软组织侧貌修复过程中拔牙与非拔牙矫治影响的Meta分析

目的：分析面部软组织侧貌修复过程中拔牙与非拔牙矫治的影响效应。 方法：以正畸矫治，拔牙矫治，软组织侧貌，orthodontics, corrective， tooth extraction，soft tissue profile为检索关键词，应用计算机检索近10年中国期刊网全文数据库、万方数据库、中文科技期刊全文数据库、CBM文章库、Medline(ovid)、 Science direct 以及手工检索并辅以文章追溯的方法收集国内、国外学者10年内公开发表的有关拔牙与非拔牙矫治软组织侧貌比较的文献。运用meta分析技术对拔牙与非拔牙矫治前后上下唇与审美平面及软组织平面的距离进行综合定量分析，根据资料异质性检验，采用固定效应模型及随机效应模型，计算合并加权均数差及其95%CI。使用Revman 5.0进行数据处理。 结果：共纳入文献5篇，共纳入患者356例。资料异质性检验显示，下唇与审美平面及软组织平面距离变化的异质性检验I2<50%，没有异质性，采用固定效应模型。上唇与审美平面及软组织平面距离>50%，具有异质性，采用随机效应模型。Meta分析结果显示，除上唇与审美平面距离外，上唇与软组织平面、下唇与审美平面及软组织平面距离合并加权均数差及95%CI均具有显著性意义。 结论：拔牙矫治明显减小了下唇与审美平面、软组织平面的距离以及上唇与软组织平面的距离。     

临界病例拔牙与不拔牙矫治对牙颌面硬组织结构的影响

目的:比较拔牙或不拔牙矫治对临界病例牙颌面硬组织结构变化的影响.方法:以5位正畸专家临床判断出的33个临界病例为样本,在头颅定位侧位片上测量上述病例治疗前后牙颌面硬组织的变化,再根据这33名患者实际接受的拔牙还是不拔牙、以及拔第一双尖牙还是拔第二双尖牙治疗进行分组.33例中有12例采用了不拔牙治疗,13例采用了拔4个第一双尖牙治疗,8例采用了拔4个第二双尖牙治疗.用头影测量学上常用的20项硬组织测量项目进行分析比较.结果:临界病例拔牙组与临界病例不拔牙组在治疗前的牙颌面硬组织结构没有统计学意义的差别;拔第一双尖牙组的前颅底平面-下牙槽座点角(SNB角)比拔第二双尖牙组的SNB角小(4.0±1.3)°(P<0.01);治疗后拔牙组与不拔牙组以及拔第一双尖牙组与拔第二双尖牙组之间的差别主要为牙位改变.结论:临界病例很难通过常规头影测量来区分是否需要拔牙治疗;这两种治疗方案的差别主要表现为前牙矢状方向突度及倾斜度的变化,而颌骨位置关系及垂直方向上下颌、牙合、颅底平面角没有显著性差别;与拔第一双尖牙相比,拔第二双尖牙可以较好的保持上切牙的唇倾度不减小,且拔第二双尖牙对牙颌面结构的影响效果与不拔牙治疗相近,但拔第一双尖牙可以明显减小上下前牙的突度和倾斜度.     

正畸治疗后满意病例牙齿转矩角的三维测量研究

目的 :研究不同错牙合分类病例矫治满意后 ,牙齿转矩与自然正常牙合的差异 ,为临床上牙齿转矩的调整提供参考。方法 :选择正畸治疗后满意病例 15 7例 ,用YM 2 115型三维测量仪对治疗后模型进行牙齿转矩测量 ,与自然正常牙合的相应数据进行比较分析。结果 :安氏Ⅰ类错牙合矫治后满意病例上下切牙转矩最接近自然正常牙合 ,上中切牙、侧切牙的转矩分别为 9.6°和 8.7°;下中切牙、侧切牙转矩分别为 1.1°和 - 1.1°。安氏Ⅱ类错牙合矫治后满意病例上切牙的转矩与正常牙合无明显差异 ,而下切牙转矩明显较为唇倾 ,为 5 .6°和 2 .1°。安氏Ⅲ类的差异更为明显 ,上切牙唇倾达 15 .2°和 12 .1° ;下切牙舌倾达 - 3.7°和 - 4 .9°。结论 :要想通过正畸方法矫治安氏Ⅱ类和Ⅲ类错牙合达到正常的覆牙合覆盖 ,上下切牙的转矩必须做出适当的调整以作补偿     

Evidence for a role of corrective eye movements during gaze fixation in saccade planning

In a three‐dimensional (3D) world most saccades are made towards visual targets that are located at different distances. We previously demonstrated that gaze shifts within 3D space consist of two stages: a target saccade followed by a corrective saccade during gaze fixation that directs the eyes to the physical target location. We proposed that, by accurately positioning the eyes on the visual object, the visual system maintains an orderly representation of the visual world. In this study we used a double saccade experiment to assess the function of corrective saccades in humans. We found that, when a corrective eye movement occurred during fixation on the first target point, the direction of the second saccade towards the next target point was accurate. When a corrective saccade was absent, a directional error of the second target saccade was observed. This finding, which cannot be explained by current models of eye movement control, supports the idea of a two‐step model in saccade programming. We suggest that the motor system sends a corollary discharge when programming a corrective saccade for maintaining an orderly representation of the visual world. In conclusion, our results indicate that corrective saccades have a role in programming target saccades within 3D space.     

Corrective Experiences of Psychotherapists in Training

Although the concept of corrective experiences (CEs) is usually linked to the process of change in psychotherapy patients, we investigated them in the professional development of therapists‐in‐training. Inasmuch as psychotherapy is a relational process, it is important to look closely at how therapists reach the position of a competent partner in corrective experiencing. In this study, we interviewed 10 therapists‐in‐training undergoing their own training therapy. Responses to these semistructured interviews were analyzed using a computer‐assisted grounded theory method. The 499 first‐level categories were grouped into 5 main themes: therapist characteristics, therapist technical interventions, therapist relational interventions, relationship experience, and outcome experience. Two core categories representing corrective experiencing were (a) unexpected unconditional support from and trust in their own therapist and (b) unexpected confrontation and limitation with their therapist as well as awareness of self–other boundaries. Results are discussed in the broader context of the CE literature, relational theory, and relational practice.     

不同方法矫治成人正畸患者的效果比较

目的:探讨成年口腔正畸患者不同正畸方法的效果。方法:随机选取2005年10月～2010年10月在我院口腔科568例成年口腔正畸治疗患者,根据正畸方法不同随机分为3组,A组190例患者采用方丝弓矫治器矫正;B组189例患者采用双弓丝矫治器;C组189例患者采用磁性托槽,对3种方法的效果进行比较。结果:A组优良16例,有效146例,总有效率为85.26%,B组优良13例,有效141例,总有效率为81.48%,C组优良13例,有效140例,总有效率为80.95%,A组总有效率略高于B组与C组,但差异无显著性,无统计学意义P>0.05。结论:方丝弓矫治器由于其施力稳定、持久,可作为成人口腔正畸的首选。     

牙槽性上颌前突伴牙列拥挤的外科正畸

目的：研究牙槽性上颌前突伴牙列拥挤牙错位、扭转的手术矫正。方法：选择３５例此类畸形的大龄青年，运用上颌前分截骨矫正的理论，结合单个牙外科正畸的方法并加以改进强调术中应 特别注意对唇侧膜蒂的保护。结果；全部病例伤口愈合良好，无骨不连，骨坏死发生，牙齿无松动。结论：这种手术方法使上颌前突伴牙列拥挤的大龄青年在短期内恢复正常的牙弓形状和咬Ｈｅ关系，面容得到明显的改善。     

Coronary artery changes 3 years after reimplantation of an anomalous right coronary artery

In this paper we report the sequelae of a patient with an anomalousright coronary artery (RCA)originating from the pulmonary artery(PA) in association with a normal heart, operated upon at theage of 13 years. Three years after the end-to-side reimplantationof the RCA, with a rim of thePA, into the aorta, the surgicalresult has been evaluated by cineangiography. Before operationboth coronary arteries were tortuous and increased in size.Afterwards the left coronary artery showed a normalized calibre,although the RCA remained tortuous with no decrease of the internaldiameter. The notable postoperative changes in shape and sizeof the LCA may be due to the disappearanceof the steal phenomenon.The lack of involutive changes in the RCA could be explainedby its thinner wall. Left ventricular wall motion, evaluatedunder resting conditions and during an atrial pacing stresstest, was found to be normal.     

北京地区中国人颅面网格正常图的建立及网格分析法的初步应用

目的 建立北京地区中国人网格正常图和网格分析系统及其初步临床应用。方法 北京地区正常He个体28人，分别在13及18岁拍摄头颅侧位X线片，应用近似Moorrees的方法建立个人网格图。经统计计算，分别得到代表两年龄段男女性的网格正常图，建立计算机化网格分析系统。结果 建立了北京地区中国人13与18岁男女性的网格正常图，进行了网格分析系统的初步临床应用。结论 网格分析法是一种比例分析方法，其结果直观、简捷、整体化，对其他角度、线距等头影测量方法是有益的补充和适当的校正，在口腔正畸及正颌外科临床中有一定参考价值。