一次性根管与常规根管治疗后冠修复对隐裂性牙髓炎患者的影响

目的 探讨一次性根管与常规根管治疗后冠修复对隐裂性牙髓炎患者的治疗效果。方法 选取2014年5月至2017年5月诊治的187例隐裂性牙髓炎患者随机分为观察组和对照组,观察组给予一次性根管治疗后冠修复,对照组给予常规根管治疗后冠修复,比较两组术前及术后1周Mohd Sulong疼痛分级、术后3个月临床疗效、术后6个月X线改变、术后2年治疗成功率。结果 术前两组Mohd Sulong疼痛分级无统计学差异(P＞0.05),冠修复术后1周两组疼痛分级无统计学差异(P＞0.05),术后3个月观察组临床疗效总有效率为97.83%较对照组88.41%显著提高(P＜0.05),术后6个月观察X线改变率为3.26%较对照组14.74%显著降低(P＜0.05),术后2年观察组治疗成功率为94.57%较对照组82.11%显著提高(P＜0.05)。结论 一次性根管治疗后冠修复能够缓解隐裂性牙髓炎疼痛,提高临床疗效,提高患者咀嚼功能和生活质量,值得在临床上推广。     

Prevalence of Apical Periodontitis and Conventional Nonsurgical Root Canal Treatment in General Adult Population: An Updated Systematic Review and Meta-analysis of Cross-sectional Studies Published between 2012 and 2020

IntroductionThis study aimed to summarize data on apical periodontitis (AP) and nonsurgical root canal treatment (NSRCT) prevalence and risk factors related to age, gender, and quality of restorative and endodontic treatment in the general population from cross-sectional studies published between 2012 and 2020.MethodsAn electronic search was performed in the following databases: Web of Science, Scopus, and PubMed. The conducted literature search covered studies published between 2012 and 2020, without restrictions on language. The STROBE and NOS tools were used for quality assessment of the included studies.ResultsSixteen articles were included in the review. In total, 200,041 teeth were examined. On average, 6.3% of teeth had AP, and 7.4% had NSRCT. Forty-one percent of RCT teeth had AP, and 3.5% of untreated teeth had AP. Female patients were less prone to AP in endodontically treated teeth only, compared with male patients (P < .001). Variable stratification of age subgroups among included studies prevented us from conducting a meta-analysis. An increase in AP frequency was found in teeth with inadequate restorative and endodontic treatment (P < .001 and P < .001, respectively). Because of high heterogeneity, these results should be taken with caution.ConclusionsThere is an increased AP prevalence in the adult general population compared with data from 2012 (6.3% versus 5.4%) in both endodontically treated (41.3% versus 35.9%) and untreated teeth (3.5% versus 2.1%). In addition, AP developed less frequently in female patients with endodontically treated teeth and in teeth with inadequate compared with adequate restorative and endodontic treatment.     

综合治疗晚期原发性肝癌72例疗效观察

目的 探讨腹腔化疗或联合其他方法综合治疗晚期原发性肝癌的治疗效果.方法 72例不能手术切除的、合并门静脉癌栓、腹腔内转移或淋巴结转移的晚期肝癌,采取腹腔化疗或者联合TACE等其他方法治疗.5-氟尿嘧啶(5-FU)0.5～0.75 g,腹腔内注入1/日,连用10～15天,总量5.0～12.5 g,最后一天腹腔内注入丝裂霉素(MMC)10 mg或卡铂100 mg.7例胆管细胞癌联合使用健择800～1000 mg.结果 全组平均生存时间13.97±6.27月.累积1年、2年生存率分别为59.7%和30.6%.肝功能Child A级平均生存时间15.91±5.49月,B级8.55±5.09月,有显著性差别.结论 腹腔化疗或联合其他综合治疗方法是肝癌并腹腔内转移的有效治疗方法,可延长部分晚期肝癌患者的生存时间,改善生活质量.     

直接数字化X线摄影在腰椎侧位影像中的应用价值

目的探讨直接数字化X线摄影（direct digitized radiography，DDR）在腰椎侧位影像中的应用价值。方法随机抽取81例患者的DDR腰椎侧位影像，使用图像后处理方法中多级图像对比增益法，又称“交响乐”功能（multi—scale image contrast amplification，MUSICA）进行后处理，同时取另81例患者进行普通X线摄影，由放射科经验丰富的医生、技师各2名对所有的腰椎侧位影像进行分析，采用常规影像质量评价指标评价两组的影像质量。结果（1）DDR腰椎侧位影像质量影像评分为13．00，普通X线影像评分为8．96，经非参数检验的配对符号秩和检验，依赖负秩计算的统计量（X^2=-7．88，P〈0．01），两组差异有统计学意义，DDR腰椎侧位组明显优于普通平片组；（2）81例中DDR腰椎图像显示满意率为92．6％（75／81），普通X线平片显示满意率为61．7％（50／81），两者差异有统计学意义（X^2=21．89，P〈0．01）。结论与普通X线影像相比，DDR影像能更好的显示下部腰椎椎体、附件及周围软组织，可获得良好的图像，有利于放射诊断工作。     

肋骨切除术在HIFU联合TACE治疗中晚期肝癌中的临床价值

目的:探讨肋骨切除术在高强度聚焦超声(Hihg intensity focused ultrasound,HIFU)联合经导管动脉栓塞化疗(Tran-seatheter arterial chemoembolization,TACE)治疗中晚期肝癌中的临床价值.方法:68例右叶中晚期肝癌分为肋骨切除组(36例,43病灶)和非肋骨切除组(32例,40病灶),随访两组患者HIFU联合TACE后的疗效,并进行比较.结果:总平均随访(11.9±11.4)月,两组中位生存期及1、2年生存率分别依次为13月、52.3%、21.8%与12月、46.8%、17.6%,两组比较无统计学意义(P=0.8155);其病灶完整消融率和消融体积>80%比例分别依次为46.5%、79.1%与37.5%、67.5%,两组比较无统计学意义(P>0.05).结论:肋骨切除术不能有效提高HIFU联合TACE治疗中晚期肝癌的疗效.     

Surgical management for mentosternal contractures by flap procedures

Mentosternal contractures still represent a surgical challenge due to their prominent position. They require early operative treatment for both function and aesthetic reasons. Careful clinical examination of scar position and traction forces, both at rest and when functioning, in addition to proper evaluation of the surrounding soft tissue are mandatory for precise preoperative planning of the required reconstruction. In general, the technically most feasible operation is favored if the functional and aesthetic results are good and postoperative risk for recurrence is low. Between 1987 and 1994, 21 patients with cervical, mentosternal, and mentothoracic contractures were operated upon. Eight patients were reconstructed with local flaps and 13 with microvascular free flaps.     

122例肝癌合并门脉癌栓的综合治疗与单纯TACE治疗效果比较

目的:研究肝癌合并门脉癌栓综合治疗的效果。方法:122例肝癌分为2组:A组(72例)行肝动脉化疗栓塞(TACE);B组(50例)行TACE结合外放射治疗。结果:A组1、2年生存率分别为22.3％、4.5％,平均生存期7.5个月;B组1、2、3年生存率分别为39.2%、21.2%、13.5%,平均生存期17.5个月,P<0.05。结论:对合并门脉癌栓的肝癌综合治疗能明显提高治疗效果。     

Distal radial fractures Injectable calcium phosphate bone cement versus conventional treatment

AMEDLINEsearchwasconductedtoidentifystudiespublishedfromJanuary1999toMarch2004thatcom-paredinjectablecalciumphosphatebone(NorianSRS)cementwithconventionaltreatmentindistalradialfrac-tures.Fromalistof13articlesidentifiedfromthesearchstrategy,fourarticleswe…     

心阻抗容积图的传统理论及其局限性

本文就心阻抗容积图的传统理论及其局限性展开讨论。由于传统理论模型与人体胸部结构差异太大，使这一方法存在很多问题。而实践中关于心输出量（ＣＯ）的计算，误差较大，可靠性差。