胫骨延长后骨痂直径与新生骨预后关系的临床分析

目的探讨胫骨延长后骨痂直径与新生骨预后的关系.方法 1996年1月～2001年12月,对68例胫骨延长者测量达所需延长长度时的骨痂直径,计算骨痂直径率(callus diameter ratios,CDR);统计拆除外固定架后2～4周时新生骨发生骨折例数及畸形角度,比较骨折和成角畸形与CDR的关系.结果拆除外固定架前胫骨前屈角度5度以上畸形19例,其中11例发生骨折;拆除外固定架后胫骨出现5度以上畸形6例,其中2例骨折;其余43例胫骨延长骨痂正常愈合.计算CDR值:CDR值小于80% 23例,其中发生新生骨骨折13例,成角畸形5度以上者21例;CDR在81%～85%之间6例,成角畸形5度以上4例;CDR值超过86% 39例,无畸形或新生骨骨折.结论胫骨延长时CDR小于80%时,容易发生新生骨骨折和畸形;CDR大于85%时,无新生骨骨折和畸形发生;两组间具有统计学意义(P＜0.05).CDR是判断骨痂能否正常愈合较为理想的检测指标.     

Prevalent vertebral deformities predict increased mortality and increased fracture rate in both men and women: A 10-year population-based study of 598 individuals from the Swedish cohort in the European Vertebral Osteoporosis Study

The aim of this study was to evaluate whether a prevalent vertebral deformity predicts mortality and fractures in both men and women. In the city of Malmö, 598 individuals (298 men, 300 women; age 50–80 years) were selected from the city's population and were included in the Swedish part of the European Vertebral Osteoporosis Study (EVOS). At baseline the participants answered a questionnaire and lateral spine radiographs were performed. The prevalence of subjects with vertebral deformity was assessed using a morphometric method. The mortality during a 10-year follow-up period was determined through the register of the National Swedish Board of Health and Welfare. Eighty-five men and 43 women died during the study period. The subsequent fracture incidence during the follow-up period was ascertained by postal questionnaires, telephone interviews and by a survey of the archives of the Department of Radiology in the city hospital. Thirty-seven men and 69 women sustained a fracture during the study period. Data are presented as hazard ratios (HR) with 95% confidence interval (95% CI) within brackets. Prevalent vertebral deformity, defined as a reduction by more than 3 standard deviations (SD) in vertebral height ratio, predicted mortality during the forthcoming decade in both men [age-adjusted HR 2.4 (95% CI 1.6–3.9)] and women [age-adjusted HR 2.3 (95% CI 1.3–4.3)]. In men there was an increased mortality due to cardiovascular and pulmonary diseases and in women due to cancer. Prevalent vertebral deformity predicted an increased risk of any fracture during the forthcoming decade in both men [age-adjusted HR 2.7 (95% CI 1.4–5.3)] and women [age-adjusted HR 1.8 (95% CI 1.1–2.9)]. Prevalent vertebral deformity predicted an increased risk of any subsequent fragility fracture in women [age-adjusted HR 2.0 (95% CI 1.1–3.5)]; however, in men the increased risk was nonsignificant [age-adjusted HR 1.9 (95% CI 0.7–5.1)]. In summary, a prevalent vertebral deformity can predict both increased mortality and increased fracture incidence during the following decade in both men and women. We conclude that prevalent vertebral deformity could be used as a risk factor in both genders for mortality and future fracture.     

汽油添加剂甲基叔丁基醚的毒性研究

目的　通过研究汽油添加剂甲基叔丁基醚 (MTBE)对小鼠体内谷胱甘肽 (GSH)、谷胱甘肽过氧化物酶 (GSH -Px)活性的改变以及骨髓微核、精子畸变率的影响 ,了解汽油添加剂甲基叔丁基醚的毒性。方法　 40只健康昆明种成年小鼠 ,体重 3 3 .3± 6 .9g ,随机分为 4组。灌胃染毒 ,染毒剂量分别为1 6 0 0、40 0、1 0 0和 0mg kg。每天 1次 ,每周 5天 ,共计 40天。结果　MTBE染毒各组小鼠体重轻度降低 ,染毒组全血及肝组织匀浆中GSH在低剂量染毒时增高 ,而高剂量时表现为降低 ,与对照组比较差异有显著性 (P <0 .0 5 ) ;GSH -Px活性明显减低 ,染毒高剂量组与对照组比较差异有高度显著性 (P <0 .0 1 ) ;骨髓嗜多染红细胞微核及精子畸变率增高 ,与对照组比较明显增高 ,差异有显著性 (P <0 .0 5 )。结论　MTBE对昆明小鼠具有一定毒性 ,可降低全血及肝脏组织中GSH -Px活性 ,低剂量时可增加全血及肝脏组织中GSH含量 ,而高剂量可降低其含量。MTBE能使骨髓微核率、精子畸形率明显增高 ,提示MTBE具有潜在的遗传毒性。     

上唇短缩畸形的手术治疗

目的 针对微笑时鼻唇部出现上唇上提并短缩,鼻小柱下方褶沟,上唇牙龈外露等现象,探讨一种治疗上唇短缩畸形的手术方法.方法 采用经口或鼻前庭切口,将鼻小柱根部鼻中隔降肌肌纤维切断及部分切除,并广泛剥离使上唇下降.结果 共为27例上唇短缩畸形患者进行手术治疗.其中9例采用了双侧鼻小柱外侧与前庭基底贯穿切口,18例采用了上唇唇龈沟切口.通过手术,患者获得微笑时上唇中部适度降低,鼻小柱下方褶沟变浅或消失,上唇牙龈外露消失的效果.6例患者还在手术矫正上唇动态短缩畸形的同时,实施了鼻整形术.通过手术可矫正鼻唇牙龈部的综合动态缺陷,获得满意的美学效果.结论 手术方法治疗上唇短缩畸形,可改善患者微笑时的表情,是值得推广的治疗方法.     

埋没导引缝合法矫治鹰钩鼻鼻尖畸形

目的介绍一种较新的矫治鹰钩鼻鼻尖畸形的手术方法。方法自1995年2月至2005年5月,采用埋没导引缝合技术对18例鹰钩鼻鼻尖畸形患者进行手术矫治,术后结合鼻管支撑的鼻孔悬吊法外固定7~10d。结果术后经14个月至3年的随访,18例患者的鼻尖外形良好,形态满意。其中1例患者因鼻腔内悬吊线穿透引起轻度炎症,术后3周剪除缝线,5d自愈。结论采用埋没导引缝合的手术方法对鹰钩鼻鼻尖畸形患者进行矫治,并结合缝合、悬吊和固定,获得了良好的术后效果。此方法是一种较理想的手术方法,值得推广应用。     

上唇短缩畸形的手术治疗

目的 针对微笑时鼻唇部出现上唇上提并短缩,鼻小柱下方褶沟,上唇牙龈外露等现象,探讨一种治疗上唇短缩畸形的手术方法.方法 采用经口或鼻前庭切口,将鼻小柱根部鼻中隔降肌肌纤维切断及部分切除,并广泛剥离使上唇下降.结果 共为27例上唇短缩畸形患者进行手术治疗.其中9例采用了双侧鼻小柱外侧与前庭基底贯穿切口,18例采用了上唇唇龈沟切口.通过手术,患者获得微笑时上唇中部适度降低,鼻小柱下方褶沟变浅或消失,上唇牙龈外露消失的效果.6例患者还在手术矫正上唇动态短缩畸形的同时,实施了鼻整形术.通过手术可矫正鼻唇牙龈部的综合动态缺陷,获得满意的美学效果.结论 手术方法治疗上唇短缩畸形,可改善患者微笑时的表情,是值得推广的治疗方法.     

伴有齿槽嵴裂的单侧唇裂术后继发鼻畸形的修复

目的探讨伴有齿槽嵴裂的单侧唇裂术后继发鼻畸形的修复方法。方法对34例伴有齿槽嵴裂的单侧唇裂术后继发畸形的患者,在行齿槽嵴植骨的同时,行彻底的鼻整形手术。结果术后随访1~3年,植骨区成活良好,鼻畸形较整形前明显改善,接近正常外形,效果满意。结论在行齿槽嵴植骨的同时,行彻底的鼻整形手术,能够取得满意的效果,并且节省了医疗费用,缩短了治疗时间。     

心理干预对错[牙合]畸形治疗中合作行为及结果的影响

目的：观察心理干预对错[牙合]畸形患者正畸治疗中合作行为及结果的影响。方法：对门诊口腔科60例青少年[牙合]畸形患者随机分为干预组和对照组各30例。两组均由从事正畸工作5年以上的主治医师采用标准方丝弓技术进行矫正治疗，干预组同时实施心理干预等心理治疗。将两组治疗中的合作行为和结果进行比较分析。结果：心理干预组自律性、主动性、自觉性、矫治时间、满意度等均明显优于对照组，差异有显著性（P〈0．01）。结论：心理干预对青少年正畸患者治疗中合作行为和结果有明显影响，通过心理干预能提高矫治的效果，保证治疗的顺利完成。     

Correction of camptodactyly with an external fixator

Camptodactyly is a flexion deformity of the proximal interphalangeal joint. Because of unsatisfactory results, treatment is not recommended for mild deformities, and in severe deformities surgery has been disappointing. A specially designed external fixator providing gradual distraction was used in a severe case. With this mildly aggressive method, an acceptable result was obtained. Received: 5 June 1997/Accepted: 2 February 1998