揭示氟素抗龋性能的成功之路

揭示氟素抗龋性能的成功之路山东医科大学口腔系（济南２５００１２）姜广水，王欣氟作为预防龋病的有效物质，在世界范围内得到了广泛的应用。据统计，世界上有３亿多人饮用氟化水源；发达国家中８０％的牙膏是含氟牙膏。所以，尽管这些国家食糖消费量逐年上升，而龋病发...     

龋病自然转归、人为干预的思考

龋病的自然转归是一个由浅到深,由局部到全身的过程.主要历经牙体硬组织阶段,穿透硬组织到达牙髓阶段,穿出根尖孔阶段.随着病情进展,患者承受的痛苦加重,临床诊疗也越来越复杂,成本增高,效果越来越差.本文从哲学量变质变角度思考,提出了一些控制龋病的想法.     

龋病发病机理的新假说：生物电化学理论

龋病发病机理的新假说──生物电化学理论第四军医大学口腔医学院（７１００３２）黄力子现有龋病发病机理理论的明显缺陷Ｍｉｌｌｅｒ关于龋病发病机理的理论,在微尔啸（Ｖｉｒｃｈｏｗ１８２１～１９０２）的细胞病理学盛行的年代,能从实现出发,把“一切病理为细胞病...     

科学发现的方法论在龋病病因学及发病机理研究中的体现

科学发现的方法论在龋病病因学及发病机理研究中的体现第四军医大学口腔预防医学教研室（西安７１００３２）阎鹏黄力子第四军医大学政治教研室（西安７１００３３）郭照江一、Ｍｉｌｅｒ化学细菌学说的成就及其局限性Ｍｉｌｅｒ（１８９０）的化学细菌学说是涉及龋病病因...     

预防性应用盐酸氟桂利嗪对高血糖SD大鼠局部脑缺血再灌注模型bcl-2表达的影响

探讨预防性应用盐酸氟桂利嗪对高血糖Sprague-Dawley(SD)大鼠局部脑缺血再灌注后bcl-2表达的影响,采用高血糖条件下SD大鼠局灶性脑缺血再灌注模型,36只雄性健康SD大鼠,建立高血糖模型后随机分为2组:高血糖组(n=18)、盐酸氟桂利嗪+高血糖组(简称氟桂利嗪组n=18),各组按脑缺血90min再灌注3h(n=6)、6h(n=6)、24h(n=6)分为3个亚组.应用免疫组织化学方法观察bcl-2的表达.结果氟桂利嗪组bcl-2于再灌注3h可见阳性表达,再灌注6h达高峰,至24h逐渐下降,各时间点之间比较差异显著,P<0.01.氟桂利嗪组与高血糖组各再灌注时间点比较,缺血区bcl-2表达增加,差异显著,各时间点均为P<0.01.证实预防性应用盐酸氟桂利嗪能使损伤脑区bcl-2表达上调,减轻高血糖条件下的局灶性脑缺血再灌注损伤.     

卡托普利异氟醚联合预处理对心脏瓣膜置换术患者的心肌保护作用

探讨卡托普利与异氟醚联合预处理对心肌缺血再灌注损伤的保护作用.选择100例瓣膜置换术惠者分为五组,分别给以不同的药物预处理.观察各组心肌酶、心肌蛋白、炎症因子的变化,以及心脏复跳率和血管活性药物使用.结果显示,卡托普利与异氟醚联合处理组的心肌酶、心肌蛋白、炎症因子以及心脏复跳率和血管活性药物用量与其他三组相比有显著性差异(P<0.05).认为卡托普利延迟相或早期相复合异氟醚预处理对心脏瓣膜置换术患者的心肌缺血再灌注损伤均具有更强保护作用,并以卡托普利延迟相组为优.     

低疟区疟疾导致胸外科术后高热的诊治体会

探讨疟疾导致术后高热的诊治方法,回顾性研究15例疟疾导致术后高热患者的诊治经过,其中1例确诊患者给予氯喹治疗后痊愈,14例疑似患者经氯喹试验性治疗后痊愈,9例患者随访1年均无复发.因此,对曾有输血史或疟疾史的术后高热患者,排除感染或变态反应后,可给予氟喹试验性治疗,无需等待确切的病原学结论.     

三种人称立场对道德规范性问题的回答

道德规范性问题是最近几十年来伦理学研究关注的焦点问题之一,但如何正确地回答规范性问题却一直是众说纷纭.要想很好地回答规范性问题,首要的一点就在于从什么视角去把握这个问题.基于此,道德哲学中一直没有得到重视的人称问题脱颖而出.通过分析道德哲学中的不同人称立场,我们有理由相信,回答规范性问题的关键是把握住第一人称立场上自律意志的反思性认可、第二人称立场上“你-我”结构相互确立的道德权威以及第三人称立场上平等适用的可解释性.     

氟暴露所致脑损伤及硒的干预作用

氟是人体必需的微量元素,但摄入过量能引起骨相系统损害。流行病学和动物实验结果表明,长期过量氟暴露还能损害中枢神经系统,从而损伤动物的学习记忆力和儿童的智商。自由基损伤伤学说可能是氟致脑损伤的机理之一。而硒也是人类必需的微量元素之一,动物实验结果表明,适量硒能拮抗氟致脑功能的损伤,其机理可能与硒的抗氧化性的生物学功能有关     

龋病学研究战略的思考

龋病学研究战略的思考上海第二医科大学附属第九人民医院（２０００１１）李鸣宇,刘正一、龋病学研究的概况１８８９年Ｍｉｌｌｅｒ提出了具有历史意义的化学细菌学说,他认为龋病是由于寄生在牙面的细菌与口腔内的碳水化合物作用产酸,将牙齿中的无机物（主要是钙盐）溶...     

The risk of dental caries in extraverts

It has been demonstrated that extraverts have a lower saliva secretion rate than introverts. Furthermore, extraverts as well as subjects with high P-scores on the EPQ have been demonstrated to have a more pronounced risk-taking behaviour, possibly including a tendency to neglect health care programs. Thus it was hypothesised that extraverts and possibly also subjects with high P-scores would have an increased risk of caries. The Swedish translation of the 97 items JEPQ was administered to 101 15-year-old adolescents controlled at the annual dental status health control. Extraverts were found to have significantly more earlier caries and significantly more total caries and a tendency towards higher values in initial and manifest caries. Subjects with high P-scores were found to have significantly more manifest caries. No significant relationships were found between the frequency of caries and the N- or L-scales in the JEPQ.     

Determinants of early- vs late-onset dental fear in a longitudinal-epidemiological study.

A longitudinal investigation of risk factors for early- and late-onset dental fear was conducted. Early-onset dental fear was related to conditioning experiences (indexed via caries level and tooth loss), service use patterns, stress reactive personality and specific beliefs about health professionals. Late-onset dental fear was related to aversive conditioning experiences, irregular service use and an external locus of control. In contrast to recent findings for dental anxiety, personality factors were not strongly related to the onset of dental fear in young adulthood. The key role played by conditioning events in the development of both early- and late-onset dental fear was confirmed. Conditioning events appear to play a different role in the development of dental fear vs dental anxiety. This may reflect important, but largely ignored differences between these two closely-related constructs. Interventions for early-onset dental fear should aim to modify both the dental fear and the personality vulnerabilities that may contribute to the development of dental fear early in the life-course.     

Predicting dental attendance from dental hygienists’ autonomy support and patients’ autonomous motivation: A randomised clinical trial

Objective: To test the hypothesis that a Self-Determination Theory (SDT) intervention designed to promote oral health care competence in an autonomy-supportive way would predict change in caries competence relative to standard care. Further, to test the SDT process path-model hypotheses with: (1) the intervention and individual differences in relative autonomous locus of causality (RALOC) predicting increases in caries competence, which in turn would positively predict dental attendance; (2) RALOC negatively predicting dental anxiety, which would negatively predict dental attendance; (3) RALOC and caries disease referred to the dentist after an autonomy-supportive clinical exam directly positively predicting dental attendance; and (4) the intervention moderating the link between RALOC and dental attendance.

Design: A randomised two-group experiment was conducted at a dental clinic with 138 patients (M_age = 23.31 yr., SD = 3.5), with pre- and post-measures in a period of 5.5 months.

Results: The experimental model was supported. The SDT path model fit the data well and supported the hypotheses explaining 63% of the variance in dental attendance.

Conclusions: Patients personality (RALOC) and hygienists promoting oral health care competence in an autonomy-supportive way, performance of autonomy-supportive clinical exams and reductions of anxiety for dental treatment have important practical implications for patients’ dental attendance.     

深度楔状缺损两种修复方法的临床疗效观察

通过光固化氢氧化钙垫底后Dyract复合体修复和直接用Fuji II玻璃离子水门汀分别修复牙颈部深度楔状缺损,临床观察6个月～24个月。对二者的治疗效果进行研究分析,认为玻璃离子水门汀直接修复深度楔状缺损治疗效果优于以光固化氢氧化钙垫底用Dyract复合体修复,Fuji II玻璃离子水门汀直接充填是一种较理想的修复深度楔状缺损技术。     

Motivation and anxiety for dental treatment: Testing a self-determination theory model of oral self-care behaviour and dental clinic attendance

The present study: (1) developed a Self-Regulation Questionnaire for Dental Treatment (SRQDT) based on Self-Determination Theory (SDT; Deci and Ryan, Psychol Inq 11:227–268, 2000), and (2) used it to test a SDT process model of oral self-care behaviours and dental clinic attendance. Patients’ perceptions of autonomy supportive (relative to controlling) dental professionals were expected to be positively associated with patients’ psychological needs satisfaction in treatment, which was expected to be positively related to relative autonomous motivation for dental treatment and perceived dental competence, and negatively related to anxiety for dental treatment. In turn, relative autonomous motivation for dental treatment and perceived dental competence were expected to be positively associated with oral self-care behaviours and dental clinic attendance. Anxiety for dental treatment was expected to be negatively related to dental clinic attendance and positively linked to putting off making a dental clinic appointment. Confirmatory factor analysis of the 5 factor SRQDT model fit the data very well, and a structural equation model supported the hypothesized process model.     

Dental phobias and anxieties: evidence for conditioning processes in the acquisition and modulation of a learned fear

The present study investigated some of the factors which differentiate individuals with dental anxieties and phobias from those without such fears. In particular, two questions were addressed: (i) What differentiates subjects who have never been anxious about dental treatment from subjects who at some time have been anxious? and (ii) What factors lead to subjects changing their attitudes either from anxious to relaxed or from relaxed to anxious? The results suggest that the factors which influence the acquisition and modulation of dental anxieties are consistent with the associative and representational processes portrayed in contemporary models of human conditioning. Subjects who reported never having had anxieties about dental treatment were less likely to have had a painful dental treatment than subjects who did report an anxiety. Subjects who did report a painful dental experience but did not acquire anxiety reported a history of dental treatment favourable to the operation of latent inhibition. Subjects who reported that they were good at enduring pain were more likely to report a longer interval between their very first dental treatment and their first painful dental treatment. Under some conditions in which latent inhibition should have precluded the acquisition of a dental fear, an anxiety appeared to be acquired because a very painful experience had attenuated the latent inhibition process. Subjects whose dental anxiety did not remit reported significantly more painful and traumatic dental experiences than subjects whose anxiety did remit.     

Childhood dental fear in relation to parental child-rearing attitudes

The aim of this study was to assess the relation between parental self-reported child-rearing attitudes and dental fear in children. The parents of 51 children with high dental fear and of 56 children with low dental fear, of different age groups, completed the Amsterdam version of the Parental Attitude Research Instrument. In addition, parents were asked to rate their own dental fear. Multivariate analysis of variance (child fear x parental fear x child age) showed a significant main effect only of child dental fear on parental self-complaints (p = .03). For parental dental fear, main effects were found on overprotection and on promotion of autonomy (p < or = .01). No age effects were found. Also, no relation between children's dental fear and parental dental fear was found. Based on the present findings, it was concluded that parents may play a more secondary, mediating role in the etiological process of dental fear in children.     

Adolescent dental fear and control: prevalence and theoretical implications.

This study examined the prevalence and etiology of dental fear in a large, representative sample of Singapore adolescents. Participants completed a questionnaire regarding fear of the dentist, dental beliefs and their most recent dental visit. The population prevalence of high dental fear was 115 fearful children per 1000 population (SE = 0.02). Children who reported painful treatment and perceived lack of control at the dentist were 13.7 times more likely to report high fear and 15.9 times less likely to be willing to return to the dentist or dental nurse. The etiology of severe clinical fear appears strongly related to direct conditioning in the presence of pain and vulnerability.     

General self-efficacy,dental anxiety and multiple fears among 20-year-olds in Norway

This paper examines the extent to which low general self-efficacy and painful dental and medical experiences are related to dental anxiety, multiple fears and to avoidance of dental care. A total of 754 20-year-olds completed a series of questionnaires, including the General Self-efficacy Scale (GSE), Geer Fear Scale (GFS) and Dental Fear Survey (DFS). Females had lower self-efficacy, higher dental anxiety and higher scores on the GFS than males. Multivariate analyses (linear stepwise regression) indicated that painful dental experiences, a high score on the GFS and negative opinions about own dental health explained 37% of the variance in DFS scores. Self-efficacy had no predictive power for dental anxiety, and only dental anxiety had predictive power for dental avoidance behavior. Thirty-eight percent of the total variance in GFS scores was explained by the following variables: being a female, high dental anxiety (DFS), low general self-efficacy (GSE) and low educational level of the mother.     

BEHAVIORAL COMMUNITY PSYCHOLOGY: ENCOURAGING LOW-INCOME PARENTS TO SEEK DENTAL CARE FOR THEIR CHILDREN1

The present study examined the effectiveness and cost efficiency of three different techniques to encourage low-income rural parents to seek dental care for their children. The families of 51 children who needed immediate dental care (determined by dental screening at a local school) were placed into three matched groups and randomly assigned to the treatment conditions: One Prompt (Note Only), Three Prompt (Note, Telephone Contact, Home Visit), and One Prompt plus $5 Incentive. The Three Prompt and One Prompt plus $5 Incentive were significantly more effective in initiating dental visits than the Note-Only procedure. Not only was the One Prompt plus $5 Incentive technique effective in producing a slightly larger percentage of initial dental visits compared to the Three-Prompt technique, it also produced a significantly larger number of followup visits. Furthermore, the cost-effectiveness analysis showed the Incentive condition to be less costly than the Three-Prompt condition in encouraging initial dental visits.