矢状向颌骨关系对全口重建颌位关系及排牙指导的初步研究

目的 分析Ⅰ、Ⅱ、Ⅲ类颌骨关系患者面部软、硬组织标志点的差异,为咬合重建或无牙颌患者修复治疗提供参考。方法 收集2019年1月—2020年9月至同济大学附属口腔医院就诊拍摄头颅定位侧位片的患者,共计329例。根据ANB大小分为Ⅰ类（2°~5°）、Ⅱ类（＞5°）和Ⅲ类患者（＜2°）;根据下颌平面角（FH MP）大小分为高角型（＞32°）、均角型（22°~32°）和低角型（＜22°）。对其进行面部软、硬组织高度、角度及比例的头影测量分析。结果 ①总人群中Ⅰ、Ⅱ、Ⅲ类患者共有22个测量值显示出统计学差异（P<0.05）,其中前下面高（ANS Me）满足Ⅲ类患者＞Ⅰ类患者＞Ⅱ类患者。②在高角型、均角型和低角型中,Ⅰ、Ⅱ、Ⅲ类患者仍有11个测量值具有统计学差异（P<0.05）。③相关性分析显示ANS Me与其余测量值均具有相关性,其中患者关节点到髁顶点的距离（Ar Gn）与ANS Me的相关系数|r|Ⅰ=0.839,|r|Ⅱ=0.732,|r|Ⅲ=0.806,均具有高度相关性。结论 Ⅰ、Ⅱ、Ⅲ类颌骨关系患者的面部测量值具有差异性,修复治疗时应该把颌骨关系作为考量之一。     

耳穴疗法镇痛的研究进展

耳穴疗法具有起效快、操作简便、价格低廉的优势,在不同性质和部位的疼痛治疗中发挥着重要作用。本文介绍了耳穴疗法镇痛的作用机制、评估方法及影响因素;归纳了耳穴疗法镇痛的干预方式,包括耳针、耳穴贴压、耳穴放血、耳穴注射和耳穴综合疗法等,以期为今后耳穴疗法镇痛的临床应用和相关研究提供参考。     

Comparison of the prevalence of myofascial trigger points of muscles acting on knee between patients with moderate degree of knee osteoarthritis and healthy matched people

IntroductionTrigger points have been implicated in the development of several musculoskeletal disorders. Trigger points harbored in lower limb muscles might represent a ubiquitous source of pain in patients with knee osteoarthritis (OA). This study was carried out to evaluate the prevalence of Myofascial Trigger Points (MTrPs) in muscles acting on the knee in patients with OA.MethodsThirty-seven patients aged at least 55 years old with a moderate degree of OA (grade III of Kellgren and Lawrence scale) were recruited. Thirty asymptomatic people, matched on age and body mass index, were considered as the control group. Ten muscles acting on the knee joint were selected. Taut bands were also identified using a skin rolling method. A pressure of 3 kg/cm² was used to identify myofascial trigger points in all muscles except the popliteus (8 kg/cm²).ResultsChi-square was performed to compare the prevalence of trigger points between the groups. The McNemar test was administered to compare the prevalence of trigger points in the right and left sides of participants. Prevalence of the trigger points was significantly higher in patients with knee OA compared with asymptomatic people in all muscles except for right (p = 0.17) and left (p = 0.41) rectus femoris, right (p = 0.61) and left (p = 0.22) sartorius and left biceps femoris (p = 0.08). Comparison of the prevalence of MTrPs bilaterally revealed that only the right and left sartorius differed significantly (p = 0.008).ConclusionsThe prevalence of MTrPs in the muscles acting on the knee joint is higher in patients with a moderate degree of knee OA compared with asymptomatic subjects.     

硅凝胶联合超脉冲CO2点阵激光术对剖宫产术后皮肤瘢痕的预防及治疗效果

目的探讨硅凝胶联合超脉冲CO₂点阵激光术对剖宫产术后皮肤瘢痕的预防及治疗效果。方法前瞻性研究纳入2018年7~8月东莞市松山湖中心医院收治的100例剖宫产术后患者作为研究对象,分为观察组和对照组,各50例。对照组不予任何干预。观察组于手术伤口拆线后立即予硅凝胶涂抹,每日3次,3个月为1个疗程;观察组完成硅凝胶疗程后,有28例患者产生瘢痕,均立即采用超脉冲CO₂点阵激光术治疗,每3个月1次,共3次。2组患者于产后3、6、9、12及18个月时采用温哥华瘢痕评分量表(VSS)对瘢痕形态进行评分,采用视觉模拟评分法(VAS)对瘢痕疼痛及瘙痒情况进行评分。记录观察组的临床疗效和治疗过程中发生的不良反应。结果产后3、6、9、12及18个月,观察组VSS评分[(6.00±1.31)、(5.38±1.35)、(4.78±1.23)、(4.20±1.1)、(3.92±1.00)分]、疼痛[(2.84±1.02)、(2.40±0.93)、(2.06±0.62)、(1.20±0.67)、(1.04±0.60)分]及瘙痒[(3.00±1.05)、(2.50±0.86)、(2.12±0.67)、(1.34±0.59)、(1.12±0.59)分]评分均呈逐渐下降趋势,且明显低于同一时间段对照组VSS评分[(6.60±1.56)、(6.44±1.25)、(6.38±1.21)、(6.46±1.51)、(6.48±1.47)分]、疼痛[(3.94±0.87)、(3.82±0.83)、(3.76±0.72)、(3.72±0.81)、(3.66±0.87)分]及瘙痒[(4.08±0.99)、(3.98±0.89)、(4.00±0.90)、(4.04±0.92)、(3.96±0.95)分]评分,差异均有统计学意义(P<0.05);而对照组VSS评分、疼痛及瘙痒评分均未见明显变化(P>0.05)。观察组经超脉冲CO₂点阵激光术治疗后9个月(产后18个月),治疗的总有效率达92.9%,总显效率82.1%。观察组不良反应发生率低:轻度色素沉着14.29%,持续性红斑7.14%。结论硅凝胶联合超脉冲CO₂点阵激光术对剖宫产术后皮肤瘢痕的预防及治疗效果满意,不良反应轻微,值得临床推广应用。     

Masthead,Volume 73, Issue 1

This review provides a summary statement of recommended implementations of arterial spin labeling (ASL) for clinical applications. It is a consensus of the ISMRM Perfusion Study Group and the European ASL in Dementia consortium, both of whom met to reach this consensus in October 2012 in Amsterdam. Although ASL continues to undergo rapid technical development, we believe that current ASL methods are robust and ready to provide useful clinical information, and that a consensus statement on recommended implementations will help the clinical community to adopt a standardized approach. In this review, we describe the major considerations and trade‐offs in implementing an ASL protocol and provide specific recommendations for a standard approach. Our conclusion is that as an optimal default implementation, we recommend pseudo‐continuous labeling, background suppression, a segmented three‐dimensional readout without vascular crushing gradients, and calculation and presentation of both label/control difference images and cerebral blood flow in absolute units using a simplified model. Magn Reson Med 73:102–116, 2015. © 2014 Wiley Periodicals, Inc.     

耳穴贴压治疗失眠疗效的Meta分析

目的系统评价耳穴贴压治疗失眠的疗效,为失眠患者的治疗提供参考。方法计算机检索PubMed、Cochrane Library、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普期刊资源整合服务平台(VIP)和万方数据知识服务平台(WanFang Data)等数据库中有关耳穴贴压治疗失眠的随机对照试验(RCT),追溯纳入文献的参考文献,文献检索时限为各数据库建库至2014年9月。按照纳入和排除标准筛选文献、提取资料并评价纳入研究的方法学质量后,采用RevMan 5.0软件进行Meta分析。结果共纳入7篇RCT,合计939例受试者。根据干预时间和对照组的干预方案进行亚组分析。Meta分析结果显示:1以干预时间为亚组分析:干预2周,耳穴贴压组的总有效率高于对照组[OR=10.66,95%CI(5.23,21.74),P0.01];干预1个月,耳穴贴压组的总有效率高于对照组[OR=4.54,95%CI(2.28,9.01),P0.01]。2以对照组治疗方案为亚组分析:与针刺组相比,耳穴贴压组总有效率高于针刺组[OR=7.70,95%CI(3.05,19.48),P0.01];与药物组相比,耳穴贴压组总有效率高于药物组[OR=7.76,95%CI(4.61,13.08),P0.01]。结论耳穴贴压治疗失眠有一定疗效,可提高患者的睡眠质量。但由于本次纳入文献差异性较大,故研究结果需谨慎对待,还需大样本、高质量的文献进一步证实其临床疗效。