胎儿远程智能监护系统的临床应用及效果观察

目的 探讨胎儿远程智能监护在高危妊娠中的临床作用.方法 选择广州医学院附属深圳沙井医院孕期28~32周的高危妊娠孕妇206例,随机分为两组,研究组103例,对照组103例.研究组免费领用我院提供的胎儿远程监护终端(胎心胎动监测仪),按需在家中进行胎儿远程监护,发现异常情况及时和医生取得联系或到医院复诊,对照组按规定定期到医院进行产前检查和胎儿监护.结果 研究组的NST异常检出率大于对照组(χ2=5.707,P<0.05),产前检查次数少于对照组(t=-15.213,P<0.05),顺产率大于对照组(χ2=14.161,P<0.05),产后出血发病率低于对照组(χ2=11.931,P<0.05).研究组的新生儿窒息、早产、羊水粪染、低体重儿发生率均显著低于对照组(χ2值分别为8.271、4.716、5.089、4.696,均P<0.05),新生儿预后不良情况明显得到改善.结论 胎儿远程智能监护应用于高危妊娠,可减少孕妇产后出血率,降低新生儿窒息和早产的发生,对提高围产期保健质量有重要的价值.     

幽门螺杆菌感染与胃粘膜肠上皮化生及不典型增生

幽门螺杆菌感染与胃粘膜肠上皮化生及不典型增生陈世耀刘天舒王吉耀张希德孙玉春上海医科大学中山医院消化科上海市２０００３２Ｓｕｂｊｅｃｔｈｅａｄｉｎｇｓｈｅｌｉｃｏｂａｃｔｅｒｉｎｆｅｃｔｉｏｎｓ；ｇａｓｔｒｉｃｍｕｃｏｓａ；ｍｅｔａｐｌａｓｉａ；...     

计算机辅助设计与辅助制作氧化锆全瓷冠的临床效果初探

目的 评价计算机辅助设计与辅助制作氧化锆全瓷冠的临床修复效果,为其临床应用提供参考.方法 选择于北京大学口腔医学院·口腔医院修复科就诊的磨牙牙体缺损患者60例.30例患者共计35颗患牙用三维激光扫描仪获取工作模型、对验模型及咬合记录的三维数据;用软件的全冠设计程序设计有咬合关系及邻牙接触关系的全解剖形态氧化锆全瓷单冠;用数控机床和氧化锆块制作、终烧结并上釉完成最终修复体,临床试戴并粘固(全瓷冠组).30例患者共计30颗患牙制作金合金铸造单冠(铸造冠组).参考改良的美国公共卫生署评价标准,戴冠后即刻、3、6、12、24个月临床观察和评价修复体外形、颜色、自身和对(牙合)牙磨耗及修复体破损情况.结果 35件氧化锆全瓷冠均未出现崩瓷及折裂,修复后24个月5例患者5件全瓷冠对(牙合)牙出现Ⅰ级磨耗,1例患者1件全瓷冠对(牙合)牙由修复后即刻的Ⅰ级磨耗变为Ⅱ级磨耗,全瓷冠抛光后对(牙合)牙磨耗未进展.30件金合金铸造冠无磨穿等破损现象,对(牙合)牙无明显磨耗.结论 用氧化锆全瓷冠修复磨牙牙体缺损,美观程度较好、不易破损、磨耗,但氧化锆全瓷冠可在一定程度上磨耗其对(牙合)天然牙,应严格把握临床适应证.     

眼玻片伤后行放射状角膜切开术切口破裂1例

<正>患者,男,20岁,因右眼弹伤后异物感半月就诊。患者于35天前在某医院行右眼放射状角膜切开术,术前2天曾来我院检查视力右0.8,左1.0,试镜右-1.00DS=1.2,左-0.50DS=1.2,术后右眼视力1.2,术后20天患者在搬物时被三轮车车灯爆破物弹伤右眼,当即感右眼疼痛,“热泪”流出,立即去原手术医院急诊,患者诉医生说“右眼角膜9点切口裂开,虹膜嵌顿须立即手术”,原手术医生将嵌顿于伤口的虹膜剪掉,角膜缝合一针,一周后出院,视力仍为1.2。此次术后已半月因异物感又来我院诊查:右视力为1.2,角膜12.3.6.9点处分别见     

人脂肪间充质干细胞与生物材料共混物三维打印体的体内成骨

目的：构建人脂肪间充质干细胞（human adipose derived mesenchymal stem cells, hASCs） 生物材料共混物三维生物打印体,检测其体内成骨能力,初步建立将细胞共混物三维生物打印技术应用于体内成骨的技术路线。方法：以P4代hASCs作为种子细胞,进行成骨向诱导,并采用碱性磷酸酶（alkaline phosphatase, ALP）染色和茜素红矿化结节染色检测其成骨向分化的能力。将种子细胞加入20 g/L海藻酸钠和80 g/L明胶混合物（细胞密度约为1×106个/mL）,采用Bioplotter三维生物打印机（德国Envision公司）进行打印,获得细胞 海藻酸钠 明胶共混物打印体,采用活-死细胞双荧光染色法观察打印体中细胞存活率,随后对打印体进行1周成骨诱导培养,作为实验组;另打印不含细胞、只含海藻酸钠 明胶溶胶的三维打印体作为对照组。将实验组和对照组打印体植入裸鼠背部皮下,于植入后6周取出样本,采用苏木精 伊红（hematoxylin-eosin, HE）染色、马松（Masson）三色法染色、免疫组织化学染色和Inveon微型CT（Micro CT）检测打印体样本的成骨情况。结果：打印体中细胞存活率达89%±2%,打印体植入6周后取出,对照组植入打印体大部分发生降解,形态不规则,为无定型凝胶状,而实验组打印体基本保持原有大小,质地坚韧。HE染色和马松三色法染色结果显示,植入6周后,实验组打印体中有类骨组织形成,并有血管长入;免疫组织化学染色结果显示,骨钙素抗体表达成阳性;Micro CT结果显示,实验组密度较高,新生骨容积为18%±1%。结论：hASCs共混物三维生物打印体可在裸鼠体内异位成骨,细胞共混物三维生物打印技术应用于体内成骨的技术路线是可行的。     

小儿烧伤休克的护理体会

通过对78例小儿烧伤休克护理分析,提出抢救是否成功与护理措施是否得当有关,作者的体会是:(1)早期建立良好的补液通道,提供有力的抢救条件是抢救休克成功的关键;(2)严格无菌操作技术,减少或防止并发感染;(3)及时处理并发症,防止病情恶化。     

功能易适数字化全口义齿的自主创新研发

SUMMARY Fabrication of conventional complete dentures involves a complex restoration method, requiring significant time and typically involving primary impressions, definitive impressions, jaw relation records, clinic try-in, and complete denture placement, which has been used for nearly a century without change. A novel digital system named Functionally Suitable Denture (FSD) was researched and deve-loped so as to reduce clinical steps, operation difficulties and errors of complete denture restoration. It pioneered a unique diagnostic complete denture aided by computer aided design (CAD) & 3D printing, by which, the functional impression, jaw relation, and try-in (3 steps) were simplified to 1 step, thus the number of visits to the dentist was reduced by 2 times. Moreover, for the first time, it put forward a CAD software of template matching based on the expert design, which was an efficient and intelligent design scheme, and the excellent denture experts' experience and skills could be inherited and iterated. The system included the 3D scanner with appropriate accuracy and high efficiency, the CAD software, the special 3D printer and process software, and the innovative clinical operation process. The Patent Cooperation Treaty (PCT) patent international search report showed that all the 15 claims of the technology were of novelty, creativity and industrial utility. All the digital products were independently developed and made by Peking University School and Hospital of Stomatology, China. The design and manufacture process of denture prosthesis was fast, simple and accurate. At the same time, personalized functional and aesthetic matching of the patients after wearing prosthesis was realized. It effectively solved the global problems of "slow, difficult and inaccurate" of the traditional manual technology of complete denture, and brought good news to edentulous patients. Compared with the traditional complete denture treatment, FSD system has a wide range of applications for different types of edentulous patients, including those with severe resorption of the alveolar ridge or a high occlusal force. Furthermore, the low-cost of 3D printers, compared with expensive milling machines, may make the approach more accessible. This review describes that our research is related to the development of the FSD system, including multi-source data acquisition technology, three generations of complete denture design software, 3D printing systems of individual tray and complete denture pattern, the clinical and laboratory operation process of the FSD system.     

膝关节功能障碍的综合康复疗效分析

目的总结分析保守治疗膝关节功能障碍的临床疗效.方法对31例膝关节功能障碍患者进行关节功能牵引、肌力训练、关节内注射和理疗等综合治疗.结果ROM(关节活动度,Rang of Motion)治疗有效率90.3%,肌力训练有效率67.7%.结论膝关节功能障碍采用保守治疗仍能取得一定的疗效.等速训练可能有助于扩大ROM.     

数字化全口义齿的临床应用和研究进展

数字化技术利用高精度三维扫描、智能辅助设计软件和多轴数控切削或3D打印技术，可以制作出精度可靠、功能适宜的修复体。然而，由于全口义齿操作的复杂性，数字化技术在全口义齿修复领域的研发进度相对缓慢。本文将从数字化全口义齿的研究现状以及临床应用两个方面，阐述目前数字化全口义齿在口腔修复临床和技工室应用和研发的进展情况。