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1.
BACKGROUND The conventional implant approach involves flap elevation,which may result in increased soft tissue and bone loss and postoperative morbidity.The flapless surgical technique,aided by three-dimensional medical imaging equipment,is regarded as a possible alternative to the conventional approach to alleviate the above issues.Several studies have been performed regarding the role of flapless implant surgery.However,the results are inconsistent and there is no robust synthesis of long-term evidence to better inform surgeons regarding which type of surgical technique is more beneficial to the long-term prognosis of patients in need of implant insertion.AIM To compare the long-term clinical performance after flapless implant surgery to that after the conventional approach with flap elevation.METHODS PubMed,EMBASE,Cochrane Central Register of Controlled Trials,and grey literature databases were searched from inception to 23 September 2019.Randomised controlled trials(RCTs)and cohort studies comparing the long-term clinical performance after flapless implant surgery to that after the conventional approach over a follow-up of three years or more were included.Meta-analyses were conducted to estimate the odds ratios(ORs)or mean differences(MDs)and their 95%confidence intervals(CIs)between the long-term implant survival rate,marginal bone loss,and complication rate of the flapless and conventional groups.Subgroup analyses were carried out to account for the possible effects of the guided or free-hand method during flapless surgery.RESULTS Ten articles,including four RCTs and six cohort studies,satisfied the eligibility criteria and nine of them were included in the meta-analysis.There was no significant difference between the long-term implant survival rate[OR=1.30,95%CI(0.37,4.54),P=0.68],marginal bone loss[MD=0.01,95%CI(-0.42,0.44),P=0.97],and complication rate[OR=1.44,95%CI(0.77,2.68),P=0.25]after flapless implant surgery and the conventional approach.Moreover,subgroup analyses revealed that there was no statistically significant difference between the implant survival rate[guided:OR=1.52,95%CI(0.19,12.35),P=0.70];free-hand:n=1,could not be estimated,marginal bone loss[guided:MD=0.22,95%CI(-0.14,0.59),P=0.23;free-hand:MD=-0.27,95%CI(-1.10,0.57),P=0.53],or complication rate[guided:OR=1.16,95%CI(0.52,2.63),P=0.71;free-hand:OR=1.75,95%CI(0.66,4.63),P=0.26]in the flapless and conventional groups either with use of the surgical guide or by the free-hand method.CONCLUSION The flapless surgery and conventional approach had comparable clinical performance over three years or more.The guided or free-hand technique does not significantly affect the long-term outcomes of flapless surgery.  相似文献   

2.
中医药以其丰富的资源、独特的疗效、较小的毒副作用,赢得了广大人民的信赖,特别是在当今化学药品毒副作用不断出现,人类回归大自然的浪潮中,中药及其制剂越来越深受世人的瞩目.但近年来,随着中药及其制剂的不断开发,有关中药不良反应的报道也日渐增多,中药的安全性问题已引起医药界的广泛关注.加入WTO后,如何正确认识中药,正确利用中药资源,已迫在眉睫.笔者现就产生中药不良反应的原因作出分析,并提出积极的防范措施以减少不良反应的发生.  相似文献   

3.
黄柏的临床药理作用   总被引:44,自引:0,他引:44  
黄柏为芸香科植物黄檗或黄皮树的干燥树皮,可分为关黄柏和川黄柏两大类,生于深山、河边、溪旁及树林中,主要分布于东北三省及河北、内蒙古、四川、云南、贵州、湖北、广西等地,山东、甘肃、浙江也有生产.  相似文献   

4.
1 病例介绍 患者,男,65岁,车祸后胸痛不适0.5 h于2007-10-23中午到急诊科就诊.患者约0.5 h前下公共汽车时因拥挤向前跌倒,胸部碰撞站台钢制护栏,自感胸痛不适,深呼吸时胸痛较明显,不伴明显呼吸困难或胸闷,无咳嗽、血痰症,无眩晕、心悸或冷汗等症,步行来诊.既往无高血压病或心脏病病史;嗜烟25年(已戒烟6年).  相似文献   

5.
王云艳 《护理研究》2008,22(15):1339-1339
整形外科门诊常做一些肿物切除术,术后常规会对切下的组织做病理检查,化验它的性质.过去我们的常规做法是由病人家属准备容器,将切下的组织标本放入容器后,倒入10%甲醛溶液固定,容器外贴上标签后送检.这样的缺点是容器大小不一,形状各异,还有许多无盖的容器,容易倾洒;另外甲醛有致癌作用,在送检的过程中难免会倾洒,这样对人体及环境会有不同程度的影响.在整形外科门诊,发现了一种好的密闭式留置标本的方法.现介绍如下.  相似文献   

6.
护士针刺伤相关因素分析   总被引:4,自引:0,他引:4  
针刺伤是一种皮肤深部的足以使受伤者出血的意外伤害,被病原体污染的血液或体液会接种到受伤者体内.护士经常与注射器等锐利器械接触,易发生针刺伤,且针刺伤是护士最常见的职业伤害类型之一[1,2].有研究证实20多种病原体可经针刺伤接种传播,包括人类免疫缺陷病毒(HIV)和乙型肝炎病毒(HBV)[1].  相似文献   

7.
BACKGROUND Cholesteryl ester storage disease(CESD)is a rare genetic disease.Its symptoms and severity are highly variable.CESD is a systemic disease that can lead to the accumulation of fat and inflammation in the liver,as well as gastrointestinal and cardiovascular disease.The majority of patients require liver transplantation due to decompensated cirrhosis.Enzyme replacement therapy has been approved based on a randomized trial.Our study aims to clinically and genetically evaluate two siblings with CESD who underwent liver transplantation,as well as their first-degree family members.CASE SUMMARY The siblings were compound heterozygous for the missense variant in LIPA exon 8,c.894G>A,(p.Gln298Gln)and a single base pair deletion,c.482del(p.Asn161Ilefs*19).Analyses of single nucleotide polymorphisms showed variants with an increased risk of fatty liver disease and fibrosis for both patients.Clinically,both patients show signs of recurrence of CESD in the liver after transplantation and additional gastrointestinal and cardiovascular signs of CESD.Three family members who were LIPA heterozygous had a lysosomal acid lipase activity below the reference value.One of these carriers,a seven-year-old boy,was found to have severe dyslipidemia and was subsequently treated with statins.CONCLUSION Our study underlines that CESD is a multi-organ disease,the progression of which may occur post-liver transplantation.Our findings underline the need for monitoring of complications and assessment of possible further treatment.  相似文献   

8.
BACKGROUND Isolated gastrointestinal venous malformations(GIVMs)are extremely rare congenital developmental abnormalities of the venous vasculature.Because of their asymptomatic nature,the diagnosis is often quite challenging.However,as symptomatic GIVMs have nonspecific clinical manifestations,misdiagnosis is very common.Here,we report a case of isolated diffuse GIVMs inducing mechanical intestinal obstruction.A literature review was also conducted to summarize clinical features,diagnostic points,treatment selections and differential diagnosis in order that doctors may have a comprehensive understanding of this disease.CASE SUMMARY A 50-year-old man presented with recurrent painless gastrointestinal bleeding for two months and failure to pass flatus and defecate with nausea and vomiting for ten days.Digital rectal examination found bright red blood and soft nodular masses 3 cm above the anal verge.Computed tomography showed that part of the descending colon and rectosigmoid colon was thickened with phleboliths in the intestinal wall.Colonoscopy exhibited bluish and reddish multinodular submucosal masses and flat submucosal serpentine vessels.Endoscopic ultrasonography showed anechoic cystic spaces within intestinal wall.The lesions were initially thought to be isolated VMs involving part of the descending colon and rectosigmoid colon.Laparoscopic subtotal proctocolectomy,pullthrough transection and coloanal anastomosis and ileostomy were performed.Histopathology revealed intact mucosa and dilated,thin-walled blood vessels in the submucosa,muscularis,and serosa involving the entire colorectum.The patient recovered with complete symptomatic relief during the 52-mo follow-up period.CONCLUSION The diagnosis of isolated GIVMs is challenging.The information presented here is significant for the diagnosis and management of symptoms.  相似文献   

9.
CA530血凝仪是日本sismexs公司生产的,因其功能齐全,性能良好,结果准确,操作简便,深受欢迎.作者在实际使用中不断摸索和探讨,积累了一些故障分析和排除方面的知识,给CA530血凝仪用户提供了可借鉴的经验,现介绍如下.  相似文献   

10.
目的总结新生儿颅内出血的早期诊断,早期预防和治疗经验,以提高对该病的诊治水平。方法回顾性分析48例新生儿颅内出血的临床资料。结果根据围产期情况,结合临床表现及CT检查作出诊断,经综合治疗后治愈32例,好转10例,自动出院4例,死亡2例。35例获随访1年,其中27例未发现后遗症,脑性瘫痪2例,脑积水2例,癫痫4例。结论新生儿颅内出血多见于早产儿,多有异常围产史,结合临床表现和头颅CT检查可确诊。对该病做出早期诊断、早期预防、积极有效的治疗,有助于减少后遗症的发生。  相似文献   

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Physiatrists are a valuable resource in legal settings, where assessment of functional capacity to perform work and of future medical needs must be determined. Physiatrists help determine what future medical care is needed to restore and maintain an individual at the maximum level of life function. This article focuses on the use of a quality of life (QOL) rehabilitation model, rather than a medical model, for enhancing functional performance, modifying environments, and facilitating patient coping. We discuss use of the QOL model to describe and influence a patient's physical, psychological, cognitive, vocational/economic, and social/leisure domains.  相似文献   

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16.
韶关市农村留守儿童孤独感状况调查   总被引:1,自引:0,他引:1  
目的了解广东省韶关市农村地区留守儿童孤独感现状及其影响因素。方法对韶关市某地区两所农村小学3~6年级学生中的489名留守儿童采用儿童孤独量表和自编调查表进行问卷调查。结果17.6%留守儿童存在孤独感,不同性别孤独感发生率无差异性,不同年龄及不同年级间孤独感发生率差异均有极显著性(P〈0.01);随年级增加,孤独感发生率呈下降趋势(X^2趋势=5.970,P〈0.05)。留守儿童孤独感与健康状况、学习成绩、学习困难程度、父母教育方式、父母间关系和老师教育方式等因素显著相关(P〈0.01~0.05)。结论农村地区留守儿童中存在一定程度的孤独感问题,老师和家长应以正确的态度和方法对待留守儿童,以减少其孤独感的发生。  相似文献   

17.
目的研究四肢瘫日常生活能力评定量表评测四肢瘫患者的重测信度及观察者间信度。方法由1位评定者应用四肢瘫日常生活能力评定量表对20例四肢瘫患者进行评定,评定后1周内再次对该患者进行评定;另1位评定者在第1位评定者初次评定后2 d内对该患者进行评定。结果第1位评定者两次评定总分的组内相关系数为0.994(P<0.01);第1位评定者与第2位评定者评定总分的组内相关系数为0.971(P<0.01)。结论四肢瘫日常生活能力评定量表具有良好的重测信度及观察者间信度。  相似文献   

18.
目的 :调查肇庆市居民颈椎病发病情况及相关问题。方法 :通过分层随机抽样选择该市区18~70岁居民5000人为研究对象 ,入户或至单位询问调查。结果 :该市居民颈椎病发病率为8.11% ,男女差异无显著性 ,随着年龄的增长 ,发病率逐渐增加。经多因素分析 :体位姿势不正确、情绪紧张、潮湿、疲劳是发病的主要诱因。结论 :该病严重影响肇庆市居民的健康 ,做好防治应从早做起 ,综合防治。  相似文献   

19.
目的评价胰腺癌治疗的Cochrane系统评价证据,以及纳入系统评价的临床随机对照试验(RCT)的方法学质量。方法检索Cochrane Library数据库(2009年第4期)中有关胰腺癌治疗的系统评价,并运用RewMan5.0.21对所纳入研究的偏倚进行评估。结果共检索到胆道支架置入术姑息治疗梗阻型胰腺癌的系统评价、放化疗治疗不能手术的进展期胰腺癌的系统评价共2篇系统评价,共纳入79个RCT。依照Cochrane协作网推荐的质量评价方法,对所纳入RCT的偏倚进行评估,表明均存在不同程度的偏倚,方法学质量普遍较低。结论 Cochrane系统评价是公认的最高质量的研究证据,但目前缺少足够强度的证据来支持胆道支架置入术姑息治疗梗阻型胰腺癌的疗效。其他治疗手段的疗效如胰腺癌围手术期的营养支持治疗等还需要通过进一步的完成系统评价来评估。建议推行临床试验透明化,实施临床试验注册制度以及按照CONSORT声明严格规范RCT的报告,以便于总结胰腺癌治疗的临床证据。  相似文献   

20.
本文监测了33例缺血性脑卒中患者血浆中内皮素 (ET)和心钠素 (ANP)的含量变化及其相关关系并进行分析 ,以探讨其在缺血性脑卒中发病过程中的作用及其相关关系。1资料与方法1.1一般资料本文选择缺血性脑卒中患者33例 ,均为我院住院病人。年龄41~83岁 ,平均60.3岁 ;病程3h~3个月 ,其中1周内30例 (90% )。33例患者中腔隙性脑梗塞13例 (梗塞面积≤15mm2) ,单发性梗塞9例 (梗塞面积>15mm2) ,多发性梗塞11例 (梗塞面积>15mm2,且病灶在两个以上者 )。梗塞部位包括脑叶、基底层、脑干 (脑…  相似文献   

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