数字化软件辅助设计在治疗偏颌畸形患者中的应用效果研究

目的　评价数字化软件辅助设计在治疗偏颌畸形患者中的应用效果。方法　选择2016年9月至2018年9月于中国医科大学附属口腔医院口腔颌面外科就诊的偏颌畸形患者18例。所有患者术前完成三维CT检查和牙列石膏模型的光学扫描，将数据分别以DICOM格式和STL格式传送至数字化工作站。在数字化软件中构建坐标系，重建上下颌骨、血管和神经束，并完成正颌外科的手术模拟预测，最后设计并打印患者上颌骨的截骨导板、复位导板和终末咬合导板。所有患者在术后6个月到口腔颌面外科门诊复查并行上下颌骨三维CT检查。利用数字化软件测量术后6个月患者两侧上颌第一磨牙点和尖牙点到眶耳平面和冠状平面的距离，计算非对称率；测量上中切牙点和颏顶点到正中矢状面距离作为术后效果的评价指标。结果　术后6个月患者两侧上颌第一磨牙点到眶耳平面和冠状平面距离的非对称率分别为（1.8 ± 1.0）%和（3.2 ± 1.7）%；两侧上颌尖牙点到眶耳平面和冠状平面距离的非对称率分别为（1.0 ± 0.8）%和（11.0 ± 4.8）%；上中切牙点和颏顶点到正中矢状面距离分别为（0.84 ± 1.05）mm和（1.49 ± 1.23）mm。所有患者均对面型表示满意。结论　数字化软件的模拟设计能够提高手术安全性，确保术中操作的精度，提高患者术后美学效果。因此，数字化软件辅助设计在治疗偏颌畸形患者中的应用具有重要的临床意义。     

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??Diagnosis in thyroid nodules with coexistent chronic autoimmune Hashimoto thyroiditis by shear wave elastography LIANG Jin-yu*??LIU Bao-xian??WANG Wei??et al. *Department of Medical Ultrasonics??Institute of Diagnostic and Interventional Ultrasound??the First Affiliated Hospital of Sun Yat-sen University??Guangzhou 510080,China
Corresponding author: WANG Wei??E-mail??wangw73@mail.sysu.edu.cn
Abstract Objective To assess the diagnostic performance of shear wave elastography (SWE) in the differentiation of thyroid nodules with coexistent Hashimoto thyroiditis??HT??. Methods From January 2013 to June 2014??conventional ultrasound (US) and SWE were performed on 297 suspicious thyroid nodules of 260 patients with histological confirmation. 73 patients with 83 nodules were included in the HT group. Results SWE value in the maglignant nodule was significant higher than that in the benign one and surrounding parenchyma (64.4±42.8??kPa vs??26.8±15.3??kPa vs??17.7±5.3??kPa, P<0.05). SWE value in HT group of malignant module was significantly higher than that of benign one and surrounding parenchyma. In the benign and malignant nodules??SWE value between HT and non-HT groups showed no significant differences (P>0.05). SWE value of surrounding parenchyma in HT group was higher than that in non-HT group and had positive correlation with TPO-Ab(r=0.307, P<0.05). Optimal value of SWE to diagnose malignancy was 39.1kPa with sensitivity, specificity and accuracy 68.9%,91.7% and 82.9%, respectively. Conclusions 39.0 kPa of SWE value showed good diagnostic performance in the differentiation of malignant and benign thyroid nodules with coexistent HT.     

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??Objective    To provide evidence for temporomandibular joint ??TMJ??prostheses design and size chosen via three-dimensional ??3D??measurements of CT data and cluster analysis of the Chinese. Methods    CT data from 448 adults from East China with normal TMJs were recruited and reconstructed by Proplan CMF 1.4 software. Thirteen parameters of the TMJ fossa and condyle-ramus units were performed by three-dimensional measurements. The data were analyzed statistically and hierarchical cluster analyses were performed to determine the size design. Results    The anatomical database of Chinese TMJ was established. There were significant differences in the 13 TMJ measurement parameters between the males and females. The glenoid fossa was grouped into 3 clusters?? and the condyle-ramus units were grouped into 4 clusters. Discriminant analyses were capable of correctly classifying 97.24% of the glenoid fossae and 94.98% of the condyle-ramus units. Conclusion    Three-dimensional measurements and cluster analysis of Chinese TMJ osseous morphology can provide an anatomical reference for prosthesis size design of Chinese TMJ replacement.     

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?? Sjögren syndrome??SS??is classified as primary Sjögren syndrome??pSS??and secondary Sjögren syndrome??sSS??. It is an autoimmune exocrinopathy characterised by lymphocytic infiltration of exocrine glands in multiple sites??including both lacrimal and salivary glands??so the patients often suffer from dry mouth and dry eyes. Now the pathogeny and its pathogenesis is still  under study??and this review will elaborate from the aspects of cytokines??antibody??gene??virus and so on.     

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??Objective??To investigate the role of grafted tissue-engineered human oral mucosa in the wound healing of nude mice. Methods??This study was conducted at the Animal Experimental Center of Institute of Basic Medicine of Chinese Academy of Medical Sciences from November 2016 to December 2016. Select 8 healthy nude mices??male??aged 3 to 4 weeks??weighing 14 ~ 15 g. Animals were anesthetized with 0.8% pentobarbital sodium. A 1.0 cm×1.0 cm full-thickness skin wound was created in the neck and back region in every mice??leaving the fascia intact. Tissue-engineered human oral mucosa was placed on the fascia of the neck and fixed in place with suture??and then fixed with a bolster dressing. In the control group??acellular dermis matrix??ADM??was placed on the fascia of the back??and all other surgical manipulation was the same as in the tissue-engineered human oral mucosa group. Eight days after grafting with the tissue-engineered human oral mucosa and ADM??the bolster dressings were removed. Histopathologic examination of the skin flaps was performed by HE staining. Results??Histopathological analysis of tissue-engineered human oral mucosa graft revealed a well-developed??multilayered and stratified squamous epithelium??and resembled native skin. But a portion of the tissue-engineered human oral mucosa epithelial layer peeled away from the ADM and ADM began to degrade. In contrast??no epithelial coverage of the ADM observed for 8 days after grafting. Conclusion??Wound healing can be enhanced by using tissue-engineered human oral mucosa graft.     

结直肠腺癌中Cox-2、MMP-9和E-cadherin的表达及临床意义

目的：探讨结直肠腺癌中Cox-2、MMP-9、E-cadherin的表达及与浸润、转移的关系。方法应用免疫组化SP法检测结直肠腺癌、正常结直肠黏膜组织中Cox-2、MMP-9、E-cad-herin蛋白的表达。结果结直肠腺癌组织中,Cox-2、MMP-9的阳性率(61．25%、66．25%)和 E-cadherin 的异常表达率(68．75%),显著高于正常结直肠黏膜组织(P<0．01)。三者均与淋巴结转移有关( P<0．05),其中E-cadherin表达与组织分化程度有关( P<0．01)。 Cox-2与 MMP-9表达呈正相关(rs =0．409,P<0．01),与E-cadherin表达呈负相关(rs=-0．370,P<0．01)。结论结直肠腺癌中Cox-2、MMP-9、E-cadherin的异常表达与肿瘤转移有关,分析三者表达对结直肠腺癌的预后评估有重要指导意义。     

以度鲁特韦为基础药物的抗HIV-1体外药效学研究

本文以研究度鲁特韦(dolutegravir,DTG)为基础药物抗HIV-1体外药效学为目的,以野生HIV-1、核苷类逆转录酶抑制剂耐药HIV-1(HIV-1RT-D67N,K70R,T215F)及整合酶抑制剂耐药HIV-1(HIV-1IN-G140S,Q148H)重组病毒模型为代表,首先比较了整合酶抑制剂与非核苷类逆转录酶抑制剂作为基础药物联合用药的体外药效学;本研究还比较了度鲁特韦和雷特格韦(raltegravir,RAL)分别与两个核苷类逆转录酶抑制剂联合用药的体外药效学。结果显示,以整合酶抑制剂DTG为基础药物抑制野生HIV-1的药效优于非核苷类逆转录酶抑制剂,与RAL效果相当;以DTG为基础药物对核苷类逆转录酶抑制剂耐药病毒(HIV-1RT-D67N,K70R,T215F)的药效与依法韦伦(efavirenz,EFV)和奈韦拉平(nevirapine,NVP)相近;对整合酶抑制剂耐药病毒(HIV-1IN-G140S,Q148H)的药效优于RAL。本研究明确了DTG联合用药的体外药效学,研究结果为临床选择药物提供了实验数据。     

中国成人心脏瓣膜病超声心动图规范化检查专家共识

心脏瓣膜病是由多种原因引起的心脏瓣膜狭窄和(或)反流所致的心脏疾病。超声心动图是证实心脏瓣膜病的诊断并评估其严重程度的首选方法。由于多方面原因,不同地区、医院和检查者之间的超声心动图检查流程和结果存在一定差异,不利于心脏瓣膜病患者的综合管理。为帮助临床医生对心脏瓣膜病作出准确而一致的诊断和评估,促进相关的临床和科研工作深入发展,制定规范化检查共识十分必要,对心脏瓣膜病的诊断、危险分层、治疗指导、预后评估等具有重要意义。