Apical root resorption in maxillary incisors when employing micro-implant and J-hook headgear anchorage: A 4-month radiographic study

This study evaluated,over a 4-month study period,the amount of apical root resorption occurring in maxillary central incisors following their retraction when employing either micro-implant or J-hook headgear anchorage.The prospective randomised clinical trial was conducted in Orthodontic Clinic,College of Stomatology,China from 2008-2009.Subjects are patients requiring fixed appliances on waiting list (n=20).In female Han Chinese patients aged from 16-26 years,standardized periapical radiographs from 10 randomly assigned patients with maxillary protrusions comprising the micro-implant group,and from 10 similar patients comprising the J-hook headgear group,were assessed for maxillary central incisor apical root resorption.Measurements before and after orthodontic therapy were also obtained from lateral cephalometric radiographs to calculate incisor horizontal retraction and vertical intrusion distances.Estimated retraction force vectors were calculated in horizontal and vertical directions for both treatment groups.Data analysis employed t-tests and the Pearson correlation test,with α=0.05 for statistical significance.The results showed that when compared with the J-hook group,significantly more apical root resorption shortening of the maxillary central incisors was observed in the micro-implant group (1.27 mm difference,95% CI=0.70-1.84,P<0.001),which was associated with a significantly larger retraction distance (P=0.004) and a smaller vertical force component (P<0.0001).We are led to conclude that continuous activation of the nickel-titanium coil springs used in the micro-implant group resulted in significantly more apical root resorption shortening and maxillary central incisor retraction than when intermittent J-hook retraction was employed.The employment of continuous duration orthodontic forces presents a risk for increased apical root resorption that requires careful radiographic monitoring.     

儿童单发与再发性尿路感染病原菌分布及耐药性分析

目的 探讨儿童单发尿路感染与再发性尿路感染的病原菌分布及耐药性，为合理使用抗生素提供依据。方法 回顾性分析2015年1月1日至2019年12月31日我科单发和再发性尿路感染住院患儿的临床资料，包括性别、年龄、尿培养结果、耐药情况及抗生素使用情况。结果 本研究共纳入尿路感染患儿777例，共987份病原学标本（单发组681份，再发组306份）。2组患者性别、年龄无统计学差异（P=0.180,P=0.055）。再发组泌尿系统畸形发生率（77.1%）显著高于单发组（20.1%），差异有统计学意义（P=0.001）。2组共检出515株病原菌（阳性检出率52.1%），其中86.4%为革兰氏阴性菌，12.0%为革兰氏阳性菌，1.5%为真菌。单发组与再发组最常见病原菌均为大肠埃希菌（70.1%vs 38.9%）。再发组非大肠埃希菌比例（61.1%）高于单发组（29.9%），差异有统计学意义（P=0.001）。药敏试验结果显示，2组大肠埃希菌、肺炎克雷伯杆菌对碳青霉烯类、β-内酰胺酶抑制剂复合制剂及磷霉素耐药性低。屎肠球菌、粪肠球菌对万古霉素、利奈唑胺、替加环素耐药性较低。多数抗菌药再发组耐药性高于单发...     

十味诃子丸联合阿魏酸哌嗪治疗慢性肾小球肾炎的临床研究

目的 探讨十味诃子丸联合阿魏酸哌嗪治疗慢性肾小球肾炎的临床疗效。方法 选取2021年1月—2023年3月南京医科大学附属江苏盛泽医院收治的136例慢性肾小球肾炎患者，按数字随机法将患者分对照组（68例）和治疗组（68例）。对照组患者口服阿魏酸哌嗪片，200 mg/次，3次/d。在对照组基础上，治疗组口服十味诃子丸，4丸/次，3次/d。两组患者治疗28 d。观察两组患者临床疗效，比较治疗前后两组患者症状缓解时间，肾功能指标尿素氮（BUN）、血清肌酐（SCr）、24 h尿蛋白量（24 h Upro），血清炎性因子白细胞介素-6（IL-6）、血管内皮生长因子（VEGF）、肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶-9（MMP-9）水平及不良反应。结果 治疗后，治疗组总有效率为98.53%，明显高于对照组总有效率（85.29%，P＜0.05）。治疗后，治疗组症状缓解时间均明显早于对照组（P＜0.05）。治疗后，两组患者BUN、SCr、24 h Upro、IL-6、TNF-α和VEGF均明显降低，而MMP-9水平明显升高（P＜0.05），且治疗组这些指标均明显好于对照组（P＜0.05）。治疗后，治疗组不良反应总发生率（4.41%）明显低于对照组发生率（10.29%，P＜0.05）。结论 十味诃子丸联合阿魏酸哌嗪治疗慢性肾小球肾炎效果确切，临床症状明显改善，调节肾功能状态，可使炎性反应减弱，且安全有效。