Prevalence of traumatic injuries to the permanent incisors in candidates for orthodontic treatment

Abstract  – The dental records made on presentation of 1367 consecutive patients (731 females and 636 males) for orthodontic treatment at a private orthodontic practice between 1998 and 2002 were examined for data relating to trauma to the permanent incisors. The results showed that 10.3% of these patients had suffered from dental trauma before the onset of orthodontic treatment. The highest prevalence of dental trauma was determined in the 11–15 years age group, corresponding to the dental developmental stage of the late mixed dentition. The most frequently affected teeth were the maxillary central incisors (79.6%), and the most common types of trauma were fracture of enamel–dentin without pulpal involvement (42.7%) and fracture of enamel (33.8%). Compared to patients with normal overjet and adequate lip coverage, the frequency of dental trauma was significantly higher in patients with increased overjet and adequate lip coverage ( P  = 0.028) or with increased overjet and inadequate lip coverage ( P  = 0.003). The results of the present study indicate that a significant percentage of candidates for orthodontic treatment, and especially those with increased overjet and inadequate lip coverage, suffer trauma to their permanent incisors before the onset of orthodontic treatment. It might also be concluded that preventive orthodontic treatment of such patients should be initiated and completed before the age of 11, i.e. in the early to middle mixed dentition.     

乳管镜对乳腺导管内疾病的诊断及介入治疗--附100例临床分析

目的:探讨乳管镜在乳腺疾病诊断和治疗中的作用.方法:应用乳腺纤维导管内视镜对100例伴乳头溢液的乳腺导管性疾病进行诊断或介入治疗.结果:13例导管内占位性疾病得到了正确诊断,87例渗出性导管病经治疗后治愈.结论:乳管镜对乳管内病变的正确诊断及手术方式可提供依据,并可对渗出性病变进行介入治疗.     

Progressive multifocal leukoencephalopathy: value of diffusion-weighted and contrast-enhanced magnetic resonance imaging for diagnosis and treatment control

Progressive multifocal leukoencephalopathy (PML) is caused by the replication of JC virus in oligodendrocytes of immunocompromised patients. Diagnosis usually relies on the polymerase chain reaction (PCR)-based demonstration of JC virus DNA in the cerebrospinal fluid. As previous reports have suggested that some patients may benefit from antiviral therapy, non-invasive early diagnosis is highly desirable. Repetitive magnetic resonance imaging (MRI) examinations (two to nine) were obtained in seven patients (aged 40–67 years, six males, one female) with classical clinical and imaging findings of PML. Five patients had underlying hematological disorders and two acquired immune deficiency syndrome. PCR of the cerebrospinal fluid (CSF) specimen was positive for JC virus DNA in six patients. MRI sequences included T2-, T1- and diffusion-weighted (DW) images in all patients and diffusion-tensor imaging (DTI) in four cases. DTI was once performed at 3T, in the remaining patients at 1.5T. All patients received antiviral treatment with cidofovir in addition to the treatment of the underlying disorder. MRI showed areas of T2 hyperintensity with involvement of the subcortical U-fibers and restricted diffusion in all patients. Areas of diffusion abnormality correlated with disease progress. Contrast enhancement was encountered once after successful treatment and heralded clinical remission with virus elimination from the CSF. Hence, MRI including DW and contrast-enhanced images may be used to evaluate disease activity. Contrast enhancement may indicate an inflammatory response and thus herald immunologic virus elimination.     

老年性痴呆的病理特征与防治对策

老年痴呆症的发生与AB以及Tau蛋白的错误折叠密切相关，是蛋白质折叠相关的疾病，早期诊断是预防老年痴呆症的首要任务，而综合治疗是人类对抗老年痴呆症的必然举措。     

载氧血红蛋白纯化工艺研究

目的改善心脑血管缺氧载氧药物是一种创新药物。由于它半径比红细胞小400~1 000倍,易于通过毛细血管,给缺血组织及时供氧,迅速缓解或纠正缺氧状态,达到治疗抢救目的。血红蛋白的纯化工艺是载氧药物研制的重要工艺步骤。方法本研究建立了一套通过热敏法分离纯化人脐带血血红蛋白的工艺以及较为完善的纯化血红蛋白质量检测指标。结果与现有的纯化方式相比,热敏法操作简便,仪器设备造价低廉,纯化与病毒灭活同时进行,得到的纯化产品损失少,纯度高,各项理化指标达到国际水平。结论本工艺适用于规模制备纯化血红蛋白,为进一步研制治疗心脑血管缺氧载氧药物创造了有利条件。     

上颌第一磨牙近中颊根第二根管的治疗体会

目的 探讨在临床上上颌第一磨牙近中颊根第二根管（MB2）的发现及扩通。方法 在25例需要进行根管治疗的上颌第一磨牙上寻找MB2，若无法找到，使用超声根管异物清除工作尖10P清理髓底及慢速圆钻去除预计位置部分牙本质，再次寻找。找到后通畅根管，若无法扩通，使用慢速圆钻在MB2根管口处向根方去除少量牙本质。结合使用EDTA再次通畅根管。结果 25颗治疗齿中有13颗找到MB2（52％），其中2颗是在超声根管锉清理髓室底后发现的，4颗在进一步去除MB2根管口位置的牙本质后发现。8颗治疗齿的MB2通畅（32％），其中3颗自然扩通，5颗在去除MB2根管口处部分矛本质并使用EDTA后通畅。结论 临床上上颌第一磨牙MB2发现率为52％。扩通率为32％。掌握MB2的解剖位置，使用超声方法以及EDTA可提高MB2的发现率和扩通率。     

交锁髓内钉治疗下肢长管状骨骨折的效果

①目的 探讨交锁髓内钉治疗下肢长管状骨骨折的效果。②方法 应用交锁髓内钉治疗下肢长管状骨骨折56例，随访8～26个月，观察治疗结果。③结果 56例病人术后对位、对线均满意，股骨骨折平均愈合时间为19．9周，胫骨骨折平均愈合时间为17．7周，2例延迟愈合。无主钉或锁钉断裂．无肢体短缩、功能障碍发生。④结论 交锁髓内钉是治疗下肢长管状骨骨折的一种理想、可靠的内固定方法，其疗效满意，值得临床推广应用。     

改进微波幅射器探头治疗宫颈糜烂疗效观察

目的：探讨改进的微波辐射器探头治疗宫颈糜烂的疗效。方法：将微波辐射器探头由双直线形、双针形、单针形等点线状改进成为“单舌形”和“双舌形”两种弧形平面探头，用于治疗宫颈糜烂。分析1999-2002年450例宫颈糜烂治疗资料，其中300例经微波治疗(A组)，150例经C02—激光治疗(B组)，随访1—3个月。结果：两组治疗后3个月内A组治愈率明显高于B组(P＜0．005)，总有效率A组明显高于B组(P＜0．025)。两组术中、术后不良反应比较：术中宫颈创面出血A组明显低于B组(P＜0．005)，术中腹痛、脱痂期出血量、术后局部感染率方面两组相似。结论：所改进的微波辐射器探头治疗宫颈糜烂治愈率高，操作安全，术后并发症少，医患乐于接受。     

Boerhaave’s syndrome: Primary repair vs. esophageal resection—Case reports and meta-analysis of the literature

Boerhaave’s syndrome is a life-threatening disease with a high mortality. With regard to the heterogeneity of treatment strategies, no comparative studies exist and recommendations remain controversial. Seventeen cases of Boerhaave’s syndrome operated on between 1989 and 2000 at our hospital were reviewed retrospectively to compare the time period between perforation and diagnosis, and the morbidity and mortality among the different treatment options. In addition, we conducted a meta-analysis of the literature including all series containing five or more patients and compared the findings with our own data. Our patients with a perforation history of less than 12 hours showed significantly fewer signs of sepsis compared to patients with a history of more than 12 hours. In a comparison of patients with primary repair vs. patients treated with esophageal resection or an exclusion operation, no differences were found. In the literature, patients with a long period of perforation (more than 24 hours) were treated more often with an esophageal resection than patients with primary repair. In cases of Boerhaave’s syndrome, primary suturing of the esophageal perforation should be reserved only for those patients presenting within 12 hours after perforation. In all other cases, depending on the extent of the tissue damage, a two-stage esophageal resection with cervical esophagostomy and gastrostomy is recommended as the safest treatment.