Platform switching and matrix metalloproteinase-8 levels in peri-implant sulcular fluid

Objectives: The concept of platform switching has been introduced to implant therapy, however long‐term data are sparse. The aim of this study was to biochemically investigate the inflammatory response mediated by MMP‐8 to platform switching after 3 years of loading, in order to understand the long‐term effect of implant/abutment mismatching on peri‐implant health. Methods: A total of 70 implants had been inserted in the posterior maxilla in 26 patients and were randomly assigned to one of the four treatment regimens (implant diameter 3.8 [control group], 4.3 [Test group 1, T₁], 4.8 [Test group 2, T₂] and 5.5 mm [Test group 3, T₃]). All implants were restored using a 3.8 mm abutment. In the test groups, this restoration resulted in a mismatching of 0.25–0.85 mm of implant–abutment diameters. Results: Thirty‐six months after prosthetic rehabilitation, peri‐implant sulcular fluid samples were taken from two aspects of all implants and from periodontally healthy adjacent teeth. Samples were processed in a conventional ELISA using monoclonal antibodies recognizing the active entity of MMP‐8. In the test groups, MMP‐8 mean values were 2.76 ng for T₁ (SD: 2.91), 3.30 ng for T₂ (SD: 1.94) and 3.18 ng for T₃ (SD: 2.46). For the control group, MMP‐8 mean value was 3.6 ng (SD: 2.23), whereas 3.38 ng (SD: 2.2) was recorded at the adjacent teeth. There were no statistically significant differences in MMP‐8 values between the groups (P=0.113, Kruskal–Wallis). Conclusions: The presence of an implant/abutment mismatching specific for this prosthetic concept is compatible with long‐term peri‐implant health as demonstrated by analysis of a sensitive biomarker of the peri‐implant inflammatory response.     

非潜入式植入法对平台转换连接种植体颈部牙槽骨吸收的影响

目的：评价非潜入式植入法对平台转换连接种植体颈部牙槽骨吸收有无影响。方法：23例共33颗后牙缺失患者按要求植入ankylos种植体,取出覆盖螺丝并上愈合基台。植入当天和二期修复时拍牙片并进行前后对比。结果：1枚种植体植入一周时出现异常予以拔除,其余种植体均能形成良好的骨结合。经牙片对比,植入当天与二期修复时种植体颈部牙槽骨无明显变化。结论：非潜入式植入法对平台转换连接种植体颈部牙槽骨吸收无明显影响。     

经自然腔道内镜外科学(NOTES)研究进展

经自然腔道内镜外科学(natural orifice transluminal endoscopic surgery,NOTES)概念自提出以来,受到内镜医师和腹腔镜医师的广泛关注,成为微创技术领域研究和争论的焦点。国内外NOTES实验研究已经证实了NOTES的安全性、可行性及有效性,有关NOTES临床应用的研究也大量发表。同时,有关NOTES操作平台、器械研发和临床应用的报道也不断增多。本文就目前NOTES临床应用进展和相关的操作平台、器械的研发及应用情况进行概述。     

Effect of Implant Design on Knee Flexion

From March 2006 to August 2008, 93 subjects (186 knees) underwent simultaneous bilateral total knee arthroplasty performed by eight surgeons at North American centers. This randomized study was conducted to determine whether non-weight-bearing passive flexion was superior for knees receiving a posterior stabilized high flexion device compared to a posterior stabilized standard device in the contra-lateral knee. Weight-bearing single leg active flexion was one secondary endpoint. Follow-up compliance was 92.5%. Results show small, but significant superiority in the motion metrics for the high flexion device compared to the standard device 12 months after surgery, especially for a subgroup of patients with pre-operative flexion less than 120° in both knees. Thus, the ideal candidate for the high flexion device may be one with lesser pre-operative flexion.     

基于智能云平台居家培训新型冠状病毒肺炎知识在储备护士中的应用

目的 探索智能云平台的居家培训方式在新型冠状病毒肺炎储备护士培训中的应用效果。方法 将我院应对新型冠状病毒肺炎的80名储备护士,前3批援助武汉的40名储备护士设为对照组,后面培训的40名储备护士设为干预组,对照组采用传统理论操作授课培训,干预组采用智能云平台的居家培训方式培训相关内容,比较2组理论、操作成绩、培训疲劳程度、培训满意度的差异。结果 对照组与干预组在理论和操作成绩上差异均无统计学意义（P>0.05）;干预组培训疲劳程度低于对照组（P<0.001）;干预组培训满意度高于对照组（P<0.05）。结论 利用智能云平台的居家培训方式在新型冠状病毒肺炎储备护士培训中,能有效保证培训的质量,并且降低培训的疲劳感,减少群体培训交叉感染病毒的风险。     

全国医用辐射防护监测信息系统构建及应用情况

目的 依托全国放射卫生信息平台,建立全国医用辐射防护监测信息系统,支持国家医用辐射防护监测项目数据上报,全面了解医用辐射防护现状。方法 根据国家医用辐射防护监测方案、法规和标准,前端采用HTML、CSS、JavaScript,后端采用JAVA语言,平台数据库采用SQL server,开发中间件为Tomcat。系统通过B/S的架构建立数据上报和分析系统,并对2017年度的监测数据进行了统计分析。结果 平台的业务组成包括数据采集（通过各业务系统）、数据资源整合（整合业务系统公共数据）、应用和展现4个层次。实现架构灵活、信息集中、操作便捷的全国医用辐射防护监测系统,完成2017年国家医用辐射防护信息的上报,汇总和数据统计分析,2017年度共上报33 565所医院放射防护基本情况和10 624台放射诊疗设备性能及防护信息。共完成统计信息报表95个,分别从时间、行政地理信息、医院级别、设备种类4个维度描述全国医用辐射防护现状。结论 医用辐射防护监测系统达到设计目的,顺利完成2017年数据上报,为了解全国医用辐射防护现状和放射诊疗防护管理政策制定提供了数据支持。     

基于B2C平台的医药电子商务顾客忠诚度研究

目的：研究商家对顾客（B2C）平台模式下医药电子商务顾客忠诚度的影响因素并提出提升顾客忠诚度的策略。方法：从商品、平台网站、顾客三个方面提出与医药B2C平台顾客忠诚度相关的假设,并根据假设运用问卷调查法和结构方程模型方法对问卷数据进行分析。结果与结论：研究证实了医药B2C平台顾客忠诚度的影响因素,按其影响作用（结构方程模型的路径系数）大小分别为：商品质量0.83、顾客转换成本0.69、网站安全性0.65、网站服务0.64、购物便利性0.53、网站声誉0.45、物流快捷性0.39、商品价格0.23。并提出了改进商品质量、建立合理价格系统、维持网站声誉、建立完善沟通机制、提升网站便利性和安全性、加强物流等有效提升医药B2C平台顾客忠诚度的建议。