头颈部恶性肿瘤患者血清可溶性白介素2受体水平

目的:研究头颈部恶性肿瘤患者血清可溶性白介素2受体(sIL-2R)水平的变化。方法:用双抗体夹心法对60例头颈部恶性肿瘤患者,60例良性肿瘤患者以及50例健康对照者的血清sIL-2R水平进行检测。结果:头颈部恶性肿瘤患者组血清sIL-2R水平显著高于健康对照组(P<0.01),而良性肿瘤患者组血清sIL-2R水平与健康对照组无统计学差异(P>0.05)。结论:血清中高sIL-2R水平可能与头颈部恶性肿瘤的发生有相关性。     

无牙颌患者的咬合垂直距离与咀嚼肌肌电关系的实验研究

作者选择了颌关系正常、能合作的15名无牙颌受试者。在4kg咬合力作用下，在不同的咬合垂直距离时，测定了颞肌及嚼肌的肌电幅值，实验结果表明，在控制咬合力状态下，无牙颌患者的咀嚼肌肌电幅值随着垂直距离增加而逐渐下降，两者间呈非常显著性负相关关系；在肌电活动变化过程中，有一相对稳定区域，由此提示，为无牙颌患者重建的咬合垂直距离有一定生理范围，约1.0mm(后牙区测点）。     

The phenomenon of the inducement of demand and various concepts in the economics of health

The article looks at the behaviour of practitioners and patients from an economic point of view, in particular at supplier-induced demand (SID). The objective is to be able to describe the factors which impact on the market for health care. To define the market for health care/dental care in general and the SID concept in particular, the following economic terminology is relevant. uncertainty, asymmetric information, moral hazard, and the agency relationship between practitioner and patient. Essentially SID results from the existence of asymmetric information (information "gap") on the health care market. The patient is less informed than the practitioner and cannot accurately assess his need for medical care. Hence decision-making authority is delegated to the practitioner who acts as the patient's agent to determine the optimal (amount of) care. This enables the practitioner to influence the demand for medical/dental care. If the practitioner is more interested in the rate of return than in the patient s need for care, a difference might arise between the care recommended by the practitioner and the care the patient would have asked for if he had the same level of information as the practitioner. This difference is called the amount of SID.     

p16基因在口腔肿瘤中的研究进展

p16基因是一种新近发现的抑癌基因,它以缺失﹑突变或甲基化的形式广泛存在于多种肿瘤中,并参与肿瘤的发生和发展。本文就p16基因在肿瘤中的研究进展及其在口腔肿瘤中的研究前景作一综述。     

Microleakage study of various soft denture liners by autoradiography: effect of accelerated aging

STATEMENT OF PROBLEM: The longevity of soft denture liners is a major clinical problem. Debonding of the soft liner from the denture base material is one of the factors that influence their longevity. Debonding of the soft liner can be attributed to microleakage at the interface. PURPOSE: This study investigated microleakage at the interface of various soft liners and base materials. MATERIALS AND METHOD: Six soft liners were investigated. Forty specimens of each material in disk form (10 mm in diameter, thickness of approximately 4 mm) were prepared. Twenty specimens of each material were stored in an accelerated weathering tester for 900 hours. For 2 days, all disks were immersed in (45)Ca radioisotope solution, then they were embedded in acrylic resin blocks and sectioned longitudinally. Autoradiographic imaging was used to determine microleakage at the interface of the soft liners and their bases. RESULTS: Significant differences between nonaged materials were found (P<.05).The difference between Molloplast B and Mucopren (silanized) was not significant (P<.05). Differences among aged materials were significant (P>.05). Differences between Mucopren (nonsilanized), Mucopren (silanized), and Ufigel P-Tokuyama were not significant (P<.05). Significantly decreased microleakage characteristics were determined for Molloplast B, Mucopren (nonsilanized) and Ufigel P liners after aging. CONCLUSION: Microleakage of Mucopren and Molloplast B lining materials was the lowest. However, the microleakage of Flexor and Simpa was the highest. The aging process did not significantly affect the microleakage characteristics of the Simpa, Flexor, Mucopren (silanized), or Tokuyama materials. Molloplast B, Mucopren (nonsilanized), and Ufigel P materials should significantly decrease microleakage properties after aging.     

全科规范化培训医师科研培训现状与需求调查

2019年4月,对四川大学华西医院全科规范化培训(简称“规培”)医师进行问卷调查,调查内容包括规培医师的基本情况、科研培训现状、科研培训需求。共发放问卷177份,回收有效问卷164份,有效回收率92.6%。分别有52名(31.7%)及31名(18.9%)规培医师参加过临床科研项目课题及临床科研相关培训,仅10名(6.1%)以第一作者发表过学术论文。大部分规培医师认为参加科研项目培训很有必要,有126名(76.8%)认为需要开展统计分析与医学文献检索知识培训,有122名(74.4%)认为需要开展临床科研设计、数据收集与管理、论文撰写与发表、医学科研英语知识培训,有121名(73.8%)认为需要开展期刊选择与投稿知识培训。研究生及非研究生规培医师对不同科研课程培训的需求差异无统计学意义(P>0.05);高、低年级规培医师仅临床科研设计课程的需求度存在差异[84.9%(45/53)比69.4%(77/111),χ²=4.55,P<0.05]。全科规培医师科研能力薄弱,可从改进全科规范化培训模式、导师指导科研工作、开展互联网教育、制定激励机制等方面提升全科规培医师的科研能力。     

清肠化湿方对溃疡性结肠炎小鼠炎症及肠道菌群的影响

目的   探究清肠化湿方对溃疡性结肠炎模型小鼠的治疗作用及机制。方法   DSS诱导制备溃疡性结肠炎小鼠模型,称小鼠体质量,量取结肠长度,制备结肠病理切片,ELISA法检测结肠组织中IL-6和TNF-α的水平,气相色谱-质谱法分析测定结肠肠道内容物中丁酸、异丁酸的含量,基于16S rRNA扩增与高通量测序技术检测分析小鼠粪便菌群的构成及丰度。结果   与正常对照组相比,溃疡性结肠炎模型小鼠表现为体质量下降,脾脏肿大,结肠长度缩短(P < 0.05~0.01),结肠组织中IL-6和TNF-α水平升高(P < 0.01),肠道内容物中丁酸、异丁酸含量下降(P < 0.01),肠道菌群组成及丰度发生变化。清肠化湿方干预治疗后,与模型组相比,治疗组小鼠体质量明显增加,脾脏肿大减轻,结肠长度增加,肠道病理损伤改善,结肠组织IL-6和TNF-α水平降低,肠道内容物中丁酸、异丁酸的含量显著增加,失衡的肠道菌群被调节趋向正常组水平。结论   清肠化湿方治疗溃疡性结肠炎的作用机制与调节肠道菌群、提高肠道内丁酸和异丁酸含量、降低促炎因子IL-6和TNF-α水平等有关。      

MSCT三维重建对股骨粗隆间骨折PFNA治疗前的临床应用价值分析

目的分析MSCT三维重建对股骨粗隆间骨折PFNA治疗前的临床应用价值。方法回顾分析本院2017年5月至2019年7月收治的90例股骨粗隆间骨折患者的临床资料,将MSCT的诊断结果进行讨论和分析,并比较MSCT检查、手术中实际测量及X线检查后股骨粗隆间骨折块数量,分析骨皮质的连续性及股骨粗隆间骨折端稳定性,与X线检查结果进行比较分析。结果经MSCT三维重建检查后股骨粗隆间骨折块数量与X线检查比较差异有统计学意义(P<0.05),与手术中实际测量结果比较差异无统计学意义(P>0.05);MSCT三维重建检查骨皮质不连续的、骨折端分型不稳定的检出率均显著高于X线检查,两者比较差异有统计学意义(P<0.05)。结论 MSCT扫描三维重建技术在股骨粗隆间骨折PFNA治疗前具有十分重要的意义,可为临床上诊断治疗股骨粗隆间骨折提供了可靠的影像学信息,能有效改善患者预后,提高患者生活质量。     

三联疗法和传统方案治疗NVG的疗效对比

目的 探讨球内注射康柏西普及Ahmed引流阀植入术联合全视网膜光凝术(panretinal photocoagulation,PRP)三联疗法和传统方案单纯睫状体光凝术(transscleral ciliary photocoagulation,TCP)联合全视网膜光凝术治疗新生血管性青光眼(neocascular-glaucoma,NVG)的临床疗效对比.方法 将2018年10月至2021年2月于锦州市中心医院明确诊断为新生血管性青光眼的患者48例48眼,按照随机数字抽签法分为试验组26例26眼,对照组22例22眼.试验组行三联治疗玻璃体腔内注射康柏西普、Ahmed引流阀植入术联合全视网膜光凝,对照组行传统疗法单纯睫状体光凝术联合全视网膜光凝.比较两组患者手术前及术后6个月眼压、视力及并发症情况.结果 术后6个月,两组眼压较治疗前均降低,且试验组眼压(12.58±3.41)mmHg低于对照组(17.32±3.29)mmHg(P<0.05).试验组视力保留及提高情况明显优于对照组.试验组术后并发症发生率为7.70％,对照组为31.82％.结论 三联疗法相较于传统方案睫状体光凝术联合全视网膜光凝术治疗新生血管性青光眼更能有效的控制患者眼压,保留现有视功能,降低并发症风险,可作为NVG患者首选治疗方案.     

腹部钝伤CT诊断与临床分析

目的评价CT检查对腹部钝伤的诊断价值。方法对240例CT检出腹部脏器损伤病例进行回顾性分析。结果 240例腹部钝伤CT检出单一器官损伤125例,肝肾同时伤36例,复合伤25例,腹腔积血195例,腹膜后血肿40例。结论 CT对腹部脏器损伤的正确诊断和临床治疗提供重要信息。