目的 探讨枸杞糖肽(Lycium barbanun glycopeptide,LbGP)对放射诱导人角质形成细胞HaCaT损伤的保护作用及其机制.方法 采用直线加速器(速率6 Gy/min)分别按4、8、12、16、20、24、28 Gy剂量对HaCaT细胞进行照射,CCK-8法检测细胞活性.以0、0.05、0.1、0.5、0.8、1.0、1.5、3mg/mL的 LbGP作用 HaCaT细胞4h,进行 12 Gy剂量放射,CCK-8法检测细胞活性.将HaCaT细胞分为空白对照组(不加LbGP不放射)、放射组(12 Gy剂量照射)、LbGP+放射组(0.8 mg/mLLbGP作用24 h,12 Gy剂量照射),照射1 h后,流式细胞术检测活性氧(reactive oxygen species,ROS)产生量,WST-8法检测超氧化物歧化酶(superoxide dismutase,SOD)活性,Western blot法检测细胞中核因子E2相关因子2(nuclear factor-E2 related factor 2,Nrf2)、p-Nrf2、NADPH 氧化还原酶 1(NADPH quinone oxidoreductase 1,NQO1)、血红素加氧酶-1(heme oxygenase-1,HO-1)蛋白表达水平;分别于放射1、3、5h后,qRT-PCR法检测Nrf2、HO-1、NQO1基因mRNA的转录水平.结果 12 Gy放射辐射量可诱导约50％细胞死亡,0.8 mg/mL LbGP对放射细胞活性保护作用最佳.放射1h后,与空白对照组比较,放射组HaCaT细胞内ROS含量显著增加(F=2.55,P＜0.001),SOD活力显著降低(F=1.23,P＜0.01),NQO1、Nrf2蛋白含量差异无统计学意义(F分别为1.78和1.00,P均＞0.05),HO-1蛋白含量明显增加(F=1.37,P＜0.05),p-Nrf2蛋白含量显著下降(F=2.75,P＜0.01);与放射组比较,LbGP+放射组HaCaT细胞内 ROS含量明显降低(F=3.61,P＜0.001),SOD活性明显升高(F=1.23,P＜0.05),Nrf2,p-Nrf2、HO-1 及NQO1蛋白含量均显著上升(F分别为4.00、2.25、6.25及1.27,P均＜0.05).放射1、3、5 h,与放射组比较,LbGP+放射组Nrf2、HO-I、NQO1基因mRNA转录水平均明显升高(F=0.20～36.00,P均＜0.05).结论 LbGP可减轻放射对HaCaT细胞的氧化应激损伤,保护细胞活性,该作用可能是通过激活Nrf2及提高其下游抗氧化酶SOD、HO-1、NQO1水平而发挥作用的.

外伤、炎症、肿瘤等因素导致的大面积骨缺损是临床上常见的疾病之一,而目前治疗大面积骨缺损存在着愈合周期长、成骨效果不佳等不足.因此,如何高效重建骨缺损区是亟需解决的问题.miRNAs作为一种内源性非编码单链RNA分子,可通过同时控制多个基因表达而发挥强大的分子管理者的作用.miRNAs不但可调控骨髓间充质干细胞成骨向分化,同时也能调节巨噬细胞的极化促进骨再生修复.因此,miRNAs可能作为治疗大面积骨缺损的新型靶点.本文综述miRNAs在骨髓间充质干细胞成骨分化及巨噬细胞极化过程中的调控作用,为靶向调节骨免疫微环境,高效诱导骨再生提供新思路.

目的 比较帐篷钉技术与传统引导骨再生术(GBR)治疗牙槽骨缺损的效果.方法 选取牙槽嵴吸收明显、种植修复前需先行骨增量术的患者22例,按简单随机分组法,分为帐篷钉技术组(试验组)11例和传统GBR组(对照组)11例,并开展骨增量手术,采用CBCT测量术区骨量、骨质变化,比较两组成骨效果.结果 试验组前牙区水平向骨增量与对照组比较,差异无统计学意义(P>0.05);总体垂直向骨增量显著高于对照组(P<0.05);后牙区水平向骨增量显著高于对照组(P<0.05);两组间垂直向骨增量比较,差异无统计学意义(P>0.05);总体水平骨增量与垂直骨增量,试验组均显著高于对照组(P>0.05).结论 应用帐篷钉技术有利于提高骨增量效果,且预后骨质良好,成骨效果稳定,支抗钉可作为帐篷钉的选择之一.

BACKGROUND: Our group has demonstrated that the immunomodulatory peptide DP7-C has good immunomodulatory functions and can efficiently transfect and deliver miRNAs into cells to exert regulatory functions.OBJECTIVE: To prepare and screen porous poly（lactic-co-glycolic acid） microspheres of different sizes loaded with immunomodulatory peptide miR-26a complexes, construct and optimize the sustained release system, and verify its biocompatibility and osteogenic ability in vivo.METHODS:（1） Microsphere preparation: Porous poly（lactic-co-glycolic acid） microspheres were prepared by double emulsification with NH4HCO3 as the poreforming agent. Three different sizes of porous poly（lactic-co-glycolic acid） microspheres were prepared by adjusting the rotational speed. The microspheres were dispersed in the solution of immunomodulatory peptide DP7-C/miR-26a complex to prepare drug-loaded microspheres. The physical properties of the microspheres were characterized. The best drug-loaded porous poly（lactic-co-glycolic acid） microspheres were selected by comparing productivity,encapsulation rate and release performance for further use.（2） In vitro cell experiment: Drug-loaded and drug-free microsphere solutions with different mass concentrations were co-cultured with rat bone marrow mesenchymal stem cells. CCK-8 assay was performed to verify biocompatibility.（3） Animal in vivo experiment: Nine adult Sprague-Dawley rats were randomly divided into blank group, control group and experimental group, with three rats in each group.Cranial defect models with a diameter of 5 mm were established in all three groups. The rats of the blank group were not implanted with the material. The rats of the control group were implanted with blank microspheres. The rats of the experimental group were implanted with microspheres loaded with DP7-C/miR-26a complex. At 8 weeks after operation, the pathological morphology and immunohistochemical staining for alkaline phosphatase of the main organs and skull defects were performed.RESULTS AND CONCLUSION:（1） Microsphere preparation: According to the relevant detection results, the drug-loaded microspheres prepared at 1 000 r/min compared with 500 and 1 200 r/min had uniform size, higher yield and better sustained release performance, which could be used in subsequent experiments.（2） In vitro cell experiment: CCK-8 assay results exhibited that drug-loaded and drug-free microsphere solutions had no effect on the proliferation of bone marrow mesenchymal stem cells and had no obvious cytotoxicity.（3） In vivo experiments: There were no pathological changes in the viscera on hematoxylineosin staining related to the treatment with the intervention. Hematoxylin-eosin staining and Masson staining demonstrated that in the blank group, the defect site was mainly filled by fibrous connective tissue, with a small amount of angiogenesis, but without obvious new bone formation. In the control group, a small amount of new bone formation, fibrous tissue hyperplasia and new capillaries could be visible at the defect site. In the experimental group, there was obvious new bone formation, different degrees of fibrous tissue hyperplasia and new capillaries in the defect area. Immunohistochemical results displayed that alkaline phosphatase was highly expressed in the experimental group compared to the blank group and the control group（P ＜ 0.05）.（4） These findings have concluded that the porous poly（lactic-co-glycolic acid）/DP7-C/miR-26a composite system has good biocompatibility and in vivo osteogenic properties and can promote bone regeneration and repair of critical bone defects in the rat skull.

背景:前期研究显示,微渠多孔羟基磷灰石具有良好骨诱导性、生物相容性、骨传导性,为临床修复颌骨缺损扩大种植适应证提供了新思路.目的:观察微渠多孔羟基磷灰石修复犬下颌骨大面积缺损后与牙种植体骨结合的情况.方法:制作微渠多孔羟基磷灰石支架.将8只比格犬随机分为实验组和对照组,每组4只,拔除犬双侧下颌前磨牙,拔牙3个月后,在双侧前磨牙处各制造2个近远端为8 mm、颊舌侧为10 mm、冠根方向为8 mm的圆柱型骨缺损,实验组植入微渠多孔羟基磷灰石支架,对照组植入自体骨;3个月后于骨缺损修复区植入直径4 mm、高度10 mm的Dentium种植体.种植体植入4,12周后取材,进行锥形束CT、Micro-CT、组织学与种植体共振频率分析.结果 与结论:①锥形束CT:植入4周后,两组种植体与周围骨界面处有部分低密度影;12周后,两组种植体与骨结合的面积增加,种植体与植入材料结合紧密,无明显暗影;②Micro-CT检测:实验组植入4周后的植体表面被覆骨量小于对照组(P<0.05),植入12周后的植体表面被覆骨量比较差异无显著性意义(P>0.05);③组织学形态:苏木精-伊红、Masson与亚甲基蓝-酸性品红染色显示,两组植入4周后术区均可见新骨形成,实验组种植体-骨结合率低于对照组(P<0.05);12周后两组植体周围骨量明显增加,两组种植体-骨结合率比较差异无显著性意义(P>0.05);④种植体共振频率分析:实验组植入4,12周后的种植体稳定系数均低于对照组(P<0.05),但两组种植体在各时间段均有良好的稳定性;⑤结果表明:微渠多孔羟基磷灰石支架能修复犬颌骨大面积缺损,诱导新生骨形成,与种植体形成良好的骨结合.

"骨免疫学"的提出为修复骨缺损提供了新的方向.通过加载生物因子赋予生物材料骨免疫调节能力是常用的方法之一.microRNAs作为内源性的非编码小RNA,调节人体至少30％的蛋白基因编码,并且具有低免疫原性,作为改性生物材料的生物因子具有巨大潜力.但鲜有调节骨免疫微环境的microRNAs报道.本综述阐述了生物材料植入体内后的宿主反应、巨噬细胞在骨愈合中的作用、miR-21、miR-26a、miR-29等靶向调节成骨细胞及免疫细胞的microRNAs.试图探寻一种新的生物材料改性策略,将具备骨免疫微环境调节能力的microRNA作为生物活性因子加载到生物材料上,未来应用这一策略使生物材料植入体内后靶向调节骨免疫微环境,获得理想的成骨效果.

目的:探讨牙源性干细胞复合微渠多孔羟基磷灰石支架(grooved porous hydroxyapatite scaffolds,HAG支架)的成骨性能,为骨缺损修复治疗提供新手段.方法:从健康成人第三磨牙中提取牙周膜干细胞(periodontal ligament stem cells,PDLSCs)及牙髓干细胞(dental pulp stem cells,DPSCs)分别接种于HAG支架上,进行多向分化鉴定及碱性磷酸酶(alkaline phosphatase,ALP)活性测定;并通过CCK-8检测细胞增殖能力;逆转录聚合酶链反应(qRT-PCR)检测骨形态发生蛋白2(bone morphogenetic protein 2,BMP-2)、骨钙 素(osteocalcin,OCN)和骨桥蛋白(osteopontin,OPN)等成骨相关基因的表达.体内研究中将搭载PDLSCs和DPSCs的HAG支架移植到裸鼠的背部皮下,8周后取材,组织切片后采用苏木精-伊红(HE)染色观察新骨形成,提取组织蛋白采用Western blot检测ALP、OCN等成骨相关蛋白的表达.结果:体外研究中DPSCs复合HAG支架组的细胞增殖能力、ALP活性,以及成骨相关基因ALP、BMP2、OCN等的表达均高于PDLSCs复合HAG支架组.体内研究中HE染色显示,PDLSCs复合HAG支架组及DPSCs复合HAG支架组均较空白HAG支架组有更多细胞生长区、纤维细胞增生及骨基质形成,且DPSCs复合HAG支架组的骨基质面积更大,成纤维细胞数量更多;PDLSCs复合HAG支架组及DPSCs复合HAG支架组成骨相关蛋白的表达量均高于空白HAG组,且DPSCs复合HAG支架组中ALP蛋白表达量显著高于PDLSCs复合HAG支架组.结论:PDLSCs、DPSCs复合HAG支架在体内外均表现出良好的成骨性能,其中DPSCs复合HAG支架的成骨性能更为优异.

背景:前期研究显示,免疫调节肽DP7具有良好的体外抗菌能力与免疫调节性.目的:探究新型免疫调节肽DP7温敏凝胶对大鼠牙周炎的治疗效果.方法:选取8周龄SD大鼠建立右上颌第一磨牙牙周炎模型,将建模成功的48只大鼠分为6组,自然愈合组不进行治疗,阳性对照组牙周袋内注入盐酸米诺环素,其余4组牙周袋内分别注入调节肽DP7浓度为0％(空白凝胶),0.1％,0.3％,1％的温敏凝胶,每周注入1次,共4周.治疗4周后,检查各组牙周探诊深度、釉牙骨质界至牙槽嵴顶距离,并进行右上颌骨组织学与免疫组化染色.结果 与结论:①1％,0.3％DP7凝胶组大鼠牙周探诊深度、釉牙骨质界至牙槽嵴顶距离均低于阳性对照组(P<0.05);②苏木精-伊红染色显示,0.1％,0.3％,1％DP7凝胶组与阳性对照组牙龈组织较完整,上皮钉突恢复正常,成纤维细胞排列有序并可见新生的毛细血管,未观察到明显的破骨细胞,空白凝胶组及自然愈合组呈现牙周炎病理表现;③Masson染色显示,0.1％,0.3％,1％DP7凝胶组与阳性对照组可见大量新生的成纤维细胞有序排列,粗大的胶原增生并可见新生的毛细血管,1％及0.3％DP7凝胶组甚至可见类骨质或新骨形成,空白凝胶组与自然愈合组未见明显的胶原纤维增生及类骨质生成;④免疫组化染色显示,0.3％,1％DP7凝胶组肿瘤坏死因子α、白细胞介素1β表达量与阳性对照组比较无差异(P>0.05),白细胞介素10、骨形态发生蛋白2、成骨特异性转录因子2表达量均高于阳性对照组(P=0.000);0.3％DP7凝胶组白细胞介素10、骨形态发生蛋白2、成骨特异性转录因子2表达量均高于1％DP7凝胶组(P<0.05);⑤结果表明,0.3％及1％免疫调节肽DP7凝胶对牙周炎具有良好的治疗作用,且0.3％免疫调节肽DP7凝胶的疗效最佳.

目的:探讨三级公立医院绩效考核体系对大型医院门诊部高质量发展的促进作用.方法:回顾性分析四川省人民医院2019-2021年与门诊相关的核心指标变化情况.结果:经过近三年的绩效考核,门诊人次数与出院人次数比从30.30降低到27.27、门诊患者平均预约诊疗率从72.74％提升到78.48％、门诊患者预约后平均等待时间从35.63分钟降低到29.43分钟,门诊患者满意度从84.57分提升到97.26分.结论:医院门诊部逐步构建符合医院发展的内部管理体系并且运用医疗质量管理工具进行过程管理,构建起与三级公立医院绩效考核指标相适应的持续发展路径,使医院运营模式和运营质效不断优化、提升,并取得了初步成效.

北京,作为首都,自明、清两代便是"会馆"云集之处,且功能不断演进……无论从建筑、人文、经济均承载城市记忆,见证光阴脚步.2022年3月,北京湖广会馆年底变身全域性活态博物馆—让老会馆重新焕发光彩,北京湖广会馆正在进行为期300余天的修缮,预计2022年底修缮完毕,届时湖广会馆将变身为一座全域性活态博物馆.借此修缮再启,本文以湖广会馆作为北京"会馆"群落之代表,通过梳理"会馆"的缘起、建构以及其他,希望为历史人文建筑之璎华—会馆,作一纪录、回顾、总结.

In esthetic rehabilitation, methods used to enhance the margin quality have always been the focus and difficulty of improving the level of diagnosis and treatment, prevention and treatment of complications, and collaboration between clinicians and technicians. However, it is impeded by the ambiguous definition and classification of margin, unstandardized tooth preparation, manufacturing process of restoration, and lack of reliable means of checking the quantitative requirements of preparation or restoration. The digital technologies that are increasingly applied, such as intra-oral scanner, impression scanner, and computerized numerical control cutting machine, have strict requirements about margin quality. Failure of recognizing margins by these scanners will hinder the digital process of diagnosis and treatment. Even if these sharp and narrow margins are successfully scanned, they cannot be milled accurately. To overcome these problems, this article demonstrated the clear and complete definition of preparation margin and restoration margin, as well as their subclassifications, by analyzing the target restoration space from a geometric perspective. Practical approaches to measuring the margin width and inspecting the margin quality were proposed. The new and full understanding and proposal about preparation margin and restoration margin characterized by measurements will effectively support the thoroughly digitalized process of esthetic rehabilitation using porcelain in fixed prosthodontics, which is based on the guidance of values.

目的 构建牙周抗菌肽缓释水凝胶,评价其性能、毒性及对大鼠牙周炎的疗效.方法 以抗菌肽DP7为主药,采用冷溶法构建一种牙周抗菌肽缓释水凝胶;检测其胶凝条件、缓释效果及稳定性.将40只大鼠随机数字表法分为4组:牙周抗菌肽缓释水凝胶组(A组)、空白凝胶组(B组)、派丽奥组(C组)、自然愈合组(D组)各10只;每组分为2小组进行毒性和疗效评价.毒性评价实验中A、B、C组分别于牙周袋注射牙周抗菌肽水凝胶、空白水凝胶、派丽奥,D组不做特殊处理,给药4周后取心、肝、脾、肺、肾器官标本HE染色,观察病理学改变.疗效评价实验中建立大鼠牙周炎模型后,按上述分组给药,第0、2、4周时观察牙龈状态,探诊牙周袋深度.结果 本实验构建的牙周抗菌肽缓释水凝胶在37℃条件下胶凝时间为(15.40±0.89)秒;持续缓释药物达到7天;在4℃环境下,72 h内维持稳定.毒性实验中心、肝、脾、肺、肾未见明显病理改变.疗效实验发现给药4周后A组牙龈炎症较B、D两组明显缓解,探诊深度降低显著(P<0.01).C组也可见牙龈红肿减轻,探诊深度低于0.2周(P<0.01).结论 本实验构建的牙周抗菌肽缓释水凝胶可作为一种辅助药物治疗牙周炎.

膀胱癌是泌尿系统中最常见的恶性肿瘤,其中肌层浸润性膀胱癌(muscle-invasive bladder cancer,MIBC)的标准治疗手段是根治性膀胱切除术联合盆腔淋巴结清扫术.而近年来,放射治疗(放疗)在MIBC保留膀胱的治疗模式中起重要作用.该文就放疗在MIBC保留膀胱治疗中的应用进展进行综述,介绍了放疗在经尿道膀胱肿瘤电切术后辅助放疗和化学治疗的三联疗法中的应用进展、根治性放疗、术前放疗、放疗联合免疫治疗、放疗技术的发展与挑战、放疗相关不良反应,旨在为进一步探索更加科学有效的保留膀胱的综合治疗模式提供参考.

背景:多孔羟基磷灰石支架具有良好的体内外成骨效能,但其所涉及的miRNAs复杂调控机制相关研究较少.目的:探讨多孔羟基磷灰石支架材料介导大鼠骨髓间充质干细胞成骨矿化过程中相关miRNA表达谱的变化.方法:体外分离、培养和鉴定大鼠骨髓间充质干细胞,将骨髓间充质干细胞与多孔羟基磷灰石支架共培养为实验组,骨髓间充质干细胞单独培养为空白对照组,分别进行成骨诱导7 d,运用miRNA高通量测序技术分析两组骨髓间充质干细胞成骨矿化过程中相关miRNA表达谱的变化并进行GO分析,筛选出两组中表达差异明显的miRNA分子并进行qRT-PCR验证.结果与结论:①与空白对照组比较,成骨诱导7 d时实验组BMP2、ALP、Runx2 mRNA表达上调,其中BMP2上调明显(P<0.05);②microRNA高通量测序结果显示miR-210-3p、miR-146a-5p等13个miRNAs明显上调;let-7c-3p、let-3615等17个miRNAs明显下调;③GO分析上调的miRNA靶基因主要参与生物学调节、细胞基因表达、基因表达调节等,包括NF-κB、Toll样受体9、细胞间黏附、白细胞介素1调节、血管生成、Hippo等信号通路;④实时荧光定量qPCR验证结果显示miRNA-210在实验组上调15倍,miR-146a-5p在实验组上调10倍(P<0.05);⑤结果表明,新型微渠多孔羟基磷灰石支架可以通过上调骨髓间充质干细胞miRNA-210-3p和miR-146a表达,促进骨髓间充质干细胞的成骨分化.

目的 探究新型抗菌肽DP7对大鼠骨髓间充质干细胞(bone marrow mesenchymal stem cells,BMSCs)增殖、迁移及成骨分化的影响.方法 将不同浓度的抗菌肽DP7与大鼠BMSCs共同培养,通过CCK8检测细胞活力情况;通过细胞划痕检测细胞迁移情况;成骨诱导大鼠BMSCs,将0、16、32、48、64 mg/L抗菌肽DP7作为附加刺激,通过碱性磷酸酶(ALP)活力测试和茜素红染色检测早期成骨情况.结果 在一定浓度范围内,抗菌肽DP7对大鼠BMSCs增殖无影响;随着抗菌肽DP7浓度的增加,大鼠BMSCs细胞迁移能力减弱;相比成骨诱导组,加入16 mg/L和32 mg/L抗菌肽对成骨形成具有促进作用,其中加入32 mg/L抗菌肽促进成骨效果最好.结论 32 mg/L新型抗菌肽DP7对大鼠骨髓间充质干细胞增殖既无抑制作用,又能促进其成骨分化,有望成为控制感染和促进成骨的有效药物.

目的 应用16S核糖体DNA(rDNA)高通量测序技术研究健康天然牙、健康种植体以及种植体周围炎的植体龈沟液内微生物菌群的差异,为理解种植体周围组织从健康至疾病状态的病因提供依据.方法 通过Illumina HiSeq 2500测序技术,分析30个龈沟液细菌的菌群结构及多样性.结果 种植体周围炎组Shannon指数低于健康牙及健康种植体组(P<0.05),细菌群落主要属于厚壁菌门(Firmicutes)、变形菌门(Proteobacteria)、梭杆菌门(Fusobacteria)、拟杆菌门(Bacteroidetes)、放线菌门(Actinobacteria)等17个门,普氏菌属(Prevotella)、密螺旋体属(Treponema)、纤毛菌属(Leptotrichia)、放线菌属(Actinomyces)、链球菌属(Streptococcus)和丁酸弧菌属(Butyrivibrio)等497个属.优势菌门以拟杆菌门在种植体周围炎组相对较高(P<0.05),属水平上丁酸弧菌为种植体周围炎的优势菌属之一,代谢产物异丁酸的增多可能是导致疾病状态的一个因素.结论 健康种植体与健康天然牙一致,呈现出丰富的微生物多态性,而当周围炎形成后,表现为相关致病菌丰度增高,而其多样性下降.

Nonsyndromic orofacial cleft (NSOFC) is a severe birth defect that occurs early in embryonic development and includes the subtypes cleft palate only (CPO), cleft lip only (CLO) and cleft lip with cleft palate (CLP). Given a lack of specific genetic factor analysis for CPO and CLO, the present study aimed to dissect the landscape of genetic factors underlying the pathogenesis of these two subtypes using 6,986 cases and 10,165 controls. By combining a genome-wide association study (GWAS) for specific subtypes of CPO and CLO, as well as functional gene network and ontology pathway analysis, we identified 18 genes/loci that surpassed genome-wide significance (P < 5 × 10-8) responsible for NSOFC, including nine for CPO, seven for CLO, two for both conditions and four that contribute to the CLP subtype. Among these 18 genes/loci, 14 are novel and identified in this study and 12 contain developmental transcription factors (TFs), suggesting that TFs are the key factors for the pathogenesis of NSOFC subtypes. Interestingly, we observed an opposite effect of the genetic variants in the IRF6 gene for CPO and CLO. Moreover, the gene expression dosage effect of IRF6 with two different alleles at the same single-nucleotide polymorphism (SNP) plays important roles in driving CPO or CLO. In addition, PAX9 is a key TF for CPO. Our findings define subtypes of NSOFC using genetic factors and their functional ontologies and provide a clue to improve their diagnosis and treatment in the future.

背景:近年来国内外研究将辛伐他汀缓释微球组装在支架材料上,发现其可完成骨缺损的修复,取得不错的效果.目的:探讨辛伐他汀缓释微球对组织工程成骨性能的影响.方法:采用薄膜分散法制作纳米脂质体辛伐他汀缓释微球,检测其粒径和多分散系数及包封率.采用透析装置检测游离辛伐他汀溶液与辛伐他汀缓释微球溶液的缓释性能.将第3代人胎盘间充质干细胞接种于多孔羟基磷灰石陶瓷支架上,待细胞贴壁生长后分2组培养,实验组加入辛伐他汀缓释微球溶液,空白组加入普通培养基,7,14,21 d后进行转录组测序,实时荧光定量PCR验证成骨基因表达水平.结果与结论:①辛伐他汀缓释微球平均粒径为(77.27±6.4)nm,多分散系数为0.131±0.040,包封率为85.6％;②游离辛伐他汀溶液在前3 d迅速释放超过了总药量的80％,辛伐他汀缓释微球溶液在前3 d的药物释放量仅约40％,此后也一直较缓慢持续释放至14 d,14 d累计释放量接近80％;③转录组测序显示,实验组骨形态发生蛋白2、骨形态发生蛋白4和血管内皮生长因子等成骨相关基因富集表达;④实时荧光定量PCR检测显示,实验组7,14,21 d的骨形态发生蛋白2、骨形态发生蛋白4、血管内皮生长因子基因表达均高于空白组(P<0.05);⑤结果表明,辛伐他汀缓释微球可促进组织工程成骨性能表达.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的:比较分级诊疗制度实施前后现场挂号与预约挂号的使用率、满意度,得出目前适应分级诊疗制度的挂号方式。分析互联网+就医模式下各种预约挂号方式的使用率、满意度及增长率,为今后发展预约挂号提供数据支持。方法:统计分级诊疗制度实施前后预约挂号与现场挂号所占比例。随机调查2016年5⁷月在我院就诊的预约患者预约方式、满意度、使用率等。结果:本调查中分级诊疗制度实施前预约挂号使用率为32.12%,实施后预约挂号使用率为40.72%,统计学差异显著（P&lt;0.05）。目前所有预约挂号方式中,采用互联网+技术的微信、支付宝预约的满意度最高为74.12%,其次为自助挂号机预约70%、诊间预约60%、电话预约52%,现场预约挂号满意度最低为46.8%。分级诊疗实施前后使用率分别为电话预约39%/29.2%、现场预约37%/28.8%,微信支付宝20%/36%。结论:分级诊疗制度的实施会不断推进预约挂号的发展,同样预约挂号方式也是分级诊疗制度实施的必然选择,门诊应该不断提升预约挂号号源与比率,才能更好的推进分级诊疗制度,促使患者有序就诊。支付宝以及微信预约方式的满意度在互联网+分级诊疗条件下的满意度最高,今后门诊挂号系统应该大力推行支付宝和微信等方便快捷的互联网预约挂号方式。</span>

Objective:To study the treatment effect of one-visit root canal therapy for molar acute pulpitis using GuttaFlow(R) 2, thus to provide a more efficient, comfortable way and lay a basis for simpler treatment. Methods:Totally 90 molar teeth were selected and divided into two groups, 45 teeth in A group used GuttaFlow(R) 2 plus single cone obturation treatment, 45 teeth in B group used i Root SP plus thermoplasticized gutta-percha technique. The treatment time, and the difference of pain index and efficiency between two groups after 24 hours, 3 days, 7 days, one month and three months were compared. Results:Concerning the treatment operation time, the group A was (63.20±6.54) min, while the group B was (86.12±8.08) min, the group A was significantly better than the group B (P＜0.01). The pain index of group A and group B was (2.40±0.54) and (4.60±1.31) at 24 hours after treatment, and (1.80±0.63) and (3.10 ±1.23) after 3 days respectively, and the difference was statistically significant (P ＜0.05). There was a significant difference between the two groups in pain index after 24 h and 3 days (P＜0.05), but no significant difference after 7 days, one month and 3 months (P＞0.05). There was no significant difference in the efficiency at each time point (P＞0.05). Conclusion:GuttaFlow(R) 2 non-heated flowable gutta-percha has a good therapeutic effect in the treatment of one-visit root canal therapy and has its unique advantage. It can be widely used in one-visit root canal therapy in molars compared with hot gum filling. It also provides a new idea for independent innovation.