CBCT测量牙槽弓长度的初步探究

目的：运用CBCT测量分析下牙槽弓的长度,并初步评价不同矢状骨面型患者下牙槽弓长度的差异。方法：随机选择未经正畸治疗的成年女性患者68人,拍摄术前CBCT,运用NNT分析软件模拟头颅侧位片与曲面断层片,比较运用曲面断层片与原始石膏模型所测下牙槽弓长度差异,并根据模拟头颅侧位片头影测量结果分析骨性I、Ⅱ及Ⅲ类患者牙槽弓长度的差异。结果：CBCT模拟曲面断层片与石膏模型测量牙槽弓长度无明显差异（P〈O．05）;骨性III类组患者下颌牙槽弓长度比骨性I类组明显较长（P〈O．05）;骨性Ⅱ类组患者下颌牙槽弓长度较骨性I类组较短,但两组差异无统计学意义（P=0．068）。结论：运用CBCT模拟曲面断层片进行牙槽弓长度测量是一种可行的方法;与骨性I类患者相比,骨性Ⅲ类患者常存在一个较长下颌牙槽弓,骨性II类患者下颌牙槽弓长度无明显减小。     

Work experiences among nurses and physicians in the beginning of their professional careers – analyses using the effort–reward imbalance model

Scand J Caring Sci; 2013; 27; 36–43 Work experiences among nurses and physicians in the beginning of their professional careers – analyses using the effort–reward imbalance model The aim of the study was to scrutinise how nurses and physicians, employed by the county councils in Sweden, assess their work environment in terms of effort and reward at the start of their career. The aim was also to estimate associations between work satisfaction and the potential outcomes from the effort–reward imbalance (ERI) questionnaire. The study group, 198 nurses and 242 physicians who graduated in 1999, is a subsample drawn from a national cross‐sectional survey. Data were collected in the third year after graduation among the nurses and in the fourth year after graduation among registered physicians. The effort–reward imbalance questionnaire, together with a question on work satisfaction, was used to evaluate psychosocial factors at work. The results reveal that nurses scored higher on effort, lower on reward and experienced higher effort–reward imbalance, compared with physicians. Women scored higher on work‐related overcommitment (WOC) compared with men. Among the physicians, logistic regression analysis revealed a statistically significant association between WOC and ERI, sex, effort and reward. Logistic regression analysis also revealed a statistically significant association between WOC and ERI and between WOC and effort among the nurses. Dissatisfaction with work was significantly higher among those who scored worst on all three ERI subscales (effort, reward and WOC) and also among those with the highest ERI ratios compared with the other respondents. In conclusion, to prevent future work‐related health problems and work dissatisfaction among nurses and physicians in the beginning of their professional careers, signs of poor psychosocial working conditions have to been taken seriously. In future work‐related stress research among healthcare personnel, gender‐specific aspects of working conditions must be further highlighted to develop more gender‐sensitive analyses.     

Sagittal abdominal diameter and waist circumference appear to be equally good as identifiers of cardiometabolic risk

Background and aimsBody mass index (BMI) and waist circumference (WC) are commonly used markers of cardiometabolic risk. However, sagittal abdominal diameter (SAD) has been proposed as a possibly more sensitive marker of intra-abdominal obesity. We investigated differences in how SAD, WC, and BMI were correlated with cardiometabolic risk markers.Methods and resultsThis cross-sectional study investigated anthropometric and metabolic baseline measurements of individuals from six trials. Multiple linear regression and (partial) correlation coefficients were used to investigate associations between SAD, WC, and BMI and cardiometabolic risk markers, including components of the metabolic syndrome as well as insulin resistance, blood lipids, and lowgrade inflammation.In total 1516 mostly overweight or obese individuals were included in the study. SAD was significantly more correlated with TG than WC for all studies, and overall increase in correlation was 0.05 (95% CI (0.02; 0.08). SAD was significantly more correlated with the markers TG and DBP 0.11 (95% CI (0.08, 0.14)) and 0.04 (95% CI (0.006, 0.07), respectively compared to BMI across all or most studies.ConclusionThis study showed that no single anthropometric indicator was consistently more strongly correlated across all markers of cardiometabolic risk. However, SAD was significantly more strongly correlated with TG than WC and significantly more strongly correlated with DBP and TG than BMI.     

矢状窦、镰旁脑膜瘤的显微外科治疗

目的分析矢状窦、镰旁脑膜瘤患者资料,比较经显微外科治疗及常规手术治疗后所取得的疗效。方法采用回顾性分析的方法,比较显微手术治疗组和常规手术组全手术切除率、死亡率、输血量等指标的差异,以评价两种治疗方式的效果。结果显微手术组全切率75.0%,高于常规手术组的46.4%(P﹤0.05);显微手术组死亡率2.27%,输血量平均(364±120)ml,均低于常规治疗组(P﹤0.05)。结论采用显微手术对矢状窦、镰旁脑膜瘤进行治疗,效果优于常规的手术治疗,术前行头颅CT、MRI等全面的辅助检查,根据肿瘤的具体情况制定相应的手术计划,熟练的显微外科技术的应用是取得良好手术效果的保证。     

Postural instability in Charcot-Marie-Tooth 1A disease

The aim of this study was to evaluate the influence of somatosensory impairment, distal muscle weakness and foot deformities on the balance in 21 CMT1A patients using a baropodometric platform.Stabilometric analysis by measuring sway area and velocity of a centre of pressure (CoP) both at open and closed eyes were used to assess postural imbalance. Static analysis, by measuring the load and the plantar surface of forefoot, midfoot and hindfoot was used to define the footprint shape and to assess as a whole foot deformities. Stabilometric and static results were compared with those of a control group. In CMT1A patients, stabilometric findings were correlated with static parameters, Achilles’ tendon retraction, distal muscle strength and CMT examination score (CMTES). CMT1A patients compared to controls had lower plantar surface and load on midfoot, and higher load on a forefoot. CMT1A patients had a greater postural instability, since they had a higher CoP velocity, both at open and closed eyes. Moreover, the CoP velocity correlated inversely with the strength of ankle dorsi-flexion muscles and directly with CMTES as whole and with the item “motor symptoms legs”. Postural imbalance was not correlated with sensory impairment and foot deformities as expressed by static analysis and Achilles’ tendon retraction.In this study we demonstrated an altered balance in CMT1A patients during upright standing. The imbalance in our CMT patients seems to be related to the weakness of ankle dorsi-flexor muscles rather than sensory impairment or foot deformities. These results could be due to a mildly affected CMT1A population, evaluated in an early stage of the disease.     

A learning method for the class imbalance problem with medical data sets

In medical data sets, data are predominately composed of “normal” samples with only a small percentage of “abnormal” ones, leading to the so-called class imbalance problems. In class imbalance problems, inputting all the data into the classifier to build up the learning model will usually lead a learning bias to the majority class. To deal with this, this paper uses a strategy which over-samples the minority class and under-samples the majority one to balance the data sets. For the majority class, this paper builds up the Gaussian type fuzzy membership function and α-cut to reduce the data size; for the minority class, we use the mega-trend diffusion membership function to generate virtual samples for the class.Furthermore, after balancing the data size of classes, this paper extends the data attribute dimension into a higher dimension space using classification related information to enhance the classification accuracy. Two medical data sets, Pima Indians’ diabetes and the BUPA liver disorders, are employed to illustrate the approach presented in this paper. The results indicate that the proposed method has better classification performance than SVM, C4.5 decision tree and two other studies.     

The sagittal anatomy of the sacrum among young adults,infants, and spondylolisthesis patients

The anatomic pelvic parameter "incidence" - the angle between the line perpendicular to the middle of the sacral plate and the line joining the middle of the sacral plate to the center of the bicoxo-femoral axis - has been shown to be strongly correlated with the sacral slope and lumbar lordosis, and ensures the individual an economical standing position. It is important for determining the sagittal curve of the spine. The angle of incidence has also been shown to depend partly on the sagittal anatomy of sacrum, which is established in childhood while learning to stand and walk. The purpose of this study was (1) to define the relationship between the sacrum and the angle of incidence, and (2) to compare these parameters in three populations: young adults, infants before walking, and patients with spondylolisthesis. Forty-four normal young adults, 32 infants not yet walking and 39 patients with spondylolisthesis due to isthmic spondylolysis underwent a sagittal full-spine radiography. A graphic table and the software for bidimensional study of the sacrum developed by J. Hecquet were used to determine various anatomic and positional parameters. Comparison tests of means, and multiple and partial correlation tests were used. A study of the reliability of the measurements using factorial plan methods was performed. The sagittal anatomic parameters of the sacrum were found to have a close relationship with the pelvic parameter of incidence angle, and therefore with the sagittal balance of the spine. The anatomy of the sacrum in spondylolisthesis patients is particular in that some features are much like those of young infants, but it is more curved and the incidence angle is significantly larger. There is a close relationship between angle of incidence and the slip of spondylolisthesis. All the parameters of young infants are significantly smaller than those of adults. It can be concluded that the sagittal anatomy of the sacrum plays a key role in spinal sagittal balance. The sacral bone is an integral a part of the pelvis and constitutes the undistorted part of the spinal curves. Organization of sagittal curves during growth can be followed up by looking at the sacrum. The sacrum in the spondylolisthesis group differs from the normal, and the greater angle of incidence and sacral slope in this group could predispose to vertebral slip.     

前列腺癌等位基因失衡(英文)

目的 了解前列腺癌克隆演变(clonal evolution)过程中遗传学机制. 方法 采用激光显微切割技术从保存的石蜡包埋组织中获取基因组DNA;利用6个位于染色体8p12-21、8p22、17q21上的具有多态性的微卫星标记,对25例患者原发癌及相应转移灶中等位基因的缺失或保留进行分析. 结果 在24例可供信息的病例中,14例(58%)在原发癌及相应转移灶中所有位点均表现为相同的等位基因缺失或保留模式,而另外10例(42%)则显示不一致的等位基因缺失.这10例中有5例原发癌表现为等位基因保留而在相应转移灶则为缺失,另外5例在一个或一个以上的位点表现为原发癌等位基因缺失而在相应转移灶保留. 结论 前列腺癌在原发癌及相应转移灶遗传组成上的差异可能与其内在异质性、整体遗传不稳定性及克隆差异有关.     

严重烧伤后不同时段酸碱失衡类型变化的探讨

目的 :探讨严重烧伤病人在伤后不同时段 (伤后 1～ 3天、 4～ 1 0天、 >1 0天 )发生酸碱失衡类型的变化 ,分析其发生的原因及机理。方法 :利用新的酸碱失衡四步判断法对我科 1 990年 1月至 2 0 0 1年 1 2月住院的 1 5 3例严重烧伤病人同步检测的血气分析和电解质结果进行分析判断。结果 :(1 )全组患者除 1 6例酸碱失衡类型属正常外 ,其余 1 37例中 ,单纯性酸碱失衡类型 4 4例 ,其中以呼吸性碱中毒 (呼碱 )最多 ,2 3例 ;双重性 5 7例 ,以呼吸性碱中毒并代谢性酸中毒 (代酸 )为主 ,2 3例 ;三重性 36例 ,以呼吸性碱中毒并高阴离子间隙 (AG)代酸并代谢性碱中毒 (代碱 )为主 ,共 2 3例。 (2 )在休克期 (伤后 1～ 3天 )以单纯性酸碱失衡类型为主 ,最多见的类型是代谢性酸中毒 (1 4例 ) ,在水肿回收期 (伤后 4～ 1 0天 )与修复期 (伤后 1 0天以后 )均以双重性酸碱失衡类型为主 ,但最多见的类型分别是呼碱 (9例 )与呼碱并代碱 (5例 )。结论 :严重烧伤患者在伤后不同时段的酸碱失衡类型比较复杂 ,烧伤休克期的酸碱失衡类型最多 ,修复期最少。发生率最多的是呼碱、呼碱并代酸以及呼碱并高阴离子间隙代酸并代碱。在各时段中 ,三重性酸碱失衡并不少见 ,以呼碱并高AG代酸并代碱为主。     

心肌梗死与心包经双侧经络电阻抗失衡的相关研究

目的　探讨心肌梗死与心包经双侧经络电阻抗的相互关系 ,寻求无创伤性临床疾病的早期诊断。方法测量左右侧心包经上的内关穴与三阴交穴位之间的电流波形 ,计算其电阻抗值。结果　观察组显示两侧电阻抗差别有显著性意义 (P <0 0 1) ;对照组两侧差别无显著性意义 (P >0 0 5 )。结论　正常人双侧经络电阻抗的对称性、经络循行线的低阻性及双侧经络电阻抗失衡与其络属脏器病变有着密切的相关性 ,此项测定可能为心脏疾病提供一种新的早期诊断的方法。