Treatment of fully edentulous patients with ITI implants

The use of ITI implants for rehabilitation of the edentulous patient has shown predictable results not only in the standard sites but also in cases of advanced alveolar ridge atrophy. Preoperative analysis, including clinical and radiological evaluation, implant selection, and determination of implant number and distribution in the edentulous maxilla and mandible, is described in this article. The surgical procedures used in standard sites are presented, the benefits of a nonsubmerged surgical approach in these cases are emphasized, and a protocol for postoperative management is recommended. Augmentation procedures in advanced osseointegration surgery call for submerged ITI implants when a simultaneous approach is chosen. Several types of advanced implant surgery that can be used are described, including membrane technique, sinus lift procedures, vertical ridge augmentation with iliac bone grafts, and correction of sagittal jaw relationship.     

Prospective study on titanium bar-retained overdentures: 2-year results

Within a monometallic concept 29 patients received titanium bar‐retained mandibular overdentures on 2 IMZ implants. The study had a prospective design with 3 months recall intervals. One of 58 implants failed after 11 months. There were no significant differences of the mean plaque scores (Silness, Löe) and the mean sulcus bleeding scores (Mühlemann, Son) at the abutments between baseline, 12 months and 24 months. Less than 40% of the subjects showed plaque score zero at 24 months. However, 89% exhibited sulcus bleeding score zero indicating health of the peri‐implant soft tissues in most cases. Plaque at the basal site of the bar was scored separately at additional measuring points located at the central area and the contact areas between bar and abutments. Bar plaque scores nearly doubled between baseline and 12 months and remained high at 24 months. Median maximal vertical bone loss around the implants was 1.7 mm after 2 years. Bone loss did not exceed one quarter of the implant length in 79%. The monometallic concept in bar‐retained overdentures on 2 implants proved its clinical suitability except for the applicability of pure titanium for bar clips. Plaque formation beneath the bar seems to be one of the major clinical problems.     

雷火灸治疗盆腔炎性疾病后遗症疗效及对血清Caspase-3、sFas影响

[目的] 探讨雷火灸治疗盆腔炎性疾病后遗症的疗效及对血清半胱氨酸蛋白酶-3（Caspase-3）、可溶性凋亡相关因子（sFas）的影响。[方法] 将65例患者随机分为对照组32例及治疗组33例,对照组予常规西药治疗,治疗组在对照组基础上予雷火灸治疗。统计两组临床疗效,观察视觉模拟评分法（VAS）评分、盆腔积液深度及炎性包块直径、血清肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、Caspase-3及sFas水平变化。[结果] 治疗组有效率高于对照组（P<0.05）。治疗后,治疗组VAS评分低于对照组（P<0.05）;治疗组盆腔积液深度、炎性包块直径小于对照组（P<0.05）;治疗组血清TNF-α、CRP水平低于对照组（P<0.05）;治疗组血清Caspase-3水平高于对照组（P<0.05）,血清sFas水平低于对照组（P<0.05）。[结论] 雷火灸治疗盆腔炎性疾病后遗症疗效显著,有利于改善疼痛症状,促进盆腔积液及炎性包块吸收,降低炎性因子水平,调节血清Caspase-3、sFas水平。     

基于快速康复外科理念的多模式护理干预在乳腺癌手术患者中的应用

目的探讨接受手术治疗的乳腺癌患者应用基于快速康复外科理念多模式护理干预的效果。方法选取2016年4月至2019年10月接受治疗的乳腺癌患者将118例,分为对照组(n=59)与试验组(n=59),两组患者均接受手术治疗,对照组应用传统护理干预模式,试验组应用基于快速康复外科理念的多模式护理模式,比较两组手术相关指标、术后6个月患肢肩关节功能恢复效果以及住院期间并发症情况。结果试验组总引流量少于对照组,引流管留置时间及住院时间均短于对照组,两组比较,差异有统计学意义(P0.05)。试验组患肢功能优良率高于对照组,两组患肢功能恢复效果比较,差异有统计学意义(P0.05)。试验组术后胸大肌萎缩、皮下积液等并发症发生率低于对照组,两组并发症发生率比较,差异有统计学意义(P0.05)。入院时两组生存质量比较,差异无统计学意义(P0.05);试验组出院时、出院后3个月及出院后6个月生存质量均高于对照组,两组比较,差异有统计学意义(P0.05)。结论采用手术治疗的乳腺癌患者围术期应用基于快速康复外科理念的多模式护理干预可提高护理质量,促进患者术后恢复。     

认知行为治疗改善自杀未遂精神分裂症患者生命质量的对照研究

目的 观察认知行为治疗对自杀未遂精神分裂症患者的心理健康状况及生命质量改善的效果,为制定提高精神分裂症患者自杀预防水平、降低和防止精神分裂症患者再次自杀的策略提供临床依据。方法 选取符合国际疾病分类第十版精神与行为障碍分类(ICD-10)中的精神分裂症诊断标准的有自杀未遂的住院患者共130例,按住院号末尾数字随机分配到认知行为治疗组(治疗组,n=66)和对照组(n=64)。治疗组予常规的药物治疗及持续12周每次约50分钟共8次的短程认知行为治疗,对照组只予常规的药物治疗,治疗12周。分别于治疗前、治疗12周末用WHO健康量表(WHOQOL-BREF)评估患者的健康状况,生命质量量表(QOLS)评定患者的生命质量,抑郁自评量表(SDS)评定患者的抑郁情绪,社会支持评定量表(SSRS)评定患者的社会支持状况。结果 与治疗前相比,治疗12周末 SDS、 WHOQOL-BREF、QOLS总分差异有统计学意义(P＜0.01);治疗组SSRS总分差异有统计学意义(P＜0.05),对照组差异无统计学意义(P＞0.05)。两组相比,SDS、WHOQOL-BREF、QOLS总分差异有统计学意义(P＜0.01) ,SSRS总分差异无统计学意义。结论 认知行为治疗有助于改善自杀未遂精神分裂症的生命质量和心理健康状况。     

中国北方城乡两地居民自杀意念、自杀未遂的调查

目的:了解中国北方城乡两地居民自杀意念、自杀未遂的发生率,以及性别之间、城乡之间的差异。方法:采用分层抽样的方法随机抽取北京市区10个居委会和河北武安农村10个村、年龄≥18岁人群共1 000人(城市和农村各500人),实际调查1 007人(城市503人,农村504人);采用自制"公众对自杀的态度问卷"对被试逐项进行调查。结果:被调查的1 007人中,有36人近1年出现过自杀意念,在性别、城乡之间差异无统计学意义(χ2=0.07,χ2=0.11;P均0.05);92人曾经有过自杀意念,在性别之间差异无统计学意义(χ2=0.11,P0.05),但农村显著多于城市(χ2=7.88,P0.05);有6人近1年出现过自杀未遂,18人曾经有过自杀未遂,在性别(χ2=0.72,χ2=0.27)、城乡之间(χ2=0.00,χ2=2.20)差异无统计学意义(P均0.05)。1 007人中有49人的亲属在过去任何时候有过自杀意念,城市显著多于农村(χ2=6.24,P0.05);20人的亲属有过自杀未遂,25人的亲属自杀死亡,城乡之间差异无统计学意义(χ2=0.82,χ2=0.38;P均0.05)。结论:中国北方城乡两地居民自杀意念、自杀未遂的发生率均相对较高,制定相应的自杀预防计划是亟待解决的问题。     

Coffee,caffeine, and risk of completed suicide: Results from three prospective cohorts of American adults

Objective.To evaluate the association between coffee and caffeine consumption and suicide risk in three large-scale cohorts of US men and women. Methods. We accessed data of 43,599 men enrolled in the Health Professionals Follow-up Study (HPFS, 1988–2008), 73,820 women in the Nurses’ Health Study (NHS, 1992–2008), and 91,005 women in the NHS II (1993–2007). Consumption of caffeine, coffee, and decaffeinated coffee, was assessed every 4 years by validated food-frequency questionnaires. Deaths from suicide were determined by physician review of death certificates. Multivariate adjusted relative risks (RRs) were estimated with Cox proportional hazard models. Cohort specific RRs were pooled using random-effect models. Results. We documented 277 deaths from suicide. Compared to those consuming ≤ 1 cup/week of caffeinated coffee (< 8 oz/237 ml), the pooled multivariate RR (95% confidence interval [CI]) of suicide was 0.55 (0.38–0.78) for those consuming 2–3 cups/day and 0.47 (0.27–0.81) for those consuming ≥ 4 cups/day (P trend < 0.001). The pooled multivariate RR (95% CI) for suicide was 0.75 (0.63–0.90) for each increment of 2 cups/day of caffeinated coffee and 0.77 (0.63–0.93) for each increment of 300 mg/day of caffeine. Conclusions. These results from three large cohorts support an association between caffeine consumption and lower risk of suicide.     

CLIL教学理念在研究生医学英语翻转课堂教学中的可行性研究

CLIL(Content and language integrated learning)教学理念中的4C’S原则即将学科知识(Content)、交际能力(Communication)、认知过程(Cognition)、文化意识(Culture)有机地融合在一起,其本质是将知识构建、思辨能力、认知参与、语言的使用和学习进行有机结合,既帮助学习者习得语言和系统知识,又培养其相应的学习能力。将CLIL教学模式中4C’S原则运用到医学专业英语翻转课堂的教学中,既能改革传统医学英语授课方式,也能促进教学效果的提升,具有良好的实践教学意义。     

系统生物学促进中医现代化

系统生物学的系统论与整体论的观点,与中医的整体观念、辨证论治的基本特点不谋而合,系统生物学的研究与发展为中医现代化开辟了新的方向。系统生物学的研究理念为中医研究的现代化提供了新的思路和启示,使传统中医与现代科技研究接轨、走向国际赋予了新的可能。中医将会绽放出新的活力,更好地服务人类的健康事业。     

护理概念的粪型变化

运用发展的观点，对普通护理概念、专业护理概念和护理新概念的内涵及其相互间的联系、区别，从理论方面进行了阐述。