保留乳头乳晕的改良根治术联合假体置入术对乳腺癌早期患者的影响观察

目的探讨保留乳头乳晕的改良根治术联合假体置入术对乳腺癌早期患者应对方式及美观效果的影响。 方法选取2017年3月至2019年3月长安医院收治的乳腺癌早期患者140例,根据手术方案分为研究组与对照组,各70例。研究组采取保留乳头乳晕的改良根治术联合假体置入术,对照组采取乳腺癌改良根治术。统计两组手术情况（手术时间、淋巴结清扫数目、术后引流量、住院时间）、并发症（皮下气肿、感染、皮肤坏死、皮下积液、上肢水肿）、美观效果,对比手术前后免疫功能（CD3⁺、CD4⁺、CD4⁺/CD8⁺）、应对方式。 结果研究组术后引流量少于对照组,住院时间短于对照组（t=13.584、8.423,P<0.001、<0.001）。术后1 d研究组CD3⁺、CD4⁺、CD4⁺/CD8⁺高于对照组（t=6.612、7.057、5.170,均P<0.001）。术后1个月研究组依靠自我、姑息、宿命、逃避评分低于对照组,情感宣泄、寻求支持、乐观、面对评分高于对照组（t=10.821、11.010、7.854、5.952、8.563、9.657、9.223、11.596,均P<0.001）。研究组并发症发生率（5.72%）低于对照组（20.00%）（χ²=6.375,P=0.012）,美观效果优良率（92.86%）高于对照组（81.43%）（χ²=4.080,P=0.043）。 结论保留乳头乳晕的改良根治术联合假体置入术治疗乳腺癌早期患者,可减少并发症,改善应对方式,提高美观效果,且对免疫功能影响较小。     

The Permian reptile Opisthodontosaurus carrolli: a model for acrodont tooth replacement and dental ontogeny

Continuous tooth replacement is common for tetrapods, but some groups of acrodont lepidosaurs have lost the ability to replace their dentition (monophyodonty). Acrodonty, where the tooth attaches to the apex of the jawbone, is an unusual form of tooth attachment that has been associated with the highly autapomorphic condition of monophyodonty. Beyond Lepidosauria, very little is known about the relationship between acrodonty and monophyodonty in other amniotes. We test for this association with a detailed study of the dentition of Opisthodontosaurus, an unusual Early Permian captorhinid eureptile with acrodont dentition. We provide clear evidence, both histological and morphological, that there were regular tooth replacement events in the lower jaw of Opisthodontosaurus, similar to its captorhinid relatives. Thus, our study of the oldest known amniote with an acrodont dentition shows that acrodonty does not inhibit tooth replacement, and that many of the characteristics assigned to lepidosaurian acrodonty are actually highly derived features of lepidosaurs that have resulted secondarily from a lack of tooth replacement. In the context of reptilian dental evolution, we propose the retention of the simple definition of acrodonty, which only pertains to the relative position of the tooth at the apex of the jaw, where the jaw possesses equal lingual and labial walls. This definition of implantation therefore focuses solely on the spatial relationship between the tooth and the jawbone, and separates this relationship from tooth development and replacement.     

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??Abstract??The purpose of the present study was to show the different choices of periodontal surgeries in resolving various clinical problems. There were both demands of restoration in bilateral posterior areas of the patient??but their remaining of local dental tissue was different. In order to immediately restore the function and esthetic of the patient's dentition??the crown-lengthening surgery was applied on the side of more dental tissue available??the tooth was extracted on the other side of less dental tissue available and cureless apical lesion??also??implant surgery was applied electively. Soft and hard tissue augmentation was finished in implantation synchronously. The effect of final restorations was good and the patient was satisfied. The periodontal surgery played the key role in multidisciplinary treatment??therefore??its indications should be carefully and comprehensively chosen in overall treatment design.     

骨增量技术在口腔种植中的应用进展

种植术区的骨质、骨量是种植手术成败的关键因素之一,临床上常常因为患者缺牙区骨量不足而使得种植医生及患者对种植牙望而却步,随着骨增量技术的发展,使得种植手术的适应证不断扩大,常见的骨增量技术包括骨劈开术、骨挤压术、引导骨再生技术、牵张成骨术、上颌窦提升术及骨移植术等,这些技术的单独及联合应用均不同程度地增加了种植手术的成功率,本文就骨增量技术在牙种植的应用进展作一综述。     

Magnesium vs. machined surfaced titanium - osteoblast and osteoclast differentiation

PURPOSE

This study focused on in vitro cell differentiation and surface characteristics in a magnesium coated titanium surface implanted on using a plasma ion source.

MATERIALS AND METHODS

40 commercially made pure titanium discs were prepared to produce Ti oxide machined surface (M) and Mg-incorporated Ti oxide machined surface (MM). Surface properties were analyzed using a scanning electron microscopy (SEM). On each surface, alkaline phosphatase (ALP) activity, alizarin red S staining for mineralization of MC3T3-E1 cells, and quantitative analysis of osteoblastic gene expression, were evaluated. Actin ring formation assay and gene expression analysis of TRAP and GAPDH performing RT-PCR were performed to characterize osteoclast differentiation on mouse bone marrow-derived macrophages (BMMs).

RESULTS

MM showed similar surface morphology and surface roughness with M, but was slightly smoother after ion implantation at the micron scale. M was more hydrophobic than MM. No significant difference between surfaces on ALP activity at 7 and 14 days were observed. Real-time PCR analyses showed similar levels of mRNA expression of the osteoblast phenotype genes; osteopontin (OPN), osteocalcin (OCN), bone sialoprotein (BSP), and collagen 1 (Col 1) in cell grown on MM at 7, 14 and 21 days. Alizarin red S staining at 21 days showed no significant difference. BMMs differentiation increased in M and MM. Actin ring formation assay and gene expression analysis of TRAP showed osteoclast differentiation to be more active on MM.

CONCLUSION

Both M and MM have a good effect on osteoblastic cell differentiation, but MM may speed the bone remodeling process by activating on osteoclast differentiation.     

外周血单个核细胞宫腔内灌注治疗对反复种植失败患者妊娠结局的影响

目的探讨自体外周血单个核细胞（PBMCs）宫腔内灌注治疗对反复种植失败（RIF）患者胚胎种植率和临床妊娠率的影响。方法按随机数字表法将纳入的39例拟行冷冻胚胎移植的RIF患者随机分为治疗组（20例）和对照组（19例）,治疗组在移植前3d抽取外周血20ml,应用淋巴细胞分离液分离PBMC后行宫腔灌注。对照组移植前未行自体PBMC宫腔灌注。结果两组患者年龄、血清卵泡刺激激素（FsH）、取卵周期数、移植周期数、移植胚胎数和单周期移植优质胚胎数均无统计学差异（P〉0．05）。两组胚胎种植率（22．8％VS．6．4％）和临床妊娠率（50．0％VS．17．6％）比较,治疗组均显著高于对照组（P％0．05）。两组单周期活婴出生率（45．0％VS．17．6％）比较无统计学差异（P〉0．05）。结论自体PBMC宫腔内灌注治疗可以提高RIF患者胚胎种植率和临床妊娠率,故可作为RIF患者胚胎移植前提供可选择的处理方案。