数字化技术在可摘局部义齿基牙全瓷冠崩瓷后再修复中的应用1例

数字化技术有助于提升可摘义齿基牙再修复的精准性及简便性,避免患者重行可摘义齿修复或利用旧活动义齿行手工堆塑基牙冠形态造成的误差,报告1例数字化技术在可摘局部义齿基牙全瓷冠崩瓷后再修复中的应用,取得了满意的治疗效果.     

数字身份与数字裂沟的伦理分析和管理研究

在信息通讯技术时代,面临着来自隐私保护、数字身份、数字裂沟、信息可及性以及信息自由等伦理和管理上的巨大挑战.数字身份可以变更、可以隐藏、甚至可以废弃的属性使得网络甚至社会的安全成为至关重要的问题.由于经济、教育、地理等条件的差异,不同的人群之间出现了信息通信技术上的隔阂这种数字裂沟的出现,可能导致歧视、贫富分化的加剧.因此相关的规定和管理是必要和紧迫的.     

网络及数字病理资源在病理住院医师培训和继续教育中的应用

网络为计算机和信息交流带来了巨大的变革,逐渐成为世界范围内的信息交流工具,加之数字病理资源的开发和逐渐普及使其成为病理住院医师培训和继续教育中的有益辅助工具。本文分析了互联网及数字病理资源在病理住院医师培训及低年资医生继续教育中的优点及其具体应用,并列举了一些对病理住院医师培训非常有帮助的医学和病理学专业网站,希望能够在传统教学模式的基础上,利用现代化的信息学技术对以形态学为主的病理学专业住院医师培训提供必要的辅助。网络及数字病理资源的广泛使用,将会成为病理住院医师规范化培训的有益补充,缩短不同级别医院低年资病理医师继续教育的差距。     

医院数字化门诊系统的设计与构建

目的探讨医院数字化门诊的设计构建方案。方法通过对门诊就诊流程的再造,开发基于医院信息管理系统（hospital information system,HIS）的数字化门诊服务系统。结果成功构建包含自助导医、办卡、充值、挂号、排队叫号、计价确认、检验结果短信预约及报告打印、查询及评价等数字化系统,实现了业务流程优化、系统数据共享,改变了传统的门诊就医模式。结论数字化门诊系统创新了就医流程,为患者提供了便捷、舒适、高效、优质的医疗服务环境。     

数字化断层融合技术在颌骨病变中的应用研究

目的：探讨数字化断层融合(TOMOS)技术在口腔有固定金属假牙的颌骨病变中的应用价值,并与多层螺旋CT (MSCT)进行对照。方法回顾分析口腔有固定金属假牙患者的TOMOS及MSCT的影像资料,每组各25例,观察曝光时间、患者受辐射剂量及对病灶的显示情况,并进行统计学分析。结果 TOMOS组的曝光时间为(0.700±0.050) s,明显少于CT组的(6.267±0.709) s,两组比较差异具有显著统计学意义(t=7.912,P<0.01);TOMOS组患者受辐射有效剂量为(0.033±0.004) mSv,明显低于CT组的(1.667±0.537) mSv,两组比较差异具有显著统计学意义(t=11.812,P<0.01);对下颌角及升支病变显示,TOMOS明显优于MSCT。结论 TOMOS检查方法实用、便捷,其辐射剂量不到CT的2%,在有金属假牙者的下颌角及升支病变的检查优势明显,可部分代替CT检查。     

一种新型数字化桩核修复技术

桩道信息获取不完整、数字化程度低等诸多缺陷限制了全数字化和半数字化桩核制造技术应用于临床.本文旨在介绍一种新型桩核数字印模采集技术,该技术利用计算机辅助设计和计算机辅助制造(computer-aided design/computer-aided manufacturing,CAD/CAM)来制作桩核,能生产出精度更高...     

数字化塑形钛网在颅骨缺损修补术中的临床运用

目的：探讨数字化塑形钛网修补颅骨缺损的临床治疗效果。方法对我院2010年8月~2013年9月收治的46例需进行颅骨缺损手术的患者行数字化塑形钛网修补术，比较同期的42例行传统手工塑形钛网颅骨修补术的患者手术质量和术后恢复情况。进行6个月的术后随访，统计评估患者术后恢复情况。结果与传统手术方法相比，数字化塑形钛网修补手术在用时、并发症发生情况等方面优势明显（P＜0.01），术后功能状态评分和生活质量评分差异无统计学意义（P＞0.05）。结论数字化塑形钛网技术在颅骨缺损的修复治疗上具有塑形美观、术后恢复效果好，可减少手术时间等诸多优点，是在条件允许的情况下的首选手术方式。     

20 years of arterial switch operation for simple TGA

Background : Arterial switch operation became the golden treatment for simple transposition of the great arteries (sTGA). We describe our experience with the arterial switch operation regarding long-term outcome and the need for re-intervention. Nevertheless, supravalvular pulmonary stenosis (SPS) remains a concern in the long run. We assess the evolution of SPS over time and evaluate the effect of technical modifications on SPS during our experience. Methods : We performed a retrospective study on 133 patients operated with ASO for TGA between October 1991 and November 2009. Last report method was used. We reviewed our pediatric cardiology and cardiac surgery database to examine the echocardiography data and electrocardiograms. A mean follow-up of 9.2 years (± 5.83 SD) was reached. Results : One (0.8%) patient deceased postoperatively due to cardiogenic shock. The overall actuarial freedom from reoperation (open and percutaneous) was 88.1%, 78.5% and 76.9% at 1, 5 and 10 years. SPS needed to be treated in 17 patients. Valve regurgitation at final investigation was maximal moderate in 5 patients for the aortic valve, 10 for pulmonary valve and 3 in tricuspid valve.

Conclusions : ASO shows excellent long-term results in sTGA with a very low morbidity and mortality and is therefore the procedure of choice. Re-intervention rate is determined by SPS. Since the extensive mobilization of the pulmonary arteries and the creation of a longer neo-pulmonary root, reduction in SPS was seen with no re-interventions in the second half of the group. To obtain a final comparison with the atrial switch operation, a longer Follow-up is necessary.     

Cervical fracture patterns associated with blunt cerebrovascular injures when utilizing computed tomographic angiography: a systematic review and meta-analysis

BACKGROUND CONTEXTPrior studies have demonstrated an association between cervical spine fractures and blunt cerebrovascular injuries (BCVI) due to the intimate anatomic relationship between the cervical spine and the vertebral arteries. Digital subtraction angiography (DSA) has historically been the gold standard, but computed tomography angiography (CTA) is commonly used to screen for BCVI in the trauma setting. However, there is no consensus regarding which fracture patterns mandate screening. Over aggressive screening may lead to increased radiation, increased false positives, and overtreatment of patients which can cause unnecessary patient harm, and increased healthcare costs.PURPOSEThe aim of this meta-analysis is to analyze which cervical spine fracture patterns are most predictive of BCVI when utilizing CTA.STUDY DESIGN/SETTINGSystematic review and meta-analysis.OUTCOME MEASURESOdds ratios for specific cervical fracture patterns and risk of developing a BCVI.METHODSA systematic literature review of all English language studies from 2000-2020 was conducted. The year 2000 was chosen as the cut-off because use of CTA prior to 2000 was rare. Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Scopus, Global Index Medicus, and ClinicalTrials.gov were queried. Studies were included if they met the following criteria: (1) the diagnostic imaging modality was CTA; (2) investigated blunt cervical trauma; (3) noted specific cervical spine fracture patterns associated with BCVI; (4) odds ratios for specific cervical spine fracture patterns or the odds ratio could be calculated; (5) subjects were 18 years old or older. Studies were excluded if they: (1) included DSA or magnetic resonance imaging; (2) included penetrating cervical trauma; (3) included pediatric patients less than 18 years of age; (4) were not written in English. All statistical analysis was performed using R Studio (RStudio, Boston, MA, USA).RESULTSThe initial search, after duplicates were removed, resulted in 10,940 articles for independent review. Six studies met the criteria for inclusion in the meta-analysis. Specific fracture patterns mentioned are isolated C1, C2, C3 fractures, any C1–C3 fracture, any C4–C7 fracture, two-level fractures, subluxation/dislocations, and transverse foramen (TF) fractures. Three studies were included in the meta-analysis for C1, C2, C1–C3, subluxations/dislocations, and TF fractures. Two studies were included in the meta-analysis for C3, C4–C7, and two-level fractures. The pooled odds ratio with 95% confidence interval for: C1 fractures and BCVI is 1.3 (0.8–2.1); C2: 1.6 (0.9–2.8); C3: 1.8 (0.9–3.6); C1–C3: 2.2 (1.1–4.2); C4–C7: 0.7 (0.3–1.7); Two-level: 2.5 (1.4–4.6); Subluxation/Dislocation: 2.9 (1.8–4.5); TF: 3.6 (1.4–8.9).DISCUSSION/CONCLUSIONThis study found that when utilizing CTA for screening of BCVI only fractures in the C1-C3 region, two-level fractures, subluxations/dislocations, and transverse foramen fractures were associated with increased incidence of a BCVI. Further refinement of protocols for CTA in the setting of blunt cervical trauma may help limit unnecessary patient harm from overtreatment and reduce healthcare costs.