钛种植术后早期放疗高压氧对种植体与骨结合的影响

目的探讨高压氧（ＨＢＯ）对钛种植术后早期放疗种植体与骨结合的影响。方法将纯钛种植体植入兔双腿胫骨干骺端,术后放疗,并在不同时期辅以ＨＢＯ治疗。对标本进行Ｘ线检查、组织学、扫描电镜及Ｘ线能谱分析。结果种植术后２周放疗,可使种植体的直接骨性结合率（ｄｉｒｅｃｔｃｏｎｔａｃｔｌｅｎｇｔｈｆｒａｃｔｉｏｎ,ＤＣＬＦ）降低４０％,新生骨的成熟明显推延,辅助ＨＢＯ治疗可提高种植体的ＤＣＬＦ,但仍低于未做放疗组。结论辅助ＨＢＯ只能从一定程度上促进种植体与骨的结合,不随治疗时间延长而有进一步改善。应用ＨＢＯ时机的不同对骨结合影响不大。     

口腔种植术后早期γ射线照射对钛种植体骨融合的影响

目前，国外开展了放疗对种植体骨融合影响的实验及临床研究。但是，有关口腔种植术后放疗对种植体骨融合影响的研究较少。笔者旨在阐明口腔种植术后早期^60coγ射线照射对钛种植体骨融合的影响。     

BEGO种植体术后短期效果观察

目的观察评价BEGO种植系统种植术后1、3个月的短期临床效果。方法20例患者共计植入种植体20枚,术后1、3个月定期随访,检查患者口腔卫生情况,通过探诊种植体周龈沟观察种植体周软组织情况,拍摄X线全景片检查种植体周硬组织变化,评价种植体术后短期临床效果。结果术后1、3个月,20例种植体周围牙槽骨吸收平均值分别为0．32mm、0．47mm,各有1例出现牙龈炎,经局部处理后炎症得以控制,未出现种植体脱落。结论采用BEGO种植系统修复的患者,术后软组织炎症出现少,边缘骨吸收在正常范围内,短期稳定性较好。     

膜引导骨再生技术在上前牙种植中应用临床效果

目的探究膜引导骨再生技术(MGBR)在上前牙种植中应用的临床效果。方法选取自2013年4月至2016年4月于无锡市第四人民医院治疗的上前牙区唇腭向骨量不足患者38例,共计患齿52颗,将使用MGBR同期植入种植体的30颗设为有膜组,无MGBR植入的种植体22颗设为无膜组。记录并比较两组修复前骨唇腭向的厚度及相对密度、种植前与修复前骨唇腭向的厚度差值及相对密度差值、种植体周骨丧失(BL)情况以及种植体短期存活率。结果修复前,两组骨唇腭向的厚度、相对密度比较,差异均无统计学意义(P>0.05);有膜组种植前与修复前骨唇腭向的厚度差值及相对密度差值显著高于无膜组,差异有统计学意义(P<0.05)。有膜组Ⅰ期术后4～6个月植体周BL[(0.14±0.04)mm]显著低于无膜组[(0.19±0.05)mm],差异有统计学意义(P<0.05)。有膜组种植体短期存活率为100.0%(30/30),无膜组为95.5%(21/22),组间比较,差异有统计学意义(P<0.05)。结论应用生物膜能够增加种植区唇腭向厚度及相对密度,缓解早期种植体周围BL,种植体短期存活率更高,在上前牙种植中临床效果良好。     

ITI种植系统用于后牙游离端缺失修复中的疗效评价

目的评价ITI种植体用于后牙游离端缺失修复中的临床疗效。方法后牙游离端缺失采用种植义齿修复的56例共227个种植体。其中即刻种植4例,上颌窦内提升术9例。3～6个月后行上部结构修复。定期随访种植牙的探诊深度、种植体骨结合状况、种植体的骨丧失水平。结果经过1～4年的随访观察,227颗种植体无一松动脱落,均未发生神经损伤和感觉异常。种植体稳定,未见其周围有X线透视区。种植体周围组织健康,种植体龈沟探诊深度为(2.93±0.37)mm;术后1年的骨丧失水平均值为(0.92±0.62)mm,1年后的平均每年骨吸收均<0.2 mm。病人对舒适度、美观性和咀嚼效率评价良好。结论 采用ITI种植系统对后牙游离端缺失进行修复,操作简单,临床效果好。     

即刻种植与拔牙窝愈合初期种植的效果比较

 目的 比较即刻种植与初期种植的种植体存留率与种植后5年边缘骨吸收的情况,为选择种植时机提供参考。方法 选择拔牙后即刻种植和拔牙后两周内行牙种植(初期种植)的患者58例,共计75颗种植体,其中初期种植的27颗植体为A组,即刻种植的48颗植体为B组,分别于术后即刻、1、3、6、12个月,以后每12个月拍摄X线片,随访5年及以上种植体存留情况,测量植体近远中牙槽嵴顶骨吸收的程度。用SPSS21.0统计软件,对寿命表法计算的两组成功率和存留率进行χ²检验,近远中骨吸收值进行两独立样本t检验。结果 A组种植体成功率79.25%,存留率100%;B组种植体在种植后1~9个月内5颗脱落,成功率76.47%,存留率89.47%,在种植体成功率方面,两者差异无统计学意义;在存留率方面,两者差异具有统计学意义。此外,术后即刻、随访5年近中牙槽嵴高度差值比较,A组为(1.16±0.32) mm,B组为(1.39±0.41) mm,P=0.216;远中牙槽嵴高度差值A组为(0.96±0.39) mm,B组为(1.05±0.52) mm,P=0.302;统计学分析显示,在种植术后5年,初期种植与即刻种植在近远中牙槽嵴改变值方面无统计学差异。结论 在拔牙窝愈合的初期(7~14 d)行种植体的植入,是可行的种植手术时机。     

全髋关节置换术对男性骨质疏松症骨密度的影响

目的：探讨全髋关节置换术（THA）对男性骨质疏松症患者骨密度（BMD）的影响。方法：THA29例，按照术前检查分为骨质疏松组和非骨质疏松组（对照组），采用双能X线骨密度仪（DEXA），检测两组术前1天和术后2个月正位腰椎和健侧髋部的BMD。结果：THA后腰椎下降3．4％，健侧髋部下降2．0％。骨质疏松组的腰椎骨量丢失明显快于对照组（P〈0．05），健侧髋部骨量丢失无显著差异。结论：THA后骨质疏松患者骨量丢失快于非骨质疏松者。术后应加强康复锻炼，以避免进一步骨量丢失。     

纳米羟基磷灰石/聚酰胺外固定支架固定钉的界面成骨能力

目的 对纳米羟基磷灰石／聚酰胺66（nHA／PA66）复合材料和不锈钢材料的2组外固定器固定钉进行实验比较,了解nHA／PA66复合材料用于固定钉的界面成骨能力。方法 特制30枚nHA／PA66外固定钉,30枚不锈钢外固定钉。成年家犬9只,每只犬的左右胫骨十分别植入各5枚,按术后4、8、12周分为3组。动物处死后,标本进行如下检查：X线、组织学、扫描电镜及计算机图像分析。结果X线观察：nHA／PA66组外固定钉无碎裂,均无放射线透亮区,周围皮质骨下骨质修复反应,可见界面模糊,密度随时间增加。金属外固定钉周围均可见不同程度的放射线透亮区,即它们与皮质骨之间X线透亮区≥0．5mm。组织学及扫描电镜观察：nHA／PA66外固定钉表面已为新生骨组织所覆盖,并不断钙化而形成成熟骨组织,骨钉界面结合完整而无间隙。金属钉组外固定钉的骨折表面与骨之间存在较大间隙,并被胶原纤维所覆盖,随着时间的延长,胶原纤维组织厚度逐渐增加。计算机图像分析观察：nHA／PA66外固定钉骨组织结合率：4周（56％）〈8周（79％）〈12周（91％）（P〈0．05）。结论nHA／PA66复合材料用于外固定钉具有一定的界面骨结合能力。     

骨质状态下牙种植体骨整合及生长改变的实验研究

为研究骨质疏松对大鼠种植体－骨界面骨整合的影响,将大鼠随机分为A组（假去势手术组）和B组9去热手术组）,在其右股骨远中1／2种植纯钛螺钉,分别于种植术后1.5及3个月时随机处死各组动物的一半,对种植部位进行X线、扫描电镜和显微镜观察。结果可见骨融合指数在1.5个月主3个月处死时,A组＞B组（P＜0.01）,新骨生成量在1.5个月处死时,A组多于B组;3个月处死时A组增加,B组减少。骨质疏松改变可使大鼠种植体－骨界面骨融合指数降低、新骨生成量减少;种植体骨界面新骨形成后,在没有外界因素作用情况下,延长时间骨整合状况改善不明显。     

引导骨再生治疗种植体周围骨缺损36例临床观察

目的通过应用引导骨再生技术，解决临床中因为局部牙槽骨骨量不足造成的牙种植体周围骨缺损。方法对36例种植手术过程中种植体周围骨缺损处填塞Bio—oss骨粉，覆盖海奥生物膜，术后及二期手术行X线检查及口腔检查。结果1例种植体松动，35例骨结合情况良好，行后期冠修复。结论应用引导骨再生技术解决种植体周围骨缺损近期疗效较好。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.