28例原发性卵黄囊瘤患者的CT表现分析

目的分析28例原发性卵黄囊瘤(YST)患者的CT表现。方法选择2015年2月至2019年12月收治的28例YST患者的临床资料进行回顾性分析,8例YST患者入院后均予以CT检查,然后对患者的CT影像学特征和临床资料数据进行分析比较。结果本研究中28例YST患者肿瘤位于性腺的有17例(60.71%),其中位于睾丸、卵巢处的分别有7例、10例,占比分别为60.71%、41.18%,均为单侧发病;9例(39.29%)位于性腺外,其中位于骶尾部、前纵隔、阴道的分别有6例、2例、1例,占比分别为66.67%、22.22%、11.11%。CT检测可见肿瘤"浅分叶",且呈"椭网形",18例(64.29%)肿瘤边界较为清晰,9例(32.14%)呈"深分叶状"形态不规则;8例(28.57%)边界模糊,肿瘤大小分析可见,肿瘤位于前纵隔、卵巢的相对较大,位于阴道、睾丸、骶尾部的相对较小。28例YST患者中,单纯型21例YST(75.00%),混合型7例(25.00%)。结论原发性卵黄囊瘤进行CT检测尤为重要,其CT表现具有一定特征性,可为临床治疗提供一定的依据。     

The role of orthodontics in management of obstructive sleep apnea

Dental sleep medicine is the field of dental practice that deals with the management of sleep-related breathing disorders, which includes obstructive sleep apnea (OSA) in adults and children. Depending on the developmental age of the patient and the cause of the apnea dental treatment options may vary. For adult patients, treatment modalities may include oral appliance therapy (OAT), orthognathic surgery and surgical or miniscrew supported palatal expansion. While for children, treatment may include non-surgical maxillary expansion and orthodontic functional appliances. Many physicians and dentists are unaware of the role dentistry, particularly orthodontics, may play in the interdisciplinary management of these disorders. This review article is an attempt to compile evidence-based relevant information on the role of orthodontists/sleep dentists in the screening, diagnosis, and management of sleep apnea. Oral sleep appliance mechanisms of action, selective efficacy, and the medical physiological outcomes are discussed. The purpose of this review is to provide a comprehensive understanding of how orthodontists and sleep physicians can work in tandem to maximize the benefits and minimize the side effects while treating patients with OSA.     

Research of connective tissue dysplasia influence on teething

PurposeThis work aimed to study the rate and quality of maturation of the mineral component of retained teeth 3.8, 4.8 and lower jaw fragment of a human in connective tissue dysplasia in different periods of postpartum ontogenesis.MethodsThe study involved 102 men (76 with connective tissue dysplasia and 26 without connective tissue dysplasia) divided into groups by age: 31–40, 41–50, 51–60 years. One tooth 3.8, 4.8 and a fragment of the alveolar part of the lower jaw in the projection of teeth 3.8, 4.8 0.5*0.5 cm in size were extracted from each examinee for medical indications.ResultsLow optical density values are observed at the age of 41–50 years, at the age of 51–60 years, indicating decreased mineral density and the presence of total areas of hypomineralization from the age 31–40 years in connective tissue dysplasia. At the age of 41–50, 51–60 years, at the boundary of connective tissue structures and periosteum, a pronounced sclerosis and deformation of delineation elements were observed; at the age of 31–40 years, the indicated changes were less pronounced. At the age of 31–40 years, the level of bone plate dissection has a local character, after 40 years, it has a generalized character.ConclusionProgressive osteoporosis of the mandible and incomplete amelogenesis are an obstacle to the correct and harmonious teething of the lower wisdom teeth after the age of 30.     

2022年上海市医师协会全科医师分会年会主题报告（一）

本文内容来源于2022年7月22日由上海市医师协会、上海市医师协会全科医师分会主办的"第二届海上全科医师论坛"，主要包括《基层医疗在整合医疗中的作用》《创建全科医学科为国家临床重点专科》《上海市基层卫生发展趋势》《拥抱变化，更好更强》四部分。其中，《基层医疗在整合医疗中的作用》从整合程度、整合层面、整合方向3个维度阐释了"整合医疗"的概念与内涵，并就整合医疗在制度、管理、支付、服务模式、技术应用5个层面的实现路径做了详细介绍；在分析基层医疗和整合医疗共性特征的基础上，阐释基层医疗在上述5个层面对整合医疗的助推作用。《创建全科医学科为国家临床重点专科》从全科医学科在卫生保健改革、满足居民卫生服务需求中的重要作用出发，阐述了创建全科医学科为国家临床重点专科的必要性，认为创建临床重点专科需做到：提高全科医学科学术地位，推进全科医学人才建设，提升全科医学科区域协同能力，形成全方位全周期健康照护专科特色，加快全科医学科研创新发展。《上海市基层卫生发展趋势》肯定了基层卫生对城市健康发展的贡献，提出在"大健康"的背景下进一步的重点工作为推进健康老龄化和实现出生人口提升计划；上海基层卫生的发展趋势在于创新，而基层卫生高质量发展工作的创新需要由全科医生作为推动者和牵头者，创造出新的健康服务模式。《拥抱变化，更好更强》，认为当前社区卫生服务的"薄弱"之处，并非发展之初的硬件或人员配置不足，而是体现在全科学科建设方面。全科医学领域工作者应主动面对和接纳当前国家健康战略的变化、健康需求的变化、医学模式的变化、自身发展/管理的变化，开展主动健康，应对多病共存，加强全-专结合，关注需方角度的服务评价，以助力全科医学学科建设。     

老年人群共病问题现状挑战与应对策略

中国已进入老龄化社会，共病是老年人群较为突出的公共健康问题。总结梳理老年人群共病领域研究现状，分析探讨相应策略对于老年共病人群的临床综合管理具有重要意义。本文重点从共病管理研究实践、共病诊疗模式、共病用药策略、共病医护团队及健康管理服务体系建设方面分析了该领域研究现状，同时提出建立以患者为中心的共病管理研究方案、推广应用老年共病评估工具、开展共病共有病因及机制研究、制订共病管理规范性指南/共识、借鉴中医学"以证统病""整体观念"思想、融合互联网+技术与智能可穿戴设备及开展共病早期风险评估与管理等应对策略，综合展望共病领域后期研究方向，以期为该领域进一步深入研究提供参考。