Effect of extracorporeal shock wave lithotripsy for the postoperative residual bilestone of choledocholithiasis

Objective To explore the effect of extracorporeal shock ware lithotripsy(ESWL) for the postoperative residual bilestone of choledocholithiasis,Method Inject contrast medium of biligrafin via T-tube,After accurate apposition with X-ray,take lithotripsy with extracorporeal shock ware .In some cases T-tube washing and transcutaneous choledochoscope were used to take out bilestones.Results The lithotripsies were successful in all the 48 patients and the lithotriptic rate was 100%,The removing rate of bilestones was over 90% with washing method,Choledochoscope was used in 6 cases,and 48 patients were completely healed In them 24 suffered from slight expanding pain in right upper abdomen or nausea and no any complications and sequelae in others.Conclusion ESWL is and effect method to heal patients with the postoperative residual bilestones of choledocholithiasis.     

Endodontic management of the maxillary first molars with two root canals: A case report and review of the literature

BACKGROUND The complex anatomy of the maxillary first molars has always been a major challenge for complete root canal treatment in endodontic therapy. Here, we present two cases of maxillary first molars, each with only two root canals, which have been rarely reported. We also perform a literature review of maxillary first molar anatomy.CASE SUMMARY The two patients were referred to the hospital after 1) finding a cavity in their tooth with a color change and, 2) a toothache during mastication, respectively.Both of these cases were diagnosed as apical periodontitis by X-ray imaging and cone beam computed tomography(CBCT). Non-surgical endodontic therapy was performed with the assistance of a dental operating microscope(DOM). CBCT showed rare but accurate images of both patients, each with two root canals and two roots in their maxillary first molars. Both roots were located in the buccal in the palatal direction, and each root had only one clear root canal. In addition,each maxillary first molar in both patients was symmetrical to that on the opposing side with only two separate root canals. Non-surgical endodontic therapy was performed with the assistance of a DOM. Finally, the teeth were restored using composite resin and the patients were satisfied with the results.CONCLUSION Making full use of CBCT and DOM would contribute to helping dentists make correct diagnoses and successfully treat teeth with rare root canal morphologies.     

Effect evaluation of artemisia desertorum spreng on ability of daily life after extraction of impacted tooth

AIM：To investigate the effect of locally used Shahaosan on preventing the complication of extraction of impacted tooth.METHODS:274 cases patients with extraction of impacted teeth were randomly devided into 3 groups named A,B and C.Shahaosan and Yunnan white drug were grocessed into drug A and B by department of pharmacy with the same color,shape and quality which are blind to doctors and patients.When the impacted teeth were extracted,administed group A (92 cases) with drug A,group b(86 cases) with drug B and group c(96 cases) was a blank control.After the operation,incidence and severe intensity of dry socket in each group were observed and evaluated by scores.RESULTS:The incidence of dry socket in group a,B and C were 0.09%(1/92),2.32%(2/86),8.33%(8/96).There was no significant difference between group A and B,group b and C,while a significant difference showed between group A and C.The PoSSe score in group A,B and C was 19.36,27.80 and 22.83 respectively.Afer the experiment the department of pharmacy informed that drug A is Shahaosan and drug b is Yunnan white drug.CONCLUSTON:Compiments of dry socket induced by extracting of lower jaw impacted teeth can be prevented by locally administered with Shahaosan,but no significant effect of alleviating the symptom of dental extraction.     

低分子肝素穿刺部位出血原因分析及注射方法探讨

Objective To analyze the reason of low molecular weight heparin injection site bruising and to investigate the injection method. Methods A total of 120 cases treated by subcutaneous injection of low molecular weight heparin calcium were received two kinds of injection technique: injection technique A was the new improved injection method ( Detaining air bubble skill combined with translation abdomen fold method used 30 s injection duration) and injection technique B was the routine method. The injected sites of method A was the left side of abdomen, the injection duration was 30 s, and 618 injections were executed; while the injection sites of method B was the right side of the abdomen, the injection duration was 10 s, and 617 injections were executed. Self comparison was done to analyze the local reactivity condition and pain degree of the two injection methods. Results There were significant differences in injection site bruising incidence rate (73.9% vs 37.2% ), hemorrhagic petechia average diameter (P＜0.01) and the degree of pain ( P ＜ 0. 05 ) between method A and method B. Conclusions Injection technique A could obviously reduce the rate of injection site hemorrhage and pain in low molecular weight heparin calcium injection.     

低分子肝素穿刺部位出血原因分析及注射方法探讨

Objective To analyze the reason of low molecular weight heparin injection site bruising and to investigate the injection method. Methods A total of 120 cases treated by subcutaneous injection of low molecular weight heparin calcium were received two kinds of injection technique: injection technique A was the new improved injection method ( Detaining air bubble skill combined with translation abdomen fold method used 30 s injection duration) and injection technique B was the routine method. The injected sites of method A was the left side of abdomen, the injection duration was 30 s, and 618 injections were executed; while the injection sites of method B was the right side of the abdomen, the injection duration was 10 s, and 617 injections were executed. Self comparison was done to analyze the local reactivity condition and pain degree of the two injection methods. Results There were significant differences in injection site bruising incidence rate (73.9% vs 37.2% ), hemorrhagic petechia average diameter (P＜0.01) and the degree of pain ( P ＜ 0. 05 ) between method A and method B. Conclusions Injection technique A could obviously reduce the rate of injection site hemorrhage and pain in low molecular weight heparin calcium injection.     

Varicocele: How this condition and its management affects men's health

Varicocele is a relatively common condition that can impact men’s health in various ways.Unfortunately,its prevalence and the availability of various different methods of repairing it might lead to unnecessary treatment.An understanding of the various ways that this condition can impact men’s health is necessary in order to manage it appropriately.At present,there is substantial evidence to support varicocele repair in men who present with infertility,abnormal semen parameters,clinical varicocele and a female partner with normal fertility(or one with a potentially correctable abnormality).Varicocele repair appears to improve seminal fluid quality and might improve pregnancy rates.It might also have a role in managing men with non-obstructive azoospermia.Varicocele can also be a cause of scrotal pain that is usually of a dull character.Varicocele repair is an effective method of managing this type of pain,especially once proper measures have been taken to exclude other possible causes of orchalgia.Conservative measures are generally not effective in managing varicocele-related scrotal pain.There is growing evidence to suggest that varicocele repair might have a role in improving the serum testosterone level in men with hypogonadism,especially in the subfertile population.Well-designed prospective studies are needed to support the utilization of varicocele repair inmanaging these patients,as well as in preventing testicular dysfunction on a prophylactic basis.     

Pain management for the child with cancer n end of life care

Data is clear that many childeren with cancer at the end of life suffer substantiall.Treatment was viewed as successful in only 27% of the patients.Pain is children who are dying os cacer can be complex and challenging to mannage.Children and parents are equal partners with members of the health care team in managing the patient‘s pain.Prevention and alleviation of pain is a primary goal of care in the child dying of cancer.Children dying of cancer may require aggressive dosing of analgesics.Medications that do not have a dose maximum should be escalated,sometimes rapidly ,to achieve adequate pain control or to maintain pain control when tolerance has occurred.The nurse‘s s role in caring for children who are in pain at the end-of-life includes assessment,identifying expected outcomes,and plan-ning ,performing,and evaluating interventions.     

Emerging infectious diseases and risks for transfusion safety;past,present and future

<正>Over the last 10 years,HIV,HCV and HBV have been the focus of blood safety with respect to decreases in infectious disease risks.In addition,screening for WNV RNA and Trypanosoma cruzi antibodies have been introduced in response to risks posed by different exposures in our donor population.HIV,HCV and HBV for the most part share similar transmission routes (i.e.,parenteral and known risk behaviors) and questioning of donors along with increasingly sensitive blood donor screening tests have been responsible for the vast majority of observed reductions in residual risk.For example,since the implementation of HIV-1/HCV NAT in the US,the American Red Cross (ARC) has detected 244 (1:270 000) HCV-infected donors and 32 (1:2 million) HIV-infected donors over the last 10 years of testing of greater than 66 million donations. Current,per-donation residual risks are estimated at 1:1 467 000 for HIV and 1:1 149 000 for HCV[1].Although higher,prior to the widespread implementation of HBV NAT,the HBV per donation residual risk from the same ARC donor population is estimated at 1:280 000-1:357 000[2]. These figures were derived by taking the product of estimated donor incidence of 3-5 per 100 000 person years and remaining window periods that range from 9.1-7.4 days for HIV and HCV,and 30-38 days for HBV.Similar methods for estimates of yield and residual risk have been used worldwide.     

Individualized minimally invasive treatment for adult testicular hydrocele: A pilot study

BACKGROUND Hydrocelectomy is the gold standard for the treatment of hydrocele,but it often causes complications after surgery,including hematoma,infection,persistent swelling,hydrocele recurrence,and chronic pain. In recent years,several methods for minimally invasive treatment of hydrocele have been introduced,but they all have limitations. Herein,we introduce a new method of individualized minimally invasive treatment for hydrocele.AIM To present a new method for the treatment of adult testicular hydrocele.METHODS Fifty-two adult patients with idiopathic testicular hydrocele were included. The key point of this procedure was that the scope of the resection of the sheath of the tunica vaginalis was determined according to the maximum diameter(d) of the effusion measured by ultrasound and the maximum diameter of the portion of the sheath pulled out of the scrotum was approximately πd/2. The surgical procedure consisted of a 2-cm incision in the anterior wall of the scrotum,drainage of the effusion,and dissection of part of the sheath of the tunica vaginalis. After the sheath was peeled away to the predetermined target extent,the pulled-out sheath was removed. The intraoperative findings and postoperative complications were analyzed.RESULTS All patients were successfully treated with a median operation time of 18 min.The median maximum diameter of the effusion on ultrasound was 3.5 cm,and the median maximum diameter of the resected sheath was 5.5 cm. Complications occurred in four(7.7%) patients: two(3.8%) cases of mild scrotal edema,one(1.9%) case of scrotal hematoma,and one(1.9%) case of wound infection. All of the complications were grade I-II. Recurrent hydrocele,chronic scrotal pain,and testicular atrophy were not observed during a median follow-up of 12 mo.CONCLUSION We report a new technique for individualized treatment of testicular hydrocele,which is quantitative and minimally invasive and yields good outcomes. Further study is warranted to verify its potential value in clinical practice.     

改良型Dewar手术治疗肩锁关节完全脱位及术后的关节功能恢复

BACKGROUND:Many scholars have reported the clinical practices and effect of Dewar operation,otherwise pain and dysfunction often occur after operation.     

涡轮机去骨増隙法与骨凿増隙法拔除复杂残根的临床比较

目的探讨拔除复杂残根的适宜方法。方法运用涡轮机去骨増隙法与骨凿増隙法拔除复杂残根各30例,并对两种方法所用时间、术中疼痛程度、术后3 d肿胀程度进行比较。结果两种方法在平均拔牙耗时14 min内的拔牙成功率、术中疼痛程度、术后3 d肿胀程度方面有显著性差异（P〈0.05）。结论涡轮机去骨増隙法适用于根骨粘连残根以及根尖形态异常的复杂牙拔除术。     

多个玻璃纤维桩树脂核修复磨牙残冠

背景：由于铸造金属桩核弹性模量大,修复磨牙残冠残根时易造成根尖部根折,难以取出、生物相容性差等缺点。目的：评价多个玻璃纤维桩修复磨牙残冠的临床效果。方法：选择26例31颗磨牙残冠,经完善根管治疗后,选择两至三个根管制作玻璃纤维桩树脂核,然后进行氧化锆全瓷冠修复,随访观察治疗效果。结果与结论：随访12～24个月,3颗全瓷冠出现颜色偏差,因后牙对美观影响不大,患者未提出异议;1颗冠崩瓷而重做外冠,1颗冠因邻接关系不良导致食物嵌塞而重做外冠,1颗冠因龈距离低,聚合度过大冠脱落,经增加辅助固位型后重做外冠,重做外冠观察半年以上未见异常。其余病例修复体外形良好,边缘密合,X射线检查桩与根管密贴,无桩或根折,根尖根周牙槽骨无吸收影像。表明多纤维桩树脂核技术修复磨牙残冠能够获得良好的近期临床效果。     

多个玻璃纤维桩树脂核修复磨牙残冠

背景:由于铸造金属桩核弹性模量大,修复磨牙残冠残根时易造成根尖部根折,难以取出、生物相容性差等缺点.目的:评价多个玻璃纤维桩修复磨牙残冠的临床效果.方法:选择26例31颗磨牙残冠,经完善根管治疗后,选择两至三个根管制作玻璃纤维桩树脂核,然后进行氧化锆全瓷冠修复,随访观察治疗效果.结果与结论:随访12~24个月,3颗全瓷冠出现颜色偏差,因后牙对美观影响不大,患者未提出异议;1颗冠崩瓷而重做外冠,1颗冠因邻接关系不良导致食物嵌塞而重做外冠,1颗冠因牙合龈距离低,聚合度过大冠脱落,经增加辅助固位型后重做外冠,重做外冠观察半年以上未见异常.其余病例修复体外形良好,边缘密合,X射线检查桩与根管密贴,无桩或根折,根尖根周牙槽骨无吸收影像.表明多纤维桩树脂核技术修复磨牙残冠能够获得良好的近期临床效果.     

兔下颌骨前牙区剩余牙槽嵴模型的建立

背景：建立合适的牙槽嵴缺损动物模型可为开展剩余牙槽嵴的保存、修复研究奠定基础。目的：建立兔下颌骨前牙区剩余牙槽嵴实验动物模型。方法：全麻下完整拔除18只新西兰大白兔双侧下颌中切牙建立兔下颌骨前牙区剩余牙槽嵴模型。术后4,8,12周,处死白兔,游标卡尺测量兔下颌剩余牙槽嵴的长度、宽度和高度,苏木精-伊红染色观察拔牙窝的愈合程度,X射线摄片观察兔下颌拔牙创内骨小梁改建情况。结果与结论：随着手术时间的延长,牙槽嵴长度、宽度和高度均逐渐降低;拔牙窝内有成骨细胞散在分布,新生骨小梁和血管网逐渐形成,牙槽窝持续沉积新生骨组织,与周围牙槽骨界限不清,骨改建生成,拔牙创愈合。苏木精-伊红染色及X射线片均证实兔前牙区剩余牙槽嵴模型建立成功。     

用金属烤瓷冠修复残冠残根90例疗效评价

评价残冠残根经完善根管治疗后，保留残冠根用金属烤瓷冠的修复效果。方法；对９０例牙根稳固，牙周组织健康，根尖周组织愈合良好的残冠奶用金属烤瓷冠修复。结果；经修复的残冠残根能恢复牙体牙冠的生理形态和正常的切割，咬Ｈｅ咀嚼功能。     

两种口腔护理方式对老年患者口腔清洁的比较

【】 目的 探讨两种口腔护理方式对具有残根残冠重度认知障碍老年患者的临床效果。 方法 选择2010年1月—2011年2月在静安老年医院,具有残根残冠的重度认知障碍的老年患者100例,随机分成实验组和对照组。实验组采取镊子外固定纱布条式口腔护理,对照组采用传统口腔护理,比较两组操作过程中棉球或纱布残留在残齿上的百分比和进行口腔护理后牙菌斑指数情况。 结果 由口腔护理后牙菌斑指数得知实验组的效果明显优于对照组,差异有统计学意义(P<0.05)。 结论 镊子外固定纱布条式的口腔护理适用于重度认知障碍的老年患者,并能达到更好的清洁效果,降低安全风险。     

根管治疗期间急性炎症发生的临床分析

目的对根管治疗期间发生急性炎症的发病情况及其相关因素进行分析。方法对58例残根残冠根管治疗情况与急性炎症的关系进行临床分析。结果发生急性炎症25例，发生率为43．0％，其中扩出根尖孔为15例，超充填为10例；中老年组在根管治疗期间急性炎症发生率高于青年组。结论对残根残冠的根管治疗，必须严格操作，认真进行，在术前术中一定要摄X线片确定操作长度，减少超扩超充，以避免急性炎症的发生。     

MACRO-LOCK石英纤维桩的修复效果及安全性评价

背景：在桩核的设计选择中,石英纤维桩因其良好的理化性能被认为是金属桩的良好替代品。目的：评价MACRO-LOCK石英纤维桩树脂核全冠修复残根、残冠的临床疗效和安全性。方法：将大面积前牙牙体缺损患者随机分为2组：石英纤维桩组患牙行完善的根管治疗后,利用MACRO-LOCK石英纤维桩、ULPDENT树脂黏接剂,PULPDENT双固化树脂核材料恢复桩核,以全瓷冠或贵金属烤瓷全冠修复。对照组患牙行传统的铸造金属桩核冠修复。随诊6个月及3年时的修复效果。结果与结论：与对照组相比,石英纤维桩组RTD-MACOK POST石英纤维桩修复后随访3年仅1例发生桩核脱落,1例出现纤维桩折断,未出现根折现象,3年随访的成功率较高（P〈0.05）。结果证实,MACRO-LOCK石英纤维桩修复残根、残冠可获得良好的远期修复效果,安全性较好。     

微创拔牙技术与凿骨劈冠法拔除残根残冠对患者疼痛及应激状况的影响

目的 探讨微创拔牙技术与凿骨劈冠法拔除残根残冠对患者疼痛及应激水平的影响.方法 将473例残根残冠患者按治疗方案不同分为微创组(285例)及常规组(188例).常规组采用凿骨劈冠法治疗,微创组采取微创拔牙技术治疗.比较两组手术时间、术中失血量、拔牙窝完整性评分、并发症发生率、治疗满意度,手术前后龈沟液炎性介质(前列腺素...     

铸造桩核烤瓷全冠在前牙残冠残根修复中的临床应用

目的：探讨铸造桩核烤瓷全冠在前牙牙体缺损修复中的作用。方法：选择前牙残冠残根104颗牙齿，在修复前行完善根管治疗。再采用铸造桩核烤瓷冠的方法修复缺损。结果：通过1～2年临床观察，该修复有效率达94．2％。结论：铸造桩核烤瓷全冠是一种良好的前牙残冠残根的修复方法。