Clinical and Radiological Outcomes of Two Implants with Different Prosthetic Interfaces and Neck Configurations: Randomized,Controlled, Split‐Mouth Clinical Trial

Background: Peri‐implant bone loss seems to occur following implant placement/loading regardless of all the efforts to eliminate it. Several factors, including surgical trauma, biologic width establishment, lack of passive fit of the superstructures, implant‐abutment microgap, and occlusal overloading, may increase peri‐implant bone loss. Over the years, new interface designs were introduced and clinical studies suggest that internal conical connection and platform shifting may be advantageous for marginal bone preservation. Purpose: To compare clinical and radiological outcomes of two implant designs with different prosthetic interfaces and neck configurations in a randomized, controlled, split‐mouth clinical trial. Materials and Methods: Thirty‐four partially edentate patients randomly received at least one internal conical connection with back‐tapered collar and platform shifting design or external‐hexagon implants with flat‐to‐flat implant‐abutment interface. Primary end point was peri‐implant bone level changes at different time points, failures of implants and/or prosthesis, any complications, implant stability quotient (ISQ) values, and periodontal parameters. Results: No dropout occurred. Marginal bone changes were statistically significantly different with better results for the internal conical connection. No implants and prosthesis failures have been observed, yielding a cumulative survival rate of 100%. A high ISQ value was found for both implants, and no statistically significant difference was found for ISQ mean values between interventions at each time point (p > .05). All implants showed no bleeding on probing and a very slight amount of plaque at the 1‐year‐in‐function visit. Conclusions: Both implant designs investigated performed similarly in terms of failure rates, providing successful results up to 1 year after loading. The back‐tapered neck configuration with conical connection and built‐in platform shifting showed statistically lower marginal bone loss than straight neck configuration with flat‐to‐flat implant‐abutment interface and external‐hexagonal connection.     

微信平台结合家庭医生签约服务 在社区高血压患者治疗中的作用

目的探讨微信平台结合家庭医生签约服务在社区高血压患者治疗中的作用。方法选取110例高血压患者作为研究对象,随机分为对照组和观察组,每组各55例。对照组患者接受家庭医生签约服务,观察组患者在此基础上加用微信平台进行干预。对比两组患者高血压防治知识掌握情况,高血压控制率、自我管理效果和月平均上门随访时间。结果观察组患者高血压防治知识得分、高血压控制率和自我管理效果均优于对照组患者,差异具有统计学意义(P0.05)。观察组患者所需月平均上门随访时间少于对照组患者,差异具有统计学意义(P0.01)。结论微信平台结合家庭医生签约服务在社区高血压患者治疗中具有积极的作用,能够有效控制高血压病情,增加患者自我管理能力,减少医护人员随访时间,是一种值得深入探索的干预模式。     

The development and validation of EpiComet‐Chip,a modified high‐throughput comet assay for the assessment of DNA methylation status

DNA damage and alterations in global DNA methylation status are associated with multiple human diseases and are frequently correlated with clinically relevant information. Therefore, assessing DNA damage and epigenetic modifications, including DNA methylation, is critical for predicting human exposure risk of pharmacological and biological agents. We previously developed a higher‐throughput platform for the single cell gel electrophoresis (comet) assay, CometChip, to assess DNA damage and genotoxic potential. Here, we utilized the methylation‐dependent endonuclease, McrBC, to develop a modified alkaline comet assay, “EpiComet,” which allows single platform evaluation of genotoxicity and global DNA methylation [5‐methylcytosine (5‐mC)] status of single‐cell populations under user‐defined conditions. Further, we leveraged the CometChip platform to create an EpiComet‐Chip system capable of performing quantification across simultaneous exposure protocols to enable unprecedented speed and simplicity. This system detected global methylation alterations in response to exposures which included chemotherapeutic and environmental agents. Using EpiComet‐Chip on 63 matched samples, we correctly identified single‐sample hypermethylation (≥1.5‐fold) at 87% (20/23), hypomethylation (≥1.25‐fold) at 100% (9/9), with a 4% (2/54) false‐negative rate (FNR), and 10% (4/40) false‐positive rate (FPR). Using a more stringent threshold to define hypermethylation (≥1.75‐fold) allowed us to correctly identify 94% of hypermethylation (17/18), but increased our FPR to 16% (7/45). The successful application of this novel technology will aid hazard identification and risk characterization of FDA‐regulated products, while providing utility for investigating epigenetic modes of action of agents in target organs, as the assay is amenable to cultured cells or nucleated cells from any tissue. Environ. Mol. Mutagen. 58:508–521, 2017. © 2017 Wiley Periodicals, Inc.     

Cholecystokinin octapeptide prevents extinction of active avoidance behavior in the rat

The effect of cholecystokinin octapeptide (CCK-8) on the performance of platform-jumping avoidance behavior was investigated in the rat. CCK-8 was injected subcutaneously once in different doses immediately after training trials. The number of avoidance responses remained high 5 and 10 days after the CCK-8 administration and the greatest effect was observed with doses of 10 and 100 ng/kg, while in control saline group the number of responses decreased after 5 days. Larger doses of CCK/8 were less effective, probably due to a sedative action.     

复合框架式内固定治疗胫骨平台粉碎性骨折26例疗效分析

目的：观察采用骨栓结合多钢板框架结构治疗胫骨平台严重粉碎性骨折的疗效。方法：用Y形切口显露骨折处，将骨块复位后，用骨栓骨栓、塑形的普通钢板或L形钢板加以固定，形成稳定的框架结构。结果：随访1～7年，优良率92％。结论：严重胫骨平台骨折应采取急诊切开复位内固定术，手术暴露是良好复位的关键，固定一定要可靠，术后要做到早活动、晚负重。     

微信平台在乳腺癌术后输液港化疗患者延伸护理中的应用

目的探讨微信公众平台在乳腺癌术后患者输液港化疗带管期间延伸护理中的应用效果。方法按入院时间段将置入输液港的412例乳腺癌化疗患者分为对照组192例、观察组220例。化疗期间及出院后对照组按常规护理;观察组在此基础上建立微信平台,组建"乳甲外科输液港快线"的微信群,为患者提供专业资讯、在线指导、输液港维护提醒等。于第4个化疗疗程开始前评价效果。结果对观察组患者共推送信息326条;观察组患者输液港知识知晓率、输液港按时维护率、患者满意度显著高于对照组,输液港相关并发症发生率显著低于对照组(均P0.01)。结论微信平台的建立及应用有利于提高乳腺癌化疗患者输液港知识,从而提高输液港维护依从性,避免输液港相关并发症。     

Gemini MKⅡ全膝关节置换的疗效评价

目的探讨采用Gemini MKⅡ旋转平台假体在人工全膝关节置换术(TKA)中的临床疗效。方法对102例患者(106膝)行TKA,均采用Gemini MKⅡ旋转平台假体进行置换,使用骨水泥固定,不置换髌骨。记录术前和术后末次随访的膝关节HSS评分及膝关节活动度。结果患者均获得随访,时间6~24个月。末次随访时,HSS评分由术前的22~54(36.42±5.64)分提高至81~93(83.60±7.34)分,P0.05;膝关节活动度由术前的54°~85°(64.2°±5.1°)提高至102°~120°(106.9°±5.1°),P0.05。X线检查未发现骨溶解及假体松动等并发症。结论 Gemini MKⅡ旋转平台假体用于TKA近期临床效果满意,但长期效果还需进一步观察。     

系统化造口教育平台在提高永久性结肠造口患者自我护理能力中的应用

目的：探讨系统化造口教育平台在提高结肠造口患者自我护理能力中的临床效果。方法将重庆医科大学附属第一医院胃肠外科198例行永久性结肠造口患者随机分为试验组和对照组,试验组运用系统化造口教育平台学习相关护理知识和技能,对照组按照传统方式接受造口知识培训,在出院当日、出院1个月后、3个月后三阶段对试验组和对照组按照自我护理能力量表（ESCA）进行现场调查或电话回访。结果系统化教育平台实施3个月后,试验组患者ESCA总分（120．87±10．31）分、自我护理技能（30．51±2．57）分、自我护理责任感（23．95±2．64）分、自我概念（26．23±1．69）分、健康知识水平（39．78±3．12）分,明显高于对照组,差异均有统计学意义（P＜0．05）。结论系统化造口教育平台提高了患者自我护理能力,改善了患者生活质量。