预防矫治后前牙旋转拥挤复发的临床研究

目的　评价改良嵴上纤维切断术(MSF)及邻面去釉接触区成形术(CPR)防止矫治后前牙旋转拥挤复发的有效性及可行性。方法　129例前牙旋转拥挤患者随机分为实验组和对照组。对照组81例仅作固定矫治;实验组 48例患者除作固定矫治外,其中23例行上下前牙MSF和CPR,余25例只作上下前牙MSF;术后3组均戴维持器1·8~ 2·3年。所有患者在安放固定矫治器前(T1期)、去除固定矫治器时(T2期)和去维持器后2·4年(T3期)各取牙模1副, 比较3组患者的不整齐指数(IRID)。结果　实验组拥挤旋转复发率平均低于对照组21·6%(P<0·001);实验组内:双因素组(MSF+CPR)下颌复发率较单因素组(MSF)低6·56%(P<0·05),但两组在防止上颌拥挤复发上无显著性差异 (P>0·05)。结论　MSF能较有效地防止矫治后前牙拥挤旋转复发,MSF配合CPR对维持下前牙矫治后的稳定具有显著效果。     

Threshold properties of single motor units in superior head of human lateral pterygoid muscle

The superior head of the human lateral pterygoid muscle (SHLP) may play a similar role in jaw movement as the inferior head (IHLP). OBJECTIVE: The aim was to determine whether threshold properties of single motor units (SMUs) within SHLP during jaw tasks were comparable to those identified for IHLP. DESIGN: In 24 human subjects, SMUs were recorded intramuscularly from computer-tomography verified sites within SHLP during standardised jaw tasks recorded by a jaw-tracking device. RESULTS: Of the 69 SMUs discriminated, 54 were active during contralateral, 52 during protrusive and 8 during ipsilateral jaw movements. The thresholds, at which SMUs commenced firing, decreased (p<0.05) as speed of contralateral or protrusive tasks increased. The data suggest an important role for SHLP in generation and control of contralateral and protrusive jaw movements. A number of lines of evidence were consistent with functional heterogeneity within SHLP. CONCLUSIONS: The similarities in SHLP and IHLP functional properties support the proposal that both heads should be regarded as a system of fibers acting as one muscle.     

纸尖法和刮匙法对龈下牙周致病菌检出比较研究

目的：比较纸尖法和刮匙法对慢性牙周炎患者龈下菌斑中牙龈卟啉单胞菌、福赛斯坦纳菌、伴放线菌嗜血菌、具核梭杆菌检出的影响。方法：对30例慢性牙周炎患者分别用纸尖和刮匙法收集4个区域牙周袋探诊最深位点龈下菌斑，采用16SrRNAPCR方法检测两种方法收集到的龈下菌斑样本中的牙龈卟啉单胞菌、福赛斯坦纳菌、伴放线菌嗜血菌、具核梭杆菌。结果：两种方法一致性较好，纸尖法与刮匙法无显著差异（P〉0．05）。结论：纸尖法与刮匙法均为比较准确的取样方法。     

根管充填质量与临床疗效观察

目的：对试尖后根管充填患牙进行临床疗效观察。方法：随机选取2006～2007年完成的根管充填病例共486个患牙X线片及临床资料,按试尖与未试尖分成实验组263个牙和对照组223个牙,通过对比充填内1周疼痛发生率观察两组根管充填质量。结果：①实验组和对照组恰填、超填和欠填率分别为88.97%和72.65%、4.18%和15.25%及6.84%和12.11%。恰填率和超填率两组间有统计学差异（p〈0.05）。②实验组和对照组无痛率、可自愈疼痛率和非自愈疼痛率分别为90.11%和79.82%、9.13%和14.80%及1.14%和4.93%。无痛率和非自愈疼痛率两组间有统计学差异（p〈0.05）。③两组恰填率与无痛率呈负相关（p〈0.05）。结论：试尖可明显提高根管充填质量,提高近期临床治疗效果。     

Comparison of bleaching effects when applied to white-spot lesions before or after resin infiltration: An in vitro study

BackgroundThe purpose of this study was to compare color alterations (ΔE) of white-spot lesions (WSLs) bleached before versus after resin infiltration (RI).MethodsUsing the facial surfaces of bovine maxillary incisors, WSLs were created and the teeth were allocated into 2 groups (n = 45/group): bleach then RI (B-RI group) and RI then bleach (RI-B group). To determine ΔE, Commission Internationale de l’Eclairage L1 a1 b1 (L1 represents lightness, ranging from black to white [0-100]; a1 represents green to red chromaticity [–150-+100]; and b1 represents blue to yellow chromaticity [–100-+150]) measurements were obtained at baseline, after WSL formation, and after RI and bleaching. Representative specimens were evaluated by means of scanning electron microscopy. Statistical analyses included the Mann-Whitney U and Wilcoxon signed rank tests (P ≤ .0016) and repeated measures analysis of variance (P ≤ .05).ResultsNo differences in ΔE were found comparing B-RI with RI-B groups or when the B-RI group was compared with bleached enamel. A statistically significant difference was found when the RI-B group was compared with bleached enamel (ΔE, 0.81; P < .001), but the difference was deemed not clinically significant. Scanning electron microscopy revealed that bleaching after RI increased surface roughness of the resin.ConclusionsThere were no clinically significant differences in ΔE of WSLs when bleach was applied before or after RI; however, applying bleaching agent after RI roughened the surface of the resin material.Practical ImplicationsResults indicate that ΔE were not clinically significantly different between WSLs bleached before versus after RI, although it is best to sequence bleaching before RI therapy, as bleaching after RI roughened the restoration’s surface.     

新型药物控释根充尖用于牙髓尖周病治疗的可行性研究

在研制根管消毒药控释系统的基础上，制备一种成形根管充填材料，命名为药折控释根充尖，抑菌实验结果提示其整体型，贮库型以及与牙胶糊剂、酚醛树脂液协同使用时均可产生抑菌作用，在大中的根充尖横断面亦有明显抑菌效果，离体牙根尖孔渗出药物的高效液相色谱分析提示，其有效浓度释药时间可持续２周以上，研究证实：药物控释根充尖可望作为一种新型的根充材料用于牙髓病、尖周病的治疗。     

情绪释放疗法联合耳穴贴压对混合痔术后疼痛及焦虑状态的疗效观察

目的探讨情绪释放疗法联合耳穴贴压对混合痔术后患者疼痛、焦虑状态的影响。方法:将99 例混合痔术后患者采用随机数字表法分为对照组( 常规护理,33 例)、耳穴组( 在常规护理基础上增加耳穴贴压干预,33 例) 和联合组( 在常规护理和耳穴贴压基础上增加情绪释放疗法干预,33 例)。观察三组干预后不同时间点的疼痛视觉模拟量表(VAS)、状态焦虑量表(S-AI) 的变化,并于干预结束后评估患者对护理的满意度。结果:联合组患者干预后48 h、72 h、7 d 的VAS评分较耳穴组、对照组更低,差异有统计学意义(P ＜ 0.05) ;联合组患者干预后72 h 的S-AI 评分较耳穴组、对照组更低,差异有统计学意义(P ＜ 0.05) ;干预结束后,联合组、耳穴组满意度评分高于对照组,差异有统计学意义(P ＜ 0.05)。结论:情绪释放疗法联合耳穴贴压能够有效降低混合痔术后患者疼痛程度,改善焦虑情绪,提高其护理满意度。     

四种多模式镇痛方案对全膝关节置换术后康复影响的回顾性分析

目的 回顾性分析四种多模式镇痛方案对全膝关节置换术后患者康复的影响。方法 通过提取电子病历系统中的数据,回顾性分析2015年4月至2020年4月行初次单侧全膝关节置换术的537例骨关节炎患者,采用四种多模式镇痛方案：A组耳穴贴压联合股神经阻滞,B组耳穴贴压联合隐神经阻滞,C组塞来昔布联合股神经阻滞,D组塞来昔布联合隐神经阻滞。统计术前一般资料及术后第1、3、7天VAS评分、股四头肌肌力、匹兹堡睡眠质量指数（PSQI）量表评分、膝关节主动活动度。结果 四组术前一般资料比较差异无统计学意义。术后第3和7天,A组和B组的VAS评分均比C组和D组低。A组和C组股四头肌肌力在术后第1和3天明显比B组和D组差。A组和B组术后第1、3、7天PSQI量表评分均低于同时间段的C组和D组。A组和B组术后第1和3天膝关节主动活动度比C组和D组大。结论 全膝关节置换术患者采用耳穴贴压联合单次收肌管隐神经阻滞更能有效缓解术后疼痛,改善睡眠,促进早期功能锻炼,达到快速康复的效果。     

盐酸青藤碱对家兔脊柱压缩性骨折愈合的影响

目的研究盐酸青藤碱夹脊穴注射治疗去势家兔L1-L5 节段脊柱压缩性骨折（Compression fractureof spine,VCF）的机制。方法家兔48 只,采用随机数字表编号后随机分为空白对照组、模型组和青藤碱组（SIN组）,除空白对照组外,其它2 组均建立去势后L1-L5 节段VCF模型。成模后SIN 组于L1-L5 节段脊柱两侧“夹脊穴”注射盐酸青藤碱,模型组和空白对照组注射等体积生理盐对照,3 组均治疗4 周。家兔骨折椎体骨生长分化因子2（Growth differentiation factor2,GDF2）、血管内皮生长因子（Vascular endothelial growth factor,VEGF）及VEGF-mRNA 表达采用免疫组化染色法测定;一氧化氮（Nitric oxide,NO）、超氧化物歧化酶（Superoxidedism utase,SOD）活性和骨保护素（OPG）采用ELISA 法检测;免疫荧光法测定脊柱椎间盘二聚糖、图像分析法测L1-L5 节段脊柱骨密度;ELISA法检测脊柱椎间盘炎性因子白细胞介素1β（IL-1β）、IL-6β、IL-17β。结果与模型组比,SIN组L1-L5 节段脊柱GDF2、VEGF和VEGFmRNA均高表达、且脊柱骨密度增强（P＜0.05）;椎间盘二聚糖增多,IL-1β、IL-6β、IL-17β降低（P＜0.05）;静脉血NO降低、OPG、SOD升高（P＜0.05）,差异均有统计学意义。结论盐酸青藤碱“夹脊穴”注射可促进家兔L1-L5节段VCF愈合