玻璃纤维桩与铸造金属桩核在前牙修复中的应用对比观察

目的对比观察玻璃纤维桩与铸造金属桩核修复前牙的疗效。方法将79例成年患者的86颗上前牙残根残冠随机分为A组、B组,各43颗,分别采用玻璃纤维桩和铸造金属桩修复,比较两组修复成功率。结果 A组修复成功率为95.35%(成功41颗,失败2颗),高于B组的83.72%(成功36颗,失败7颗),P<0.05。结论与铸造金属桩比较,采用玻璃纤维桩修复前牙残根残冠效果好。     

DT Light—Post纤维桩在前牙缺损修复中的应用

目的探讨DT Ught Post纤维桩在前牙修复中的应用效果。方法将同期行前牙缺损修复的102例患者（患牙126颗）随机分为观察组53例（患牙63颗）和对照组49例（患牙63颗）,两组均行完善的根管治疗,其后分别用DT Light-Poet纤维桩和铸造金属桩制作桩核,再用全冠进行修复。随访16～24个月,观察两组修复成功率。结果观察组分别有1颗患牙出现修复体松动脱落及牙根尖周炎,修复成功率为96．83％（61／63）;对照组出现牙根折及牙龈黑线6颗,牙修复体松动脱落及牙根尖周炎各2颗,修复成功率为84．13％（53／63）。观察组修复成功率显著高于对照组（P〈0．05）。结论DT Light-Post纤维桩用于前牙缺损修复成功率高、美学效果好。     

纤维桩和金属桩修复上颌前牙残根残冠的临床效果观察

目的对比纤维桩和金属桩对上颌前牙残根残冠的修复效果。方法选取2007-08～2008-08到该院就诊经纤维桩修复上颌前牙残根残冠患者62例,共78颗患牙;选取同期经金属桩修复上颌前牙残根残冠患者56例,共70颗患牙。患者定期按时随访,对比二者的修复效果。结果经纤维桩修复的修复体固位和稳定良好,未发现折裂和松动,烤瓷冠边缘密合,牙龈无色素沉着,牙周情况良好,根周无病变。成功78颗,成功率为100.0%。经金属桩修复的上颌前牙残根残冠成功53颗,失败17颗(分别为牙根折3颗,桩核松动脱落2颗,牙龈边缘出现色素沉着12颗),成功率为75.7%,经纤维桩修复上颌前牙残根残冠成功率高于金属桩(χ2=21.40,P<0.01)。结论纤维桩较金属桩更适合于上颌前牙残根残冠的修复治疗。     

前牙残冠残根牙体组织剩余量对两种桩核材料修复效果的影响

目的评价前牙残冠残根牙体组织剩余量对玻璃纤维核桩冠和铸造纯钛核桩冠的修复效果。方法选择前牙残根残冠患者87例,共120颗患牙,经过完善的根管治疗后,根据牙体组织残余量将患牙分为2组:有牙本质肩领组和无牙本质肩领组。每组再按核桩材料的不同分为两个亚组:铸造纯钛核桩冠组和玻璃纤维核桩冠组,之后患牙行金属烤瓷冠修复,随访2 a。结果 2 a后有牙本质肩领组修复总成功率为98.34%,本组亚组中两组核材料桩冠修复效果无显著差异;无牙本质肩领组修复总成功率为95.00%,本组亚组中两组核材料桩冠修复效果有较大差异。结论牙体组织剩余量是影响修复效果的重要因素,根据剩余牙体组织的量选择桩核材料可提高修复成功率。     

玻璃纤维桩核与铸造金属桩核在残根残冠及无桩牙体修复中的应用效果比较

目的：比较玻璃纤维桩核（GFPC）与铸造金属桩核（CMPC）在残根残冠及无桩（WP）牙体修复中的应用效果。方法选择行牙体修复者80例、148颗牙,其中接受GFPC修复42例（77颗）、CMPC修复33例（45颗）,WP修复5例（26颗）。随访1年,观察不同修复形式牙留存率、并发症及基牙丧失情况。结果148颗修复牙中,出现并发症10颗,基牙丧失13颗。 GFPC修复牙留存率为96．10％（74／77）,CMPC修复为86．67％（39／45）,WP修复为85．71％（18／21）,三组比较P均＞0．05。 GFPC修复并发症发生率为11．69％（9／77）,CMPC修复为22．22％（10／45）,WP修复为19．23％（5／26）,三组比较P均＞0．05。结论 GFPC、CMPC与WP修复均可获得较为满意的牙留存率,但应重视各类并发症,尤其是根折裂。     

铸造金属桩核树脂全冠的临床应用

用铸造合金材料桩核树脂全冠修复前牙残根、残冠、扭转牙、倾斜牙、畸形牙，详细介绍了根管预备原则，金属桩核蜡形制作方法。经对３４例患者４１颗牙的临床观察，修复效果良好，特别利于错位牙，扭转牙，倾斜牙的修复。     

玻璃纤维桩在前牙牙体缺损修复中的应用

2004年12月～2005年12月，我们采用玻璃纤维桩修复前牙牙体缺损，并与传统的铸造桩核作比较。现将结果报告如下。     

两种桩系统修复对根管治疗牙强度的影响

目的探讨两种桩系统修复对根管治疗牙强度影响的临床效果。方法选取60颗于我院进行近期拔除的完整人上颌中切牙,将其随机分为两组,对30颗对照组牙齿实施铸造镍铬桩核及铸造全冠修复治疗,对30颗观察组牙齿实施玻璃纤维桩Para Post Fiber White、复合树脂核及铸造全冠修复治疗,观察两组患者的治疗效果。结果两组患者的牙断裂强度无显著差别,P0.05,无统计学意义;其中观察组的可修复性断裂效果显著优于对照组,P0.05,有统计学意义。结论两种桩系统对治疗后牙强度的影响无显著差别,其中玻璃纤维桩术弹性模型与牙本质近似,可修复的破坏效果好。     

多根管纤维桩联合氧化锆全瓷冠修复老年人磨牙大面积缺损的疗效

龋病导致的磨牙大面积缺损是严重影响老年人健康的多发性牙体疾病,常因治疗不及时致牙齿拔除和牙列缺损,其残根残冠可通过完善的根管治疗技术予以保留,并通过修复方法恢复其正常解剖形态和生理功能.核桩冠是修复磨牙残冠的主要方法.常见的核桩材料有铸造金属桩核、纤维桩、全瓷桩等[1,2],有很多不足[3].近年来,生物相容性良好、不影响核磁成像检查的纤维桩材料作为金属桩核的替代品被广泛应用于临床,结合上部全瓷冠的使用,取得了良好的临床修复效果[4,5].本研究应用多根管纤维桩及氧化锆全瓷冠修复老年人磨牙大面积牙体缺损,评价其临床疗效,为应用此种修复方式保留老年人磨牙残冠提供依据.     

纤维桩树脂核在老年患者牙残根、残冠中的应用

金属桩核修复无论是成品桩还是铸造桩，由于其刚性大、弹性模量（180～200GPa）远高于牙本质（18．6GPa），其传导应力作用较大，可能在已预备的牙体及根管壁的牙本质上产生较大应力集中，易导致牙根的折裂。临床研究也表明无髓牙上桩核冠修复的失败率高于其他任何一种在活髓牙上进行的修复。桩折、桩弯曲、固位不足、核折裂或根管折裂均会导致修复失败。     

Eating disorders and chronic post traumatic stress disorder: issues of psychopathology and comorbidity

This article reviews in both directions the recent literature on the relationship between Eating Disorders (ED) and chronic Post Traumatic Stress Disorder (PTSD) to shed some light on an area of comorbidity for too long overlooked. PTSD may be the commonest anxiety disorder in ED but it seems to be independent from ED. Clinicians should be aware that PTSD might represent more than just an occasional occurrence in ED clinical work and should know how to approach it. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association.     

The effects of blood pressure on post stroke cognitive impairment: BP and PSCI

Cognitive function following acute ischemic stroke (AIS) is critical to prognosis and quality of life. Hypertension is a risk factor for stroke and is associated with post stroke cognitive impairment (PSCI). However, the optimal blood pressure parameters after AIS is unknown. This is a sub‐study of the Impairment of CognitiON and Sleep after acute ischemic stroke or transient ischemic attack in Chinese patients (ICONS) study conducted between August 2015 and March 2018. Cognition was assessed at two‐week (2w), three‐month (3 m), and twelve‐month (12 m) by Montreal Cognitive Assessment (MoCA). A total of 682 participants who met the inclusion criteria were enrolled. The primary outcome was cognitive changes after 3 and 12 months post stroke. Among 682 participants, the mean age was 59.35 ± 10.40 years and 72.29% were men. PSCI patients with high systolic blood pressure (SBP ≥140 mm Hg) at 3 m not only had worse cognition as evidenced by MoCA scores at 3 m but also predicted worse scores at 12 m. When participants were stratified into cognitively stable/improved (MoCA score ≥0, 2w vs. 12 m) and cognitively impaired (MoCA score ≤‐2, 2w vs. 12 m), those with high SBP were more likely to be cognitively impaired (OR 2.17, 95%CI 1.12–4.21, p < .05) and less likely to be cognitively stable/improved (OR 0.66, 95%CI 0.44–0.99, p < .05). SBP more than 140 mm Hg is associated with worse cognitive performance after ischemic stroke. Patients with SBP lower than 140 mm Hg have better cognitive outcome at 3‐month and 1 year after stroke.     

复方甲氧那明联合孟鲁司特对感染后咳嗽的疗效观察

目的观察复方甲氧那明联合孟鲁司特对感染后咳嗽的治疗效果。方法将90例患者分为3组：治疗组30例予复方甲氧那明胶囊及孟鲁司特片治疗;对照组30例使用强力枇杷露及阿奇霉素片治疗,观察治疗10 d后疗效,并与拒绝用药治疗的患者（模型组）比较。结果治疗后治疗组总有效率为93.3%,对照组总有效率为47.0%,模型组总有效率为23.3%,治疗组效果较模型组有明显改善（P〈0.01）,同时治疗组与对照组比较,疗效更明显（P〈0.01）。结论复方甲氧那明联合孟鲁司特治疗感染后咳嗽,可明显控制临床症状且无明显的不良反应。     

Velocity vector imaging in assessing the regional systolic function of patients with post myocardial infarction

PURPOSE: To assess the regional systolic function in patients with post myocardial infarction (PMI), using the velocity vector imaging (VVI) technique, a new two-dimensional echocardiographic method. METHODS: Two-dimensional images of apical four, two chambers and apical long-axis view were obtained in 20 patients with PMI and 15 normal controls. The segmental myocardial systolic peak strain (epsilon), strain rate (SRs), and segmental ejection fraction (SEF) were analyzed with VVI offline software. The result of epsilon in middle segments of the normal control analyzed by VVI was compared with that by tissue Doppler imaging (DTI). RESULTS: The segmental epsilon, SRs, and SEF were significantly lower in infarct segments than in the corresponding segments of the normal controls. There were significant difference in average epsilon, SRs, and SEF among infarct, noninfarct, and normal control segments. The segmental epsilon, SRs, and SEF did not vary significantly from basal to apical segments in the normal control subjects. There was a good correlation on epsilon in middle segments between VVI and DTI (r = 0.710, P < 0.01). The interobserver variability was 4.6% and the intraobserver variability was 7.0%, respectively. CONCLUSIONS: The regional systolic function decreased in infarct segments compared with the adjacent noninfarct segments and normal control segments. The systolic function of adjacent noninfarct area was also affected by infarct areas. VVI could recognize and quantify the abnormality of infarct segments and therefore could be a useful tool in assessing the myocardial regional systolic function.     

Efficacy of R-BAC in relapsed,refractory mantle cell lymphoma post BTK inhibitor therapy

Patients with mantle cell lymphoma progressing on Bruton’s tyrosine kinase inhibitor (BTKi) have very poor prognosis and there is currently no standard of care. In this retrospective cohort study, patients progressing on BTKi received R-BAC (rituximab, bendamustine, cytarabine). Overall response rate was 83% (complete response 60%) and 31% were bridged to allogeneic stem cell transplant (alloSCT). Median progression-free survival was 10.1 months (95% confidence interval (CI) 6·9–13·3) and median overall survival was 12·5 months (95% CI 11·0–14·0). In those consolidated with alloSCT only one patient relapsed. R-BAC demonstrates a high response rate in the post-BTKi setting and in transplant eligible patients is an effective bridge to alloSCT.     

The CAPTURE registry: results of carotid stenting with embolic protection in the post approval setting.

BACKGROUND: Pivotal study data examining carotid stenting with embolic protection as a less invasive alternative to endarterectomy for high surgical risk patients have been acquired under controlled conditions with highly selected physicians and hospitals. This report examines outcomes of carotid stenting post-approval after diffusion of this technology to a broader cross-section of physicians and hospitals. METHODS: The Carotid Acculink/Accunet Post-Approval Trial to Uncover Unanticipated or Rare Events (CAPTURE) is a prospective, multi-center registry to assess two important aspects of the post-IDE experience: the safety of carotid stenting by physicians with varying levels of experience as a measure of the adequacy of physician training, and the identification of rare/unexpected device-related complications. The primary endpoint was a composite of death, any stroke, or myocardial infarction within 30 days post-procedure. RESULTS: 3,500 patients were enrolled by 353 physicians at 144 sites. The 30-day primary endpoint event rate was 6.3% (95% CI: 5.5-7.1%) and did not differ among the three operator experience levels (5.3%, 6.0%, and 7.4%; P = 0.31) from most to least experienced, respectively. There were no differences in outcomes among physician specialties when adjusted for case mix. There were no unanticipated device related adverse events. CONCLUSIONS: The results of the CAPTURE study compare favorably to those achieved in the predicate pivotal investigations, and suggest that the post-approval transfer of this new therapy to the community practice setting via carotid stent training programs is effective in preparing physicians with varying experience levels and specialty training backgrounds.     

含乌司他丁造影剂胰管显影与ERCP术后胰腺炎相关性研究

目的用含乌司他丁造影剂显影胰管,以观察ERCP术后胰腺炎的发生率和预防的临床对照研究。方法将2008年1月至2009年7月上海交通大学医学院附属仁济医院嘉定分院178例患者随机分成对照组85例、实验组93例,实验组用含乌司他丁造影剂显影胰管、而对照组用常规造影剂,操作要求用缓力推注造影剂且仅显示主胰管。结果178例发生ERCP术后胰腺炎共15例,发生率为8.9%,其中对照组11例、占12.9%(11/85),实验组4例、占4.3%(4/93),两组发生率比较差异有统计学意义P0.05,诊断性ERCP术后胰腺炎发生率,对照组和实验组分别为44.4%(4/9)和14.3%(1/7),统计分析差异无统计学意义P0.05。全部患者为轻型胰腺炎,经保守治疗痊愈。结论在ERCP术操作中使用含乌司他丁造影剂显影胰管,能降低ERCP术后胰腺炎的发生率,但不能完全避免术后胰腺炎的发生。     

Temporary pancreatic stent to prevent post endoscopic retrograde cholangiopancreatography pancreatitis: a preliminary, single-center, randomized controlled trial

Background

Post endoscopic retrograde cholangiopancreatography (post-ERCP) pancreatitis is the most common complication of ERCP, which can occasionally become serious or fatal. This preliminary study was to prospectively evaluate the efficacy of a temporary unflanged pancreatic duct stent (PS) to prevent post-ERCP pancreatitis.

Methods

A total of 64 patients were randomly divided into a control group, which did not undergo stenting, and a stent group. The stent used was a 5-Fr pigtail PS without an inner flange.

Results

Placement of an unflanged PS was successful and without complications in all 32 patients. The rates of hyperamylasemia were 50.0% and 34.4% in the control and stent groups, respectively (P > 0.05), and the mean serum amylase levels were 456.2 and 257.9 IU/l, respectively (P = 0.035). The overall rates of post-ERCP pancreatitis diagnosed according to Cotton's criteria were 12.5% and 3.1% in the control and stent groups, respectively (P > 0.05). The severity of pancreatitis was severe in one patient, moderate in one, and mild in two in the control group, whereas in the stent group, the single case of pancreatitis was mild.

Conclusions

Placement of an unflanged 5-Fr PS may be useful in preventing post-ERCP pancreatitis.     

感冒后咳嗽敏感性及气道神经源性炎症改变

目的观察感冒后咳嗽患者(cough post infectious,CPI)的咳嗽敏感性以及气道分泌物神经肽变化,探讨其可能的发病机制。方法以2005年1~6月于广州呼吸疾病研究所慢性咳嗽专科门诊诊断10例CPI患者(CPI组)及10名正常志愿者(正常对照组)为研究对象,通过辣椒素咳嗽激发试验测定气道咳嗽敏感性;观察诱导痰细胞总数以及细胞分类比例;测定痰上清液P物质(SP)、神经肽A(NKA)、神经肽B(NKB)及降钙素基因相关肽(CGRP);检测诱导痰细胞SP、NKA及SP受体(NK-1)的表达,并进行分析比较。结果CPI组咳嗽阈值lgC5为1.16±0.61,明显低于正常对照组(2.64±0.28)(P<0.001)。CPI组诱导痰细胞总数(WBC)及细胞分类比例与正常对照组差异均无显著性意义。CPI组诱导痰上清液SP质量浓度为(516.3±494.2)ng/L,显著高于正常对照组[(141.7±34.5)ng/L,P<0.05];CGRP质量浓度为(141.2±80.8)ng/L,显著高于正常对照组[(74.3±38.2)ng/L,P<0.05];而2组间NKA、NKB的质量浓度差异均无显著性意义。CPI组痰细胞SP、NK-1蛋白的表达分别为1.86±0.81和1.20±0.75,显著高于正常对照组的(0.65±0.44和0.27±0.24)(P<0.01);而2组间NKA蛋白表达差异无显著性意义。结论CPI患者的咳嗽敏感性增高,并伴随气道神经源性炎症,提示其与CPI发病相关。     

Coronary angiography post first myocardial infarction in the asymptomatic or mildly symptomatic patient: Clinical,angiographic, and prospective observations

The role of coronary arteriography In the asymptomatic or mildly symptomatic post first myocardlal infarction patient is controversial. Thirty-one class 0–1 patients (Canadian Heart Association Grading System) underwent coronary arteriography within six months (mean 67 days) of their first myocardlal Infarction. Coronary arteriography revealed three-vessel disease in nine (29%), two-vessel disease in ten (32%), single-vessel disease in ten (32%), and normal coronary arteries in two (6%). No pattern had left main disease, and two (6%) had teft main equivalent disease. In 12 patients with single-vessel disease or normal coronary arteries there were no morbid events over a mean follow-up period of 26 months. In the 19 with multivessel disease, eight (40%) developed a cardiac event during a mean follow-up period of 11.4 months. These Included one who elected to undergo immediate aortocoronary bypass surgery, two with unstable angina, three acute myocardial infarctions, and two deaths. Based on these date and a review of the literature, a scheme Is proposed for the subsequent evaluation and treatment of this patient group.