光固化壳聚糖-明胶复合三维支架对维持拔牙后牙槽嵴高度和宽度的影响

目的 研究新型光固化壳聚糖 明胶复合三维支架在拔牙后动物模型位点保存中的应用。方法 采用二甲基亚砜/光固联技术合成新型光固化壳聚糖 明胶复合三维支架,并采用乳液冷冻干燥法,制备了支架/rhBMP 2复合体。取8只Beagle犬,取下颌拔牙窝为实验位点,左右两侧共计64个位点,随机分为空白对照组（Control组）、空白支架组（S0组）、支架+肝素组（SH组）、支架+BMP2组（SB组）,并植入相应支架。术后90 d处死动物,采集术前、术后牙槽嵴髙度及宽度数据,并取下牙槽窝加上近远中两个牙位的牙槽骨,行显微 CT扫描和组织学检查。结果 在牙槽骨宽度、高度丧失上,S0、SH、SB组均小于Control组（P<0.05）,组间比较中,SB组均小于S0、SH组（P<0.05）;显微CT 三维重建后显示S0、SH、SB组较好的保留了原牙槽嵴宽度和外形,Control组牙槽嵴则明显变窄,并出现局部吸收;组织学上,SB组基本未见吸收,形成了成熟的骨小梁,骨质钙化程度高于Control组、S0组、SH组。结论 新型三维支架在动物模型上可以实现良好的成骨效果,较好地维持了拔牙后牙槽嵴的高度和宽度。     

A new paradigm in the management of acute type A aortic dissection: Total aortic repair

The currently accepted guidelines of open surgical repair for acute type A aortic dissection include the resection of the primary entry tear, replacement of the ascending aorta and “hemi-arch” with an open distal anastomosis, and aortic valve resuspension and some form of obliteration of the aortic root false lumen. The principal aim is protection against aortic rupture, aortic regurgitation, and coronary ischemia and restoration of antegrade preferential true lumen perfusion. Proponents argue that this operation is tailored to be in the armamentarium of most cardiac surgeons and deliver the lowest early operative risk while leaving the infrequent long-term sequelae to be dealt with electively by experienced aortic centers. Although this may sound to be a compelling argument, the actual outcomes suggest that it falls significantly short of achieving its noble goals on both acute and chronic counts. This led us to develop a seemingly more radical paradigm, which aims to achieve total aortic healing in the acute phase. We describe a total aortic repair technique for acute type A aortic dissection consisting of “branch first” total arch repair, followed by thoracoabdominal stenting and balloon rupture of the septum. The total aortic repair technique ensures that the aortic valve, ascending aorta, and arch are surgically securely repaired, and provides complete decompression of the false lumen as well as internal support in the remainder of the aorta. This has provided excellent early results and will hopefully minimize future complications and interventions.     

The Use of the Woodchuck as an Animal Model for Evaluation of Transarterial Embolization

There are many shortcomings of current animal models as surrogates of hepatocellular carcinoma that handicap preclinical testing of embolization agents. The present study explores the feasibility of using the woodchuck (Marmota monax) as an animal model for the testing of novel embolization agents. Four woodchucks underwent magnetic resonance imaging, angiography, and left lobar hepatic artery particle embolization. Percutaneous access, arteriography, and lobar embolization were successful in all animals, with angiographic stasis obtained in the target vessel with minimal reflux of embolic material. These results support the feasibility of the woodchuck as an animal model for preclinical testing of embolization agents.     

Percutaneous MR Imaging–Guided Cryoablation of Small Renal Masses in a 3-T Closed-Bore MR Imaging Environment: Initial Experience

Purpose

To assess the feasibility of percutaneous magnetic resonance (MR) imaging–guided cryoablation of small renal masses (SRMs) in a 3-T environment and to evaluate intraprocedural imaging, procedural safety, and initial outcomes.

Imaging behind occluded areas with an iatrogenic perforated balloon: A safe,practical, and simple new method of visualizing the distal lumen in total occlusion

Objective

In the present study, we investigated the effectiveness and reliability of a new method that reveals whether guidewire advanced distal to the lesion is in the lumen in patients with acute (ATO) or chronic coronary total occlusion (CTO).

Methods

Forty‐one patients with symptomatic ATO and 22 patients with CTO who were admitted into our catheterization laboratory between January 2016 and March 2017 were included. In patients in whom antegrade filling could not be demonstrated after passing 0.014″ guidewire beyond the total lesion, a 1.25 × 15 mm balloon was punctured with a needle outside the operative field to visualize the total lesion. This perforated balloon was then used to deliver an opaque substance through this hole to visualize the distal part.

Results

The mean age of our 63 patients was 66 ± 12 years. They had diabetes (57%), hypertension (100%), and a history of PCI (85%). The mean procedural time was 27 ± 6.8 min, and the mean volume of contrast material used was 93.9 ± 24 mL. This technique was 100% successful in accurately demonstrating the distal lumen and preventing complications.

Conclusion

This new method we developed is much simpler and more useful than other methods for visualization of the true lumen because we can re‐orient the balloon at the time of opaque injection and use 190 cm guidewire without additional costs. Additionally, one balloon is sufficient for the operation.

     

慢性牙周炎与2型糖尿病的关系研究进展

慢性牙周炎（chronic periodontitis,CP）与糖尿病（diabetes mellitus,DM）关系密切,其相互影响是近年来牙周医学研究的热点。DM是CP的危险因素之一,可通过多种机制促进CP发生发展,同时CP也是DM的第6大并发症,可影响DM病程进展,约90%以上的DM为2型糖尿病（type 2 diabetes mellitus,T2DM）,本文就CP和T2DM相互影响的特点及机制等方面的研究进展作一综述。     

镍钛器械Waveone治疗磨牙根管的临床效果

目的 评价使用机用镍钛器械Waveone预备磨牙根管的临床效果。方法 使用新型单根根管预备锉Waveone采用冠向下法预备67颗磨牙,不锈钢K锉采用逐步后退技术预备54颗磨牙。均使用侧方加压技术进行根管充填。比较两组根管预备所需时间、器械分离情况和根管充填效果。结果 使用Waveone进行根管预备根管充填恰充率为91.1%,高于不锈钢器械组的66.7%（P＜0.01）,预备时间为(17.76±1.96)min少于不锈钢器械组的(33.82±2.37)min（P＜0.01）。结论 使用Waveone进行根管预备时间短,预备锥度好根管充填密合度强。