富含血小板血浆与玻璃酸钠治疗早期踝关节骨性关节炎疗效对比

目的:对比富含血小板血浆(PRP)与玻璃酸钠在早期踝关节骨性关节炎中的应用效果,为临床提供参考。方法:60例早期踝关节骨性关节炎患者随机分成两组,各30例。A组给予玻璃酸钠注射剂关节腔注射,B组给予自体PRP关节腔注射。对比两组患者治疗1个月、2个月、3个月、6个月后疼痛视觉模拟评分(VAS)、踝关节Baird-Jackson评分、10m步行时间等指标变化,以及两组药品不良反应发生情况。结果:治疗1个月后开始,两组各项指标均较治疗前明显改善(P<0.05)。治疗1个月后,A组踝关节Baird-Jackson评分、VAS评分、10 m步行步数优于B组(P<0.05)。治疗3个月后,B组踝关节Baird-Jackson评分、VAS评分、10 m步行步数优于A组(P<0.05)。两组药品不良反应发生率无显著差异(P>0.05)。结论:关节腔内注射玻璃酸钠和PRP治疗早期踝关节骨性关节炎均有较好疗效,注射PRP在3~6个月时疗效优于注射玻璃酸钠。     

Fluoride bioactive glass paste improves bond durability and remineralizes tooth structure prior to adhesive restoration

ObjectiveThe current study aimed at examining a fluoride containing bioactive glass (BiominF®) paste as a temporary filling material capable of remineralizing the demineralized enamel or dentin, and its ability to decrease a simulated dentinal fluids pressure on the resin/dentin interface, without affecting the shear bond strength of a universal bonding agent to enamel and dentin.Methods60 premolars were utilized for the acid resistance, trans-microradiography (TMR) and shear bond strength (SBS) experiments. Enamel and dentin discs were demineralized for 4 days to create a subsurface demineralized zone followed by applying BiominF® paste, 1.23% acidulated phosphate fluoride, or a temporary filling material for 24 h.30 extracted human non-carious third molars were utilized for the pulpal pressure experiment in which direct communication to the pulp chamber was created by cutting at a level approximately 1 mm below the cemento-enamel junction while the coronal enamel was ground to expose mid coronal dentin. The dentin surface was exposed to a simulated pulpal pressure. The dentin surfaces had BiominF® paste, an oxalate desensitizing agent, or temporary filling material followed by application of a universal adhesive system.ResultsOne way ANOVA showed that BiominF® paste remineralized effectively the demineralized enamel or dentin, did not affect the bond strength of the enamel and dentin surfaces to the tested adhesive system p < 0.05, and improved the acid resistance of the demineralized enamel and dentin against a secondary erosive challenge. Moreover, BiominF® paste decreased the nanoleakage expression in the dentin/adhesive interface exposed to a simulated pulpal pressure.SignificanceBiominF® paste may serve as a temporary filling material that may improve the longevity of adhesive restorations and help to conserve tooth structures by preserving the demineralized enamel and dentin form cutting during cavity preparation.     

当药苷调节兴奋-收缩耦联改善心肌缺血再灌注损伤的机制

目的 探索当药苷通过兴奋-收缩耦联信号通路对缺血再灌注损伤后心脏收缩/舒张功能的影响。方法 24只健康雄性SD大鼠随机分为正常组、模型组、10 μmol·L^-1当药苷给药组与1 μmol·L^-1地高辛给药组,并采用Langendorff系统结合左前降支冠状动脉结扎建立缺血再灌注损伤模型（I/R）,2,3,5-氯化三苯基四氮唑（TTC）染色检测各组心脏梗死面积,Powerlab生理记录仪检测血流动力学参数,如左心室舒张压（LVDP）、左心室终末舒张压（LVEDP）、左心室终末收缩压（LVESP）、左心室内压最大上升速率（+dp/dt_max）和左心室内压最大下降速率（-dp/dt_max）;提取分离乳鼠原代心肌细胞（NRCMs）,建立缺氧/复氧（H/R）损伤模型,随机分为正常组、模型组、1 μmol·L^-1当药苷给药组和10 μmol·L^-1当药苷给药组,多功能成像细胞分析仪和激光共聚焦显微镜测定各组心肌细胞活力、心率、收缩幅度、收缩时程、达峰时程和舒张时程及钙瞬变峰值。根据前期转录组学测序结果及文献调研,利用实时荧光定量聚合酶链式反应（Real-time PCR）检测L型钙通道相关基因（Cacnb2）,细胞色素C氧化酶相关基因（Cox6a2）,肌钙蛋白（Tnnc1、Tnni3、Tnnt2）、肌动蛋白（Actc1）、肌球蛋白（Myh6、Myl2、Myl4）等兴奋-收缩耦联通路基因的mRNA表达并对差异基因进行聚类分析。结果 与正常组比较,模型组心肌梗死面积显著增加（P<0.01）、LVDP显著降低（P<0.01）、LVEDP显著上升（P<0.01）、LVESP明显下降（P<0.05）、+dp/dt_max有下降趋势和-dp/dt_max上升趋势及心肌细胞活力降低、心率降低、收缩幅度降低、收缩时程升高、达峰时程升高和舒张时程升高（P<0.01）,而当药苷可以逆转上述指标（P<0.05）。此外,心肌细胞经H/R损伤后,Cacnb2、Cox6a2、Tnnc1、Tnni3、Tnnt2、Actc1、Myh6、Myl2、Myl4等兴奋-收缩耦联通路的基因表达下降（P<0.05、P<0.01）。而使用当药苷预处理后,可以增强上述基因的表达（P<0.05）。结论 当药苷通过调节兴奋-收缩耦联信号通路,从而调节原代乳鼠心肌细胞内钙离子水平,增强心肌收缩功能,对抗I/R损伤。     

PJ间期对鉴别间歇性宽QRS波的意义

目的 分析PJ间期在鉴别间歇性宽QRS波(即间歇性WPW预激综合征、间歇性束支阻滞及舒张晚期室性早搏)中的意义.方法 随机收集我院2018年1月至2020年1月动态心电图诊断为舒张晚期室性早搏、间歇性WPW预激综合征、间歇性束支传导阻滞患者分成三组,每组各50例,分析三组研究对象的PJ间期与其自身窦性激动经房室交界及左...     

PDCA管理后死亡医学证明书填写质量分析

目的 探讨PDCA管理对死亡医学证明书填写质量的影响.方法 选择2018年10月—2019年5月我院实施PDCA管理前开具的死亡医学证明书68份作为对照组,选择2019年10月—2020年5月我院实施PDCA管理后开具的死亡医学证明书71份作为研究组,比较两组填写质量.结果 研究组的死亡医学证明书患者基本信息填写完整率...     

Cone-beam Computed Tomographic–based Assessment of Filled C-shaped Canals: Artifact Expression of Cone-beam Computed Tomography as Opposed to Micro–computed Tomography and Nano–computed Tomography

IntroductionThe present study investigated the assessment of root canal fillings in a series of cone-beam computed tomographic (CBCT) images obtained from endodontically treated mandibular molars with C-shaped canals.MethodsClinically comparable high (HR) and normal (NR) resolution protocols were selected in 3D Accuitomo 170 (J Morita Corporation, Kyoto, Japan), NewTom VGi evo (Cefla QR Verona, Verona, Italy), ProMax 3D Max (Pro; Planmeca, Helsinki, Finland), and Pax-i3D Green Premium (Pax; Vatech, Gyeonggi, South Korea). Micro–computed tomographic and nano–computed tomographic images were considered as the reference standard. The set of images was evaluated according to beam hardening artifact patterns (dark streaks, hypodense areas, and volume distortion).ResultsRegarding dark streaks, the Fleiss kappa test showed that Pax HR and NR and Pro HR images showed the highest artifact expression. Hypodense areas were detected in 100% and 99.1% of the images obtained using Pax HR and NR, respectively. Kappa tests showed highest distortion for images derived from the Pax and Pro CBCT devices. Root canal filling assessment was considered appropriate in 100% of the 3D Accuitomo 170 HR, NewTom VGi evo NR, micro–computed tomographic, and nano–computed tomographic images.ConclusionsThe present study confirms the large variability in CBCT-derived artifact expression. Highlighting the increased artifact expression for particular CBCT systems, it may be concluded that for diagnosis of endodontically filled molars with C-shaped canals, the choice of CBCT unit and protocol is essential.     

Biocompatibility and Bioactive Potential of New Calcium Silicate–based Endodontic Sealers: Bio-C Sealer and Sealer Plus BC

IntroductionBio-C Sealer (BC; Angelus, Londrina, PR, Brazil) and Sealer Plus BC (SPBC; MK Life, Porto Alegre, Brazil) are new ready-to-use bioceramic endodontic sealers. The aim of this study was to evaluate the biocompatibility and bioactive potential of BC and SPBC sealers in comparison with AH Plus (AHP; Dentsply DeTrey Gmbh, Konstanz, Germany) in subcutaneous tissue of rats.MethodsPolyethylene tubes filled with materials and empty tubes, serving as the control group, were implanted in the subcutaneous tissues of rats. After 7, 15, 30, and 60 days, the tubes with connective tissue were removed, and inflammatory cells (ICs)/mm² and immunolabeled cells for interleukin (IL)-6 were evaluated. Osteocalcin and von Kossa analysis were also performed. Data were submitted to analysis of variance and Tukey tests, with a significance level of 5%.ResultsAt 7 days, SPBC showed lower ICs than BC (P < .05). AHP exhibited greater immunolabeled cells for IL-6 (P < .05). After 15 days, BC showed lower ICs and IL-6 compared with other materials. At 30 days, SPBC and AHP showed higher values for ICs (P < .05). After 60 days, calcium silicate sealers did not show statistical difference (P > .05) for ICs and IL-6, with values lower than AHP (P < .05). The materials showed positive structures to von Kossa staining. BC exhibited osteocalcin labeling in all periods. SPBC showed osteocalcin labeling from 15–60 days. AHP and the control group did not exhibit osteocalcin labeling.ConclusionsBC and SPBC sealers are biocompatible and present bioactive potential.     

Pre‐Registration Assessment of Bone‐Filling Products

The use of bone‐filling material to repair bone defects and fix implanted bone grafts is a developing area in medicine. Investigators can evaluate bone‐filling materials through use of several indices to make comparisons and to determine suitability for application in humans¹. However, it is quite difficult to transform their discovery into practical use, because the viability of the studied material might require examination of all aspects of properties. In addition, for a material to become a product, a complete procedure involving a declaration, registration, and approval is necessary. This article introduces the technical indices that the investigators and reporters should provide in their declaration and registration data to meet the relevant standards in China. The indices include physical and chemical properties, biocompatibility, biosecurity, pre‐clinical animal model tests, sterilization and disinfection, product duration, and packaging. Full consideration of all possible indices is crucial to realize the transformation from a designed product to a commercial medical device, which requires effective interaction between clinicians and engineers.