福建地区汉族人群对微笑美学参数喜好度的研究

目的    探讨微笑美学参数的改变对微笑美的影响,并研究福建地区汉族人群对微笑美学参数的喜好度,为临床诊疗提供参考。方法　选取1张美观协调的志愿者（福建医科大学口腔医学院本科生）微笑图像作为模板图像,通过调整颊隙率、侧切牙与中切牙宽度比值、上中切牙宽长比例和牙龈暴露量等微笑美学参数对模板图像进行修改,获得24张微笑图像,作为调查资料。选择2019年3—9月于福建医科大学附属口腔医院就诊的成年患者158例［男75例、女83例,年龄（29.8 ± 5.5）岁］作为调查对象,对24张微笑图像进行视觉模拟评分（visual analogue scale,VAS）,并对所获VAS评分进行Kruskal-Wallis检验和Mann-Whitney检验。结果　颊隙率为0 ~ 15%、侧切牙与中切牙宽度比值为62% ~ 87%、上中切牙宽长比例为80% ~ 95%,以及牙龈暴露量为-1 ~ 1 mm时,其VAS评分在相应微笑美学参数中相对较高（均P < 0.05）。结论    颊隙率、侧切牙与中切牙宽度比值、上中切牙宽长比例以及牙龈暴露量均可对微笑美产生显著影响。     

多学科综合治疗挽救重度牙周炎患牙的临床观察（附1例5年随访报告）

重度牙周炎患者多存在深牙周袋及严重牙槽骨吸收的患牙,常判定为“预后无望”,而此类患牙的临床处置一直以来都面临挑战。此外,伴牙列缺损及错牙合畸形的重度牙周炎患者临床中常需要应用多学科综合治疗,以达到牙周健康、恢复功能、改善美观的目标。文章完整展示1例应用牙周-正畸-种植修复综合治疗的重度牙周炎病例,挽救重度牙周炎患牙,并获得稳定的治疗效果,为临床诊疗此类问题积累经验。     

自噬对高胆固醇饮食大鼠下颌骨结构改变的影响研究

目的    探讨自噬对高胆固醇饮食大鼠下颌骨结构改变的影响及辛伐他汀的治疗效果。方法　将30只SD大鼠随机分为正常饮食组（NC组）10只、高胆固醇组20只;喂养24周后,高胆固醇组再随机分成两组,每组10只,一组继续喂养高胆固醇饲料（HC组）,另一组在高胆固醇饲料中加入5 mg/kg辛伐他汀（HC+SIM组）。喂养32周后,取大鼠空腹血进行生化检测;处死大鼠后对下颌骨进行骨组织形态分析;实时荧光定量PCR（qRT-PCR）及免疫组织化学染色检测各组自噬相关基因Lc3及p62的mRNA和蛋白表达水平。结果　（1）3组总胆固醇和低密度脂蛋白水平总的比较,差异均有统计学意义（F值分别为21.539、16.596,均P < 0.05）;其中NC组和HC+SIM组总胆固醇和低密度脂蛋白水平均低于HC组（均P < 0.05）,而NC组和HC+SIM组组间比较,差异无统计学意义（P > 0.05）。（2）与NC组比较,HC组大鼠骨体积分数、骨小梁厚度、骨小梁数目明显下降,而骨小梁间隔增加,Lc3及p62 mRNA表达水平明显升高,差异均有统计学意义（均P < 0.05）;与HC组比较,HC+SIM组骨体积分数、骨小梁厚度、骨小梁数目均明显升高,骨小梁间隔减小,p62 mRNA和蛋白表达水平明显下降,差异均有统计学意义（均P < 0.05）;而NC组和HC+SIM组这些指标组间比较,差异均无统计学意义（均P > 0.05）。结论    自噬可能参与调控高胆固醇饮食大鼠下颌骨结构的改变,辛伐他汀能够改善高胆固醇饮食导致的大鼠下颌骨微结构的破坏     

颌骨囊肿术后骨形成的影像学评估

手术是颌骨囊肿的主要治疗方法。囊肿刮除术、开窗减压术（袋形术）在临床上广泛应用。术后采用影像学方法观察骨腔的愈合或囊腔的缩小,是术后疗效评估及开窗减压术后选择二期囊肿刮除术时机的必要措施。由于不同的手术方式,上、下颌骨结构的差别,病变类型、大小以及患者年龄等差异,可能影响囊肿术后骨沉积的速率与结果。文章结合文献和笔者的经验,就颌骨囊肿术后骨形成的影像特点与相关因素做一概述。     

家长陪同对口腔门诊患儿七氟烷全身麻醉苏醒期躁动的影响研究

目的　研究家长陪同对口腔门诊患儿七氟烷全身麻醉苏醒期躁动的影响。方法　选取2017年6—12月于重庆医科大学附属口腔医院行七氟烷全身麻醉口腔治疗患儿120例,随机分为陪同组和未陪同组,每组60例。陪同组患儿在治疗前麻醉诱导期及治疗后苏醒期均有家长陪同,未陪同组患儿在麻醉诱导期及苏醒期均无家长陪同。采用小儿麻醉苏醒期躁动量化评分表（pediatric anesthesia emergence delirium scale,PAED）对患儿麻醉苏醒期躁动情况进行评分,并计算躁动发生率。结果　陪同组PAED评分为（9.18 ± 3.41）分,未陪同组PAED评分为（10.57 ± 3.62）分,两组PAED评分比较,差异有统计学意义（t = 2.04,P = 0.03）。陪同组躁动发生率（26.67%）明显低于非陪同组（50.00%）,差异有统计学意义（χ2 = 6.91,P = 0.01）。结论　治疗前麻醉诱导期及治疗后苏醒期有家长陪同,可减少患儿躁动的发生,提高家长对口腔治疗的满意度,促进良好的医患关系。     

下前牙区即刻种植同期引导骨再生结合帐篷式植骨术实施种植修复临床观察（附1例报告）

随着生活水平及治疗技术的提高,种植修复成为越来越多患者的选择。良好的牙槽嵴和牙龈解剖形态的保存或重建是修复体获得满意美学效果和长期稳定性的先决条件。下前牙是牙周炎的好发牙位,下前牙松动脱落伴随下颌骨的吸收势必会造成软硬组织缺陷。文章完整展示了1例罹患重度牙周病变的下前牙即刻种植、同期引导骨再生结合帐篷式植骨术创造良好硬组织三维条件,获得最终较好种植修复效果的具体实施步骤,积累了针对此类问题的临床经验。     

22-j?hriger Sportler mit Sinusarrest und Pausen bis 7?Sekunden

A 22-year-old athlete with nocturnal asymptomatic episodes of transient sinus arrest/sinoatrial block up to 7.3?s and recurrent inappropriate sinus tachycardias which had been incidentally found during Holter electrocardiography diagnostics is presented. In spite of extensive diagnostic work-up including invasive procedures like coronary angiography and electrophysiological study, no causal etiology was found. Based on the normal findings and the lack of symptoms, we decided not to implant a permanent pacemaker. After 14?months, the patient is still asymptomatic. Howerver, the 24-h Holter electrocardiography shows unchanged frequency of nocturnal transient sinus arrest episodes.     

��ͯ����ϸ���԰�����4���ٴ�����

??Objective??To investigate the clinical features??diagnosis??treatment and prognosis of eosinophilic cystitis in pediatric population. Methods??The records of four patients who had been diagnosed and treated for eosinophilic cystitis from January 2012 to May 2015 in Shengjing Hospital were retrospectively reviewed. Results??All the four patients were boys whose age ranged from 6 to 8 years. The main symptoms of the 4 cases were frequent micturition??odynuria??dysuria??suprapubic pain and hematuria.All of the 4 cases had significant peripheral eosinophilia and increased bladder wall thickness. All of the patients were diagnosed with biopsy. Bladder interstitial eosinophil infiltration was revealed by histopathology. The clinical symptoms??peripheral eosinophilia and bladder imaging changes were relieved after steroids and antihistamines treatment. Three cases developed recurrence. Total course of oral corticosteroids ranged from 3 months to 18 months. One case remained persistent remission for 2 years??two cases had are recurrence and one case had two recurrences. Conclusion??Bladder biopsy is essential to establishing the diagnosis of eosinophilic cystitis. Patients with peripheral eosinophilia and the increased bladder wall thickness should be considered with eosinophilic cystitis. Steroids is effective as medical therapy for eosinophilic cystitis and close long-term follow-up is necessary.     

��ͯ����������ϸ���ۺ���13���ٴ�����

??Objective To investigate the clinical characteristics and treatment of hypereosinophilic syndrome??HES?? in children. Methods The clinical manifestations?? laboratory examinations??gastroscopy and imaging features??pathological results and therapy experience in 13 HES children admitted in Beijing Children’s Hospital??Capital Medical University from January 2009 to February 2016 and related literatures were analyzed retrospectively. Results Of the 13 patients evaluated?? 7 were male??54%?? and 6 were female??46%??. The median age at diagnosis was 9.6 years old??ranging 3 to 14 years old??. The median course of disease was 23 months??ranging 1 to 72 months??. The peripheral eosionophil counts ranged ??4.5—29.2??×109/L??mean 13.5×109/L??. Gastrointestinal tract was the most commonly involved organ?? and was reported in 92%??12/13?? of patients. It was followed in frequency by urinary system??84%????pulmonary??53%????cardiac??23%????and skin??8%?? and liver??8%??. A total of 2 sites were involved in 6 patients??3 sites were involved in 5 patients and 4 sites were involved in 2 patients. Treatment of oral prednisone therapy was given and follow-up of 10 patients had no clinical symptoms??2 patients had stopped prednisone??. But eosionophil counts still increased to varying degrees. Three patients were lost to follow-up. Conclusion HES in children is more common in school age and adolescent children. Gastrointestinal tract??urinary system and pulmonary involvement are more common. Glucocorticoid treatment is effective??which requires to be maintained in small dose in the long term.     

复发性急性胰腺炎42例CT及病因分析

目的通过对复发性急性胰腺炎（RAP）患者CT表现及病因分析,探讨影响急性胰腺炎（AP）复发的病因,减少RAP发生。方法对42例RAP患者的CT表现及病因进行分析。结果 RAP主要病因为胆源性31例、高脂血症合并脂肪肝12例、酒精性7例。CT表现均见胰腺局部或弥漫性增大,边界模糊。16例可见小网膜囊积液混浊,肾前筋膜增厚;8例伴胰腺假性囊肿;伴胆石症14例、胆囊炎17例、胆管扩张6例。结论对于RAP患者,胰腺CT是诊断急性胰腺炎的金标准。积极彻底治疗胆道系统疾病,控制血脂水平、戒酒可降低RAP的复发。胆囊切除不能很好地防止AP的复发。