磁驱动血泵溶血分析

测试磁驱动轴流心室辅助装置主体血泵溶血性能。利用计算流体力学(CFD)软件ANSYS,基于红细胞受到切应力和相应曝光时间的计算溶血方法预测血泵溶血性能,计算红细胞粒子随着时间推移在血泵内运动轨迹上受到破坏程度。通过体外模拟循环实验实际测试血泵体外溶血性能,计算得到血泵实际标准溶血指数。CFD计算结果转化的标准溶血指数与实际体外实验结果比较相差较大,与CFD计算简化和实际计算循环周期有很大关系。磁驱动轴流心室辅助装置主体血泵有较好的实际溶血性能,血泵实验期间无不良状况发生,可以进行进一步实验。     

Relationships of sleep duration with sociodemographic and health‐related factors,psychiatric disorders and sleep disturbances in a community sample of Korean adults

The aim of this study is to examine relationships of sleep duration with sociodemographic and health‐related factors, psychiatric disorders and sleep disturbances in a nationwide sample in Korea. A total of 6510 subjects aged 18–64 years participated in this study. Logistic regression was used to calculate the odd ratios and 95% confidence intervals of the covariates, psychiatric disorders and sleep disturbances across the following sleep duration categories: 5 h or less, 6, 7, 8 and 9 h or more per day. Low levels of education, unemployment and physical illness were associated with sleeping for 5 h or less and 9 h or more. Being older and widowed/divorced/separated, high levels of physical activity, pain/discomfort, obesity and high scores on the General Health Questionnaires were associated with sleeping for 5 h or less. Female, being younger and underweight were associated with sleeping for 9 h or more. Alcohol dependence, anxiety disorder and social phobia were associated significantly with sleeping for 5 h or less and 9 h or more. Other psychiatric disorders were more common in subjects who slept for 5 h or less (e.g. alcohol use disorder, mood disorder, major depressive disorder, dysthymic disorder, obsessive‐compulsive disorder and specific phobia) or 9 h or more (e.g. post‐traumatic stress disorder). In addition, subjects who slept for 5 h or less reported more sleep disturbances than did subjects who slept for 7 h. Short or long sleep is associated with psychiatric disorders and/or sleep disturbance, therefore attention to the mental health of short or long sleepers is needed.     

Experimental studies of pathogenesis of chronic fluoride intoxication

The article presents the results of studies of occupational fluorosis pathogenesis on experimental model of chronic fluoride intoxication (CFI). In early fluoride intoxication, fluoride and calcium in the body are in compensatory relations. Later, they are disturbed. High reaction ability of fluoride in CFI is associated with hypocalciemia which triggers parathyroid hyperactivity. This results in hyperproduction of PHH which is unrelated with development of secondary hyperparathyrosis. CFI is accompanied also with elevated calcitonin having a hypocalciemic and hypophosphatemic action. The experiments showed double content of collagen fragments of bone tissue in urine of animals with fluoride intoxication which reflects resorption of bone tissue. Serum osteocalcin rose three-fold as it was unable to include in the bone tissue. There was also activation of lipid peroxidation in subnormal activity of respiratory enzymes.     

New Cochrane Systematic Reviews – Cochrane Oral Health Group

ENAMEL MATRIX DERIVATIVE (EMDOGAIN®) FOR PERIODONTAL TISSUE REGENERATION IN INTRABONY DEFECTS (Cochrane Review). In: THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS, ISSUE 4, 2005.Esposito M, Grusovin MG, Coulthard P, Worthington H

Background

Periodontitis is a chronic infective disease of the gums caused by bacteria present in dental plaque. This condition induces the breakdown of the tooth-supporting apparatus until teeth are lost. Surgery may be indicated to arrest disease progression and regenerate lost tissues. Several surgical techniques have been developed to regenerate periodontal tissues including guided tissue regeneration (GTR), bone grafting (BG), and the use of enamel matrix derivative (EMD). EMD is an extract of enamel matrix and contains amelogenins of various molecular weights. Amelogenins are involved in the formation of enamel and periodontal attachment formation during tooth development.

Objectives

The objectives were to test whether EMD is effective, and to compare EMD versus GTR and various BG procedures for the treatment of intrabony defects.

Search strategy

We searched the Cochrane OHG Trials Register, Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE. Several journals were hand searched. No language restrictions were applied. Authors of randomized controlled clinical trials (RCTs) who were identified, personal contacts, and the manufacturer were contacted to identify unpublished trials. The most recent search was May 2005.

Selection criteria

Selected studies were RCTs on patients affected by periodontitis having intrabony defects of at least 3 mm treated with EMD compared with open flap debridement, GTR, and various BG procedures with at least 1 year of follow-up. The outcome measures considered were tooth loss, changes in probing attachment levels (PAL), pocket depths (PPD), gingival recessions (REC), bone levels from the bottom of the defects on intraoral radiographs, esthetics, and adverse events. The following time points were to be evaluated: 1, 5, and 10 years.

Data collection & analysis

Screening of eligible studies, assessment of the methodological quality of the trials, and data extraction were conducted in duplicate and independently by 2 authors. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CI). It was decided not to investigate heterogeneity, but a sensitivity analysis for the risk of bias of the trials was performed.

Main results

Ten trials were included out of 29 potentially eligible trials. No included trial presented data after 5 years of follow-up, therefore all data refer to the 1-year time point. A meta-analysis including 8 trials showed that EMD-treated sites displayed statistically significant PAL improvements (mean difference 1.2 mm, 95% CI 0.7 to 1.7) and PPD reduction (0.8 mm, 95% CI 0.5 to 1.0) when compared to placebo or control treated sites, although a high degree of heterogeneity was found. Significantly more sites had less than 2 mm PAL gain in the control group, with RR 0.48 (95% CI 0.29 to 0.80). Approximately 6 patients needed to be treated (NNT) to have 1 patient gaining 2 mm or more PAL over the control group, based on a prevalence in the control group of 35%. No differences in tooth loss or esthetic appearance as judged by the patients were observed. When evaluating the only 2 trials at a low risk of bias in a sensitivity analysis, the effect size for PAL was 0.6 mm, which was less than 1.2 mm for the overall result. Comparing EMD with GTR (5 trials), GTR showed a statistically significant increase of REC (0.4 mm) and significantly more postoperative complications. No trials were found comparing EMD with BG.

Reviewers' conclusions

One year after its application, EMD significantly improved PAL levels (1.2 mm) and PPD reduction (0.8 mm) when compared to a placebo or control, however, the high degree of heterogeneity observed among trials suggests that results have to be interpreted with great caution. In addition, a sensitivity analysis indicated that the overall treatment effect might be overestimated. The actual clinical advantages of using EMD are unknown. With the exception of significantly more postoperative complications in the GTR group, there was no evidence of clinically important differences between GTR and EMD.

Abstract

INTERVENTIONS FOR REPLACING MISSING TEETH: DENTAL IMPLANTS IN ZYGOMATIC BONE FOR THE REHABILITATION OF THE SEVERELY DEFICIENT EDENTULOUS MAXILLA (Cochrane Review). In: THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS, ISSUE 4, 2005.Esposito M, Worthington HV, Coulthard P

Background

Dental implants are used for replacing missing teeth. Placing dental implants is limited by the presence of adequate bone volume permitting their anchorage. Several bone-augmentation procedures have been developed to solve this problem. Zygomatic implants are long screw-shaped implants developed as a partial or complete alternative to bone augmentation procedures for the severely atrophic maxilla. One to 3 zygomatic implants can be inserted through the posterior alveolar crest and maxillary sinus to engage the body of the zygomatic bone. A couple of conventional dental implants are also needed in the frontal region of the maxilla to stabilize the prosthesis. The potential main advantages of zygomatic implants could be that in some situations bone grafting may not be needed and a fixed denture could be fitted sooner. Another specific indication for using zygomatic implants could be the need for maxillary reconstruction after maxillectomy in cancer patients.

Objectives

The objective was to test the hypothesis of no difference in outcomes between zygomatic implants with and without bone-augmenting procedures in comparison with conventional dental implants in augmented bone for severely resorbed maxillae.

Search strategy

We searched the Cochrane Oral Health Group's Trial Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE. We hand searched several dental journals. No language restrictions were applied. Personal contacts and all known zygomatic implant manufacturers were contacted to identify unpublished trials. The most recent search was May 2005.

Selection criteria

Studies selected were randomized controlled clinical trials (RCTs) that included patients with severely resorbed maxillae who could not be rehabilitated with conventional dental implants and were treated with zygomatic implants with and without bone grafts versus patients treated with conventional dental implants in conjunction with bone-augmentation procedures having a follow-up of at least 1 year. Outcome measures considered were prosthesis and implant failures, side effects, patient satisfaction, and cost-effectiveness.

Data collection & analysis

Screening of eligible studies, assessment of the methodological quality of trials, and data extraction were to be conducted in duplicate and independently by 2 authors. Results were to be expressed as random-effects models using weighted mean differences for continuous outcomes and risk ratio for dichotomous outcomes with 95% confidence intervals. Heterogeneity was to be investigated including both clinical and methodological factors.

Main results

No RCTs or controlled clinical trials (CCTs) were identified.

Reviewers' conclusions

There is the need for RCTs in this area to assess whether zygomatic implants offer some advantages over alternative bone-augmentation techniques for treating atrophic maxillae.     

Treatment of psoriasis with fumaric acid esters: results of a prospective multicentre study

Systemic treatment of psoriasis with fumaric acid esters (FAE) has been found effective by empirical means. In recent years clinical studies have confirmed the antipsoriatic activity of a defined mixture of different FAE. The aim of the present prospective multicentre study was to investigate further the efficacy and safety of FAE therapy in a large number of patients with severe psoriasis vulgaris. From 101 patients included in the study 70 completed the treatment period of 4 months. Discontinuation was due to adverse events in seven, lack of efficacy in two, and other reasons, such as non-attendance for scheduled visits, in 22 patients. Evaluation of overall efficacy showed a decrease in psoriasis area and severity index of 80% after 4 months of FAE therapy. Laboratory investigations revealed a slight overall decrease of lymphocytes during the treatment period which was more than 50% below baseline in 10 patients. During weeks 4 and 8 mean eosinophil counts were above the normal range. At the end of FAE therapy elevated eosinophil counts had returned to normal values. None of the patients showed changes in renal function parameters throughout the study. Adverse events were reported in 69% of the patients mainly consisting of gastrointestinal complaints (56%) and flushing (31%). In five patients gastrointestinal complaints and in two patients flushing led to withdrawal from the study. Taken together the results of this multicentre study showed in a large number of patients that systemic FAE treatment is effective in severe psoriasis vulgaris. Transient eosinophilia seems to be a characteristic feature of FAE therapy, while lymphocytopenia is usually mild. Adverse effects are dose-related and consist mainly of gastrointestinal complaints and flushing.     

恶性淋巴瘤贫血发生率调查分析

目的：研究恶性淋巴瘤患者的贫血发生情况及其影响因素。方法：对我院2007—05-04—2012-09—30住院的1474例恶性淋巴瘤患者（初治1145例,复治329例）进行回顾性分析,统计其贫血发生率,并根据初治或复治、不同．病理类型、性别、年龄、临床分期或是否有B症状进行分组分析。结果：初治患者的贫血发生率为23．3％（267／1145）,复治患者的贫血发生率为41．9％（138／329）,明显升高,χ2=44．5,P〈0．001。不同病理类型初治患者贫血发生率由高至低依次为淋巴浆细胞淋巴瘤75．0％,血管免疫母T细胞淋巴瘤40．0％,套细胞淋巴瘤32．6％,外周T细胞淋巴瘤（非特指型）29．4％,弥漫大B细胞淋巴瘤25．3％,霍奇金淋巴瘤24．8％,边缘区B细胞淋巴瘤24．7％,NK／T细胞淋巴瘤21．4％,Burkitt淋巴瘤16．7％,问变大T细胞淋巴瘤14．3％,淋巴母细胞淋巴瘤11．3％,滤泡性淋巴瘤10．7％,蕈样霉菌病10％,弥漫小B细胞淋巴瘤8．3％。单因素分析发现,病理类型（χ2=32．4,P=0．002）、年龄（χ2=8．0,P=0．005）、分期（χ2=60．7,P〈0．001）和B症状（χ2=127．8,P〈0．001）是初治淋巴瘤贫血的危险因素。初治的贫血患者中侵犯食管、胃和肠等部位的患者比例较高,为35．2％（94／267）。结论：恶性淋巴瘤患者有较高的贫血发生率,复治患者贫血发生率明显高于初治患者,初治患者贫血的发生与病理类型、年龄、分期和B症状有密切关系。年龄〉60岁、Ⅲ～Ⅳ期、胃肠道侵犯、有B症状患者更易发生贫血。     

不同产地牡丹皮饮片质量评价

目的对不同产地牡丹皮饮片进行质量评价。方法采用化学及仪器分析的方法测定3种不同产地牡丹皮饮片的水分、灰分、浸出物、丹皮酚、丹皮总苷及丹皮多糖含量。结果不同产地牡丹皮饮片有效成分含量有显著差异。结论3种不同产地的牡丹皮饮片样品中,安徽铜陵牡丹皮饮片质量最优。     

地塞米松对家兔失血性休克-再灌注损伤的防治作用

目的：探讨地塞米松对失血性休克－再灌注损伤的防治作用。方法：制备家兔失血性休克模型,随机分为地塞米松保护组（Ⅱ组）和未用地塞米松对照组（Ⅰ组）,检测血浆和组织一氧化氮代谢产物（NOP）、丙二醛（MDA）含量及平均动脉压（MAP）。结果：休克前2组动物NOP、MDA及MAP间均无统计学差异。休克90分钟时2组动物NOP、MDA均明显升高,MAP均显著下降,再灌注后,Ⅱ组NOP及MDA均逐渐下降,再灌注3小时后接近休克前水平,但明显低于休克90分钟和Ⅰ组同时间点水平;Ⅱ组MAP逐渐上升,再灌注3小时后接近休克前水平,但明显高于休克90分钟和Ⅰ组同时间点水平。此外,Ⅱ组心、肺、肝、肾、肠道组织NOP及MDA含量均明显低于Ⅰ组。结论：地塞米松可降低一氧化氮及氧自由基水平,减轻脂质过氧化反应,对休克－再灌注损伤起良好的防护作用。     

Reduction of immunosuppression for transplant-associated skin cancer: expert consensus survey

BACKGROUND: Reduction of immunosuppression is considered a reasonable adjuvant therapeutic strategy in solid-organ transplant recipients experiencing multiple or high-risk skin cancers. However, the literature provides no guidance about what threshold of cancer development would warrant initiation of reduction of immunosuppression. OBJECTIVES: To develop expert consensus guidelines for initiation of reduction of transplant-associated immunosuppression for solid-organ transplant recipients with severe skin cancer. METHODS: An expert consensus panel was convened by the International Transplant Skin Cancer Collaborative and Skin Care for Organ Transplant Patients Europe Reduction of Immunosuppression Task Force. Thirteen hypothetical patient scenarios with graduated morbidity and mortality risks were presented and mean and mode expert opinions about appropriate level of reduction of systemic immunosuppression (mild, moderate, severe) were generated. RESULTS: Mild reduction of transplant-associated immunosuppression was considered warranted once multiple skin cancers per year developed or with individual high-risk skin cancers. Moderate reduction was considered appropriate when patients experienced > 25 skin cancers per year or for skin cancers with a 10% 3-year risk of mortality. Severe reduction was considered warranted only for life-threatening skin cancers. CONCLUSIONS: Reduction of immunosuppression is considered a reasonable adjuvant management strategy for transplant recipients with numerous or life-threatening skin cancers. Proposed guidelines are presented for the graduated reduction of immunosuppression coincident with the increasing skin cancer risks.     

阿克他利对Ⅱ型胶原性关节炎小鼠的治疗作用及部分机制研究

 目的 研究阿克他利(Acta)对小鼠Ⅱ型胶原性关节炎(CIA)的治疗作用。方法 采用Ⅱ型胶原(CⅡ)乳剂皮内注射诱导的小鼠CIA模型。在此基础上,检测小鼠足肿胀、免疫功能的改变,以及对CⅡ的迟发性变态反应(DTH)和血清中抗CⅡ抗体的测定,同时进行了病理组织学的检查。结果 Acta(10,30,90 mg·kg^-1)ig对CⅡ诱导的小鼠足肿胀有明显的抑制作用;体外研究发现,Acta(10,30,90 mg·kg^-1)能使CIA小鼠过高的ConA增殖反应和IL-2的产生恢复至接近正常,同时对CIA小鼠过高的IL-1产生有明显的抑制作用;Acta(10,30,90 mg·kg^-1)ig可以明显减轻CⅡ诱发迟发性变态反应(DTH),但Acta对CIA小鼠体内的抗体的产生无显著影响。病理学检查表明,Acta(10,30,90 mg·kg^-1)ig可以减轻CIA小鼠的骨膜增生和软骨破坏。结论 Acta对CIA小鼠具有治疗作用,该作用可能是通过细胞免疫调节实现的。