缩短全口义齿修复患者平均椅旁治疗浪费时间

目的缩短全口义齿修复患者平均椅旁治疗浪费时间，提高工作质量和效率。方法按照问题解决型品管圈活动步骤进行问题改进，改进措施包括专项学习个别托盘制作、全数字化流程制作支架、改善基础设施、加强培训等。结果全口义齿修复患者平均椅旁治疗浪费时间从113 min缩短至28 min，提高了工作效率，提升了圈员能力。结论品管圈作为一项有效的质量管理工具，其应用可以缩短全口义齿修复患者平均椅旁治疗浪费时间，值得推广。     

CT引导下经蝶腭穴芒针透刺蝶腭神经节治疗变应性鼻炎的临床观察*

目的观察CT引导下经蝶腭穴芒针透刺蝶腭神经节治疗变应性鼻炎的临床疗效。方法 将72例变应性鼻炎患者随机分为试验组和对照组，试验组采用CT引导下经蝶腭穴芒针透刺蝶腭神经节；对照组采用常规针刺蝶腭穴及常规穴位，疗程结束后评定临床疗效。结果 试验组的总有效率为94.44%，对照组的总有效率为77.78%，差异具有统计学意义。试验组的指标改善均优于对照组。结论 在CT引导下，采用芒针透刺蝶腭神经节治疗变应性鼻炎，其治疗方法颇具特色，提高了透刺蝶腭神经节的准确性及安全性，从而为非CT引导时透刺的角度与深度提供了一定的参考依据。     

中草药种植品质知识图谱的构建

科学合理地种植中草药是解决中药资源紧缺、保障中药质量的根本方法。中草药品质受种子种苗、种植措施、土壤状况等多种因素影响，各影响因素对中草药品质产生不同的作用，但迄今为止并没有通过调控中草药种植因素分析中药材品质的模型和方法。因此，本研究通过文献调研结合专家种植经验，综合分析影响中草药种植指标的复杂因素，以提高中药材品质为目标，基于图数据库的方法构建影响不同中草药种植品质的知识图谱，探讨中草药种植因素与指标之间的关系，通过调节影响中药材品质的因素，为中草药种植以及提高中药品质提供依据。     

Next-generation sequencing through multigene panel testing for the diagnosis of hereditary epidermolysis bullosa in Chinese population

Epidermolysis bullosa (EB) is a heritable blistering disorder. We performed a next-generation sequencing-based multigene panel test and successfully predicted 100% of the EB types, including, 36 EB simplex (EBS), 13 junctional EB (JEB), 86 dystrophic EB (DEB), and 3 Kindler EB. Chinese JEB and recessive DEB (RDEB) patients have relatively mild phenotypes; for severe type separately accounts for 45.5% and 23.8%, respectively. We identified 96 novel and 49 recurrent pathogenic variants in 11 genes, although we failed to detect the second mutation in one JEB and five RDEB patients. We identified one novel p.E475K mosaic mutation in the clinically normal mother of one out of 13 EBS patients with KRT5 mutations, one recurrent p.G2034R mosaic mutation, and one novel p.G2043R mosaic mutation in the clinically normal relatives of two out of 19 dominant DEB patients. This study shows that next-generation technology could be an effective tool in diagnosing EB.     

Coinheritance of generalized pustular psoriasis and familial Behçet‐like autoinflammatory syndrome with variants in IL36RN and TNFAIP3 in the heterozygous state

Generalized pustular psoriasis (GPP) is now known to be caused by biallelic variants in IL36RN and monoallelic variants in CARD14 and AP1S3. The presence of a modifier locus or oligogenic inheritance have been hypothesized. We report on a patient with a unique coinheritance of pathogenic variants in IL36RN (c.115+6T>C) and TNFAIP3 (c.547C>T, p.R183 * ) causing the genetic entities GPP and familial Behçet‐like autoinflammatory syndrome (AISBL). The heterozygous variant in IL36RN identified by Sanger sequencing was inherited from his unaffected father, while the heterozygous variant in TNFAIP3 was detected by whole‐exome sequencing and was also identified in the patient's AISBL‐affected maternal relatives. Further functional studies are required to research whether the variant of TNFAIP3 plays a part in the development of GPP or simply causes the Behçet's disease phenotype. However, our data suggest that whole‐exome sequencing for the heterozygous carrier of the IL36RN gene in GPP be used to find the potential second genetic locus.     

胰高血糖素样肽1受体激动剂类降糖药致2型糖尿病患者头疼和眩晕的网状Meta分析

摘 要 目的：使用网状Meta分析系统评价胰高血糖素样肽1受体激动剂（GLP-1 RAs）类降糖药对2型糖尿病（T2DM）患者头疼和眩晕的影响。方法：系统检索Medline、Embase、Clinical trials和Cochrane数据库中（截止2017年6月23日）比较GLP-1 RAs与传统降糖药或安慰剂对头疼和眩晕发生风险影响的随机对照试验（RCT）,采用贝叶斯网状Meta分析对纳入的研究进行分析。结果：共纳入100项RCTs,包括15种干预措施：8种GLP-1 RAs类降糖药（艾塞那肽、艾塞那肽缓释剂、利拉鲁肽、利西拉来、他司鲁肽、阿必鲁肽、杜拉鲁肽、索玛鲁肽）、安慰剂、2种二肽基肽酶-4（DPP-4）抑制剂（西格列汀和维格列汀）和4种传统降糖药（胰岛素、二甲双胍、磺脲类、噻唑烷二酮类）。网状Meta分析结果显示：与胰岛素相比,艾塞那肽（OR=1.35,95%CI：1.13~1.60）、利拉鲁肽（OR=1.35,95%CI：1.12~1.62）、利西拉来（OR=1.59,95%CI：1.22~2.06）和他司鲁肽（OR=1.78,95%CI：1.33~2.37）致T2DM患者发生头疼的风险增加;与安慰剂、胰岛素及噻唑烷二酮相比,艾塞那肽和利拉鲁肽显著增加了眩晕发生的风险（OR的取值范围为1.56~2.56）。此外,后验概率显示,致T2DM患者发生头疼风险最高的前三位为艾塞那肽缓释剂、二甲双胍、他司鲁肽;致T2DM患者发生眩晕风险最高的前三位为利拉鲁肽、利西拉来和艾塞那肽。结论：艾塞那肽缓释剂和他司鲁肽显著增加了头疼的发生风险,利拉鲁肽显著增加了眩晕的发生风险,但仍建议开展相应的大型前瞻性研究加以验证。     

Targeted delivery of hyaluronic acid-coated solid lipid nanoparticles for rheumatoid arthritis therapy

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease. Long-term, high-dose glucocorticoid therapy can be used to treat the disease, but the fact that the drug distributes systemically can give rise to severe adverse effects. Here we develop a targeted system for treating RA in which the glucocorticoid prednisolone (PD) is encapsulated within solid lipid nanoparticles (SLNs) coated with hyaluronic acid (HA), giving rise to HA-SLNs/PD. HA binds to hyaluronic receptor CD44, which is over-expressed on the surface of synovial lymphocytes, macrophages and fibroblasts in inflamed joints in RA. As predicted, HA-SLNs/PD particles accumulated in affected joint tissue after intravenous injection into mice with collagen-induced arthritis (CIA), and HA-SLNs/PD persisted longer in circulation and preserved bone and cartilage better than free drug or drug encapsulated in SLNs without HA. HA-SLNs/PD reduced joint swelling, bone erosion and levels of inflammatory cytokines in serum. These results suggest that encapsulating glucocorticoids such as PD in HA-coated SLNs may render them safe and effective for treating inflammatory disorders.     

Comparison of Radiovisiography with radiographic film in root length determination

Radiovisiography is a digital intraoral radiographic imaging system requiring a substantial reduction of radiation dosage to the patient over film. For Radiovisiography to replace film, it must be shown to be as efficacious. In this study, a technique of obtaining Radiovisiography and D-speed film images from the same X- ray beam was developed with the use of rare-earth filters. The quality of the resultant radiovisiographic images was verified in vitro with pure radiovisiographic images of teeth in a dried mandible with soft tissue simulation. Two examiners compared Radiovisiography with D-speed film for 20 root length estimations using the same in-vitro model. A clinical study was then carried out on mandibular molars of patients undergoing endodontic treatment, where 35 root lengths were obtained. The results of both in vitro and clinical studies showed no statistical differences in the estimated root lengths using the two imaging systems. The measuring grid available in the Radiovisiography unit produced similarly accurate results. Furthermore, the clinical study demonstrated the effective use of Radiovisiography during root canal treatment, with instant images.