牙周基础治疗对伴2型糖尿病牙周炎患者肿瘤坏死因子-α的影响

目的通过检测牙周基础治疗前,后伴2型糖尿病牙周炎患者肿瘤坏死因子-α(TNF-α)浓度,来研究2型糖尿病患者与牙周炎症的相互关系。方法纳入我院牙周科中重度牙周炎70例。其中伴2型糖尿病牙周炎患者35例(伴糖尿病牙周炎组),无系统疾病者35例(单纯牙周炎组)。健康对照组35例。这其中伴糖尿病牙周炎组中HbA1c<7%为血糖控制较好组(A组),HbA1c>7%为血糖控制较差组(B组)。三组患者分别进行问卷调查,治疗前,及治疗后3个月分别记录全口探诊深度(PD),附着丧失(AL)出血指数(BI)和菌斑指数(PLI)及TNF-α检查。结果伴糖尿病牙周炎组及单纯牙周炎组PD、AL、BI、PLI与治疗前相比差异有统计学意义(P<0.05)。其中基线时伴糖尿病组中B组(血糖控制较差者)牙周炎症重于A组(血糖控制较好者)(P<0.05)治疗后两组差异无统计学意义(P>0.05)。基线时伴糖尿病牙周炎组和单纯牙周炎组的TNF-α浓度均显著高于健康组,差异有统计学意义(P<0.05),伴糖尿病牙周炎组的TNF-α浓度高于单纯牙周炎组的TNF-α浓度,差异有统计学意义(P<0.05),伴糖尿病牙周炎组B组(血糖控制较差者)的TNF-α浓度高于A组(血糖控制较好者)差异有统计学意义(P<0.05)。牙周基础治疗前,基础治疗后3个月伴糖尿病牙周炎组B组(血糖控制较差者)TNF-α浓度降低,差异有统计学意义(P<0.05),其余组治疗前后TNF-α浓度无明显改变(P>0.05)。结论牙周基础治疗可改善伴糖尿病牙周炎及单纯牙周炎患者的牙周状态,同时也可一定程度改善血糖控制较差的伴2型糖尿病牙周炎患者的TNF-α浓度     

盐酸米诺环素联合多联抗生素糊剂对牙周炎合并牙髓病变相关炎症因子的影响

目的:探究应用盐酸米诺环素缓释剂联合多联抗生素糊剂对牙周炎合并牙髓病变患者炎症相关因子的影响。方法:选择2016年2月至2017年12月于温州医科大学附属东阳医院接受治疗的慢性牙周炎合并牙髓病变患者116例,按随机数字表法随机分为对照组和观察组,各58例。对照组行常规治疗,观察组在对照组的基础上,给予盐酸米诺环素缓释剂联合多联抗生素糊剂治疗。观察2组的疗效,治疗前后牙周探诊深度(PD)、菌斑指数(PLI)、龈沟出血指数(SBI)、牙周附着水平(AL)、牙龈指数(GI)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素1β(IL-1β)、白介素-5 (IL-5)、白介素-6 (IL-6)、白介素-8 (IL-8)、白介素-17 (IL-17)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平。结果:观察组治疗总有效率为96.55%,高于对照组的86.21%,差异具有统计学意义(Z=6.765, P<0.05)。与治疗前对比,2组治疗后PD、AL、SBI、PLI、GI、IL-1β、IL-5、IL-6、IL-8、IL-17、CRP、TNF-α、MDA水平均降低(P<0.05), SOD水平升高(P<0.05),观察组患者治疗后的PD、AL、SBI、PLI、GI、IL-1β、IL-5、IL-6、IL-8、IL-17、CRP、TNF-α、MDA水平均低于对照组,SOD水平高于对照组,差异具有统计学意义(P<0.05)。结论:盐酸米诺环素缓释剂联合多联抗生素糊剂对牙周炎合并牙髓病变治疗效果较好,能有效地修复牙周状态,降低IL-1β、IL-5、IL-6、IL-8、IL-17、CRP、TNF-α等炎症因子水平,抑制炎症反应;同时提高SOD活性,降低MDA水平,减少脂质过氧化物的形成,保护机体免受过氧化损伤。     

牙周基础干预联合益生菌对老年2型糖尿病伴慢性牙周炎患者龈沟液脂联素及炎症因子的影响

目的 探讨牙周基础干预联合益生菌治疗对老年2型糖尿病伴慢性牙周炎患者龈沟液脂联素及炎症因子的影响。方法 90例老年2型糖尿病合并慢性牙周炎患者作为研究对象,依据随机数字表法分为对照组和观察组,各45例。对照组患者给予牙周基础干预,观察组患者在对照组基础上给予双歧杆菌乳杆菌三联活菌治疗。比较两组干预前后牙周临床指标[牙周探诊深度(PD)、附着丧失(AL)、菌斑指数(PLI)、龈沟出血指数(SBI)]及龈沟液脂联素、炎症因子[白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)],临床疗效。结果 干预后,对照组PLI、SBI均低于本组干预前,观察组PD、AL、PLI、SBI均低于本组干预前及对照组,差异均有统计学意义(P<0.05)。干预后,两组龈沟液脂联素水平均高于本组干预前, IL-6、hs-CRP水平均低于本组干预前,且观察组龈沟液脂联素(1.42±0.16)μg/ml高于对照组的(1.14±0.18)μg/ml, IL-6(3.02±0.30)μg/L、hs-CRP(8.12±0.92)μg/L低于对照组的(3.76±0.33)、(12.05±1.35)μg/L,差异均...     

2型糖尿病肾病患者血IL-6、TNF-α、hs-CRP检测的临床意义

目的探讨2型糖尿病肾病患者血浆白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)水平的变化及其临床意义。方法将2型糖尿病患者分为单纯糖尿病组(SDM组)43例、早期肾病组(EDN组)39例、临床肾病组(CDN组)52例,设健康对照组20例,分别检测3组血浆IL-6、TNF-α、hs-CRP水平。将相关因素进行logistic多因素回归分析。结果 2型糖尿病肾病患者血浆IL-6、TNF-α、hs-CRP水平显著高于单纯糖尿病组及对照组(P<0.01)。Logistic回归发现IL-6、TNF-α、hs-CRP等均是2型糖尿病肾病的独立危险因素(P<0.05)。结论 IL-6、TNF-α、hs-CRP水平与2型糖尿病肾病相关,其血浆水平与2型糖尿病肾病的严重程度一致。     

2型糖尿病肾病患者血IL-6、TNF-α、hs-CRP检测的临床意义

目的 探讨2型糖尿病肾病患者血浆白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)水平的变化及其临床意义.方法 将2型糖尿病患者分为单纯糖尿病组(SDM组)43例、早期肾病组(EDN组)39例、临床肾病组(CDN组)52例,设健康对照组20例,分别检测3组血浆IL-6、TNF-α、hs-CRP水平.将相关因素进行logistic多因素回归分析.结果 2型糖尿病肾病患者血浆IL-6、TNF-α、hs-CRP水平显著高于单纯糖尿病组及对照组(P<0.01).Logistic回归发现IL-6、TNF-α、hs-CRP等均是2型糖尿病肾病的独立危险因素(P<0.05).结论 IL-6、TNF-α、hs-CRP水平与2型糖尿病肾病相关,其血浆水平与2型糖尿病肾病的严重程度一致.     

2型糖尿病合并牙周炎患者血清淀粉样蛋白A变化及其临床意义

目的：观察2型糖尿病合并牙周炎患者血清淀粉样蛋白A（ SAA）变化,探讨其临床意义。方法选择本院2012年6月—2013年9月门诊及住院初诊2型糖尿病患者82例,分为单纯糖尿病组（39例）和糖尿病合并牙周炎组（43例）,同时选择30例健康人作为对照组。记录3组龈沟出血指数（ SBI）和探诊深度（ PD）,采用酶联免疫法测定法检测各组血清 SAA 水平,同时测定各组空腹血糖（ FBG ）、空腹胰岛素（ Fins ）、胰岛素抵抗指数（HOMA-IR）、白素介6（IL-6）、肿瘤坏死因子α（TNF-α）等,并分析SAA与各指标的相关性。结果单纯糖尿病组和糖尿病合并牙周炎组血清SAA水平高于对照组,糖尿病合并牙周炎组血清SAA水平高于单纯糖尿病组,差异均有统计学意义（ P〈0.05）。血清SAA水平与FBG、TNF-α、IL-6、SBI、Fins、PD和HOMA-IR成正相关（ P〈0.05）。结论2型糖尿病合并牙周炎患者血清SAA水平与炎性反应及胰岛素抵抗密切相关,是反映牙周破坏程度的敏感指标,可成为判断牙周炎严重程度的参考指标。     

肿瘤坏死因子α、白细胞介素6和超敏C反应蛋白与2型糖尿病胰岛素抵抗的关系

目的 研究2型糖尿病患者肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)和超敏C反应蛋白(hs-CRP)与胰岛素抵抗的关系.方法 选择60例2型糖尿病患者(T2DM组)和30例健康体检者(对照组),测定两组空腹血清TNF-α,IL-6和hs-CRP水平,同时分别测定两组患者的体质量指数(BMI)、空腹血糖、血清胰岛素水平,计算胰岛素抵抗指数(HOMA-IR).结果 T2DM组TNF-α,IL-6和hs-CRP水平分别为(22.82±5.65) ng/L、( 18.92±5.35) mg/L、(13.14±4.27) mg/L,均明显高于对照组(t=5.18,5.71,4.99,均P ＜0.01).在T2DM组中TNF-α,IL-6和hs-CRP均与HOMA-IR呈正相关(t=0.55,0.62,0.69,均P＜0.05).结论 TNF-α,IL-6和hs-CRP参与了2型糖尿病的发病过程,与胰岛素抵抗密切相关.     

Florida探针对伴糖尿病牙周炎患者牙周治疗的评估

目的 利用Florida探针评价合并糖尿病慢性牙周炎患者牙周非手术治疗的疗效.方法 选择合并糖尿病慢性牙周炎患者10例,进行牙周非手术治疗,使用Florida探针检测患者在治疗前和治疗结束后3个月时的牙周探诊深度(PD)和附着丧失(AL).结果 前牙组、后牙组和所有牙组在治疗后PD和AL较治疗前均有改善(P＜0.01),且前牙组牙周袋深度治疗前后的改变较后牙组明显(P＜0.05).6个位点治疗前后的PD和AL有统计学差异(P＜0.05),而6个位点治疗前后的差值比较则无统计学意义(P＞0.05).结论 慢性牙周炎伴糖尿病患者对牙周非手术治疗具有良好的治疗反应.Florida探针能够较准确、客观地评价牙周状况.     

自锁托槽矫治器对慢性广泛型牙周炎正畸治疗患者龈沟液中IL-1β和TNF-α表达的影响

目的 研究慢性广泛型牙周炎患者戴用自锁托槽矫治器与传统托槽矫治器在正畸治疗初期阶段龈沟液(GCF)含量及GCF内白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)浓度的变化.方法 选择需做固定矫治治疗的轻中度慢性广泛型牙周炎患者12例,按照随机数字表法分为传统托槽组(传统组)和自锁托槽组(自锁组),每组6例.分别测量患者戴用矫治器前(T0),戴用矫治器后1周(T1)、2周(T2)、4周(T3)受试牙位:11、21、31、41的GCF及GCF内IL-1β和TNF-α的浓度.结果 T1、T2、T3期GCF量、GCF内IL-1β和TNF-α的浓度均较T0期增高,差异有统计学意义(P＜0.05),且随着戴用时间的延长,GCF、GCF中IL-1β和TNF-α的浓度有逐渐升高趋势;每个检测时间点自锁组GCF、IL-1β和TNF-α浓度均低于传统组,差异有统计学意义(P＜0.05).结论 自锁托槽矫治器有益于减少正畸治疗对慢性广泛型牙周炎患者牙周健康带来的不良影响.     

2型糖尿病伴慢性牙周炎患者的血糖和炎性因子水平与疾病严重程度的相关性

目的 探讨血糖水平、TNF-α、IL-1、IL-6和PGE-2炎性因子水平与糖尿病伴慢性牙周炎患者疾病严重程度的相关性。方法 选择我院2012年12月至2015年12月收治的2型糖尿病伴慢性牙周炎患者102例。检测血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)和前列腺素-2(PGE-2)。检测血浆糖化血红蛋白(HbA1c)水平,以HbA1c和胰岛素抵抗指数评估糖尿病病变程度,以牙龈指数评估牙周炎病变程度。分析血糖水平、TNF-α、IL-1、IL-6和PGE-2炎性因子水平与糖尿病伴慢性牙周炎患者疾病严重程度的相关性。结果 轻、中、重度HbA1c组牙龈指数等级分布有显著差异(P＜0.05),Person相关性检验结果显示血糖水平与牙龈指数等级存在显著正相关(P＜0.05)。任意两组牙龈指数等级比较,胰岛素抵抗指数均存在显著差异(P＜0.05),二者呈显著正相关(r=0.468,P=0.009)。任意两组牙龈指数等级比较,血清TNF-α、IL-1、IL-6和PGE-2水平均存在显著差异(P＜0.05),血清各炎性因子与牙龈指数等级呈显著正相关(r=0.211,P=0.044;r=0.354,P=0.023;r=0.396,P=0.017;r=0.538,P=0.011)。结论 2型糖尿病伴慢性牙周炎患者的血糖水平和血清TNF-α、IL-1、IL-6和PGE-2炎性因子水平与牙周病变程度呈显著正相关,治疗此类患者应该兼顾控制血糖和消除炎症。     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Acamprosate and naltrexone treatment effects on ethanol and sucrose seeking and intake in ethanol-dependent and nondependent rats

Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Self-stimulation and amphetamine: Tolerance to d and l isomers and cross tolerance to cocaine and methylphenidate

The effects of the d and l isomers of amphetamine on self-stimulation responding were tested following acute and chronic administration. Tolerance and post-drug depression of responding occurred in tests with both isomers, indicating no role for p-hydroxynorephedrine (PHN) which is one of the metabolites of d-amphetamine. In the second experiment, d-amphetamine, methylphenidate and cocaine all produced quantitatively and qualitatively similar effects on self-stimulation responding following acute administration. Following chronic administration of d-amphetamine, animals showed tolerance to all three drugs, indicating cross-tolerance among them. These data are consistent with an hypothesis that tolerance and post-drug depression following chronic amphetamine treatment are the result of decreases in postsynaptic receptor sensitivity, which would lead to a decreased effectiveness of all three drugs, regardless of their pre-synaptic mechanisms.     

Synthesis and anti-inflammatory and analgesic activities of pyridyloxy- and phenoxyalkanoic acid derivatives

Synthesis of pyridyloxy-, pyridyloxyphenoxy- and phenoxylphenoxyalkanate derivatives and their anti-inflammatory and analgesic activities were investigated. Analysis of structure-activity relationships showed that in pyridyloxyalkanoic acid derivatives anti-edematous potency was associated with the presence of chlorophenoxypropionic acid moiety and 2-nitrated methyl propionates contributed to the analgesic activity.