重庆市女性Angle′Ⅱ类2分类错(牙合)畸形患者模型测量分析

目的 比较分析重庆市女性Angle′Ⅱ类2分类错(牙合)畸形患者模型特征,为临床正畸诊断和治疗提供参考.方法 收集56例重庆市女性Angle′Ⅱ类2分类患者牙模型作为实验组,重庆市女性正常(牙合)数据作为对照组.用数显游标卡尺测量实验组模型牙冠高度,牙弓宽度和长度,计算出临床冠中心高度,并与对照组进行对比分析研究.结果 实验组临床牙冠高度、临床冠中心高度及上下颌牙弓宽度均较对照组小,大部分测量值与对照组相比,差异均有统计学意义;实验组上下颌牙弓长度,除下颌中切牙近中接触点到第一磨牙中央窝连线的垂直距离较对照组大外,其余均较对照组小.大部分测量值与对照组相比,差异均有统计学意义.结论 重庆市女性Angle′Ⅱ类2分类错(牙合)畸形患者正畸治疗前应结合模型测量制定方案.治疗中注意托槽定位,上下颌可适当进行扩弓、唇展前牙获得间隙.     

The clinical and electrophysiological implications of asymptomatic atrial fibrillation

Atrial fibrillation (AF) is the commonest arrhythmia encountered in clinical practice and is frequently associated with significant symptoms. Asymptomatic AF may also increase the risks of heart failure, thromboembolism and cardiomyopathy but its prevalence is significantly underestimated by routine surveillance methods. The development of long-term external monitors and implantable devices has offered a new insight into the true prevalence of asymptomatic AF. Similar management strategies should be applied to both symptomatic and asymptomatic patient groups and anticoagulation should be continued indefinitely in those with a history of AF and risk factors for thromboembolism. Enhanced detection of clinically silent AF could improve outcomes but the resource implications will be significant.     

Psychosocial aspects of patient-activated atrial defibrillation

Atrial Defibrillator. INTRODUCTION: The atrial defibrillator empowers patients to cardiovert themselves from atrial arrhythmias at a time that is socially and physically acceptable, thereby preventing hospitalization. The long-term psychosocial effects of repeated use of the patient-activated atrial defibrillator at home are unknown. METHODS AND RESULTS: Eighteen patients underwent placement of the Jewel AF atrial defibrillator for persistent atrial fibrillation only. All patients performed manually activated cardioversions at home under self-administered sedation. Automatic shock therapies were disabled. Hospital Anxiety and Depression Scale and Multidimensional Health Locus of Control questionnaires were obtained before implant. All patients completed questionnaires 1 year after device implant and at long-term follow-up. The spouse or partner of each patient was interviewed to identify positive and negative aspects of manual cardioversion at home. The baseline patient scores for both anxiety (5.7 +/- 2.7) and depression (3.4 +/- 2.3) fell within the predefined range of normality. At 1 year, there was no significant change in anxiety (4.9 +/- 3.7, P = 0.39) or depression (2.4 +/- 1.8, P = 0.06). At long-term follow-up (mean 28 months), a total of 377 patient-activated cardioversions were performed out of hospital (median 15 per patient). Scores for anxiety (6.0 +/- 4.0, P = 0.70) and depression (3.2 +/- 2.5, P = 0.68) remained unchanged. CONCLUSION: During long-term follow-up, patient-activated cardioversion using the atrial defibrillator was not associated with increased anxiety or depression. The procedure was well tolerated by patients and their partners, offering an acceptable treatment option for patients with recurrent persistent atrial fibrillation.     

DC cardioversion of persistent atrial fibrillation: a comparison of two protocols

BackgroundCurrent guidelines for transthoracic direct-current cardioversion (DCCV) of atrial fibrillation (AF) recommend a step-up energy protocol. The aim of this study was to compare such a protocol with a protocol involving a high initial energy shock, anteroposterior paddle position and reversal of shock polarity, on cardioversion efficacy, total energy delivery, use of sedation and patient tolerability.Methods261 patients (mean age 71 ± 10 years, 62% male) referred for elective DCCV of persistent AF were enrolled. Patients were randomised to either protocol A: (1) 200 J anteroapical, (2) 360 J anteroapical, (3) 360 J anteroposterior; or protocol B: (1) 360 J anteroapical, (2) 360 J anteroposterior, and (3) 360 J posteroanterior. All procedures were performed under sedation with intravenous diazepam.ResultsProtocol B improved shock success rates (protocol A first shock success rate = 42%, protocol B = 68%, p < 0.001; protocol A second shock success rate = 72%, protocol B 86%, p = 0.006; protocol A third shock success rate = 83%, protocol B = 92%, p = 0.03) and required fewer shocks to achieve sinus rhythm (1.3 ± 0.6) compared with protocol A (1.6 ± 0.7, p < 0.001). There were no differences in cumulative energy used (protocol A 473 ± 286 J, protocol B 436 ± 273 J, p = 0.24) or sedation requirements (protocol A diazepam 22.1 ± 9.0 mg, protocol B 21.7 ± 8.9 mg, p = 0.75). Both protocols were equally well tolerated by patients.ConclusionHigh initial energy increased success rates and decreased the number of shocks but resulted in similar cumulative energy delivery, sedation use and patient tolerability compared with a conventional step-up protocol.     

Benzopyrans are selective estrogen receptor beta agonists with novel activity in models of benign prostatic hyperplasia

Benzopyran selective estrogen receptor beta agonist-1 (SERBA-1) shows potent, selective binding and agonist function in estrogen receptor beta (ERbeta) in vitro assays. X-ray crystal structures of SERBA-1 in ERalpha and beta help explain observed beta-selectivity of this ligand. SERBA-1 in vivo demonstrates involution of the ventral prostate in CD-1 mice (ERbeta effect), while having no effect on gonadal hormone levels (ERalpha effect) at 10x the efficacious dose, consistent with in vitro properties of this molecule.     

Anorexia nervosa in males: Clinical features and outcome

The clinical features and long-term outcome of anorexia nervosa in male patients was investigated by a comparison with a matched group of female patients. The clinical features were remarkably similar in, both groups, whereas the long-term outcome was marginally worse in men. It is suggested that a multicentre study is needed in order to overcome the problem posed by the small numbers of male cases reported.     

RGC-32 regulates reactive astrocytosis and extracellular matrix deposition in experimental autoimmune encephalomyelitis

Extracellular matrix (ECM) deposition in active demyelinating multiple sclerosis (MS) lesions may impede axonal regeneration and can modify immune reactions. Response gene to complement (RGC)-32 plays an important role in the mediation of TGF-β downstream effects, but its role in gliosis has not been investigated. To gain more insight into the role played by RGC-32 in gliosis, we investigated its involvement in TGF-β-induced ECM expression and the upregulation of the reactive astrocyte markers α-smooth muscle actin (α-SMA) and nestin. In cultured neonatal rat astrocytes, collagens I, IV, and V, fibronectin, α-SMA, and nestin were significantly induced by TGF-β stimulation, and RGC-32 silencing resulted in a significant reduction in their expression. Using astrocytes isolated from RGC-32 knock-out (KO) mice, we found that the expression of TGF-β-induced collagens I, IV, and V, fibronectin, and α-SMA was significantly reduced in RGC-32 KO mice when compared with wild-type (WT) mice. SIS3 inhibition of Smad3 phosphorylation was also associated with a significant reduction in RGC-32 nuclear translocation and TGF-β-induced collagen I expression. In addition, during experimental autoimmune encephalomyelitis (EAE), RGC-32 KO mouse astrocytes displayed an elongated, bipolar phenotype, resembling immature astrocytes and glial progenitors whereas those from WT mice had a reactive, hypertrophied phenotype. Taken together, our data demonstrate that RGC-32 plays an important role in mediating TGF-β-induced reactive astrogliosis in EAE. Therefore, RGC-32 may represent a new target for therapeutic intervention in MS.     

Variations in dental and alveolar arch dimensions among different malocclusion groups in a sample of untreated patients

This study compares the different transverse relationships of the upper and lower arches in the 4 different malocclusion groups and describes the origin of these transverse discrepancies. Knowledge of dental and alveolar arch dimensions will help the clinician in diagnosis and treatment planning of patients with different malocclusions.