慢性阻塞性肺疾病合并焦虑抑郁判断及对策

焦虑抑郁是慢性阻塞性肺疾病（COPD）常见的合并症之一,不仅影响患者的疾病严重程度,也是评估患者预后 的重要因素。文章从COPD合并焦虑抑郁的危险因素、临床判断及处置对策进行概述,为临床早期、规范诊治COPD 合并焦虑抑郁提供参考。     

超声波提取芒果叶总黄酮

目的为充分利用芒果叶植物资源,避免资源的浪费,探讨芒果叶总黄酮的提取方法。方法采用超声波乙醇浸提法从芒果叶中提取黄酮类物质,对所提取的黄酮类物质进行验证,并用紫外分光光度法测定含量。结果测得样品中总黄酮的含量C=2.900mg/mL,回收率为100.2%,其纯度和产率均较高。结论该方法采用全物理过程,无任何污染,是提取芒果叶黄酮类物质的有效途径。     

硫酸镁治疗慢性阻塞性肺疾病的Meta分析

目的系统评价硫酸镁治疗慢性阻塞性肺疾病的有效性与安全性。方法计算机检索Pubmed、Cochrane Library、Embase、CBM、CNKI、VIP、中华医学会数字化期刊、ISI Web of Knowledge等数据库。纳入硫酸镁静脉给药治疗慢性阻塞性肺疾病的随机对照试验（RCT）,检索时限均为建库至2015年2月。由2位研究者按照纳入与排除标准选择文献并进行质量评价,再采用RevMan5.0软件进行Meta分析。结果共计15个RCT, 955例患者。与对照组相比,硫酸镁有较高的临床体征改善率(OR=3.22,95%CI=1.87~5.55,P<0.01),能够改善患者第一秒用力呼气容积占预计值百分比（the first second forced expiratory volume percentage of expected value,FEV1%）(MD=10.17,95%CI=9.07~11.18,P<0.01)。但是同对照组相比,硫酸镁对患者第一秒呼气量（forced expiratory volume in one second,FEV1）(MD=0.05,95%CI=0.00~0.10,P=0.03)、第一秒呼吸容积占用力肺活量百分比（the first seconds breathing volume percentage of forced vital capacity,FEV1/FVC）(MD=1.43,95%CI=0.00~2.85,P=0.05)、动脉血气pH(MD=-0.01,95%CI=-0.03~0.01,P=0.43)、动脉血气PO2(MD=-3.97,95%CI=-7.41~15.35,P=0.49)、动脉血气PCO2 (MD=0.94,95%CI=-2.69~4.57,P=0.61)的改善均无显著影响,其不良反应发生率与对照组相似(MD=-0.94,95%CI=-0.23~0.04,P=0.19)。临床体征缓解率、不良反应发生率的漏斗图两侧显示不对称,提示纳入评价的文献存在发表性偏倚。结论静脉滴注硫酸镁可以显著改善患者肺功能的FEV1%,明显改善临床体征,且不良反应发生率较低,但对其他试验指标改善不明显。受纳入研究数量及质量限制,上述结论尚需要更多高质量、大样本、多中心的RCT加以验证。     

高压氧暴露对富血小板纤维蛋白形态学作用研究

目的　探讨高压氧（hyperbaric oxygen,HBO）暴露对富血小板纤维蛋白（platelet-rich fibrin,PRF）的形态学影响。方法　选30例健康志愿者抽血制备PRF,均分为3组,试验1组PRF用0.25 MPa HBO暴露1 h,试验2组用0.25 MPa HBO暴露0.5 h,对照组不用HBO暴露,分别用光学显微镜、扫描电镜（SEM）和透射电镜（TEM）观察并比较3组形态学差异。结果　光学显微镜观察发现：试验1组胶原纤维染为红色,纤维排列致密,血小板多;试验2组纤维排列稍致密,血小板量较多;对照组纤维排列稀疏,血小板最少。SEM观察发现：试验1组纤维中多个血小板伸出突起,位于纤维表面或纤维之间;试验2组致密的胶原纤维交错排列,血小板伸出突起;对照组胶原纤维排列成网状,包裹多个静止的血小板。TEM观察发现：试验1组血小板内α-颗粒释放后成空泡状,在纤维蛋白或细胞之间散在颗粒样物质,白细胞中线粒体和粗面内质网增多;试验2组较多血小板α-颗粒释放,血小板内见空泡样结构;对照组血小板内α-颗粒处于激活或静止状态。结论　HBO对PRF中血小板激活有促进作用,使血小板α-颗粒释放生长因子于网状排列的胶原纤维中,发挥生物学作用。     

侧支根管研究进展

侧支根管为发自根管的细小分支,常与根管呈接近垂直角度,贯穿牙本质和牙骨质,通向牙周膜。侧支根管作为根管解剖结构的一部分,与根管治疗成功率有着密切的关系。文章就侧支根管的形成与分布、影像学表现、清理消毒、对根管充填的影响及与根尖周病的关系做一综述。     

种植体周围炎对牙龈中组织蛋白酶B表达影响的实验研究

目的    组织蛋白酶B（Cathepsin B,CatB）是一种能在许多慢性炎症进展中发挥重要作用的溶酶体半胱氨酸蛋白酶,本研究旨在观察牙龈卟啉单胞菌（Porphyromonas gingivalis,P.g）感染后的人单核细胞系THP-1中和种植体周围炎患者的牙龈组织中CatB表达量与炎症及自噬的关系。方法    P.g感染人单核细胞系THP-1细胞后,用CatB抑制剂CA-074Me处理THP-1细胞,Western blot对比CA-074Me处理前后CatB、自噬相关蛋白Beclin-1、肿瘤坏死因子-α（tumor necrosis factor -α,TNF-α）和白介素-1β（interleukin-1β,IL-1β）的表达情况。取志愿者正常牙龈组织和种植体周围炎患者的牙龈组织,分别制作冰冻切片后对CatB、Beclin-1和TNF-α进行免疫荧光染色,并提取蛋白采用Western blot检测CatB、Beclin-1和TNF-α在牙龈组织中的表达情况。结果    经P.g感染的THP-1细胞中CatB、Beclin-1、TNF-α和IL-1β的表达量均增高,且这些指标在CatB抑制剂的作用下降低;种植体周围炎患者的牙龈组织中,CatB、Beclin-1和TNF-α的表达量均明显高于正常牙龈组织。结论    P.g感染的人单核细胞和种植体周围炎患者牙龈组织中CatB的表达增高,且这一变化与自噬及促炎因子的分泌相关。     

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??Objective    To evaluate the position of maxillary impacted canines and resorption of neighboring incisors with cone beam computed tomography ??CBCT??. Methods    Impacted maxillary canines in sixty-seven patients were selected and scanned by the Planmeca ProMax 3D at Stomatological Hospital of Jilin University from Dec.2015 to Jan.2017. The three-dimensional images were obtained by Invivo 5.4.5 software. Each impacted canine was positioned and the root resorption of adjacent incisors was observed in sagittal??coronal and axial views. Results    In sagittal plane view??except 10 horizontal impacted canines ??12.0%?? and 1 inverted impacted canine ??1.2%????33.7% of impactions were labial??30.1% were palatal??and 22.9% were middle. In coronal plane view??12.0% of the cusp tips of maxillary impacted canines were near the crown of the adjacent incisor??42.2% were near cervical third of the root of the adjacent incisor??24.1% were near middle third of the root of the adjacent incisor??9.6% were near apical third of the root of the adjacent incisor??and 12.0% were near the root tip of the adjacent incisor.In axial plane view??65.1% of impactions were mesial??12.0% of impactions were distal??and 9.6% were middle. About 17.9% lateral incisors had root resorption??and 9.7% central incisors ??13?? had root resorption??the difference being statistical ??P < 0.05??. Conclusion    CBCT is a better way in the diagnosis and analysis of the position and root resorption of maxillary impacted canines??which provides guidance to the treatment.     

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??Objective??To study the anesthetic effect of infiltration anesthesia and block anesthesia in the treatment for irreversible pulpitis. Methods??Seven electronic databases were searched including Pubmed??Cochrane Library and CNKI??which were updated until April 1st??2017. Two researchers finished the screenings??data extraction and bias risk evaluation separately. RevMan 5.2 was utilized to finish the data processing and statistical analysis. Results??There was no significant difference in the success rate of anesthesia in the treatment of irreversible pulpitis ??RR = 0.96??95% CI = 0.85??1.09??P =0.56?? comparing infiltration anesthesia with block anesthesia. Infiltration anesthesia was less painful at the time of injection ??RR = 0.41??95% CI = 0.19??0.88??P = 0.02??. Conclusion??There is no significant difference in anesthesia effect between infiltration anesthesia and block anesthesia in the treatment of irreversible pulpitis. Infiltration anesthesia is less painful than block anesthesia at injection.     

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??Abstract??Objective??To analyze the relationship between blood pressure and BMI??waist circumference??WC?? and fat mass percentile??FMP?? among children and adolescents??7??17 years?? in Beijing. Methods??As part of the Beijing Children and Adolescent Metabolic Syndrome Study??BCAMS????data of weight?? height?? FMP??WC?? and blood pressure were collected from 19 488 subjects aged 7??17 years from April to October in 2004. Overweight and obesity were defined according to BMI??WC and FMP criteria. Analyze the relationship between blood pressure and BMI??WC and FMP??as well as the change and trend of hypertension. Results??The levels of SBP and DBP increased in the order of normal weight to overweight and obesity. With age and gender controlled??BMI??WC and FMP were independently positively correlated with SBP and DBP ??P < 0.001??. The incidence of hypertension was significantly higher in the BMI??WC and FMP overweight and obesity groups than in the normal group??and the difference had statistical significance. The relative risk of hypertension in the obesity group is 3 to 7 times that of the normal group??and the risk in BMI obesity/FMP obesity group and the BMI obesity/abdominal obesity group was 7.3 and 6.8 times that of the normal group respectively.Conclusion??BMI??WC and FMP are closely related to SBP and DBP in children and adolescents. BMI is a better index for hypertension??the heavier the childrn??the higher the risk of hypertension.     

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??Abstract??Objective To study the clinical effect on patients with generalized aggressive periodontitis who accepted periodontal systematic therapy for 5 years. Methods Ten patients with generalized aggressive periodontitis were selected in the Periodontology and Oral Mucosa Department??Stomatological Hospital of Dalian from January 2006 to January 2007. These patients accepted periodontal systematic therapy for 5 years??including??periodontal initial therapy??periodontal surgical therapy??and periodontal supportive therapy. Clinical parameters of probing depth(PD)??clinical attachment level(CAL)??tooth mobility(TM)and bleeding on probing(BOP)were recorded by Florida electronic probe at baseline and 1-5 years after therapy??then analysis was carried out. Panoramic tomogram and the first molar intraoral radiography were detected before and 5 years after therapy. Results PD and CAL were decreased 1-5 years after periodontal systematic therapy??the positive sites of BOP were reduced and TM was improved. The statistical differences were detected(P < 0.01). The positive sites of BOP were reduced in the 5th year than in 1-3years??and the statistical differences were detected(P < 0.05). Conclusion To generalized aggressive periodontitis??the effect of periodontal systematic therapy of 5 years is effective and stable.