A型肉毒毒素在下面部轮廓年轻化治疗中的疗效分析与评价

目的定量评价A型肉毒毒素对下面部的年轻化作用。方法对30例下面部宽大伴有皮肤松垂的患者采用A型肉毒毒素注射咬肌、降口角肌及颏颈缘的颈阔肌,以治疗前后的照片做对比,并应用Angel软件进行治疗前后的定量测量评价。结果本组共30例患者,术后1、6个月随访,瘦脸的疗效维持良好,自然表情时颏颈线平均提升1．7mm。结论对平均年龄46．5岁的患者,通过A型肉毒毒素的治疗,在6个月内能有效改善下面部轮廓,并提升颏颈线,重复治疗依然有效,是一种可以推广的微创技术。     

数字乳腺断层摄影及其合成二维影像技术在乳腺癌筛查中的研究进展

目前乳腺X线检查仍是乳腺癌早期诊断的有效检查方法之一,主要包括全视野数字化乳腺摄影（FFDM）、数字乳腺断层摄影（DBT）、合成乳腺X线摄影（SM）以及3种技术的联合应用（FFDM联合DBT、SM联合DBT）。对DBT、SM和SM联合DBT在乳腺筛查中诊断效能、影像质量及辐射剂量等进行比较。SM联合DBT可有效平衡辐射剂量和诊断效能,但仍然在判读时间、信息的存储与传输和检查成本方面存在局限性。就以上3种检查技术在乳腺癌筛查中的研究进展予以综述。     

数字化技术用于牙列缺失患者口腔种植修复中的效果

〔摘 要〕 目的：评定口腔种植修复中施以数字化技术修复牙列缺失的效果。方法：选取 2020 年 1 月至 2021 年 12 月泉州医学高等专科学校附属人民医院接收的牙列缺失患者 100 例,以随机数字表法分为对照组与观察组,每组 50 例。对照组患者施以常规口腔种植修复方案,观察组患者施以数字化技术口腔种植修复方案,比较两组患者的修 复效果及并发症发生率。结果：观察组患者的总有效率比对照组更高,差异具有统计学意义（P ＜ 0.05）;观察组患 者各项口腔功能与舒适度评分均比对照组更高,差异具有统计学意义（P ＜ 0.05）;观察组患者各项种植体位置偏差 值均比对照组更低,差异具有统计学意义（P ＜ 0.05）;观察组患者治疗后的并发症发生率比对照组更低,差异具有 统计学意义（P ＜ 0.05）;观察组患者对治疗的总满意率比对照组更高,差异具有统计学意义（P ＜ 0.05）。结论： 在牙列缺失修复中施以数字化技术口腔种植修复方案,可以更好地提高患者的口腔功能与舒适度,且能更有效地减少 并发症发生率与种植体位置术前术后偏差值。     

The use of digital dermoscopy in the surveillance of melanocytic skin lesions: A real-life retrospective study comparing university hospital and private practices

BackgroundFew studies have evaluated the role of digital dermoscopy (DD) in the surveillance of pigmented lesions in real-life practice.Patients and methodsPatients followed with DD by 4 hospital dermatologists (group 1) and 4 private dermatologists (group 2) were retrospectively included if they had had at least 2 DD examinations for a minimum of 4 pigmented lesions. Their characteristics, risk factors, history of excision of benign nevi and melanomas prior to and during the DD follow-up, and characteristics of detected melanomas, were recorded.ResultsOne hundred and ninety-six patients were included in group 1 and 205 in groups 2. A family history of melanoma (25% vs. 12%, p < 0.01), a personal history of melanoma before DD follow-up (47% vs. 15%, p < 0.01), and a family (3% vs. 0%, p = 0.01) and personal (8% vs. 1%, p < 0.01) germline CDKN2a mutation were more frequent in group 1 than in group 2. In both groups, the number of excisions of benign lesions was higher before DD follow-up (380 and 347, respectively) than during DD follow-up (194 and 132). During follow-up, 29 melanomas were detected in group 1, with a median Breslow thickness of 0.4 mm, versus 1.3 mm for melanomas diagnosed before DD follow-up (p < 0.02). In group 2, 4 melanoma and 5 superficial atypical melanocytic proliferations of unknown significance were detected. The median Breslow thickness of newly diagnosed melanomas was 0.35 mm vs. 0.6 mm before DD follow-up (p = 0.1).ConclusionIn both populations in real-life practice, DD seemed to allow the detection of thin melanomas and to decrease the rate of “futile” resections.     

Post-processing of DLP-printed denture base polymer: Impact of a protective coating on the surface characteristics,flexural properties,cytotoxicity, and microbial adhesion

ObjectivesTo investigate the effect of a protective coating on the surface characteristics, flexural properties, cytotoxicity, and microbial adhesion of vat-photopolymerization additive-manufacturing denture base polymers.MethodsThe specimens were additively manufactured using digital light processing (DLP). Specimen surfaces were coated with the same printed resin, and mechanical polishing was used for comparison. Surface topography, arithmetical mean height (S_a), and water contact angle values were measured. Furthermore, flexural strength (FS)/modulus and fractography were evaluated. Also, cytotoxicity was evaluated by an extract test. Finally, an adhesion test was used to investigate the adhesion of mixed oral bacteria to the specimens.ResultsThe S_a values in the polished (0.26 ± 0.08 µm) and coated (0.38 ± 0.14 µm) groups were significantly lower than in the untreated (2.21 ± 0.42 µm) and control (2.01 ± 0.37 µm) groups. The coating treatment resulted in a higher FS compared to the untreated surface (p = 0.0002). After the coating treatment, no significant differences were found in relative cell viability between the groups (p > 0.05). The quantitative results showed significantly higher bacterial adhesion in the untreated group than in the polished (p = 0.0047) and coated (p < 0.0001) groups.SignificanceThe surface characteristics and flexural properties were optimized by the protective coating. Also, the protective coating did not adversely affect cytocompatibility. Moreover, the coating treatment could effectively decrease oral bacteria adhering to the surfaces. Therefore, the protective coating treatment can be a less time-consuming alternative to mechanical polishing as a post-processing procedure for the digital denture.     

2种种植修复制作工艺的Ti-base基台一体冠用于口腔种植单冠修复精度的研究

目的: 比较2种工艺制作的Ti-base基台一体冠的精度,为单牙种植修复工艺的选择提供实验依据。方法: 选择就诊于上海市普陀区眼病牙病防治所口腔种植科的30例单颗后牙缺失患者,临床进行传统印模,得到装有种植体替代体的石膏模型。每个患者取2个模型,按照制作工艺不同分为2组,实验组为安装扫描杆进行扫描,对照组为安装Ti-base基台直接扫描。将2组修复冠沿颊舌向剖开,利用电镜观察测量点与Ti-Base基台之间的距离。利用万能测力仪的加载力,通过接触氧化锆牙冠传递至基台及替代体处,观察氧化锆冠所能承载最大力量。采用SPSS 22.0软件包对数据进行统计学分析。结果: 实验组冠与Ti-base基台缝隙大小显著小于对照组（P<0.05）;2组Ti-base基台一体冠中氧化锆的抗压强度相比,实验组的抗压强度与对照组接近,无统计学差异（P>0.05）。结论: 安装扫描杆转移种植体位置到数字化修复软件中,比直接用扫描仪获得Ti-base基台相关数据信息更为精确可靠,加工制造的修复冠精密度和稳定度更高,推荐在口腔种植修复工艺中应用。     

Breast screening using 2D-mammography or integrating digital breast tomosynthesis (3D-mammography) for single-reading or double-reading – Evidence to guide future screening strategies

PurposeWe compared detection measures for breast screening strategies comprising single-reading or double-reading using standard 2D-mammography or 2D/3D-mammography, based on the ‘screening with tomosynthesis or standard mammography’ (STORM) trial.MethodsSTORM prospectively examined screen-reading in two sequential phases, 2D-mammography alone and integrated 2D/3D-mammography, in asymptomatic women participating in Trento and Verona (Northern Italy) population-based screening services. Outcomes were ascertained from assessment and/or excision histology or follow-up. For each screen-reading strategy we calculated the number of detected and non-detected (including interval) cancers, cancer detection rates (CDRs), false positive recall (FPR) measures and incremental CDR relative to a comparator strategy. We estimated the false:true positive (FP:TP) ratio and sensitivity of each mammography screening strategy. Paired binary data were compared using McNemar’s test.ResultsAmongst 7292 screening participants, there were 65 (including six interval) breast cancers; estimated first-year interval cancer rate was 0.82/1000 screens (95% confidence interval (CI): 0.30–1.79/1000). For single-reading, 35 cancers were detected at both 2D and 2D/3D-mammography, 20 cancers were detected only with 2D/3D-mammography compared with none at 2D-mammography alone (p < 0.001) and 10 cancers were not detected. For double-reading, 39 cancers were detected at 2D-mammography and 2D/3D-mammography, 20 were detected only with 2D/3D-mammography compared with none detected at 2D-mammography alone (p < 0.001) and six cancers were not detected. The incremental CDR attributable to 2D/3D-mammography (versus 2D-mammography) of 2.7/1000 screens (95% CI: 1.6–4.2) was evident for single and for double-reading. Incremental CDR attributable to double-reading (versus single-reading) of 0.55/1000 screens (95% CI: −0.02–1.4) was evident for 2D-mammography and for 2D/3D-mammography. Estimated FP:TP ratios showed that 2D/3D-mammography screening strategies had more favourable FP to TP trade-off and higher sensitivity, applying single-reading or double-reading, relative to 2D-mammography screening.ConclusionThe evidence we report warrants rethinking of breast screening strategies and should be used to inform future evaluations of 2D/3D-mammography that assess whether or not the estimated incremental detection translates into improved screening outcomes such as a reduction in interval cancer rates.     

颅颌面整形手术机器人在颏部水平截骨手术中的精确性分析

目的 探讨颅颌面整形手术机器人在颏部水平截骨手术中的应用效果和精确性.方法 回顾分析2015年1月至2020年12月接受传统颏部水平截骨手术的10例小颏畸形患者(临床组)的临床资料,并通过颅颌面整形手术机器人对该组患者1:1的3D石膏模型(机器人组)进行颏部水平截骨手术操作.以本团队前期实验研究数据标准为参考,利用数字...     

MSCTA和DSA对缺血性脑血管病的诊断价值比较

目的探讨多层螺旋CT脑血管造影(MSCTA)在缺血性脑血管病(ICVD)中的诊断价值,同时分析血管病变的分布情况。方法随机抽取2005年4月至2012年2月住院的缺血性脑血管病变患者64例,且在入院1周之内均经多层螺旋CT血管造影和数字减影血管造影(DSA)检查。由2位放射科医师独立进行阅片,其结果分别进行Kappa一致性检验和ROC曲线分析。结果①2位医师判读结果经Kappa一致性检验,Kappa值为0.914和0.876,P0.05,说明2种医师有良好的一致性。②取其中1位医师的MSCTA与DSA判读结果进行ROC曲线分析,AZ值分别为0.849和0.858,说明2位检查方法诊断效能无明显差异。③颈内动脉病变所占比例最高(34%),其次颈总动脉(24%),椎-基底动脉系统病变较少。结论 MSCTA与DSA检查结果有较高的一致性;同时可以反映病变血管分布和管壁情况。     

DR图像质量控制方法探讨

目的对DR非甲级片进行技术分析,探讨DR图像质控的方法。方法根据日常工作评片统计对400张非甲级片进行原因分析,对各种机器型号产生图像的原理,图像的质量,以及技术方法进行研究总结,工作流程中每一个细节均可能对图像质量造成影响。结果影响DR图像质量的因素包括：（1）摄片技术参数：摄影条件选择得当是图像质量的保证。（2）X线机器工作性能：技术员要熟悉各种型号机器的性能,最大程度发挥机器的效能。（3）量子噪声：曝光时要兼顾噪声和曝光剂量。（4）图像后处理技术：操作技师对要显示的内容和感兴趣区有价值的部分做适当的后处理,调节适宜的窗宽、窗位,有利于观察病变,它是控制图像质量的关键。（5）激光相机：使用前进行调试和校正,正确掌握打印机的各种指标和性能,而且平时注意维护。结论影响DR图像质量因素大多是人为的。严格按照x线摄影技术的要求进行DR的摄影可获得优质片。