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牙列缺损(delect of dentition)是口腔修复临床中的常见病、多发病,对患者的外貌、咀嚼功能、发音等均有不同程度的影响,同时也不利于患者生理、心理健康.随着社会人口的老龄化,这类疾病的发生率也将日益增高.可摘局部义齿这种传统的修复方式作为对牙列缺损的修复,可以恢复大多数患者缺牙区的形态和部分功能,但其临床修复效果的差强人意和容易出现的一些问题是众所周知的.     

Molecular characterization of hepatitis B virus surface antigen mutants in Singapore patients with hepatocellular carcinoma and hepatitis B virus carriers negative for HBsAg but positive for anti‐HBs and anti‐HBc

Background and Aims : Mutations on the a‐determinant of hepatitis B virus surface antigen (HBsAg), capable of escaping detection and vaccination, are identified in HBsAg‐positive/anti‐HBs‐positive vaccinated infants. We studied the prevalence of these mutants in HBsAg‐negative/anti‐HBc‐positive chronic HBV carriers and patients with hepatocellular carcinoma (HCC). Methods : DNA sequence coding for the antigenic a‐determinant of HBsAg was amplified from either HCC genomic DNA or serum samples of the selected patients and sequenced. The replicative mutant genomes were reconstituted in vitro and their reactivity to commercial kits measured. Results : Mutations within and/or outside the a‐determinant were identified in patients seronegative for HBsAg. They were then reconstituted in vitro and transiently transfected into HepG2 cells. Culture medium containing secreted HBV viral particles was collected and assayed for their binding to commercial kits. Drastic decrease of reactivity to these kits was seen with most of the identified mutations, including those located outside the a‐determinant. Conclusion : The existence of a more complex antigenic structure of HBsAg is indicated by the decreased reactivity to detection of mutations, some of which are outside the a‐determinant, escape vaccination and may persist in seronegative patients. The high proportion of HBsAg mutants that are integrated in HCC genomes suggests a role of these mutants in hepatocarcinogenesis, possibly leading to mutant HBV‐related HCC. © 2002 Blackwell Publishing Asia Pty Ltd     

Primary study on correlation between β2-adrenoceptor haplotypes and asthma in children of Han nationality in Chongqing

Objective: To investigate the correlation between β2-adrenergic receptors (β2-AR) haplotypes and asthma of Hah nationality children in Chongqing region. Methods: PCR and restriction fragment analysis were used to study 16, 27loci of the β2-AR polymorphism in 76 unrelated asthmatic children and in 100 healthy children and adults of Han nationality as control. A statistical analysis of the correlation between glycine (Gly)16 allele, Gly16/glutamine (Gln)27 haplotype and asthmatic clinical status was carried out. Results: There was no significant increase of the frequency of Gly16 and Gln27 allele in the asthmatic group as compared with the control group (P＞0.05). There was a significant increase of the frequency of Gly16 allele and Gly16/Gln27 haplotype in severe asthmatic cases than in the mild and moderate asthmatic ones (P＜0.01, 0.05). Conclusion: It is considered that asthma is not caused by Gly and Gln alleles ofβ2-AR polymorphisms. Glyl6 allele and Gly16/Gln27 haplotype are possibly correlated with the severity of the clinical manifestations in the children of Han nationality in Chongqing.     

心脏周围组织内心电场传播的衰减

目的 查明心电传播的衰减是否满足与距离的平方呈反比的关系。方法 采用头胸导联,电极从第4肋间隙穿刺胸腔,记录35只成年新西兰兔胸腔内不同方位、与心脏不同距离的测试点心电图,比较同一测试点记录的心电图R(r)波振幅与理论计算值之间的差异。结果 所有测试方向上记录的R(r)波振幅随距离延长而递减,但幅度远小于随距离平方递减的幅度（P<0.05）。结论 心脏周围组织对心电场的衰减幅度不满足容积导体的V=E×cosΘ/r2。     

粉刺消口服液治疗寻常痤疮的临床研究

目的 观察自行研制的粉刺消口服液对青少年发病率较高的丘疹型和脓疱型寻常痤疮的治疗作用。方法 将10余味中草药进行加工提取,制成口服液。30ml/次,2次／d口服。治疗丘疹型和脓疱型等典型寻常痤疮,25d为1疗程,连续服用2疗程统计疗效。结果 106例自愿受试者中,治愈59例（55．6％）;显效25例（23．6％）;有效16例（15．1％）;无效6例（5．7％）。结论 粉刺消口服液对丘疹型和脓疱型寻常痤疮有较高疗效。     

苦参碱对豚鼠心室肌细胞胞浆〔Ca~(2 )〕_i的影响

目的　研究中药苦参碱对豚鼠心室肌细胞胞浆钙的影响。方法应用激光扫描共聚焦显微技术动态测量单个豚鼠心室肌细胞胞浆钙的浓度。结果在细胞外钙浓度为１．８ｍｍｏｌ／Ｌ时,１～１００μｍｏｌ／Ｌ苦参碱可使细胞内钙离子浓度（〔Ｃａ２＋〕ｉ）呈剂量依赖性增高后下降;而在细胞外无钙的情况下细胞内钙不增高,且低于空白对照组的细胞内钙浓度（Ｐ＜０．０１）。结论苦参碱剂量依赖性促进外钙内流,但不具有促进内钙释放的作用,同时当细胞内钙增高后又可以使〔Ｃａ２＋〕ｉ下降。     

关节镜治疗婴幼儿化脓性膝关节炎的疗效分析

目的 探讨关节镜治疗婴幼儿化脓性膝关节炎的疗效。方法 回顾性分析2016年2月至2020年3月我院小儿骨科收治的16例婴幼儿化脓性膝关节炎的临床资料,患儿入院即给予足量敏感抗生素治疗,择期采用直径2.7 mm关节镜系统行膝关节清创术,其中10例术后留置冲洗引流、6例未行引流。记录患儿体温、儿童疼痛行为量表（FLACC）评分、应用躁动评分（SAS）、MRI髌上囊积液最大宽度及白细胞计数（WBC）、中性粒细胞计数（NEUT）、红细胞沉降率（ESR）、C-反应蛋白（CRP）及降钙素原（PCT）等感染指标。结果 所有患儿均获得随访,随访时间为（38.44±11.44）个月（23~63）个月。术后体温［（36.86±0.22） ℃］、FLACC评分［（2.19±0.91）分］、SAS评分［（1.25±0.45）分］、MRI髌上囊积液最大宽度［（4.88±1.67） mm］、WBC［（7.45±2.01）10⁹/L］、NEUT［（3.86±1.18）10⁹/L］、ESR［（14.81±4.00） mm/h］、CRP［（14.75±5.90） mg/L］及PCT［（0.04±0.02） ng/mL］均低于术前（P＜0.05）。但引流组与未引流组体温、FLACC评分、SAS评分、MRI髌上囊积液最大宽度及WBC、NEUT、ESR、CRP及PCT的差异无统计学意义（P＞0.05）。末次随访时患儿两侧膝关节活动度比较,差异无统计学意义（P＞0.05）,未见膝关节内外翻畸形或下肢短缩等并发症。结论 采用直径2.7 mm的关节镜系统治疗婴幼儿化脓性膝关节炎,可以有效显露和清理脓性组织,增加感染治愈率,避免切开引流造成的继发损伤。     

儿童肾恶性横纹肌样瘤CT表现

目的 观察儿童肾恶性横纹肌样瘤（MRTK）的CT表现。方法 回顾性分析经病理证实的19例MRTK患儿,观察其CT表现。结果 19例MRTK中,11例以血尿为主诉就诊;病变位于左肾10例、右肾9例,均为单发病灶,位置多邻近肾门,最大径4.53~15.32 cm,平均（8.42±2.77） cm;其中11例呈类圆形,8例为不规则形;12例边缘呈分叶状,7例边缘基本光滑;13例边界不清,6例边界清楚;CT平扫呈混杂密度肿块,增强后肿瘤实性部分强化程度低于正常肾实质,内见多发坏死囊变;其中14例见较明显的偏心性囊变,囊实性交界区多模糊不清;12例瘤体内见出血,5例见细线状或砂砾状钙化;10例肾周包膜下积液/血,6例肾包膜增厚;9例侵犯肾盂或肾窦。术后病理提示9例侵犯肾包膜,4例淋巴结转移;免疫组织化学染色19例整合酶相互作用蛋白1（INI-1）均（－）。结论 儿童MRTK的CT表现具有一定特征性,有助于诊断。     

医疗卫生服务供给侧结构性改革的内涵与基本路径[]*

在人民群众美好生活需要与发展不平衡、不充分的矛盾背景下,推进医疗卫生服务供给侧结构性改革是满足人民群众美好健康生活需要的客观要求。推进医疗卫生服务供给侧结构性改革的根本任务是转变发展理念,优化医疗卫生资源配置、延伸医疗卫生服务链条、促进要素的高水平融合,实现高质量发展需要。     

紫花松果菊亲脂性成分的研究

目的 :分离紫花松果菊的化学成分。方法 :溶剂法和色谱法分离化学成分 ,波谱鉴定其结构。结果 :从地上部分得到 3个化合物 ,1β,6α-二羟基-4(14)桉叶烯(1) ,二十四酸 (4),二十六醇 (5) ;1个混合物 ,(2E ,4E ,8Z ,10E) 异丁基 2 ,4,8,10 十二四烯酰胺 (2 ) ,(2E ,4E ,8Z ,10Z) 异丁基 2 ,4,8,10 十二四烯酰胺 (3)。结论 :化合物1,4和 5为首次从该植物获得。