Does the Modification of the Apical Geometry of a Dental Implant Affect Its Primary Stability? A Comparative Ex Vivo Study

(1) Background: Primary stability—one fundamental criterion for the success of dental implants—is influenced by implant geometry even if the effect of apical shape modifications on implant primary stability has not yet been examined. Therefore, the aim of the ex vivo study was to compare primary stability of implants differing in apically located screw threads (J-line) or a flat tip (K-line) only. (2) Methods: 28 implants of each group of the same diameter (4.3 mm) were randomly inserted into porcine bone blocks. The first group (9, 11 and 13 mm) was inserted into “hard”, the second (11 mm) into “soft” bone, here using a normal and an undersized drilling protocol. Insertion torque (Ncm), Periotest^® value, resonance frequency (implant stability coefficient, ISQ) and push-out force (N) were measured. (3) Results: In “hard” bone, primary stability increased with increasing length in both groups but it was significantly higher in J-line (p < 0.03). An undersized preparation of the implant bed in “soft” bone resulted in a significant increase in primary stability in both groups. Here, J-line also showed a significantly increased primary stability when compared to equally prepared K-line (insertion torque: 37 Ncm vs. 26 Ncm; Periotest^®: −6.5 vs. −4.3; push-out force: 365 N vs. 329 N; p < 0.05 each). (4) Conclusions: Primary stability is significantly higher with increasing implant length and apically located screw threads as well as with undersized drilling protocols. When preparing the implant site and subsequently selecting the implant system, modifying factors such as implant geometry (also at the tip) should be taken into account.     

壮医药线点灸联合针挑疗法对血管氧化应激损伤的影响

目的:探讨壮医药线点灸联合针挑疗法对血管氧化应激损伤的影响。方法:Wistar大鼠随机分为对照组、假手术组、模型组、联合组,每组20只。采用坐骨神经慢性压迫损伤法复制血管氧化损伤模型。联合组取双侧"足三里"进行药线点灸,取左侧"阳陵泉""环跳"进行针挑,点灸和针挑均7d为1个疗程,共进行3个疗程的治疗。采用放射免疫分析法检测血浆6-酮-前列环素F 1α(6-keto-PGF 1α)、血栓素B 2(TXB 2)、一氧化氮(NO)、内皮素(ET)的水平,免疫组化法观察股动脉环氧合酶2(COX-2)表达及血管形态学改变。结果:和对照组比较,模型组6-keto-PGF 1α、NO水平下降(P0.05),而TXB 2、ET水平显著上升(P0.01)。和模型组比较,联合组6-keto-PGF 1α、NO水平上升(P0.05),而TXB 2、ET水平显著下降(P0.01)。模型组COX-2表达较对照组增多,联合组COX-2表达较模型组显著减少(P0.01)。模型组血管内膜增生,管壁增厚;联合组血管内膜增生,管壁增厚现象减轻。结论:壮医药线点灸联合针挑疗法可以下调COX-2表达,进而调节前列环素2/血栓素A 2及NO/ET平衡,抑制血管内膜增生和血管重构,可能是其抗血管氧化损伤的作用机制之一。     

护士标准化病人在自缢与噎食急救护理技能培训中的应用

目的：探讨护士标准化病人( NSP)在低年资护士自缢、噎食急救护理技能培训中的应用方法及效果。方法参考华西医院筛选NSP的标准筛选出4名NSP,以60名广州市脑科医院护龄在3年内的护士为研究对象,采用随机对照的研究方法分为研究组30名与对照组30名。研究组使用NSP进行培训,对照组使用常规方法进行培训,用教育环境评估量表( DREEM)、理论和技能考核成绩及满意度评价两组培训效果。结果两组护士干预后急救理论考试成绩均较干预前提高,差异有统计学意义(P<0.05),且研究组成绩高于对照组,但差异无统计学意义(P>0.05)。研究组护士DREEM量表总分、对学习、对教师和对学术的自我认知评分均高于对照组,差异有统计学意义( t 值分别为7.086,9.443,10.462,8.620;P<0.05)。研究组噎食急救护理技能考核成绩高于对照组,差异有统计学意义(t=2.759,P<0.05),但自缢急救护理技能成绩比较差异无统计学意义(P>0.05)。两组护士对急救技能培训应用NSP的满意度比较差异无统计学意义(P>0.05)。结论在急救护理技能培训中应用NSP可以改善教育环境,提高护士的噎食急救护理技能水平,但在提高理论考核成绩、自缢急救护理技能方面与常规培训方法相比无明显优势。     

四种内镜下尼龙绳结扎法处理上消化道黏膜下肿瘤的疗效评价

目的 评价内镜下尼龙绳结扎技术治疗上消化道黏膜下肿瘤的临床疗效与安全性.方法 选择位于食管、胃、十二指肠的黏膜下肿瘤,采用内镜下尼龙绳结扎治疗,包括直接结扎、透明帽辅助结扎、双通道内镜结扎以及联合黏膜下剥离术（ESD）结扎.术后内镜随访,评价治疗效果与安全性.结果 自2006年6月至2008年12月共入选128例黏膜下肿瘤患者,食管28例,胃82例,十二指肠18例.3例采用直接结扎法,105例采用透明帽辅助结扎法,8例采用双通道内镜结扎法,12例联合ESD结扎.111例患者接受内镜随访,16例病灶（14.4%）较前明显缩小,16例（14.4%）尼龙绳未脱落,其余71例（63.9%）病人病灶完全消失,治疗有效率为92.8%.均未出现迟发性穿孔、出血等并发症.结论 内镜下尼龙绳结扎联合其他辅助方法治疗上消化道黏膜下肿瘤是安全及有效的.     

“悬吊法”在三叉神经微血管减压术中的应用(附43例分析)

目的探讨"悬吊法"在微血管减压术中的应用。方法利用"悬吊法"对43例患者行微血管减压术。结果 43例患者术后疼痛均立即消失,无伤残及死亡病例,术后总有效率达100%,随访2～42月,平均24个月,无复发病例。术后发生脑脊液漏1例,面部麻木1例,出院时均治愈。结论利用"悬吊法"对三叉神经进行减压,减压充分,能提高治愈率,减少术后复发。     

穴位埋药线对脑缺血再灌注大鼠uPA的影响

目的观察穴位埋药线对脑缺血再灌注大鼠尿激酶型纤溶酶原激活物（uPA）的影响。方法大脑中动脉线栓法（MCAO）制备脑缺血再灌注模型,运用免疫组化法检测缺血区uPA含量的变化以及穴位埋药线对其的影响。结果模型组大鼠缺血侧皮质区uPA含量均有高水平表达,穴位埋药线1d组与模型组比较无明显差异（P〉0．05）,3d及5d组可下调uPA表达,与模型组比较差异显著（P〈0．01）。结论穴位埋药线治疗可能是通过调节uPA蛋白的表达,减轻脑微血管基底膜的损害进而通过保护脑微血管的完整性来达到脑保护作用。     

Use of Triple-Convergence Polypropylene Thread™ for the Aesthetic Correction of Partial Facial Paralysis

Rehabilitation and reanimation of the paralyzed face remains a challenge. A variety of autografts and allografts have been used for static facial suspension. We report two cases of long-standing partial facial paralysis treated with 3C triple-convergence polypropylene thread. A 39-year-old woman with right-sided partial facial paralysis underwent an endoscopy-assisted facial suspension using the 3C threads and a 60-year-old woman with right-sided partial facial paralysis underwent a round face-lifting combined with endoscopic brow lift and placement of 3C triple-convergence polypropylene threads. Its use for partial facial paralysis has not been previously described. The 1-year follow-up shows effective preservation of the surgical result and patient satisfaction.     

膝内侧副韧带断裂手术治疗62例临床分析

目的探讨用粗丝线、螺钉治疗膝内侧副韧带断裂的疗效。方法回顾性分析62例膝内侧副韧带断裂手术患者资料。以王亦璁膝关节韧带损伤的评估标准进行评价。结果62例病人关节活动正常,行走无不适感,无半蹲起立失调。4例股四头肌轻度萎缩,行走正常。X线片示关节间隙在外翻状态下正常。结论粗丝线、螺钉固定术是治疗膝内侧副韧带断裂的有效方法之一。     

壮医药线点灸疗法概论

壮医药线点灸疗法是壮医常用的外治法,是将壮药泡制的苎麻线点燃后直接灼灸患者体表的一定穴位或部位以治疗疾病的一种方法。主要介绍该疗法的定义、治疗机理、主要功效、适应症、禁忌症、技术操作规范(药线制备、选穴方法、施术程序、疗程及注意事项)及其应用等。