Twin-block矫治器治疗下颌后缩对鼻唇颏协调性的影响

目的:研究Twin-block矫治器治疗安氏Ⅱ1类下颌后缩患者对鼻唇颏协调性的影响。方法:选择自然生长和使用Twin-block矫治成功的40例骨性Ⅱ类错患者为研究对象,将其分为对照组和Twin-block组,每组均为20例患者。在正畸治疗前后拍摄X线头颅定位侧位片,对治疗前后X线头影测量值进行比较。结果:治疗组上唇审美平面距、下唇审美平面距、上唇突角、上下唇突角、颏沟倾角、上唇颏突角、软组织面角减小;上唇倾角、下唇倾角、鼻唇角、颏唇沟角、Z角、面突角、软组织面高、软组织下面高增大,与对照组比较均具有统计学意义(P<0.05)。结论:Twin-block矫治器可显著减小上下唇突度,促进面下1/3高度的生长,在一定程度上恢复了鼻、唇、颏之间的协调性,使侧貌轮廓变得自然舒缓,软组织侧貌趋于直面型。     

青岛市青少年与北美青少年面部软组织形态比较

目的:测量青岛市青少年的软组织侧貌正常值,并与北美青少年进行比较。方法:从青岛市13所中学的12~18岁3100名青少年学生中随机选取48名青少年,拍摄头颅定位侧位片,进行头影测量研究。运用Holdaway和Ricketts的测量方法,选取7个标准线,2个角度,12个线距进行测量。结果:比较软组织侧貌的角度,男性和女性之间有在软组织面角、H角,上唇厚度三项,有显著差异(P<0.05)。相对于整个软组织侧貌,男性的上唇厚度比较大,女性的上唇相对于鼻颏部更加后移。青岛青少年与北美正常值比较,在鼻突度,上下唇中点至E线距,颏部软组织厚度等四项指标差异明显。结论:青岛市青少年软组织侧貌男性较女性上唇突出,女性相对协调。青岛青少年相对于北美,鼻部和颏部后移,上下唇相对前突。     

中国汉族青年唇颏部特征的研究

目的观察本校中国汉族男女性侧面软组织唇、颏部形态特点。方法选择2010—2015级在校学生。自然头位取正侧位照片,观察下唇高、颏高度、下唇颏高、颏唇沟深度、容貌面高、形态面高、面宽等特征。结果 (1)青年男女性之间在下唇高、颏高度、下唇颏高、颏唇沟深度、容貌面高、形态面高具有显著差异(P0.05)。(2)青年男女性下唇位置类型均以外倾型最多,女性内倾型少于男性;男女性颏位置类型以外凸型最多,男性颏后缩型以及垂直型多于女性。结论青年男性唇、颏高度以及面高度均高于女性;男性唇、颏部侧貌软组织立体感优于女性。     

乌鲁木齐地区正常(牙合)成人软组织侧貌Holdaway法分析研究

目的:建立乌鲁木齐地区正常(牙合)成人软组织侧貌Holdaway分析法正常参考值范围,比较乌鲁木齐人与北美白人及乌鲁木齐男女之间软组织侧貌差异,分析乌鲁木齐人软组织侧貌特征。方法:调查2 000名乌鲁木齐籍大学生,从中获得70名正常(牙合)学生,随机选取正常(牙合)学生53名(男25名,女28名),拍摄其X线头颅侧位片,用Winceph9.0软件定点描图,用Holdaway分析法测量分析,最后用SPSS 22.0统计软件对数据进行统计学处理,将结果与北美白人正常值进行比较。结果:乌鲁木齐男性和女性上唇基部厚度、上唇软组织厚度、颏唇沟深度之间比较,差异有统计学意义。乌鲁木齐人和北美白人除软组织面角之间比较,差异无统计学意义(P0.05),其余测量项目比较,差异均有统计学意义。结论:乌鲁木齐男性较女性唇部软组织丰满、颏唇沟深,乌鲁木齐人软组织侧貌与北美白人之间存在差异;不同民族、不同地区和不同性别的人们软组织侧貌特征不同,医者在临床治疗方案设计中需要综合考虑这些因素。     

安氏Ⅱ类2分类错He青少年侧貌的美学特征

目的：通过Ⅱ类2分类错He与正常He青少年面部侧貌头影测量指标比较，评价Ⅱ类2分类错He青少年侧面的美学特征。方法：对29例安氏Ⅱ类2分类错He患者（男12例，女17例）及49例侧貌美观的正常He儿童（男24例，女25例）进行面部软组织侧貌X线头影测量，样本年龄范围12－14岁。EXECEL软件建立数据库，STATA5．0软件统计分析。结果：两性间比较，无统计学差异。与正常He组比较，安氏Ⅱ类2分类错He组中，鼻唇角，上下唇突角增大（P＜0．050。下唇倾角，上下唇角，下唇突角，颏沟倾角，颏唇沟角及下唇－E距减小（P＜0．05）。同时，软组织全面突角，面突角，上唇倾角，上唇突角，面角，上唇颏突角，上唇－E距，Z角及上下唇高与正常组比较未发现统计学差异（P＞0．05）。结论：与正常He组比较，大多数安Ⅱ类2分类错He青少年具有较好的侧面外貌。     

安氏Ⅱ类2分类错牙青少年侧貌的美学特征

目的:通过Ⅱ类2分类错(牙合)与正常(牙合)青少年面部侧貌头影测量指标比较,评价Ⅱ类2分类错(牙合)青少年侧面的美学特征.方法:对29例安氏Ⅱ类2分类错(牙合)患者(男12例,女17例)及49例侧貌美观的正常(牙合)儿童(男24例,女25例)进行面部软组织侧貌X线头影测量,样本年龄范围12-14岁.EXECEL软件建立数据库,STATA5.0软件统计分析.结果:两性间比较,无统计学差异.与正常(牙合)组比较,安氏Ⅱ类2分类错(牙合)组中,鼻唇角、上下唇突角增大(P＜0.05).下唇倾角、上下唇角、下唇突角、颏沟倾角、颏唇沟角及下唇-E距减小(P＜0.05).同时,软组织全面突角、面突角、上唇倾角、上唇突角、面角、上唇颏突角、上唇-E距、Z角及上下唇高与正常组比较未发现统计学差异(P＞0.05).结论:与正常(牙合)组比较,大多数安氏Ⅱ类2分类错(牙合)青少年具有较好的侧面外貌.     

分裂簧式改良斜面导板矫治恒牙列后期安氏Ⅱ类Ⅰ分类错牙合软组织变化分析

目的:分析固定矫治技术配合分裂簧式改良斜面导板,矫治恒牙列后期伴上颌缩窄、下颌后缩的骨性安氏Ⅱ类Ⅰ分类错牙合患者矫治前后软组织侧貌变化。方法:选取30例恒牙列后期伴上颌缩窄、下颌后缩的骨性安氏Ⅱ类Ⅰ分类错牙合患者,采用标准方丝弓固定矫治技术配合分裂簧式改良斜面导板进行矫治,测量矫治前后代表软组织侧貌的各项指标并对其进行统计分析。结果:矫治后面角、鼻突度增大,颏部软组织增厚,H角、下唇突点-H线距离、鼻下点-H线、上唇凹深、颏唇沟深度减小,矫治前后差异具有统计学意义(P0.05);鼻突角、上唇基部厚度治疗前后差异无统计学意义(P0.05)。结论:运用标准方丝弓矫治技术,同时配合分裂簧式改良斜面导板,可有效减小恒牙列后期骨性安氏Ⅱ类Ⅰ分类错牙合患者侧面型突度,改善其软组织侧貌。     

安徽省正常He青年面部软组织侧貌分析

目的；建立安徽省正常He青年软组织侧貌常用指标的参考值，并探讨其软组织侧貌的性别特征。方法：以102名安徽籍正常He大学生为对象，拍摄头颅定位侧貌照片，运用IDAS软件获取各项测量指标值并以SPSS统计软件处理。结果：建立了安徽省正常He青年软组织侧貌常用指标的参考值；正常He青年男女在面部垂直向以及侧貌突度方面差异有显著性。结论：安徽省正常He青年男性面上部高和上下唇长以及软组织侧貌突度大于女性，女性的颏部男性前突。     

广东成年女性安氏Ⅰ类开唇露齿拔牙矫正前后软组织侧位变化的比较

目的了解广东成年女性安氏Ⅰ类开唇露齿患者拔除4个第1双尖牙矫正后软组织侧貌变化情况，评价该类患者矫正后软组织变化的意义。方法回顾性研究15例广东成年女性安氏Ⅰ类开唇露齿患者，用头颅侧位分析法分析拔牙矫正前后软组织X线片，再将同一测量值于矫正前后做配对t检验，了解有无显著性差异，分析判断矫正后唇组织变化的意义。结果在角度方面：鼻唇角、上下唇角、Z角增加；线距方面：上下唇长和上下唇厚加大，而上下唇审美平面距和上下唇突距皆缩小，且变化有统计学意义；面凸角、面角、上下唇基角和颏厚等变化无统计学意义。结论该类患者拔除4个第1双尖牙的矫正可以使患者面部严重不协调关系有明显改善；但唇厚较治疗前加大，唇间距仅部分缩小，上前牙仍有部分外露，患者仍然有开唇露齿的面像，其进一步好转依赖于患者唇肌功能的改善。     

安徽省正常殆青年面部软组织侧貌分析

目的 :建立安徽省正常牙合青年软组织侧貌常用指标的参考值 ,并探讨其软组织侧貌的性别特征。方法 :以 10 2名安徽籍正常牙合大学生为对象 ,拍摄头颅定位侧貌照片 ,运用IDAS软件获取各项测量指标值并以SPSS统计软件处理。结果 :建立了安徽省正常牙合青年软组织侧貌常用指标的参考值 ;正常牙合青年男女在面部垂直向以及侧貌突度方面差异有显著性。结论 :安徽省正常牙合青年男性面上部高和上下唇长以及软组织侧貌突度大于女性 ,女性的颏部较男性前突。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.