Periodontal conditions among the middle-aged and the elderly in Hong Kong

Abstract The aim of this study was to describe the periodontal conditions in 372 35–44-yr-old and 537 noninstitutionalized 65–74-yr-old Hong Kong Chinese who were examined clinically for loss of attachment, recession, probing depth, calculus, and bleeding after probing. Community Periodontal Index (CPI) data and treatment need indications were compiled from index teeth or their substitutes. The prevalence of loss of attachment varied considerably in both cohorts according to the definition of the threshold (≥6, ≥9, and ≥12 mm, respectively). The mean numbers of teeth with loss of attachment at the ≥6-mm threshold and at higher thresholds were small. In both age cohorts, about one-fifth of subjects had probing depths ≥6-mm, while al the ≥9-mm threshold only 2–3% were so affected. Although recession was an important component of loss of attachment in the younger cohort, in the older cohort the prevalence and extent of recession were greater than for probing depths at thresholds ≥4 mm. All subjects had one or more teeth with calculus, bleeding, or both, most teeth being so affected. Eighty-four of the 537 65–74-yr-old subjects were excluded either because of edentulousness or because extractions indicated for the remaining teeth would have rendered the subjects edentulous. The distribution of subjects according to their highest CPI score was remarkably similar for the two cohorts. No subjects in either age group were assessed as “healthy” (CPI code 0) or had “bleeding only” (code 1) as their highest score. While most subjects scored CPI code 2 or 3 us their highest score, only 17% of the younger and 15% of the older cohort scored Community Periodontal Index of Treatment Needs (CPITN) code 4. Differences in the mean number of sextants affected by CPI codes between the two cohorts were mainly due to a greater number of excluded sextants in the older cohort. CPI findings for 35–44-yr-olds differed little from those reported in 1984.     

‘Translation is not enough’: using the Global Person Generated Index (GPGI) to assess individual quality of life in Bangladesh,Thailand, and Ethiopia

Currently few subjective measures of Quality of Life (QoL) are available for use in developing countries, which limits their theoretical, methodological, and practical contribution (for example, exploring the relationship between economic development and QoL, and ensuring effective and equitable service provision). One reason for this is the difficulty of ensuring that translated measures preserve conceptual, item, semantic, operational, measurement; and functional equivalence (Herdman, M., Fox-Rushby, J., & Badia, X. (1998). Quality of Life Research, 7, 331), which is illustrated by an account of the translation, pre-piloting, and administration of a new individualised QoL measure, the Global Person Generated Index or 'GPGI'. The GPGI is based on the widely used Patient Generated Index (Ruta, Camfield, & Martin, (2004) Quality of Life Research, 13, 1545.) and offers many of the advantages of the participatory approaches commonly used in developing countries, with added methodological rigour, and quantitative outcomes. It was successfully validated in Bangladesh, Thailand, and Ethiopia, using quantitative and qualitative methods--open-ended, semi-structured interviews (SSIs), conducted immediately post-administration. Both the measure and method of 'qualitative validation' described later in the paper offer an exciting alternative for future researchers and practitioners in this field. The quantitative results suggest the GPGI shows cultural sensitivity, and is able to capture both the areas that are important to respondents, and aspects of life one would expect to impact on QoL in developing countries. There were strong correlation between scores from the GPGI and SSIs for the area of health, and moderate correlations for 'material wellbeing' (MWB)('Material wellbeing' refers to respondents' perceptions of their achievement in the areas of farming, debt reduction, assets, crops, livestock, job, land, property, and agriculture) and children. Weak to moderate correlations were observed between the Satisfaction with Life Scale and the GPGI; however, the highest coefficient was between the GPGI and the most conceptually similar item. Statistically significant differences were seen in GPGI scores between rich and poor, urban and rural respondents, and different countries. Health and material wellbeing scores, derived from the SSIs, also showed a linear relationship with GPGI scores, with a suggestion of curvilinearity at the higher levels, as predicted by a general QoL causal model. In conclusion, the GPGI has great potential for use in this area, especially when supported by extensive interviewer training, and supplemented with a cognitive appraisal schedule.     

CPM在髌骨骨折张力带内固定术后的应用

目的 探讨CPM在髌骨骨折改良张力带内固定术后的应用效果。方法 早期应用CPM治疗髌骨骨折行改良张力带内固定术后病人156例。结果 所有病例均得到随访，临床疗效优良率为98％。结论 在髌骨骨折行改良张力带内固定术后早期应用CMP，可显著利于膝关节功能恢复，提高治愈率。     

持续靶控输注异丙酚复合硬膜外麻醉用于上腹部手术探讨

目的:评价持续靶控输注异丙酚复合硬膜外阻滞有用于上腹部手术的可行性。方法:30例胃癌手术患者,ASAⅠ～Ⅱ级。随机分成靶控输注异丙酚全麻(T)组15例,靶控异丙酚复合硬膜外阻滞(T+E)组15例。结果:(T+E)组术后躁动、芬太尼、丙泊酚的用量低于(T)组(P<0.05)。异丙酚单位标准化剂量亦较低。两组苏醒时间相似。诱导后两组血压均显著下降(P<0.05),T+E组在诱导后DBP的下降幅度较T组更为显著(P<0.05),T组在探查、术毕、拨管后的SBP、DBP、MAP比(T+E)组显著增高(P<0.05)。两组诱导后至术毕BIS、SEF显著下降,两组间的比较无统计学意义(P>0.05)。结论:靶控输注异丙酚复合硬膜外阻滞用于上腹部手术是可行的,具有异丙酚、芬太尼的用量少、苏醒快、术后躁动少,麻醉深度易于调控,血液动力学较稳定,是一种良好的麻醉方式。     

改良超滤技术在体外循环中的应用

目的　观察改良动、静脉超滤技术在体外循环 (CPB)中作用及效果。方法　 4 8例病人随机分为两组 ,各 2 4例 ,超滤组于CPB停机后 ,待血液动力学基本稳定时 ,使体内血液经动脉供血管经超滤器超滤后进入右房。对照组不行改良动、静脉超滤。结果　术后输入库血量对照组 5 90ml,超滤组 310ml(P <0 .0 1)。超滤组平均滤出液5 4 0ml,术后血细胞比容、血小板、血浆蛋白、纤维蛋白与超滤前比速度增高 (P <0 .0 1)。结论　改良动、静脉超滤技术有利于术后多余水分排出 ,可减少术后并发症和输血量 ,适用于小体重、血液稀释度大的婴幼儿和长时间CPB者。     

改良Hardinge入路在非骨水泥全髋置换术中的应用

目的：对改良Hardinge入路行全髋置换进行评价。方法：对经改良Hardinge入路行非骨水泥全髋置换（THR－CL）术并获术后6个月以上随访的32例病人进行总结。结果：优良28例（88％），很好4例（12％），其中轻度跛行6例（19％），下肢不等长＞2cm1例（3％），改良Trendelenburg试验阳性3例（10％）。结论：此入路创伤小，暴露好，利于假体定位，易于控制下肢长度，术后外展肌功能恢复快。     

Mr imaging of hepatic nodular regenerative hyperplasia

Nodular regenerative hyperplasia (NRH), a rare condition that is commonly associated with noncirrhotic portal hypertension, is not well described in the MR literature. Three patients at two institutions were identified who had both abdominal MR imaging and pathologic evidence of NRH. All examinations were performed at 1.5 T and included axial T1- and T2-weighted spin-echo (SE) images. The MR studies were reviewed by two radiologists in consensus. Two patients had multiple liver lesions that had high signal components on T1-weighted images and were predominantly isointense with liver on the T2-weighted images. One patient had no focal lesions identified. NRH, when visualized on MR images, appears as multifocal masses with shortened Tl and T2 similar to liver. NRH should be considered in the differential diagnosis of hepatocellular tumors, especially in patients with a predisposing condition.     

效益评价中指标筛选及其假设检验

西文介绍了综合效益评价中指标的逐步筛选及其假设检验方法，用该法选出的指标具有独立性强、代表性好的优点。同是分析处理了全国３４家县级医院的投入指标，从中筛选出５个指标参与评价。     

改良松解术式治疗耻骨直肠肌综合征的临床观察(附31例报告)

目的:观察改良松解术式治疗耻骨直肠肌综合征的临床效果。方法:2004~2005年采用肛门后横切口耻骨直肠肌全束部分切断术治疗耻骨直肠肌综合征31例。结果:手术总有效率为96·8%。平均住院时间(10·58±2·35)d,平均切口愈合时间(12·16±2·08)d。结论:采用肛门后横切口耻骨直肠肌全束部分切断术的方法疗效确切,具有并发症少、切口愈合时间快和住院时间短的优点。