金属全冠修复后牙缺损的临床观察

目的:从临床角度分析戴用铸造全冠和锤造全冠修复体后出现的问题。方法:选取579件铸造全冠和184件锤造全冠修复体,并对其使用的患者做2年随访,对金属全冠的边缘密合性、邻接关系、脱位、牙龈炎、继发龋等作了分析。结果:铸造全冠出现问题12个,占2.1%,锤造全冠37个,占31.0%。结论:铸造全冠与锤造全冠相比,是比较优选的修复体。     

三种方法制作的Ｐlat—Ⅱ型铸造陶瓷全冠适合性的比较

[目的]探讨改善Plat-Ⅱ型铸造陶瓷全冠适合性的方法。[方法]分别用常规脱模铸法、代型隙料法、带模铸造法制作Palt-Ⅱ型铸造陶瓷全冠２４个，用磷酸锌粘固粉粘固于各自的代型上，测试各组冠，各个部位的粘固剂量度，比较其适合性。[结果]３种方法制作的全冠其粘固剂平均厚度分别为：５２μm、４２μm、３０μm，边缘乳升量分别为：６３μm、５９μm、４２μm。３种方法制作的全冠边缘浮升量、轴壁、Ｈe面粘固剂厚度均有显性差异（Ｐ＜０.０１）。[结论]用代型隙料法和带模铸造法制作的Palt-Ⅱ型铸造陶瓷全冠能显提高边缘适合性。     

不同粘固剂对全冠修复体边缘适合性的影响

目的探讨不同粘固剂对全冠修复体边缘适合性的影响。方法实验制作32个离体人类上颌第3磨牙铸造全冠修复标本。随机数字表法分成4组，每组8个标本。分别用树脂粘接系统、玻璃离子粘固剂、聚羧酸粘固剂及磷酸锌粘固剂粘固。粘固前后，应用体视显微镜测量铸造全冠的边缘适合性并进行比较。结果粘固前后各组间边缘适合性差异均无统计学意义（P〉0．05）。结论树脂粘接系统具有与玻璃离子粘固剂、聚羧酸粘固剂及磷酸锌粘固剂相同的良好的全冠粘固后边缘适合性。     

两种铸造金属全冠适合性研究

目的：研究镍铬合金铸造全冠与金钯合金铸造全冠适合性的差异。方法：选取日进标准下颌第一磨牙铸造全冠预备体30颗,分为两组,每组15颗。第一组制作镍铬合金铸造全冠,第二组制作金钯合金铸造全冠,在扫描仪下测量边缘间隙及内间隙,数据进行统计学处理。结果：镍铬合金铸造全冠边缘间隙的平均值为（95.760 0±2.444 76）μm,轴面内间隙的平均值为（68.240 0±3.108 24）μm,面内间隙的平均值为（188.600 0±4.533 21）μm;金钯合金铸造全冠边缘间隙的平均值为（79.666 7±2.644 85）μm,轴面内间隙的平均值为（52.226 7±2.930 01）μm,面内间隙的平均值为（148.873 3±2.998 92）μm,相同间隙组间差异有统计学意义（P〈0.01）。结论：金钯合金铸造全冠的适合性优于镍铬合金铸造全冠。     

锤造和铸造全冠在临床上的应用

目的：探讨锤造和铸造全冠在牙体缺损修复过程中的应用效果。方法：对1994～2004年100例患者120颗牙体缺损用锤造和铸造全冠修复的回顾性分析。结果：100例牙体缺损患者用锤造和铸造全冠修复后，为期几年追踪观察，大部分患者在咀嚼功能、恢复形态、邻接及咬殆关系方面满意，占86％。14例冠修复后不满意，占14％。结论：应用锤造和铸造全冠修复牙体缺损是比较理想的方法，对不满意病例予改进措施，临床上可广泛应用。     

不同隙料厚度对全瓷冠适合性的影响

目的研究InLab MC XL系统不同隙料厚度对Cerec Blocs全瓷冠边缘和内部适合性的影响。方法制备右上颌第一磨牙全冠预备体模型并翻制硅橡胶阴模,分别灌制全瓷石膏、超硬石膏预备体模型各30个。30个全瓷石膏预备体用于光学印模采集,获得30个数字化代型并完全随机分为6组分别设置不同隙料厚度值:0(A组)、10(B组)、20(C组)、30(D组)、40μm(E组)和50μm(F组),每组5个。30个超硬石膏预备体用于全瓷冠黏结,经包埋、剖开后,体式显微镜扫描试件剖面。结果 C、D组边缘适合性均介于30～120μm,内部适合性均介于30～300μm。C组与D组冠边缘适合性比较有统计学差异(P<0.05)。C、D组冠内部适合性不均匀,面适合性相对较大。结论当隙料厚度为20、30μm时,全瓷冠的边缘和内部适合性均在临床可接受范围内;30μm的冠边缘适合性优于20μm,但20、30μm的冠面适合性较差。     

种植前牙Ceramage聚合瓷全冠与烤瓷冠的临床效果比较

目的 比较Ceramage聚合瓷全冠与烤瓷冠在前牙种植修复的效果.方法 随机选取修复种植前牙的Ceramage聚合瓷全冠与烤瓷冠各50件,戴用后评价其戴用后形态、边缘适合性、颜色、12个月后评价修复体磨耗程度及折裂情况.结果 经秩和检验分析,Ceramage聚合瓷冠与烤瓷冠的边缘适合性,12个月后的磨损与折裂无显著性区别,均能达到很好的边缘适合性,较好的抗折性,差异无统计学意义(P>0.05).Ceramage聚合瓷冠与烤瓷冠的形态、颜色等性能方面有显著性改变,差异有统计学意义(P<0.05).结论 Ceramage聚合瓷全冠在种植前牙修复中适用范围较烤瓷冠更广.     

100件金属全冠修复失败原因分析

１００件金属全冠修复失败原因分析张莘（南京市口腔医院修复科，南京２１０００８）关键词金属全冠；铸造全冠；锤造全冠；龈边缘；继发龋对于牙体严重缺损的后牙，金属全冠不失为一种保存牙体的重要修复手段，可分为锤造和铸造全冠２种。因其具有使用方便、装戴舒适、...     

两种方法制作Cercon系统二氧化锆全瓷冠边缘适合性的比较性研究

目的以钴铬金属基底烤瓷冠作为对照组,利用硅橡胶复制冠边缘间隙的方法来研究两种方法制作Cercon系统二氧化锆全瓷冠的边缘适合性,为临床应用提供理论依据。方法选取1个因正畸拔除的无龋的下颌前磨牙,常规行牙体预备,采用双重印模法取模,复制24个相同尺寸的超硬石膏代型。将代型随机分为3组（钴铬金属烤瓷冠、Cercon CAD／CAM系统二氧化锆全瓷冠、Cercon ClassⅡ激光扫描系统制作二氧化锆全瓷冠）,分别制作8个瓷全冠修复体。利用硅橡胶轻体复制冠边缘间隙的测量法进行绝对边缘间隙测量,然后沿冠的颊舌侧和近远中边缘中点切为4份。在体式显微镜下采集绝对边缘间隙的数码图像,进行绝对边缘间隙的测量,将所得数据使用SPSS13．0软件包进行分析。结果3种绝对边缘间隙的平均值在48．68～98．69μm之间。与对照组比较,CenconCAD／CAM系统二氧化锆全瓷冠、CenconClass11激光扫描系统制作的二氧化锆全瓷冠的绝对边缘间隙与对照组相比均具有显著性差异。结论（1）在本实验条件下,与钴铬金属烤瓷冠相比,CerconCAD／CAM系统二氧化锆全瓷冠和CerconClassⅡ激光扫描系统制作二氧化锆全瓷冠都显示较小的绝对边缘间隙;（2）CerconCAD／CAM系统二氧化锆制作的全瓷冠与CerconClassⅡ激光扫描系统制作的二氧化锆全瓷冠相比显示较小的绝对边缘间隙;（3）CerconCAD／CAM系统二氧化锆全瓷冠、CerconClassⅡ激光扫描系统制作二氧化锆全瓷冠和失蜡法制作的钴铬烤瓷冠的绝对边缘间隙均在临床可接受的100μm以内。     

三种方法制作的Plat-Ⅱ型铸造陶瓷全冠适合性的比较

【目的】探讨改善Plat-Ⅱ型铸造陶瓷全冠适合性的方法。【方法】分别用常规脱模铸造法、代型隙料法、带模铸造法制作Plat-Ⅱ型铸造陶瓷全冠24个,用磷酸锌粘固粉粘固于各自的代型上,测试各组冠,各个部位的粘固剂厚度,比较其适合性。【结果】3种方法制作的全冠其粘固剂平均厚度分别为52μm、42μm、30μm,边缘浮升量分别为63μm、59μm、42μm。3种方法制作的全冠边缘浮升量、轴壁、牙合面粘固剂厚度均有显著性差异（P<0.01）。【结论】用代型隙料法和带模铸造法制作的Plat-Ⅱ型铸造陶瓷全冠能显著提高边缘适合性。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.