自体骨块移植和Bio-Oss骨粉在上前牙区骨量不足种植术中的应用

目的探讨下颌第三磨牙区取骨用于上前牙区骨量不足种植术的方法。方法对于拟行上前牙种植,但骨量不足并有第三磨牙的患者,利用种植机截取合适的骨块,采用Bio-Oss和骨块移植,表面覆盖Bio-Gide胶原膜,同期或Ⅱ期植入种植体。结果所有种植体结合良好,6-8个月烤瓷牙修复,形态和功能良好,患者满意。结论上前牙牙槽骨不足可以运用此方法修复。     

垂直纵向骨劈开联合骨挤压和骨引导再生术在上颌前牙种植中的应用

目的评价上颌前牙区牙槽骨水平宽度不足的患者应用垂直纵向骨劈开联合骨挤压和骨引导再生术行种植体植入的临床效果。方法22例上前牙单牙缺失伴牙槽骨萎缩导致前牙区牙槽骨水平宽度不足,唇侧骨板骨吸收的患者,应用垂直纵向骨劈开联合骨挤压和骨引导再生术植入22颗种植体,术后6个月暴露种植体,完成上部修复。结果术后无明显并发症发生,修复完成后观察7~36个月,种植体行使功能良好,无种植体丢失。结论对上颌前牙区牙槽骨水平宽度不足的患者,应用垂直纵向骨劈开联合骨挤压和骨引导再生术行种植体植入,可改善牙槽骨质,可避免因钻骨造成骨量缺失,保存骨量,提高GBR成功率,拓宽了种植手术适应证的范围,获得种植体的Ⅰ期植入,大大改善修复后美学效果,临床效果良好。     

单钉近嵴顶固定颏部骨块移植术在上前牙骨增量种植中的应用

目的：评价单钉近嵴顶固定颏部骨块移植术在上前牙区骨增量种植中的临床应用和疗效。方法：2013年1—6月收集上前牙区牙槽嵴严重吸收患者5 例,年龄19~24岁,平均21.6岁,其中单牙缺失3例,多牙缺失2例。取患者颏部块状骨,采用单钉近嵴顶固定法行自体骨块移植,术后定期随访。种植体植入术前拍摄锥形束CT（cone beam computed tomography,CBCT）,观察移植骨愈合情况,并测量牙槽嵴宽度和钛钉距牙槽嵴顶距离。参考CBCT检查结果,常规完成种植体植入术,待种植体骨结合形成后完成种植修复。结果：5 例自体骨块移植术全部成功,无1 例出现相关并发症。术后上前牙区骨量充足,固定钛钉顶端接近牙槽嵴顶。结论：采用单钉近嵴顶固定法行颏部自体骨块移植能有效改善上前牙区的骨量严重不足,临床疗效良好。     

因牙周炎缺失上前牙种植修复后短期软组织美学效果评价

目的:评价因牙周炎缺失上前牙种植修复后的短期软组织美学效果.方法:选择因牙周炎需拔除上前牙的患者15人,共涉及牙齿20颗,患牙两侧有天然牙,所有患者均已接受系统牙周治疗.拔牙后自然愈合2～3个月,采用常规翻瓣种植手术植入种植体,术中记录牙槽骨缺损的程度、种植体植入深度(种植体距离邻牙釉牙骨质界连线的距离)等指标,采用埋入愈合方式.愈合3个月后行二期手术并完成修复.修复后1～3个月复查,用红色美学评分(pink esthetic score,PES)评价软组织美学效果.结果:所有种植体均成功达到骨结合,没有早期种植体松动脱落发生.因牙周炎缺失的上前牙经种植修复后,PES均值为(9.6±2.4)分(5～13分),其中3颗修复体的PES低于7分.仅有水平骨缺损的13个位点种植修复后的PES均值为(10.5±1.9)分,显著高于伴有垂直向骨缺损的7个位点[(7.9±2.3)分,P＜0.05].PES与种植体植入深度呈负相关关系(r=-0.608,P＜0.01).结论:因牙周炎导致的前牙缺失存在较高的种植美学风险,牙槽骨缺损尤其是垂直骨缺损的程度和部位是影响软组织美学效果的主要因素.     

牙槽嵴劈开术对牙槽骨水平宽度不足种植牙患者的效果观察

目的 探讨牙槽骨水平宽度不足的种植牙患者应用牙槽嵴骨劈开术的临床疗效.方法 收集要求种植固定修复的上颌牙列缺失患者48例,所选患者有充足的牙槽嵴高度（＞ 10 mm）,但牙槽嵴骨宽度仅3～4 mm,牙槽骨骨量不足且基牙分布不均,采用牙槽嵴骨劈开术形成唇颊侧骨瓣,在腭侧骨板与唇颊侧骨瓣之间共植入75枚种植体.术后6个月种植修复,定期随诊.结果 种植区软组织愈合好,种植体骨结合良好,牙槽嵴宽度增加达4～5mm,平均增宽4.4 mm,2枚种植体术后6个月失败,失败率为2.67％,剩余种植体均稳固性好,完成烤瓷修复后美学效果好,追踪24个月以上,无种植体失败.结论 牙槽嵴骨劈开术保证了牙槽骨厚度不足患者的种植修复难题,效果显著.     

外六角牙种植系统与引导骨再生术

目的 观察、评估外六角Anthogyr牙种植系统与引导骨再生术配合应用修复牙缺损.方法 选择种植床存在牙槽骨缺损的26例患者共计植入42枚外六角种植体,配合植入Bio-oss骨粉,Bio-gide生物膜覆盖.4～6月后行Ⅱ期手术并进行烤瓷牙修复.结果 1枚种植体缺损处新骨生成较少,Ⅱ期手术前脱落;41枚有足够的新骨生成并获得修复成功.结论 外六角牙种植系统可配合引导骨再生术可修复牙缺失.     

拔牙后位点保存技术进展

<正>牙种植是牙缺失的最佳修复方法。但是,拔牙后牙槽窝发生的一系列变化,会对种植修复的治疗方案和美学效果产生影响。牙槽骨骨量不足则被认为是种植手术需要处理的重点,拔牙后导致的牙槽骨吸收是骨量不足的一个常见原因。骨壁高度的降低增大了种植体植入时骨缺损出现的可能性,导致手术难度加大,还有可能引起龈乳头退缩,损害修复     

牙种植体周围骨缺损自我修复的研究现状

种植体周围骨缺损是导致种植失败的主要原因之一,目前骨移植材料及引导骨再生技术的不断发展成熟,已广泛应用于牙种植体周围骨缺损修复。但牙槽骨本身具有较强的成骨、自我修复的能力。种植体周围骨缺损在一定范围内即小于骨缺损临界值时,牙槽骨可以自我修复形成新骨,此时,运用骨移植材料及引导骨再生技术无法充分发挥其潜能。所以,对于种植体周围的骨缺损自我修复研究尤显迫切。     

种植体规格、手术方式与上前牙区种植体唇侧骨吸收量的相关性研究

  目的  探讨不同种植体规格及手术方式等因素对上颌前牙区种植体唇侧骨板高度吸收的影响。  方法  选取43例符合实验纳入标准的患者实施上颌前牙区种植手术,共植入植体55枚。收集患者的临床资料和种植体植入后1周、植入后6个月、修复后6个月、修复后12个月的锥形束CT (CBCT)资料,计算患者在各个时期(植入后6个月、修复后6个月、修复后12个月、植入后18个月)唇侧骨板高度的吸收量并分组进行统计学分析。  结果  种植手术时机、种植手术类型、种植手术方式对上前牙区种植体唇侧骨板高度吸收量无明显影响;在植入后18个月时,种植体直径对上前牙区种植体唇侧骨板高度吸收量有影响(P < 0.05);在植入后6个月和植入后18个月时,种植体骨内的位置对上前牙区种植体唇侧骨板高度吸收量有影响(P < 0.05)。  结论  使用更大直径的种植体,将种植体与基台连接平面放置在牙槽骨上缘有利于减少种植体唇侧骨板高度吸收。     

牙槽骨骨量不足的病因及治疗方法探讨

随着物质生活水平的提高,人们对生活质量的要求也提出了更高的要求,种植义齿由于具有美观、舒适、咀嚼效率高等特点,日益成为缺牙修复的趋势,但牙槽骨骨量不足成为制约种植修复的难题之一.种植修复关键是要在种植体和骨组织之间形成骨结合,最基本的条件是要有足够的牙槽骨骨量.本文就引起牙槽骨骨量不足的病因及治疗方法展开综述.     

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.     

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.     

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.