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??Objective    To compare the short-term clinical effect of different degrees of wear in the posterior area of the implant denture. Methods    From January 2009 to December 2013??469 patients??the average age was 50.9??with partial loss of posterior teeth were followed up for 6 - 72 months. According to the degree of wear of natural teeth??they were divided into three groups??the non-wear group of 201 cases??457 implants????163 cases in mild-wear group??289 implants????105 cases in severe-wear group??235 implants??. The five-year cumulative survival rates of implants in the three groups were counted and the numerical values of bone resorption around the implants were measured. Results    Three groups of patients had no implant loss??the 5-year retention rate was 100%??there was no significant difference in bone resorption at the end of 3 months??6 months??1 year and 2 years after the repair??P > 0.05????there was no significant difference in the incidence of postoperative complications??P > 0.05??. Conclusion    In short time??the patients with mild wear and severe wear can have good clinical effect??whereas long-term effect need to be followed up.     

末端根帽支撑的MK1附着体在下颌单侧后牙缺失修复中的临床应用

目的：评价末端根帽支撑的MK1附着体在下颌单侧后牙缺失修复中的临床效果。方法：以29例采用MK1附着体进行修复治疗的患者作为研究对象，实验组以10例患者修复体远中处有经根帽修复后的残根，其余19位患者作为对照组。1年后随访，从患者主观感受、临床检查及X线检查评价修复效果。结果：实验组、对照组患者对MK1附着体义齿的主观满意度分别为8．38±0．85、8．27±1．10，两组间无统计学差异（P〉0．05）。实验组、对照组缺牙区牙槽嵴吸收例数分别为0例、5例，差异无统计学意义（P〉0．05）；实验组、对照组近缺牙区基牙牙槽骨吸收例数分别为0例、5例，差异无统计学意义（P．〉0．05）；实验组、对照组义齿修整例数分别为1例、10例，差异有统计学意义（P〈0．05）。结论：MK1附着体义齿稳定及固位性能艮好，是一种较理想的下颌单侧后牙缺失的固定一活动联合修复体。末端残根根帽修复后更利于MK1的临床疗效。     

腔镜下与开放手术行会师术治疗后尿道断裂临床疗效对照研究

目的:探讨腔镜下与开放手术行会师术在后尿道断裂患者中的应用效果。方法:选择我院泌尿外科后尿道断裂患者86例,随机分为观察组和对照组,对照组43例开放手术行会师术,而观察组43例则腔镜下行会师术,分析对比两组患者术中出血量、手术时间、住院时间、住院费用及术后性功能障碍发生率等。结果 :观察组患者在术中出血量、手术时间、住院时间及术后性功能障碍发生率均低于对照组(P<0.05),而观察组患者住院费用明显高于对照组(P<0.05),但两组手术成功率无显著性差异(P>0.05)。结论:腔镜下行会师术治疗后尿道断裂具有术中出血量少、手术时间短、住院时间及术后性功能障碍发生率少等优点。     

Evaluation of titanium release from titanium alloy implants in patients with spinal instrumentation

ObjectiveThis study was performed to investigate the baseline serum titanium levels in patients with short-segment titanium alloy posterior instrumentation and to assess patient-, implant-, and surgery-related factors that might affect the serum titanium level.MethodTwo groups of patients were included in the study. The study group comprised 39 patients who had undergone short-segment posterior instrumentation from January 2013 to June 2016. The control group comprised 11 randomly selected patients who presented to the outpatient clinic with no history of orthopedic surgery. The serum titanium levels and inter-group differences were analyzed.ResultsThe mean serum titanium level was significantly higher in the study group than in the control group. No significant difference was observed between patients with different etiologies, implants used for fusion, numbers of instrumented segments, or postoperative durations.ConclusionThe serum titanium levels of patients with posterior lumbar spinal instrumentation are significantly higher than those of the normal population even after achievement of solid fusion. These levels are not affected by the use of transverse connectors, the use of cages, the operated segments, or the duration of implants.     

颈椎后路单开门椎管成形术对脊髓型颈椎病患者疗效及预后

目的通过不同手术方法探究颈椎后路单开门椎管成形术对脊髓型颈椎病患者的临床治疗效果及远期预后情况。方法将患者随机分两组,锚钉悬吊固定组(AS组):采用颈椎后路单开门椎管成形术中的锚钉悬吊固定法;Arch钢板固定组(TP组):采用颈椎后路单开门椎管成形术中的Arch钢板固定法。每组各45例。通过两种方法分析AS组与TP组的神经功能、轴性症状、开门角度和门轴侧融合率的疗效及远期预后差异性。结果手术前AS组与TP组JOA评分无差异性,AS组与TP组手术后1年与手术前相比较JOA评分均明显升高;AS组与TP组相比较神经功能改善率无差异性;术后1年,TP组11例发生轴性症状,发生率为24.44%,AS组26例发生轴性症状,发生率为57.78%,经比较有明显差异。通过CT测量开门角度,术后1个月和1年,TP组与AS组相比较开门角度明显增大,两组术后1年与术后1个月相比较降低,但TP组仍大于AS组。结论在颈椎后路单开门椎管成形术中Arch钢板固定法优于锚钉悬吊固定法,对脊髓型颈椎病患者的治疗效果显著,且一年内远期预后整体效果好,Arch钢板固定法好于锚钉悬吊固定法。     

Posterior lamellar reconstruction: a comprehensive review of the literature

The aim of the review is to describe the different techniques and materials available to reconstruct the tarsoconjunctival layer of the eyelid; to analyze their indications, advantages, and disadvantages.

We searched the Cochrane, PubMed, and Ovid MEDLINE databases for English articles published between January 1990 and January 2017 using variations of the following key words: “posterior lamella,” “eyelid reconstruction,” “tarsoconjunctival,” “flap,” and “graft.” Two reviewers checked the abstracts of the articles found to eliminate redundant or not relevant articles. The references of the identified articles were screened manually to include relevant works not found through the initial search.

The search identified 174 articles. Only a few articles with a therapeutic level of evidence were found. Techniques for the posterior lamellar reconstruction can be categorized as local, regional, and distant flaps; tarsoconjunctival, heterotopic, homologous, and heterologous grafts. Several techniques and variations on the techniques exist to reconstruct the posterior lamella, and, for similar indications, there’s no evidence of the primacy of one over the other. Defect size and location as well as patient features must guide the oculoplastic surgeon’s choice. The use of biomaterials can avoid possible complications of the donor site.     

Muscle functional MRI analysis of trunk muscle recruitment during extension exercises in asymptomatic individuals

The present study examined the activity levels of the thoracic and lumbar extensor muscles during different extension exercise modalities in healthy individuals. Therefore, 14 subjects performed four different types of extension exercises in prone position: dynamic trunk extension, dynamic–static trunk extension, dynamic leg extension, and dynamic–static leg extension. Pre‐ and post‐exercise muscle functional magnetic resonance imaging scans from the latissimus dorsi, the thoracic and lumbar parts of the longissimus, iliocostalis, and multifidus were performed. Differences in water relaxation values (T2‐relaxation) before and after exercise were calculated (T2‐shift) as a measure of muscle activity and compared between extension modalities. Linear mixed‐model analysis revealed higher lumbar extensor activity during trunk extension compared with leg extension (T2‐shift of 5.01 ms and 3.55 ms, respectively) and during the dynamic–static exercise performance compared with the dynamic exercise performance (T2‐shift of 4.77 ms and 3.55 ms, respectively). No significant differences in the thoracic extensor activity between the exercises could be demonstrated. During all extension exercises, the latissimus dorsi was the least activated compared with the paraspinal muscles. While all extension exercises are equivalent effective to train the thoracic muscles, trunk extension exercises performed in a dynamic–static way are the most appropriate to enhance lumbar muscle strength.     

角膜后表面散光的测量及临床意义

角膜散光由角膜前表面散光（anterior astigmatism，AA）和角膜后表面散光（posterior astigmatism，PA）组成。据文献统计，PA在-0.01~-1.10 D范围内，85.0%~96.1%为逆规散光。随着年龄的增长，PA总体呈现由逆规向顺规漂移的趋势，AA的趋势则与之相反。因此，对于青年人，PA使总角膜散光（total astigmatism，TA）减小；对于老年人，PA使TA增大。在临床上，忽略PA会错误估计TA，影响屈光性白内障手术后的视觉质量。本文旨在介绍PA的测量方法及临床意义，以供眼科医生在临床工作中参考。     

A transgluteal approach—Back to the future

Minimally invasive approaches to total hip arthroplasty have received much attention from both the lay press as well as the orthopaedic community. The potential for enhanced recovery and improved pain control in the perioperative period are in high demand from patients. We present a transgluteal approach to total hip arthroplasty as an alternative to the direct anterior approach that has the potential to maintain all of the possible benefits of a soft tissue sparing approach with a lower risk profile.