Study of Occlusal-maxillo-facial 3-dimentional Structural Change of Orthodontic Therapy of Crossbite Malocclusion by Modified ACTIVATOR Appliance

Summary: Occlusal-maxillo-facial structural change of crossbite malocclusion after orthodontic thera-py by modified ACTIVATOR appliance was investigated. Eighty crossbite cases of deciduous denti tion and mixed dentition were treated by modified ACTIVATOR. Through pre- and post-treatment analysis of stone model, Schuller‘s position X-ray and craniofaciometrics, the change in craniofacial length, width and height in early-phase crossbite malocclusion was studied. The results showed that there was no significant change in the width of maxillary and mandibular dental arch. Maxillary length and protrusion was increased significantly, upper incisors slopped labially. The lower incisors slopped lingually, mental angle decreased more severely. The lower and posterior facial height was in creased to normal level.     

239 CASES OF HIGH FEVER IN VIRAL UPPERRESPIRATORY INFECTION (URI) TREATED WITHXIANG SHI QING JIE (XSQJ) BAG TEA

XSQJ bag tea was used to treat 239 cases of Ugh fever caused by viral upper respiratory infection, widely spreading in summer and autumn. For comparison, a control group treated by penicillin combined with Ganmao Qingre Chongji or Banlangen Chongji was set up. The results showed the effect of XSQ J bag tea on the time of abating fever, resolving symptoms and physical signs were significantly better than that of the control group.     

Management of mediastinal infections after open—heart surgery in 18 cases

Two methods were employed in the management of 18 patients with mediastinal infec-tions after open-heart surgery in a 10-year-period from 1980 to 1989.The first 3 cases weretreated with local debridement and drainage of the involved areas.Of them,1 was cured and 2 de-veloped chronic osteomyelitis of the sternum with an average hospitalization of 91 d.The other 15cases were treated with radical debridement and closed retrosternal irrigation of antibiotic solutions.Fourteen out of the 15 cases were successfully cured with an average hospitalization of 15d and 1case suffered from a recurrence of infection.No hospital mortality occurred in this series and 2 latedeaths were not related to mediastinal infections.It is believed by the authors that radicaldebridement in association with retrosternal irrigation is a far much better method than localdebridement combined with drainage in the management of mediastinal infections afteropen-heart surgery.     

Clinical effect of tip-edge plus appliance in children with angle II1 malocclusion

The effects of Tip-Edge plus appliance in the treatment of Angle Ⅱ1 malocclusion and the mechanism were investigated. Fifty-two Angle Ⅱ1 children, aged from 12.3-14.2 years, with mandibu- lar retrusion in permanent dentition were selected and treated with Tip-Edge plus appliance. Lateral cephalometric films taken before and after treatment were analyzed. The arithmetic mean and standard deviation were calculated for each variable. Paired t-test was performed to evaluate the significant treatment change. Results showed that the average treatment time was 16 months. Normal overjet and overbite were established with retroclination of upper incisors and proclination of lower incisors. U1-NA was decreased by 15.4° （P〈0.01）. ANB and Y axial angle were decreased significantly （P〈0.05） Soft tissue measurements showed that FCA and UL-E were decreased dramatically （P〈0.05）, and LL-E was increased significantly （P〈0.05）. Remarkable soft tissue change was noted after the treatment and convex facial profile changed to the straight profile. In conclusion, Tip-Edge plus technique can quickly and efficiently correct anterior bite and lateral outlook.     

Application of Monoclonal Antibodies against Epidemic Hemorrhagic Fever Virus in Early Clinical Diagnosis and in Viral Antigen Analysis

Indirect fluorescent antibody test (IFAT) was employed to detectviral antigens in the peripheral blood lymphocytes from 77 patients withclinically diagnosed epidemic hemorrhagic fever (EHF). The positive ratewas 50.7%, and it was 64.3% (27/42) for early cases (2nd to 5th day ofdisease). It was found that the earlier and the more severe the cases were,the higher the positive rate was. Three McAbs, 4B9, 4E7 and 3H4 havebeen introduced to IFAT. Five reaction patterns of the three McAbs withviral antigen positive cases were observed. The McAbs showed theirdifferences in respect of positive rate. Combination of McAbs could raisethe positive rate. In the cases of early phase with positive EHFV antigensin the leucocytes, the positive rate of specific IgM in acute phase sera was96.3%. The positive rate and accuracy of EHF early diagnosis could beraised by combined application of detection of the viral antigens andspecific serum IgM in the acute phase.     

Management of intra-articular fracture of the fingers via mini external fixator combined with limited internal fixation

Background Intra-articular fractures of the fingers are common problems to emergency physicians and hand surgeons Inappropriate management of these injuries may result in chronic pain, stiffness, deformity, or post traumatic arthritis. Ideal treatment necessitates the restoration of a stable and congruent joint that will allow early mobilization. The purpose of this study was to investigate the results of intra-articular fracture of the fingers by mini external fixator combined with limited internal fixation. Methods From May 2005 to May 2007, a total of 26 patients with intra-articular fracture of the fingers were treated by mini external fixator combined with limited internal fixation. Of the 26 cases, 11 involved in metacarpophalangeal joint, and 15 interphalangeal joint in proximal interphalangeal. Kirschner wire, mini wire and absorbable suture were used for limited internal fixation. All patients were followed up and patients were accomplished with total active motion （TAM） of fingers. Results All patients were reviewed by an independent observer. The mean follow up was 13 months （range 9 to 24 months）. Subjective, objective and radiographic results were evaluated. X-ray films revealed fracture union and the average radiographic union time was 7 weeks with a range of 5-12 weeks and the phalange shortening or rotation in 2 cases, joint incongruity （less than 1 mm） and joint space narrowing in 3 cases respectively. Phalangeal shortening or rotation was observed in 2 cases and joint incongruity or joint space narrowing was observed in 3 cases. An artificial implant was performed on one case for traumatic arthritis 1.5 years after surgery. Based on TAM the overall good-excellent rate of joint motion function was 80.8%. Conclusion Mini external fixator combined with limited internal fixation is a reliable and effective method for treatment of intra-articular fracture of the fingers.     

The Imageological Measurement of Sternoclavicular Joint and Its Clinical Application

Objective: The paper aims to investigate its imageological anatomical features, and design a new style plate for facilitating therapy of SCJ dislocation according to these data. Methods: Fifty-three healthy Chinese volunteers examined with chest computed tomography (CT) in our hospital were included into the study. Volunteers with SCJ deformity or injury were excluded from the study. The coronal, sagittal and axial images of the sternoclavicular region from the superior border of the clavicle to sternal angle were reconstructed. The diameter of the sternal head in inferolateral to superomedial direction(DOSH), the length of clavicular notch and the angle between clavicular notch and sternum were measured on the coronal images. The angle between presternum and trunk were measured on the sagittal images. The following issues were measured in the axial images, including ⑴ the anteroposterior dimensions of sternal head, clavicular notch and presternum; ⑵ the SCJ wide; ⑶ the distance between bilateral clavicles; and ⑷ the minimal distance from presternum to the underlying structures in the thoracic cavity. New plate was designed according to the data measured in the study to treat SCJ dislocation or subluxation. Six dislocated joints were repaired by the new designed plate . All these cases were available for a mean duration of follow-up of 10 months (range, 9-12months). Result: The proximal clavicle is higher than the presternum in a horizontal position. On the axial images, the anteroposterior dimension of the sternal head was longer than the presternum, and the center region of the presternum was thinner than the edges. The left SCJ space was 0.82±0.21cm, and the right was 0.87±0.22cm. Among the structures going behind the sternum in the thoracic cavity, the left bilateral innominate vein ran nearest to the presternum. The distance from the anterior cortex of sterna to left bilateral innominate vein was 2.38±0.61cm. A new-style plate was designed according to our measurement. Anatomical reduction of the dislocated joint and safe insertion of screws into the presternum was achieved in the management of SCJ dislocation with the use of the new plate. All cases have got satisfactory clinical effect by follow-up office visit. Conclusions: Normal parameters of the SCJ were measured on the CT images. The measurement can facilitate the treatment of SCJ dislocation or subluxation. The new designed plate can be used to treat SCJ dislocation effectively and safely.     

Oinical study on thymomas and thymomas with myasthenia gravis

Objective To present the clinical experience in treating thymomas and thymomas with myasthenia gravis (MG). Methods Between 1975 to 1997,285 patients with thymoma were surgically treated. 168 cases of thymus tumor (TT,Group Ⅰ ) were compared to 90 cases of thymus tumor with myasthenia gravis (TTMG, Group Ⅱ ). Results In group Ⅰ , the average age was 38. 4 years, the youngest was 4 years old. In 93. 4%, the diameter of tumors was 5 cm. 61. 2% were in stages Ⅲ and Ⅳ of clinical pathology. In group Ⅱ ,the average age was 46.2 with the youngest of 20 years old,the diameter of tumor under 3 cm and 5 cm was 34.6 % and 65.6 % . 55.2 % was in stage Ⅰ of clinical pathology. Conclusion Many cases of thymoma in early stage received early treatment. The diagnostic standard of thymoma in early stage is: (1) the diameter of tumor is below 3 cm. (2) In stage I of clinical pathology. The clinical characteristics of TTMG are: short history, the rapid progress, serious MG symptoms,and the high incidence of thymus-     

Percutaneous reduction combined with bone graft in treatment of displaced intra-articular calcaneal fractures

Objective： To introduce the experience and key points of percutaneous reduction combined with bone graft to treat calcaneal fractures. Methods： Percutaneous reduction and internal fixation combined with bone graft was performed from April 2004 to April 2006 on 15 cases （16 sides） with intra-articular calcaneal fractures including 13 males （14 feet） and 2 females （2 feet） ,with average age of 36. 6 years （24-61 years）. All patients underwent radiography including lateral and axial views for calcaneus, oblique view for foot and three-dimensional CT imaging reconstruction. According to Sanders classification, there were 12 feet of type Ⅱ （3 type Ⅱa, 3 type Ⅱb and 8 type Ⅱc） and 2 feet of type Illac. The length of calcaneus was recovered through traction by Steinmann pin which passed through calcaneal tubercle perpendicularly and the posterior facet was elevated until reduction by a curve scissors through an 0.5 cm incision along the primary fracture line of lateral calcaneus. The calcaneus was fixed with different cannulated cancellous screws according to the type of fractures. Then bone graft was injected to fill the defect of calcaneus through lateral incision. Results： All patients were followed up for an average of 18.4 months （ranged, 12 to 34 months）. No complication such as wound infection, screw breakage and calcaneum varus was found postoperatively. The average time for bone healing was 10 weeks. The results were excellent in 12 cases, good in 4 cases according to the American Orthopaedic Foot and Ankle Society （AOFAS） hindfoot score. The rate of excellent and good clinical results was 100%. The mean AOFAS hindfoot score in tongue type group （86.5±4.4） was better than in joint depression type group （81.2±1.7, P〈0.05）. Radiography showed basic restoration of Bohler＇s angle, Gissane＇s angle and calcaneal shape. Conclusion： The combination of percutaneous reduction and injectable bone graft is suitable for surgical treatment of Sanders Ⅱ and Ⅲ type calcaneal fractures, with advantages of simple operation, fewer complications and good clinical results.     

Treatment of Floating Knee Injury in Children

The necessity and superiority of the surgical operation on children with floating knee injury and the fracture union and complications were investigated. Twenty-eight children with floating knee injury were subjected to open reduction and internal fixation or external fixator. The patients were followed up for 18 months to 7 years. The curative effectiveness was scored by Karlstrom criteria. The results showed that no nonunion or deformity was found. The affected limb was 1.2 cm to 1.5 cm longer in 2 cases, 0.8 to 1.2 cm shorter in 3 cases than the contralateral. No severe dysfunction of knee joint occurred. The excellent-good rate was 92.8 % and the curative rate 71.4 respectively. So for children whose age is older than 5 years, it＇s a good way to treat the fractures of femur and tibia with open reduction and internal fixation or external fixator. The method can be advantageous for the nursing care, early function recovery, shortening of the hospital stay and avoidance of severe complications.     

前方牵引结合直丝弓技术矫正前牙反颌

目的：评价上颌前方牵引器结合直丝弓技术矫正前牙反颌的疗效，探寻临床对前牙反颌的有效治疗方法。方法：应用上颌前方牵引配合直丝弓技术，对15例Ⅲ类错颌的替牙期儿童进行治疗。结果：经5—8个月的前方牵引后使用直丝弓矫治器，使前牙覆颌覆盖显著，有较好的治疗效果。结论：对于Ⅲ类错颌，采用前方牵引结合直丝弓矫正技术，临床疗效显著，疗程缩短，是有效的治疗方法。     

前方牵引器矫治儿童替牙期骨性反36例疗效观察

目的探讨上颌前方牵引治疗儿童替牙期骨性反的疗效。方法应用面具和改良颏兜前方牵引器对36例替牙期骨性反颌的儿童进行早期治疗。结果经过6～12个月的前方牵引,使前牙覆颌覆盖以及侧貌得到显著改善。36例替牙期后方牵引治疗前后X线头影测量结果证实,SNA、SNB、ANB、上中-NA、下中-NB、MP-SN牵引前后出现显著变化,差异有统计学意义(P<0.05)。结论可调面具式前方牵引器促进上颌骨向前发育,抑制下颌骨向前发育,可以有效改善侧貌外形。     

“2×4”矫治技术结合颌间Ⅲ类牵引在替牙期前牙反矫治中的临床应用

目的探讨"2×4"矫治技术在矫治替牙期前牙反中的矫治效果。方法上下两侧磨牙上制作带环,上下4颗切牙粘贴托槽,视前牙拥挤度选择0.014或0.016英吋的镍钛圆丝排齐前牙。用0.016英吋的澳丝上颌弓丝在颊面管近中端弯制停止曲,停上曲紧抵颊面管,弓丝前端离开前牙唇面2.0 mm入槽结扎。下颌弓丝双侧侧切牙远中端弯制牵引圈,配合Ⅲ类牵引以解除前牙反。结果 16例替牙期前牙反病例经"2×4"技术矫治后均获得满意效果。结论 "2×4"矫治技术配合Ⅲ类牵引,能有效地解除前牙反,改善面型,促进上颌骨的正常发育,抑制下颌前伸。是替牙期前牙反矫治中一种方便、有效的矫治技术。     

两种不同前方牵引矫治器矫治替牙早期骨性Ⅲ类错的临床 研究

目的 临床研究改良 Nance 弓前方牵引矫治器和树脂冠腭开展前方牵引矫治器,观察这两种不同形式的前方牵引对替牙早期骨性Ⅲ类错治疗前后骨骼、牙齿、面型的变化,评价其临床矫治效果。方法 选择24 例替牙早期骨性Ⅲ类错畸形患者,分别应用改良Nance 弓前方牵引矫治器和树脂冠腭开展前方牵引矫治器进行治疗, 通过两组X 线头颅侧位片进行测量,比较治疗前后软硬组织的变化。结果 两个治疗组SNA、ANB、NA-PA、Ptm-A 均增大,A 点分别前移1.99 mm和2.61 mm,且有统计学意义（P＜0.05）。 结论 两种前方牵引矫治器治疗替牙早期骨性Ⅲ类错均有效,有利于Ⅲ类骨骼的调整,但树脂冠腭开展前方牵引组A 点前移较多。     

恒牙早期前牙反伴牙列拥挤的分期矫治

目的探寻一种治疗恒牙早期前牙反牙合伴牙列拥挤的良好途径。方法选择13例恒牙早期前牙反牙合伴牙列拥挤病例,进行分期非拔牙矫治:①上颌牙合垫矫治器解除前牙反牙合;②远中移动上颌磨牙开辟间隙,解除拥挤;③固定矫治器排齐牙列、关闭牙隙。结果13例患者经5~8个月后,解除前牙反牙合,上颌第1磨牙平均远移约3.6 mm。结论分期非拔牙矫治恒牙早期前牙反牙合伴牙列拥挤,方法可行,且疗效稳定。     

McNamara分析法评价替牙列晚期Ⅲ类骨性错(牙合)前方牵引的疗效

目的 采用McNamara分析法评价前方牵引对替牙列晚期Ⅲ类骨性错(牙合)的治疗效果.方法 选择20例替牙列晚期骨性反(牙合)患者(其中男11例,女9例),用面罩前方牵引治疗,治疗前后拍摄头颅侧位X线片,采用McNamara分析法用t检验进行比较分析.结果 治疗后矢状方向上有效上颌长度,上颌突度,上切牙突距增大;垂直方向上下前面高增大.结论 前方牵引能够改善Ⅲ类骨性错(牙合)的矢状关系,有利于错(牙合)的纠正.     

FR-Ⅲ矫治早期反He后He颌面改变

目的 研究乳牙及替牙期反He经FR-Ⅲ矫治后He颌面的改变。方法 选择乳牙期及替牙期反He患者64例，全部采用FR-Ⅲ治疗，对治疗前后的牙He模型、薛氏位关节片及头颅定位侧位片进行测量分析，研究He颌面长、宽、高的改变情况。结果 上下颌牙弓宽度治疗前后无明显改变；上颌长度及突度增大，上切牙唇倾；下颌髁突后退至正常位，上下颌基骨关系明显改善；下切牙舌倾及颏角变小更趋严重；下面高及后面高增加。结论 FR-Ⅲ矫治器可重新调整口颌系统的肌功能，促进牙弓和颌骨的正常发育。     

FR-Ⅲ矫治早期反(牙合)后(牙合)颌面改变

目的 研究乳牙及替牙期反牙合经FR-Ⅲ矫治后牙合颌面的改变。方法 选择乳牙期及替牙期反牙合患者64例,全部采用FR-Ⅲ治疗,对治疗前后的牙牙合模型、薛氏位关节片及头颅定位侧位片进行测量分析,研究牙合颌面长、宽、高的改变情况。结果 上下颌牙弓宽度治疗前后无明显改变;上颌长度及突度增大,上切牙唇倾;下颌髁突后退至正常位,上下颌基骨关系明显改善;下切牙舌倾及颏角变小更趋严重;下面高及后面高增加。结论 FR-Ⅲ矫治器可重新调整口颌系统的肌功能,促进牙弓和颌骨的正常发育。     

摇椅弓加上颌平面导板打开咬合的临床效果

目的：探讨摇椅弓加上颌平面导板打开咬合的临床效果。方法：选择安氏Ⅱ类Ⅱ以上深覆殆患者40名,摇椅弓加上颌平面导板组20名,单独用摇椅弓组20名,通过X线头影测量分析比较患者矫治前后的变化。结果：摇椅弓加上颌平面导板组ANB减小更明显,FH—MP,PP—MP,N—Me,U6-PP,L6-MP增大更明显,明显缩短了打开咬合的时间,差异均有统计学意义（P〈0．05）。结论：摇椅弓加上颌平面导板是一种快速有效打开咬合的方法,且对改善低角病例的面形更有利。