不同血液净化方式和时机对脓毒症致急性肾损伤的防治效果分析

目的探讨不同血液净化方法与时机对脓毒症相关性急性肾损伤(AKI)的防治效果。方法选择2016年10月～2017年10月我院收治的94例脓毒症致AKI患者为观察对象,采用随机数字表法分为研究组和对照组各47例,对照组采取间歇性血液透析(IHD)治疗,研究组采取连续性血液净化(CRRT)治疗,观察比较两组患者的临床效果。结果治疗后,两组患者的血清肌酐(Cr)、尿素氮(BUN)、白蛋白(ALB)及急性生理和慢性健康评分(APACHE-Ⅱ)均有改善,且研究组优于对照组,差异均有统计学意义(P0.05)。研究组患者的肾功能恢复率为59.57%、存活率为85.11%,高于对照组的31.91%和61.70%,差异均有统计意义(P0.05)。结论在合适时机采取CRRT治疗脓毒症相关性AKI的效果确切,可有效改善患者病情,促进肾功能恢复,提高患者生存质量。     

寻常型银屑病患者血清IL-17、IL-18、VEGF的表达及与病情严重程度的相关性研究

目的:探讨寻常型银屑病患者血清白介素17(IL-17)、白介素18(IL-18)、血管内皮生长因子(VEGF)的表达及与病情严重程度的相关性。方法:选取2015年8月到2017年4月在我院接受治疗的寻常型银屑病患者86例为研究组,另选取同期在我院体检结果为健康的志愿者40例作为健康对照组,并根据临床症状和病情变化对研究组患者进行分组,其中进行期银屑病组32例,静止期银屑病组24例,退行期银屑病组30例。对比研究组和健康对照组血清中IL-17、IL-18、VEGF水平,对比不同严重程度的寻常型银屑病患者血清中IL-17、IL-18、VEGF水平和PASI评分,采用Spearman相关性分析IL-17、IL-18、VEGF的表达与PASI评分的相关性。结果:研究组患者血清中的IL-17、IL-18、VEGF水平显著高于健康对照组(P0.05),进行期银屑病组患者血清中IL-17、IL-18、VEGF水平和PASI评分显著高于静止期银屑病组和退行期银屑病组,静止期银屑病组患者血清中IL-17、IL-18、VEGF水平和PASI评分显著高于退行期银屑病组(P0.05),Spearman相关性分析结果显示,研究组患者血清中IL-17、IL-18、VEGF水平与PASI评分均呈正相关(P0.05)。结论:寻常型银屑病患者血清中IL-17、IL-18、VEGF水平异常升高,且其水平与病情严重程度有关,对上述三种指标进行监测有助于临床治疗寻常型银屑病。     

高血压脑出血患者高迁移率族蛋白-1、铁蛋白、血管内皮素的表达及其临床意义

目的:探讨高血压脑出血患者高迁移率族蛋白-1(HMGB-1)、铁蛋白(SF)、血管内皮素(ET-1)的表达水平及其临床意义。方法:选择泰山医学院附属聊城市第二人民医院2014年6月至2017年12月收治的高血压脑出血患者96例作为研究组,另选择同期于该院体检的健康志愿者80例作为对照组。根据神经缺损程度将研究组分为轻度组28例、中度组43例和重度组25例,根据预后结果将研究组分为预后良好组62例和预后不良组34例。比较研究组和对照组、不同神经缺损程度及不同预后患者血清HMGB-1、SF、ET-1水平,并分析高血压脑出血患者血清HMGB-1、SF、ET-1水平与美国国立研究院急性脑卒中量表(NIHSS)的相关性。结果:研究组血清HMGB-1、SF、ET-1水平均显著高于对照组(P0.05)。研究组患者神经缺损程度越严重,血清HMGB-1、SF、ET-1水平越高(P0.05)。预后不良组患者血清HMGB-1、SF、ET-1水平高于预后良好组(P0.05)。经Pearson相关性分析显示,高血压脑出血患者血清HMGB-1、SF、ET-1水平与NIHSS评分均呈正相关(P0.05)。结论:高血压脑出血患者血清HMGB-1、SF、ET-1水平与神经缺损程度、预后密切相关,三指标水平越高,患者病情越严重,且预后越差,检测上述指标对患者病情和预后的评估具有一定的参考作用。     

帕金森病患者血清中IL-17、CysC、Hcy水平变化及其在病情评估中的价值

目的:探讨帕金森病(PD)患者血清中白介素-17(IL-17)、胱抑素C(Cys C)、同型半胱氨酸(Hcy)水平变化及其在病情评估中的应用。方法:选择2013年5月至2015年3月我院神经内科诊疗的91例PD患者作为研究组,根据简易智力量表评价标准将患者分为认知功能障碍(A组)和无认知功能障碍(B组);根据Hoehn-Yahr(H-Y)分期标准分为早期组、中期组和晚期组。另选择同期我院健康体检中心的健康志愿者53例作为对照组。检测受试者血清中IL-17、Cys C及Hcy的水平,进行统计分析。结果:与对照组相比,研究组患者血清中的各指标水平明显升高(P0.05);同时,检测结果发现,A组患者血清中各指标水平显著高于B组(P0.05);另外,随着H-Y分期的递增,PD患者血清中各指标水平明显升高(P0.05)。结论:PD患者血清中的IL-17、Cys C、Hcy水平异常表达,在患有认知功能障碍的PD患者血清中的水平更高,同时,各指标对于不同H-Y分期的PD患者具有表征作用,对于临床诊断及病情评估具有重要意义,值得进行广泛推广。     

健康教育对预防系统性红斑狼疮患者复发率的影响

目的 探讨健康教育对预防系统性红斑狼疮(SLE)患者复发的影响.方法 将2009~2010年我科收治行常规药物治疗和卫生宣教的128例SLE患者为对照组;将2011~2012 年收治行规范化治疗和连续系统的健康教育的136例SLE患者为观察组,即将健康教育贯穿于病人住院期间及出院后1年,根据病人不同时期的身心需求,实施连续系统的健康教育.结果 两组患者均病情好转出院,随访1年,观察组所有患者均坚持服药、建立良好生活方式、定期来院复查和化疗,仅3例病情复发,复发率为2.2%;对照组仅76%患者定期来院复查和化疗,复发16例,复发率为12.5%,明显高于观察组.结论 对SLE患者进行规范化治疗和连续系统的健康教育、定期随访,可有效的预防和减少SLE复发率及并发症发生率,提高患者生活质量.     

慢性牙周炎与原发性肝硬化的相关性分析

目的:探究慢性牙周炎与原发性肝硬化之间的相关性。方法:选择2017年1月至2019年1月于我院接受治疗的60例原发性肝硬化患者为研究组,选择同期于我院接受体格检查的100例健康个体为对照组,对两组患者分别实施牙周检查,对比两组患者牙周炎发生率,分析吸烟、饮酒对牙周炎发生率影响,按照Child-改良分级法对肝硬化患者进行评分并分级,对比各级原发性肝硬化患者慢性牙周亚发生率,并就慢性牙周炎与肝硬化相关性进行分析。结果:(1)对照组慢性牙周炎发生率显著低于研究组慢性牙周炎发病率(44.00%vs. 71.67%,P0.05);(2)研究组和对照组中吸烟者的慢性牙周炎患病率显著高于不吸烟者(P0.05),研究组中吸烟者发生慢性牙周炎患病率高于对照组,对比无统计学意义(P0.05);研究组和对照组饮酒者的慢性牙周炎患病率显著高于不饮酒者(P0.05),研究组中饮酒者发生慢性牙周炎患病率显著高于对照组(P0.05);(3)随着原发性肝硬化患者评分的升高,患者牙周炎患病率也随之上升,牙周附着丧失程度也出现加剧(P0.05)。结论:原发性肝硬化患者慢性牙周炎患病率高于健康个体,随着肝硬化患者病情的加剧,患者慢性牙周炎发生率也随之上升;另外,吸烟及饮酒会增加健康个体慢性牙周炎患病率。     

aAd-p53基因靶向治疗癌性胸腹水的临床效果分析

目的:探讨aAd-p53注射液靶向灌注治疗癌性胸腹水的临床疗效和安全性。方法:选择2012年5月-2014年2月在我院接受治疗的癌性胸腹水患者80例,根据治疗方法的不同,将患者随机分为研究组和对照组,每组40例。研究组患者采用腔内灌注rAd-p53治疗,对照组患者采用表阿霉素灌注治疗,观察并比较两组患者的治疗总有效率、不良反应的发生率及KPS功能评分的变化情况。结果:所有患者均顺利完成灌注治疗,病情获得好转,生存质量得到改善。研究组和对照组的治疗总有效率分别为70%、67.5%,两组比较无显著性差异(P0.05)。两组治疗后KPS评分均显著高于治疗前,且研究组高于对照组,差异具有统计学意义(P0.05)。研究组和对照组不良反应的发生率分别为20%和25%,研究组低于对照组,但两组差异并无统计学意义(P0.05)。结论:rAd-p53注射液靶向灌注治疗是一种治疗癌性胸腹水安全有效的方法,值得临床推广。     

IL-33在强直性脊柱炎患者外周血中的表达及意义

目的:探讨IL-33在强直性脊柱炎(AS)患者外周血中的表达水平及临床意义。方法:选择我院2013年12月至2014年8月收治的80例AS患者作为研究组,另选取同期在我院进行健康体检的80例作为对照组。检测两组患者外周血中IL-33的表达情况,记录研究组患者病情活动指数(BASDAI)、红细胞沉降率(ESR)及C-反应蛋白(CRP)水平,分析IL-33表达水平与BASDAI、ESR及CRP的相关性。结果:研究组患者血浆IL-33水平明显高于对照组,差异具有统计学意义(t=6.15,P=0.025)。AS患者外周血IL-33水平与BASDAI和CRP具有显著正相关关系(r=0.432,0.525,P=0.034,0.029),而与ESR无显著相关性(r=0.175,P=0.214)。结论:AS患者外周血中IL-33呈高表达,说明其可能参与AS的发生及发展。     

强直性脊柱炎患者外周血TNF-α、IL-17、IL-33的表达及与疾病活动程度的相关性研究

目的:探讨强直性脊柱炎(AS)患者外周血肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)、白细胞介素-33(IL-33)的表达及与疾病活动程度的相关性。方法:选取2016年5月到2017年6月在我院接受治疗的AS患者74例作为研究组,另选取同期在我院体检的健康志愿者40例作为对照组,根据AS病情活动评分量表(BASDAI)将研究组患者分为A组(BASDAI4分,32例)和B组(BASDAI得分≦4分,42例),比较研究组和对照组外周血中TNF-α、IL-17、IL-33水平,比较A组和B组外周血中TNF-α、IL-17、IL-33、C反应蛋白(CRP)、红细胞沉降率(ESR),采用Spearman相关性分析TNF-α、IL-17、IL-33水平与BASDAI得分及CRP、ESR的相关性。结果:研究组外周血中TNF-α、IL-17、IL-33水平明显高于对照组,差异有统计学意义(P0.05),A组外周血中TNF-α、IL-17、IL-33、CRP、ESR明显高于B组,差异有统计学意义(P0.05);AS患者TNF-α、IL-17、IL-33水平与BASDAI得分及CRP、ESR水平均呈正相关(P0.05)。结论:TNF-α、IL-17、IL-33在AS患者外周血中呈现高表达,并且与患者BASDAI得分及CRP、ESR水平呈正相关。     

慢性肾衰竭患者治疗前后血清CysC,Hcy及PTH水平变化及临床意义

目的:探讨慢性肾衰竭(CRF)患者治疗前后血清胱抑素C(Cys C)、同型半胱氨酸(Hcy)及甲状旁腺激素(PTH)水平变化及临床意义。方法:筛选2013年12月至2014年12月我院就诊的CRF患者258例作为研究组,并选取同时期健康体检者258例为对照组,研究组患者入院后针对病情给予相应治疗,检测研究组治疗前后血清肌酐(Scr)、尿素氮(BUN)、Cys C、Hcy及PTH水平变化,分析不同分期CRF患者各指标的水平差异,并与对照组进行对比分析,分析Scr、BUN与Cys C、Hcy及PTH的相关性。结果:研究组血清Scr、BUN、PTH、Cys C和Hcy水平均明显高于对照组,异有统计学意义(P0.05),经过治疗后以上各项指标水平较前明显下降,差异有统计学意义(P0.05),但仍明显高于对照组,差异有统计学意义(P0.05);研究组患者Scr、BUN、Cys C、Hcy及PTH水平随着CRF分期发展而上升,其中尿毒症期肾功能衰竭期肾功能失代偿期肾功能代偿期,组间比较差异均有统计学意义(P0.05);采用Pearson相关性分析,研究组患者的Scr、BUN水平分别与Cys C、Hcy及PTH的水平呈正相关(r=0.731、0.642、0.813,P0.05;r=0.682、0.752、0.833,P0.05)。结论:Cys C、Hcy、PTH水平能够反映CRF患者临床治疗效果,反映疾病的严重程度,为CRF患者的诊断和预后提供参考,具有重要的临床意义。     

Inhibitory effect of oral Lactobacillus against oral pathogens

Aims: To determine the inhibitory effect of oral Lactobacillus against putative oral pathogens. Methods and Results: Total 357 strains comprising 10 species of oral Lactobacillus, Lactobacillus fermentum (195), Lactobacillus salivarius (53), Lactobacillus casei (20), Lactobacillus gasseri (18), Lactobacillus rhamnosus (14), Lactobacillus paracasei (12), Lactobacillus mucosae (12), Lactobacillus oris (12), Lactobacillus plantarum (11) and Lactobacillus vaginalis (10) were used as producer strains. Inhibitory effect against a panel of indicators, periodontitis‐ and caries‐related pathogens, was assessed. Most oral Lactobacillus was able to inhibit the growth of both periodontitis‐ and caries‐related pathogens. The strongest inhibitory activity was associated with Lact. paracasei, Lact. plantarum, Lact. rhamnosus, Lact. casei and Lact. salivarius. Lactobacillus SD1–SD6, representing the six species with the strong inhibitory effect, inhibited growth of Streptococcus mutans ATCC 25175 in the biofilm model. Also, it was demonstrated that growth of Strep. mutans was inhibited in a mixture with Lact. paracasei SD1. The inhibition was enhanced in acidic condition and 5% glucose. Conclusions: The results have shown that oral Lactobacillus SD1–SD6 showed a strong inhibitory effect against Strep. mutans and Streptococcus sobrinus, as well as, Gram‐negative periodontal pathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Significance and Impact of the Study: The results indicated that Lactobacillus may be of benefit as probiotics for the prevention of oral diseases.     

The targeted oral

An oral examination for assessing senior undergraduate students is described. The examinations were conducted in a room with a one-way mirror so that all students could learn from each other. This procedure was much appreciated by the participants.     

Cytometric analysis of oral scrapings of patients with oral lichen planus

A. Acha‐Sagredo, Y. Jiménez, J. V. Bagán, M. A. Echebarria‐Goicouria and J. M. Aguirre‐Utric analysis of oral scrapings of patients with oral lichen planus Objective: Aneuploidy has been associated with malignant and premalignant oral lesions. In the past few years, its application in oral precancerous lesions and its prognostic meaning have been controversial issues. The aim of our study was to characterize alterations in DNA content by automated DNA image cytometry in oral scrapings of patients with oral lichen planus. Methods: Cytological samples from 40 patients clinicopathologically diagnosed with oral lichen planus were analysed by DNA image cytometry. Results: All the cases were classified as diploid, showing a predominant population of cells with normal DNA content (DNA index, 0.85–1.15). Atrophic/erosive lesions showed a higher percentage of tetraploid cells when compared with reticular/papular lesions but this was not statistically significant (P = 0.09). Conclusions: Aneuploidy does not seem a common event in oral lichen planus lesions. However, we consider that the use of DNA image cytometry of oral scrapings may be an easy and helpful methodology in the follow‐up of patients with these lesions.     

口腔微生态失衡导致口腔异味的研究

目的介绍口腔微生态失调与口腔疾病的关系,口腔疾病出现口腔气味异常的机制。综合分析口腔微生态与口腔健康的研究动态及意义。展望口腔微生态调整在口腔疾病治疗中的作用研究,尤其在消除口腔异昧的积极作用。方法由第一、二作者应用计算机通过pubmed检索NCBI数据库1992年至2007年相关文献,检索词为“Micro ecology”,限定语言种类为“English”;同时检索CNKI全文数据库、维普全文数据库1995年至2007年相关文献,检索词为“微生态”,限定语言种类为中文。纳入标准：文章内容与口腔微生态相关的研究、以及在口腔疾病研究领域有关。排除标准：较陈旧的文献和重复研究。结果共收集到106篇相关文献,21篇文献纳入本文,其中,19篇为综述和述评类文献,19篇为中文杂志,2篇为外文杂志。结论致病菌大量生长繁殖,口腔微生态失调,菌斑内微生物之间以及机体与菌斑之间相互作用分解蛋白产生硫化物,这些代谢产物包括H2S、CH3SH、CH3SCH3、吲哚、甲基吲哚、挥发脂肪酸和聚胺等发出刺激性气味,产生口腔异味。治疗口腔异味应该考虑平衡口腔微生态,调整口腔菌群。口腔异味的治疗又有利于口腔菌群平衡。提示我们治疗口腔疾病应该考虑口腔微生态平衡。     

Genes and oral cancer

Oral cancers have been one of the leading causes of deaths particularly in the developing countries. Prime reason for this high mortality and morbidity is attributed to the delay in diagnosis and prompt treatment. Relentless research in the field of oncology has led to the advent of novel procedures for the early detection of oral cancers. Molecular biology is highly promising in this regard. It is a procedure that detects alterations at a molecular level much before they are seen under a microscope and much before clinical changes occur. Molecular studies serve as the basis by which we will eventually be able not only to augment clinical assessment and classification of oral lesions but also predict malignant potential of oral lesions, thus reducing the incidence and increasing the scope for early diagnosis and treatment of oral cancers. However, making such sophisticated tools available for the common man in developing countries is one of the most important challenges faced today.     

Computer aided morphometric analysis of oral leukoplakia and oral squamous cell carcinoma

We compared the changes in the cells in the basal layer of normal mucosa, oral leukoplakia with dysplasia and different grades of oral squamous cell carcinoma (OSCC) using computer aided image analysis of tissue sections. We investigated three morphometric parameters: nuclear area (NA), cell area (CA) and their ratio (NA:CA). NA and NA:CA ratio showed a statistically significant increase from dysplasia to increasing grades of OSCC. Nuclear size was useful for differentiating normal tissue, potentially malignant leukoplakia and OSCC.     

The new oral anticoagulants

In patients with nonvalvular atrial fibrillation oral anticoagulation with the vitamin K antagonists acenocoumarol, phenprocoumon and warfarin reduces the risk of stroke by more than 60%, whereas single or double antiplatelet therapy is much less effective and sometimes associated with a similar bleeding risk as vitamin K antagonists. Besides bleeding, INR monitoring and high interindividual variability remain the largest drawbacks of vitamin K antagonists. In the last decade oral agents have been developed that directly block the activity of thrombin (factor IIa), as well as drugs that directly inhibit activated factor X (Xa), which is the first protein in the final common pathway to the activation of thrombin. These agents have huge advantages in that they do not need monitoring and have a fast onset and offset of action. This survey addresses the role of classical and modern anticoagulation in stroke prevention in atrial fibrillation. (Neth Heart J 2010;18:314-8.)