Marginal bone level change during sequential loading periods of partial edentulous rehabilitation using immediately loaded self-tapping implants: a 6.5-year retrospective study

PURPOSEA large number of studies have suggested the practicability and predictability of immediate implant function, but few studies have reported marginal bone level changes during sequential loading periods. The purpose of this study was to evaluate the marginal bone remodeling of immediately loaded self-tapping implants both at each time point and during each loading period between two time points.MATERIALS AND METHODSThe patients included in this retrospective study were treated with immediately loaded NobelSpeedy Replace implants between August 2008 and July 2009. Differences in the marginal bone level (MBL) at each time point and the marginal bone level change (ΔMBL) between two time points were analyzed with Bonferroni correction (P < .05).RESULTSOverall, 24 patients (mean age, 47.3 ± 12.8 years) with 42 immediately loaded implants and a median follow-up of 6.5 years (IQR, 67.8 months) were included. The cumulative survival rate after 10 - 12 years was 95.2%. Continuous but slow marginal bone loss was observed during long-term follow-up. MBL at both 7.5 years and 11 years was significantly lower than that at loading, 6 months, 2 years and 4 years (P < .05). No bone loss difference was found in any period before 4 years of follow up (P > .05). The loading period of 4 years to 7.5 years showed the largest ΔMBL compared to those of other time periods (P < .05).CONCLUSIONSlight bone loss occurred continuously, and more radical changes of marginal bone can be observed during the period of 4-7.5 years. Thus, long-term effective follow-up of immediately loaded implants is needed.     

对海洛因依赖者心理健康与应对方式的研究

目的了解海洛因依赖者的心理健康状况及应对方式。方法对入组的60例吸毒者,在脱毒后、出所前、出所随访中作SCL-90和简易应对方式的测查,并与正常对照组比较分析。结果SCL-90和简易应对方式各因子均值比较,心理症状戒毒组比正常对照组高（P〈0.05）,积极应对戒毒组比正常对照组低（P〈0.05）,消极应对戒毒组比正常对照组高（P〈0.05）,消极应对与心理症状显著相关（P〈0.05）。出所前组与正常男性比较,仅其他因子（睡眠饮食障碍）戒毒者高（P〈0.05）。所外随访未复吸组与正常对照男性比较,无显著差异（P〉0.05）。回顾未复吸组在往所戒毒期间与正常对照男性比较,有躯体化、强迫、抑郁、焦虑、敌对、精神、其他7个因子和总均分有显著差异（P〈0.05）,17例复吸者作了同样的比较分析,除积极应对因子外,余因子均有显著差异（P〈0.05）。17例复吸者再入所时,各因子均值高于正常对照组（P〈0.05）。结论吸食海洛因成瘾可造成吸毒者心理健康状况恶化和应对方式不良,心理症状与消极应对方式相关,有诸多心理健康问题和对社会应激事件通常采用消极应对方式的戒毒者,其复吸的可能性要大。     

一例终末期儿童尤文肉瘤的护理

骨肉瘤、软骨肉瘤和尤文肉瘤是最常见的三种原发恶性骨肿瘤。尤文肉瘤多发生于5～20岁,是一种起源于神经外胚层细胞的恶性小圆细胞肿瘤,多发于椎旁、四肢、腹膜后、躯干等不同的部位,恶性程度及侵袭性较高,20%～30%的尤文肉瘤发现时已远处转移,如肺转移和骨骼转移。主要治疗方法为局部手术切除、化学治疗、放射治疗,复发、难治性尤文肉瘤治疗效果差。某医院科室收治一例儿童尤文肉瘤,随着疾病的不断恶化,出现了肿瘤并发症,但在医护团队的精心医治和照护下,患者顺利、安详度过了生命的最后阶段。     

新型鼻咽通气道联合超声引导下神经阻滞在骨科下肢手术中的应用

目的 评估新型鼻咽通气道联合超声引导下神经阻滞麻醉在骨科手术中供氧的有效性及呼气末二氧化碳分压(PetCO2)监测的准确性.方法 选取择期行骨科下肢手术的40例患者为研究对象,行腰丛+坐骨神经阻滞麻醉,轻度镇静下置入新型鼻咽通气道,连接供氧管,监测PetCO2,行桡动脉穿刺,监测血气分析结果,术中持续小剂量丙泊酚泵入进...     

心脏不停跳心内直视手术113例

目的探讨不停跳心内直视手术的方法和意义。方法浅低温（31℃-34℃）不停跳心脏直视手术共113例,男59例,女54例。年龄4-73岁,平均31.4岁。其中房间隔缺损（atrial septal defect,ASD）22例,室间隔缺损（ventricular septal defect,VSD）32例,法乐氏三联征（triad of Fallot,F3）3例,双腔右心室1例,Ebstein畸形3例,二尖瓣置换手术（mitral valve replacement,MVR）36例,主动脉瓣置换手术（aortic valve replacement,AVR）9例,双瓣置换手术（double valves replacemnet,DVR）7例。结果1例二尖瓣置换手术因术中暴露极差而被迫降温心脏停跳操作外,其余全为非停跳手术,全组手术顺利,无死亡,术后恢复良好。结论心脏不停跳手术简化了手术操作程序,方便手术后管理,减少了心脏停跳后的负面影响。     

姜黄素抑制β淀粉样蛋白25～35诱导PC12细胞凋亡的实验研究

目的探讨姜黄索对β淀粉样蛋白(Aβ)25～35诱导的PC12细胞损伤的保护作用。方法采用不同浓度的Aβ25～35处理分化后的PC12细胞,同时应用姜黄素进行干预,采用四甲基偶氮唑盐法检测细胞活力及代谢状态,采用磷脂酰丝氨酸外翻法检测细胞凋亡,采用流式细胞仪检测细胞凋亡率。结果Aβ25～35处理24h后,PC12细胞活力显著下降,且呈剂量依赖性。姜黄素(5～20μmol/L)对Aβ25～35诱导的细胞凋亡具有明显的抑制作用。与仅以20μmol/L Aβ25～35处理相比,5μmol/L姜黄素 20μmol/L Aβ25～35处理后的细胞凋亡百分比明显降低(P<0.01)。结论Aβ25～35能够诱导PC12细胞凋亡,姜黄素对其诱导的PC12细胞凋亡具有保护作用。     

蛋白芯片检测丙型肝炎病毒分片段抗体

目的 用蛋白芯片的方法检测丙型肝炎病毒（HCV）分片段抗体。方法 利用生物芯片技术和化学发光技术将高度纯化的抗原HCV Core、NS3、NS4、NS5以特定微阵列固定在固相载体上,用化学发光免疫法检测抗HCV Core、抗HCV NS3、抗HCV NS4和抗HCV NS5。结果 174份血清中HCV抗体阳性87份,HCV抗体阴性87份,其中献血员33份,非丙型肝炎的其他肝病患者39份,非肝病者15份。87例雅培公司的AxSYM（微粒子发光）检测抗HCV阳性患者中,蛋白芯片检出阳性85份,阳性率为97．70％;在174份标本中,蛋白芯片检出阳性标本88份,其中抗HCV阳性87份,阳性率98．86％;抗HCV NS3检出49份,阳性率为55．68％;抗HCV NS4检出68份,阳性率为77．27％;抗HCV NS5检出37份,阳性率为42．05％;抗HCV Core检出69份,阳性率为78．41％。结论 蛋白芯片显示较高的敏感性和特异性,具有临床实用价值。     

酶联免疫吸附试验检测人疱疹病毒7型抗体的研究

目的 建立一种简便、快速、可靠的检测人疱疹病毒7型（HHV7）特异性IgG和IgM酶联免疫吸附试验（ELISA）。方法 应用HHV7标准株Glasgow感染SupT1细胞,制备并纯化细胞工程抗原和重组ppS5抗原;对325份血清HHV7抗体进行检测,建立HHV7特异性IgM和IgG间接ELISA,并与Qiagen公司ELISA试剂盒检测结果进行比较。结果 采用细胞工程抗原和重组抗原制备的HHV7 IgG和IgM ELISA诊断试剂敏感性、特异性、稳定性及重复性[变异系数（CV）〈10％]较好;以Qiagen公司ELISA试剂盒为参比,重组抗原IgG ELISA检测上述标本的敏感性、特异性和符合率分别为98．1％、94．1％和97．8％,IgM ELISA分别为84．6％、99．7％和99．1％;与细胞工程抗原相比,重组抗原诊断试剂的特异性高而敏感性略低。结论 自制HHV7 IgG和IgM ELISA检测试剂敏感特异,可用于临床HHV7感染的诊断及流行病学调查。     

Risk factors of perioperative complications and management with enhanced recovery after primary surgery in women with epithelial ovarian carcinoma in a single center

The present study aimed to evaluate the postoperative complications and the impact of an enhanced recovery programme in patients who underwent primary surgery (including extensive upper abdominal surgery) for epithelial ovarian carcinoma (EOC). All patients with stage I–IV ovarian carcinoma who underwent primary surgery were identified, and postoperative complications were evaluated and graded according to the Clavien-Dindo classification. Of 161 patients, 46 (28.57%) underwent surgical staging, 27 (16.77%) standard cytoreduction, 12 (7.45%) en bloc debulking and 76 (47.20%) extraradical debulking. A total of 157 patients (97.52%) achieved optimal tumor reduction (<1 cm). The mean postoperative hospitalization time was 17.33±11.29 days after completion of the initial postoperative chemotherapy (IPC), and the IPC interval was 16.22±10.09 days. A total of 13 patients (8.07%) had grade 3 complications (9 with wound dehiscence, 3 with digestive tract leakage and 1 with a bladder fistula). A total of 2 patients (1.24%) had grade 4–5 complications [1 patient with severe pneumonia returned to the intensive care unit (ICU) for tracheotomy and respiration rehabilitation; the other patient died of septicemia on day 19]. The multivariate analysis of the preoperative factors revealed that a human epididymis protein 4 (HE4) level of ≥717 pM (P=0.015) and Federation International of Gynecology and Obstetrics (FIGO) stage IV (P=0.004; compared with stage IIIC) were associated with grade 3–5 complications. The bootstrap analysis revealed that a cancer antigen 125 (CA125) level of ≥1,012 U/ml (P=0.034), a HE4 level of ≥717 pM (P=0.007) and FIGO stage IV (P=0.002; compared with stage IIIC) were significantly associated with grade 3–5 complications. Meanwhile, the multivariate analysis of the postoperative factors did not reveal any risk factors associated with grade 3–5 complications; the bootstrap analysis revealed that only transfer to the ICU after surgery (P=0.026) was significantly associated with grade 3–5 complications. In conclusion, the study found that application of enhanced recovery after surgery protocols is feasible in patients with EOC, especially in those undergoing advanced extensive upper abdominal surgery, and CA125, HE4 and FIGO stage IV were related with the occurrence of adverse perioperative outcomes.     

蚓激酶胶囊治疗脑梗死疗效观察

目的 探讨蚓激酶胶囊对康复期脑梗死治疗的有效性及安全性.方法 146例脑梗死的病人进行8周蚓激酶胶囊的治疗,分别在治疗前后进行《中国脑卒中量表》(CSS)和《日常生活能力Barthel指数》(ADL)的临床疗效评定,实验室检查血常规、血糖、纤维蛋白原(Fig)、肝肾功能和作心电图检查.结果 蚓激酶胶囊治疗4周、8周CSS及ADL评分均较治疗前有显著改善(P＜0.01),治疗后空腹血糖下降,Fig降低,治疗前后病人的肝功能、肾功能、心电图检查的变化,差异无显著意义(P＞0.05),未发现严重的药物毒副作用.结论 蚓激酶胶囊能有效治疗康复期脑梗死患者,耐受性好,安全性高.