游离端缺失可摘局部义齿设计临床体会

目的：了解游离可摘局部义齿的设计特点，针对不同的牙体和牙槽嵴情况，和不同层次的患者的需求，设计不同的类型的奇摘局部义齿，以达到满意修复效果。     

附着体义齿与卡环可摘局部义齿咀嚼效率研究

目的 比较附着体义齿和卡环可摘局部义齿的咀嚼效率。方法 选择加例下颌牙列末端游离缺损患者。每例分别在卡环可摘局部义齿和附着体义齿修复后1个月，采用吸光度法测试其咀嚼效率，佩带两种义齿后的咀嚼效率进行自身前后比较，作配对t检验。结果 卡环活动义齿的平均吸光度值为0．813，附着体义齿的平均吸光度值为0．894，两种义齿的咀嚼效率比较，差异有显著性意义（P〈0．01）。结论 在下颌游离缺损修复中，冠外附着体义齿的咀嚼效率高于卡环可摘局部义齿。     

附着体可摘局部义齿修复后患者满意度的调查

目的:比较游离端牙列缺损患者行附着体可摘局部义齿和传统可摘局部义齿修复的主观感受。方法:为46例游离端牙列缺损患者制作19件附着体可摘局部义齿(每件义齿设计1￣2副附着体)和27件传统可摘局部义齿,戴用义齿经1￣2次修改,于修复后1个月行满意度问卷调查。结果:附着体可摘局部义齿在外观、舒适性、稳固性、咀嚼功能、语音功能5个单项满意度及均满意度方面高于传统可摘局部义齿,差异有非常显著性(P<0.01),在易清洁单项的满意度上低于传统可摘局部义齿,差异有非常显著性(P<0.01)。结论:游离端牙列缺损患者行附着体可摘局部义齿修复,较传统可摘局部义齿能更好地满足患者需求,达到良好的修复效果。     

磁性附着体在铸造局部可摘义齿中的应用

磁性附着体的基本应用方法是将衔铁部分固定在口腔内余留牙的牙根上,而将永磁体部分固定在义齿中,利用二间的磁引力使义齿保持在牙槽嵴上,有体积小、固位力强、自然美观等特点.作运用此项技术,修复了可局部义齿17例（22件）,经过半年至6年的临床观察,效果满意.     

Vitallium2000铸造支架可摘局部义齿的临床应用

背景:Vitallium 2000引入中国较晚,鲜有临床应用报道.目的:观察Vitallium 2000铸造支架可摘局部义齿的应用效果.方法:选择大连市口腔医院修复科进行可摘局部义齿修复患者67例,采用精密铸造技术,用Vitallium 2000材料进行铸造支架可摘局部义齿修复,制作修复体86件,采用患者自我评价和口内检查的方式,在义齿使用一两年后,对义齿的使用情况进行随访.结果与结论:支架义齿适应快,舒适,稳固,咀嚼有力且无异味.口腔检查提示义齿固位及咬合关系良好,口腔黏膜基本正常,基牙无松动和继发龋.失败病例中1例戴牙后反复压痛,重新制作,人工牙和基托控制咬合力后使用良好;在半年和1年后的复查中,共出现3例基牙牙周炎,通过牙周治疗,2个月后复查,牙周良好.提示Vitallium 2000铸造支架可摘局部义齿临床疗效良好.     

Vitallium 2000铸造支架可摘局部义齿的临床应用

背景：Vitallium 2000引入中国较晚,鲜有临床应用报道。目的：观察Vitallium 2000铸造支架可摘局部义齿的应用效果。方法：选择大连市口腔医院修复科进行可摘局部义齿修复患者67例,采用精密铸造技术,用Vitallium 2000材料进行铸造支架可摘局部义齿修复,制作修复体86件,采用患者自我评价和口内检查的方式,在义齿使用一两年后,对义齿的使用情况进行随访。结果与结论：支架义齿适应快,舒适,稳固,咀嚼有力且无异味。口腔检查提示义齿固位及咬合关系良好,口腔黏膜基本正常,基牙无松动和继发龋。失败病例中1例戴牙后反复压痛,重新制作,人工牙和基托控制咬合力后使用良好;在半年和1年后的复查中,共出现3例基牙牙周炎,通过牙周治疗,2个月后复查,牙周良好。提示Vitallium 2000铸造支架可摘局部义齿临床疗效良好。     

铸造支架式可摘局部义齿折断临床初步分析

随着修复技术的进步，整体铸造支架可摘局部义齿已在国内广泛应用，取得了较好的临床效果。但在现实生活中，由于义齿每天反复承受多次的咀嚼压力，义齿戴后折断的现象时有发生，本文收集10例铸造支架折断修复失败病例，就其折断原因进行初步分析。     

旋转就位法在可摘局部义齿中的应用

在临床上根据观测模型时,模型的位置的不同所确定的可摘局部义齿的就位方向可分为垂直向、前后向以及左右向。然而在实际工作中,可摘局部义齿戴入方向单纯的直线式戴入并不多,往往结合着旋转方式。2 0 0 0年以来我们对部分可摘局部义齿的就位采取了旋转就位方式,总结如下。1　对象和方法1.1　对象　本组男6 5例,女5 3例,年龄2 8～75岁,平均5 1.5岁。共计12 5件可摘局部义齿。其中肯氏分类1类5 8例,肯氏2类35例,肯氏3类2 0例,肯氏4类12例。1.2　方法1.2 .1　原理　如图1所示为义齿旋转就位的原理(参考Jacbo-son TE[1 ] )。图1中的旋转中心…     

可摘局部义齿对基牙牙周健康的远期影响

为了探讨可摘局部义齿对基牙牙周健康的影响，我们对28例第一磨牙缺失患者进行可摘局部义齿修复，并对基牙牙周指数进行为期4a的追踪观察，现报道如下。     

可摘局部义齿修复的功能及美观1780例分析

目的:探讨提高可摘局部义齿修复的功能及美观,以获得满意的修复效果。方法:选择1 780例患者根据K ennedy分类法,对各类缺失分别选择不同基托材料,以提高功能及美观设计的可摘局部义齿修复体2 000件,经3~5 a随访,临床观察及满意度调查。结果:满意度达99.4%。结论:选择不同基托材料可提高可摘局部义齿修复的功能及改善美观。     

培门冬酶与左旋门冬酰胺酶治疗儿童白血病效果比较

目的观察比较培门冬酶（PEG-ASP）与左旋门冬酰胺酶（L-ASP）治疗儿童急性淋巴细胞白血病（ALL）的临床效果及酶活性变化。方法回顾性分析54例初发的ALL病儿,在诱导缓解期中采用L-ASP治疗27例,PEG-ASP治疗27例,观察两组病儿骨髓抑制程度、恢复时间及临床缓解程度,比较两组病儿微小残留病（MRD）值及门冬酰胺酶的活性。结果两组病儿骨髓抑制恢复时间比较差异有显著性（t=3.05,P〈0.05）;低、中、高危组病儿骨髓抑制程度比较差异均无显著性（P〉0.05）;L-ASP组低、中、高危及T系、B系ALL的临床缓解程度与PEG-ASP组相比,差异均无显著性（P〉0.05）;L-ASP、PEG-ASP诱导治疗后,两组MRD值比较差异均无显著性（P〉0.05）;L-ASP及PEG-ASP用药后活性均大于100U.L-1,且PEG-ASP活性持续2周。结论 L-ASP与PEG-ASP治疗儿童ALL疗效相当,但PEG-ASP的作用时间长,值得临床进一步推广应用。     

阿立哌唑与氟哌啶醇治疗首发精神分裂症效果比较

目的比较阿立哌唑与氟哌啶醇治疗首发精神分裂症的疗效及安全性。方法将60例首发精神分裂症病人随机分为阿立哌唑组与氟哌啶醇组,分别应用阿立哌唑与氟哌啶醇进行治疗,疗程8周,用阳性症状与阴性症状量表PANSS和副反应量表（TESS）评定疗效和不良反应。结果阿立哌唑组与氟哌啶醇组的总体临床疗效相当,不良反应较轻。结论阿立哌唑治疗首发精神分裂症有效,副作用少,依从性好,安全性高。     

宫颈癌介入化疗与全身静脉化疗的效果比较

目的评价介入化疗与全身静脉化疗在宫颈癌治疗中的应用价值。方法选取Ⅱa～Ⅱb期宫颈癌病人98例,随机分为两组,介入治疗组50例先行介入栓塞化疗及放疗,全身化疗组48例先行全身静脉化疗及放疗,后继行宫颈癌根治术治疗,评定两组的近期效果及不良反应。结果两组病人化疗及放疗均明显有效,临床总有效率分别为76％及50％,两组比较差异有显著性（x^2=7．12,P〈0．05）;术后病理证实介入治疗组疗效亦明显优于全身化疗组（x^2=4．99,P〈0．05）;而术后淋巴结转移率介入治疗组明显低于全身化疗组（x^2=7．02,P〈0．05）;不良反应介入治疗组明显轻于静脉化疗组,差异有显著性（x^2=4．67～11．91,P〈0．05、0．01）。结论宫颈癌介入栓塞化疗联合放疗治疗效果明显优于静脉化疗联合放疗,副作用明显低于静脉化疗联合放疗,是一种可行、有效的宫颈癌辅助治疗手段。     

THE RESPONSE TO RESPIRATORY RESISTANCE : A COMPARISON OF THE EFFECTS PRODUCED BY PARTIAL OBSTRUCTION IN THE INSPIRATORY AND EXPIRATORY PHASES OF RESPIRATION.

1. A study has been made of the effects of resistance to respiration in the inspiratory and expiratory phases. 2. Resistance to inspiration caused an increase in respiratory rate, a decrease in tidal air, and in most instances a severe limitation of the minute volume of pulmonary ventilation. Anoxemia and acidosis accompanied these changes. 3. When resistance was removed the respiratory rate continued to be rapid, but the tidal air and minute volume increased. As a result of this there was a fall in pCO₂, a rise in pH, and in some cases a complete disappearance of anoxemia. 3. Resistance to expiration slowed the respiratory rate and produced a constant decrease in the minute volume of pulmonary ventilation. Anoxemia and carbon dioxide retention occurred, but were less pronounced than in the inspiratory experiments. Release of resistance to expiration resulted in a return of all functions to their normal, or approximately normal, levels. 4. A difference in the gross pulmonary pathology found at autopsy in these two types of experiments has been described, and an attempt has been made to correlate changes in function with changes in structure. 5. No direct evidence has been supplied for the liability to fatigue of the respiratory center.     

A COMPARISON OF CHANGE IN 3D SCAPULAR KINEMATICS WITH MAXIMAL CONTRACTIONS AND FORCE PRODUCTION WITH SCAPULAR MUSCLE TESTS BETWEEN ASYMPTOMATIC OVERHEAD ATHLETES WITH AND WITHOUT SCAPULAR DYSKINESIS

Background

The significance of scapular dyskinesis is being challenged due to a lack of the association with pain and ability to predict injury in athletic populations. However, it is unknown whether asymptomatic overhead athletes with dyskinesis cope by normalizing scapular position with higher demand activities.

Hypothesis/Purpose

The purpose of this study was to compare change in scapular kinematics from an active unweighted contraction to a maximal isometric contraction in asymptomatic overhead athletes with and without scapular dyskinesis. Secondarily, force generated with manual muscle tests were explored for differences and relationships with kinematics.

Study Design

Cross‐sectional laboratory study

Methods

Twenty‐five matched asymptomatic overhead athletes with (n=14) and without (n=11) scapular dyskinesis, defined with a reliable and validated clinical method, participated in this study. Three‐dimensional scapular kinematics were evaluated in an active unweighted condition, and during maximal isometric contractions at 90 ° of shoulder flexion. Isometric force produced with lower trapezius and serratus anterior manual muscle tests were assessed with a dynamometer. Changes in scapular kinematics were compared between groups. Differences in force generated with manual muscle tests between groups and relationships with kinematics were explored.

Results

Athletes with dyskinesis demonstrated greater deficits in scapular upward rotation with maximal contraction (p=<0.001), less external rotation (p=0.036) and weaker lower trapezius manual muscle test strength (p=0.031). Lower trapezius (p=0.003;r=0.57) and serratus anterior (p=0.042;r=0.41) manual muscle test strength deficits were fair to moderately associated with a lack of scapular upward rotation during maximal contraction.

Conclusion

Small to moderate changes in scapular kinematics are normal responses to a maximal contraction, but with scapular dyskinesis this response is accentuated. Athletes with dyskinesis generate less force with lower trapezius manual muscle testing compared to athletes without dyskinesis. Decreased strength with lower trapezius and serratus anterior manual muscle testing was also related to a lack of upward rotation in all athletes.

Level of Evidence

3     

脐动脉血乳酸水平与羊水过少新生儿结局的关系

目的 研究脐动脉血乳酸水平与羊水过少新生儿结局之间的关系.方法 选择198例临产前超声检查提示羊水过少、胎心监护无应激试验（NST）反应型的孕妇作为观察组,以同期住院的200例羊水正常、NST反应型的孕妇作为对照组,检测两组新生儿脐动脉血乳酸水平及生后行为神经评分并进行比较.结果 观察组脐动脉血乳酸水平明显高于对照组（t=1.98,P〈0.05）.以对照组脐动x -±2.58s为界值,观察组脐动脉血乳酸超过界值者占32.83%,其中不良结局儿占63.53%.结论 脐动脉高血乳酸水平与羊水过少新生儿不良结局有关.     

自体角膜缘干细胞与人羊膜移植治疗翼状胬肉效果比较

目的 观察自体角膜缘干细胞移植与羊膜移植治疗翼状胬肉的临床效果。方法 选择我院门诊治疗的翼状胬肉病人100例（127眼）,随机分为2组。A组64例（84眼）采用自体角膜缘干细胞移植治疗,B组36例（43眼）采用人羊膜移植治疗。随诊观察2年。结果 A组治愈79眼（94．05％）,复发5眼（5．95%）;B组治愈39眼（90．70％）,复发4眼（9．30％）,两组比较差异无统计学意义（χ^2=0.11,P〉0．05）。结论 自体角膜缘干细胞移植与人羊膜移植治疗翼状胬肉均效果良好,复发率低。     

STUDIES ON IMMUNOLOGICAL RELATIONSHIPS AMONG THE PNEUMOCOCCI : II. A COMPARISON OF THE ANTIBODY RESPONSES OF MICE AND OF RABBITS TO IMMUNIZATION WITH TYPICAL TYPE III PNEUMOCOCCI AND TO IMMUNIZATION WITH A RELATED STRAIN.

The paper reports an experimental comparison of the antibody responses of mice and of rabbits to immunization with typical Type III pneumococci and a strain related to Type III. The results as a whole show that the relative antigenic effectiveness of these two kinds of related pneumococci, is different in different animals. In rabbits the strain related to but not identical with Type III elicits the better response; in mice, the typical Type III strain is more effective. These relationships furnish an example of the influence of the species of animal upon the effectiveness of even closely related bacterial antigens.     

胃癌病人外周血XPD751基因多态性与奥沙利铂化疗敏感性的关系

目的探讨胃癌病人外周血白细胞中DNA修复基因XPD751基因多态性与奥沙利铂化疗效果的关系。方法收集经病理学检查确诊的胃癌128例,所有病例化疗前取静脉血,提取白细胞DNA,用TaqMan-MGB探针等位基因分型技术检测XPD751基因型。比较其基因型与接受奥沙利铂化疗病人临床疗效的关系。结果在128例胃癌病人中,XPD751A／A、A／C和C／C基因型分别为104（81．3％）、23（17．9％）和1例（0．8％）。经化疗后,63例病人有效,总有效率为49．2％。XPD751A／A、A／C＋C／C基因型有效率分别为53．3％（56／105）、30．4％（7／23）,两者相比差异有统计学意义（χ^2=3．958,P（O．05）。携带A／A基因型病人的腹泻程度高于A／C＋C／C基因型病人（χ^2=7．212,P〈O．05）。结论XPD751基因多态性可能与胃癌对奥沙利铂为基础的化疗敏感性相关。     

OBSERVATIONS ON THE WASSERMANN REACTION : A COMPARISON OF THE NEW SYSTEM OF NOGUCHI WITH THAT USING CHOLESTEROLIZED ANTIGEN ACCORDING TO MCINTOSH AND FILDES.

The Wassermann reaction carried out according to the method of McIntosh and Fildes, with cholesterolized antigen and with certain allowances for the presence of native anti-sheep amboceptor; leads to about the same result as when it is done according to the recent proposal of Noguchi, with the native human complement and acetone-insoluble lipoids as antigen. The differences are such as to suggest that from the point of view of diagnosis the Noguchi method is the more conservative but that there is definite advantage in using two metnods as distinct in origin of materials as these, partly for the purpose of control and partly in the hope of acquiring new information of importance. As a measure of control of treatment the cholesterol antigen appears to us to be the more valuable. The Wassermann reaction alone, by whatever method it may be done, can only be used in the diagnosis of syphilis in conjunction with presumption based on other grounds. That it fails to appear in a considerable percentage of syphilitics is well known. That the reaction is positive in other conditions is not so generally recognized. Fresh instances of this in certain febrile cases are here recorded.