无托槽隐形矫治器与固定矫治器在拔除四颗第一前磨牙矫治拥挤中的应用与临床分析

目的:通过采用无托槽隐形矫治器与固定矫治器拔除4颗第一前磨牙的临床分析,探讨无托槽隐形矫治技术的具体优势。方法:选取2010年6月-2014年6月在我院拔除4颗第一前磨牙矫治拥挤的患者90例,随机均分为对照组和观察组,其中对照组采用固定矫治器进行治疗,观察组采用无托槽隐形矫治器进行治疗,对比两组患者的治疗效果。结果:90例患者均实现了牙齿排列的整齐并有效关闭了拔牙的间隙。观察组在疗程评估的有效率方面略高于参照组,但是两组并没有显著的差异。而在美观满意度、舒适满意度和便捷满意度3个指标上,观察组的满意度明显高于参照组,存在着显著的差别。结论:固定矫治器和无托槽隐形矫治器对于拔除4颗第一前磨牙矫治拥挤均能形成显著的疗效,但是无托槽隐形矫治器不但美观大方,还能够大大降低医生的劳动强度,所以在拔除4颗第一前磨牙矫治拥挤方面,无托槽隐形矫治器相对于固定矫治器具有较大的优势。     

肺浸润性黏液腺癌1例报告及文献复习

目的：探讨肺浸润性黏液腺癌（IMAs）患者的临床特征、诊断方法和治疗过程,提高临床医生对IMAs的认识。方法：收集1例IMAs患者的一般资料、影像学表现和治疗方案,并进行相关文献复习。结果：患者,女性,42岁,因咳嗽和咳痰入院,CT检查显示双肺斑片状影,因疑似双肺肺炎行抗感染治疗后症状未见好转,经支气管镜肺活检术（TBLB）及胸水脱落细胞检测结果均为炎性表现,后经皮穿刺活检病理回报为IMAs。基因检测结果为KRAS外显子2点突变。行紫杉醇加卡铂并联合应用血管靶向药物贝伐珠单抗化疗后,患者临床症状明显改善,肺部影像学表现明显改变。结论：IMAs是一种特殊病理类型的肺腺癌（ADCs）,该类患者影像学表现多样,基因表达特殊,治疗原则与其他类型ADCs不同。     

保定市843名放射工作人员职业健康状况

目的 分析843名放射工作人员职业健康监护资料和个人剂量监测数据,为进一步做好放射防护工作提供参考依据。方法 收集2016年至2017年保定市843名放射工作人员的职业健康检查资料及个人剂量监测数据,对职业健康检查状况进行检查,同时对四项敏感指标(包括血常规、眼晶状体状况、甲状腺功能、染色体畸变)进行检测,运用SPSS 17.0进行方差分析和趋势性χ²分析。结果 女性放射工作人员的血常规异常率高于男性,差别有统计学意义(P=0.014);职业健康检查结果异常率(P=0.002)、甲功五项异常率(P=0.024)随着工龄增加逐渐增加,差别有统计学意义;1~5 mSv组的眼晶状体混浊率高于最低探测水平(MDL)~<1 mSv组,差别有统计学意义(P=0.028)。从事核医学(P=0.040)、介入放射学(P=0.012)人员的染色体畸变率均大于放射诊断人员,差别有统计学意义。结论 小剂量电离辐射长期照射会对放射工作人员的健康状况产生影响,女性、高工龄、从事介入放射学和核医学的放射工作人员更易发生职业性损害。     

Llama antibody fragments have good potential for application as HIV type 1 topical microbicides

There is an urgent global need for preventive strategies against HIV-1 infections. Llama heavy-chain antibody fragments (VHH) are a class of molecules recently described as potent cross-clade HIV-1 entry inhibitors. We studied the potential of a VHH-based microbicide in an application-oriented fashion. We show that VHH can be inexpensively produced in high amounts in the GRAS organism Saccharomyces cerevisiae, resulting in a very pure and endotoxin free product. VHH are very stable under conditions they might encounter during transport, storage, or use by women. We developed active formulations of VHH in aqueous gel and compressed and lyophilized tablets for controlled release from an intravaginal device. The release profile of the VHH from, e.g., a vaginal ring suggests sufficient bioavailability and protective concentration of the molecule at the mucosal site at the moment of the infection. The ex vivo penetration kinetics through human tissues show that the VHH diffuse into the mucosal layer and open the possibility to create a second defense layer either by blocking the HIV receptor binding sites or by blocking the receptors of immune cells in the mucosa. In conclusion, our data show that VHH have a high potential for HIV-1 microbicide application because of their low production costs, their high stability, and their favorable release and tissue penetration properties.     

Safety and Effectiveness of Transvenous Lead Extraction in Octogenarians

Transvenous Lead Extraction . Introduction: As the population ages, the number of elderly patients with implantable cardiac devices referred for transvenous lead extraction will dramatically increase in Western countries. The safety and effectiveness of lead extraction in elderly patients has not been well evaluated. We report the safety and effectiveness of transvenous lead extraction in octogenarians. Methods and Results: From January 2005 to January 2011, we reviewed data from consecutive patients ≥ 80 years referred to our institutions for transvenous lead extraction because of cardiac device infection or lead malfunction. Clinical characteristics, procedural features, and periprocedural major and minor complications were compared between octogenarians and younger patients. Out of 849 patients undergoing lead extraction in the participating institutions during the study period, 150 (18%) patients were octogenarians (mean age 84 years; range 80–96; 64% males). A significantly higher percentage of octogenarians presented with chronic renal failure (55% vs 26%; P < 0.001), history of malignancy (22% vs 6%; P < 0.001), and chronic obstructive pulmonary disease (46% vs 19%; P < 0.001). Complete lead extraction rates were similar in the 2 age groups (97% in octogenarians vs 96% in patients <80 years; P = 0.39). Periprocedural death occurred in 2 (1.3%) patients ≥80 years and in 5 (0.72%) patients <80 years (P = 0.45 for comparison). No differences in terms of other periprocedural major and minor complications were found between the 2 age groups. Conclusion: Despite presenting with a significantly higher rate of comorbidities, transvenous lead extraction can be performed safely and successfully in octogenarians. (J Cardiovasc Electrophysiol, Vol. 23 pp. 1103‐1108, October 2012)     

Management of bleeding disorders in adults

Development of FVIII inhibitors is currently the most severe and challenging complication of haemophilia A treatment and represents a very large economic burden for a chronic disease. As a result, clinical research is making major efforts to optimize the therapeutic approaches for this condition. In this section we will review some important aspects of the management of haemophilia in adults, including an overview of bleeding in women with von Willebrand disease, an analysis of FVIII consumption in patients with severe haemophilia A, an update of the ongoing RES.I.ST study, long-term prophylaxis and experience from the Pro.Will study, current evidence relating to economic aspects of the treatment of haemophilic patients with inhibitors (based on the PROFIT study), and an overview of musculoskeletal complications in adults with severe bleeding disorders.