Rehabilitation of Patient with Acquired Maxillary Defect, using a Closed Hollow Bulb Obturator

Palliative care means providing support and care for patients with life-threatening or debilitating illness so that they can live their life as comfortably as possible. The fact that cure is no longer a reality does not mean that care cannot be made available. Partial maxillectomy defect presents a prosthodontic challenge in terms of re-establishing oronasal separation. Such defect has direct effect on cosmetic, function and psychology of the patient. This article describes step by step clinical and laboratory procedures involved in the rehabilitation of a hemimaxillectomy patient, using a definitive closed hollow bulb obturator, which improved his physical, emotional, functional, social and spiritual needs.     

Rapid isolation of high-affinity human antibodies against the tumor vascular marker Endosialin/TEM1, using a paired yeast-display/secretory scFv library platform

Endosialin/TEM1 is predominantly expressed on neovasculature, thus ideally suited for diagnostic, targeted imaging and therapy of cancer. To isolate TEM1-specific affinity reagents, we thought to screen a recombinant antibody (scFv) library derived from the repertoire of a patient with thrombotic thrombocytopenic purpura (TTP), as autoimmune disorders may produce self-reactive specificities. The yeast-display scFv library was constructed by homologous recombination of the TTP patient repertoire originally expressed on M13 bacteriophage in the novel vector pAGA2 for yeast-display expression. The TTP yeast-display library (10⁹ members) was screened by magnetic and flow sorting with human TEM1 recombinant protein. A pool of yeast-display scFv able to detect 2 nM of TEM1 was obtained and transformed into yeast-secreted scFv by homologous recombination using the novel p416 BCCP vector for yeast secretion of biotinylated scFv. Anti-TEM1 yeast-secreted scFv were independently validated in vitro by flow cytometry analysis and ELISA assays, then in vivo biotinylated in N-termini to produce biobodies. Biobody-78 bound specifically to Endosialin/TEM1-expressing ovarian tumor in vivo, with functional stability over 48 h. Our results suggest that our novel paired display-secretory yeast libraries can serve as an ideal platform for the rapid isolation of high-affinity reagents, and that anti-TEM1 biobody-78 can be used for in vitro assays including flow cytometry analysis, as well as in vivo for targeted imaging and therapy of cancer.     

开塞露灌肠治疗前列腺增生尿潴留患者护理体会

目的：观察应用开塞露保留灌肠治疗前列腺增生尿潴留的疗效。方法：对42例良性前列腺增生症尿潴留病人在使用传统诱导排尿无效后,利用不同剂量（40、60、80mL）开塞露保留灌肠治疗,并观察排便、排尿时间。结果：42例尿潴留病人中36例排便、排尿,总有效率85.7%,60mL及80mL开塞露保留灌肠患者有效率明显高于40mL灌肠者（P〈0.05）,排尿时间亦明显缩短（P〈0.05）。结论：开塞露保留灌肠可促进排尿,用量在60～80mL为宜。     

婴幼儿静脉留置针两种封管液的封管效果观察

目的：比较婴幼儿静脉留置针使用中2种不同封管液封管的效果。方法：160例住院婴幼儿随机分为两组,实验组在输液完毕后用5U／mL的肝素钠盐水封管,对照组用0．9％生理盐水封管,比较两组留置针的平均留置时间及堵管、液体外渗、静脉炎、皮疹的发生率。结果：实验纽留置针平均留置时间[（3．64±1．68）d]时间明显长于对照组[（3．01±1．42）d],差异有统计学意义（t=2．54,P〈0．05）;实验组堵管率明显（4．89％）低于对照组（16．67％）,差异有统计学意义（P〈0．05）;两组液体外渗、静脉炎、皮疹的发生率差异无统计学意义（P〉0．05）。结论：在婴幼儿静脉留置针的应用中,用5U／mL的肝素钠盐水封管配制方法简单,安全系数高,能延长留置针的留置时间,效果优于生理盐水封管,值得在临床推广应用。     

Capsule endoscopy retention as a helpful tool in the management of a young patient with suspected small-bowel disease

Capsule endoscopy is an easy and painless procedure permitting visualization of the entire small-bowel during its normal peristalsis. However, important problems exist concerning capsule retention in patients at risk of small bowel obstruction. The present report describes a young patient who had recurrent episodes of overt gastrointestinal bleeding of obscure origin, 18 years after small bowel resection in infancy for ileal atresia. Capsule endoscopy was performed, resulting in capsule retention in the distal small bowel. However, this event contributed to patient management by clearly identifying the site of obstruction and can be used to guide surgical intervention, where an anastomotic ulcer is identified.     

灌肠为主治疗溃疡性结肠炎的临床疗效研究

目的观察以灌肠为主要手段治疗溃疡性结肠炎(UC)的临床疗效。方法采用对照试验,治疗组以中西药联合使用,对照组单纯用西药,两组均以灌肠为主,配合口服用药治疗。根据临床症状、大便检查和结肠镜复查结果进行疗效比较。结果治疗组总有效率为91.3%,明显优于对照组的56.5%(P<0.05)。治疗后随访1年,治疗组比对照组复发病例明显减少。结论以保留灌肠为主要方法治疗UC效果良好,复发率低,值得临床观察与验证。     

套简冠附着体义齿修复多数牙缺失的临床效果评价

目的探讨套筒冠附着体义齿修复多数牙缺失的临床效果。方法收集单颌多数牙缺失、仅余留2～6颗天然牙的患者15例,制作套筒冠义齿18件,随访6个月一2年,询问患者对义齿的主观感受、咀嚼效率、义齿固位和稳定性,摄X线全景片,了解义齿、基牙和牙周情况。结果患者普遍认为义齿易适应、美观、固位稳定性好、咀嚼有力。12例曾使用过传统可摘局部义齿的患者对比两种义齿,明显感觉套筒冠义齿更加舒适、美观、稳定。复查X线片示套筒冠修复后各基牙牙周膜正常,牙槽骨无明显吸收。结论套简冠义齿修复多数牙缺失的牙列缺损临床效果良好。     

Short-term postorthodontic changes in the absence of retention

Objective:To evaluate short-term postorthodontic tooth movement without retention.Materials and Methods:Thirty consenting patients participated in the study. At the end of active treatment (T₁), final archwires were removed while leaving the fixed appliances on, and alginate impressions were taken. Four weeks later (T₂) a second set of impressions was taken. A clinical examination performed at T₂ determined if the fixed appliances could be removed or if additional treatment was required. Based on the examination, patients were divided into two groups. Patients in group I (n  =  13) had their fixed appliances removed, while those in group II (n  =  17) required additional treatment. The American Board of Orthodontics'' Objective Grading System scores and the following six variables were measured on plaster casts at T₁ and T₂: maxillary and mandibular crowding or spacing, overbite, overjet, and mandibular intercanine and intermolar widths. Data were analyzed to detect potential changes from T₁ to T₂ and to evaluate differences between the groups.Results:Mandibular crowding, overjet, and interproximal contacts worsened for the entire sample, while marginal ridges, occlusal contacts, and total American Board of Orthodontics scores improved. No statistically significant changes were found within group I from T₁ to T₂. Mandibular crowding, overbite, overjet, alignment/rotations, and interproximal contacts worsened within group II from T₁ to T₂, while marginal ridges and occlusal contacts improved. Significant differences were noted between the groups in terms of alignment/rotations, interproximal contacts, and mandibular intercanine width.Conclusion:Short-term postorthodontic tooth movement without retainers demonstrated improvement in specific characteristics of the occlusion but negatively affected alignment and interproximal contacts in the sample.     

Bone inductive proteins to enhance postorthodontic stability: A pilot study

Objectives:To evaluate the use of bone morphogenetic proteins to enhance postorthodontic stability in sheep and to develop a biological method of postorthodontic retention.Materials and Methods:First incisors were extracted in four mature and healthy sheep, and the second incisors were tipped reciprocally toward the midline and then retained. Dried bone matrix was injected into the distal periodontal space of the left second incisor. The right second incisor was left as a control. Both incisors were retained in the tipped position for 4 weeks. Then, the orthodontic appliance was removed and the teeth were left without retention. Six weeks later, the animals were killed and serial sections were prepared for histologic observation.Results:Unlike the control, the experimental second incisor maintained its tipped position with minimal relapse. On the distal periodontal space of the experimental tooth, areas of focal fusion between newly formed bone and newly formed areas of hypercementosis were observed. In the distal periodontal space of the control tooth, osteoclastic activity was observed along most of the socket wall, and the periodontal space appeared narrow and compressed. This brought the tooth close to the boundary of the alveolar bone, confirming the relapse observed on that side.Conclusion:This study proposes a new method of retention in which a biologically safe osteoinductive material is used to retain the teeth via induction of points of approximation between the cementum and alveolar bone.     

普通肝素钠稀释液正压封静脉留置针管在儿科的应用和临床观察

目的探讨普通肝素钠正压封静脉留置针管的临床效果。方法将88例留置静脉针患儿随机分为观察组和对照组,观察组：44例患儿用普通肝素钠稀释液2ml进行静脉留置针正压封管;对照组：44例患儿用生理盐水3ml进行静脉留置针正压封管。结果88例留置静脉针的患儿中,观察组使用普通肝素钠正压封管的静脉留置针留置的时间明显长于对照组,为3—4d。留置期间无血回流堵塞,患儿无任何不适主诉。与对照组比较有显著性差异（P〈0．05）。结论用普通肝素钠稀释液进行正压封管可减少静脉留置针堵塞,延长留置时间,减轻患儿因反复穿刺的痛苦。