的影响;以FAKA方1.2,1.6,2.0 g·L~(-1)干预,设立空白组,培养24 h后,采用实时荧光定量聚合酶链式反应(Real-time PCR)检测FZKA方对A549细胞人第10号染色体同源丢失性磷酸酶-张力蛋白(phosphatase and tensin homolog deleted on chromosome ten,PTEN)mRNA水平的影响;孵育24 h后,采用蛋白质免疫印迹法(Western blot)分析FZKA方对PTEN,磷脂酰肌醇3-激酶(phosphatidylinositol-3-kinase,PI3K),磷酸化的促凋亡蛋白Bad(Phospho-Bad,p-Bad)表达的影响并探讨其相关性。结果:与空白组比较,FZKA方能明显抑制A549细胞增殖,处理24 h后,FZKA从0.8 g·L~(-1)开始,处理48,72 h后,FZKA方从0.4 g·L~(-1)开始,细胞存活率明显降低(P0.05,P0.01);与空白组比较,处理24 h后,FZKA方从0.8 g·L~(-1)开始以浓度依赖性上调PTEN mRNA和蛋白的表达(P0.05,P0.01),FZKA方从1.6 g·L~(-1)开始以浓度依赖性下调PI3K蛋白表达(P0.05,P0.01),从2 h开始以时间依赖性上调p-Bad蛋白的表达(P0.05,P0.01)。结论:FZKA方可通过上调PTEN来调控下游PI3K/Akt/Bad通路相关蛋白的表达进而抑制A549的增殖,促进肺癌细胞凋亡。     

补骨脂酚的提取纯化工艺优选及其对骨质疏松症的治疗作用分析

目的:优选补骨脂酚的提取纯化工艺,并考察其对骨质疏松症的治疗作用。方法:使用乙醇回流法提取,经D101型大孔树脂纯化,通过单因素试验优选工艺条件,冷冻干燥后得到补骨脂酚;采用斑马鱼体内试验评价补骨脂酚对骨密度和骨骼发育钙化的影响。结果:优选的工艺条件为加8倍量85%乙醇浸泡过夜,回流提取3次,每次2 h,边搅拌边往补骨脂酚粗提物中加入0.2%氢氧化钠水溶液至完全溶解,过预处理好的D101型大孔树脂柱处理,上样流速1 BV·h~(-1),静置4 h,加水6 BV洗脱,用60%乙醇2 BV洗脱,加95%乙醇4 BV洗脱,收集95%乙醇的洗脱液;制备的补骨脂酚质量分数80%,收率10%。斑马鱼体内活性研究表明补骨脂酚能提高斑马鱼骨质疏松症的骨密度,且能促进正常斑马鱼骨骼发育钙化。结论:此工艺具有绿色环保、操作简便等优点,所得补骨脂酚的纯度和收率均比较理想,可开发成预防或治疗骨质疏松症的药品和食品。     

总义齿、覆盖义齿和种植覆盖义齿修复后咀嚼效率和下颌运动型的比较

目的　比较总义齿 (completedenture ,CD )、覆盖义齿 (completeoverdenture ,COD )和种植覆盖义齿 (implant supportedoverdenture ,IOD)修复后患者的咀嚼效率和下颌运动轨迹的差异。 方法　分别选取CD、COD和IOD修复后患者各 14名 ,在义齿正常戴用半年后测量患者的咀嚼效率和下颌运动轨迹。对下颌运动轨迹从规则程度、末端集中性、额状面的分型和咀嚼运动中的接触滑动4个方面进行评价 ,测试用食物为杏仁和小枣。结果　IOD组患者咀嚼枣和杏仁的效率均显著高于CD组 (P <0 0 1) ;COD组患者咀嚼杏仁的效率显著高于CD组 (P <0 0 1)。COD组患者咀嚼枣的效率高于CD组 ,且IOD组患者咀嚼枣和杏仁的效率高于COD组 ,但其间差异无显著性。IOD组患者下颌运动轨迹的规则程度显著优于CD组 (P <0 0 5 ) ,末端轨迹集中性也显著优于CD组 (P <0 0 1)。结论　IOD和COD修复有利于提高无牙颌患者或口内只保留个别残根患者的咀嚼效率。IOD修复患者较CD修复患者具有更加规则的下颌运动型。     

Caries increment in the permanent dentition of Mexican children in relation to prior caries experience on permanent and primary dentitions

OBJECTIVE: To evaluate the likelihood of caries increment in schoolchildren, based on their prior caries experience. MATERIAL AND METHODS: We undertook a longitudinal study in 452 six-to-nine year olds between 1999 and 2001 in Mexico, with dental exams conducted by two standardized examiners (kappa>0.85). The dependent variable was the DMFT increment, dichotomized as without increment, and at least one unit of increment. Independent variables estimated caries experience at baseline. Data were analyzed using non-parametric tests and generalized linear models (log-binomial) to calculate relative risk (RR) adjusted for age and sex. RESULTS: The percentage of caries-free children diminished by 20.5% from 1999 to 2001. DMFT index increased two-fold, from 0.25+/-0.70 in 1999 to 0.77+/-1.30 in 2001 (p<0.001). The overall risk for this sample was 24%. The DMFT increment was higher (p<0.001) in children with DMFT>0 and dmft>0 in 1999 (RR=1.89, 95% CI=1.37-2.62; RR=2.71, 95% CI=1.94-3.76, respectively). The likelihood for DMFT increment from the 1999 levels was: (1) 2.78 times higher (95% CI=2.06-3.76) if schoolchildren had caries in any of the first permanent molars and (2) 1.62 times higher (95% CI=1.20-2.19) if schoolchildren were affected by high severity caries at baseline. CONCLUSIONS: Both caries prevalence and mean DMFT had significant increments in 18 months. Dental caries in the primary (dmft) and permanent (DMFT) dentitions at baseline are goods indicators of subsequent caries development in this group of children in a medium income country. This relationship became stronger when the occurrence of caries in the first permanent molars was included.     

Laser treatment of an oral papilloma in the pediatric dental office: a case report.

Squamous cell papilloma is a benign proliferation of the stratified squamous epithelium. It is typically an exophytic lesion smaller than 1 cm. Its appearance varies from cauliflower-like to fingerlike, while the base may be pedunculated or sessile. This article describes the case of an 11-year-old girl who presented with an asymptomatic whitish lesion of papillomatous appearance in the oral mucosa distal to the maxillary left permanent first molar. The lesion was removed using an Er,Cr:YSGG laser. For anesthesia, 10 mg of 2% lidocaine with epinephrine 1:100,000 was infiltrated around the lesion. No pain medication was required after surgery, and wound healing was excellent and rapidly achieved. The oral pathology report confirmed the presurgical clinical diagnosis. Laser dentistry is a modern technology that can be used by dental clinicians to treat these kinds of oral lesions and should be considered as an alternative to conventional surgery.     

Early implant failure. Prognostic capacity of Periotest: retrospective study of a large sample

Objectives: The objectives of this study were to determine the accuracy of Periotest^® to monitor primary implant stability at first‐stage surgery, to identify by multivariate analysis the variables associated with early implant failure and to compare Periotest^® with radiographic study in the diagnosis of implant stability at second‐stage surgery (during osseointegration period). Material and methods: A 10‐year retrospective study was conducted on 1084 Brånemark^® implants placed in 316 patients. Clinical variables, implant diameter and length, Periotest^® values (PTVs) and radiological variables were analyzed in bivariate and multivariate studies in order to determine their influence on early implant failure. Results: After examination of the sensitivity and specificity values obtained for different PTV cutoff points, a cutoff PTV of ?2 was selected (84% sensitivity and 39% specificity). In the bivariate analysis, early failure was significantly related to smoking habits, implant location, bone type, implant features and PTVs (?2 and ≥?2). In the final multiple logistic model, only age (odds ratio (OR)=4.53; 95% confidence interval (CI), 1.34–15.27), smoking habits (OR=2.5; 95% CI, 1.3–4.79), bone type (OR=1.93; 95% CI, 1.01–3.7) and PTV at first surgery (OR=3.01; 95% CI, 1.5–6.02) were independently related to early failure. Conclusions: The Periotest^® (with ?2 cutoff) at first surgery offers high sensitivity in the prognosis of early implant loss and shows a greater capacity to evaluate stability during the osseointegration period compared with radiographic study.     

五倍子对感染根管内厌氧菌抑制作用的体外研究

目的:观察中药五倍子对感染根管内几种常见优势专性厌氧菌和兼性厌氧菌的抑菌作用。方法:采用试管二倍稀释法,测定五倍子水提取物在体外环境下对厌氧消化链球菌、内氏放线菌、具核梭杆菌、中间普雷沃菌、金黄色葡萄球菌、大肠杆菌的最小抑菌浓度(MIC)和杀菌浓度(MBC),同时以氢氧化钙做对照。结果:五倍子对各种试验菌株均有抑制作用,对不同的菌株,MIC和MBC值不同,而氢氧化钙对内氏放线菌、金黄色葡萄球菌、大肠杆菌在试验浓度范围内无抑制作用。结论:五倍子水提取物抗菌效果较好且广泛,用于根管内封药具有一定的应用前景。     

自酸蚀黏接系统对充填体边缘密合性影响的研究

目的 观察4种自酸蚀黏接系统对充填体在牙釉质和牙骨质处边缘密合性的影响。方法 36颗离体牙于颊、舌侧牙颈部预备Ⅴ类洞型，分别用4种自酸蚀黏接材料（Prime ＆ Bond NT，SE-Bond，Adper^TM Prompt^TM，FL-Bond）处理后，充填4种牙体充填材料（Dyract AP、Cleanrfil AP-X、3MZ100、Beautifil），采用染料渗透和扫描电镜方法观察温度循环前后充填体在牙釉质和牙骨质处的密合性。结果 4种充填体在经温度循环后，牙釉质处的密合性都明显降低（P〈0．01）；在牙骨质处，Dyract AP和Clearfil AP-X的密合性无明显变化（P〉0．05），3MZ100密合性明显提高（P〈0．01），而Beautifil的密合性明显降低（P〈0．05）。结论 4种自酸蚀黏接材料在牙釉质处的黏接强度有待进一步增强以获得良好的边缘密合性。