托幼机构组织-参与健康教育对儿童口腔保健的干预效果评价

目的：探索并推广改善学龄前儿童口腔保健知识和行为习惯的健康教育模式。方法随机选取朝阳区2所幼儿园的451例儿童作为干预组，采用互动式课程系统进行儿童口腔保健的干预；选取另外2所幼儿园的521例儿童作为对照组，不进行特殊的健康教育与行为干预。干预结束后，比较干预组和对照组儿童口腔保健知识和口腔保健行为习惯的改善程度；并调查干预组幼儿园工作人员对互动式课程系统的使用意见。结果干预组儿童口腔保健知识和行为习惯在干预前后比较差异有统计学意义（t＝14．31，P＜0．001），口腔保健知识掌握率由81．79％提高到94．89％，提高幅度大于对照组（t＝5．34，P＜0．001）。结论组织-参与式健康教育模式对提高儿童口腔保健知识掌握率和改善口腔保健行为习惯具有明显效果，可在幼儿园推广应用。     

Effect of electric toothbrush on residents' oral hygiene: a randomized clinical trial in nursing homes

A single‐blinded, randomized controlled clinical trial was performed to investigate the effect of electric toothbrushes (ET) compared with manual toothbrushes (MT) on residents in nursing homes and to evaluate the caregiver's opinion on ET. A sample of 180 nursing‐home residents were given either a new ET or a new MT. Oral examinations were performed to measure dental hygiene, using the Oral Hygiene Index‐Simplified (OHI‐S). Both groups received the same instructions for use. After 2 months participants were re‐examined. Questionnaires were then sent to their caregivers. Participants' mean age was 86.1 ± 7.7 yr, and the mean number of remaining teeth was 20 ± 5.6. No specific intervention effect was found for ET. Both groups showed identical improvements in the OHI‐S, from 1.27 ± 0.63 at baseline (the mean value for all participants) to 1.01 ± 0.53 after 2 months. Of 152 caregivers who responded to the questionnaire, the majority evaluated ET to be beneficial and less time‐consuming compared with MT, also for demented residents. In a frail population, no difference is found in the effect of ET compared with MT. However, the ET appears to be a useful aid for residents who receive assistance with dental hygiene.     

Case of punctate palmoplantar keratoderma type I treated with combination of low‐dose oral acitretin and topical salicylic acid and steroid

Palmoplantar keratodermas (PPK) are heterogeneous disorders characterized by abnormal keratinization. Especially, punctate PPK (PPPK), one of the subtypes of hereditary PPK, is a rare punctate keratoderma characterized by tiny “raindrop” keratoses having a tendency to coalesce on the edge of soles, which are exposed to sustained pressure. If typical punctate lesions are confined to the palms and soles and the patient has a family history and late onset, it can be considered as PPPK type I (PPKP1), also called Buschke–Fisher–Brauer disease. The exact etiology of PPPK has not been fully understood. Furthermore, no standardized treatment for PPPK has been established and treatment options are limited. Above all, traditional systemic retinoids have been used in several cases, but dose‐related adverse effects are common. Therefore, combination of low‐dose systemic retinoids and adjuvant topical therapy can be an alternative treatment option for PPPK. Herein, we report a case of PPKP1 treated with combination of low‐dose oral acitretin (10 mg/day) and topical salicylic acid and steroid. Despite low capacity, low‐dose acitretin showed excellent regression of the lesions by combined use of topical ointments. The supplementary topical therapy may be useful in reducing the dose of systemic retinoids and preventing potential toxicity.     

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??With the development of medical and health undertakings and people's increasing emphasis on health?? the change of modern lifestyles and the rapid development of modern medicine have led to an increasing number of patients attending oral clinics with systemic diseases. Other systemic diseases due to the use of new drugs and new technologies has put forward new requirements for traditional oral medical services. The development of minimally invasive and comfortable medical services has also put higher demands on the knowledge structure and clinical capabilities of doctors. This article summarizes the mode of treatment of sedation and analgesia in Oral Clinic with Oral Pain Relief Center and describes the model and the techniques it covers.     

p66~(Shc)基因敲除对小鼠缺血缺氧性脑损伤的保护作用

目的探讨p66Shc基因敲除对小鼠缺血缺氧性脑损伤(hypoxic-ischemic brain injury,HIBI)的保护作用及可能的机理。方法将C57小鼠分为假手术组(野生型,sham operation,SO)、HIBI野生型组(hypoxic-ischemic wild type,HIWT)和HIBI-p66Shc基因敲除组(hypoxic-ischemic knock-out,HIKO),每组20只。采用右侧颈总动脉结扎-浸入低氧环境的方法制备小鼠HIBI模型。随后对各组小鼠神经功能障碍情况、HIBI损伤灶体积、血清神经元特异性烯醇化酶(neuronspecific enolase,NSE)水平和脑组织匀浆中白细胞介素-1β(interleukin-1β,IL-1β)的水平进行测量和比对。结果 HIBI造模24 h后,HIKO组小鼠的神经功能缺损程度评分(1.87±0.30)低于HIWT组小鼠(2.49±0.26),HIKO组小鼠脑梗死灶体积[(22.66±4.20)mm3]小于HIWT组小鼠[(27.31±3.23)mm3],HIKO组小鼠血清NSE含量[(8.97±0.74)ng/ml]显著低于HIWT组小鼠[(11.26±0.68)ng/ml],HIKO组小鼠脑组织IL-1β含量[(1.72±0.30)ng/ml]显著低于HIWT组小鼠[(2.07±0.28)ng/ml],P均<0.05。结论 p66Shc基因敲除可通过降低小鼠HIBI发生后脑组织IL-1β的表达,起到脑保护作用。     

老年妇女绝经后阴道流血的原因分析与治疗对策探讨

目的探讨分析老年妇女绝经后阴道流血的原因及治疗方案。方法回顾分析2007年1月-2011年12月我院接收的211例绝经后阴道流血及血性白带为主要症状的女性患者,排除因妊娠引起流血的病例,对其余患者进行妇科检查、经阴或腹部B超检查、TCT检查及宫腔镜下病理活检。观察分析所有患者的阴道流血的病因及病变程度。结果依据本组患者的各项检查及病理报告可分为：生殖器官炎症125例,子宫肌瘤18例,恶性肿瘤53例,其他15例。结论绝经早期阴道流血多数患者由生殖器官良性病变引起的,但随着绝经时间的延长,恶性程度越高,针对病因选取恰当的治疗方式才是行之有效的方案。     

Clinical trial with a new low oestrogen combined oral contraceptive

Summary

An oral contraceptive combination of 30 μg. ethinyl oestradiol and 150 μg. D-norgestrel was studied in 98 patients over 1216 cycles. No pregnancies were reported during the trial period. Cycle control was good: 96.7% of cycles were 28 ± 3 days with a mean duration of menstrual bleeding of 4.3 days. Bleeding irregularities were not marked; amenorrhoea occurred in 1.7% of cycles, spotting in 5.4% and breakthrough bleeding in 5.8 %. The incidence of side-effects commonly associated with combined oral contraceptives was also low.

The author concludes, therefore, that this new lower-dose combination is an effective and relatively trouble-free ovulation inhibitor.