快速诊断多房棘球蚴病胶体金免疫层析试条方法的建立与评价

目的建立快速、简便诊断多房棘球蚴病的胶体金免疫层析试条方法。方法提取多房棘球蚴原头节总RNA,通过RT-PCR获得编码Em18基因片段并克隆入pGEX-3X表达载体,异丙基-β-D-硫代半乳糖苷(IPTG)诱导表达得到重组蛋白;采用柠檬酸三钠还原法制备胶体金,标记抗人IgG单克隆抗体;将重组Em18抗原包被于硝酸纤维素膜适当位置,制成检测特异抗体的胶体金免疫层析试条。用该试条检测多房棘球蚴病(56份)、细粒棘球蚴病(87份)、囊尾蚴病(30份)、日本血吸虫病(10份)和弓形虫病(10份)患者血清,以及健康人(50份)血清,以评价其检测的敏感性和特异性,同时用ELISA法进行平行检测,以评价该试条的诊断性能。结果以重组蛋白Em18为抗原胶体金免疫层析试条检测多房棘球蚴病患者血清,敏感性为92.9%(52/56)。与细粒棘球蚴病和囊尾蚴病患者血清分别存在9.2%(8/87)和3.3%(1/30)的交叉反应,与健康人血清存在8.0%(4/50)的假阳性率,与日本血吸虫病和弓形虫病患者血清则无交叉反应,特异性为93.0%(174/187)。ELISA法检测的敏感性和特异性分别为94.6%(54/56)和92%(172/187),与试条法比较两者差异均无统计学意义(P>0.05)。kappa分析结果显示,试条法与ELISA法检测多房棘球蚴病患者血清的结果高度一致(κ=0.98)。结论以重组Em18抗原建立的快速诊断胶体金免疫层析试条,检测多房棘球蚴病的敏感性和特异性均较高。     

巨噬细胞刺激蛋白对烟熏大鼠肺泡巨噬细胞氧化应激和细胞因子产生的影响

目的 探讨巨噬细胞刺激蛋白(MSP)对烟熏大鼠肺泡巨噬细胞氧化应激和细胞因子产生的影响.方法 培养正常和烟熏不同时间(1个月、2个月、3个月)的大鼠肺泡巨噬细胞,给予不同浓度MSP处理24 h,采用酶联免疫法检测细胞上清液中细胞因子肿瘤坏死因子α(TNF-α)、白介索8(IL-8)和IL-1β的浓度,比色法检测细胞上清液中丙二醛(MDA)和超氧化物歧化酶(SOD)的水平.结果 ①MSP呈浓度依赖性促进正常组和各烟熏组大鼠肺泡巨噬细胞分泌TNF-α、IL-8和IL-1β;经MSP处理后,各烟熏组大鼠肺泡巨噬细胞上清液中TNF-α、IL-8和n-1β浓度均高于正常组(P＜0.05);大鼠肺泡巨噬细胞上清液中TNF-α、IL-8和IL-1β浓度随烟熏时间延长呈时间依赖性增加.②MSP呈浓度依赖性促进正常组和各烟熏组大鼠肺泡巨噬细胞分泌MDA,抑制其产生SOD;烟熏2个月组和烟熏3个月组大鼠肺泡巨噬细胞上清液中MDA水平均高于正常组(P＜0.05),SOD水平均低于正常组(P＜0.05);随着烟熏时间延长,大鼠肺泡巨噬细胞上清液中MDA水平呈时间依赖性增加,SOD水平呈时间依赖性降低.结论 MSP呈浓度依赖性促进正常和烟熏大鼠肺泡巨噬细胞分泌TNF-α、IL-8、IL-1β和MDA,抑制其产生SOD.MSP促烟熏大鼠肺泡巨噬细胞分泌TNF-α、IL-8、IL-1β、MDA及抑制其产生SOD的作用较正常大鼠更显著,且烟熏时间越长此作用越明显.     

S-nitrosoglutathione decreases inflammation and bone resorption in experimental periodontitis in rats

Background: S‐nitrosoglutathione (GSNO) is a nitric oxide donor that may exert antioxidant, anti‐inflammatory, and microbicidal actions and is thus a potential drug for the topical treatment of periodontitis. In this study, the effect of intragingival injections of GSNO‐containing polyvinylpyrrolidone (PVP) formulations is evaluated in a rat model of periodontitis. Methods: Periodontal disease was induced by placing a sterilized nylon (000) thread ligature around the cervix of the second left upper molar of the animals, which received intragingival injections of PVP; saline; or PVP/GSNO solutions which corresponded to GSNO doses of 25, 100, and 500 nmol; 1 hour before periodontitis induction, and thereafter, daily for 11 days. Results: PVP/GSNO formulations at doses of 25 and/or 100, but not 500 nmol caused significant inhibition of alveolar bone loss, increase of bone alkaline phosphatase, decrease of myeloperoxidase activity, as well as significant reduction of inflammatory and oxidative stress markers when compared to saline and PVP groups. These effects were also associated with a decrease of matrix metalloproteinases 1 and 8, inducible nitric oxide synthase, and nuclear factor‐κB immunostaining in the periodontium. Conclusion: Local intragingival injections of GSNO reduces inflammation and bone loss in experimental periodontal disease.     

Diabetes mellitus may increase bone loss after occlusal trauma and experimental periodontitis

Background: Diabetes mellitus (DM) involves metabolic changes that can negatively influence periodontal tissues, resulting in more prevalent and severe periodontitis and impaired bone formation. Occlusal trauma (OT) is an injury of the supportive periodontium that results in bone loss. It can be hypothesized that DM would increase bone loss after OT, mainly when associated with periodontitis. Thus, the aim of the present study is to evaluate the influence of DM on bone response in the furcation area of teeth subjected to OT in the presence, or absence, of experimental periodontitis (EP) in the rat model. Methods: Thirty-two male Wistar rats were assigned to four groups: 1) group 1 (G1): DM+OT+EP (n = 8); 2) group 2 (G2): DM+OT (n = 8); 3) group 3 (G3): OT+EP (n = 8); and 4) group 4 (G4): OT (n = 8). G1 and G2 received a single intraperitoneal injection of streptozotocin (STZ). After 10 days, G1 and G3 were subjected to EP by ligature placement. Fifteen days after the start of EP, OT was induced by the creation of a premature contact. The animals were euthanized 35 days after DM induction. Results: DM enhanced bone loss in the presence of OT combined with EP, but did not increase bone loss in teeth subjected to OT alone. EP caused greater bone loss when associated with OT. Conclusion: Within the limits of this animal study, it can be concluded that DM enhances bone loss in the presence of occlusal trauma associated with EP.     

Enamel Matrix Derivative in Intrabony Defects: Prognostic Parameters of Clinical and Radiographic Treatment Outcomes

Background: The purpose of this retrospective case series study is to identify possible preoperative parameters that could predict postoperative probing depth (PD), clinical attachment level (CAL) gain, or radiographic defect resolution in intrabony defects treated with enamel matrix derivative (EMD). Methods: Sixty‐one chronic periodontitis patients, each contributing a 2‐ or 3‐wall intrabony defect treated with EMD, were included. Clinical parameters recorded included the following: PD; CAL; gingival margin position; supracrestal soft tissue (SST); surgical distances of cemento‐enamel junction (CEJ) to bone crest (CEJ‐BC), CEJ to base of the defect (CEJ‐BD), and BC to BD (BC‐BD); and depth of 2‐ and 3‐wall components. Radiographic parameters recorded included the following: CEJ‐BC, CEJ‐BD, BC‐BD distances, and radiographic defect angle. Postoperative assessments were performed at 12 months. Results: The probability of postoperative PD >4 mm increased 1.6‐fold (odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.2 to 2.3) with each 1‐mm baseline PD increase. Baseline PD and surgical CEJ‐BD were statistically significant predictors of CAL gain; the greater the baseline PD (OR = 0.5; 95% CI = 0.3 to 0.8) and bone loss (OR = 0.6; 95% CI = 0.3 to 0.9), the less likely that postoperative CAL gain was ≤3 mm. Smoking and SST were significantly associated with defect resolution; failure to achieve ≥65% defect resolution was six‐fold greater for smokers (OR = 6.5; 95% CI = 1.7 to 24.5) and almost double (OR = 1.7; 95% CI = 1.1 to 2.8) for each millimeter of SST increase. Conclusion: In EMD‐treated intrabony defects, baseline PD predicts both CAL gain and postoperative PD. Smoking and SST are predictors of defect resolution.     

Vertical ridge augmentation using an equine bone and collagen block infused with recombinant human platelet-derived growth factor-BB: a randomized single-masked histologic study in non-human primates

Background: This study tests the effectiveness of hydroxyapatite and collagen bone blocks of equine origin (eHAC), infused with recombinant human platelet‐derived growth factor‐BB (rhPDGF‐BB), to augment localized posterior mandibular defects in non‐human primates (Papio hamadryas). Methods: Bilateral critical‐sized defects simulating severe atrophy were created at the time of the posterior teeth extraction. Test and control blocks (without growth factor) were randomly grafted into the respective sites in each non‐human primate. Results: All sites exhibited vertical ridge augmentation, with physiologic hard‐ and soft‐tissue integration of the blocks when clinical and histologic examinations were done at 4 months after the vertical ridge augmentation procedure. There was a clear, although non‐significant, tendency to increased regeneration in the test sites. As in the first two preclinical studies in this series using canines, experimental eHAC blocks infused with rhPDGF‐BB proved to be a predictable and technically viable method to predictably regenerate bone and soft tissue in critical‐sized defects. Conclusion: This investigation supplies additional evidence that eHAC blocks infused with rhPDGF‐BB growth factor is a predictable and technically feasible option for vertical augmentation of severely resorbed ridges.     

Reconstruction of the alveolar cleft: effect of preoperative extraction of deciduous teeth at the sites of clefts on the incidence of postoperative complications

Our objective was to find out if the extraction of deciduous teeth at the sites of clefts 3-8 weeks before alveolar bone grafting (ABG) would reduce the number of postoperative complications. Chart reviews were reviewed retrospectively of patients who had had ABG from March 2006 to June 2009. To reduce variables only healthy, non-syndromic, cooperative patients were included. Eleven patients had had their deciduous teeth extracted at the cleft sites 3-8 weeks before ABG and 10 patients had had the extractions done intraoperatively at the same time as ABG. There was a single case of postoperative infection and no wound dehiscence in the preoperative extraction group, and there were no delays in postoperative orthodontic treatment. In the intraoperative group there were 3 cases of local wound infection and 6 cases of minor dehiscence, and orthodontic treatment was delayed for 3-6 months in all patients with complications. All patients had successful ABG, eruption of teeth, and orthodontic treatment; but patients who had their deciduous teeth at the cleft sites extracted preoperatively had fewer wound complications than patients whose extractions were done at the same time as the ABG.     

呼出气一氧化氮测定在COPD频繁急性加重表型患者中的临床意义

目的 探讨中央和外周气道呼出气一氧化氮(FeNO)在慢性阻塞性肺病(COPD)频繁急性加重表型患者中的临床意义。方法 收集2019年1月至2021年6月安徽医科大学第四附属医院呼吸与危重症医学科收治的90例COPD患者作为研究对象,在一年内因急性加重次数≥2次的患者纳入频繁急性加重组(n=23),急性加重次数≤1次的患者纳入非频繁急性加重组(n=67)。测定两组中央气道一氧化氮(FeNO₅₀)浓度和外周气道呼出气一氧化氮(FeNO₂₀₀)浓度、肺泡气一氧化氮(CaNO)浓度并收集白细胞计数、血嗜酸粒细胞百分比、血清总免疫球蛋白E(IgE)、慢性阻塞性肺疾病评估测试(CAT)评分及肺功能等相关指标,对进行对比分析。结果 COPD频繁急性加重组FeNO₂₀₀、CaNO、C反应蛋白(CRP)、血清总IgE、CAT评分均高于非频繁急性加重组,第一秒用力呼气容积占预计值百分比(FEV1%)低于非频繁急性加重组(P＜0.05)。在COPD急性加重患者中,FeNO₂₀₀、CaNO与FEV1%呈负相关(r=-0.305、-0.439,P＜0.05),与血清总IgE呈正相关(r=0.523、0.514,P＜0.05),其中CaNO还与CRP呈正相关(r=0.321,P=0.023)。结论 COPD频繁急性加重表型患者中央和外周FeNO浓度存在差异,FeNO₂₀₀、CaNO均可作为COPD患者外周小气道炎症指标。     

氯膦酸二钠脂质体对大鼠重症急性胰腺炎肺损伤的影响及与Akt、MAPK（ERK1/2）通路的关系

目的:探讨氯膦酸二钠脂质体(LC)对大鼠重症急性胰腺炎(SAP)肺损伤的影响及与Akt、MAPK(ERK1/2)通路的关系。方法:将48只SD大鼠随机均分为假手术组、SAP模型组(模型组)、SAP模型+LC处理组(LC组),后两组采用膜下注射5%牛磺胆酸钠制作SAP模型,并分别于造模后尾静脉注射空白脂质体与LC。各组分别于术后2、6h后检测血清淀粉酶(AMS)、IL-6、TNF-α的含量,观察肺组织病理学变化,及肺组织中Akt和MAPK(ERK1/2)的表达。结果:与假手术组比较,模型组与LC组血清AMS、IL-6及TNF-α含量、肺组织病理学评分,肺组织Akt和MAPK(ERK1/2)表达水平均明显升高,且均随时间延长而更加明显(均P0.05),但LC组的上述指标在各时间点上均明显低于模型组(均P0.05)。结论:LC有减轻大鼠SAP肺损伤的作用,机制可能与肺泡巨噬细胞吞噬LC后,Akt和MAPK(ERK1/2)信号通路抑制,从而减少炎症细胞因子的释放有关。     

A review of the functional and esthetic requirements for dental implants

BACKGROUND: The esthetic replacement of teeth has become an important standard for implant dentistry. While defining this goal has not been difficult, the ability to restore implants esthetically has been fraught with obstacles and sometimes has not been attainable. The purpose of this review is to summarize essential anatomical and surgical considerations for cosmetic implant dentistry. METHODS: This article provides a summary of the predominant findings from clinical studies and case reports that help develop implant surgical guidelines for better esthetic outcomes. RESULTS: Soft- and hard-tissue requirements for placing an implant in an ideal position are defined. The authors discuss the best treatment approaches as well as the limitations associated with esthetic implant placement. They evaluate the available data specifically for the maxillary anterior sextant, since this anatomical region has higher esthetic demands. CONCLUSIONS: Several parameters and various surgical techniques have been developed to manipulate soft- and hard-tissue contours and to control the esthetic outcome for implant-supported restorations. CLINICAL IMPLICATIONS: It is essential for practitioners to understand the anatomical basis for and limitations of implant dentistry in the esthetic zone.