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目的 比较改良眶隔法和传统睑板法切开重睑术中的应用效果及对术后重睑形态、瘢痕发生率、角膜暴露率的影响。方法 选取2020年3月-2021年3月首都医疗爱育华医院收治的80例单睑患者,采用随机数字表法将其分对照组和观察组,各40例。对照组接受传统睑板法切开重睑术,观察组接受改良眶隔法切开重睑术,比较两组术后重睑形态、瘢痕发生率、角膜暴露率、并发症发生率。结果 观察组总有效率高于对照组,差异有统计学意义(P<0.05);观察组GAIS评分高于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05);观察组右侧角膜暴露率增加值、左侧角膜暴露率增加值高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为5.00%,低于对照组的22.50%,差异有统计学意义(P<0.05)。结论 相比于传统睑板法切开重睑术,改良眶隔法切开重睑术不会过度增加术后角膜暴露率,术后瘢痕发生率更低,重睑形态更理想,患者接受度更高。  相似文献   
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Stones in the common bile duct (CBD) are reported worldwide, and this condition is majorly managed through endoscopic retrograde cholangiopancreatography (ERCP). CBD stone recurrence is an important issue after endoscopic stone removal. Therefore, it is essential to identify its risk factors to determine the necessity of regular follow-up in patients who underwent endoscopic removal of CBD stones. The authors identified that the S and polyline morphological subtypes of CBD were associated with increased stone recurrence. New morphological subtypes of CBD presented by the authors can be important risk predictors of recurrence after endoscopic stone removal. Furthermore, the new morphological subtypes of CBD may predict the risk of residual CBD stones or technical difficulty in CBD stone removal. Further studies with a large sample size and longer follow-up durations are warranted to examine the usefulness of the newly identified morphological subtypes of CBD in predicting the outcomes of ERCP for CBD stone removal.  相似文献   
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牙槽骨是牙种植修复的重要解剖基础,其不同的缺损程度决定了不同骨增量手术方案的选择,其中牙槽骨缺损骨增量手术是种植修复中非常关键的技术,然而其最终质、量、形重建效果受到诸多因素的影响。为了提高治疗效果,达到美观与功能兼顾的重建目标,临床医师需要掌握诊疗原则与规范的操作方法。为此,本文结合当前国内专家的临床经验与国外的相关临床指南,从牙槽骨缺损分类、骨增量手术方案的选择方面,对牙槽骨缺损骨增量技术进行了总结,形成专家共识。本共识建议:根据牙槽骨缺损与预期种植体植入位点的关系将缺损分为Ⅰ?0、Ⅰ?Ⅰ、Ⅱ?0、Ⅱ?Ⅰ及Ⅱ?Ⅱ五种类型。其中Ⅰ?0型为牙槽骨一侧骨板缺损不超过预期种植体长度的50%,另一侧无明显缺损;首选引导骨再生同期种植体植入术。Ⅰ?Ⅰ型为牙槽骨两侧骨板缺损均未超过预期种植体长度的50%;首选块状自体骨移植术进行骨增量,延期种植或经牙槽嵴顶上颌窦底提升同期种植体植入术。Ⅱ?0型为牙槽骨一侧骨板缺损超过预期种植体长度的50%,另一侧无明显缺损;首选块状自体骨移植术(厚度≤4 mm)或牙槽嵴劈开术(厚度>4 mm)进行骨增量,延期种植。Ⅱ?Ⅰ型为牙槽骨两侧骨板缺损,一侧骨板缺损超过预期种植体长度的50%,另一侧骨板缺损不超过预期种植体长度的50%;首选块状自体骨移植术或自体皮质骨帐篷技术或经牙槽嵴顶/侧壁开窗上颌窦底提升术进行骨增量,延期种植。Ⅱ?Ⅱ型为牙槽骨两侧骨板缺损且均超过预期种植体长度的50%,首选引导骨再生术联合使用刚性支架或侧壁开窗上颌窦底提升术或自体皮质骨帐篷技术,延期种植。本共识可为临床医生在牙槽骨缺损骨增量手术方案选择方面提供参考借鉴。  相似文献   
6.
This study evaluates the impact of tooth-borne Surgically Assisted Rapid Mandibular Expansion (SARME) on the temporomandibular joint (TMJ) function and condylar morphology.Medical records of patients who received a SARME between 2014 and 2018 are retrospectively reviewed concerning functional problems. Morphological changes of the condyles are analyzed by means of surface registration of 3D reconstructed CBCT scans preoperatively and one-year postoperatively, and correlated to functional outcome.In 68 patients data are complete. The risk of TMJ dysfunction is slightly increased from 18 to 25% at a mean of 14 months after SARME. This is attributed to an increase in the number of minor problems (75–82%). The presence of complaints before SARME is the only identifiable risk factor for also having complaints after the intervention (p = 0.0019). In one patient with pre-existent TMJ dysfunction complaints deteriorated after SARME. After SARME no cases of extended condylar resorption are described. There is no correlation between morphological condylar changes and the prevalence of TMJ dysfunction (p = 0.7121 for appositional and p = 0.3038 for resorptive changes). However, appositional and resorptive changes at the condylar head appear to correlate with growth potential, based on age, gender and skeletal deformity (p < 0.0001 and p = 0.0154 respectively).Within the limitations of the study it seems that SARME does not have a negative impact on TMJ function or condylar integrity and, therefore, the choice for or against this approach can be made without considering consequences for TMJ a major issue for the decision.  相似文献   
7.
目的:评价在发热疾病临床诊断过程中显微镜血细胞形态学检验的临床应用价值。方法:纳入2019年2月~2020年2月在本院接受发热疾病治疗的48例患者作为观察组,接受常规健康体检者48例作为对照组,所有实验对象均给予显微镜血细胞形态学检验,对其检验结果进行分析与比较。结果:统计与分析后发现,观察组患者除平均红细胞血红蛋白外的血细胞形态学指标与对照组健康体检者存在显著差异,具有统计学意义(P<0.05);同时,与对照组健康体检者相比观察组患者异常细胞、白细胞改变、小细胞贫血、大细胞贫血、异型淋巴细胞改变等血细胞形态异常检出率明显较高(P<0.05)。结论:大多数发热疾病患者会出现血细胞形态学异常变化,因此,实施发热疾病患者临床诊断的过程中可以运用显微镜血细胞形态学检验,以便及时发现患者的病情并给予针对性治疗。  相似文献   
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目的:探讨长期配戴角膜塑形镜对角膜形态、角膜生物力学以及客观视觉质量的影响。方法:回顾性研究。收集2019-10/2020-12在我院配戴角膜塑形镜2a的近视患者33例60眼,其中男19例35眼,女14例25眼,平均年龄11.80±1.51岁,平均等效球镜为-3.25±0.69D。收集患者配戴前和配戴2a时的相关数据资料。利用Pentacam三维眼前节分析系统测量角膜最薄点中心3mm区域前后表面曲率半径(ARC和PRC)、角膜最薄点厚度(THP)、角膜扩张综合偏差分析指数(BADD)。Corvis ST生物力学分析仪测量非接触生物力学校正眼压(bIOP)、最大形变幅度(DA)、最大反向半径(HCR)、顶点和1mm间形变幅度比值(DR)、硬度参数(SPA1)、角膜生物力学参数(CBI)。运用Pentacam与Corvis ST联合诊断系统分析得出断层扫描生物力学指数(TBI)。OQAS-Ⅱ客观视觉质量分析系统测量调制传递函数截止频率(MTF cutoff)、斯特烈尔比(SR)、客观散射系数(OSI)以及OV值(OV100%、OV20%和OV9%)。对患者配戴角膜塑形镜前和连续配戴角膜塑形镜2a的上述各项参数进行比较。结果:配戴角膜塑形镜2a与配戴前相比ARC增高、THP降低、BADD增高,比较有差异(t=-9.38、2.85、-13.08,均P<0.05),PRC与配戴前相比无差异(t=-1.49,P>0.05);配戴角膜塑形镜2a与配戴前相比DA增高、HCR降低,比较有差异(t=-2.37、2.28,均P<0.05),bIOP、DR、SPA1、CBI、TBI分别与配戴前相比无差异(t=1.36、-1.87、1.27、-0.95、-1.49,均P>0.05);配戴角膜塑形镜2a SR较配戴前增高,OV20%和OV9%较配戴前均降低,比较有差异(t=-5.31、8.37、2.34,均P<0.05),MTF cutoff、OSI、OV100%与配戴前相比无差异(t=-1.57、-1.35、1.11,均P>0.05)。结论:长期配戴角膜塑形镜改变角膜前表面形态,对角膜生物力学无明显影响,患者日间客观视觉质量提高,而夜间视觉质量下降。  相似文献   
9.
Intratumor heterogeneity is a main cause of the dismal prognosis of glioblastoma (GBM). Yet, there remains a lack of a uniform assessment of the degree of heterogeneity. With a multiscale approach, we addressed the hypothesis that intratumor heterogeneity exists on different levels comprising traditional regional analyses, but also innovative methods including computer-assisted analysis of tumor morphology combined with epigenomic data. With this aim, 157 biopsies of 37 patients with therapy-naive IDH-wildtype GBM were analyzed regarding the intratumor variance of protein expression of glial marker GFAP, microglia marker Iba1 and proliferation marker Mib1. Hematoxylin and eosin stained slides were evaluated for tumor vascularization. For the estimation of pixel intensity and nuclear profiling, automated analysis was used. Additionally, DNA methylation profiling was conducted separately for the single biopsies. Scoring systems were established to integrate several parameters into one score for the four examined modalities of heterogeneity (regional, cellular, pixel-level and epigenomic). As a result, we could show that heterogeneity was detected in all four modalities. Furthermore, for the regional, cellular and epigenomic level, we confirmed the results of earlier studies stating that a higher degree of heterogeneity is associated with poorer overall survival. To integrate all modalities into one score, we designed a predictor of longer survival, which showed a highly significant separation regarding the OS. In conclusion, multiscale intratumor heterogeneity exists in glioblastoma and its degree has an impact on overall survival. In future studies, the implementation of a broadly feasible heterogeneity index should be considered.  相似文献   
10.
ObjectiveThe objective of this study was to investigate the association between morphological variation and postsurgical pulmonary vein (PV) stenosis (PPVS) in patients with cardiac total anomalous pulmonary venous connection (TAPVC).MethodsThis single-center, retrospective study included 168 pediatric patients who underwent surgical repair of cardiac TAPVC from 2013 to 2019 (connection to the coronary sinus [CS], n = 136; connection directly to the right atrium [RA], n = 32). Three-dimensional computed tomography modeling and geometric analysis were performed to investigate the morphological features; their relevance to the PPVS was examined.ResultsThe connection type had no association with PPVS (CS type: 18% vs right atrial type: 19%; P = .89) but there was a higher incidence of PPVS in patients with a single PV orifice than > 1 orifice (P < .001). Confluence-to-total PV area ratio (hazard ratio, 4.78, 95% CI, 1.86-12.32; P = .001) and length of drainage route (hazard ratio, 1.22; 95% CI, 1.14-1.31; P < .001) had a 4- and 1-fold increase in the risk for PPVS in the CS type after adjustment for age and preoperative pulmonary venous obstruction. In the right atrial type, those with anomalous PV return to the RA roof were more likely to develop PPVS than to the posterior wall of the RA (P < .001).ConclusionsThe number of inter-junction PV orifice correlated with PPVS development in cardiac TAPVC. The confluence-to-total PV ratio, length of drainage route, and anomalous PV return to the RA roof are important predictors for PPVS. Morphological subcategorization in this clinical setting can potentially assist in surgical decision-making.  相似文献   
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