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。     

机用镍钛根管器械分离后旁路通过术的研究进展

机用镍钛根管器械因其工作效率高、成型能力好而被广泛应用于临床。但由于其在使用过程中发生分离概率较高,而器械分离于根管内在一定程度上影响了根管治疗的效果。旁路通过术作为处理器械分离的保守方法之一,成功率较高。本文就机用镍钛根管器械分离后的旁路通过术的研究进展做一综述。     

两种镍钛机用器械联合使用在根管预备中的应用研究

目的:评价使用Protaper和Hero642两种镍钛机用器械混合使用在预备根管时的临床效果。方法:选取需行根管治疗的162颗患有牙髓炎及根尖周炎的磨牙,分别使用机用镍钛器械Protaper、Hero642和两种器械混合使用预备根管,3组均使用侧压充填法充填根管。记录根管预备时间及器械折断数量。根据治疗前、中、后的X线片计算弯曲根管的弯曲度变化,评价根管预备和充填的效果。结果:Protaper和Hero642及两种器械混合使用预备根管时预备根管时间短,根管锥度、流畅度好,术后疼痛发生少且程度轻。Protaper器械折断11支、Hero642器械折断5支,两种器械混合使用预备根管发生器械折断4支(P<0.05)。结论:镍钛机动器械Protaper、Hero642预备磨牙根管成形、根充效果好。Protaper减小根管弯曲度较Hero642明显,根充效果好,但易折断。Hero642操作简单,不易折断。两种镍钛机动器械混合使用则兼顾了两种方法的优点。     

镍钛机动器械联合不同超声冲洗液对慢性根尖周炎进行一次性根管治疗的临床研究

背景：临床一次性根管治疗中,超声冲洗可提高根管冲洗的质量,可通过超声的协同作用,让冲洗液达到根管预备器械所不能彻底清理的区域,如根尖狭部、侧支根管等,达到去除腐质清理消毒的目的。 目的：探讨镍钛机动器械联合不同超声冲洗液进行一次性根管治疗的临床疗效。 方法：选择460例慢性根尖周炎患者,共460颗患牙,随机分为3组,次氯酸钠组使用Mtwo镍钛机动器械联合2.5%次氯酸钠超声冲洗清理根管,银离子抗菌液组使用镍钛机动器械联合活性银离子抗菌液超声冲洗清理根管,对照组使用K锉双氧水＋生理盐水注射器根管冲洗,在根管预备完成后即刻根充。术后24 h由患者采用目测类比量表进行疼痛程度自评;7 d复诊时评价3组术后急性反应;术后6,12个月复诊,临床检查结合X射线机根尖周指数进行疗效评价。 结果与结论：次氯酸钠组、银离子抗菌液组术后疼痛程度、急性反应发生率低于对照组（P＜0.05）,次氯酸钠组、银离子抗菌液组间疼痛程度与急性反应发生率无差异（P＞0.05）;术后6个月,3组治愈率差异无显著性意义（P＞0.05）,但12个月后对照组治愈率低于其他两组（P＜0.05）。结果说明使用Mtwo镍钛机动器械联合超声冲洗对慢性根尖周炎患者一次性根管治疗,取得了可靠的近远期临床疗效。     

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。     

Protaper机用镍钛器械在前牙根管预备中的应用

目的：评价Protaper机用镍钛器械在前牙根管预备中的临床效果。方法：选择38例牙髓炎或根尖周炎患者40颗患牙，均为单根管前牙，随机分成两组。A组（n=20）采用机用镍钛器械Portaper预备根管，B组（n=20）采用K锉常规法预备根管，两组均采用侧向加压充填法充填根管。比较两组根管预备时间，并根据治疗前后X线牙片评价根管预备和充填效果。结果：A组根管预备时间明显短于B组（P〈0．001），A组1例欠充0．5mm，B组3例欠充1．0mm，两组充填的锥度、流畅度从X线牙片上看在根尖1／3，A组连续锥形比B组更为明显些。结论：Protaper机用镍钛器械快速、安全、成形效果好，在前牙根管预备中完全可以代替传统的不锈钢K锉。     

根管初预备对机用ProTaper镍钛器械变形折断率影响的研究

目的探讨手用不锈钢K锉初预备根管至不同直径对机用Protape镍钛器械的变形折断率的影响。方法比较手用不锈钢器械初预备根管后联合机用ProTaper镍钛器械预备根管,与使用机用ProTaper镍钛器械预备根管,不同方法中镍钛器械变形折断率。结果手用不锈钢器械初预备根管至20#或25#再联合机用ProTaper镍钛器械预备根管,与使用机用ProTaper镍钛器械预备根管,不同方法中镍钛器械变形折断率的差异有统计学意义（P〈0.05）。结论手用不锈钢器械初预备根管至20#或25#可以提升机用ProTaper镍钛器械的使用寿命和降低机用镍钛根管器械变形折断率,为临床选择良好的根管预备方法提供依据,降低器械折断率,提高根管镍钛器械使用寿命。     

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。     

R-Endo镍钛器械在根管再治疗中去除填充物的临床效果

选取60颗下颌前磨牙,用Hero 642镍钛机预备后用冷侧方加压法填充。然后将其随机分为三组,每组均为20颗。三组分别使用手用H锉(M组)、机用Hero 642(H组)、机用R-Endo组(R组)去除根管内的填充物。比较三组的根管内填充物的残留量以及操作时间。结果三组内均有存在一定的填充物残留现象,其中R组和H组的填充物残留百分比以及操作时间均要少于M组,差异均有统计学意义(P0.05)。R-Endo镍钛机用器械能缩短清理根管内填充物的时间,降低根管充填物的残余量,有利于提高牙体牙髓疾病患者临床治疗效果。     

健康教育在机用镍钛锉行根管治疗术中的应用

根管治疗是一种治疗牙髓病、根尖周病的有效方法，是通过机械和化学的方法预备根管，将存在于牙髓腔内已发生不可复性损害的牙髓组织和作为根尖周病的病源刺激物全部清除，以消除感染并使根管清洁成形，再经过药物消毒和严密地充填根管以达到防止再感染的目的。机用镍钛锉预备根管是近年我国开展的一项新技术。为使患者对根管治疗方法及相关知识有科学的认识，消除患者的紧张情绪，减轻疲劳，提高术中的配合程度，我们对2005年3—6月选择首次行根管治疗术的70例患者，进行健康教育，取得满意的效果，现报道如下。     

四种暂封材料对根管治疗后冠方微渗漏的影响

背景:临床上需要进行根管治疗的牙齿多数有较大牙体缺损,甚至是残冠、残根,而且永久性修复体需要在治疗后一段时间才能完成,故根管治疗后冠修复前暂时封固对冠方微渗漏的影响已经被临床医生所重视。目的:评价不同暂封材料对根管治疗后牙冠方微渗漏的影响,探讨根管治疗后牙冠方微渗漏发生情况及与时间的关系。方法:收集人离体牙126颗,其中120颗为实验组,3颗为阳性对照组,3颗为阴性对照组。实验组和阳性对照组牙齿进行根管治疗,而后采用牙齿牙胶尖和AH-plus根管糊剂冷侧压充填实验组根管,随机均分为4组,分别以Coltosol、Caviton、ZOE、Ceivitron暂封材料暂封根管治疗后的牙冠方,阳性对照组不充填根管,阴性对照组牙齿保持完整。分别于暂封1,2,4周观察各组样本染料微渗漏情况。结果与结论:阴性对照组未见染料渗入根管,阳性对照组可见整个根管被染色。暂封1周时,Coltosol组、Caviton组微渗漏长度短于ZOE组和Ceivitron组(P<0.05);暂封2周时,Coltosol组微渗漏长度短于Ceivitron组(P<0.05);暂封4周时,Coltosol组、Caviton组和ZOE组微渗漏长度短于Ceivitron组(P<0.05)。随暂封时间的延长,4种材料组微渗漏长度均增加,组内不同时间点微渗漏长度差异均有显著性意义(P<0.05)。结果表明Coltosol和Caviton材料的暂封效果较好,其次为ZOE,Ceivitron最差,Coltosol和Caviton用于暂封的适宜时间为一二周,ZOE和Ceivitron为1周。     

Evaluation of nursing documentation. A comparative study using the instruments NoGA and Cat-ch-ing after an educational intervention

In this article we describe the results of a comparative study focusing on the evaluation of nursing documentation before and after an educational intervention. An additional aim is to report the results of a comparison between quality measurements of nursing documentation using the examination instruments NoGA and Cat-ch-ing and, against this background, to recommend an instrument for future examinations. The educational intervention was directed towards nurses at Helsingborg hospital/health care district. The intervention, which comprised supervision, group sessions, lectures and field trips, covered a period of two years and was built on a learning model. In all, the data material examined included 515 nursing records collected from 52 units. The study reports on a comparison of the examination results from four different clinics for the years 1994 and 1997. The results show a statistically significant difference between the four clinics before the intervention, a difference that disappeared after the intervention. Furthermore, the results show a statistically significant improvement in documentation after the intervention. For future examinations, it is recommended that the examination instrument Cat-ch-ing should be used and that methods for examination of the content of the documentation must be developed.     

三种中医治疗方案在促进腹部术后胃肠功能恢复的对比研究

目的：探讨腹部术后患者使用大承气汤外敷神阙穴加电磁波治疗仪（ TDP ）照射对促进腹部术后患者胃肠功能恢复的影响。方法将本院腹部术后120例患者随机分为3组（中药内服组、经皮给药组、经皮给药加TDP照射组）,每组40例,其中中药内服组患者在术后6 h开始服用大承气汤,每日2次;经皮给药组患者在术后30 min,常规消毒局部皮肤后取大黄药膏3 g外敷于神阙穴位置,并用医用胶布进行固定,每日1次,24 h更换;经皮给药加TDP照射组患者在经皮给药组的基础上,在每次更换药物后用TDP照射30 min,并注意观察局部皮肤有无红肿热痛的情况,防止烫伤。比较3组患者的术后胃肠道蠕动时间、肛门排气时间及首次排便时间,及干预前后3组患者的MODS评分情况。结果经皮给药加TDP照射组在术后胃肠道蠕动时间、肛门排气时间、首次排便时间及MODS评分改善程度上均明显优于经皮给药组及中药内服组（ P＜0．05）。结论经皮给药敷神阙穴加TDP照射能够缩短腹部手术患者胃肠道的恢复时间,促进腹部手术患者的康复,在临床值得进一步推广。     

热牙胶充填与冷牙胶侧方加压在根管充填中应用的临床效果比较

目的比较在根管填充中分别应用热牙胶和冷牙胶侧方加压进行充填的临床效果。方法选择60例急性牙髓炎和根尖周病患者行根管充填,随机将其分为治疗组、对照组各30例。治疗组应用热牙胶填充,对照组为冷牙胶侧方加压填充。术后均随访3个月,比较两组患者的术中、术后效果。结果治疗组根管充填时间明显低于对照组(P0.05);术后根尖周疼痛病例数比较组间差异不明显(P0.05);治疗组术后3个月临床总有效率为96.7%,明显高于对照组的80.0%(P0.05)。结论应用热牙胶进行根管填充可减少术后根尖周疼痛发生人数,缩短治疗时间,能较好地封闭侧枝根管,有效提高临床疗效,可作为根管充填的首选方法。     

超声造影评价高强度聚焦超声和射频消融治疗不同大小子宫肌瘤疗效及比较

目的采用超声造影技术评价高强度聚焦超声(HIFU)和射频消融治疗子宫肌瘤的疗效,并比较两者对不同大小子宫肌瘤疗效的差异。方法 100例子宫肌瘤患者共138个肌瘤,随机分为2组,每组各50例,分别接受HIFU及射频消融治疗。HIFU组16例患者24个肌瘤直径2.0～4.0cm,26例患者32个肌瘤直径4.0～6.0cm,8例患者12个肌瘤直径6.0～8.0cm;射频消融组14例患者22个肌瘤直径2.0～4.0cm,27例患者35个肌瘤直径4.0～6.0cm,9例患者13个肌瘤直径6.0～8.0cm。所有患者均于治疗前、后1周内行超声造影。采用Chi-squareχ2检验比较HIFU、射频消融治疗不同大小子宫肌瘤完全消融率、术后并发症发生率。结果 HIFU组、射频消融组直径2.0～4.0cm子宫肌瘤完全消融率分别为91.7%(2/24)和95.5%(1/22),差异无统计学意义(χ2=0.270,P>0.05);HIFU组、射频消融组直径4.0～6.0cm子宫肌瘤完全消融率分别为56.3%(18/32)和94.3%(33/35),HIFU组完全消融率低于射频消融组,且差异有统计学意义(χ2=13.304,P<0.05);HIFU组、射频消融组直径6.0～8.0cm子宫肌瘤完全消融率分别为16.7%(2/12)和76.9%(10/13),HIFU组与射频消融组的完全消融率均降低,但射频消融组的完全消融率仍高于HIFU组,且差异有统计学意义(χ2=10.711,P<0.05)。术后并发症包括发热、下腹部疼痛、盆腔积液、阴道排液及单侧下肢麻木。HIFU组并发症发生率为16.0%(8/50),低于射频消融组的36.0%(18/50),差异有统计学意义(χ2=4.917,P<0.05)。结论 HIFU和射频消融对于直径4.0cm以下子宫肌瘤疗效显著。对于直径6.0cm以上的子宫肌瘤,射频消融可取得较好疗效。HIFU作为一种无创治疗手段,可作为小肌瘤非手术治疗的首选方法。     

Assessment of follicular development in clomiphene induced cycles by means of ultrasound and laparoscopy: A comparative study

Fifty clomiphene/H.C.G. stimulated patients undergoing laparoscopy as part of their infertility work up consented to participate in a study on: the reproducibility of ultrasonic measurement of follicular size as expressed by the inter and intra observer variation; the accuracy of ultrasonic assessment of location, number and size of follicles and the growth rate of the Graafian follicle during the last 12 hr prior to oocyte collection. The inter and intra observer variation was moderate to good. Correct diagnosis of the dominant follicle was made in 73%, of the number of follicles in 72% and of follicular size (difference in size between ultrasound and laparoscopy < 2 mm) in 48% of the material studied. There was a rather wide range in follicular growth rate values during the last 10–17 hr prior to laparoscopy.     

A comparative electrochemical study of non-enzymatic glucose,ascorbic acid,and albumin detection by using a ternary mesoporous metal oxide (ZrO2, SiO2 and In2O3) modified graphene composite based biosensor

In this study, we present an electrochemical investigation of a ternary mesoporous metal oxide (ZrO₂, SiO₂ and In₂O₃) modified graphene composite for non-enzymatic glucose, ascorbic acid, and albumin detection in urine at physiological pH. Synergetic property of ZrO₂–Ag–G–SiO₂ and In₂O₃–G–SiO₂ were investigated via cyclic voltammetry (CV) using FTO glass and copper-foil electrodes with no prerequisite of solid antacid expansion. The mesoporous ZrO₂–Ag–G–SiO₂ and In₂O₃–G–SiO₂ composites were synthesized and characterized using XRD, SEM, TEM, Raman spectroscopy, XPS, DRS, BET, and photocurrent measurements. Upon increasing the glucose concentration from 0 to 3 mM, CV results indicated two anodic peaks at +0.18 V and +0.42 V versus Ag/AgCl, corresponding to Zr³⁺ and Zr⁴⁺, respectively, considering the presence of glucose in urine. Moreover, the effects of high surface area In₂O₃–G–SiO₂ were observed upon the examination of ZrO₂–Ag–G–SiO₂. In₂O₃–G–SiO₂ demonstrated a decent electrochemical pattern in glucose, ascorbic acid, and albumin sensing. Nevertheless, insignificant synergistic effects were observed in In₂O₃-G, ZrO₂-G, and ZrO₂–G–SiO₂. In₂O₃–G–SiO₂ performed well under a wide range of electrolytes and urine, and showed no activity toward uric acid, suggesting potential for biodetection in urine.

In this study, we present an electrochemical investigation of a ternary mesoporous metal oxide (ZrO₂, SiO₂ and In₂O₃) modified graphene composite for non-enzymatic glucose, ascorbic acid, and albumin detection in urine at physiological pH.     

A practical method to study functional impairment of proteins by glycation and effects of inhibitors using current coagulation/fibrinolysis reagent kits

Objectives We undertook the present work to device a simple method to study the effects of inhibitors on functional impairment of proteins by the action of glycating agents.Design and methods For that purpose, we first tested the feasibility and optimized the conditions to employ glycation of human plasma coupled with AT III and plasminogen activity measurement, using coagulation test kits available in most clinical laboratories.Results Using D-BUT-CHT-lys-pNA as a plasmin-specific substrate, we show that incubation of plasma with fructose, glyceraldehyde or MG but not glucose decreases plasminogen activity reaching more than 40% in 16 h. A parallel dose-dependent decrease in heparin activation of AT III by up to a 50% was demonstrated using SAR-PRO-ARG-pNA as a specific thrombin substrate. We studied the effects of aminoguanidine, carnosine, quercetin aglycone, alpha tocopherol and ascorbic acid.Conclusion The methods afforded good discrimination between the known different reactivities of glycating sugars as well as the action of known antiglycation agents. They provide a practical system for monitoring the action of putative antiglycation agents.