在药理学教学中渗透美育

药理学内容的局限性,容易使传统的课堂教学失之呆板乏味;而美感作为自由感受,具有自由直观的因素,有助于发展学生的创造性思维.笔者在药理教学中,就如何融会美育于药理学教学中,做了积极的探索.     

Techniques to minimize skin incision scar for external dacryocystorhinostomy

Although there has been a narrowing in the gap in successful functional outcomes between external and endonasal DCR, external DCR is still being frequently performed when cost, availability of additional surgical instruments and visual systems, surgeon’s experience and preference are concerned. Nonetheless, skin incisions at the lateral nasal sidewall of the lower eyelid inevitably leave cutaneous scars. The purpose of this review is to evaluate the outcomes of current modified surgical practices that prevent a conspicuous scar in external DCR.     

即刻种植翻瓣与不翻瓣术临床疗效分析

目的:评估即刻种植中翻瓣或不翻瓣手术唇侧骨板骨吸收量、种植体留存率、软组织得分,为临床选择不同的术式提供参考。方法:选取上颌前牙即刻种植的42例患者作为研究对象,分为翻瓣组（22例、24颗种植体）和不翻瓣组（20例、22颗种植体）。应用Mimics软件,通过拟合,比较患者术后当天和术后6个月局部骨量。采用SPSS 20.0软件包分析种植术后6个月时的骨吸收量平均值和方差,统计种植体留存率。于永久修复后2年,对2组患者的粉色美学指数（pink esthetic score, PES）及牙龈乳头指数（papilla index score, PIS）进行评分。结果:翻瓣组与不翻瓣组种植体平台（种植体颈部平台）、中部（种植体长度1/2）、根尖点（种植体最底端）种植术后6个月的骨吸收量分别为（0.591±0.604）、（1.145±0.923）、（0.951±1.092）mm和（0.384±0.321）、（0.469±0.321）、（0.209±0.288）mm。种植体中部及根尖点骨吸收量具有显著差异,种植体颈部骨吸收量无显著差异。2组种植体在观察期内无一脱落,种植体存留率为100%。翻瓣组（19例）及不翻瓣组（18例）单颗种植冠的PES及PIS得分分别为（7.34±1.132）、（8.04±0.631）和（2.04±0.591）、（2.41±0.254）,差异无统计学意义。结论:即刻种植时翻瓣与不翻瓣相比,种植体边缘骨水平均相对稳定,不翻瓣组骨吸收低于翻瓣组。永久修复后2年,两者的PES、PIS无显著差异。     

论外科手术与美容

回顾近年来从事美容整形外科的实践，就外科手术与美容的关系进行分析，指出外科手术当前存在的问题有：只顾治疗疾病，缺乏美学知识；操作粗糙，缺乏美容外科基本技能；违背外科手术原则和对术后效果不能实事求是认识等。同时提出了相应的预防措施，强调外科医生不仅要有高超的诊断和治疗技术，同时也要掌握医学美学的基本理论知识，具有较高的审美水平，把美容外科原则及技巧和外科手术紧密结合，对提高我国美容整形的整体素质至关重要。     

Keystone design perforator island flap in facial defect reconstruction

Facial defect coverage is a common subject in the field of reconstructive surgery. There are many methods for facial defect reconstruction, and reconstructive surgeons should choose the most appropriate method on a case-by-case basis to achieve both functional and aesthetic improvement. Among various options for facial reconstruction, the local flap technique is considered the best reconstructive modality to provide good tissue matches of color and texture, which is consistent with the ideal goal of reconstruction (replacement of like-with-like). Keystone design perforator island flap (KDPIF), devised by Behan in 2003, has been applied to various fields of reconstructive surgery in the past decade due to its design simplicity, robust vascular supply, and reproducibility. Several studies have reported KDPIF reconstruction of facial defects, such as large parotid defects, small-to-moderate nasal defects, and eyelid defects. However, KDPIF has been used relatively less in facial defects than in other body regions, such as the trunk and extremities. The purpose of this review is to provide an organized overview of facial KDPIF reconstruction including the classification of KDPIF, modifications, physiology, mechanism of flap movement, consideration of facial relaxed skin tension lines and aesthetics, surgical techniques, clinical applications, and precautions for successful execution of KDPIF reconstruction.     

Marquardt’s Phi Mask: Pitfalls of Relying on Fashion Models and the Golden Ratio to Describe a Beautiful Face

Background Stephen Marquardt has derived a mask from the golden ratio that he claims represents the “ideal” facial archetype. Many have found his mask convincing, including cosmetic surgeons. However, Marquardt’s mask is associated with numerous problems. The method used to examine goodness of fit with the proportions in the mask is faulty. The mask is ill-suited for non-European populations, especially sub-Saharan Africans and East Asians. The mask also appears to approximate the face shape of masculinized European women. Given that the general public strongly and overwhelmingly prefers above average facial femininity in women, white women seeking aesthetic facial surgery would be ill-advised to aim toward a better fit with Marquardt’s mask. This article aims to show the proper way of assessing goodness of fit with Marquardt’s mask, to address the shape of the mask as it pertains to masculinity-femininity, and to discuss the broader issue of an objective assessment of facial attractiveness. Methods Generalized Procrustes analysis is used to show how goodness of fit with Marquardt’s mask can be assessed. Thin-plate spline analysis is used to illustrate visually how sample faces, including northwestern European averages, differ from Marquardt’s mask. Results Marquardt’s mask best describes the facial proportions of masculinized white women as seen in fashion models. Conclusions Marquardt’s mask does not appear to describe “ideal” face shape even for white women because its proportions are inconsistent with the optimal preferences of most people, especially with regard to femininity.     

The bleaching of teeth: a review of the literature

OBJECTIVES: To review current knowledge of tooth whitening with respect to external bleaching methods. DATA: The scope is the external bleaching of vital teeth and focuses on mechanisms; in vivo and in vitro measurement methods, and factors influencing the efficacy of the whitening process. SOURCES: "Medline" and "ISI Web of Science" databases from 1966 and 1974, respectively were searched electronically with key words tooth, teeth, colo*r, white*, bleach* and peroxide. CONCLUSIONS: The importance of tooth whitening for patients and consumers has seen a dramatic increase in the number of products and procedures over recent years, with a concomitant rise in publications on this topic. Literature suggests that the mechanisms of tooth whitening by peroxide occur by the diffusion of peroxide through enamel to cause oxidation and hence lightening of coloured species, particularly within the dentinal regions. A number of approaches are available for measuring changes in tooth colour. These include visual measurements by trained clinicians and instrumental measurements using spectrophotometry, chromameters and digital image analysis. The key factors that affect tooth whitening efficacy by peroxide containing products are concentration and time. In general, higher concentrations are faster than lower concentrations. However, lower concentrations can approach the efficacy of higher concentrations with extended treatment times. Alternative bleach systems to peroxide have received only minor attention. The efficacy of light activated systems versus non-light activated controls in clinical studies is limited and conflicting. Other factors which can influence tooth bleaching outcome include type of stain, initial tooth colour and subject age.     

Reading and writing direction effects on the aesthetic appreciation of photographs

Does reading and writing direction (RWD) influence the aesthetic appreciation of photography? Pérez González showed that nineteenth-century Iranian and Spanish professional photographers manifest lateral biases linked to RWD in their compositions. The present study aimed to test whether a population sample showed similar biases. Photographs with left-to-right (L–R) and right-to-left (R–L) directionality were selected from Pérez González’s collections and presented in both original and mirror-reversed forms to Spanish (L–R readers) and Moroccan (R–L readers) participants. In Experiment 1, participants rated each picture for its aesthetic pleasingness. The results showed neither effects of lateral organization nor interactions with RWD. In Experiment 2, each picture and its mirror version were presented together and participants chose the one they liked better. Spaniards preferred rightward versions and Moroccans preferred leftward versions. RWD therefore affects aesthetic impressions of photography in our participants when people pay attention to the lateral spatial dimension of pictures. The observed directional aesthetic preferences were not sensitive to the sex of the model in the photographs, failing to support expectations from the hypotheses of emotionality and agency. Preferences were attributable to the interaction between general scanning strategies and scanning habits linked to RWD.