颞叶癫痼患者长程数字化视频EEG与过度换气EEG痫样放电规律探讨

目的：了解长程数字化视频EEG与过度换气EEG的癎样放电规律.方法：评估52例颞叶癫癎患者长程数字化视频EEG与过度换气EEG的癎样放电特点.结果：过度换气EEG癎样放电检出率明显低于浅睡期EEG,差异具有极显著意义（P＜0.01）;但与清醒期和深睡期EEG癎样放电检出率比较差异无显著意义（P＞0.05）.结论：颞叶癫癎患者浅睡期EEG癎样放电率明显高于过度换气EEG,对颞叶癫癎患者进行睡眠EEG检测,有助于提高癎样放电的检出率.     

锥形束CT诊断颌面部异物1例

<正>张口受限为颌面外科的常见疾患,但颌面部异物引起张口受限多为个案报道[1-3]。准确定位异物位置及其形状大小,是外科手术取出异物,保证手术成功的关键。锥形束CT(cone beam computed tomography,CBCT)因其独特的三维成像特点,可以精确定位,更好地引导外科手术的顺利进行[4-6]。现对我院收治的1例颌面部异物引起的张口受限患者的临床资料进行报道,并结合文献回顾对CBCT在颌面异物诊断中的应用价值进行讨论。     

重度磨耗对大鼠三叉神经节中CGRP表达的影响

目的：探讨重度磨耗对大鼠三又神经节中降钙素基因相关肽（calcitonin gene—related petide,CGRP）表达的影响。方法：8周龄雄性SD大鼠75只,随机平均分为操作对照组、空白对照组和实验组,每组各25只,实验组用人工逐次磨低大鼠牙冠高度的方法建立重度磨耗动物模型。各组分别于干预后3、7、14、21、28天处死5只动物,取出双侧三叉神经节,通过免疫荧光染色的方法观察三叉神经节中CGRP的表达变化。结果：与空白对照组和操作对照组相比,实验组3天组和7天组的CGRP阳性神经元数量明显增加（P〈0．05）,14天组和21天组CGRP阳性神经元数量有所减少,但仍明显多于对照组（P〈0．05）,28天组基本恢复正常（P〉0．05）。结论：重度磨耗可导致大鼠三叉神经节内CGRP表达的可逆性变化。     

P物质、血管活性肠肽在OLP血清中的表达

目的：检测P物质（SP）、血管活性肠肽（VIP）在口腔扁平苔藓（OLP）血清中的表达,并探讨SP、VIP与OLP的关系。方法：采用酶联免疫吸附法（ELISA）检测40例OLP和正常人血清中SP、VIP的含量。结果：SP在OLP患者血清中的含量高于正常人血清中含量（P〈0．05）,VIP在OLP患者血清中的含量与正常人血清中的含量无差异（P〉0．05）。结论：SP在OLP的发生发展中可能参与了淋巴细胞的浸润及增殖,并参与了OLP慢性炎症机制。     

BMP-2和地塞米松对体外培养大鼠牙囊细胞矿化能力的影响

目的:探讨BMP-2和地塞米松联合作用对大鼠牙囊细胞分化能力的影响,为牙囊细胞在牙周组织工程中的应用提供实验依据。方法:取生长状态良好的第3代大鼠牙囊细胞,血清饥饿同步化后,分别加入含BMP-2(100ng/ml)、地塞米松Dex(10-8mol/ml)、BMP-2(100ng/ml)+地塞米松(10-8mol/ml)的DMEM培养液,通过碱性磷酸酶(ALP)检测试剂盒、钙化结节染色分别检测不同诱导条件下对大鼠牙囊细胞分化的影响。结果:经BMP-2、Dex、BMP-2+Dex诱导后,体外培养的大鼠牙囊细胞碱性磷酸酶活性均显著高于未诱导组,各组间ALP活性与对照组相比差异有统计学意义(P<0.01)。BMP-2+Dex诱导组ALP活性最强,与BMP-2诱导组间差异有统计学意义(P<0.01),而与Dex诱导组间ALP活性则差异无统计学意义(P>0.01)。培养14d时,BMP-2+Dex诱导组牙囊细胞ALP活性增强最为显著,与BMP-2诱导组及Dex诱导组相比差异均有统计学意义(P<0.01)。矿化结节计数分析显示,各组细胞矿化结节形成的数量及面积明显存在显著的差异,BMP-2、Dex、BMP-2+Dex诱导组与未诱导组相比,其矿化结节形成量差异均有统计学意义(P<0.01),BMP-2+Dex诱导组矿化结节形成量明显大于BMP-2和Dex单独诱导组。结论:BMP-2、地塞米松均能促进牙囊细胞的分化,然而两者联合作用促分化的能力最为显著,提示其在牙周组织工程中的应用前景。     

GC护牙素在固定正畸中预防釉质脱矿的临床研究

目的观察固定正畸矫治中GC护牙素预防牙釉质脱矿的临床效果。方法选择固定矫治器治疗的患者64名,随机分为2组,护牙素组32例,657颗牙;对照组32例,678颗牙。矫治结束后对牙面脱矿情况进行临床观察,用SPSS13.0统计软件进行数据处理分析。结果矫治前二组患者被观察牙齿牙釉质脱矿率和脱矿程度均无明显差异(P>0.05)。矫治后护牙素组牙釉质脱矿率为5.78%,对照组为15.78%。护牙素处理组牙釉质脱矿率和脱矿程度明显低于对照组,有显著性差异(P<0.01)。结论在固定正畸治疗中配合使用GC护牙素处理牙面,可预防牙釉质脱矿的发生。     

1835名军事飞行人员颞下颌关节紊乱病的流行病学调查

目的：研究颞下颌关节紊乱病在我军飞行人员中的患病情况,探讨我军飞行人员颞下颌关节紊乱病的发病因素.方法：对1835名飞行人员进行口腔检查和颞下颌关节检查,筛选出颞下颌关节紊乱病患者,评估飞行人员颞下颌关节紊乱病与年龄、飞行时间、机种、咬合关系、不良习惯之间的关系.结果：歼击机飞行人员颞下颌关节紊乱病发病率最高（33.43％）,运输机飞行人员发病率最低（23.45％）,P＜0.05;颞下颌关节紊乱病发病率与飞行人员年龄、飞行时间无显著关系;心理因素、睡眠质量、夜磨牙、偏侧咀嚼习惯、第三磨牙伸长与飞行人员颞下颌关节紊乱病发病高度相关.错骀畸形是飞行人员TMD的重要发病因素,其中锁滁、开赡患者TMD发病率较高,其次是深覆盖、深覆骀及反骀患者.结论：飞行人员颞下颌关节紊乱病发病的重要因素是心理素质差、睡眠障碍、夜磨牙、偏侧咀嚼习惯及错（牙合）畸形.     

牙周炎与慢性阻塞性肺疾病关系的流行病学研究

目的通过流行病学调查及临床检查,探讨牙周炎与慢性阻塞性肺疾病（COPD）之间的相关性。方法收集中国医科大学附属第一医院、盛京医院、第四医院和沈阳市第八人民医院2008年10月至2009年4月确诊为COPD的患者266例,其中稳定期COPD患者160例,急性加重期COPD（AE—COPD）患者106例,检查并记录所有患者6颗指数牙（61 6、6 16）的简化1：7腔卫生指数（OHI—S）、龈沟出血指数（SBI）、牙周探诊深度（PD）、临床附着丧失（CAL）,同时对所有患者进行肺功能指标的检查,并进行口腔问卷调查。结果（1）AE—COPD组的吸烟率为47．2％,明显高于稳定期COPD组（P〈0．01）;（2）AE—COPD组的SBI、PD及CAL明显高于稳定期COPD组（P〈0．01）;（3）AE—COPD组的OHI—S、SBI、PD及CAL均与FEVl％呈负相关（r分别为-0．309、-0．333、-0．395、-0．702,均P〈0．01）,其中CAL与FEVI％的相关性最强;稳定期COPD组CAL与FEVI％呈负相关（r=-0．657,P〈0．01）。结论（1）吸烟作为牙周炎和COPD的共同危险因素,在牙周炎和COPD的发生和发展中发挥重要作用;（2）AE—COPD患者的牙周炎症程度均随着肺功能的减弱而加重,提示牙周炎与COPD之间存在一定相关性。     

Outcomes of pulmonary metastases in hepatoblastoma — is the prognosis always poor?

Background

Hepatoblastoma is a rare tumour accounting for approximately 1% of all paediatric malignancies. Hepatoblastoma complicated by pulmonary metastatic disease continues to cause management difficulties due to a lack of robust evidence and treatment guidelines.

Method

This series is the experience of a tertiary paediatric referral centre. Patients were prospectively enlisted, and their charts were retrospectively reviewed.

Results

Thirty-seven patients were treated for hepatoblastoma from 1995 to 2012 inclusive. The overall survival was 34/37(91.9%). Eight patients had lung metastases at diagnosis (LMD) and twenty-nine did not (NLMD). Two-year EFS was 62.5% in the LMD group and 89.3% in the NLMD group (p = 0.078). Overall survival in the LMD and NLMD groups was 100% and 89.7%, respectively (p = 0.389). Two patients in the LMD group required multiple thoracic resections to achieve cure. Within the NLMD group, two patients developed lung metastases whilst on treatment, and both of these patients died.

Conclusion

In this series, children presenting with lung metastases had a higher risk of relapse but excellent overall survival. However, children who developed pulmonary disease during treatment had a poor prognosis. We advocate aggressive surgical treatment of pulmonary hepatoblastoma to achieve cure.     

Hospital Episode Statistics data analysis of postoperative venous thromboembolus in patients undergoing urological surgery: a review of 126,891 cases

Introduction

Current guidelines on venous thromboembolism (VTE) prevention do not reflect the potential varying risk for patients undergoing different urological procedures. Our study aimed to establish the procedure specific rate of postoperative VTE in patients undergoing urological surgery.

Methods

Hospital Episode Statistics were obtained for all patients undergoing common urological procedures between April 2009 and April 2010. This cohort was followed up to identify all patients reattending with either deep vein thrombosis (DVT) or pulmonary embolism (PE) within 12 months.

Results

A total of 126,891 individuals underwent urological surgery during the study period. This included 89,628 men (70.6%) and 37,236 women (29.3%) with a mean age of 65.2 years. At the 12-month follow-up, 839 patients (0.66%) were readmitted with VTE. Of these, 373 (0.29%) were admitted with DVT and 466 (0.37%) with PE. The procedure-specific rate of VTE varied significantly between 2.86% following cystectomy and 0.23% following urethral dilatation. Procedures performed in the lithotomy position carried a significantly lower risk of VTE than those performed in the supine position (0.60% vs 1.28%, p<0.0001). Furthermore, of all procedures performed in the lithotomy position, those performed on benign conditions carried a significantly lower risk than those performed on malignant disease (0.52% vs 0.79%, p<0.0001).

Conclusions

Procedure specific rates of postoperative VTE vary widely among patients undergoing urological procedures. These findings suggest the potential benefit of prolonging the use of thromboprophylaxis in high-risk patients but also exploring the apparent lack of need for routine thromboprophylaxis in patients undergoing low-risk procedures.