前牙桩冠修复的临床体会

目的观察玻璃纤维桩与铸造金属桩在前牙桩冠修复中的临床疗效。方法2005—2010年对93例患者口内的176颗经完善根管治疗的前牙行桩冠修复。随即分成两组,牙体缺损位于龈缘上的采用玻璃纤维桩,牙体缺损位于龈缘下的采用铸造桩。结果桩冠修复后3年,玻璃纤维桩失败2例,均为冠脱落。铸造桩失败3例,其中冠脱落l例,桩核脱落1例,根折1例。缡论玻璃纤维桩修复牙体缺损位于龈缘上前牙和铸造桩修复牙体缺损位于龈缘下的前牙时,均可以获得良好的临床修复效果。     

病案首页主要诊断的选择

介绍并分析了病案首页主要诊断数据采集现状,阐述了正确选择和填写病案首页主要诊断的重要性.同时还介绍了如何正确选择主要诊断,明确了主要诊断的定义,主要诊断选择的原则.此外,还介绍了一些在正确选择主要诊断方面的一些体会.这些内容旨在针对目前主要诊断的状况及存在的问题进行分析,以帮助医务人员在工作中正确填写主要诊断.     

Z350纳米树脂美容修复前牙的疗效分析

目的了解使用Z350纳米树脂进行前牙修复美容的方法,探讨Z350纳米树脂对前牙修复美容的疗效。方法将100例需进行前牙修复美容者随机分为两组,每组各50例。观察组使用Z350纳米树脂进行前牙修复美容,对照组使用Z250复合树脂治疗前牙修复美容,观察修复完成及1年后的医生及患者的满意度及临床疗效,然后进行对比研究。结果修复美容完成时两组的医生和患者满意度及修复完成与修复完成1年后的观察组满意度没有显著差异,P>0.05,而修复美容1年后的对照组组内及两组的医生和患者满意度均存在显著差异,P<0.05;且两组手术成功率也存在显著差异,P<0.05。结论使用Z350纳米树脂进行前牙修复美容成功率高,医患满意度高,值得临床推广。     

A Phase II Study of Midostaurin and 5-Azacitidine for Untreated Elderly and Unfit Patients With FLT3 Wild-type Acute Myelogenous Leukemia

BackgroundMidostaurin, a multikinase inhibitor, is approved for treatment of FLT3-mutant acute myeloid leukemia (AML). A phase I study established that midostaurin 75 mg orally twice daily for 14 days with standard dose azacitidine was safe and tolerable in elderly patients with AML. Herein, we report the phase II expansion cohort of previously untreated elderly or unfit patients with AML.Patients and MethodsPrimary objectives were to further describe the toxicity profile and determine the response rate in untreated patients with AML. Patients received midostaurin 75 mg orally twice daily on days 8 to 21 in combination with intravenous azacitidine at 75 mg/m² on days 1 to 7. Plasma inhibitory activity assay for FLT3 was performed pretreatment and on day 8 and day 15 of each cycle.ResultsTwenty-six patients (median age, 74 years; range, 59-85 years) with FLT3 wild-type AML were accrued. Patients received a median of 2 cycles of therapy (range, 1-10 cycles). Seven (29%) of 24 evaluable patients achieved a clinical response (4 complete response; 1 complete response with incomplete count recovery; and 2 partial response). The median overall survival was 244 days (95% confidence interval, 203-467 days). Hematologic, infectious, and gastrointestinal toxicities were comparable to similar studies. Peripheral blood FLT3 wild-type phosphorylation declined to 8% to 55% of pretreatment by day 15 of cycle 1 (7 patients) and declined with subsequent cycles (< 10% baseline) in 2 patients who were analyzed after cycle 3.ConclusionMultiple cycles of azacitidine and midostaurin were not well-tolerated, but persistent inhibition of FLT3 wild-type phosphorylation suggest intermittent dosing of midostaurin should be considered in future low-intensity regimens for FLT3-mutant AML.     

Foot manifestations in a patient with COVID-19 and Epstein-Barr virus: A case study

SARS-CoV-2 (COVID-19) is highly-contagious. It can lead to respiratory distress—and in some cases—death. Recent reports and observations have identified an association between COVID-19 and manifestations in the feet. However, there are very few reports that describe the course of these foot manifestations in any detail. The authors present a case study chronicling the progression of foot issues in a COVID-19 positive patient who also was positive for the Epstein-Barr virus.     

卿氏湿疹疱洗方2号治疗血虚风燥型手足慢性湿疹临床疗效观察

目的:探讨卿氏湿疹泡洗方2号对血虚风燥型手足慢性湿疹的效果。方法:选取我院2018年1月-2018年9月血虚风燥型手足慢性湿疹患者116例,根据治疗方案不同分为研究组(58例)和参照组(58例),参照组给予卤米松乳膏联合尿素乳膏,研究组给予卿氏湿疹疱洗方2号联合尿素乳膏,比较两组治疗效果、治疗前后湿疹面积及严重度指数(Eczema Area and Severity Index,EASI)、皮肤病生活质量指数(Dermatology life uality Index,DLQI)及不良反应。结果:研究组治疗总有效率为94.83%(55/58),高于参照组82.76%(48/58)(P<0.05);两组治疗后EASI、DLQI评分均低于治疗前,且研究组低于参照组(P<0.05);两组均未见严重不良反应。结论:卿氏湿疹泡洗方2号治疗血虚风燥型手足慢性湿疹患者疗效确切,可明显改善临床症状,缩小湿疹面积,提高患者生活质量,且不增加不良反应,安全性高,值得临床推广应用。     

Percutaneous minimal invasive Achilles tendon lengthening improves clinical and radiographic outcomes in severe flexible flatfeet with shortened triceps sureae complex in early childhood: A retrospective study

BackgroundSevere flexible flatfeet with triceps surae complex shortening are prognostically unfavorable in early childhood and may compromise normal foot development.MethodsThis retrospective, IRB-approved study included 20 children (38 feet) under 6 years with severe flexible flatfeet and triceps surae complex shortening. Treatment included minimally invasive percutaneous achilles tendon lengthening followed by a 4-week cast fixation and corrective orthotic therapy under talo-navicular reposition for at least 6-months. Preoperative weightbearing x-rays and at the last available follow-up included anteroposterior talus-first metatarsal angle and lateral talus pitch, Meary’s and talocalcaneal angle and were compared to reference values. ROM, surgeon-rated clinical outcomes and complications/re-interventions were evaluated.ResultsAge at surgery was 3.7 years (1.3–5.9 y) and follow-up time was 4.3 years (1.1–8.9 y). No complications occurred. Clinical outcome was good (68 %) to very good (26 %). Ratio of normal angles increased significantly for three angles. Dorsiflexion ROM improved from ?5.0 ± 6.8° at baseline to 15.7 ± 7.6°.ConclusionsWith significant improvements in clinical and radiographic outcomes, minimal-invasive percutaneous Achilles tendon lengthening followed by orthotic therapy seems to be a valuable treatment option for selected preschool-aged patients with severe, flexible flatfeet with significantly shortened triceps surae.Level of EvidenceIV     

注射用A型肉毒毒素联合眼袋整形术治疗眼周皮肤松弛的临床效果

目的 探讨注射用A型肉毒毒素联合眼袋整形术治疗眼周皮肤松弛的效果。方法 选择我院2020年 6月-2022年6月收治的1200例眼周皮肤松弛患者为研究对象,按照随机数字表法分为对照组与观察组, 各600例。对照组使用眼袋整形术治疗,观察组使用注射用A型肉毒毒素联合眼袋整形术治疗,比较两组 临床疗效、并发症发生情况、术后鱼尾纹、睑袋发生情况及满意度。结果 观察组皮肤色泽增强率、睑 袋减轻率、鱼尾纹改善率高于对照组（P＜0.05）;观察组并发症发生率低于对照组,但差异无统计学意 义（P＞0.05）;观察组动态、静态时睑袋及鱼尾纹发生率均低于对照组（P＜0.05）;观察组满意度高于对 照组（P＜0.05）。结论 在眼袋整形术治疗眼周皮肤松弛的基础上给予注射用A型肉毒毒素可进一步提高治 疗效果,促使皮肤色泽改善,预防鱼尾纹、睑袋发生,美学效果及患者满意度较高,值得临床应用。     

Deleterious de novo variants of X‐linked ZC4H2 in females cause a variable phenotype with neurogenic arthrogryposis multiplex congenita

Pathogenic variants in the X‐linked gene ZC4H2, which encodes a zinc‐finger protein, cause an infrequently described syndromic form of arthrogryposis multiplex congenita (AMC) with central and peripheral nervous system involvement. We present genetic and detailed phenotypic information on 23 newly identified families and simplex cases that include 19 affected females from 18 families and 14 affected males from nine families. Of note, the 15 females with deleterious de novo ZC4H2 variants presented with phenotypes ranging from mild to severe, and their clinical features overlapped with those seen in affected males. By contrast, of the nine carrier females with inherited ZC4H2 missense variants that were deleterious in affected male relatives, four were symptomatic. We also compared clinical phenotypes with previously published cases of both sexes and provide an overview on 48 males and 57 females from 42 families. The spectrum of ZC4H2 defects comprises novel and recurrent mostly inherited missense variants in affected males, and de novo splicing, frameshift, nonsense, and partial ZC4H2 deletions in affected females. Pathogenicity of two newly identified missense variants was further supported by studies in zebrafish. We propose ZC4H2 as a good candidate for early genetic testing of males and females with a clinical suspicion of fetal hypo‐/akinesia and/or (neurogenic) AMC.     

温水浸足降温55例临床分析

采用低于体温2℃～3℃的温水浸足降温法,观察55例多种原因引起的高热病人降温情况,并与常规物理降温50例进行效果比较。结果浸足降温有效率为94.6%,对照组为84.0%,差异有显著性(P＜0.05)。且观察组降温后60　min体温回升率为47.3%,常规组为56.0%。提示温水浸足降温法可用于高热病人降温。