恒磨牙邻面龋充填治疗的疗效评价

目的：评价用银汞合会、町乐丽菲露AP-X复合树脂及Beautifil氟化玻璃聚合体对恒磨牙邻面龋进行充填治疗的临床效果。方法：选择58-71岁门诊患者176例416颗恒磨牙邻面龋患牙，按龋损部位分为龈缘组和龈上组，每组随机分为3组，分别用银汞合金、可乐丽菲露AP-X及Beautifil氟化玻璃聚合体按各闩洞型制备要求备涧后进行充填。银汞合金组深龋用聚羧酸锌水门汀垫底后充填；可乐丽菲露AP-X组及Beautifil氟化玻璃聚合体组深龋用Ionosit-Baseliiler垫底后充填。随访18-24个月观察治疗效果。结果：患者复查回访率为86．93％。龈缘组中，银汞合金组成功率92．31％；可乐丽菲露AP-X组成功率92．65％；Beautifil氟化玻璃聚合体组成功率87．76％。经χ2检验，3组差异均兀显著性。龈上组中，银汞合金组成功率91．30％；町乐丽菲露AP—X组成功率97．44％；Beautifil氟化玻璃聚合体组成功率95．77％。经χ2检验，3组差异均无显著性。结论：银汞合金、可乐丽菲露AP-X及Beautifil氟化玻璃聚合体修复恒磨牙邻面龋的临床嫂果良好，3组之间无明显茺异。     

维生素D3衍生物对人成骨细胞生长和碱性磷酸酶活性的影响

目的：使用人胎成骨细胞（ＯＢ）为体外模型，观察了１，２５－双羟维生素Ｄ３〔１，２５（ＯＨ）２Ｄ３〕、２４，２５－双羟维生素Ｄ３［２４，２５（ＯＨ）２Ｄ３）］对ＯＢ生长和代谢的影响。方法：用ＡＬＰ测定法和Ｂｒａｄｆｏｒｄ蛋白含量法。结果：１，２５（ＯＨ）２Ｄ３在浓度为１０８ｍｏｌ／Ｌ时，刺激碱性磷酸酶（ＡＬＰ）的活性。但抑制ＯＢ的生长。２４，２５（ＯＨ）２Ｄ３在１０－８ｍｏｌ／Ｌ时无上述作用。结论：１，２５（ＯＨ）２Ｄ３对ＯＢ的ＡＬＰ有直接的促活作用，其作用与时间相关。２４，２５（ＯＨ）２Ｄ３对ＯＢ的ＡＬＰ活性无关。１，２５（ＯＨ）２Ｄ３对人胎ＯＢ生长有抑制作用。     

18F-FDG PET显像在头颈肿瘤诊断中的作用评价

目的:比较~(18)F脱氧葡萄糖正电子发射体层显像(~(18)F-FDG PET)与CT/MRI检查在头颈肿瘤诊断中的应用价值。方法:54例头颈肿瘤患者在术前2周分别进行PET与CT、MRI检查,以病理结果为金标准,分析2种方法在敏感度、特异度及准确率方面的差异,采用SPSS13.0软件包对数据进行X~2检验。结果:PET和CT、MRI分别准确判断了54例肿瘤中的48和43例,PET在敏感度、特异度及准确率方面分别比CT、MRI高7.4%、15.3%和9.3%,但差异均无显著性。结论:PET在头颈肿瘤诊断的敏感度、特异度及准确率方面优于CT、MRI,但结果无统计学差异。     

Potential risk of mitomycin Cat high concentrations on peripheral nerve structure

Although the local application of mitomycin C may prevent epidural adhesion after laminectomy, mitomycin C can induce neurotoxicity in optic and acoustic nerves at high concentrations. To determine the safe concentration range for mitomycin C, cotton pads soaked with mitomycin C at different concentrations(0.1, 0.3, 0.5, and 0.7 mg/mL) were immediately applied for 5 minutes to the operation area of rats that had undergone laminectomy at L1. Rat sciatic nerves, instead of dorsal nerves, were used in this study. The results showed that mitomycin C at 0.1–0.5 mg/mL did not damage the structure and function of the sciatic nerve, while at 0.7 mg/mL, mitomycin C significantly reduced the thickness of the sciatic nerve myelin sheath compared with lower concentrations, though no functional change was found. These experimental findings indicate that the local application of mitomycin C at low concentrations is safe to prevent scar adhesion following laminectomy, but that mitomycin C at high concentrations( 0.7 mg/mL) has potential safety risks to peripheral nerve structures.     

术中 X-线定位在神经内镜切除甲介型蝶窦垂体瘤手术中的应用简

目的探讨术中x-线定位在经神经内镜下甲介型蝶窦垂体瘤手术的应用。方法回顾性分析6例甲介型蝶窦垂体瘤病人的临床资料,均采用神经内镜下垂体瘤切除结合术中X-线定位方法。结果术中X-线定位准确4例;2例发生纵向偏差,均纠正。肿瘤全切除5例,次全切除1例。术后激素水平正常,视力视野改善。出现暂时性尿崩1例,治疗后痊愈。无脑脊液鼻漏、垂体功能低下、蝶窦炎发生,无死亡病例。6例病人随访3年,均无复发。结论神经内镜技术结合术中X-线定位是一种治疗甲介型蝶窦垂体瘤的安全、有效方法。     

轻中型颅脑损伤后认知功能障碍的DTI研究

目的应用弥散张量成像(diffusion tensor imaging,DTI)技术探讨轻中型颅脑损伤病人不同部位脑白质微结构改变与其认知功能障碍的相关性。方法分析127例轻中型颅脑损伤病人的临床资料,伤后10 d采用蒙特利尔认知评估量表(Mo CA)评定有无认知功能障碍,并常规行头颅MRI检查,采集DTI数据,测量两侧额叶、颞叶内侧、顶叶,胼胝体膝部和压部,中脑部位的感兴趣区各向异性分数(FA值)、表观弥散系数(ADC值),并与Mo CA评估结果进行相关性分析。结果以Mo CA量表为标准评定,无认知功能障碍41例(32.28%,无认知障碍组),存在认知功能障碍86例(67.72%,认知障碍组),主要表现为视空间与执行功能、注意力和计算力、语言、抽象能力、延迟记忆的障碍。与无认知障碍的病人相比,认知障碍的病人两侧额叶、颞叶内侧、胼胝体膝部FA值降低,ADC值增加,差异具有统计学意义(P0.01)。结论轻中型颅脑损伤病人早期存在显著认知功能障碍,以视空间与执行功能、注意力和计算力、语言、抽象能力、延迟记忆障碍为主。颅脑损伤后早期认知功能障碍与病人额叶、颞叶、胼胝体白质受损密切相关。     

【特刊综述】雄激素对骨骼肌的作用：对乏力的发展和治疗的意义

雄激素对骨骼肌合成有明显影响,随着年龄增大,雄激素的下降常伴随肌量和肌力的下降。这种肌量和肌功能的下降,被称为少肌症或肌体老化,是老年人体质弱化（男性化减退）进展的关键事项。也是导致快速机能衰退及其不良后果的关键。雄激素水平下降对老年男性体质弱化（男性化减退）的潜在影响和对躯体功能的促进治疗作用无疑已经引起了相当的关注。本综述概述了近期关于肌肉老化、少肌症、老年体质弱化的概念、定义,并评估了关于雄激素和老年体质弱化的研究进展。近期源于观测性和介入性研究的证据强烈支持雄激素对老年男性肌量的作用,但雄激素对肌力和特有的躯体功能的效用并不明确。研究显示,雄激素治疗在老年男性中通常有良好的耐受性,而近期的研究则关注于雄激素的高剂量治疗和对于心血管风险较高人群的治疗。雄激素受体调节剂（SARMs）的初期试验研究显示传统雄激素治疗对于老年患者在肌量和肌功能方面有相同的效用。将来的重要研究方向包括利用这类雄激素治疗并结合适用于不同老年患者群体促进躯体功能的运动训练,同时将更多地关注近期关于激素水平、身体成分及躯体功能间关系的观测性（回顾性）研究。     

补阳还五汤治疗中风后肢体痉挛的随机单盲对照研究

目的:探究补阳还五汤治疗中风后肢体痉挛的临床效果,研究作用机制、提高疗效、改善患者生命质量。方法:选取2015年8月至2018年7月南宁市中医医院收治的中风后肢体痉挛患者112例作为研究对象,按照入组先后顺序分成对照组和观察组,每组56例。2组均营养脑细胞、控制血压、调节血脂治疗,对照组辅助康复治疗,观察组加用补阳还五汤治疗,均治疗4周,观察治疗前、完成治疗后Fugl-Meyer功能量表、日常生活能力积分(ADL)、神经功能缺损程度(NDS)、改良Ashworth量表、肌电图、血液流变学(包括全血黏度、血浆黏度、纤维蛋白原、血小板聚集指数、红细胞变形指数)、神经元指标甘氨酸(Gly)、γ-氨基丁酸(GABA)变化并比较,完成治疗后总结疗效情况。结果:1)完成治疗后2组Hmax、Mmax、H/Mmax较治疗前均显著下降(P0.05),完成治疗后观察组以上指标均显著低于对照组(P0.05)。2)完成治疗后2组Fugl-Meyer功能量表、ADL较治疗前均显著升高,NDS、改良Ashworth量表较治疗前显著下降(P0.05),完成治疗后观察组NDS评分、改良Ashworth量表显著低于对照组,余显著高于对照组(P0.05)。3)完成治疗后2组全血黏度、血浆黏度、纤维蛋白原、血小板聚集指数、红细胞聚集指数较治疗前均显著下降(P0.05),完成治疗后观察组以上指标均显著低于对照组(P0.05)。4)完成治疗后2组Gly、GABA较治疗前均显著下降(P0.05),完成治疗后观察组以上指标均显著低于对照组(P0.05)。5)完成治疗后观察组治愈率、总有效率显著高于对照组(P0.05)。结论:补阳还五汤能提高中风肢体痉挛神经元生长水平,促进血液循环,从而缓解痉挛症状,提高生命质量。     

The Relationship between Recent Stressful Life Events,Personality Traits,Perceived Family Functioning and Internet Addiction among College Students

Internet addiction (IA) is an emerging social and mental health issue among youths. Analysis of risk factors, as well as their interactions, is crucial for understanding the development of IA. This study investigated the relationship between recent stressful life events, personality traits, perceived family functioning and IA in 892 college students. Subjects were classified into categories (non‐addicted, mild IA or severe IA) using the Chen Internet Addiction Scale. Stressful life events, personality traits and family functioning were assessed using the Adolescent Self‐Rating Life Events Checklist, the Eysenck Personality Questionnaire, and the Family Adaptability and Cohesion Scale, respectively. The results indicated that compared with non‐addicted subjects, subjects with severe IA (9.98%) had lower family functioning, lower extraversion, higher neuroticism and psychoticism, and more stressful life events, and subjects with mild IA (11.21%) had higher neuroticism and more health and adaptation problems. Neuroticism and health and adaptation problems were potential predictors of IA. An interaction effect between psychoticism and total life stress on IA was also found. These findings highlight the role of personality traits and life stress and their interactions in college students' IA. Further research should explore the mechanisms underlying the interaction effect of psychoticism with life stress on IA. Copyright © 2013 John Wiley & Sons, Ltd.     

Individualized endovascular treatment of high-grade traumatic vertebral artery injury

Background

Traumatic vertebral artery injury (TVAI) is associated with craniocervical trauma that can lead to potentially fatal posterior circulation stroke. It presents a clinical challenge since it is hard to detect and there are no widely accepted guidelines on diagnosis and management. High-grade TVAI is more difficult to treat and no consensus has been reached yet.

Methods

We performed a single-center, long-term, therapeutic study involving 272 patients with craniocervical injury, eleven of which were diagnosed with high-grade TVAI. Individualized endovascular treatments were performed on these patients based upon the hemodynamic and morphological characteristics of the injured vertebral artery. Postoperative angiography was conducted at 2 weeks, 3 months and 6 months, and then annually after intervention.

Results

Ten vertebral pseudoaneurysms and one arteriovenous fistula (AVF) were confirmed by postoperative angiography. All the participants’ neurological deficit symptoms disappeared or were significantly alleviated gradually, and no new symptoms were found after endovascular treatment. Follow-up angiography of the patients with pseudoaneurysms showed a normally shaped vertebral artery with no stenosis or aneurysms; the angiographic result of the patient with the AVF presented successful embolization in the proximal vertebral artery fistula with no progression or new stenosis. Their modified Rankin Scale (mRS) scores were also satisfactory.

Conclusions

Application of individualized endovascular therapy in high-grade TVAI is safe, technically feasible and clinically effective, but there is no comparison between endovascular management and other management approaches because randomized trials cannot be carried out currently.