上颌前牙区不翻瓣即刻牙种植术对患者口腔内软硬组织的影响

目的：分析上颌前牙区不翻瓣即刻牙种植术对患者口腔内软硬组织的影响。方法选择2010年3月至2013年3月在我院接受手术治疗的前牙或者前磨牙修复患者100例作为研究对象。以数字法随机分成观察组和对照组各50例。对照组实施翻瓣的即刻牙种植手术,观察组则实施不翻瓣的即刻牙种植手术,统计并对比两组术后整体情况、术后软硬组织情况,以及治疗前后的PES评分与VAS评分。结果观察组患者术后1 d的肿胀和疼痛率均明显低于对照组,而术后12个月的牙龈乳头指数明显高于对照组,差异均有统计学意义(P<0.05);两组患者术后12个月的骨愈合及牙龈沟出血方面比较差异均无统计学意义(P>0.05);观察组患者术后12个月的嵴顶吸收值明显少于对照组,差异有统计学意义(P<0.05);两组患者术后7 d的牙槽嵴顶和植体距离及术后12个月的牙龈沟深度比较差异均无统计学意义(P>0.05);两组治疗后的PES评分及VAS评分较治疗前均有上升,但观察组的上升程度明显高于对照组,差异有统计学意义(P<0.05)。结论在上颌前牙区实施不翻瓣的即刻牙种植手术,疗效更佳,更具美感,值得推广。     

不翻瓣即刻牙种植术治疗前牙或前磨牙缺损患者的效果

目的:观察不翻瓣即刻牙种植术治疗前牙或前磨牙缺损患者的效果。方法:选取90例行即刻牙种植术的牙缺损患者作为研究对象,按随机数字表法将其分为对照组和观察组各45例。对照组给予翻瓣即刻牙种植术,观察组给予不翻瓣即刻牙种植术,比较两组美观程度、龈沟深度、牙槽嵴顶吸收水平、术后并发症发生率和种植成功率。结果:观察组术后6个月的红色美学指数高于对照组,术后3 d的视觉模拟评分低于对照组,术后1年的龈沟深度及牙槽嵴顶吸收水平低于对照组,差异均有统计学意义(P<0.05);观察组术后1个月的并发症发生率为4.44%(2/45),低于对照组的17.78%(8/45),差异有统计学意义(P<0.05);观察组种植成功率为97.78%(44/45),高于对照组的82.22%(37/45),差异有统计学意义(P<0.05)。结论:不翻瓣即刻牙种植术治疗前牙或前磨牙缺损患者可提高种植成功率,降低术后并发症发生率、视觉模拟评分和牙槽嵴顶吸收水平,减小龈沟深度,效果优于翻瓣即刻牙种植术。     

即刻种植即刻修复在上颌前牙临床应用分析

目的：探讨即刻种植和即刻修复技术在上颌前牙区的临床应用效果。方法：选取接受即刻种植即刻修复的患者40例设为观察组,植入牙位均为上颌前牙区,种植体共46颗,另选取常规延期修复治疗的40例患者为对照组,植入牙位亦均为上颌前牙区,种植体共50颗。观察组患者接受即刻种植即刻修复,对照组患者行常规延期修复治疗。比较2组患者种植体体积及骨吸收水平和治疗效果。结果：观察组种植体长度、种植体直径显著大于对照组,差异有统计学意义（P＜0．05）;观察组6个月的骨吸收水平显著小于对照组,差异有统计学意义（P＜0．05）。观察组有效率为92．5％,显著大于对照组,结果有统计学意义（P＜0．05）。结论：与传统延期修复技术相比,即刻种植和即刻修复具有缩短疗程、减少手术次数、降低手术创伤的优点,并且具有美观的效果,但在临床应用中,应严格把握适应证,规范治疗步骤。     

前牙区微创延期即刻种植临床研究

目的研究微创延期即刻种植术的近期临床效果。方法选择前牙区微创拔牙患者41例,随机分成A组和B组。拔牙后4～8周分别用微创不翻瓣（A组）和翻瓣（B组）两种方法植入ITl种植体。收集手术时间、疼痛反应、种植体存留率、咀嚼功能和软硬组织状况等数据进行统计分析。结果A组在手术时间、肿胀、疼痛反应、牙槽嵴顶吸收和牙龈乳头指数较B组佳,P〈0．05。全部病例存留率100％,能行使正常咀嚼功能。结论前牙区微创拔牙后行微创延期即刻种植．近期效果可靠．可临床府用推广．     

引导骨再生术、骨劈开术、牙槽嵴扩张术三联治疗上颌前牙狭窄牙槽嵴种植患者的效果

目的:观察引导骨再生术(GBR)、骨劈开术、牙槽嵴扩张术三联治疗上颌前牙狭窄牙槽嵴种植患者的效果。方法:选取72例上颌前牙狭窄牙槽嵴种植患者为研究对象,按照随机数字表法分为观察组与对照组各36例。对照组给予骨劈开术联合牙槽嵴扩张术治疗,观察组在对照组基础上给予GBR治疗。比较两组牙槽骨高度、牙槽骨骨量、种植床骨密度、种植成功率、红色美学指数(PES)评分、白色美学指数(WES)评分和治疗满意度。结果:术后3个月,两组牙槽骨高度、牙槽骨骨量、种植床骨密度均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组种植成功率为100.00%,明显高于对照组的83.33%,差异有统计学意义(P<0.05);术后12个月,观察组PES和WES评分均高于对照组,差异有统计学意义(P<0.05);观察组固位功能、咀嚼功能、舒适度满意度均高于对照组,差异有统计学意义(P<0.05)。结论:GBR、骨劈开术、牙槽嵴扩张术三联治疗上颌前牙狭窄牙槽嵴种植患者可提高牙槽骨高度、牙槽骨骨量、种植床骨密度、PES评分、WES评分,提高种植成功率和治疗满意度,效果优于骨劈开术联合牙槽嵴扩张术治疗。     

即刻与延期前牙种植义齿修复的临床效果及主观满意度调查

目的：观察上颌前牙区即刻与延期种植义齿修复的临床效果及患者主观满意度。方法选取37例上颌单个前牙种植患者为研究对象,根据种植方法不同分为即刻种植组（n＝17）和延期种植组（n＝20）,观察种植义齿修复完成及12个月后两组患者种植体周围软组织、牙槽骨吸收情况及患者的主观满意度。结果种植义齿修复完成,即刻种植组红色美学指数（PES ）为（9．82±2．40）分,延期种植组PES为（9．70±1．69）分。随访12个月,种植体成功率100％,即刻种植组PES为（11．12±2．47）分,延期种植组PES为（10．40±1．93）分。两组患者修复完成时与修复完成后12个月的 PES评分比较差异无统计学意义（ P＞0．05）。修复完成后12个月的X线片与修复完成时比较,即刻种植组骨吸收低于延期种植组（ P＜0．05）;满意度调查结果提示即刻修复组患者对软组织附着高度、整体美观效果优于延期修复组（P＜0．05）。结论即刻种植可降低牙槽骨吸收,提高患者满意度。     

EMS系统与牙周翻瓣术治疗中重度慢性单根牙周炎及多根牙周炎的疗效比较

目的比较瑞士医迈斯(EMS)系统与牙周翻瓣术治疗中重度慢性单根牙及多根牙周炎的疗效。方法选择2017年3月至2018年3月安徽省第二人民医院口腔科收治的中重度慢性牙周炎患者100例为研究对象,采用随机数字表法将患者分为观察组及对照组,各50例,同时依据患牙数量分别分成单根牙组与多根牙组,观察组采用EMS系统治疗,对照组采用牙周翻瓣术治疗,治疗后12个月随访。比较两组单根牙组、多根牙组患者牙周探诊深度(PD)和牙龈退缩长度(GR)、临床附着丧失长度(CAL)及探诊出血阳性率(BOP)。结果观察组单根牙患者的GR及CAL较对照组低,差异有统计学意义(P <0. 05),但两组PD及BOP阳性率相比,差异无统计学意义(P>0. 05)。观察组多根牙患者PD、CAL水平及BOP阳性率较对照组高,GR较对照组低,差异均有统计学意义(P <0. 05)。结论对于中重度慢性牙周炎患者,如是单根牙宜选择EMS系统治疗,多根牙则建议使用牙周翻瓣术治疗。     

改良牙槽嵴顶结缔组织转瓣技术在上颌前牙种植美学修复中的应用

目的探究改良牙槽嵴顶结缔组织转瓣技术在上颌前牙种植美学修复中的应用效果。方法选取上颌前牙种植患者50例作为研究对象,未进行转瓣数患者25例作为对照组,25例复诊行二期手术且术前评估种植区唇侧软组织丰满度不足接受转瓣术治疗患者作为实验组,观察两组患者美学指数等指标。结果实验组患者T0-T4唇侧丰满度评分明显高于对照组患者,组间对比差异具有统计学意义(P 0.05);实验组患者T1-T0增加值明显大于对照组患者,组间对比差异具有统计学意义(P0.05);实验组患者T3-T0增加值为(0.274±0.115),明显大于对照组T3-T0的(0.096±0.022),组间对比差异具有统计学意义(P0.05);T3实验组与对照组患者PES美学评分分别为(10.85±0.15)分、(10.80±0.14)分,明显高于T2实验组与对照组患者PES美学评分,组间对比差异具有统计学意义(P0.05)。结论种植二期应用改良牙槽嵴顶结缔组织转瓣技术,所能够达到的效果为提升软组织丰满度稳定程度,且不会对PES评分造成影响。     

前牙即刻种植美学效果的临床分析

目的 探讨上颌前牙即刻种植义齿修复的临床美学效果.方法 选择我院2011年1月至2012年2月43例单个上颌前牙损坏患者分为观察组(n=23)与对照组(n=20),观察组行单个前牙即刻种植,对照组行单个前牙延期种植,观察比较两组患者牙龈乳头指数、骨吸收情况,评估其美学效果.结果 1年后两组患者种植体均发生了骨结合,种植体全部成功,成功率100%.观察组牙龈乳头指数优于对照组,两组比较差异有统计学意义(P<0.05);两组骨吸收均在正常范围内,骨吸收前6个月两组比较差异有统计学意义(P<0.05),后6个月比较差异无统计学意义(P>0.05).结果 上颌前牙区行即刻种植获得的软硬组织外形较延期种植更佳,牙龈乳头美学效果尤其更理想.     

颈椎前后路联合术治疗脊髓型颈椎病的临床疗效观察

目的探讨颈椎前后路联合术治疗脊髓型颈椎病的临床疗效。方法选取2009年1月～2011年1月我院收治住院的因脊髓型颈椎病行颈椎手术的患者106例,将其按照手术方式的不同分为观察组和对照1组、对照2组,对照1组35例行颈椎前路椎体次全切减压植骨融合内固定术,对照2组35例行颈椎后路单开门椎管扩大成形术．观察组36例行颈椎前后路联合术,术后随访6～12个月,比较三组患者神经功能优良率、手术前后JOA评分及颈椎弧度D值。结果术后观察组神经功能优良率为86．11％,高于对照1组的71．43％和对照2组的74．28％,观察组与对照组比较差异有统计学意义（χ2=9．365,P〈0．05）,两对照组问差异无统计学意义（P〉0．05）。随访6-12个月,三组患者术后3、6、12个月JOA评分均较术前改善,差异有统计学意义（P〈0．05）;且观察组改善较对照组明显（均P〈0．05）。颈椎D值对照1组、观察组患者术后较术前有改善,与术前比较差异有统计学意义（均P〈0．05）;对照2组术后即刻与随访6、12个月比较,差异有统计学意义（P〈0．05）。对照1组术后3例有不同程度咽痛,对照2组2例,观察组2例,均3～5d后缓解;t组无一例椎动脉损伤患者,无严重并发症发生。结论颈椎前后路联合术治疗脊髓型颈椎病能达到较好的治疗效果,能较好地恢复和维持颈椎生理弧度,行颈椎后路手术者术后颈椎弧度部分丢失。     

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.