冷牙胶侧方加压和高温热塑充填技术根尖封闭性体外实验研究

目的：比较冷牙胶侧加压充填技术与高温热塑充填技术根尖封闭效果。方法：选取离体颌牙40颗,随机分为A组（16颗牙）、B组（16颗牙）、实验阳性组（4颗牙）、实验阴性组（4颗牙）,A组采用冷牙胶侧加压充填技术,B组采用高温热塑充填技术,比较分析不同组剐渗漏现象、顺应性、封闭性能。结果：高温热塑充填技术组渗入长度[（1．01±0．16）mm]明显少于冷牙胶侧方加压充填组;1．5、3．5mm横截面封闭能力、顺应性（0．9448±0．0221、0．9543±0．0200;0．9558±0．0164、0．9722±0．0142）、1．5、3．5mm横截面100～250封闭能力（0．9496±0．0168、0．95884-0．0176）、≥250封闭能力（0．9421±0．0165、0．9516±0．0214）明显高于冷牙胶侧方充填技术（P均〈0．05）。结论：高温热塑充填技术可以增强填充材料的顺应性,减少渗漏现象,提高封闲效果。     

多院区网真视频网络的QoS设计

介绍网真技术的特点,医院网真系统的设计架构和QoS的相关技术,讨论了在多院区环境下如何设计园区网络QoS,给出了配置参考方案,保障网真视频系统端到端的IP网络服务质量,充分发挥网真系统的先进性。     

移动医疗系统实施与应用

医院信息系统现有模式存在的问题是信息化在病房最终20米环节断裂导致信息的准确性难以保证,容易发生医疗行为偏差。通过对医院原来 HIS 系统功能进行加减法操作,实施移动医疗系统,引进全流程医疗数据“闭环”管理模式,能够有效优化操作流程、降低病房最终20米环节出现的医疗差错,提升患者服务水平。     

Using Cost-Effectiveness Analysis to Address Health Equity Concerns

This articles serves as a guide to using cost-effectiveness analysis (CEA) to address health equity concerns. We first introduce the "equity impact plane," a tool for considering trade-offs between improving total health—the objective underpinning conventional CEA—and equity objectives, such as reducing social inequality in health or prioritizing the severely ill. Improving total health may clash with reducing social inequality in health, for example, when effective delivery of services to disadvantaged communities requires additional costs. Who gains and who loses from a cost-increasing health program depends on differences among people in terms of health risks, uptake, quality, adherence, capacity to benefit, and—crucially—who bears the opportunity costs of diverting scarce resources from other uses. We describe two main ways of using CEA to address health equity concerns: 1) equity impact analysis, which quantifies the distribution of costs and effects by equity-relevant variables, such as socioeconomic status, location, ethnicity, sex, and severity of illness; and 2) equity trade-off analysis, which quantifies trade-offs between improving total health and other equity objectives. One way to analyze equity trade-offs is to count the cost of fairer but less cost-effective options in terms of health forgone. Another method is to explore how much concern for equity is required to choose fairer but less cost-effective options using equity weights or parameters. We hope this article will help the health technology assessment community navigate the practical options now available for conducting equity-informative CEA that gives policymakers a better understanding of equity impacts and trade-offs.     

A Low-Cost Wireless Bite Force Measurement Device

Assessing maximum voluntary bite force is important to characterize the functional state of the masticatory system. Due to several factors affecting the estimation of the maximum bite force, a unique solution combining desirable features such as reliability, accuracy, precision, usability, and comfort is not available. The aim of the present study was to develop a low-cost bite force measurement device allowing for subject-specific customization, comfortable bite force expression, and reliable force estimation over time. The device was realized using an inexpensive load cell, two 3D printed ergonomic forks hosting reusable subject-specific silicone molds, a read-out system based on a low-cost microcontroller, and a wireless link to a personal computer. A simple model was used to estimate bite force taking into account individual morphology and device placement in the mouth. Measurement reliability, accuracy, and precision were assessed on a calibration dataset. A validation procedure on healthy participants was performed to assess the repeatability of the measurements over multiple repetitions and sessions. A 2% precision and 2% accuracy were achieved on measurements of forces in the physiological range of adult bite forces. Multiple recordings on healthy participants demonstrated good repeatability (coefficient of variation 11%) with no significant effect of repetition and session. The novel device provides an affordable and reliable solution for assessing maximum bite force that can be easily used to perform clinical evaluations in single sessions or in longitudinal studies.     

Removal of Stair-Step Effects in Binder Jetting Additive Manufacturing Using Grayscale and Dithering-Based Droplet Distribution

Binder jetting is a layer-based additive manufacturing process for three-dimensional parts in which a print head selectively deposits binder onto a thin layer of powder. After the deposition of the binder, a new layer of powder is applied. This process repeats to create three-dimensional parts. The binder jetting principle can be adapted to many different materials. Its advantages are the high productivity and the high degree of freedom of design without the need for support structures. In this work, the combination of binder jetting and casting is utilized to fabricate metal parts. However, the achieved properties of binder jetting parts limit the potential of this technology, specifically regarding surface quality. The most apparent surface phenomenon is the so-called stair-step effect. It is considered an inherent feature of the process and only treatable by post-processing. This paper presents a method to remove the stair-step effect entirely in a binder jetting process. The result is achieved by controlling the binder saturation of the individual voxel volumes by either over or underfilling them. The saturation is controlled by droplet size variation as well as dithering, creating a controlled migration of the binder between powder particles. This work applies the approach to silica sand particle material with an organic binder for casting molds and cores. The results prove the effectiveness of this approach and outline a field of research not identified previously.     

3D Printed Customized Facemask for Maxillary Protraction in the Early Treatment of a Class III Malocclusion: Proof-of-Concept Clinical Case

In order to improve fit and comfort, a maxillary protraction facemask customized to the patient’s anatomy was produced by means of 3D face scanning, digital design and additive manufacturing. An 8-year-old patient in need of early treatment for the Class III malocclusion received a rapid palatal expander and a Petit-type facemask, whose components were digitally designed on a 3D scan of the patient’s face. For face scanning, the iPad Pro 2018 tablet (Apple, Cupertino, CA, USA) with the Bellus3D DentalPro application (Bellus3D, Campbell, CA, USA) was used. Facemask components were modelled with 3D Blender software. The rests were 3D printed in BioMed Clear biocompatible resin (Formlabs, Somerville, MA, USA), and the bar in stainless steel. For greater comfort, the internal surface of the rests was lined with a polymer gel pad (Silipos, Niagara Falls, NY, USA). The manufacturing procedure of the customized facemask is patented. The patient wore the facemask at night for a period of 9 months. The patient’s experience was evaluated with a questionnaire at 1 week, 3, 6, and 10 months of treatment. The customized facemask was well accepted by the patient and obtained the expected treatment outcome. Furthermore, 3D face scanning, 3D modelling and 3D printing allow for the manufacturing of customized facemasks with improved fit and comfort, favoring patient compliance and treatment success.     

Ultrasonic-Aided Co-Precipitation of Tannins and Chitosan Ammonium Salt on Cotton Fabric for Antimicrobial and Ultraviolet-Shielding Properties: An Efficient,Colourless, and Eco-Finishing Strategy

Sustainable fabrication of protective cotton, using bio-extracts, is becoming increasingly attractive. However, many shortcomings—including the introduction of potentially hazardous mordants or modifiers to cotton, annoying colour changes after finishing, and low processing efficiency—require further melioration. Therefore, an efficient ultrasonic-assisted colourless finishing process was developed in this study, to fabricate ultraviolet-proof and antimicrobial cotton. A pair of oppositely charged bio-based substances, i.e., tannin acid (TA) and hydroxypropyltrimethyl ammonium chloride chitosan (HACC) were introduced during the ultrasonic process. The results reveal that cationic HACC significantly promotes the adsorption of TA to cotton. The apparent colour of the cotton remained almost unchanged after finishing. Based on Pesudo first-/second-order kinetic models, chemisorption was verified as the dominant mechanism. Efficiency under ultrasound was enhanced by 5.3% (70 °C) and 27% (90 °C), respectively. A mathematical modelling study established the factors to be in the following order of significance: concentration > pH > temperature. Under optimal conditions, a theoretical maximum UPF of 380.8 was achieved. TA (8 g/L)-treated cotton deactivated up to 98% of Escherichia coli, and also provided excellent UV-shielding performance. In general, the ultrasonic-assisted eco-dyeing and finishing process for cotton was explored in depth from practical and theoretical perspectives, which should push forward the development of the sustainable textile industry.     

LH活性药物联合FSH促排在Poseidon 1组、2组患者的疗效分析

目的 探讨使用FSH联合LH活性药物促排在Poseidon 1组、2组低预后患者中的有效性。方法 回顾分析2014年1月～2019年12月在广州医科大学附属第三医院进行IVF/ICSI助孕Poseidon 1组、2组低预后患者的临床资料。将患者分为两组：FSH组（单纯使用FSH促排,共1 679例1 740周期）、FSH+LH组（FSH联合LH活性药物促排,共471例478周期）,比较两组间的基础指标及临床结局指标,其中卵泡-卵母细胞转化指数（Follicle-To-Oocyte Index,FOI）为主要的结局指标。结果 FSH+LH组与FSH组的卵巢储备基线差异无统计学意义（P> 0.05）。FSH组的FOI较高,卵泡输出率（Follicular Output Rate,FORT）、获卵数、MII卵率、受精率、临床妊娠率、胚胎种植率等结局指标与FSH+LH组无统计学差异（P> 0.05）。结论 黄体期长方案常规联合LH活性药物促排,并不能改善非预期卵巢反应不良患者的结局,且增加患者经济成本,不推荐常规使用。     

革兰阴性杆菌去阻遏持续高产AmpC酶检测及耐药性分析

目的:了解近期临床分离的30株革兰氏阴性杆菌去阻遏持续高产AmpC酶情况及对15种抗菌药物的耐药性,并对三种AmpC酶检测方法进行比较,为临床提供常规检测和用药的参考。方法:用头孢西丁药敏法、表型筛选法和三维实验法分别检测AmpC酶,用纸片扩散法进行体外药敏实验。结果:头孢西丁药敏法、表型筛选法和三维实验法的AmpC酶检出率分别为56.7%、13.3%、10.0%,头孢西丁药敏实验与三维实验相比,存在较高假阳性率82.4%,表型筛选法与三维实验符合率达96.7%;17株耐头孢西丁菌株的药敏实验显示出严重的多重耐药,对青霉素类及加β-内酰胺酶抑制剂克拉维酸的复合药物、氨基糖苷类均呈高比例耐药,对加β-内酰胺酶抑制剂舒巴坦和他唑巴坦的头孢菌素类较为敏感,而对亚安培南和头孢肶肟的敏感率达100%。结论:表型筛选法操作简单省时,且准确率高,适合临床推广使用;治疗产AmpC酶菌感染以亚安培南和第四代头孢菌素头孢肶肟较优。