上颌牙列及MBT直丝弓矫治器三维有限元模型的建立

目的建立上颌MBT直丝弓矫治器的三维有限元力学分析数学模型。方法利用多层螺旋CT扫描获得上颌牙列及上颌牙槽骨的原始数据,采用Matlab、CoreldrawI、mageware、UG、ANSYS软件相结合的方法,建立上颌牙列、牙周膜、牙槽骨、MBT直丝弓矫治器的三维实体和三维有限元模型。结果建立了上颌牙列及MBT直丝弓矫治器的三维实体和三维有限元模型。结论应用螺旋CT扫描结合多种软件建立了上颌牙列及MBT直丝弓矫治器的三维实体和三维有限元模型,方法便捷有效,模型仿真性好,为进一步分析MBT直丝弓矫治器的力学行为提供了一个良好的平台。     

Deciphering the role of Rhodnius prolixus CYP4G genes in straight and methyl‐branched hydrocarbon formation and in desiccation tolerance

Insect cuticle hydrocarbons are involved primarily in waterproofing the cuticle, but also participate in chemical communication and regulate the penetration of insecticides and microorganisms. The last step in insect hydrocarbon biosynthesis is carried out by an insect‐specific cytochrome P450 of the 4G subfamily (CYP4G). Two genes (CYP4G106 and CYP4G107) have been reported in the triatomines Rhodnius prolixus and Triatoma infestans. In this work, their molecular and functional characterization is carried out in R. prolixus, and their relevance to insect survival is assessed. Both genes are expressed almost exclusively in the integument and have an expression pattern dependent on the developmental stage and feeding status. CYP4G106 silencing diminished significantly the straight‐chain hydrocarbon production while a significant reduction – mostly of methyl‐branched chain hydrocarbons – was observed after CYP4G107 silencing. Molecular docking analyses using different aldehydes as hydrocarbon precursors predicted a better fit of straight‐chain aldehydes with CYP4G106 and methyl‐branched aldehydes with CYP4G107. Survival bioassays exposing the silenced insects to desiccation stress showed that CYP4G107 is determinant for the waterproofing properties of the R. prolixus cuticle. This is the first report on the in vivo specificity of two CYP4Gs to make mostly straight or methyl‐branched hydrocarbons, and also on their differential contribution to insect desiccation.     

The effect of manual therapy and neuroplasticity education on chronic low back pain: a randomized clinical trial

Objective: To determine if a neuroplasticity educational explanation for a manual therapy technique will produce a different outcome compared to a traditional mechanical explanation.

Methods: Sixty-two patients with chronic low back pain (CLBP) were recruited for the study. Following consent, demographic data were obtained as well as pain ratings for low back pain (LBP) and leg pain (Numeric Pain Rating Scale), disability (Oswestry Disability Index), fear-avoidance (Fear-Avoidance-Beliefs Questionnaire), forward flexion (fingertips-to-floor), and straight leg raise (SLR) (inclinometer). Patients were then randomly allocated to receive one of two explanations (neuroplasticity or mechanical), a manual therapy technique to their lumbar spine, followed by post-intervention measurements of LBP, leg pain, forward flexion, and SLR.

Results: Sixty-two patients (female 35 [56.5%]), with a mean age of 60.1 years and mean duration of 9.26 years of CLBP participated in the study. There were no statistically significant interactions for LBP (p = .325), leg pain (p = .172), and trunk flexion (p = .818) between the groups, but SLR showed a significant difference in favor of the neuroplasticity explanation (p = .041). Additionally, the neuroplasticity group were 7.2 times (95% confidence interval = 1.8–28.6) more likely to improve beyond the MDC on the SLR than participants in the mechanical group.

Discussion: The results of this study show that a neuroplasticity explanation, compared to a traditional biomechanical explanation, resulted in a measureable difference in SLR in patients with CLBP when receiving manual therapy. Future studies need to explore if the increase in SLR correlated to changes in cortical maps of the low back.     

Free Communications

Tension-free vaginal tape (TVT) is a well-established surgical procedure for treating female urinary stress incontinence. The operation, described by Ulmsten et al. in 1995, is based on a midurethral Prolene tape support. TVT is accepted as an easy-to-learn and safe minimally invasive surgical technique. Bladder perforation with sling material was described as a complication of former surgical methods for correcting female urinary stress incontinence as well as of TVT. The aim of this analysis was to determine whether the use of a straight inserter for identifying and displacing the bladder prior to inserting TVT needles reduces the occurrence of bladder penetration. Out of 524 patients undergoing TVT and followed for up to 68 months, 68 (13%) had TVT bladder penetrations, all of which were diagnosed and corrected during surgery. All but the last 50 patients had a straight inserter introduced during the procedure. The effect of this surgical step is estimated and discussed.     

针灸拔罐及推拿法治疗早期强直性脊柱炎的疗效观察

强直性脊柱炎（ankylosing spondylistis,AS）是一种以自身免疫为特征的主要累及脊柱及骶髂关节的慢性炎症性的疾患.临床发病早期多为慢性迁延,具有隐匿性,使早期诊断具有一定的困难;晚期见出现脊柱强直、畸形、治疗难奏良效.故早期诊治尤为重要.笔者自2008年3月～2009年8月,采用针灸（TDP）、拔罐、推拿治疗早期AS患者36例,取得了满意的临床疗效.     

整合性正畸治疗

[摘要] 整合性正畸治疗(complete clinical orthodontics,CCO)的理念,是一个整合各种先进正畸理论,强调在一个统一的体系下进行诊断、计划制定和实施的综合性治疗理念。它不单单是一种矫治技术,更是力求用一种综合手段治疗所有类型患者并达到良好、稳定效果的独特理念。在这一框架内,结合运用了主动自锁托槽、直丝弓矫治器和Thermal镍钛弓丝等矫治理论的精髓和先进的矫治材料,主导思想是用统一的矫治技术解决所有的畸形矫治,达到一致的矫治效果。     

Morphological characteristics of external auditory canal in congenital aural stenosis patients

ObjectiveTo investigate characteristics of congenital aural stenosis (CAS) patients' external auditory canal (EAC) (position, length, orientation, etc.) and compare them with normal EAC.

利用ABO-OGS指数评价个性化舌侧与传统唇侧系统疗效研究

目的    通过ABO-OGS指数对个性化舌侧矫治系统以及传统的唇侧直丝弓矫治系统的治疗结果进行对比研究。方法    选取2012—2015年上海交通大学医学院附属第九人民医院正畸科20例接受正畸治疗的错畸形患者,个性化舌侧系统与传统唇侧系统矫治各10例,分别测量正畸治疗后模型的美国正畸协会客观评分系统（ABO-OGS）指数,计算各项所占比重,使用独立t检验比较评估两种矫治系统的差异。结果    个性化舌侧病例平均总计分为25.3分,传统唇侧直丝弓病例平均总计分为24.5分,两者相差0.8。个性化舌侧矫治系统在唇舌向倾斜度方面以及牙根倾斜度方面得分高于唇侧,分别相差1.3及0.5,但差异均无统计学意义（均P＞0.05）。结论        个性化舌侧矫治系统与传统唇侧直丝弓矫治系统各个项目的评分及总分方面差异无统计学意义,均能达到令人满意的治疗效果。     

直丝弓矫治技术用于安氏骨性Ⅱ类错畸形治疗前后面型的改变

目的探讨直丝弓矫治技术对安氏Ⅱ类骨性错畸形患者骨面型的改变情况。方法在矫治前拍摄的头颅定位侧位片上,筛选出8例安氏Ⅱ类骨性错畸形患者,应用直丝弓矫治技术进行矫治,矫治结束后,在同样条件下再拍摄头颅定位侧位片,行头影测量分析,与治疗前数值进行比较,观察骨面型的改变情况。结果直丝弓矫治对安氏Ⅱ类骨性错畸形患者的面型略有改变,但患者的深覆及深覆盖的纠正更多是由下前牙唇侧倾斜来代偿完成。结论安氏Ⅱ类骨性错畸形患者在恒牙期早期或恒牙期直接采用直丝弓矫治技术进行矫治,对牙齿排列和咬合关系调整虽然有一定的治疗效果,但是对侧面型的改善程度有限,不能达到理想的矫治效果。     

直丝弓矫治器结合小平导矫治前牙深覆(牙合)

目的 :总结直丝弓矫治器结合小平导矫治前牙深覆牙合的临床效果。方法 :选择安氏Ⅱ类错牙合 3 0例 ,男 12例 ,女 18例 ,年龄 11— 14岁。均采用直丝弓固定矫治器 ,结合上颌小平导打开咬合。矫治前拍摄头颅定位侧位片 ,待咬合打开 ,后牙有接触时拍阶段头颅定位侧位片。选择头影测量指标 2 2项 ,对测量结果进行t检验。结果 :MP -SN、PP -MP、S -Ar -Go三项指标在戴小平导前后均有显著性差异 ,说明下颌平面角增大 ,并且主要是下颌骨后旋的结果。S -Go、N -Me、ANS -Me在戴用后也有显著增大。这均有利于改善低角病例的面形。L1-MP(mm)、Overbite(mm )戴小平导后显著减小 ,而U 6-PP(mm)、L6-MP(mm)显著增大 ,说明下前牙明显压低 ,上下后牙明显升高。结论 :直丝弓矫治器结合上颌小平导矫治前牙深覆牙合是一种快速有效解除前牙深覆牙合的方法。