骨性安氏Ⅲ类错?上颌骨慢扩弓结合前方牵引的疗效评价

目的：评价骨性安氏III类错?患者经上颌慢速扩弓结合前方牵引治疗的效果。方法：治疗组包括22例患者，开始治疗年龄平均为9.8岁，治疗时间0.7年，慢速螺旋扩大器扩弓每周旋转90°～270°，（90°相当于0.25?mm）前方牵引力值为600～800?g/侧，治疗结束时覆盖至少为2?mm。分别在治疗前、治疗结束时及治疗结束后1.4年拍摄头颅定位侧位X线片。对照组为年龄、性别及下颌平面角匹配的未经治疗的骨性安氏I类错?骨面型正常儿童22例。结果：治疗组上颌骨前部较对照组每年前移量多1.6?mm，上颌骨后部较前部明显下移，下颌骨后下旋转同时下切牙直立。1.4年后上颌骨前部相对后缩、后部上移，抵消部分治疗效果。下颌骨的生长方向趋于正常，下切牙略唇倾。结论：上颌扩弓和前方牵引治疗骨性安氏III类错?有利于减轻错?程度。     

前方牵引矫治安氏错（牙合）62例分析

目的 分析前方牵引结合上颌快速扩弓矫治替牙期安氏Ⅲ类错（牙合）的临床效果.方法 对62例替牙期安氏Ⅲ类错（牙合）病例,采用上颌固定方法,选择扩弓器进行上颌快速扩弓,扩弓结束后给予上颌前方牵引.治疗前后,采用X线测量分析患者的头颅侧位片,对比分析治疗前、后软组织和硬组织的变化情况.结果 经过治疗后,全部病例安氏Ⅲ类错（牙合）情况解除,覆盖显示正常,矫治前后的软硬组织指标出现显著性变化,上颌骨呈明显的是矢状向增长.结论 前方牵引结合上颌快速扩弓矫治,可明显改善上颌骨向前生长,促使下颌骨向后、向下旋转,有效缓解骨面畸形状况,明显改善患者面貌.     

螺旋扩弓器与上颌前方牵引治疗上颌后缩型安氏Ⅲ类错畸形

为了探讨螺旋扩弓器与上颌前方牵引治疗骨性上颌后缩型安氏Ⅲ类错牙合中,引起的患儿牙颌结构变化。选择5例骨性上颌后缩型安氏Ⅲ类错牙合的替牙期患者,男1名、女4名,年龄范围7~10.5岁,平均年龄8.5岁,患者前牙反牙合,上颌相对于下颌后缩,下前牙无法退至对刃牙合。应用螺旋扩弓器与前方牵引器治疗,进行治疗前、后及结束后1 a的头影测量分析。螺旋扩弓器与前方牵引器治疗能够促进上颌骨生长,下颌骨轻度向下向后旋转、面形改善。SNA显著增大、平均增大2.0度,治疗后上切牙唇倾,下切牙合倾。覆盖增加6.5mm。结束后1 a覆盖减少1.2mm,原因为下颌向前生长和下切牙唇倾。     

前方牵引联合快速扩弓矫治替牙期骨性安氏Ⅲ类错20例

目的探讨前方牵引联合快速扩弓矫治替牙期骨性安氏Ⅲ类错的临床矫治效果。方法选择20例6-13岁替牙期骨性反患者,运用上颌固定快速扩弓器扩弓并配合面具支架进行上颌前方牵引,在患者治疗前后拍摄头颅侧位片,进行X线头影测量分析,比较矫治前后面部软硬组织的变化。结果20例患者均解除了前牙反情况,覆覆盖正常,患者矫治前后相关软硬组织指标发生明显变化,SNA角、ANB角显著增大,SNB角减小,MP-SN角增大,患者上颌骨矢状向增长显著,下颌骨发生向下向后旋转,侧貌明显改善。结论快速扩弓联合前方牵引治疗替牙期骨性Ⅲ类错能有效促进上颌骨向前生长,并使下颌骨向下向后旋转,从而有效地解除了患者的Ⅲ类骨面畸形,使患者的面貌得到良好改善。     

螺旋扩弓器与上颌前方牵引治疗上颌后缩型安氏Ⅲ类错(牙合)畸形

为了探讨螺旋扩弓器与上颌前方牵引治疗骨性上颌后缩型安氏Ⅲ类错(牙合)中,引起的患儿牙颌结构变化.选择5例骨性上颌后缩型安氏Ⅲ类错牙合的替牙期患者,男1名、女4名,年龄范围7～10.5岁,平均年龄8.5岁,患者前牙反牙合,上颌相对于下颌后缩,下前牙无法退至对刃(牙合).应用螺旋扩弓器与前方牵引器治疗,进行治疗前、后及结束后1a的头影测量分析.螺旋扩弓器与前方牵引器治疗能够促进上颌骨生长,下颌骨轻度向下向后旋转、面形改善.SNA显著增大、平均增大2.0度,治疗后上切牙唇倾,下切(牙合)倾.覆盖增加6.5mm.结束后1a覆盖减少1.2mm,原因为下颌向前生长和下切牙唇倾.     

上颌前方牵引的临床应用体会

骨性安氏Ⅲ类错[牙合]是一种随生长发育加重的错[牙合]畸形，据统计，在骨性安氏Ⅲ类错[牙合]中，伴有上颌后缩者，替牙期占13％，恒牙期占34％。前方牵引主要用于治疗替牙期骨性安氏Ⅲ类错[牙合]患者，其主要目的促进上颌骨的发育，改善上下颌骨间大小和位置的不协调关系。以往大部分研究表明：前方牵引后，上颌骨位置表现出不同程度的前移，下颌骨多出现顺时针旋转。也有研究表明，上颌骨有刺激性的向前生疑，而对下颌骨生长的限制不明显。目前我们对骨性安氏Ⅲ类错[牙合]的早期矫治通常采用前方牵引与上腭快速扩弓联合应用的综合性治疗办法，取得明显的疗效。     

带环粘结式上颌快速扩弓联合前方牵引矫治替牙期骨性Ⅲ类错（牙合）的临床观察

目的探讨带环粘结式上颌快速扩弓联合前方牵引对替牙期骨性Ⅲ类错（牙合）的矫治效果。方法选择22例替牙期骨性反（牙合）患者,用带环粘结式快速扩弓联合前方牵引治疗,并对治疗前后的头颅定位侧位片进行X线头影测量分析。结果22例患者均解除前牙反（牙合）,覆（牙合）覆盖正常,反映上颌骨失状向生长（SNA）和上下颌骨前后向（ANB）的指标明显增加,而反映下颌骨失状向生长（SNB）和下颌骨长度（Go-Gn）的指标则没有明显增长。鼻唇角趋于正常,软组织侧貌明显改善。结论带环粘结式上颌快速扩弓联合前方牵引治疗替牙期骨性Ⅲ类错（牙合）,上颌骨明显向前发育,下颌骨生长受到抑制,软组织侧貌得到明显改善。     

前方牵引治疗安氏Ⅲ类骨性错(牙合)畸形的临床分析

目的 对早期安氏Ⅲ类骨性错(牙合)畸形患者应用前方牵引矫治进行疗效评价.方法 对28例安氏Ⅲ类错(牙合)患者采用上颌前方牵引矫治器进行矫治,对矫治前后X线头影测量结果进行分析.结果 上颌前方牵引可有效地促进上颌骨向前生长,抑制下颌骨向前生长.结论 上颌前方牵引是早期治疗安氏Ⅲ类错(牙合)的有效方法.     

前方牵引矫治不同年龄骨性Ⅲ类错合的临床研究

目的 研究上颌前方牵引矫治不同年龄段安氏骨性Ⅲ类错合临床效果.方法 19例患者按年龄分为两组,均行前方牵引而后对两组治疗前后X线头颅定位侧位片进行头影测量分析.结果 矫治结束后上颌骨前移、长度增加,ANB角增大,下颌骨向后下旋转.上前牙唇倾,下前牙轻度舌倾,上唇位置前移,下唇位置无明显改变,软组织侧貌改善.两组对比证明小年龄组颌骨变化大而大年龄组牙齿的改变更大.结论 上颌前方牵引是矫正因上颌发育不足而导致的安氏骨性Ⅲ类错合的有效方法,既能很好的促进上颌骨生长和前移,同时又可以控制下颌骨的生长,并有效地影响下颌骨的生长方向.矫治时间:乳牙、替牙早期效果好.     

前方牵引矫治恒牙早期骨性Ⅲ类错(牙合)的硬组织变化

目的 了解联合应用前方牵引和快速扩弓矫治恒牙早期骨性Ⅲ类错(牙合)的效果.方法 选取14例恒牙早期骨性Ⅲ类错(牙合)病儿为治疗组,应用前方牵引和快速扩弓矫治法治疗6个月,在治疗前、后拍摄头颅侧位X线片;选取12例未治疗的骨性错病儿为对照组,比较两组病儿硬组织变化情况.结果 治疗组发生显著的硬组织改变,上颌骨向前移位,下颌骨向下、后旋转.下颌平面顺时针旋转,下面高显著增加,覆(牙合)显著减小.结论 前方牵引联合快速扩弓能够对恒牙早期骨性Ⅲ类错(牙合)病儿的牙颌面产生显著的矫形效果.     

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.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.