Profile机用根管预备器械预备弯曲根管的效果分析

目的 评价Profile镍钛合金机用根管锉保持根管弯曲度的能力、工作安全性和工作效率。方法 弯曲根管模型和近中弯曲根管离体下颌磨牙各50颗，并各自平均分为商组：Profile。镍钛合金机用根管撞组和K型锉组。分别预备至主尖锉^#30和^#40，对两组器械预备前后的根管弯曲度、形态、断针情况和工作时间进行测量并统计分析。结果 Profile组的根管弯曲度变化和工作时间较手用器械组减小明显，K型锉组根管弯曲度(17&;#177;7)&;#176;，Profile组(5&;#177;4)&;#176;，t＝7．151，P＝0．000；K型锉组根管预备时间(645&;#177;90)&;#176;，Profile组(487&;#177;77)s，t=6．746，P＝0．000。结论 Profile镍钛合金机用根管撞可以较好地保持根管的原有弯曲度，使用安全，省时。     

ProTaper Universal机括镍钛锉与手用不锈钢锉:根管预备的安全性比较

背景:磨牙的牙根数量多,根管形态复杂、走向弯曲狭窄,对根管预备器械物理机械性能要求较高。目的:评价ProTaper Universal机括镍钛锉与手用不锈钢锉用于根管预备的临床效果。方法:选择100例下颌第一磨牙急性牙髓炎患者,按照随机配对原则分为实验组和对照组。实验组采用ProTaper Universal机括镍钛根管锉进行根管预备,对照组采用手持K型不锈钢锉进行根管预备,比较两组根管治疗后的根管预备时间、根管预备前后弯曲度和根管充填质量。结果与结论:根管治疗后两组患牙根管的临床症状均得到了明显控制和改善。实验组根管预备时间明显短于对照组(P<0.05);两组根管预备后的弯曲度均低于根管预备前(P<0.05),并且实验组预备的根管弯曲度变化更大;实验组根管充填质量优于对照组(P<0.05)。结果表明在磨牙根管治疗中使用ProTaper Universal机括镍钛根管锉,操作更加简便、省时省力,具有根管成型性好、安全性好、工作效率高、根充效果好等特点。     

ProTaper机用镍钛锉预备后牙弯曲根管的疗效分析

目的:分析ProTaper机用镍钛锉预备后牙弯曲根管的临床疗效。方法:选择有弯曲根管的急、慢性牙髓炎、根尖周炎的后牙80例,实验组40例采用ProTaper机用镍钛锉及冠根向技术预备根管,对照组40例采用K锉及逐步后退技术预备根管,两组均用侧向加压法充填根管,根据X线片评价根管预备及充填效果。结果:实验组无根管偏移、根管侧穿、台阶形成等并发症发生,能维持根管的弯曲度和走向,且具有操作时间短,术后疼痛发生率低,根管充填效果好等优点。结论:ProTaper机用镍钛锉预备后牙弯曲根管安全、快速、有效,值得临床推广应用。     

三种机用镍钛器械在预备弯曲根管中的临床应用

目的:探讨机用镍钛器械Profile、Protaper和Hero642在预备弯曲根管中的临床应用。方法:选取有弯曲根管的牙髓炎或根尖周炎患牙160颗,分A、B、C、D4组,分别用Profile、Protaper、Hero642和不锈钢K锉预备根管,全部患牙均采用侧向加压法充填根管。根据X线片评价根管预备和充填的效果。结果:3种机用镍钛器械均能很好地维持根管的弯曲和走向,根管的锥度和流畅度佳。无根管偏移、根尖阻塞、台阶形成等并发症发生,术后疼痛发生少且程度轻。Protaper的操作时间比Prorile和Hero642短,有2根镍钛器械折断。结论:机用镍钛器械Profile、Protaper和Hero642预备弯曲根管成形效果好,极少有根管内并发症发生,Protaper比Profile和Hero642更快速、高效,但临床操作中须注意预防器械折断。     

登士柏机用镍钛根管锉在磨牙弯曲根管治疗中的临床应用

目的 观察登士柏机用镍钛根管器械磨牙弯曲根管预备的临床应用效果.方法 选择435颗磨牙1 566个根管随机分为3组,机用PT组镍钛根管锉预备根管,手用PT组镍钛根管锉预备根管,两组均使用冠根向深入法预备技术,K型组不锈钢K锉(ISO标准型)预备根管,使用逐步后退法预备技术.3组均采用侧压法充填根管.比较每组根管预备操作时间,及根管充填恰填率.结果 机用PT组每个根管预备操作时间明显少于其他两组(P＜0.05),机用PT组与手用PT组在根管治疗中根管充填效果差异无统计学意义(P＞0.05).手用PT组根管预备操作时间明显少于不锈钢K型组(P＜0.05),手用PT组根管适充率明显高于不锈钢K型组(P＜0.05).结论 机用 ProTaper在磨牙弯曲根管预备中有明显的优越性,成行更快速高效,省时省力,能获得良好根管成行效果,在临床上得到越来越广泛地青睐认可,提高了口腔根管治疗水平,值得临床普及推广,临床操作中须预防器械折断.     

乙二胺四乙酸凝胶在弯曲根管预备中的应用效果评价

目的评价弯曲根管预备中应用乙二胺四乙酸(EDTA)凝胶的临床效果。方法将155例患者的189颗患牙分为三组,A组67颗患牙行不锈钢K锉结合手用镍钛锉+EDTA凝胶根管预备,0.5%次氯酸钠及生理盐水交替冲洗;B组59颗患牙行不锈钢K锉结合手用镍钛锉根管预备,0.5%次氯酸钠及生理盐水交替冲洗;C组63颗患牙行不锈钢K锉结合手用镍钛锉根管预备,3%双氧水及生理盐水交替冲洗。评价各组间根管预备情况、根管充填效果及约诊间疼痛的差异。结果 A组在弯曲根管预备过程中预备时间及器械折断率均明显低于B、C两组,根管充填成功率高于B、C两组,差异均有统计学意义(P<0.05);三组约诊间疼痛的发生率差异无统计学意义(P>0.05)。结论在弯曲根管的预备过程中应用EDTA凝胶,能有效提高根管预备的效率及根管的预备质量。     

机用 ProTaper 器械预备磨牙重度弯曲根管对根管工作长度的影响

目的：观察机用 ProTaper 器械预备磨牙重度弯曲根管对根管工作长度的影响。方法选择磨牙根管弯曲度在25＆#176;~45＆#176;的牙髓炎、根尖炎患者307颗牙386个重度弯曲根管,随机分为对照组和实验组,对照组151颗磨牙186个根管使用 GG 钻联合手用不锈钢 K 锉采用逐步后退法预备根管,分别测量预备前、后根管长度;实验组156颗牙200个根管使用机用 ProTaper 器械预备根管,分别测量预备前和 SX、S1、S2、F1、F2、F3预备后根管长度,将数据进行统计学分析。结果对照组和实验组组预备前后根管长度变化比较,差异有统计学意义（ t ＝14.28,P 〈0.01）,实验组内 SX、S1、S2、F1、F2、F3预备后根管长度变化差异无统计学意义（P 〉0.05）。结论机用 ProTaper 器械预备磨牙重度弯曲根管后对根管工作长度影响小,根管预备效果好。     

机用镍钛器械ProTaper预备磨牙根管的临床评价

目的评价机用Pro Taper镍钛根管器械行磨牙根管预备的临床疗效。方法 2011年1月至2013年12月选取患有磨牙牙髓炎或根尖周炎的患者99例,共116颗磨牙;随机分为实验组(49例,58颗牙)和对照组(50例,58颗牙)。对照组用不锈钢K型锉预备根管,实验组用机用镍钛器Pro Taper根管锉预备根管。充填根管过程两组患者均采用侧向加压法。根据X线片评价根管预备和充填效果,且记录每颗患牙的单个根管预备所用时间、术后不良反应及远期疗效。结果与对照组相比,机用Pro Taper镍钛器械预备单根管所耗时间短,根管预备后疼痛发生率低,根管适充率高,根管治疗术后1年疗效好。结论使用机用Pro Taper器械进行恒磨牙根管预备快速、高效,根充效果好,术后疼痛少,值得临床推广。     

两种根管预备方法临床效果比较

目的比较机用镍钛根管扩大锉profile与手用不锈钢扩大锉K—file两种根管预备方法的临床效果。方法两组后牙根管分别用机用镍钛扩大锉profile、手用不锈钢扩大锉k-file进行预备，比较术后充填和疼痛情况。结果机用镍钛根管扩大锉profile比手用根管扩大锉k-file省时省力，去除感染组织较彻底，术后疼痛小，但在较弯曲根尖段易折断。结论利用两种方法的优缺点互补，可增加工作效率，减少并发症。     

ProTaper手用根管锉在磨牙根管预备中的应用

目的:评价ProTaper手用根管锉预备磨牙根管的临床疗效。方法:将50颗磨牙共160个根管随机分为两组:实验组采用ProTaper手用根管锉冠向下预备根管,对照组采用不锈钢K锉逐步后退法预备根管。两组均采用侧方加压充填法充填根管,用X线片评价根管预备及根充的效果。结果:ProTaper手用根管锉能较好地维持根管的形态,操作时间短,根管预备后疼痛发生率低。结论:ProTaper手用根管锉预备磨牙根管安全、有效,节省时间,临床应用价值较高。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.