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1.
目的观察不同产地白术组成四君子汤治疗脾胃气虚证的临床疗效,测定不同产地白术组成四君子汤的主要成分含量,探究四君子汤的物质基础。方法158例脾胃气虚证患者为研究对象,①随机抽取50例,再随机分为五组,每组10例。采购安徽、浙江、湖南、河北、河南产地的白术,贵州的茯苓、吉林的人参、新疆的甘草,组成5种不同产地的白术及相同产地的茯苓、人参、甘草四君子汤,分别给予五组患者服用,治疗14 d后计算五组的改善积分。其中,浙江产地的白术四君子汤改善积分最高,河南产地的白术四君子汤改善积分最低。②将剩余的108例患者随机分为观察1组(38例)、观察2组(38例)、对照组(32例)。对照组给予常规对症治疗,观察1组给予常规对症+浙江产地的白术四君子汤治疗,观察2组给予常规对症+河南产地的白术四君子汤治疗。四君子汤方剂组成及治疗时间同上。比较观察1组、观察2组、对照组的治疗效果,观察不同产地白术的四君子汤成分含量检测结果。结果观察1组的总有效率为94.74%,观察2组的总有效率为78.95%,对照组的总有效率为56.25%。观察1组与观察2组的总有效率均高于对照组,观察1组的总有效率高于观察2组,差异具有统计学意义(P<0.05)。浙江产地白术的四君子汤中的白术内酯Ⅰ、白术内酯Ⅱ、白术内酯Ⅲ含量及总量均最高,河南产地白术的四君子汤中的总量最低。结论推测白术内酯Ⅰ、白术内酯Ⅱ、白术内酯Ⅲ是四君子汤治疗脾胃气虚证的物质基础。  相似文献   
2.

Statement of problem

Trials comparing the overall performances of digital and conventional workflows in restorative dentistry are lacking.

Purpose

The purpose of the third part of this clinical study was to test whether the fit of zirconia 3-unit frameworks for fixed partial dentures fabricated with fully digital workflows differed from that of metal frameworks fabricated with the conventional workflow.

Material and methods

In each of 10 participants, 4 fixed-partial-denture frameworks were fabricated for the same abutment teeth according to a randomly generated sequence. Digital workflows were applied for the fabrication of 3 zirconia frameworks with Lava, iTero, and Cerec infiniDent systems. The conventional workflow included a polyether impression, manual waxing, the lost-wax technique, and the casting of a metal framework. The discrepancies between the frameworks and the abutment teeth were registered using the replica technique with polyvinyl siloxane. The dimensions of the marginal discrepancy (Discrepancymarginal) and the internal discrepancy in 4 different regions of interest (Discrepancyshoulder, Discrepancyaxial, Discrepancycusp, and Discrepancyocclusal) were assessed using a light microscope. Post hoc t tests with Bonferroni correction were applied to detect differences (α=.05).

Results

Discrepancyshoulder was 96.1 ±61.7 μm for the iTero, 106.9 ±96.0 μm for the Lava, 112.2 ±76.7 μm for the Cerec infiniDent, and 126.5 ±91.0 μm for the conventional workflow. The difference between the iTero and the conventional workflow was statistically significant (P=.029). Discrepancyocclusal was 153.5 ±66.8 μm for the iTero, 203.3 ±127.9 μm for the Lava, 179.7 ±63.1 μm for the Cerec infiniDent, and 148.8 ±66.8 μm for the conventional workflow. Discrepancyocclusal was significantly lower for the conventional workflow than for the Lava and the Cerec infindent workflows (P<.01). The iTero resulted in significantly lower values of Discrepancyocclusal than the Lava and the Cerec infiniDent workflows (P<.01).

Conclusions

In terms of framework fit in the region of the shoulder, digitally fabricated zirconia 3-unit frameworks presented similar or better fit than the conventionally fabricated metal frameworks. In the occlusal regions, the conventionally fabricated metal frameworks achieved a more favorable fit than the CAD-CAM zirconia frameworks.  相似文献   
3.
4.
ObjectiveDescribe the risk of poverty and social exclusion in children aged 8-11 years from Gipuzkoa and Valencia (Spain), through AROPE (At Risk Of Poverty or Social Exclusion) indicators, and evaluate their associated factors in the INMA Project (Childhood and Environment).MethodFamilies in Gipuzkoa and Valencia (394 and 382, respectively) completed a questionnaire in 2015-2016. Low work intensity (LWI), at risk of poverty (RP) and material deprivation (MD) were estimated. AROPE consisted in meeting any of the previous sub-indicators. Socio-demographic, family and parental characteristics were considered. Frequencies, Venn's diagrams, and chi-square and Fisher tests were used in bivariate analysis and logistic regression in multivariate analysis.ResultsFor LWI, RP, MD and AROPE, prevalence of 2.5%, 5.6%, 2.3% and 7.2% were obtained in Gipuzkoa, and 8.1%, 31.5%, 7.8% and 34.7% in Valencia, respectively. In the multivariate analysis, the AROPE was associated in both areas with maternal social class and non-nuclear families. In Gipuzkoa, it was also related to maternal education. In Valencia, other factors were the mother's foreign origin, and paternal education and smoking.ConclusionThere is higher AROPE prevalence in Valencia. Social class and family type were shared factors, but a differential pattern is observed in other social determinants. It is essential to implement social policies to reduce this axis of inequalities in health, especially in childhood.  相似文献   
5.
目的分析对比某医院2016年1月1日-2018年12月31日脑梗死住院患者医药分开综合改革前后住院费用差异。方法采用卡方检验方法分析脑梗死住院患者医改前后性别、患者来源、付费方式和治疗方式的差异;T检验方法分析医改前后脑梗死住院患者各项费用对比差异;分层分析脑梗死住院患者的不同治疗方式在医改前后各项费用的差异。结果脑梗死住院患者医改前后例均费用分别为23259元和24442元,控制其他因素的影响,医改前后脑梗死住院患者费用没有差异(P=0.744),医改后脑梗死住院患者例均药费降低(P<0.001)、例均检查费增加(P=0.002)、例均材料费增加(P<0.001)和例均治疗费增加(P<0.001);分层分析不同治疗方式,脑梗死住院患者医改后例均费用内科治疗减少了877元(P=0.0.094),手术治疗增加了21545元(P=0.076),介入治疗增加了12863元(P=0.295),后二者的例均材料费增加了分别为15243元(P=0.037)和16907元(P<0.001)。结论脑梗死住院患者医药分开综合改革前后费用没有统计学差异,脑梗死介入治疗和手术治疗费用增加归因于材料费用增加。  相似文献   
6.
PurposeTo assess myocardial extracellular volume fraction (ECV) measurement provided by a single-source dual-energy computed tomography (SSDE-CT) acquisition added at the end of a routine CT examination before transcatether aortic valve implantation (TAVI) compared to cardiac magnetic resonance imaging (MRI).Materials and methodsTwenty-one patients (10 men, 11 women; mean age, 86 ± 4.9 years [SD]; age range: 71–92 years) with severe aortic stenosis underwent standard pre-TAVI CT with additional cardiac SSDE-CT acquisition 7 minutes after intravenous administration of iodinated contrast material and myocardial MRI including pre- and post-contrast T1-maps. Myocardial ECV and standard deviation (σECV) were calculated in the 16-segments model. ECV provided by SSDE-CT was compared to ECV provided by MRI, which served as the reference. Analyses were performed on a per-segment basis and on a per-patient involving the mean value of the 16-segments.ResultsECV was slightly overestimated by SSDE-CT (29.9 ± 4.6 [SD] %; range: 20.9%–48.3%) compared to MRI (29.1 ± 3.9 [SD] %; range: 22.0%–50.7%) (P < 0.0001) with a bias and limits of agreement of +2.3% (95%CI: −16.1%– + 20.6%) and +2.5% (95%CI: −2.1%– + 7.1%) for per-segment and per-patient-analyses, respectively. Good (r = 0.81 for per-segment-analysis) to excellent (r = 0.97 for per-patient-analysis) linear relationships (both P < 0.0001) were obtained. The σECV was significantly higher at SSDE-CT (P < 0.0001). Additional radiation dose from CT was 1.89 ± 0.38 (SD) mSv (range: 1.48–2.47 mSv).ConclusionA single additional SSDE-CT acquisition added at the end of a standard pre-TAVI CT protocol can provide ECV measurement with good to excellent linear relationship with MRI.  相似文献   
7.
《Dental materials》2020,36(4):e93-e108
ObjectiveThe aim of this systemic review, conducted in accordance with the PRISMA statement, was to investigate the impact of surface pretreatments on the bonding strength of high performance polymers (HPPs).MethodsEight databases were searched through March 2019. Risk of bias was assessed and random effects meta-analyses were applied to analyze mean differences in shear bond strength (SBS) and tensile bond strength (TBS), considering surface pretreatments and bonding agents after 24h and thermocycling.ResultsA total of 235 relevant titles and abstracts were found, yielding 11 final selections. Low risk of bias was observed in most studies. For polyetheretherketone (PEEK) specimens, random-effect models showed that, compared to non-treated controls, pretreatments associated with Visio.link® (Bredent, Senden, GE) increased TBS by 26.72 MPa (95% confidence interval (CI), 19.69–33.76; p < 0.00001) and increased SBS by 4.86 MPa (95% CI, 2.61–7.10; p < 0.00001). Air abrasion improved SBS by 4.90 MPa (95% CI, 3.90–5.90; p < 0.00001) (50 μm alumina) and 4.51 MPa (95% CI, 1.85–7.18; p = 0.0009) (silica-coated CoJet). In comparison to non-treated controls, Visio.link® and Signum PEEK Bond® (Heraeus Kulzer, Hanau, GE) increased SBS by 33.76 MPa (95% CI, 18.72–48.81; p < 0.00001) and 33.28 MPa (95% CI, 17.48–49.07; p < 0.00001), respectively. No differences were found between Visio.link® and Signum PEEK Bond® or Monobond Plus/Heliobond® (Ivoclar Vivadent, Schaan, LH) (p > 0.05). Similar results were observed for polyetherketoneketone (PEKK) specimens.SignificanceThis review shows improved HPP bonding following the application of various surface pretreatments, including air abrasion and bonding agents.  相似文献   
8.
[目的]阐发细辛宣营功效在经方配伍中的体现。[方法]追思传承,运用文献分析的方法,搜集整理《神农本草经》和《名医别录》等中医药经典对细辛的阐述,通过分析张仲景在《伤寒论》及《金匮要略》中运用细辛的情况,选用以当归四逆汤为代表的经典方剂,从经方的配伍应用中探讨细辛宣营的特点。[结果]在以历代医家对细辛的认知基础上,仲景在经方的配伍应用中对细辛宣营之功的运用分为四方面:第一,细辛可宣营而散寒解表,如当归四逆汤;第二,细辛可宣营而温化水饮,如苓甘五味姜辛汤;第三,细辛可宣营而通阳行痹,如三黄汤;第四,细辛可宣营而和血安胎,如白术散。[结论]细辛在经方的配伍应用中宣营之功体现为四方面,即散寒解表、温化水饮、通阳行痹、和血安胎,虽为辛热之品,只要合理搭配,即可宣营且不伤阴。  相似文献   
9.
《Dental materials》2020,36(8):1038-1051
ObjectivesThis study aimed to investigate the collective influence of material properties and design parameters on the fracture behavior of monolithic dental crowns.MethodsThree-dimensional (3D) models (N = 90) with different combinations of design parameters (thickness, cusp angle and occlusal notch geometry) and material type (lithium disilicate, feldspar ceramic, zirconia, hybrid resin ceramic and hybrid polymer-infiltrated ceramic) were developed for the failure analysis using extended finite element method (XFEM) to identify the stress distribution, crack initiation load, fracture surface area and fracture pattern. Analytical formulation, in vitro fracture tests and fractographic analysis of dedicated models were also performed to validate the findings of the XFEM simulation.ResultsFor all material types considered, crowns with a sharp occlusal notch design had a significantly lower fracture resistance against occlusal loading. In most of the models, greater crown thickness and cusp angle resulted in a higher crack initiation load. However, the effect of cusp angle was dominant when the angle was in the low range of 50° for which increasing thickness did not enhance the crack initiation load.SignificanceComparing the critical load of crack initiation for different models with the maximum biting force revealed that for the studied monolithic materials excluding zirconia, a design with a rounded occlusal notch, 70° cusp angle and medium thickness (1.5 mm occlusal) is an optimum combination of design parameters in terms of tooth conservation and fracture resistance. Zirconia crowns exhibited sufficient strength for a more conservative design with less thickness (1.05 mm occlusal) and sharper cusp angle (60°).  相似文献   
10.
Transactional sex has been associated with a high risk of HIV acquisition and unintended pregnancy among young women in urban slums in sub-Saharan Africa. However, few studies have explored the structural drivers of transactional sex from the perspective of both genders in these settings. This paper explores how young men and women understand the factors that lead to transactional sex among their peers, and how deprivation of material resources (housing, food and health care access) and consumerism (a desire for fashionable goods) may instigate transactional sex in the urban slums of Blantyre, Malawi. Data from 5 focus group discussions and 12 in-depth interviews undertaken with a total of 60 young men and women aged 18–23 years old, conducted between December 2012 and May 2013, were analysed using anticipated and grounded codes. Housing and food deprivation influenced decisions to engage in transactional sex for both young men and women. Poor health care access and a desire for fashionable goods (such as the latest hair or clothing styles and cellular phones) influenced the decisions of young women that led to transactional sex. Interventions that engage with deprivations and consumerism are essential to reducing sexual and reproductive health risks in urban slums.  相似文献   
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