正畸治疗下切牙先天缺失23例临床体会

目的探讨下切牙先天缺失的矫治方法。方法以伴有下切牙先天缺失的23例错[牙合]畸形患者为研究对象，对下切牙缺失的部位、数日、错[牙合]类型、矫治方法进行分析，并对缺失1颗下中切牙、拔除上颌2颗第一前磨牙和下颌1颗非缺牙侧第一前磨牙的病例及缺失2颗下中切牙、拔除上颌2颗第一前磨牙的病例的Bolton指数分析进行统计学检验。结果23例患者正畸治疗疗后均取得了较好的疗效。两组拔牙病例之间的Bohon指数全牙比无统计学差异（P〉0．05），而前牙比和前牙不调量有统计学差异（P〈0．01）。结论先天缺1颗下中切牙上下颌均需拔牙者，在下颌非缺牙侧选择拔1颗前磨牙比拔1颗中切牙对Bohon指数影响要小。     

Bolton指数指导分析先天缺失单个下切牙病例牙量不调

目的 为临床诊治先天性缺失单个下切牙选择适当的矫治方案提供帮助.方法 采用Bolton分析法,计算分析先天缺失单个下切牙病例模拟治疗方案的全牙比及需调整牙量.选择50副先天缺失单个下切牙病例治疗前模型为实验组,选择100副无先天缺牙,无牙量不调的错合畸形病例治疗前模型为对照组.实验组模拟7种治疗方案,对照组模拟6种常规对称拔除双尖牙治疗方案,以对照组相应的全牙比为参照目标分别计算实验组上颌或下颌需调整牙量.结果 当实验组模拟拔除2个上颌双尖牙达到对照组模拟拔除上下4个双尖牙的结果时,上颌或下颌需调整牙量均较多（约9～11 mm）,实验组模拟拔除2个上双尖牙和1个下切牙达到对照组模拟拔除上下4个双尖牙的结果,上颌或下颌需调整牙量均较少（约2～4 mm）.结论 当先天缺失单个下切牙病例设计拔除2个上颌双尖牙和1个下颌切牙的矫治计划时无论上、下颌需调整的牙量较少,临床可根据具体情况优先选择.     

下切牙先天性缺失致错畸形矫治10例

1　临床资料　因单颗下切牙先天性缺失 ,引起 Bolton指数不调 ,导致错牙合畸形的患者 10 (男 6 ,女 4 )例 ;年龄 12～ 2 1(平均 16 .5 )岁 .疗程 6～ 14 (平均 10 ) mo.安氏 I类 7例 ,II类 3例 .患者拒绝拔牙矫治 ,同意配合邻面去釉方丝弓矫正器矫治者 ;牙齿发育完全 ,牙齿磨耗量低 ,口腔卫生好 ,不易患龋者 .矫治前常规模型分析 ,头影测量 ,照像 ,计算 Bolton指数 .由于患者下颌均缺失 1颗切牙 ,致 Bolton指数前牙比或全牙比均小于正常值 ,故计算时 ,先算出与目前下颌前牙量或全牙量相匹配的上颌牙量 ,其与实际值间的差 ,即为上颌相对过…     

下切牙先天性缺失致错牙合畸形矫治10例

1 临床资料因单颗下切牙先天性缺失,引起Bolton指数不调,导致错牙合畸形的患者10(男6,女4)例;年龄12～21(平均16.5)岁. 疗程6～14(平均10) mo. 安氏I类7例,II类3例. 患者拒绝拔牙矫治,同意配合邻面去釉方丝弓矫正器矫治者;牙齿发育完全,牙齿磨耗量低,口腔卫生好,不易患龋者. 矫治前常规模型分析,头影测量,照像,计算Bolton指数. 由于患者下颌均缺失1颗切牙,致Bolton指数前牙比或全牙比均小于正常值,故计算时,先算出与目前下颌前牙量或全牙量相匹配的上颌牙量,其与实际值间的差,即为上颌相对过多的量,也就是需去釉的总量.     

下颌先天性缺失一颗恒切牙的正畸学研究

下颌先天性缺失一颗恒切牙在我国有较高发生率,引起下颌先天缺牙的病因繁多,但遗传倾向或家族聚集性被推测为其首要病因,可能与同源盒基因TGFA、MSX1和PAX9的突变有密切的联系。下颌缺失一颗恒切牙后容易引起下颌骨发育不足和下颌切牙向内倾斜,进而导致Ⅱ类面型和Ⅱ类错牙合增多,前牙覆牙合覆盖加大,下颌中线不调,Bolton指数减小等临床表现,给正畸矫治增加了难度。临床上正畸医师常通过对患者面型、牙列拥挤度、磨牙关系、前牙覆牙合覆盖、Bolton指数以及患者自身诉求等方面综合考虑,必要时行诊断性蜡合排列试验协助建立组牙保护牙合,选择拔牙、邻面去釉或开辟间隙修复等方法进行正畸矫治。     

本地区不同错患者Bolton指数及上颌侧切牙宽度的测量分析

目的:探讨本地区不同错患者Bolton指数及Bolton指数不调的发生率,侧切牙宽度异常在Bolton指数不调中的比率。方法:选取本院正畸科2005-2013年收治的140例正畸患者石膏模型,牙性与骨性错类型一致,分类为Ⅰ、Ⅱ、Ⅲ类3个组。测量分析Bolton指数,并获取所有病例双侧上颌侧切牙宽度,采用SPSS 13.0软件包对数据处理。结果:Ⅰ、Ⅱ、Ⅲ类各类错的Bolton指数前牙比、全牙比在不同性别间差异无统计学意义(P0.05)。Ⅲ类Bolton指数全牙比最大,与Ⅰ、Ⅱ类相比,差异有统计学意义(P=0.000)。以中国人正常Bolton指数±2个标准差为标准,错患者的前牙比、全牙比不调发生率分别为16.43%和15.00%,当以Bolton指数不调量|TSD|≥1.5 mm为标准时,Bolton指数前牙比、全牙比不调发生率分别为17.86%和29.29%。侧切牙牙冠宽度异常在前牙和全牙牙量不调病例中所占比例分别为16.7%、18.0%。结论:不同类型错间Bolton指数不协调差异无统计学意义,TSD实际值可以为临床医生提供更多有关牙量不调信息,临床矫治设计应从牙量协调角度预测分析。Bolton指数不调与侧切牙宽度异常有关,治疗应注意。     

邻面去釉在矫治下颌先天缺失双下切牙中的应用

目的探讨邻面去釉在矫治下颌先天缺失双下切牙中的应用价值。方法选择下颌先天缺失双下切牙伴有上颌牙齿拥挤或上颌前突而需拔除双侧上颌第一前磨牙进行矫治的患者15例,在Bolton指数分析指导下对下颌牙齿进行邻面去釉。结果上下颌牙齿Bolton指数恢复正常,达到了良好的咬关系及美观的效果。结论对于先天下颌双切牙缺失且伴有上颌牙齿拥挤或上颌前突而需拔除双侧上颌第一前磨牙进行矫治的患者,结合在Bolton指数分析指导下对下颌牙齿进行邻面去釉,可使上下颌牙齿Bolton指数恢复正常,有助于达到良好的咬[牙合]关系和美观的效果。     

拔除下颌切牙配合邻面去釉矫治错的体会

目的探讨正畸拔除下颌切牙的诊治特点和如何配合邻面去釉调整bolton指数。方法选择设计拔除下颌切牙矫治错畸形患者16例,其中单纯拔除1个下颌切牙者9例,下颌拔除切牙、上颌拔除第一双尖牙者7例,配合邻面去釉使Bolton指数接近正常值。结果单纯拔除一个下颌切牙的9例患者,平均疗程（8.6±0.5）个月。下颌拔除切牙、上颌拔除双尖牙的7例患者,平均疗程（21.5±1）个月。结论单纯拔除一个下切牙者可缩短疗程,但应尽量减少邻面去釉。设计为下颌拔除2个切牙,上颌拔除第一双尖牙时,减数模式比减数模式可减少邻面去釉。     

下颌切牙先天缺失方丝弓矫治的临床分析

目的：总结评价下颌切牙先天缺失方丝弓矫治的临床效果，探讨下颌切牙先天缺失方丝弓矫治难点和要点。方法：选择正畸门诊12例因牙列不齐要求矫治的下颌切牙先天缺牙患者使用减数拔牙方丝弓矫治技术进行矫治，对其临床资料进行回顾总结分析。结果：12例下颌前牙先天缺失并牙列不齐的患者经15～23个月，平均18．6个月的正畸治疗。患者牙弓间隙关闭，上下牙弓协调，覆颌，覆盖正常，面部侧貌协调。结论：下颌前牙先天缺失可以通过上颌单颌或双颌不对称拔牙矫治来协调上下牙弓，改善患者的覆颌，达到个别正常颌，获得满意的治疗效果。     

下颌切牙先天缺失的临床矫治分析

先天缺牙是错(牙合)畸形的病因之一,它对邻牙的位置、牙弓形态、牙齿排列及颌骨的生长均可造成影响,从而导致牙弓内出现间隙,牙弓不对称及上下牙弓不协调,并影响颌面软硬组织的正常发育及口腔功能和颜面美观[1].在恒牙列中,除上下第三磨牙外,先天缺牙发生的顺序为下颌切牙,上颌第二双尖牙,下颌第二双尖牙及上颌切牙[2].有学者研究发现,下切牙缺失的比例占所有缺牙患者的38.1%～50.78%[3;4].因此,探讨下颌切牙先天缺失的矫治设计对正畸临床工作有着非常重要的意义.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.