Patient-level and practice-level characteristics associated with receipt of preventive dental services: 48-month incidence

Objectives: This study aims to: a) quantify the incidence of preventive dental services [in‐office fluoride application and dental cleaning (prophylaxis)]; b) determine if these services are effectively targeted to patients with the highest need; and c) quantify the role of practice characteristics and patient‐level factors in service receipt. Methods: A population‐based prospective cohort study was conducted with 873 adults who had at least one tooth at baseline, 743 of whom provided 48‐month data. In‐person interviews and clinical examinations were conducted biennially for 48 months, with 6‐monthly telephone interviews in between. Dental records were abstracted afterward, and practices that served participants completed questionnaires. Analysis was limited to persons with at least one dental visit of any type during follow‐up (87 percent of the sample). Results: Only 9 percent of the persons received at least one fluoride application; 75 percent received a dental cleaning. Persons with high need were actually less likely to have received preventive services. In multivariable regression analyses, characteristics of the practice in which the subject received care were very strongly related to fluoride receipt, independent of patient‐specific characteristics. Conclusions: One preventive procedure was common; the other was uncommon. However, practices did not effectively target high‐risk patients for either procedure. Instead, both services were typically received by persons with the least need for them. These findings are consistent with the conclusion that practitioners greatly influenced the delivery of fluoride services, with substantial contributions also made by patient‐level predisposing and enabling factors for both preventive services.     

Evaluation of Nutritional Status and Eating Pattern in First and Second-Time Denture Wearers: A Prospective 60 Days (2 Months) Pilot Study

Elderly individuals with extensive tooth loss preferentially consume soft, easier to chew foods which have a low nutrient density. The purpose of this study was to suggest that every complete denture wearer has to be periodically counseled by a registered Dietician and Dentist for check up to avoid malnutrition and disease. Fourteen patients were selected for this study. Seven of them with four or five teeth remaining without any functional units and seven patients who were known cases of complete denture wearers with ill-fitting or worn out dentures. The results of the study analyzed the change in eating pattern and hence the nutritional status of two groups of edentulous subjects; Group I (patients who underwent a recent transition from partially edentulous state to a completely edentulous state), and Group II (known complete denture wearers for five to ten years). Clinical examination of Group I showed an improvement, by, the decrease in percentages in both the paleness of the conjunctiva and nails of the selected patients. In Group II, there was a significant change in anthropometry and iron intake and the clinical examination showed positive changes in the patient's normal appearance, eyes and nails. Paired sample statistics between both the groups evaluated significant changes in energy, iron and vitamin C intakes in the dietary assessment chart. The general questionnaire assessment showed an improvement in the eating pattern of both the groups, which, may definitely account for a positive change in the nutritional status of the participants later. This study emphasizes that every complete denture wearer needs to be periodically counseled by a registered dietician and dentist for checkup to avoid malnutrition and disease.     

高低角型男孩颅面部软组织侧貌水平向生长变化的纵向研究

目的：探讨高低角型男孩颅面部软组织侧貌在水平方向的生长变化。方法：根据Bjork前颅基底稳定结构重迭法,头影测量20名男孩在自然头势状态下9、12、15和18岁的X线头颅定位侧位片,然后,统计分析颅面部软组织侧貌Ga、N′、Nasal、Sn、A′、Ls、Li、B′、Pg及Gn各点至垂直平面(Pr-VER)的水平向距离变化以及上下唇至美学平面(E—line)的垂直距离变化。结果：1)高低角型男孩在9～18岁期间额部、鼻根部及唇部与鼻尖的水平距离随年龄增加而增加,而颏部与鼻尖水平距离虽有增加,但在某些阶段其距离反而缩短。2)高角型男孩Ga、N′、Nasal、Pg及Gn点到Pr水平距离其各阶段各测量值明显大于低角型,可唇部表现则不同,高角型唇部比低角型表现为更为前突。3)高角型颏部向前生长移动幅度小于低角型,而唇部向前生长幅度明显大于低角型。相对于美学平面,低角型上下唇在9～18岁期间后退幅度明显大于高角型。结论：高低角型男孩颅面部软组织侧貌生长变化存在显著差异,其主要区别在于唇部及颏部。这对正畸临床诊断与治疗具有借鉴作用。     

TMJ symptoms reduce chewing amplitude and velocity,and increase variability

Objective: The null hypothesis was that mandibular amplitude, velocity, and variability during gum chewing are not altered in subjects with temporomandibular joint (TMJ) internal derangements (ID).

Methods: Thirty symptomatic subjects with confirmed ID consented to chew gum on their left and right sides while being tracked by an incisor-point jaw tracker. A gender and age matched control group (p > 0.67) volunteered to be likewise recorded. Student’s t-test compared the ID group’s mean values to the control group.

Results: The control group opened wider (p < 0.05) and chewed faster (p < 0.05) than the ID group. The mean cycle time of the ID group (0.929 s) was longer than the control group (0.751 s; p < 0.05) and more variable (p < 0.05).

Discussion: The ID group exhibited reduced amplitude and velocity but increased variability during chewing. The null hypothesis was rejected. Further study of adaptation to ID by patients should be pursued.     

独立分量分析和小波熵在动作模式分类中的应用

在表面肌电信号(electromyography,EMG)中,各类动作的识别是一个重要研究方向.本文采用独立分量分析independent component analysis,ICA)对肌电信号进行处理,消除各动作信号之间的相互线性耦合叠加,并采用信号的小波熵作为特征向量进行模式识别.试验表明,在对信号进行先期ICA处理以后,动作模式的识别效果较好.此方法也可应用于其他生理信号的识别分类.     

图像视觉诱发电位自律空间频率刺激疗法治疗儿童弱视的疗效

目的：比较图像视觉诱发电位自律空间频率刺激疗法(PVEP-CD综合疗法)与传统疗法治疗儿童弱视的临床效果,评价PVEP-CD综合疗法治疗儿童弱视的疗效。

方法：收集2018-04/2019-01于我院确诊的弱视儿童38例54眼,随机分为传统综合疗法组(19例27眼,运用屈光矫正+遮盖/压抑+精细目力训练治疗)和PVEP-CD综合疗法组(19例27眼,运用屈光矫正+遮盖/压抑+PVEP-CD治疗)。分别于治疗前和治疗6mo后进行最佳矫正视力(BCVA)和近立体视锐度检测,评估临床疗效。

结果：治疗6mo后,两组患儿弱视眼BCVA(有效率均≥85%)均明显改善,且PVEP-CD综合疗法组弱视眼BCVA提高行数\〖3(2,3)行\〗、双眼近立体视锐度改善有效率(89%)及提高等级\〖2(1,4)级\〗均高于传统综合疗法组(均P<0.05); ≥6周岁患儿中,PVEP-CD综合疗法组弱视眼BCVA提高行数显著高于传统综合疗法组(P=0.018); 轻度弱视患儿中,PVEP-CD综合疗法组近立体视锐度改善有效率(P=0.048)及提高等级(P=0.029)均显著优于传统综合疗法组; 中度弱视患儿中,PVEP-CD综合疗法组弱视眼BCVA提高行数显著高于传统综合疗法组(P=0.003)。

结论：PVEP-CD综合疗法与传统疗法均可有效提高BCVA,临床疗效显著; 与传统综合疗法相比,PVEP-CD综合疗法能较大幅度提高BCVA和近立体视锐度等级,更有效地促进弱视儿童双眼视功能恢复。     

Circadian fluctuations in three types of sensory modules in healthy subjects

This study was designed to observe and compare the circadian fluctuations in tactile sense, joint reposition sense and two-point discrimination in healthy subjects. Twenty-one healthy adult subjects received perceptual ability tests through these three different sensory modules at approximately 9：00, 13：00 and 18：00 in a day. The distribution of ranking for perceptual ability was significantly different among the three different time points in each individual, with highest perceptual ability in the evening compared with noon and morning, in terms of tactile sense and two-point discrimination. These findings suggest that the perceptual ability of healthy subjects fluctuates according to the time points in a day.     

男性生殖道感染标本采集和细菌定位培养改良法

目的:改良男性生殖道感染标本采集和细菌定位培养法,探讨标本采集和病原体分离对前列腺炎诊断与治疗的影响。方法:分别采集200例前列腺炎样症状患者的分段尿液、前列腺按摩液(EPS)和精液标本,定量接种培养液分离培养,根据分离物的菌落数及分布规律评估其实验室诊断意义。结果:从200例前列腺炎样症状患者检出病原体468株,包括细菌414株(占88.5%)、真菌12株(占2.6%)、支原体40株(占8.5%)、衣原体2株(占0.4%)。其中仅从EPS分离到病原体的患者为66例(占33.0%),仅从精液分离到病原体的患者为34例(占17.0%),EPS和精液均分离到病原体的患者为100例(占50.0%)。在这些标本中仅分离到1种病原体的分别为EPS 36例(占18.0%),精液20例(占10.0%),EPS和精液39例(占19.5%);分离到2种病原体的分别为EPS 30例(占15.0%),精液14例(占7.0%),EPS和精液60例(占30.0%);1例从EPS和精液分离到3种病原体(占0.5%)。结论:复数菌感染(MMI)、多器官感染(MOI)和耐药性菌株感染在前列腺炎样症状患者常见,是造成临床及实验室诊断漏诊和误诊的常见因素以及影响治疗效果的重要机制,MMI和MOI可通过标本采集和细菌定位培养改良法进行诊断与鉴别诊断。     

湖南地区痔病中医证型分布及其相关因素的临床研究

分析湖南地区痔病患者中医证型的分布规律及其相关因素,为中医辨证论治提供依据。收集湖南省内6家三级医院肛肠科门诊和住院部的痔病患者978例,记录其人口学资料、症状、体征等临床资料,进行统计学分析,分析证型分布的规律性。结果显示,湖南省痔病患者中医证型分布频次高低依次为湿热下注型、脾虚气陷型、风邪挟热型、气滞血瘀型、气血亏虚型及其他证型。结果表明,湖南地区痔病患者中以湿热下注、脾虚气陷两种证型最为突出。     

基于指纹图谱及化学模式识别研究盐制对五子衍宗丸化学成分的影响

目的建立不同炮制品组方五子衍宗丸(Wuzi Yanzong Pills,WYP)的HPLC指纹图谱,研究盐制对WYP化学成分的影响。方法采用HPLC法建立不同炮制品组方WYP的指纹图谱,并进行相似度评价,采用方差分析、聚类分析(CA)、主成分分析(PCA)与偏最小二乘法-判别分析(PLS-DA)对结果进行评价。结果 WYP全生品组、药典组、盐制组指纹图谱相似度均大于0.9,标定了18个共有峰,利用对照品指认出绿原酸(5号峰)、鞣花酸(10号峰)、金丝桃苷(11号峰)、异槲皮苷(12号峰)、毛蕊花糖苷(13号峰)、紫云英苷(14号峰)、槲皮素(15号峰)、山柰酚(17号峰)、五味子醇甲(18号峰)9个成分,归属性分析表明峰2来源于枸杞子,峰3、5、7、9、11、12、14、15、17来源于菟丝子,峰6、8、10、16来源于覆盆子,峰13来源于车前子,峰18来源于五味子,峰1是覆盆子和五味子共有成分,峰4是枸杞子和覆盆子共有成分。药物炮制后组方WYP未出现色谱峰的增加,但峰面积发生变化。通过CA将WYP全生品组、药典组、盐制组聚为3类,PCA筛选出4个主成分,PLS-DA标记出峰1、13(毛蕊花糖苷)、10(鞣花酸)、7、4、11(金丝桃苷)、12(异槲皮苷)、3、5(绿原酸)共9个差异性成分;绿原酸、鞣花酸、金丝桃苷、异槲皮苷、山柰酚、五味子醇甲及峰1、3、4、7、8共11个成分可能是不同炮制品组方WYP的差异标志物。结论建立的指纹图谱测定方法稳定、可靠,炮制后组方WYP的化学成分发生变化,结果可为WYP中如何选用药物炮制品提供一定的依据。