脱细胞真皮基质在上前牙GBR种植术中的临床研究

目的：研究采用脱细胞真皮基质进行引导骨组织再生技术（GBR）并同期种植体植入的短期临床效果。方法29例上前牙脱细胞真皮基质进行 GBR并同期植入种植体,经软组织塑形后,完成最终上部结构。随访3～9个月,对种植体周围软硬组织进行评价。结果29例均获得良好骨整合,种植体无松动脱落。种植体周围软硬组织状态良好,美学效果满意。结论采用脱细胞真皮基质进行上前牙 GBR并同期植入种植体,短期内可获得较满意的临床效果。     

上颌前牙美学区骨量不足种植修复的临床研究

目的改良骨劈开技术联合引导骨组织再生术(GBR)种植修复上颌前牙美学区单颗牙缺失的效果。方法选取江门市口腔医院2018年5月至2020年5月收治的30例上颌前牙美学区单颗牙缺失患者分为研究组和对照组,研究组给予改良骨劈开技术联合GBR技术治疗,对照组仅给予常规GBR术治疗,比较两组患者不同时间点种植体唇侧骨宽度、种植体颈上骨高度、红色美学指数(PES)、牙冠白色美学指数(WES)。结果植入即刻两组患者种植体唇侧骨宽度和种植体颈上骨高度比较,差异无统计学意义(P>0.05);植入后6个月、12个月研究组种植体唇侧骨宽度和种植体颈上骨高度均高于对照组(P<0.05),种植修复即刻、修复后6个月、修复后12个月两组患者PES、WES评分比较,差异均无统计学意义(P>0.05)。结论改良骨劈开技术联合GBR技术种植修复上颌前牙美学区单颗牙缺失患者可提高骨增量效果,获得良好的美学效果,具备良好的应用前景,值得推广。     

数字化导板辅助种植修复技术对前牙美学区修复效果的影响

目的探究数字化导板辅助种植修复技术对前牙美学区修复效果的影响。方法选取2018年9月至2020年9月于本院接受上前牙种植修复的111例患者作为研究对象,按照随机数字表法分为对照组(n=55,63枚种植体)与实验组(n=56,64枚种植体)。对照组采用常规种植修复,实验组采用数字化导板辅助种植修复,比较两组修复后种植体位置偏差情况、牙菌斑指数、修复前后美学效果评分及植入后不良反应。结果修复后,实验组种植体位置偏差距离短于对照组,牙菌斑指数低于对照组,白美学分数及红美学分数均高于对照组,不良反应发生率低于对照组,差异均有统计学意义(P<0.05)。结论数字化导板辅助种植修复技术可提高植入位置精准度及美学评分,减少牙菌斑产生且植入后安全型性较高。     

种植体规格、手术方式与上前牙区种植体唇侧骨吸收量的相关性研究

  目的  探讨不同种植体规格及手术方式等因素对上颌前牙区种植体唇侧骨板高度吸收的影响。  方法  选取43例符合实验纳入标准的患者实施上颌前牙区种植手术,共植入植体55枚。收集患者的临床资料和种植体植入后1周、植入后6个月、修复后6个月、修复后12个月的锥形束CT (CBCT)资料,计算患者在各个时期(植入后6个月、修复后6个月、修复后12个月、植入后18个月)唇侧骨板高度的吸收量并分组进行统计学分析。  结果  种植手术时机、种植手术类型、种植手术方式对上前牙区种植体唇侧骨板高度吸收量无明显影响;在植入后18个月时,种植体直径对上前牙区种植体唇侧骨板高度吸收量有影响(P < 0.05);在植入后6个月和植入后18个月时,种植体骨内的位置对上前牙区种植体唇侧骨板高度吸收量有影响(P < 0.05)。  结论  使用更大直径的种植体,将种植体与基台连接平面放置在牙槽骨上缘有利于减少种植体唇侧骨板高度吸收。     

前牙区骨劈开同期种植修复1年后软组织美学效果评价

目的:评价上颌前牙区行骨劈开术后,同期植入种植体修复1年后的软组织美学效果。方法:收集上颌前牙区牙列缺损伴牙槽骨水平宽度不足的患者14例,采用骨劈开术同期植入17枚种植体,术后6个月行二期手术并完成修复。采用粉红美学评分(Pink Esthetic Score,PES)对种植义齿周围软组织状况进行计分,评估修复1年后的种植成功率和软组织美学效果。结果:种植修复1年后的成功率为94.12%(16/17),1例出现唇侧种植体颈部暴露导致修复失败。PES得分最高为14,最低为6,均值为(10.41±2.09)。近中牙乳头和软组织形态的平均得分最低,分别为(1.17±0.86)和(1.17±0.73)。软组织质地的平均得分最高,为(1.88±0.33)。结论:骨劈开术能有效增加骨量,在软组织美学上基本达到满意的效果。     

上前牙区即刻种植修复临床牙龈美学观察

目的评价种植体即刻种植修复的牙龈美学效果及患者对美观的满意度。方法观察15例患者在拔牙后即刻植入XIVE种植体20枚,同时接入基台行复合树脂临时冠修复,并用Super-BandB＆C超强树脂固定于邻牙3个月,4~6个月以后行永久性修复,对患者进行满意度调查,并与同期20枚XIVE种植体延期种植相比较。结果 12个月时所有的种植体都发生了骨结合现象,与延期种植比较,即刻种植义齿周围的软组织外形正常,患者对即刻种植修复的美学效果更加满意。X线观察显示,即刻种植前6个月骨吸收小于延期种植（P〈0.05）,6至12个月吸收量与延期种植无明显差别（P〉0.05）。结论严格掌握了适应证,并保证初期稳定性,上前牙即刻种植修复比延期修复可获得更佳的软组织外形,尤其是牙间乳头美学效果更理想。     

因牙周炎缺失上前牙种植修复后短期软组织美学效果评价

目的:评价因牙周炎缺失上前牙种植修复后的短期软组织美学效果.方法:选择因牙周炎需拔除上前牙的患者15人,共涉及牙齿20颗,患牙两侧有天然牙,所有患者均已接受系统牙周治疗.拔牙后自然愈合2～3个月,采用常规翻瓣种植手术植入种植体,术中记录牙槽骨缺损的程度、种植体植入深度(种植体距离邻牙釉牙骨质界连线的距离)等指标,采用埋入愈合方式.愈合3个月后行二期手术并完成修复.修复后1～3个月复查,用红色美学评分(pink esthetic score,PES)评价软组织美学效果.结果:所有种植体均成功达到骨结合,没有早期种植体松动脱落发生.因牙周炎缺失的上前牙经种植修复后,PES均值为(9.6±2.4)分(5～13分),其中3颗修复体的PES低于7分.仅有水平骨缺损的13个位点种植修复后的PES均值为(10.5±1.9)分,显著高于伴有垂直向骨缺损的7个位点[(7.9±2.3)分,P＜0.05].PES与种植体植入深度呈负相关关系(r=-0.608,P＜0.01).结论:因牙周炎导致的前牙缺失存在较高的种植美学风险,牙槽骨缺损尤其是垂直骨缺损的程度和部位是影响软组织美学效果的主要因素.     

牙槽嵴劈开术对牙槽骨水平宽度不足种植牙患者的效果观察

目的 探讨牙槽骨水平宽度不足的种植牙患者应用牙槽嵴骨劈开术的临床疗效.方法 收集要求种植固定修复的上颌牙列缺失患者48例,所选患者有充足的牙槽嵴高度（＞ 10 mm）,但牙槽嵴骨宽度仅3～4 mm,牙槽骨骨量不足且基牙分布不均,采用牙槽嵴骨劈开术形成唇颊侧骨瓣,在腭侧骨板与唇颊侧骨瓣之间共植入75枚种植体.术后6个月种植修复,定期随诊.结果 种植区软组织愈合好,种植体骨结合良好,牙槽嵴宽度增加达4～5mm,平均增宽4.4 mm,2枚种植体术后6个月失败,失败率为2.67％,剩余种植体均稳固性好,完成烤瓷修复后美学效果好,追踪24个月以上,无种植体失败.结论 牙槽嵴骨劈开术保证了牙槽骨厚度不足患者的种植修复难题,效果显著.     

直基台与角度基台修复前牙区种植义齿短期临床效果评价

目的探讨在前牙区应用角度基台后,种植义齿的短期临床效果,评估直基台与角度基台修复的种植义齿美学状态。方法选取2014年1月至2018年1月在中国科学技术大学附属第一医院(安徽省立医院)口腔医学中心就诊的前牙区牙列缺损的患者24例,其中直基台修复种植义齿12颗,角度基台修复种植义齿12颗,随访6个月,观察种植体有无机械并发症,包括是否稳定、修复体是否完整、种植体义齿红色美学指数,评价角度基台种植义齿修复的临床疗效。结果种植义齿修复完成后6个月复查时,24颗种植体均在位,无松动脱落,叩诊无疼痛;修复体完整,无崩瓷。1颗直基台修复的种植修复体在种植修复完成后6个月时松动;软组织红色美学指数直基台和角度基台比较差异无统计学意义(P> 0. 05)。结论直基台和角度基台修复的种植义齿均可应用于前牙区缺失牙患者。     

Endopore种植体即刻种植的临床研究

目的：应用Endopore 系统种植体行即刻种植，并对种植效果进行临床分析。方法：对具有即刻种植适应症18例患行26个人工牙种植体植入，牙槽窝较宽加用人冻干脱钙骨植入或联合超薄钛膜覆盖，3-6个月后，行种植义齿修复。结果：26个种植体植入后，伤口一期愈合，义齿修复后行使咀嚼功能3-36月，未发现种植失败。结论：即刻种植应严格掌握适应症，避免牙槽骨损伤，保证充分的骨组织与种植体结合，软组织要充分松驰，伤口无张力缝合。     

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…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

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.     

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.     

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.