经颅多普勒超声联合颈动脉超声对缺血性脑血管病的诊断价值

目的分析经颅多普勒超声(TCD)联合颈动脉超声对缺血性脑血管病的诊断价值。方法选取缺血性脑血管病患者93例,均行数字减影血管造影(DSA)、TCD及颈动脉超声检查,并以DSA结果为诊断标准,比较TCD和颈动脉超声单用及两者联合的检查结果,分析三者在缺血性脑血管病中的诊断灵敏度、特异度、阳性预测值及阴性预测值。结果 93例患者颅内外异常血管共763条。单用TCD显示颅内血管异常73例,异常血管294条;单用颈动脉超声显示颅外血管异常64例,异常血管275条;TCD联合颈动脉超声显示颅内外血管异常89例,异常血管569条。TCD联合颈动脉超声在缺血性脑血管病诊断方面的灵敏度、特异度、阳性预测值及阴性预测值均高于单用TCD及单用颈动脉超声。结论 TCD联合颈动脉超声可提高缺血性脑血管病诊断的准确性,可作为颅内外血管病变诊断的有效检查手段。     

Secrets and disclosure in donor conception

This article considers the disclosure, sharing and exchange of information on being donor conceived within families, drawing on data from a study undertaken with donor‐conceived adults registered with UK Donor Link (a voluntary DNA‐linking register). This paper considers the narratives of how respondents found out they were donor‐conceived and what events triggered disclosure of this information. This paper then goes on to examine the role secrecy played in their family life and uses the concept of ‘display’ to explore how secrecy affected their relationships with their immediate and extended family. Secrets are notoriously ‘leaky’ and we found complex patterns of knowing and uncertainty about whom in the family knew that the person was donor‐conceived. We argue that what is kept secret and from whom provides insights into the multifaceted web of social relationships that can be created by donor‐conception, and how knowledge can be managed and controlled in attempts to display and maintain family narratives of biogenetic connection.     

过滤对一种IgG2亚型EGFR单抗中不溶性微粒的影响

目的：探讨过滤操作对一种免疫球蛋白G2（immunoglobin G2,IgG2）亚型表皮生长因子受体（epidermal growth factor receptor,EGFR）单克隆抗体（单抗）生物类似药（similar biotherapeutic product,SBP）候选药中不溶性微粒的影响。方法：利用微流数字成像（microflow digital imaging,MDI）技术对某厂家生产的IgG2亚型EGFR单抗SBP候选药与其原研药（reference biotherapeutic product,RBP）中不同粒径的不溶性微粒进行比较;采用0.22 μm的滤器对EGFR单抗SBP候选药进行过滤,并采用MDI法立即对不同粒径和性质的不溶性微粒进行检测和分析;再将过滤后的EGFR单抗SBP候选药在室温静置2 h,并采用MDI法对不同粒径和性质的不溶性微粒进行检测和分析。结果：某IgG2亚型EGFR单抗SBP候选药中不同粒径的不溶性微粒数量明显高于RBP;用0.22 μm的滤器过滤后,EGFR单抗SBP候选药中的不溶性微粒数由8.51×10⁵粒·mL^-1降为1.52×10⁴粒·mL^-1,且主要成分蛋白聚体、气泡和纤维均明显减少;室温静置2 h后,其中的不溶性微粒数由1.52×10⁴粒·mL^-1增加至3.23×10⁴粒·mL^-1,且增加的微粒主要为蛋白聚体。结论：与原研药相比,该EGFR单抗SBP候选药蛋白聚体水平较高,过滤后有明显改善,但随着放置时间延长,蛋白聚体含量又有明显增加。这提示我们需加强研发,以提高SBP候选药的产品质量、安全性和有效性。     

Physiological in vitro sacroiliac joint motion: a study on three‐dimensional posterior pelvic ring kinematics

The sacroiliac joint (SIJ) is a well‐known source of low back and pelvic pain, of increasing interest for both conservative and surgical treatment. Alterations in the kinematics of the pelvis have been hypothesized as a major cause of SIJ‐related pain. However, definitions of both the range and the extent of physiological movement are controversial, and there are no clear baseline data for pathological alterations. The present study combined a novel biomechanical setup allowing for physiological motion of the lumbosacral transition and pelvis without restricting the SIJ movement in vitro, combined with optical image correlation. Six fresh human pelvises (81 ± 10 years, three females, three males) were tested, with bodyweight‐adapted loading applied to the fifth lumbar vertebra and both acetabula. Deformation at the lumbopelvises was determined computationally from three‐dimensional image correlation data. Sacroiliac joint motion under the loading of 100% bodyweight primarily consisted of a z‐axis rotation (0.16°) and an inferior translation of the sacrum relative to the ilium (0.32 mm). Sacroiliac joint flexion‐extension rotations were minute (< 0.02°). Corresponding movements of the SIJ were found at the lumbosacral transition, with an anterior translation of L5 relative to the sacrum of ?0.97 mm and an inferior translation of 0.11 mm, respectively. Moreover, a flexion of 1.82° was observed at the lumbosacral transition. Within the innominate bone and at the pubic symphysis, small complementary rotations were seen around a vertical axis, accounting for ?0.10° and 0.11°, respectively. Other motions were minute and accompanied by large interindividual variation. The present study provides evidence of different SIJ motions than reported previously when exerted by physiological loading. Sacroiliac joint kinematics were in the sub‐degree and sub‐millimeter range, in line with previous in vivo and in vitro findings, largely limited to the sagittal rotation and an inferior translation of the sacrum relative to the ilium. This given physiological loading scenario underlines the relevance of the lumbosacral transition when considering the overall motion of the lumbopelvis, and how relatively little the other segments contribute to overall motion.     

Digital Promotion of Energy Drinks to Young Adults Is More Strongly Linked to Consumption Than Other Media

Objective

To examine whether digital marketing strategies are more strongly associated with energy drink use than other marketing and whether Theory of Planned Behavior (TPB) constructs mediated the effects of digital marketing on energy drink use.

Comparison of conventional and TACT (Tuned Aperture Computed Tomography) digital subtraction radiography in detection of pericrestal bone-gain

Tuned Aperture Computed Tomography or TACT is a relatively new technique that transforms correlated two-dimensional images into a three-dimensional display. Associating TACT with digital subtraction radiography (TACT-DSR) may enhance its use in the detection of diseases. This study aims to assess observer performance in the task of detecting simulated bone-gain in periodontal defects, comparing conventional and TACT DSR. Buccal, lingual and proximal pericrestal bony defects in a human dry skull were imaged with and without increments of crushed-bone and wax mixtures using standardized vertical bitewing projections, acquired with an intraoral digital receptor in a tomographic X-ray machine. One hundred and twenty pairs of baseline and follow-up images were obtained for each imaging modality. Post-acquisition processing including image-registration, density-correction and subtraction operation were applied to both transmission images and TACT-slices. Eight calibrated observers evaluated the presence or absence of pericrestal bone-gain using a 5-point confidence scale. Details about the location of periodontal defects and the amount of bone-gain for each subtracted image were recorded and used in the statistical analysis. Observer performance and study design factors were analyzed by means of receiver operating characteristic (ROC) curve analysis and ANOVA. Mean values of areas under ROC curves for bone-gain detection performance were 0.82 for conventional DSR and 0.90 for TACT-DSR. TACT-DSR provided statistically superior detection performance of simulated periodontal bone-gain over conventional DSR for tooth-obscured defects (p = 0.001) and for the smallest bone mass (p = 0.024). The findings support TACT-DSR's potential to provide greater sensitivity and technique flexibility in detecting periodontal bone-gain than standard DSR.     

直丝弓矫治技术用于安氏骨性Ⅱ类错畸形治疗前后面型的改变

目的探讨直丝弓矫治技术对安氏Ⅱ类骨性错畸形患者骨面型的改变情况。方法在矫治前拍摄的头颅定位侧位片上,筛选出8例安氏Ⅱ类骨性错畸形患者,应用直丝弓矫治技术进行矫治,矫治结束后,在同样条件下再拍摄头颅定位侧位片,行头影测量分析,与治疗前数值进行比较,观察骨面型的改变情况。结果直丝弓矫治对安氏Ⅱ类骨性错畸形患者的面型略有改变,但患者的深覆及深覆盖的纠正更多是由下前牙唇侧倾斜来代偿完成。结论安氏Ⅱ类骨性错畸形患者在恒牙期早期或恒牙期直接采用直丝弓矫治技术进行矫治,对牙齿排列和咬合关系调整虽然有一定的治疗效果,但是对侧面型的改善程度有限,不能达到理想的矫治效果。     

Dental magnetic resonance imaging for periodontal indication – a new approach of imaging residual periodontal bone support

Objective: The standard imaging techniques used in dentistry consist of two-dimensional radiographic techniques like intraoral periapical (PA) radiographs, bitewings or extraoral panoramic X-rays. Three-dimensional methods, such as cone beam computed tomography (CBCT), are not standard procedures. In several fields of dentistry, such as oral surgery or implantology, dental magnetic resonance imaging (DMRI), a technique without radiation exposure, has already been introduced as a new promising diagnostic tool. The aim of this study was to compare the agreement of DMRI and PA radiographs in measuring residual periodontal bone support.

Material and methods: In this study, the residual periodontal bone support of 21 teeth was investigated and compared with DMRI and PA radiographs by two independent raters. Intra-class correlation coefficients (ICCs) were calculated using the software R to identify the intra-rater and inter-rater agreement of the two modalities. Bland–Altman plots were created to directly compare the two methods.

Results: Overall, all calculated ICC values showed an excellent intra-rater and inter-rater agreement (>0.9) for DMRI, as well as PA radiographs. Bland–Altman analysis also showed a strong agreement between both diagnostic methods in this study.

Conclusions: In conclusion, there was a strong agreement between DMRI and PA. Thus, DMRI proved to be a comparable method to PA radiographs for evaluating the proportion of residual periodontal bone support.     

Comparison between RVG UI sensor and Kodak InSight film for detection of incipient proximal caries

Object The purpose of this study was to compare the efficacy of the four combination modes of Trophy RadioVisioGraphy UI sensor (Trex-Trophy Radiology Inc., Marne-la-Valee, France) and Kodak InSight film (Eastman Kodak Co., Rochester, NY) for detecting proximal dental caries. Materials and Methods Thirty extracted human upper premolars were selected. Of 60 surfaces, 25 had carious lesions in the form of small cavities, and the rest showed no evidence of caries as verified by a micro computed tomogram (micro CT; XCT Research SA+, Stratec Medizintechnik GmbH, Pforzheim, Germany). All teeth were radiographed with the paralleling technique (60kV, 40 cm focus-to-sensor distance). Four combination modes (high-resolution caries mode—HRC; high-sensitivity caries mode—HSC; high-resolution periodontal mode—HRP; and high-resolution endo mode—HRE) were used. Exposure was set at 0.12 sec for HRC, 0.08 sec for HSC, 0.16 sec for HRP, 0.12 sec for HRE, and 0.16 sec for the Kodak InSight film. The resulting images were evaluated by three oral radiologists. The same three observers evaluated the digital images, and were allowed to use the contrast and brightness controls in doing so. Possible differences in ROC curve areas among image modalities were assessed by the Friedman test. Results The mean ROC curve areas were 0.66±0.11 for HRC, 0.78±0.02 for HSC, 0.76±0.04 for HRE, 0.77±0.04 for HRP, and 0.71±0.09 for the Kodak InSight film. There were no statistically significant differences between HRC, HSC, HRE, HRP and the Kodak InSight film in terms of proximal caries detection. Conclusion The four modes of RVG UI system are each a viable alternative to intraoral film for the detection of incipient dental caries.