一种具监测功能的高精度微量移液器的设计

目的针对全自动临床检验仪器传统移液方式的精度以及可靠性限制问题,设计一款带有液面监测功能的高精度微量移液器。方法基于气动置换技术,以STM32微处理器为主控芯片,通过实时检测移液器内部压力变化,实现了液面探测、吸样异常监测等功能。采用位置-速度双闭环PID算法实现对直线步进电机的精确定位,提高样本吸取的准确度。最后,通过移液过程监测实验和吸样精度验证实验,验证了设计的微量移液器的液面探测功能、吸样异常识别功能及吸样精度。结果该微量移液器移液精度较高,移液误差较小,重复性较好,并能实现移液的全过程监测。结论本文设计的微量移液器满足JJG646—2006国家标准设计规范,适用于全自动临床医疗检验仪器。     

B超、CT、MRI/MRCP联合CA19-9检测对恶性梗阻性黄疸的诊断价值

目的探讨B超、CT、MRI/MRCP联合CA19-9检测对恶性梗阻性黄疸的诊断价值.方法对资料齐全,诊断明确的44例恶性梗阻性黄疸病人的临床资料进行分析.结果单项检查,B超定位准确率97.7%(43/44),定性准确率72.7%(32/44);CT定位准确率97.7%(43/44),定性准确率79.5%(35/44);MRI/MRCP定位准确率100%(44/44),定性准确率88.6%(39/44).统计学分析:3项检查的定位诊断率和定性诊断率均无显著性差异(P＞0.05).B超、CT联合CA19-9检测定性准确率均为97.7%(43/44),MRI/MRCP联合CA19-9检测定性准确率100%.结论影像学检查和血清CA19-9检测诊断恶性梗阻性黄疸各有优势与不足.二者联合可以大大提高诊断正确率,可作为可疑恶性梗阻性黄疸的常规检查方法.     

低剂量射线长期暴露对人群健康影响

目的了解长期接触放射线人群的健康状况,为放射性职业健康监护提供理论依据。方法于2016年以辽宁省内594名接触放射工作人员(接触组)和297名半年内未接触放射线人员(对照组)为调查对象,采用现况调查方法采集调查对象人口学基本信息、放射性职业接触状况、按照《放射工作人员职业健康管理办法》进行健康体检,采用一般描述性统计分析方法探讨长期接触低剂量放射线对人群的健康损害及影响因素。结果对照组人群白细胞计数异常检出率与眼晶状体浑浊率分别为0.015%、0.030%,放射线接触组人群白细胞计数异常检出率与晶状体浑浊率分别为0.042%、0.150%;与对照组比较,放射线接触组人群白细胞计数异常检出率及眼晶状体浑浊率明显升高,差异有统计学意义(P<0.05);2组人群血红蛋白、血小板、血糖异常检出率差异无统计学意义(P>0.05)。工龄0~9、10~19、≥20年放射线接触者眼晶状体浑浊率分别为0.039%、0.063%和0.133%;不同工龄放射线接触者眼晶状体浑浊率差异有统计学意义(P<0.05);从事放射治疗、介入放射、放射诊断、投照、工业探伤等放射工种之间各项健康指标差异无统计学意义(P>0.05)。结论长期低剂量射线暴露对人体健康具有一定影响,应加强放射线接触人群放射线防护意识,定期进行健康检查。     

肾小球肾炎中医辨证与检验指标相关意义研究

目的探讨研究肾小球肾炎中医辨证与病理检查指标之间的关系及意义。方法研究资料均选择我院接收治疗的肾小球肾炎患者,选择治疗时间为2014年5月—2016年5月,共选择86例患者,并采用中医辨证方法对86例患者进行分型,分别为肝肾阴虚型、气阴两虚型、脾肾气虚型,并观察中医证型与肾脏病理之间的关系。结果病理损害为Ⅱ级至Ⅲ级中,肝肾阴虚型占比8.14%,气阴两虚型占比9.30%,脾肾气虚型占比24.42%,数据比较差异具有统计学意义(P0.05)。病理损害为Ⅳ级至Ⅴ级中,肝肾阴虚型占比27.91%,气阴两虚型占比13.95%,脾肾气虚型病理占比16.28%,数据比较差异具有统计学意义(P0.05);肝肾阴虚型患者的肾小球损伤积分、肾小管间质损伤积分、肾血管损伤积分均显著高于气阴两虚型、脾肾气虚型两组患者,数据比较差异具有统计学意义(P0.05)。结论肝肾阴虚型、气阴两虚型、脾肾气虚型比较,脾肾气虚型IgA肾病慢性肾小球肾炎患者病理损害最轻,而肝肾阴虚型IgA肾病患者病理损害最严重,但仍然需要进行进一步临床研究和探讨。     

激光扫描共焦显微镜活体组织诊断技术的应用进展

激光扫描共焦显微镜作为一种新的无创诊断技术,能对人体体表组织细胞在活体进行观察,相对于常规组织学检查,它不需要标本切取、固定、包埋、切片、染色等繁琐的过程,具有很大的优势。它能在活体组织观察细胞形态和组织结构,甚至在使用增强对照的试剂后,能在分子水平观察细胞的活动。口腔黏膜、体表皮肤由于其特殊的位置及结构,使激光扫描共焦显微镜在这些方面得到广泛的应用。作者对激光扫描共焦显微镜在口腔黏膜、皮肤病变的活体组织诊断以及外科手术中的应用进行综述。     

Comparison of clinical and magnetic resonance imaging diagnoses in patients with TMD history

The aim of this study was to evaluate the diagnostic accuracy of a well-defined clinical examination for diagnosing anterior disc displacement with and without reduction. A series of 40 patients with temporomandibular disorder (TMD) history were examined according to well-defined routine criteria. This examination included detailed history-taking, standardized clinical head and neck examination that included measurements of the range of motion, palpation of the temporomandibular joints and muscles of mastication for pain and auscultation of joint sounds. Magnetic resonance images of the joints were used as 'gold standard'. Diagnostic accuracy of the clinical examination was 83% for determining normal disc-condyle relationship, 72% for diagnosing anterior disc displacement with reduction, and 81% for diagnosing anterior disc displacement without reduction. Our results suggest that anterior displacement of the disc can be diagnosed with considerable accuracy using a well-defined clinical examination only. Therefore, we conclude that not all patients with TMD symptoms require magnetic resonance imaging examination before treatment.     

颌面专用CT下颌骨检查技术

目的：研究颌面专用CT（QR-DVT 9000 NEWTOM）下颌骨检查技术的建立方法及技术要点,观察颌面专用CT下颌骨检查技术,在下颌骨X线检查中的优势.方法：对下颌骨疾病患者进行颌面专用CT扫描和重建成像,对其重建轴位影像进行曲面、矢状位、冠状位以及3D影像的后处理,并与常规X线片对比分析.结果：颌面专用CT下颌骨检查技术优于下颌骨常规X线检查,分别以水平位、曲面、矢状位、冠状位以及3D等多方位影像显示下颌骨的信息.结论：颌面专用CT下颌骨检查技术,在下颌骨的X线检查中有着明显的优势,并能够有效地指导临床手术.     

Study on the necessity for cross-section imaging of the posterior mandible for treatment planning of standard cases in implant dentistry

OBJECTIVE: To investigate whether cross-section imaging influences the planning and therapy of standard implant cases in the posterior mandible. MATERIAL AND METHODS: In a prospective study conducted over 16 months, the planned treatment (standard implant therapy without bone augmentation procedures in the premolar and molar regions of the mandible) was compared with the postoperative result in 50 randomly selected patients. Clinical examinations and panoramic radiographs were performed pre- and postoperatively, whereas cross-sectional tomography was performed only preoperatively. RESULTS: The vertical magnification factor in the panoramic radiographs was very constant pre- and postoperatively with 1 : 1.27 and in the spiral tomograms with 1 : 1.52. In 11 of 77 implant sites, the mandibular canal could not be evaluated in the spiral tomograms. The additional information from cross-sectional spiral tomography did not influence the original planning in 74 of 77 (96.1%) implant sites. Based on the postoperative panoramic radiograph, the average distance from the tip of the implants to the mandibular canal was 3.04+/-2.06 mm. In two cases (2.6%), transient postoperative altered tactile sensation of the mental nerve was found. CONCLUSION: The information from preoperative cross-sectional spiral tomography has minor impact on treatment planning in standard implant cases in mandibular premolar and molar regions. The clinical examination provides sufficient information for selecting implant diameter and the panoramic radiograph provides sufficient information for implant length selection.     

Association between vaping and untreated caries: A cross-sectional study of National Health and Nutrition Examination Survey 2017-2018 data

BackgroundWith the rise in the prevalence of electronic cigarette (e-cigarette) and vaping products and the emergence of evidence indicating their cariogenic potential, it is essential to examine the association between vaping and untreated caries at a population level.MethodsThe authors obtained data from the 2017-2018 National Health and Nutrition Examination Survey and investigated the outcome variable—untreated caries—using oral health examination data. The authors applied multiple logistic regression analyses to assess the association between untreated caries and smoking (cigarette smoking, vaping, and both) while controlling for education, race or ethnicity, income, age, sex, and time since previous dental visit.ResultsA total of 4,618 participants were included in the analyses for this cross-sectional study. Participants who currently smoked e-cigarettes were more likely to have untreated caries (odds ratio, 1.69; 95% CI, 1.24 to 2.29) than those who had never smoked, when adjusted for demographic variables. Similarly, dual smokers (e-cigarette and conventional smokers) were more likely to have untreated caries compared with nondual smokers (odds ratio, 2.43; 95% CI, 1.36 to 4.36).ConclusionBoth vaping and dual smoking are associated with an increased occurrence of untreated caries.Practical ImplicationsVaping status should be included as a part of health history questionnaires for patients. Dental professionals should be informed of the potential oral health implications of vaping and, in turn, impart this knowledge to patients.     

颅下颌紊乱病患者髁突长轴水平角的测量观察

在１２４例颅下颌紊乱病患者的颏顶位颅底平片上测量了髁突长轴水平角，以了解Ｘ线片上髁突长轴水平角的人群分布规律，以及与颅下颌关节病变严重程度的关系。本组髁突长轴水平角均值为１５．１４°；左右侧之间、男女之间以及４０岁前与４０岁后的角度均值相比较均无显著性差异（Ｐ＞０．０５）。男性患者右侧关节患骨性病变时的髁突长轴水平角较右侧关节患非骨性病变时为大（Ｐ＜０．０５）。提示髁突长轴水平角的增大可预示病变的严重程度