电动牙刷加速正畸牙齿移动的临床研究

目的探讨电动牙刷加速正畸牙齿移动的临床效果。方法选择30例需要拔除两侧上颌第一双尖牙的患者．进行配对实验。患者均采用MBT直丝弓矫正器,以150g拉力将尖牙向远中移动。左侧（实验侧）每日使用电动牙刷刷洗左侧上颌牙列2次,每次10min。而右侧（正常侧）则不采用电动牙刷刷洗。观察28d,分别测定记录尖牙移动距离．牙周状况和牙体长度。结果实验第7、14、21及28天使用电动牙刷侧尖牙移动距离分别为0．470、0．923、1．128及1．375mm,正常侧为0．361、0．784、0．944、1．149mm,两侧的差异有统计学意义（P〈0．05）。两侧尖牙牙周状况和牙体长度的差异无统计学意义（P〉0．05）。结论使用电动牙刷能够有效加速正畸牙齿的移动,对正畸移动牙齿牙周和牙体长度没有影响。     

骨皮质切开加速正畸牙齿移动对牙根吸收的影响

近年来,加速正畸牙齿移动的各种治疗方法受到广泛关注与研究,其中以牙周手术方法的临床应用较多,主要包括骨皮质切开术、牙周辅助加速成骨正畸技术(periodontally accelerated osteogenic orthodontics,PAOO)、超声骨刀骨皮质切开术和微型骨穿孔术(micro-osteoperforations,MOPs)[1].上述手术通过制造牙槽骨的创伤,激活局部加速现象(regional acceleratory phenomenon,RAP),不仅增加了局部组织灌注,加速了骨与牙周组织的更新,而且降低了骨密度,有利于牙槽骨内细胞招募,从而为加速牙齿移动创造良好的微环境[2].     

强迫症患者的整夜多导睡眠图监测

目的探讨强迫症(OCD)患者多导睡眠图(PSG)睡眠参数的变化特征。方法应用多导睡眠生理仪,采用眼电图和下颌肌电图及脑电图技术,对27例OCD患者的PSG进行整夜监测,并与33名正常受试者(NC)对照。结果OCD组快速眼运动(REM)睡眠潜伏期为(57.7±21.4)min,较NC组的(87.8±11.7)min明显前移(P<0.01)。OCD组患者的REM活动度、强度、密度以及第1阶段睡眠均较NC组明显增加,分别为(119.8±54.5)Uvs(80.7±9.2)U(P<0.01)、(27.8±13.4)%vs(17.8±2.3)%(P<0.01)、(147.4±69.2)%vs(95.7±8.1)%(P<0.05)、(19.9±11.4)%vs(9.1±1.9)%(P<0.01);而睡眠潜伏期延迟,睡眠效率降低。结论PSG中的REM活动度、强度和密度均增加,可能是强迫症患者的脑电生理学特点。     

Dr Emil Flusser: Forgotten precursor of the medical peace movement

In 1932 the Bohemian paediatrician Emil Flusser published a book in which he argued that war was the result of a psychic epidemic, and that its prevention was a task for the medical profession. Einstein supported Flusser by writing a foreword to the work. The burning of the book in 1933 by the Nazis was followed by that of the author and his family in 1942. Both events help to explain the total oblivion which has befallen this early proposal for a medical peace movement.     

Announcements

Rotating head-to-head agglutinates of human spermatozoa were always observed to turn counterclockwise. The phenomenon seems to suggest a unidirectional rotatory component in the tail movement that may be related to the substructure of the axoneme.     

An investigation into the predictive ability of rehabilitation clinicians

Purpose: There is increasing pressure by providers, purchasers and recipients of service within the United Kingdom for a more accurate prediction of rehabilitation outcomes. The purpose of this research was to investigate how accurately clinicians were predicting rehabilitation outcomes. Method: The study was carried out among 47 patients admitted to a general rehabilitation unit. The Functional Independence Measure and Functional Assessment Measure (FAM) were used as the outcome measure. Results: The results showed a statistically significant positive correlation between goal scores and discharge scores as a total population using Spearmans correlation co-efficient. When breaking the sample into an orthopaedic and CVA population, the predictive ability for the orthopaedic population was consistently higher than for the CVA population. Conclusions: The results of this study suggest that the predictive ability of clinicians is good for the rehabilitation population although the prediction is consistently better with the orthopaedic population than the CVA population.     

Spontaneous migration of bullet from arm to forearm and its ultrasound guided removal

Spontaneous migration of a retained bullet is rare. We are presenting here a case of a 24-year-old male with spontaneous migration of bullet from arm to forearm. At the time of initial injury, bullet was left inside the arm as it was deep and patient had no complaints. Three months after injury, he started complaining of pain over forearm and tingling sensations in the forearm and hand over median nerve distribution. Radiographs showed bullet in the proximal forearm. The bullet was than precisely localized and removed under ultrasound guidance. This case report emphasizes the fact that spontaneous migration of bullet in extremities may occur and have the potential to cause neurovascular damage. Removal under ultrasound guidance is a viable option in such locations.     

损毁室旁核对迷走神经抑制皮层诱发的下颌运动的影响

损毁家兔单、双侧室旁核，观察迷走神经对皮层诱发的下颌运动抑制性影响的变化，发现损毁单侧室旁核不影响刺激迷走神经中枢端对皮层诱发的下颌运动的抑制作用；损毁双侧室旁核，迷走神经对皮层诱发的下颌运动的抑制作用消失。     

强制性使用运动疗法对脑卒中偏瘫患者上肢使用能力的恢复作用

目的：观察强制性使用运动疗法对脑卒中偏瘫患者上肢使用能力和运动功能的康复疗效。 方法：恢复期脑卒中上肢偏瘫患者20例，随机分为强制性使用运动疗法组(简称CI组)10例，对照组10例，CI组进行强制性使用运动疗法，对照组进行反复作业疗法，每周5 d,每日连续3h，共治疗3周；治疗前、治疗后1周、治疗后6及12个月分别采用MAL指数评定法评定患侧肢体的使用能力，采用WMFT运动功能评定法评定患侧肢体运动功能。 结果：治疗后1周2组的MAL指数均高于治疗前（P<0.01）；CI组治疗后6及12个月的MAL指数较治疗前均显著提高（P<0.05或P<0.01），对照组治疗后6及12个月的MAL指数与治疗前比较差异均无显著性(P>0.05)；2组的WMFT分数在治疗前、治疗后1周及12个月均无明显变化(P>0.05)。 结论： 强制性使用运动疗法对脑卒中偏瘫患者的上肢使用能力有较好的康复疗效，但对运动功能改善不明显。     

Functional outcomes and complications after treatment of distal radius fracture in patients sixty years and over: A systematic review and network meta-analysis

AimThis network meta-analysis aims to compare functional outcomes and complications between conservative treatment and surgery for distal radius fractures in patients aged 60 years and over.MethodsWe searched the PubMed, EMBASE, and Web of Science databases for randomized controlled trials (RCTs) assessing the effect of conservative treatment and surgery for distal radius fractures in patients aged 60 years and over. Primary outcomes included grip strength and overall complications. Secondary outcomes included Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Patient-Rated Wrist Evaluation (PRWE) scores, wrist range of motion and forearm rotation, and radiographic assessment. All continuous outcomes were assessed using standardized mean differences (SMDs) with 95% confidence intervals (CIs), and binary outcomes were assessed using odds ratio (OR) with 95% CIs. The surface under the cumulative ranking curve (SUCRA) was used to determine a hierarchy of treatments. Cluster analysis was performed for grouping treatments based on the SUCRA values of primary outcomes.ResultsFourteen RCTs were included to compare conservative treatment, volar lockedplate (VLP), K-wires fixation, and external-fixation. VLP outperformed conservative treatment for 1-year and minimum 2-year grip strength (SMD; 0.28 [0.07 to 0.48] and 0.27 [0.02 to 0.53], respectively). VLP yielded the optimal grip strength at 1-year and minimum 2-year follow-up (SUCRA; 89.8% and 86.7%, respectively). In a subgroup analysis of patients aged 60 to 80 years old, VLP outperformed conservative treatment in DASH and PRWE scores (SMD, 0.33 [0.10, 0.56] and 0.23 [0.01, 0.45], respectively). In addition, VLP had the fewest complications (SUCRA = 84.3%). Cluster analysis suggested that VLP and K-wire fixation were more effective treatment groups.ConclusionEvidence to date demonstrates that VLP provides measurable benefits in grip strength and fewer complications to those 60 years of age and over, and that benefit is not reflected in current practice guidelines. There is a subgroup of patients where K-wire fixation outcomes are similar to those of VLP; defining this subgroup may yield substantial societal benefits.