目的 探讨尼莫地平对无症状脑梗塞认知功能障碍的改善作用及安全性。方法 将80例无症状脑梗塞患者随机分为治疗组和对照组,每组40例,于治疗前及治疗后3月分别进行蒙特利尔认知量表(MoCA)、简易智能状态量表(MMSE)、画钟测验(CDT)评估,并比较2组的评分结果。结果 尼莫地平治疗后3月MMSE 评分为(26.35±3.26)分,MoCA评分为(25.53±4.31)分,CDT评分为(6.12±2.23)分,较对照组分别为MMSE 评分为(23.12±3.45)分,MoCA评分为(22.21±3.63)分,CDT评分为(4.35±2.61)分有改善,差异均有统计学意义(P<0.05)。80例患者中MoCA评测异常组在视空间与执行能力、延迟记忆、注意力及计算力、抽象思维等分项得分明显低于MoCA评测正常组(P<0.05)。结论 尼莫地平能有效改善无症状脑梗塞患者的认知功能,且安全性较高。

Objective To explore the role of nimodipine in improving cognitive function in silent cerebral infarction patients and its safety. Methods Eighty SCI patients were divided randomly into 2 groups.MMSE、MoCA and CDT scores were assessed before treatement and after 3 month of treatment.The results were compared between the 2 groups. Results MMSE、MoCA and CDT scores of Nimodipine group(26.35±3.26, 25.53±4.31, 6.12±2.23, respectively), improved when compared with the control(23.12±3.45, 22.21±3.63, 4.35±2.61,respectively),and the difference was statistical significance (P<0.05). The patients with abnormal MoCA had lower scores in several cognitive domains (visuospatial and executive abilities, delayed memory, attention and capacity of calculation, abstract thinking (P<0.05) compared with control group. Conclusion Nimodipine could improve effectively the cognitive function in SCI patients and with a higher safety.

目的 探讨脉管炎围手术期出现焦虑症状及影响因素和护理以提高在围手术期的生活质量。方法 通过对脉管炎患者进行问卷调查焦虑发生及影响因素。结果 脉管炎围手术期患者出现焦虑是十分常见的,生活质量下降直接或间接影响手术的成功率。结论 有效的护理干预能改善各方面的焦虑因素,使患者在围手术期保持心情舒畅,从而适应截肢形象的改变,提高生活质量。

目的 氧化苦参碱对视网膜母细胞瘤细胞SM-106凋亡的诱导作用及机制。方法 以不同作用时间(24 h、48 h、72 h)和不同作用浓度(12.5 μl/mL、25 μl/mL、50 μl/mL、100 μl/mL)氧化苦参碱处理视网膜母细胞瘤细胞SM-106,分别采用流式细胞仪及western blot检测视网膜母细胞瘤细胞SM-106细胞凋亡及其凋亡因子(Bax、Bcl-2)蛋白表达。结果 氧化苦参碱可促进SM-106细胞体外凋亡,上调Bax蛋白表达及Bax/Bcl-2蛋白表达比值,下调Bcl-2蛋白表达,并呈现剂量及时间依赖性。结论 氧化苦参碱可诱导视网膜母细胞瘤细胞SM-106凋亡,调控凋亡因子Bax、Bcl-2的表达是其可能作用机制。

Objective To evaluate the apoptosis and its mechanism of retinoblastoma cells SM-106 induced by oxymatrine. Methods Retinoblastoma cells SM-106 were treated with different time(24 h、48 h、72 h)and different concentrations(12.5 μl/mL, 25 μl/mL, 50 μl/mL or 100 μl/mL) of oxymatrine. The apoptosis and protein expression of apoptosis factors (Bax and Bcl-2) were respectively determined by flow cytometry and western blot. Results Oxymatrine significantly promoted the SM-106 cells apoptosis in vitro, raised Bax protein expression and Bax/Bcl-2 protein expression ratio, reduced the Bcl-2 protein expression, and showed the dose and time dependent. Conclusion Oxymatrine is able to induce the apoptosis in retinoblastoma cells SM-106. Regulating apoptosis related gene Bax and Bcl-2 expression may be the mechanism of apoptosis.

目的 体外构建胶原—壳聚糖复合支架材料,分析其物理化学性质及生物相容性,探讨其应用于组织工程支架材料的可行性。方法 利用冷冻干燥的方法构建三维多孔的胶原支架材料,通过甲醛交联以及添加壳聚糖的方法改善其物理化学性能。通过体外降解实验以及电镜扫描的方法检测材料的各项物理化学指标;通过细胞接种的方法研究材料的生物相容性。结果 胶原—壳聚糖复合材料通过冷冻干燥的方法,能够获得稳定的三维多孔结构,电镜显示孔隙贯通,体外降解速度降低,并且能够支持细胞生长。理化性质分析显示该结构适合细胞生长,具有良好的生物相容性。结论 本课题体外构建胶原—壳聚糖复合支架材料,满足组织工程生物材料的理化以及生物相容性要求,为其应用于组织工程支架材料提供重要的依据。

Objective We build up the Collagen-Chitosan compound scaffold in vitro,and study the physical,chemical and biological properties,to analyze the feasibility in tissue engineering. Methods The three-dimensional porous scaffold was obtained by freezing-drying method,and optimized by using formaldehyde and Chitosan.We used hydrolysis in vitro and SEM scanning to investigate its physical and chemical properties.The biocompatibility of scaffold was analyzed in MEF cells. Results Collagen-Chitosan compound scaffold we obtained by freezing-drying method was a kind of stable 3D vesicular structure.The scaffold degenerated in decreased velocity in vitro.The physical and chemical properties showed that it was suitable for the cells grow in it,which suggested that it has a good biocompatibility. Conclusion This kind of Collagen-Chitosan compound scaffold is constructed.It's qualified by the physical and chemical properties,and biocompatibility which the biomaterials require.The evidence are important for its application in tissue engineering.

目的 对比分析二氧化锆全瓷冠与钴铬合金烤瓷冠修复牙体牙列缺损的临床疗效。方法 选择2008年3月以来广东工业大学医院口腔科和江西省萍乡市安源区现代口腔门诊部牙体牙列缺损全冠修复患者150例364颗,随机分为2组,实验组采用二氧化锆全瓷冠75例185颗,对照组采用钴铬合金烤瓷冠75例179颗,修复后随访2年对比观察,结果采用χ²检验分析。结果 两组在修复体完整性、固位、边缘密合度、牙敏感症状、继发龋、邻面接触点、过敏反应方面差异无统计学意义(P＞0.05);但在牙龈状况、龈缘着色、颜色匹配方面差异有统计学意义(P＜0.01)。结论 二氧化锆全瓷冠修复体美学效果和生物相容性优于钴铬合金烤瓷冠。

Objective To compare and analyze the clinical effects of restoring tooth dentition defect by using zirconium dioxide full porcelain crowns and cobalt chromium alloy porcelain crowns. Methods 150 patients with 364 teeth suffering from tooth dentition defect in hospital of guangdong university of technology and modern stomatology clinic in pingxiang since March of 2008 are chosen and randomly divided into two groups. 75 patients with 185 teeth in the experimental group are restored with zirconium dioxide full porcelain crowns and 75 patients with 179 teeth in the control group are restored with cobalt chromium alloy porcelain crowns, which was followed up with 2-year observation. Results There is no statistical significance between the two groups in terms of repair integrity, retention, edge adaptation, tooth sensitivity symptoms, secondary caries, contact points, and allergic reaction(P＞0.05). But statistical significance exists in gingival status, gingival coloration, and color matching(P＜0.01). Conclusion Zirconium dioxide full porcelain crowns are superior to cobalt chromium alloy porcelain crowns in aesthetic effect and biocompatibility.

目的 探究低分子量肝素在维持性血液透析治疗中的疗效及安全性。方法 资料随机选取2013年6月—2014年6月本院收治的140例维持性血液透析患者,按照随机数字表法分为研究组与对照组,每组70例。血液透析时对照组采用普通肝素抗凝,研究组采用低分子量肝素抗凝,分析两组治疗效果和安全性。结果 两组透析器与透析管道凝血等级0、1、2级患者比较均无差异(P＞0.05),透析后15 min~4 h研究组APTT、TT水平均低于对照组(P＜0.05);研究组穿刺点压迫止血时间短于对照组(P＜0.05,P＜0.01),透析后两组不良反应发生率比较无差异(P＞0.05)。结论 维持性血液透析治疗应用低分子量肝素抗凝疗效确切,可减少透析器及透析管道凝血现象的发生,提高血液透析的安全性及质量。

目的 探讨锥形纤维桩核与金属铸造桩核在残冠残根修复治疗中的临床效果。方法 65例患者共计69颗残冠残根经完善的根管治疗后采用锥形玻璃纤维桩树脂核和全冠修复,另外32例41颗牙经铸造桩核冠修复,观察疗效对比。结果 所有病例每年复查一次,平均随访期为2年,69颗纤维桩修复患牙未发现牙根折裂,其中66颗全冠与桩核固位稳定,无主诉不适、牙周健康、患者对修复体美学效果与咀嚼功能均感满意。3例失败病例分别为全冠、纤维桩核松动脱落各1颗,有1颗纤维桩折断,成功率为95.6%。金属铸造桩核组41颗患牙失败4例,其中根折2例,均已拔除,牙龈炎伴牙龈及修复体颈缘变色1例,改用纤维桩修复,继发龋1例,成功率为90.2%。结论 纤维桩树脂核具有美学效果好,机械性能好,无腐蚀,耐疲劳,易拆除,不易根折等优点,可替代铸造桩核作为理想的冠、残根桩核修复材料。

目的 探讨血浆D-二聚体及纤维蛋白原在社区获得性肺炎患者严重程度评估的应用价值。方法 收集110例社区获得性肺炎患者的临床资料,根据CURB-65评分标准对患者进行分组,分别测定患者血浆D-二聚体及纤维蛋白原水平,比较其在不同分组间的差异及通过ROC曲线了解其在重症社区获得性肺炎诊断中的价值。结果 不同CURB-65分组间D-二聚体、纤维蛋白原水平比较差异有统计学意义(P<0.05),重症肺炎组D-二聚体、纤维蛋白原水平明显高于非重症肺炎组(P<0.05)。ROC曲线显示入院D-二聚体、纤维蛋白原水平诊断重症肺炎曲线下面积(AUC)分别为0.815、0.777。结论 血浆D-二聚体及纤维蛋白原可以有效评估社区获得性肺炎患者病情的严重程度,其是诊断重症肺炎的一个良好指标。

Objective To evaluate the prediction and evaluation of plasma D-dimer and fibrinogen levels upon the severity of community acquired pneumonia(CAP). Methods Clinical variables of 180 patients with CAP were evaluated and divided into different groups by CURB65.Plasma D-dimer and fibrinogen were measured to compare their levels among different groups and evaluate the prediction in the diagnosis of the severe CAP by ROC curve. Results The mean D-dimer and fibrinogen level were different significantly among different CURB65 groups. D-dimer and fibrinogen level of severe CAP were significantly higher than non-serious pnrumonia group. The area under the curve of the D-dimer, fibrinogen in the diagnosis of severe pneumonia were 0.815, 0.777. Conclusion Plasma D-dimer and fibrinogen can effectively evaluate the severity of illness in patients with community acquired pneumonia and they could be useful for assessment of the severity of CAP.

目的 评价急性心肌梗塞患者转往有条件医院行PCI治疗前应用替罗非班(血小板Ⅱb/Ⅲa受体拮抗剂)的临床疗效与安全性。方法 选取从2013年1月—2014年9月诊断为急性心肌梗塞行PCI治疗的患者共66例。随机分为观察组(确定转院行PCI治疗前在我院应用替罗非班) 34例、对照组(转运到花都区人民医院心内科行PCI治疗后应用替罗非班) 32例。观察比较两组患者首次造影的冠脉血流情况与术后的冠脉血流情况、PCI时心电图抬高的ST回落情况与心肌标志物峰值前移情况、住院期间与随访30天期间不良心血管事件(MAGC)的发生情况(支架内血栓与二次血运重建发生率、再梗塞率、心绞痛、死亡率)以及两组的不良反应。结果 观察组首次造影的冠脉血流优于对照组;术后的冠脉血流观察组优于对照组(P<0.05);PCI时心电图ST回落≥1/2的情况与TNI、CK-MB峰值前移情况优于对照组(P<0.05);不良心血管事件发生率较对照组少(P<0.05);不良反应发生率差异无统计学意义(P>0.05)。结论 急性心梗转院PCI患者,转院前应用替罗非班比转院后应用获益更大,安全性尚可。这类病人,在确定转院之时即时应用替罗非班是合理时机。

目的 对比微创稳定系统(LISS)与解剖板治疗股骨远端复杂骨折的疗效比较。方法 45例股骨远端复杂骨折分别应用LISS及解剖板治疗。其中LISS组25例,解剖板组20例。结果 术后LISS组随访12～18个月,平均14.1个月;解剖板组随访12～18个月,平均13.9个月。所有患者手术切口均一期愈合。骨折愈合时间及术后并发症发生总数两组比较差异无统计学意义。LISS组的植骨例数少于解剖板组。切口大小、手术时间、术中失血及Merohan疗效比较,LISS组优于解剖板组。结论 LISS及解剖板治疗股骨远端复杂骨折均可取得满意疗效,但LISS系统创伤小,骨折固定牢固,体现微创原则,是治疗股骨远端复杂骨折的新趋势。