流动树脂垫衬联合高强度流动树脂修复牙邻（牙合）面洞的疗效分析

【目的】探讨流动树脂垫衬联合高强度流动树脂在牙邻（牙合）面洞修复治疗中的疗效。【方法】选取接受牙邻（牙合）面洞修复的患者164例,根据修复方法不同分为观察组与对照组,观察组采用流动树脂垫衬联合高强度流动树脂修复,对照组采用“三明治”技术修复。两组治疗后6个月及1年采用改良的USPHS临床修复体质量评估疗效并比较。【结果】修复6个月及12个月后观察组患者修复体边缘着色及术后牙本质敏感症的发生率均显著低于对照组,其差异均有统计学意义（ P ＜0．05）;但两组修复体完整性和继发龋发生率的比较均无统计学差异（ P ＞0．05）。【结论】流动树脂垫衬联合高强度流动树脂在牙邻（牙合）面洞患者修复中的疗效显著,可降低患者的术后牙本质敏感症反应,恢复患牙的形态和美观。     

早期手术治疗感染性心内膜炎的可行性探讨

目的 探讨早期手术治疗感染性心内膜炎(IE)的可行性.方法 1996年6月至2011年7月,135例IE患者接受手术治疗.分为A组(早期手术治疗组,2008年后收治的患者)和B组(传统治疗组,2008年前收治的患者).比较两组患者死亡、治疗后心功能不全、感染复发、出院后栓塞等事件,分析患者生存情况.结果 两组患者一般资料无差异.组间比较,A组患者整体死亡比例下降(9.4％对23.0％,P=0.016);心脏功能衰竭患者比例减少(5.4％对26.2％,P＜0.001);两组患者感染复发比例无差异(0对4.9％,P=0.112;).A组患者手术比例高(67.6％对32.8％,P＜0.001),手术死亡率及再感染发生率未增加(6.0％对15.0％,P=0.222;0对5.0％,P=0.405).结论 早期积极合理的外科治疗可以改善IE患者整体预后.     

全膝关节置换翻修术中保留与非保留髌骨假体的Meta分析

目的通过Meta分析,比较全膝关节置换翻修术（RTKA）中髌骨假体保留与否的疗效差异。方法全面检索国内外关于RTKA中与是否保留髌骨假体疗效相关的文献,经特定的纳入、排除标准筛选文献,提取临床评分、功能评分、SF躯体及心理评分、患者满意度等相关数据后,采用Review Manager（Rev Man）4.2.10软件进行Meta分析。结果纳入随机对照研究3篇,共计231例RTKA患者,其中保留髌骨假体组共154例,非保留髌骨假体组共77例。Meta分析结果显示,保留髌骨假体组的临床评分（P=0.91）、功能评分（P=0.35）、SF躯体（P=0.39）及心理评分（P=0.13）与非保留组差异均无统计学意义。结论 RTKA术中髌骨假体的保留与否对术后症状改善、功能恢复等无明显的影响。     

一种新型间隔器技术在膝关节置换术后感染二期翻修中的应用

目的探讨一种新型间隔器制作方法在全膝关节置换术（TKA）后假体周围感染治疗方面的可行性和有效性。方法本研究纳入2009年7月至2012年1月间收入院的6例TKA术后慢性深部感染患者,采用二期翻修手术治疗第一阶段彻底清创后使用消毒后的股骨假体、新内衬和抗生素骨水泥作为关节间隔器,确认感染控制后行第二阶段膝关节翻修手术。术后观察感染控制情况和关节功能恢复情况。结果共5例患者按计划接受新型间隔器的二期翻修术。平均随访时间（24．4±10．5）个月（8—37个月）;术前、间隔器安置后、二期翻修后平均HSS评分分别为（40±5．3）分（32-46分）,（47±2．6）分（43～50分）,（65．4±2．3）分（62～68分）。术前、间隔器安置后、二期翻修后平均关节活动度分别为（75°±3．5°）（70°-80°）,（94°±4．2°）（90°～100°）,（106。±4．20）（100°-110°）。总体感染消除率为83．3％。结论消毒后假体和抗生素骨水泥组成的间隔器在治疗TKA术后假体周围感染上有优良的临床前景。     

踝关节发育不良的人工关节置换术

目的研究人工踝关节置换治疗发育性踝关节不良的中期疗效。方法自1997年10月～2010年12月,人工踝关节置换治疗踝关节疾患66例中踝关节发育不良6例,男5例,女1例,年龄44.5～59岁,平均52.7岁。幼儿时有外伤史4例,不明2例,病程5～11年。结果 6例6踝获6～11年随访,平均8年4个月。术前、后踝关节功能采用Kofoed评价法,术前踝关节功能平均36分（30～40分）4例,17分（0～29）2例;术后优（85～100分）3例,良（75～84分）3例,均无疼痛。仅1例作了步态分析,术前跛行步态（站立相超过58%）,术后正常步态（站立相15%～45%周期内）。结论人工踝关节置换治疗踝关节发育不良具有良好疗效。     

Are penile prostheses a viable option to recommend for gay men?

When talking to a gay men's prostate cancer support group on erectile dysfunction a question was asked of the author if he had evidence that a penile prosthesis would be rigid enough for anal sex. As a heterosexual male with no knowledge of a homosexual man with a prosthesis, the author could not answer the question. The local representative could not give the author a definitive answer either and there was no specific literature on this subject. However, testing of the rigidity of penile prosthesis demonstrated buckling forces of 800 g. On the basis of reported values that anal penetration requires 33% more rigidity than vaginal sex, the minimum rigidity required for vaginal sex is 500 g. Based on this figure a minimum rigidity of 634 mg is required for anal sex. A rigidity of 800 mg should therefore facilitate anal sex. This article considers current literature on the difference between heterosexual and homosexual prosthesis needs to aid health practitioners in decision‐making.     

20例乳腺癌腔镜辅助下保留乳头改良根治术＋Ⅰ期假体植入乳房重建术围术期护理

目的：探讨乳腺癌腔镜保乳改良根治术＋Ⅰ期假体植入乳房重建术的围术期护理要点。方法回顾性分析20例手术患者护理病历资料,分析护理计划及护理方法,总结护理经验。结果20例患者重建乳房外形、患肢功能良好,无并发症发生,术后随访5～29个月,中位平均随访时间为15个月,所有病例无局部复发和转移,美体效果满意。结论乳腺癌腔镜保乳改良根治术Ⅰ期假体植入乳房重建术创伤小、恢复快、美容效果好,做好围术期护理能减少术后并发症的发生,更好地促进患者的恢复,提高患者的生存质量。     

一种基于表面肌电信号映射人体下肢运动意图的方法

智能膝关节假肢是截肢患者恢复日常运动的重要辅具。对人体下肢运动意图的识别是实现下肢假肢控制的关键。该文针对此问题,提出了一种通过表面肌电信号预测膝关节角度的方法。对表面肌电提取时域特征,通过 BP 神经网络模型建立平地行走过程中表面肌电信号和膝关节角度的映射关系,预测膝关节角度。     

Results of the Kudo elbow prosthesis in patients with rheumatoid arthritis: a preliminary report

Sixteen elbows in 15 rheumatoid arthritis patients had a total elbow replacement with insertion of a non-constrained surface-replacement prosthesis. One patient died of an unrelated cause, but all the others were available for follow-up (mean follow-up period: 35.4 months). The results were graded according to a modified version of the Morrey elbow score. A good result was seen in 13 elbows and a fair result in two. One infection occurred, which was cured with intravenous antibiotics and maintenance of the prosthesis in place; however, recurrent dislocation persisted. Another patient had postoperative instability with recurrent subluxations. Eleven patients were very satisfied and one was satisfied. The total active range of motion increased significantly from 70.3^o (SD 29.6) to 97.0^o (SD 15.4), mainly by increased flexion. The modified Morrey score increased significantly from 32.7 (SD 13.1) to 89.3 (SD 10.3). Pain decreased from severe (n=12) and moderate (n=3) preoperatively to mild (n=5) and absent (n=10) postoperatively.     

Effect of the amount of thickness reduction on color and translucency of dental monolithic zirconia ceramics

PURPOSE

This study investigated the effect of amount of thickness reduction on color and translucency of dental monolithic zirconia ceramics.

MATERIALS AND METHODS

One-hundred sixty-five monolithic zirconia specimens (16.3 mm × 16.3 mm × 2.0 mm) were divided into 5 groups (Group I to V) according to the number of A2-coloring liquid applications. Each group was then divided into 11 subgroups by reducing the thickness up to 1.0 mm in 0.1-mm increments (Subgroup 0 to 10, n=3). Colors and spectral distributions were measured according to CIELAB on a reflection spectrophotometer. All measurements were performed on five different areas of each specimen. Color difference (ΔE^*_ab) and translucency parameter (TP) were calculated. Data were analyzed using one-way ANOVA and multiple comparison Scheffé test (α=.05).

RESULTS

There were significant differences in CIE L^* between Subgroup 0 and other subgroups in all groups. CIE a^* increased (0.52<R²<0.73), while CIE b^* decreased (0.00<R²<0.74) in all groups with increasing thickness reduction. Perceptible color differences (ΔE^* _ab>3.7) were obtained between Subgroup 0 and other subgroups. TP values generally increased as the thickness reduction increased in all groups (R²>0.89, P<.001).

CONCLUSION

Increasing thickness reduction reduces lightness and increases a reddish, bluish appearance, and translucency of monolithic zirconia ceramics.