腺样体肥大对儿童各类错牙合影响的头影测量研究

目的：了解腺样体肥大对错牙合儿童颌骨发育的影响。方法对要求行口腔正畸治疗的儿童按腺样体/鼻咽腔比率（adenoidal-nasopharyngeal ratio,A/N）分为试验组（A/N＞0．66）60例和对照组（A/N≤0．66）66例,进行头影测量研究。结果试验组Ⅰ类骨型测量指标中 NA-PA、MP-SN 和 FH-MP 均较对照组增大（P ＜0．05）;Ⅱ类骨型各测量指标与对照组比较差异均无统计学意义（P ＞0．05）;Ⅲ类骨型测量指标中 SNB、Po-NB 较对照组减小, MP-SN 角较对照组增大（P ＜0．05）。结论腺样体肥大对错牙合儿童骨骼的影响在矢状方向上,下颌骨位置后移,在垂直方向上,下颌的陡度增加,下颌呈顺时针方向旋转。     

低分子肝素联合乌司他丁治疗急性百草枯中毒大鼠肺纤维化的实验研究

目的探讨低分子肝素联合乌司他丁减轻急性百草枯（PQ）中毒大鼠肺纤维化的可能作用机制。方法55只雄性SD大鼠,随机分成正常对照组（A组）、模型组（B组）、治疗组（C组）;B、C组禁食1h后经口一次灌胃百草枯75mg／kg制作PQ大鼠肺纤维化模型,A组经口一次性注人等量生理盐水;c组造模后皮下注射低分子肝素钠1000U／d,同时腹腔注射乌司他丁10万U,共14d,A、B组给予0．2ml／d生理盐水皮下注射。分别于造模后1、3、7、14、28d测定血清转化生长因子β1（TGFβ1）、基质金属蛋白酶9（MMP-9）含量;并取肺组织做HE染色。结果与A组比较,B组血清TGF-β1第3天始明显升高（P〈0．01）,血清MMP-9于第7天逐渐上升（P〈0．05）,第28天明显升高（P〈0．01）;与B组各相同时间点比较,C组MMP-9水平下降,至第7天差异有统计学意义（P〈0．05）,第28天出现明显下降（P〈0．01）;而血清TGF．131在第14天开始出现明显下降（P〈0．01）。B组于造模后早期即出现肺泡壁增厚,炎症细胞浸润明显,毛细血管充血、水肿等,14d肉眼可见肺表面溃疡形成,镜下可见肺泡间隔成纤维母细胞、肌纤维细胞增生,肺泡塌陷;C组于14d时镜下可见有肺泡壁毛细血管充血,炎性细胞浸润较B组轻,肺纤维化程度也有所减轻。结论低分子肝素联合乌司他丁可减少MMP-9的合成,从而减轻大鼠纤维化程度,其途径可能通过减少TGF．Bl的合成。     

Twinblock矫治器对颌面部软硬组织生长的改良作用

背景:国内外学者研究发现Twinblock矫治器能有效促进安氏Ⅱ类错(牙合)患者的下颌骨生长,并改善其下颌后缩的侧貌.那么Twinblock矫治器除了促进下颌生长外,还具有哪些生长改良的作用而改变了Ⅱ类错牙厶患者颅颌面的软硬组织结构呢?目的:观察Twinblock矫治器治疗后Ⅱ类错(牙合)者颅颌面软硬组织的改变.方法:选择河北医科大学附属口腔医院正畸科的替牙晚期和恒牙早期安氏Ⅱ类1分类错牙合患者48例,男30例,女18例,年龄9.58～12.37岁,平均11.6岁.接受Twinblock治疗的恒牙早期安氏Ⅱ类1分类患者27例为治疗组,根据病例对照原则,选择放弃治疗的矫治恒牙早期安氏Ⅱ类1分类的患者21例为对照组.采用头影测量分析,比较治疗组治疗前后和对照组的变化.结果与结论:通过治疗组和对照组的对比分析,发现Twinblock矫治器一方面能增强自然生长过程中下颌长度的增长,出现上唇突度的减小和颏唇沟角减小的趋势,另一方面,Twinblock矫治器能抑制自然生长过程中面部垂直距离减小和面突度增加的趋势,使治疗后上下颌骨间在矢状方向的位差缩小,面型趋于协调.提示Twinblock对颌面部软硬组织有生长改良作用,Twinblock矫治器对安氏Ⅱ类错牙厶患者生长促进和生长抑制协同作用,使Ⅱ类错牙台患者的骨面型更加协调.     

计算机辅助数学模型分析Twin-block功能矫治后的组织相关性

背景：功能矫治器的观察对象都是处于生长期的青少年,在研究功能矫治是否有效的问题时,必须要考虑儿童本身的生长发育条件。 目的：排除自然生长因素对实验结果的影响,采用计算机辅助数学分析Twin-block矫治器治疗后Ⅱ类错牙合患者颅颌面软硬组织的相关性。 方法：选择Hagg手腕骨片为FG-G期的安氏Ⅱ类1分类下颌后缩患者31例,其中接受Twin-block功能矫治的Ⅱ类错牙合患者17例,放弃正畸治疗的Ⅱ类错牙合患者14例,2组患者年龄、性别相匹配。分别在治疗前后和自然生长前后拍摄头颅侧位片,观察Twin-block功能矫治前后和自然生长前后侧位片软硬组织头影测量值的变化规律,建立两组数学对比模型。 结果与结论：通过数学对比模型发现,在Twin-block矫治后软组织测量项目Ls-EP、Pn-HP、NB-Pg’-Ls与硬组织测量项目ANB之间存在明显的曲线关系,方程为：NB-Pg’ -Ls=-0.119 1(ANB)2 +3.002 9(ANB)+ 6.148 5,Pn-HP=0.021 4(ANB)2 -1.026 7(ANB)+ 0.347 4,Ls-EP =0.132 4(ANB)2 -0.536 4(ANB)+1.553 7。在自然生长前后,软硬组织的改变差异无显著性意义。提示Twin-block矫治后ANB的角度是改善Ⅱ类错牙合患者软组织侧貌的决定性因素。     

主要头影测量指标评价Ⅱ类错治功能矫治效果

背景:国内外学者通过大量的头影测量研究,阐述了功能矫治器矫治安氏Ⅱ类1分类错邪患者的牙颌面软硬组织变化,但对哪些是反映功能矫治疗效的主要指标并没有统一的认识.目的:从常用的头影测量项目中,筛选出对Ⅱ类错(牙合)的功能矫治效果起主要作用的评价指标,为临床诊治提供参考.设计、时间及地点:对比观察,于1999-08/2007-02在河北医科大学附属口腔医院正畸科完成.对象:选择恒牙早期安氏Ⅱ类,分类患者67例,其中接受功能矫治的患者40例,放弃功能矫治的患者27例.方法:对40例接受功能矫治的Ⅱ类错(牙合)患者及27例放弃治疗的II类错(牙合)胎患者进行X射线头影测量,通过数理统计排除自然生长因素,逐步筛查出影响Ⅱ类错(牙合)功能矫治效果的主要指标.主要观察指标:应用数学方法分5个步骤从58个头影测量项目中逐步筛查出影响Ⅱ类错(牙合)功能矫治效果的主要指标,58个项目中包括33项硬组织测量项目和25项软组织测量项目.结果:通过数学方法逐步筛查,得出影响Ⅱ类错(牙合)功能矫治效果的主要指标为U1-NA(mm),U1-NA,APDI,Ls-EP.结论:4项主要指标Ul-NA(mm),U1-NA,APDI,Ls-EP能客观、精确地评价Ⅱ类错(牙合)功能矫治的效果.     

半月板桶柄状撕裂的MRI诊断与关节镜下分类的相关研究

目的 探讨MRI对半月板桶柄状撕裂的诊断与关节镜下分类的比较研究.方法 分析63例患者65个经关节镜检查证实为半月板桶柄状撕裂的术前MRI的特征性表现,并将5种MRI征象(双后交叉韧带征、半月板翻转征、空领结征、碎块内移征和外周残半月板征)与关节镜下Dandy分型进行比较.结果 MRI桶柄状撕裂诊断符合率89.2%.碎块内移征和空领结征阳性率最高,分别为84.6%和81.5%;双后交叉韧带征(双PCL征)、半月板翻转征(双前角征)、外周残半月板征不如上二者普遍(阳性率分别为43%、21.5%、29.3%).未发现外侧半月板双PCL征;内侧半月板交锁Ⅰ型和Ⅱ型及外侧半月板半长全宽型、全长半宽型与MRI碎块内移征和空领结征有相关性;2例为半月板撕裂Ⅲ级信号,5例为假阴性.结论 5种MRI征象中最少2种(碎块内移征和空领结征阳性率最高)以上出现应高度怀疑为桶柄状撕裂. Abstract： Objective To evaluate the arthroscopic findings of meniscal bucket handle tears and to correlate them with the proposed MR imaging signs of meniscal bucket handle tears suggested in the literature. Methods Sixty-three patients who had a diagnosis of bucket handle tear in arthroscopy were included in our study.Meniscal tears were evaluated in arthroscopy according to Dandy's classification.The MRIs were retrospectively analyzed regarding the following findings:absence of bow tie sign,presence of double posterior cruciate ligament(PCL), fragment within the intercondylar region,flipped meniscus sign, abnormal circumferential meniscus sign. Sensitivity were evaluated for the presence of each individual sign. Results Locked types Ⅰand Ⅱfragment of medial meniscus and half-length,whole-width and whole length-half-width fragement of lateral meniscus in arthroscopy were correlated with fragement within the intercondylar notch and absent bow tie signs in MRI.We didn't find the double PCL sign in any of the patients with a lateral meniscal bucket handle tear.The most common signs in MR imagings of meniscal bucket handle tears were the fragement in the notch sign and the absent bow tie sign.They were observed with frequency of 84.6% and 81.5% respectively.The presence of double posterior cruciate ligament, flipped meniscus sign, abnormal circumferential meniscus sign were less common(43%,21.5% and 29.2%,respectively). Conclusions The presence of at least two of the five MRI signs should be regarded as highly suggestive for bucket handle tears of menisci.     

医疗机构减少药品调配和给药差错的研究

医疗机构中用药差错比较普遍,而调配和给药错误在用药差错中占有较高比例。美国的研究表明,虽然总体上调配和给药错误的发生率比较低,但是由于医疗机构中药品使用量大,一个比较繁忙的医疗机构药房7个月内共发生5075次差错,其中79％被发现。另有研究指出,备药和发药错误占用药差错的11％～21％。我国对调配和给药错误尚缺乏全国性的实证数据,但个别医院的研究表明,调配和给药错误对病人安全的影响是比较显著的。本文从调配和给药差错的影响因素、国外减少相关差错的先进技术与干预措施角度进行分析,提出建议,供国内药学工作者参考。     

降钙素对大白兔糖尿病骨质疏松模型假体骨密度及生物力学的影响

Objective To investigate the influence of calcitonin on bone mineral density and biomechanics around the artificial pros-thesis in ovariectomized diabetic rabbit model. Methods Fourteen femina New Zealand white rabbits at the age of 5 months old were select-ed, which weight 2.24 -2.65kg, averaging 2.26kg. First, the model of rabbit with diabetic osteoporosis was successfully established by the compound method of ovariectomy plus streptozotocin. Osteotomy in the middle part of femur was performed in both groups, fixation of artifi-cial prosthesis was done with 3.0 kirschner wire. After that, Rabbit models with diabetic osteoporosis were randomly divided into experimen-tal group and control group. Rabbits in the experimental group were treated with calcitonin 6U intramuscular injection once every other day. In control group, intramuscular injection of normal saline solution 1.5ml once every three days. Rabbit models of two groups were sacrificed in the 24th week. The BMD of the region of interest (ROI) around the prosthesis were detected before experiment and 8, 16 and 24 weeks after injection. After rabbits were killed, experimental femurs in both groups were complete removal and soft tissues were rejected. Determi-nation of the pull-out and torsion bone biomechanics experiments of prosthesis was done in both groups respectively. Results The BMD of ROI in the experimental group before operation was (0.1863±0.004)g/cm2 and (0.1753±0.005)g/cm2 in 24 weeks after operation, in control group before operation was (0.1865±0.002)g/cm2 and (0.1638±0.005)g/cm2 in 24 weeks after operation. There were significant difference between the two groups(P < 0.05). Biomechanical show that the pull-out strength in the experimental group was (312.68±8.73 )N/cm2 and (205.43±12.45 ) N/cm2 in control group. There were significant difference between the two groups(P < 0.05). The tor-sion strength in experimental group was (80.47±2.51) N/cm2 and (38.52±0.64) N/cm2 in control group. There were significant differ-ence between the two groups(P < 0.05). Conclusion Salmon calcitonin can reduce the bone turnover rate around prosthesis and decrease bone absorption in the rabbit of diabetic osteoporosis models, accelerate the bone formation around prosthesis, and increase the BMD. It can ameliorate the quality of bone around prosthesis, improve its biomechanics property, and increase the holding power between prosthesis and body mass. It is of clinical significance for the prevention and treatment of aseptic loosening artificial prosthesis.     

妊娠期糖尿病患者孕期血糖监测与妊娠结局分析

目的探讨妊娠期糖尿病患者血糖控制对妊娠结局的影响。方法分析2007年7月至2008年7月住院分娩的153例妊娠期糖尿病患者,74例孕期血糖控制满意（A组）,79例控制不满意（B组）,将两组妊娠结局进行比较分析。结果A组子痫前期、羊水过多、巨大儿、新生儿低血糖、新生儿高胆红素血症发生率低于B组（分别为5．41％比17．72％、4．05％比20．25％、12．16％比31．65％、5．41％比20．25％、8．11％比30．38％）（P〈0．05）;A组胎膜早破、早产、产后出血、胎儿宫内窘迫发生率低于B组,但两组比较差异无统计学意义。结论妊娠期糖尿病对母婴近、远期危害大,孕期控制好血糖可减少母婴并发症。     

内养功

内养功是以吐纳为主的防治疾病、保健养生的优秀功法,明末清初流传于民间。20世纪40年代经刘贵珍先生挖掘、整理并应用于临床。该功法分静功和动功两种练习形式,＂形气神合＂贯穿于功法始终。停闭呼吸（亦称为＂不平衡式呼吸法＂）和意念的配合是锻炼的重点。呼吸停闭、气沉丹田、默念字句、舌体起落,具有大脑静、脏腑动的锻炼特点。其初级静功和中极静功的练习内容如下。