牙齿外漂白中的显微硬度分析

显微硬度测量法能间接反映牙体硬组织的矿物含量变化,是目前评价牙齿漂白产品对牙体硬组织影响最常用的方法之一。样本种类、漂白剂、测量部位、储存环境等都可能会造成牙体矿物含量的变化,从而导致牙体显微硬度值的差异。本文就牙齿外漂白中显微硬度测量法的应用及相关影响因素的研究作一综述。     

HBV混合感染中前C／cp区变异与HBeAg的相关性研究

目的 研究慢性乙型病毒性肝炎患者血清HBeAg表达与HBV混合感染中前C/C基因启动子cp变异的关系.方法 采用聚合酶链反应扩增HBV-前C/cp基因,以PUC18为载体构建质粒,并进行DNA序列测定后用DNAStar软件包进行序列分析.结果 9例患者体内共构建356份HBV-前C/cp质粒;测序结果显示同一患者体内均存在多种变异形式的HBV-前C/cp基因,HBeAg阳性患者体内多为野生株,而HBeAg阴性患者多为突变株;发现13种热点突变形式,其中12种在HBeAg阴性和HBeAg阳性患者体内分布有显著性差异.结论 HBV前C/cp区基因变异是导致HBeAg阴转的重要原因之一;HBV感染者体内同时存在多种变异形式的病毒株,野生株/突变株的比例波动在一定程度上决定血清HBeAg的水平.     

SD雌性大鼠性发育早期性器官等脏器和性激素的动态变化

目的 探讨正常SD雌性大鼠性成熟前不同日龄段的脏器与促黄体生成素(LH)、促卵泡素(FSH)、雌二醇(E2)等性激素的变化及其关系.方法 从生产群中取出印窝密度状态一致的SD大鼠,在不同日龄随机选取雌性大鼠,检测15、25、32、40日龄时大鼠体重、主要脏器指数,子宫、卵巢组织变化和15、25、32、40、60日龄大鼠血清LH、FSH、E2水平.结果记录了SD雌性大鼠性成熟前各脏器指数和卵巢、子宫组织变化,结果显示大鼠卵巢、子宫的增长速度大于体重的增长,而其他脏器增速大都小于体重的增长.本研究还记录了血清LH、FSH、E2水平在不同日龄段的变化规律,表明血清LH、E2浓度在32日龄时出现较为明显升高.结论 不同日龄大鼠脏器指数的动态变化提示大鼠性器官在性发育早期得到机体的优先发育.血清LH、E2水平在32日龄时有了明显升高,提示性腺轴功能已经激活.60日龄大鼠血清性激素水平的波动类似于动情周期的规律性变化,推测大鼠在60日龄前即已进人性成熟,这些结果将为大鼠性发育的相关研究提供重要的参考数据.     

后尿道狭窄的诊断和治疗——2O年经验总结

吻合术142例次;经会阴加阴茎海绵体中隔切开86例次;经会阴加耻骨下缘切除196例次;经耻骨劈开联合会阴径路后尿道端端吻合术68例次.426例随访3～120个月,平均32个月.其中302例排尿通畅,无需尿道扩张;12例分别行尿道扩张2～6次后排尿稳定;32例行直视下尿道内切开术后排尿通畅;53例经过再次或3次后尿道端端吻合术获得治愈.总手术治愈率为93.7%(399/426). 结论 根据后尿道狭窄或闭锁患者的病情选择合适的影像学诊断方法和合理有效的手术径路和手术技巧,有助于提高后尿道狭窄的诊治水平.     

犬舌黏膜与颊黏膜组合移植重建尿道的实验研究

目的 探讨犬舌黏膜与颊黏膜组合移植替代尿道的可行性和有效性. 方法杂种雌犬7只,平均体质量13 kg,剥离尿道黏膜4 cm×1 cm,取2 cm×1 cm舌侧面黏膜和颊黏膜各1条,拼接后移植至尿道内,恢复尿道黏膜的连续性.术后留置硅胶导尿管1周,拔除尿管后观察排尿情况.1.5～12.0个月后行逆行尿道造影检测实验犬尿道通畅情况,并用10 F尿管证实有无狭窄.随后处死实验犬,测定移植物长度并行病理组织学检查,观察舌黏膜与颊黏膜组合移植至尿道后组织学改变情况. 结果7只实验犬均存活,排尿通畅6只,发生尿道狭窄1只;无尿瘘.移植手术前后舌黏膜和颊黏膜拼接长度分别为(4.00±0.15)和(3.75±0.23)cm,差异有统计学意义(P＜0.05).排尿通畅犬移植黏膜存活良好;舌黏膜与颊黏膜交界处愈合良好,无狭窄发生;光镜下见鳞状上皮呈连续分布,拼接移植黏膜的鳞状上皮与尿道的移行上皮区分明显,移植黏膜的鳞状上:皮有渐被尿道移行上皮替代的趋势.结论 犬舌黏膜和颊黏膜组合移植可替代尿道黏膜并恢复尿道的连续性.     

舌黏膜尿道成形治疗前尿道狭窄（附80例报告）

目的：研究舌黏膜尿道成形治疗尿道狭窄的有效性和安全性。方法：2006年8月～2008年12月采用舌黏膜尿道成形治疗80例前尿道狭窄,尿道狭窄段2．5～18cm,其中30例为长段尿道狭窄（9～18cm）采用双侧舌黏膜或舌黏膜与颊黏膜或与带蒂包皮拼接尿道成形治疗。尿道成形采用两种术式：保留原尿道板的扩大尿道腔37例;埋藏黏膜条43例。结果：术后随访4～30（平均16．8）个月,7例发生并发症,其中尿瘘4例,再次发生尿道狭窄3例,其余患者排尿通畅,最大尿流率从15．2～54．6（平均28．7）ml／s。结论：舌黏膜是一种修复前尿道狭窄较好的尿道替代物,双侧舌黏膜尿道成形能成功治疗长段、复杂性尿道狭窄。     

Ritual Circumcision: No Longer a Problem for Health Services in the British Isles

INTRODUCTION

Primary care trust (PCT) funding of a ritual circumcision service has recently been withdrawn from our unit, raising concerns that this may result in greater morbidity from community circumcision. The aims of this study were to document our circumcision practice before and after the withdrawal of PCT funding and to determine its effect on the morbidity from circumcision. In addition, we wanted to survey all paediatric surgical centres in the British Isles to ascertain how many still offer a ritual circumcision service.

PATIENTS AND METHODS

We retrospectively reviewed our circumcision practice for 1 year prior to the removal of UK Government funding, and then performed a prospective audit of our practice for the 12 months following funding withdrawal. An e-mail survey was also performed of all paediatric surgical units to determine the ritual circumcision service provision throughout the British Isles.

RESULTS

A total of 213 boys underwent circumcision during the 12 months prior to the withdrawal of funding, of which 106 cases (50%) were ritual circumcisions. After funding withdrawal, 99 boys underwent circumcision, of which 98 cases (99%) were for medical reasons. A similar number of boys were re-admitted after a hospital circumcision during the two review periods (5 versus 4 patients), whereas the number admitted following a community circumcision rose after funding withdrawal (6 versus 11 patients). Only a third of British paediatric surgical centres offer a ritual circumcision service, and a significant proportion of these were either providing the service without PCT funding, or were reconsidering their decision to continue.

CONCLUSIONS

PCT funding withdrawal for ritual circumcision had an impact on our unit''s procedural case volume. This represented a cost saving to the trust, despite a higher rate of admissions for postoperative complications. There is an inequality in healthcare provision throughout the British Isles for ritual circumcision, and we feel it is vital to offer support and training to medical and non-medical practitioners who are being asked to perform a greater number of circumcisions in the community.     

The renaissance of insulin pump treatment in childhood type 1 diabetes

Current goals for the treatment of children and adolescents with type 1 diabetes mellitus include achieving near-normal blood sugar levels, minimizing the risk of hypoglycemia, optimizing quality of life, and preventing or delaying long-term microvascular and macrovascular complications. Continuous subcutaneous insulin infusion (CSII), or insulin pump therapy, provides a treatment option that can assist in the attainment of all of these goals in all ages of children. In pediatric patients, CSII has been demonstrated to reduce both glycosylated hemoglobin levels and frequency of severe hypoglycemia, without sacrifices in safety, quality of life, or weight gain, particularly in conjunction with the use of new insulin analogs and improvements in pump technology. Clinical studies of safety and efficacy of CSII in children are reviewed, as well as criteria for patient selection and practical considerations using pump therapy in youth with T1DM. Supported by grants from the National Institute of Health (K12 DK063709, T32 DK063703 and RR 00125), the Juvenile Diabetes Research Foundation, and the Stephen I. Morse Pediatric Diabetes Research Fund.     

Effects of nandrolone decanoate compared with placebo or testosterone on HIV-associated wasting

Objectives Current research is unclear about the most effective pharmacological agents for managing the loss of weight and fat-free mass common in HIV/AIDS. The aim of this study was to compare nandrolone decanoate with placebo and testosterone. Methods The study was a multicentre randomized double-blind placebo-controlled trial. Three hundred and three adult HIV-positive male patients with a weight loss of 5-15% in the last 12 months, or a body mass index of 17-19 kg/m(2), or a body cell mass/height ratio lower than 13.5 kg/m, were randomly assigned to receive nandrolone decanoate (150 mg), testosterone (250 mg) or placebo intramuscularly every 2 weeks for 12 weeks. Fat-free mass, weight, immune markers and perception of treatment were the main outcome measures. Results Treatment with nandrolone resulted in significantly greater increases in fat-free mass [mean increase 1.34 kg; 95% confidence interval (CI) 0.60; 2.08 kg] and in weight (mean increase 1.48 kg; 95% CI 0.82; 2.14 kg) compared with placebo. The mean increase in weight with nandrolone of 1.00 kg (95% CI 0.27; 1.74 kg) when compared with testosterone was significant, although the difference in fat free mass did not reach significance (mean increase 0.69 kg; 95% CI-0.13; 1.51 kg). Patient perception of benefit was significantly greater in the nandrolone group when compared with both the placebo and the testosterone groups. Conclusions Treatment with nandrolone decanoate increased body weight when compared with placebo and testosterone. Nandrolone decanoate treatment resulted in greater increases in fat-free mass than placebo and demonstrated a trend for a significant increase when compared with testosterone.