腰椎间盘突出患者血清疼痛物质及炎性应激指标的变化研究

背景：腰椎间盘突出是临床较为常见的疾病,多数患者有不同程度的疼痛表现,严重影响生活质量。目的：探讨腰椎间盘突出患者血清疼痛物质及炎性应激指标的变化。方法方法：收集2012年7月至2014年5月收治的88例腰椎间盘突出患者（观察组）和同期进行健康体检的88例志愿者（对照组）的外周静脉血。采用酶联免疫法检测两组的血清疼痛物质（P物质、神经肽Y、神经生长因子）及炎性应激指标（白细胞介素-1β、白细胞介素-6、白细胞介素-8、白细胞介素-10、降钙素原、超敏热休克蛋白、肿瘤坏死因子-α、干扰素-γ）水平并进行比较,同时比较观察组中不同PPI分级者的检测水平。结果：观察组的血清疼痛物质及炎性应激指标水平均显著高于对照组,且观察组中PPI分级较高者的检测水平高于PPI分级较低者（P〈0.05）。结论：腰椎间盘突出患者血清疼痛物质及炎性应激指标均呈高表达状态,且受疼痛程度的影响较大。     

Measurement of three-dimensional perioral soft tissue changes in dentoalveolar protrusion patients after orthodontic treatment using a structured light scanner

Objective:To evaluate the three-dimensional (3D) perioral soft tissue changes after orthodontic treatment in patients with dentoalveolar protrusion using structured light–based scanners.Materials and Methods:Forty-four Korean adults (19 men and 25 women, 21.4 ± 3.4 years) with dentoalveolar protrusion treated by extraction of all four first premolars and then en masse retraction with maximum anchorage were evaluated. Lateral cephalograms and 3D facial scans were obtained before treatment (T1) and immediately after debonding (T2). Superimposition was performed, and 27 perioral landmarks were identified. The 3D changes in the landmarks and ratio of movement of the soft tissue relative to the horizontal incisal tip were evaluated. A paired t-test and one-way analysis of variance were performed.Results:The upper incisors were retracted 5.76 mm and the lower incisors were retracted 4.62 mm (P < .001). The upper lip moved inferoposteriorly, and the lower lip moved superoposteriorly. In the lower lip, upward movement was greater than backward movement (P < .001). The most prominent changes appeared at the greatest bulge area. The relative ratios were 42%–53% in the upper lip area and 22%–82% in the lower lip area. The lip corners moved superoposteriorly (P < .001). Subnasale moved downward (P < .05) and posteriorly (P < .001), while the landmarks under the nostrils moved upward and posteriorly (P < .001).Conclusion:Facial scans from white structured light scanners efficiently evaluated 3D perioral soft tissue in dentoalveolar protrusion patients. Backward movement and significant vertical movement of the lip were observed. The nasal and lip angle areas showed considerable changes.     

Severe unilateral scissor bite and bimaxillary protrusion treated by horseshoe Le Fort I osteotomy combined with mid-alveolar osteotomy

This report describes an orthognathic surgical case employing horseshoe Le Fort I osteotomy (HLFO) combined with mid-alveolar osteotomy and bilateral sagittal split ramus osteotomy (BSSRO) for a patient with severe unilateral scissor bite and bimaxillary protrusion. A female patient (aged 26 years, 2 months) presented with a chief complaint of dysmasesis caused by scissor bite on the right side. The clinical examination revealed difficulty in lip closure and a convex profile. Overerupted right maxillary premolars and molars and lingual tipping of the right mandibular premolars and molars were indicated before treatment. After 3 months of presurgical orthodontic treatment, two-jaw surgery involving a combination of HLFO with mid-alveolar osteotomy and BSSRO was performed. A good interdigitation in the right side was established by superior-posterior-medial movement of the dento-alveolar segment of the maxilla. Next, both the maxilla and mandible were moved superiorly and posteriorly to correct the improper lip protrusion, thereby improving the patient''s profile. Our results suggest that this new orthognathic surgery technique—achieved by combining HLFO with mid-alveolar osteotomy and BSSRO—is effective for adult patients exhibiting severe unilateral scissor bite and bimaxillary protrusion.     

高角型双颌前突矫治前后软硬组织改变分析

目的探讨正畸治疗对高角型双颌前突患者软硬组织矢状及垂直向的影响。方法对18例高角型双颌前突患者在拔除4个第一前磨牙后,采用直丝弓矫治技术进行矫治。矫治前后拍摄X线头颅侧位定位片,并对矫治前后软硬组织侧貌的变化进行分析。结果①上下颌骨矢状及垂直向关系无明显变化;②上下前牙突度和倾斜度明显减小;③上下磨牙垂直向及矢状向支抗得到较好控制,牙合平面角无明显改变;④上下唇突度明显减小,上唇长度加长,下唇长度减小。颏厚度增加1.70mm,颏唇沟加深1.13 mm。结论高角型双颌前突患者拔牙矫治后垂直向及矢状向支抗可得到较好控制,侧貌有明显改善。     

杜仲腰痛丸对髓核非压迫性突出大鼠背根节中降钙素基因相关肽含量的影响

目的 观察杜仲腰痛丸对髓核非压迫性突出大鼠背根节（DRG）中降钙素基因相关肽（CGRP）含量的影响。方法 取健康、雄性Wistar大鼠50只,随机分为假手术组（A组）、模型组（B组）、阳性对照组（C组,伸筋丹组）、杜仲腰痛丸高剂量组（D组）、杜仲腰痛丸低剂量组（E组）,每组10只。将大鼠自身的尾椎髓核取出移植于左侧L5和L6神经根背侧,造成大鼠非压迫性髓核突出模型,通过免疫组化的方法测定大鼠2周时DRG中CGRP的变化。结果 B、C、D和E组DRG中CGRP阳性神经元的表达明显增加,B、C、D和E组CGRP阳性神经元的免疫反应强度与A组比较均增高（P〈0．05）,其中B组与A组比较显著增高（P〈0．01）,但C、D、E组与B组比较为低（P〈0．05）,D、E组与C组比较为低（P〈0．05）。结论 杜仲腰痛丸可通过下调或者抑制非机械压迫性髓核对神经根损伤后DRG内的痛觉神经递质CGRP的释放而发挥镇痛作用。     

上颌前突矫治术后软组织侧貌改变的研究

目的:分析上颌前份节段性骨切开矫治上颌前突术后软组织侧貌改变情况,探讨其稳定性。方法:对21例上颌前份节段性骨切开成年男性患者术前、术后1个月及术后1年的X线头影测量片进行对比研究。结果:术后软组织侧貌改变:上中切牙切缘点Is平均后移6.1±2.7m(mP<0.01),上唇突点Ls平均后移4.6±1.6m(mP<0.01),鼻唇角Cm-Sn-Ls平均增加6.8°±5.6(°P<0.01),上下唇间隙Stms-Stmi平均缩小4.5±3.5m(mP<0.01),露齿程度Is-Stms平均减小2.1±2.2m(mP<0.05),上唇突度减小,上唇厚度、长度及软组织面型角G-Sn-Pgss无显著改变(P<0.05)。术后1年颜面软组织侧貌改变的稳定性与术后早期相比,在水平方向上,所有指标复发率均超过10%。在垂直方向上各项指标复发率均在10%以内。结论:上颌前份节段性骨切开术矫正上颌前突,患者软组织侧貌的改善明显,效果稳定。     

椎间盘突出症与椎间不稳310例治疗效果分析

目的探讨椎间不稳与腰椎间盘突出的发生、发展及对手术或保守治疗的影响和作用。方法310例病例分为手术组和保守治疗组,手术治疗69例,采用开窗摘除突出的椎间盘。有滑脱者进行椎间植骨融合;保守治疗136例,采用床头牵引,每天牵引2～4小时,尽量卧床休息,下床活动时腰围固定,治疗时间4～8周。结果手术组50例术后得到随访,随访时间平均27（6～60）个月,2例有腰痛和下肢疼痛,较术前减轻,1例会阴部感觉减退,优良率94％。保守治疗组110侧得到随访,平均随访时间24（6～72）个月。89例症状消失和明显好转,优良率为81％。结论椎间不稳对椎间盘突出的发生及发展有很重要的影响,治疗时也不能忽视。重视腰部稳定,对手术和保守治疗都很重要。     

青少年单侧不完全性唇腭裂植骨术后上颌骨及上气道的CBCT研究

目的 评估青少年单侧不完全性唇腭裂患者术后上颌骨及上气道的三维形态结构特征,并探索二者之间的相关性.方法 选取8～12岁青少年单侧不完全性唇腭裂术后患者30例及与年龄、性别相匹配的非唇聘裂骨性Ⅰ类错畸形患者30例,拍摄CBCT影像并对其上颌骨及上气道进行三维结构参数的测量分析,分析唇腭裂组上颌骨及上气道三维结构参数的...     

多开窗潜行椎管减压加髓核摘除术治疗多段腰椎间盘突出症并椎管狭窄症

目的探索不同术式对多段腰椎间盘突出症并椎管狭窄症的疗效影响。方法将60例患者分为观察组(35例)和对照组(25例),观察组采用多开窗潜行椎管减压加髓核摘除术,对照组采用半椎板切除加髓核摘除术。结果观察组有效率91.4%,对照组有效率60%,两组有显著性差异(P<0.05)。结论多开窗潜行椎管减压加髓核摘除术不仅彻底减除了神经根通道上对神经根的压迫因素,而且创伤小,保持了脊椎的稳定。是治疗多段腰椎间盘突出症并椎管狭窄的好方法。     

正颌联合正畸矫正骨性上颌前突畸形

目的 探讨用正颌手术联合口腔正畸治疗上颌骨水平向发育过度畸形.方法 采用上颌前部骨切开术,结合术前,术后的固定正畸方法联合治疗.结果 12例患者治疗后取得较好的外观效果及咬合关系.结论 正颌外科结合正畸对于上颌前突畸形的治疗能取得最佳的治疗效果.