正颌手术对骨性Ⅲ类错畸形患者语音功能的影响

目的: 探讨正颌手术对骨性Ⅲ类错畸形患者术后语音功能的影响。方法: 选择 31例骨性Ⅲ类错畸形成人患者,分别在术前1周、术后 3个月采集颌面 CT 扫描数据、语音数据。将采集的CT数据导入Dolphin软件,对咽部解剖结构进行测量、分析及头颅X线头影测量分析;对语音数据进行主观和客观评价。采用SPSS 24.0软件包进行统计学分析。结果: 正颌手术后,软腭下缘到咽后壁的距离、会厌上缘到咽后壁的距离及其相应的横截面积和口咽、喉咽的体积较术前均有显著差异（P<0.01）。头颅X线片分析显示,术前和术后SNA、SNB、ANB、OJ、OBJ差异具有统计学意义（P<0.05）。正颌患者术后语音情况较术前发生改变,差异具有统计学意义（P<0.05）。正颌手术前、后,元音/a/B2、B3、B4,/i/B1、B2,/u/B1、B2、B4的差异具有统计学意义（P<0.05）,辅音/x/、/zh/、/s/下限频率及/zh/能量值的变化有统计学意义（P<0.05）,辅音/z/的语图形态变化有统计学意义（P<0.05）。上颌骨前移距离与△S1、△VOP、语音变化存在高度相关或显著相关。结论: 正颌手术对上、下颌骨的移动,引起咽腔解剖结构改变,导致术后语音改变。     

牵张成骨术整复猕猴腭裂后胰岛素样生长因子-1与碱性磷酸酶表达研究

Objective To investigate the osteogenesis mechanism by analysis of the expression of insulin-like growth factor-I (IGF-1)and alkaline phesphatas (ALP)in the reconstruction of cleft palate(CP) with distraction osteogenesis (DO) in rhesus. Methods The CP animal models were established surgically. 21 rhesus in experimental group underwent DO to close the soft and bony defect, followed by consolidations. Every 3 animals were killed and the specimen were taken out after consolidation of 1, 2, 4, 6, 8, 12, 24 weeks. The mRNA of IGF-1 and ALP were detected with Real-time BT-PCB technique. The expression of IGF-1 and ALP was quantitatively analyzed by ELISA. The results were compared with those in control and sham groups (each of 2 animals), respectively. Results Since consolidation, the mRNA of IGF-1 and ALP increased significantly at one week and reached the peak at two weeks, but decrease to control level after 12 weeks of consolidation. The expression of IGF-1 also increased to peak level afiert two weeks of consolidation. The expression of ALT increased significantly since consolidation and reach the peak value after six weeks. They all decreased to nearly control level after 8 ～ 12 weeks. Conclusions The palate cleft can be successfully closed with new formed bone after DO. The mechanism of bone consolidation is intramembranons bone formation.     

双层腓骨移植联合牙种植重建下颌咬合功能

目的临床研究双层腓骨移植联合牙种植在下颌咬合功能重建中的价值。方法选择青岛大学附属医院口腔颌面外科2012年8月~2015年3月间8例行下颌骨节段性截骨的患者,一期行双层腓骨瓣修复下颌骨缺损,二期在移植腓骨上行牙种植,恢复缺损区的咬合关系,临床观察其骨移植及种植术后咬合功能的重建情况。结果 8例患者的移植腓骨均成活,一期愈合良好,双层腓骨恢复了足够的下颌骨高度,为二期牙种植创造了良好的骨床条件。二期的牙种植手术均获成功,义齿修复后,咬合功能恢复良好。随访0.5年到3年,种植体无脱落。结论双层腓骨移植联合牙种植是一种良好的下颌骨节段性缺损后咬合功能重建的方法。     

牵张成骨术整复猕猴腭裂骨桥蛋白与骨钙蛋白表达研究

Objective To study the mechanism of new bone formation and remodeling of distraction osteogenesis(DO) by analysis of the expression of osteopotin(OPN)and osteecalcin(OC). Methods Rhesus were operated to reconstruct the animal model of cleft palate(CP). The CP was closed by DO in experimental group(n=21). After consolidation of 1, 2, 4, 6, 8, 12, 24 weeks, every 3 animals were killed to collect the specimens, respectively. The OPN and OC and their mRNA were detected quantitatively by Real-time RT-PCR and ELISA, respectively. The animals in control group(n=2) and sham group(n=2) were used as control. Results The mRNA expression of OPN increased since 2nd week of consolidation and reached the peak at 4th week(7.59±0.37). The mRNA expression of OC was up-regulaed since 4th week, and reach the peak at 6th week(7.94±0.31). Then they decreased to about the level in sham group at 24th week(P > 0.05). The OPN and OC were highly expressed during 4 to 6 weeks of consolidation. During 8 to 12 weeks, they decreased like their mRNA expression. Conclusion The intramembraneons new bone formation after DO can reconstruct the bone defect of CP. The new formed bone can be remodeled to be quite normal bone tissue.     

针刺为主治疗急性腰扭伤200例

目的:观察针刺、拔罐、艾灸配合活血化瘀止痛酊治疗急性腰扭伤的临床疗效。方法:200例急性腰扭伤患者采用针刺、拔罐、艾灸配合活血化瘀止痛酊治疗,每日1次,10次为1疗程,1个疗程后评定疗效。结果:200例中,痊愈153例,显效47例,总有效率100%。结论:针刺、拔罐、艾灸配合活血化瘀止痛酊疗效显著,值得临床推广应用。     

牵张成骨术整复猕猴腭裂后胰岛素样生长因子-1与碱性磷酸酶表达研究

Objective To investigate the osteogenesis mechanism by analysis of the expression of insulin-like growth factor-I (IGF-1)and alkaline phesphatas (ALP)in the reconstruction of cleft palate(CP) with distraction osteogenesis (DO) in rhesus. Methods The CP animal models were established surgically. 21 rhesus in experimental group underwent DO to close the soft and bony defect, followed by consolidations. Every 3 animals were killed and the specimen were taken out after consolidation of 1, 2, 4, 6, 8, 12, 24 weeks. The mRNA of IGF-1 and ALP were detected with Real-time BT-PCB technique. The expression of IGF-1 and ALP was quantitatively analyzed by ELISA. The results were compared with those in control and sham groups (each of 2 animals), respectively. Results Since consolidation, the mRNA of IGF-1 and ALP increased significantly at one week and reached the peak at two weeks, but decrease to control level after 12 weeks of consolidation. The expression of IGF-1 also increased to peak level afiert two weeks of consolidation. The expression of ALT increased significantly since consolidation and reach the peak value after six weeks. They all decreased to nearly control level after 8 ～ 12 weeks. Conclusions The palate cleft can be successfully closed with new formed bone after DO. The mechanism of bone consolidation is intramembranons bone formation.     

牵张成骨术整复猕猴腭裂后胰岛素样生长因子-1与碱性磷酸酶表达研究

Objective To investigate the osteogenesis mechanism by analysis of the expression of insulin-like growth factor-I (IGF-1)and alkaline phesphatas (ALP)in the reconstruction of cleft palate(CP) with distraction osteogenesis (DO) in rhesus. Methods The CP animal models were established surgically. 21 rhesus in experimental group underwent DO to close the soft and bony defect, followed by consolidations. Every 3 animals were killed and the specimen were taken out after consolidation of 1, 2, 4, 6, 8, 12, 24 weeks. The mRNA of IGF-1 and ALP were detected with Real-time BT-PCB technique. The expression of IGF-1 and ALP was quantitatively analyzed by ELISA. The results were compared with those in control and sham groups (each of 2 animals), respectively. Results Since consolidation, the mRNA of IGF-1 and ALP increased significantly at one week and reached the peak at two weeks, but decrease to control level after 12 weeks of consolidation. The expression of IGF-1 also increased to peak level afiert two weeks of consolidation. The expression of ALT increased significantly since consolidation and reach the peak value after six weeks. They all decreased to nearly control level after 8 ～ 12 weeks. Conclusions The palate cleft can be successfully closed with new formed bone after DO. The mechanism of bone consolidation is intramembranons bone formation.     

牵张成骨术整复猕猴腭裂后胰岛素样生长因子-1与碱性磷酸酶表达研究

Objective To investigate the osteogenesis mechanism by analysis of the expression of insulin-like growth factor-I (IGF-1)and alkaline phesphatas (ALP)in the reconstruction of cleft palate(CP) with distraction osteogenesis (DO) in rhesus. Methods The CP animal models were established surgically. 21 rhesus in experimental group underwent DO to close the soft and bony defect, followed by consolidations. Every 3 animals were killed and the specimen were taken out after consolidation of 1, 2, 4, 6, 8, 12, 24 weeks. The mRNA of IGF-1 and ALP were detected with Real-time BT-PCB technique. The expression of IGF-1 and ALP was quantitatively analyzed by ELISA. The results were compared with those in control and sham groups (each of 2 animals), respectively. Results Since consolidation, the mRNA of IGF-1 and ALP increased significantly at one week and reached the peak at two weeks, but decrease to control level after 12 weeks of consolidation. The expression of IGF-1 also increased to peak level afiert two weeks of consolidation. The expression of ALT increased significantly since consolidation and reach the peak value after six weeks. They all decreased to nearly control level after 8 ～ 12 weeks. Conclusions The palate cleft can be successfully closed with new formed bone after DO. The mechanism of bone consolidation is intramembranons bone formation.     

牵张成骨术整复猕猴腭裂骨桥蛋白与骨钙蛋白表达研究

目的 以牵张成骨术整复猕猴腭裂骨缺损,定量分析新骨在不同时期骨桥蛋白(osteopetin,OPN)与骨钙蛋白(osteocalcin,OC)的表达水平,探讨新骨生成与改建的规律.方法 以猕猴为对象建立腭裂动物模型.实验组动物21只行牵张成骨术整复其聘部软硬组织缺损,关闭裂隙后固定.固定期第1、2 4、6、8、12及24周分别取材,各3只动物.采用实时定量PeR法(real-time,RT-PCR)定量比较OPN与OC的mRNA表达水平,并以酶联免疫吸附试验法(ELISA)定量分析其OPN与OC含量,与实验对照组及健康对照组(各2只动物)结果进行比较.结果 固定期第2周OPNmRNA表达上调,第4周达最高(7.59±0.37);而OC mRNA表达则自第4周开始上调(4.98±0.21),第6周时达最大值(7.94±0.31);随后开始下降,至第24周时两者的mRNA表达水平接近健康对照组(P>0.05).ELISA结果显示:固定期第4、6周OPN分别为(4.75±0.15)ng/mg和(4.86±0.09)ng/mg,OC分别为(3.18±0.16)ng/mg和(3.63±0.33)ng/mg,两者均为高水平表达.至第8～12周以后蛋白表达趋势与其对应mRNA表达基本一致.结论 应用牵张成骨术整复腭裂骨缺损,其牵张区域新骨生成,裂隙被骨运送盘移动封闭,腭部裂隙被完全修复.