学龄前儿童口腔中挥发性硫化物的检出情况及其相关因素

目的:了解学龄前儿童口腔中挥发性硫化物的检出情况,分析引起学龄前儿童口臭的主要相关因素,为儿童口臭和相关疾病的预防和治疗提供依据. 方法:对北京市某幼儿园170名4~6岁学龄前儿童口腔中挥发性硫化物( volatile sulfur compounds,VSC)含量和口腔健康状况进行检查,对儿童家长进行问卷调查,挥发性硫化物的检测使用便携式气相色谱仪OralChromaTM. 使用SPSS 13. 0软件包,进行VSC与口腔健康状况和行为等的单因素和多因素分析. 结果:单因素分析结果显示,检出口臭的儿童占全部受检人数的34. 4%. 女童口腔中硫化氢( hydro-gen sulfide,H2S)[(1.59 ±2.41) ng/10 mL]和VSC总量[(2.14 ±4.42) ng/10 mL]高于男童(P<0.05). 舌苔指数高的儿童的H2S[舌苔面积(1.68 ±2.48) ng/10 mL,舌苔厚度(2.18 ±2.69) ng/10 mL)和VSC总量[舌苔面积(2. 26 ± 4. 31) ng/10 mL,舌苔厚度(2. 41 ± 3. 02) ng/10 mL]高于舌苔指数低的儿童(P<0. 01). 简化软垢指数记分值≥2的位点数值与甲硫醇(methyl mercaptan,CH3SH)和二甲基硫[dimethyl sulfide,(CH3)2S]浓度呈正相关(P<0.01);母亲受教育程度在本科及以上的儿童口腔中H2S值[(1.19 ±1.62)ng/10 mL]显著低于母亲教育程度在本科以下的儿童(P<0. 01);甜食进食频率高的儿童H2S浓度[(1. 04 ± 1. 55) ng/10 mL]低于频率低的儿童(P<0. 01);有张口呼吸习惯的儿童CH3SH和(CH3)2S浓度[(0. 29 ± 1. 92) ng/10 mL,(0. 37 ± 2. 06) ng/10 mL]显著高于没有张口呼吸习惯的儿童(P<0. 05). Logistic多因素分析结果显示,舌苔指数高、母亲教育程度低的儿童VSC高于舌苔指数低和母亲教育程度高的儿童. 结论:学龄前儿童口臭检出率高,性别、舌苔指数、软垢指数、母亲教育程度、甜食进食频率、张口呼吸等因素是儿童口臭的相关影响因素,不同影响因素导致不同VSC成分的改变.     

颈椎不稳的评估及研究现状

颈椎不稳的评估及治疗是骨科医生常面临的一个问题,对颈椎不稳判定的观点众多。对颈椎稳定程度的评估,既是制定治疗方案前的必要评估,也对患者的愈后有重要的预见意义。本文就颈椎不稳的含义、检查手段及其治疗的现状做一综述。     

后路截骨矫形螺钉置入内固定修复胸腰段僵硬性角状后凸畸形：中期随访评价

BACKGROUND: During spinal orthopedic repair, the main difficulty is to maximize the correction of the deformity, simultaneously, to reduce the incidence of trauma and complications, especially to avoid the corresponding spinal nerve injury.OBJECTIVE: To evaluate the curative effect of one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation in the treatment of rigid angular kyphosis of thoracolumbar spine.METHODS: We retrospectively analyzed the data of 42 cases of rigid angular kyphosis of thoracolumbar spine that were treated by one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation. All patients received detailed imaging examination before and after operation. Kyphosis angle, Frankel grading and perioperative complications were recorded in all patients. X-ray films or CT films showed the bone graft fusion during follow-up.RESULTS AND CONCLUSION:Patients were followed up for 10-36 months after treatment. The average time of bone graft fusion was 5.1 months. Cobb’s angle of kyphosis was corrected from 78.4° (38°-110°) preoperatively to 7°(-8°-24°) at 10 days after treatment. The correction rate was 90%. The average angle during final follow-up was 7.9°, with an average loss of 0.9°. In 16 paresis patients, Frankel grading results showed grade B in 0 case, grade C in 3 cases, grade D in 5 cases, and grade E in 8 cases during final follow-up, showing significant improvement as compared with that pre-treatment (P < 0.05). Among 42 patients, 5 cases had complications. At 7 months after treatment, there were screw and titanium rod loosening at the distal end of the fusion segment in 1 case, cerebrospinal fluid leakage in 2 cases, transient double lower limb weakness in 1 case, pain in one side of lower limb in 1 case, and no severe complications appeared. These results verified that one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation could achieve satisfactory clinical outcomes in rigid angular kyphosis of thoracolumbar spine. The internal fixation was stable and with a high fusion rate and few complications. The medium-term effect was satisfactory.  中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

浅谈闭合灌流冲洗法治疗手创伤后骨关节感染的临床价值

目的：探究闭合灌流冲洗法治疗手创伤后骨关节感染的临床效果。方法：选取2014年11月-2015年12月期间我院收治的手创伤后骨关节感染患者24例作为研究对象，全部研究对象都进行病灶清除，然后给予闭合灌流冲洗，观察其治疗效果。结果：本次研究中，经过治疗，治疗有效率为95.83%（23/24），不存在不良反应；半年后，全部患者的肢体功能无异常，未出现复发情况。结论：将该种方法治疗骨关节感染治疗过程中，效果确切，可将其作为骨关节感染的有效治疗措施。     

二氢杨梅素抑制破骨细胞生成改善糖尿病大鼠牙槽骨吸收

目的:研究二氢杨梅素(dihydromyricetin, DMY)对糖尿病诱导的大鼠牙周牙槽骨吸收的影响及可能的作用机制。方法:使用125、250、500 mg/kg的DMY作用于链脲佐菌素(streptozotocin, STZ)诱导的糖尿病大鼠模型，制取磨牙切片进行数字切片扫描仪，计算破骨细胞数目；大鼠上颌骨进行Micro-CT扫描，分析牙槽骨吸收情况。体外培养MC3T3-E1细胞使用10、20、40μmol/L的DMY处理，MTT法检测细胞活力；体外培养破骨细胞使用10、20、40μmol/L DMY处理，抗酒石酸酸性磷酸酶(TRAP)染色进行破骨细胞观察和计数，ELISA检测促炎细胞因子IL-1β和抗炎细胞因子IL-10。结果:DMY抑制STZ大鼠牙槽骨破骨细胞的生成；缓解STZ大鼠牙槽骨的吸收。体外实验DMY抑制RANKL诱导的破骨细胞的生成，抑制RANKL诱导破骨细胞生成过程中IL-1β的表达。并且10、20、40μmol/L DMY对MC3T3-E1细胞无毒性。结论:DMY通过抑制破骨细胞的生成，减少糖尿病造成的牙槽骨吸收。