上颌神经诱发三叉神经皮层电位的研究

目的　探讨三叉神经的分支上颌神经皮层诱发电位的特点及与三叉神经其他分支皮层诱发电位的差异。方法　通过刺激 10名健康成人的眶下神经 ,收集刺激对侧的三叉神经诱发电位 (TSEP)。结果　①刺激发生 2 0ms左右出现P1,其后N1～N5等 9个波峰依次出现 ;②P3、N3、P4潜伏期稳定 ,N3～N4振幅高且图形规律 ;③上颌神经皮层诱发电位与下颌神经皮层诱发电位无明显差异。结论　上颌神经TSEP中高峰电位出现于 110ms的N3P4波 ,波幅 >10 μV ,其潜伏期相对稳定 ,形成上颌神经TSEP的特点 ,早期的P1～N2波幅较低 ,但可以因周围神经的改变而有较大的变化 ;正常上颌神经的TSEP各波潜伏期、图形特点、峰峰电位差与下颌神经TSEP差异不明显。根据图形特点、参数可以作为临床三叉神经上颌支功能状态和病理改变的判定指标     

Attitudes of general dental practitioners in Europe to the microbial risk associated with dental unit water systems

Dental Unit Water Systems (DUWS) are used in dental practices to provide water for cooling of dental equipment and irrigation of the oral cavity. However, they have been demonstrated to be contaminated with micro-organisms. There are currently no European Union (EU) Commission guidelines for the microbial quality of water discharged by DUWS. This study was part of an EU research programme to investigate the microbial contamination of DUWS in general dental practice (GDP) in the UK, Denmark, Germany, The Netherlands, Ireland, Greece and Spain. OBJECTIVE: To undertake a questionnaire survey on the type of DUWS in use and determine the attitude of GDPs to the risk of microbial infection from DUWS. MATERIALS AND METHODS: The questionnaire was written and translated into the language of each country before being posted to each participating dentist. Dentists were asked to complete the questionnaire survey and return it by post. RESULTS AND CONCLUSIONS: The major findings were that the majority of dentists did not clean, disinfect or determine the microbial load of their DUWS, and that dentists would welcome regular monitoring and advice on maintaining their DUWS; the introduction of guidelines; and recommendations on controlling the microbial load of DUWS.     

The effect of various jaw motor tasks on body sway

Alterations of body sway caused by isometric contractions of the jaw muscles have been reported previously. The objective of this study was to test if motor tasks of the masticatory system with different control demands affect body posture differently during quiet stance. Position and sway displacements of the center of foot pressure (COP) were measured for 20 healthy subjects who either kept the mandible at rest or performed unilateral and bilateral maximum voluntary teeth clenching, feedback-controlled biting tasks at submaximum bite forces, or unilateral chewing. Two weeks later the measurements were repeated. Compared with quiet stance, the COP results revealed significant changes during the feedback-controlled biting tasks. Robust sway reduction and anterior displacement of the COP were observed under these conditions. Body oscillations were not significantly affected by maximum bites or by unilateral chewing. For most of the variables investigated there were no significant differences between unilateral and bilateral biting. Robust sway reduction during feedback-controlled biting tasks in healthy subjects involved a stiffening phenomenon that was attributed to the common physiological repertoire of posture control, and might optimize the stability of posture under these conditions.     

重症监护室医护人员对潮湿相关性皮肤损伤的知信行水平调查

目的：调查浙江温州地区三甲医院重症监护室医护人员对潮湿相关性皮肤损伤（MASD）的知信行现状,为提高监护室医护人员对MASD知信行水平提出切实可行的建议。方法：采用方便抽样法抽取三家三甲医院160名医护人员作为研究对象,通过一般资料调查表及MASD知信行调查问卷对其进行调查。结果：本研究共发放160份问卷,回收有效问卷共151份,有效回收率为94.38%。医护人员关于MASD知识、态度及行为的得分分别为（43.03±8.38）分、 （23.64±3.24）分和（13.98±3.16）分;不同工龄、职称、受教育程度医护人员知信行得分差异有统计学意义（P ＜0.05）。结论： 重症监护室医护人员对MASD的态度较积极,知识水平偏低,行为尚欠缺。其中医师对于皮肤问题的重视程度较低,医护人员的合作意识欠缺,对此需开展针对性培训,提高医护人员相关理论知识及合作行为能力,规范MASD的预防及处理方法。     

Low-frequency repetitive transcranial magnetic stimulation for dyskinesia and motor performance in Parkinson’s disease

Dyskinesias are one of the most frequent and disabling complications of the long-term treatment of Parkinson’s disease (PD). Although the cause is not completely understood, it appears that an imbalance between excitatory and inhibitory inputs from the basal ganglia to the motor cortex leads to overactivation of motor and premotor areas. Overactivation of the supplementary motor area (SMA) has been observed in neuroimaging studies in dyskinetic PD patients. We investigated the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) of the SMA on levodopa-induced dyskinesias (LID) and motor performance in PD. We tested whether longer duration (10 days) and higher number of total pulses (1800 pulses) would enhance the beneficial effect. Seventeen dyskinetic PD patients were randomly assigned to real rTMS or sham (placebo) rTMS, and 1 Hz rTMS or sham rTMS was applied over the SMA for 10 consecutive days. Patients were assessed at baseline and 1 day after the last rTMS with a levodopa challenge test, and video recordings were taken. Dyskinesias and motor performance were rated off-line by two blinded raters using video recordings. After 10 days of treatment with rTMS, we observed that 1 Hz rTMS delivered over the SMA had decreased LID lasting for 24 hours without a change in motor performance, whereas sham rTMS induced no significant change in dyskinesia scores. These results support a possible therapeutic effect of low-frequency rTMS in LID. However, in order to suggest rTMS as an effective treatment, long-term observations and further investigations with a larger patient population are essential.