龈沟液的量与牙周组织炎症的关系

对100例牙周炎及40例牙龈炎患者的龈沟液量进行测定，并以64例正常人为对照，结果正常人男女性别间及上下颌、左右侧牙齿的龈沟液量无显著差异，但龈沟液量与牙周组织的炎症密切相关，并且其流量与炎症状况及骨破坏程度有关，提示龈沟液流量可作为检测牙周组织炎症活动期的客观指标。     

Study of resistance performance of Al2O3–ZnO–Y2O3 thermal control coating exposed to vacuum-ultraviolet irradiation

As deep space exploration moves farther and farther away, thermal control coating of the in-orbit spacecraft will suffer a serious vacuum-ultraviolet radiation environment, which seriously threatens the reliability of the spacecraft in orbit. Therefore, it is important to improve the vacuum-ultraviolet resistance performance of the thermal control coating. In this work, the inorganic Al₂O₃–ZnO–Y₂O₃ thermal control coating was in situ fabricated on a 6061 aluminum alloy surface by PEO technology, and its vacuum-ultraviolet resistance performance was investigated. The results show that the Al₂O₃–ZnO–Y₂O₃ thermal control coating has a good resistance performance to vacuum-ultraviolet radiation, which is mainly because the large extinction coefficients of the ZnO and Y₂O₃ materials in the ultraviolet band are conducive to improving the ultraviolet resistance performance. Furthermore, the life prediction model of the Al₂O₃–ZnO–Y₂O₃ thermal control coating shows that its Δα_s value first slightly increases and then tends to be stable with the increase of ultraviolet irradiation time from 0 ESH to 25 000 ESH, and the maximum variation of Δα_s is about 0.0536. This work provides a material basis and technical support for the thermal control system of spacecraft with long life and high reliability.

The Al₂O₃–ZnO–Y₂O₃ thermal control coating in situ fabricated by PEO technology, shows a good resistance performance to vacuum-ultraviolet radiation. Further, its life prediction model at vacuum-ultraviolet irradiation is preliminarily established.     

腰椎滑脱症外科治疗策略选择

目的探讨不同类型腰椎滑脱症及合并症的手术治疗方式、疗效及优缺点。方法2000年2月～2004年4月应用后路椎弓根螺钉复位内固定后，分别采用后外侧植骨融合术、后路椎体间植骨融合术及前路椎体问植骨融合术治疗不同类型腰椎滑脱症及合并症的患者78例，比较术后及随访时疗效、滑脱椎体复位率、椎间隙高度恢复率、植骨融合率以及复位丢失率。结果术后28例Ⅰ度滑脱及37例Ⅱ度腰椎滑脱患者获得解剖复位．9例Ⅱ度滑脱及4例Ⅲ度腰椎滑脱患者矫正至Ⅰ度滑脱。随访时总体优良率为89．72％，42例椎体间植骨患者植骨融合良好，滑脱椎体复位无丢失，椎间隙高度维持良好；36例后外侧植骨者有12例复位丢失，2例椎弓根螺钉松动，2枚椎弓根螺钉断裂：结论对小于Ⅱ度退变性腰椎滑脱合并腰椎管狭窄者宜选用后路椎弓根钉复位固定加后外侧植骨融合术；对峡部裂性腰椎滑脱合并腰椎管狭窄者宜选用后路椎弓根钉固定加椎体间植骨融合术；对Ⅱ度以上峡部裂性单纯腰椎滑脱者以及腰椎滑脱翻修者宜选用后路椎弓根钉固定加前路椎体间植骨融合术。     

门静脉、肠系膜上静脉的解剖与临床应用的初步研究

目的 为提高肝门胆管癌和壶腹周围癌的手术切除率,使该区域受肿瘤浸润的血管能同时切除,血管直接重建提供解剖学依据.方法 在实施肝门胆管癌切除术及胰十二指肠切除术中,对病人的肝蒂内门静脉干、胰腺钩突内的肠系膜上静脉干进行解剖学定位并分段测量长度及可以纵向折叠的长度,以此估计可切除的静脉长度及重新再建血管的长度.结果 测量肝蒂内门静脉干104例,男性(5.8±1.99)cm,女性(5.5±O.81)cm,优势长度大于4.5cm者,男性56例占76.7%,女性25例占80.6%.胰腺钩突内段肠系膜上静脉干测量54例,男性(3.7±0.77)cm,女性(3.5±0.64)cm,优势长度大于3.0cm者,男性28例占77.6%,女性14例占77.8%.门静脉纵向折叠移动的范围在1.8～4.2cm,平均折叠2.2(1.8～2.4)cm者占66.3%,平均折叠2.8(2.5～4.2)cm者占33.7%.切除胰十二指肠后胰腺钩突内肠系膜上静脉段纵向折叠范围平均4.0cm,最长达5.2cm.结论 肝门胆管癌和壶腹周围癌切除术合并受浸血管切除在一定范围是可行的.     

决策树分析在医学信息管理教学实践中的应用

决策树法为卫生管理者提供了一个有价值的作决策的工具,它是用树状图法来描述各种方案在不同情况下的收益,据此计算每种方案的期望收益从而作出决策的方法,是较常用的风险型决策法.应用决策树分析法构建我校信息管理专业课及专业基础课的教学方案,得出了外校和本校教师相结合进行教学的办法是可行的方案的结论.     

中西药结合治疗输卵管妊娠的疗效分析

目的探讨中西药结合治疗输卵管妊娠的临床效果。方法56例未破裂型输卵管妊娠患者,将其分成两组,中西药结合组40例给予甲氨喋呤(MTX)多次静脉注射,次日加四氢叶酸钙解毒,并辅以具有灭胚胎及活血化瘀作用的中药治疗。对照组16例,MTX多次静脉注射,次日加四氢叶酸钙解毒。治疗后定期检查血-βHCG及B超,注意患者的腹痛、阴道流血、腹泻、肛门坠胀感、黑色大便等及生命体征情况。结果中西药结合组38例治愈,治愈率95.00%,血-βHCG平均3.6 d开始下降,18.7 d下降为正常,47.5%呈现一过性上升;再次异位妊娠率2.5%;副反应发生率30.00%。对照组15例治愈,治愈率93.75%,血HCG平均9.9d开始下降,28.9 d下降为正常。两组相比,治愈率无显著性差异,血-βHCG下降时间和速度均有显著性差异(P<0.05)。结论符合保守治疗条件的输卵管妊娠患者采用中西药结合治疗效果良好,疗程缩短。     

Combination of CRAFITY score with Alpha-fetoprotein response predicts a favorable outcome of atezolizumab plus bevacizumab for unresectable hepatocellular carcinoma

Immune checkpoint inhibitors (ICIs) with atezolizumab plus bevacizumab are promising agents for unresectable hepatocellular carcinoma (HCC). We tried to guide the treatment based on recent developed CRAFITY score combining with on-treatment AFP response. Eighty-nine patients who received atezolizumab plus bevacizumab regardless of as a first-line therapy or not for unresectable HCC were enrolled for analyses. Radiologic evaluation was based on modified Response Evaluation Criteria in Solid Tumors (mRECIST). The objective response rate (ORR) and disease control rate (DCR) were 25.0% and 65.5%, respectively. Multivariate analysis showed that low CRAFITY score (AFP<100 ng/ml or CRP<10 mg/l) and satisfactory AFP response at 6 weeks (≥75% decrease or ≤10% increase from baseline) were independent factors determining good overall survival (OS) (hazard ratio [HR]=0.143, P=0.002 & HR=0.337, P=0.031), progression-free survival (PFS) (HR=0.419, P=0.022 & HR=0.429, P=0.025) and good responder (odds ratio [OR]=1.763, P=0.044 & OR=3.881, P=0.011). Patients were further divided into three classes by combination of CRAFITY score and AFP response at 6 weeks [The CAR (CRAFITY score and AFP-Response) classification)]: low CRAFITY score with satisfactory AFP response at 6 weeks (class I), either high CRAFITY score or unsatisfactory AFP response at 6 weeks (class II) and high CRAFITY score together with unsatisfactory AFP response at 6 weeks (class III). ORR was 35.0%, 18.2%, and 0% in class I, II and III patients, respectively (overall P=0.034). Patients in the class I had the best OS and PFS, followed by class II and class III (median OS: not reached vs. 11.1 vs. 4.3 months, log-rank P<0.001; median PFS: 7.9 vs. 6.6 vs. 2.6 months, log-rank P=0.001). Combination CRAFITY score and AFP response at 6 weeks with AUROC predicts OS and tumor response to be 0.809 and 0.798, respectively, better than either CRAFITY score (0.771 & 0.750) or AFP response at 6 weeks (0.725 & 0.680) alone. In conclusions, the CAR classification which combining CRAFITY score and AFP response at 6 weeks provides a practical guidance for atezolizumab plus bevacizumab therapy in unresectable HCC patients.     

阴道碘氧治疗细菌性阴道病疗效观察

目的探讨阴道碘氧消毒法加阴道后穹隆置甲硝唑治疗细菌性阴道病的价值与安全性。方法将符合细菌性阴道病诊断标准的100例病人,分为观察组和对照组两组。观察组给予阴道碘氧消毒法加阴道后穹隆置甲硝唑;对照组给予甲硝唑口服加阴道后穹隆置甲硝唑。两组均于用药1疗程后,及停药后2周、3个月复诊,判断疗效及复发情况。结果观察组总有效率为98.1%,对照组为95.8%,两组相比无显著差异(P>0.05);停药2周和3个月的复发率观察组为9.6%与23.1%。对照组为29.2%与37.5%,两组相比,差异均非常显著(P<0.01)。结论阴道碘氧消毒法加阴道后穹隆置甲硝唑治疗细菌性阴道病疗效可靠,复发率低,且安全。