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。     

Is herniography useful?

Herniography has been used for 25 years in the diagnosis of occult herniation but has not gained widespread acceptance in the UK, despite studies confirming its high sensitivity and specificity for occult hernias and an excellent record of safety and patient acceptability. The traditional approach in the UK to suspected occult groin herniation has been surgical exploration. This study examined the use of herniography in a single district general hospital to assess its impact in limiting unnecessary groin explorations and allowing discharge of patients without hernias. The case notes of 90 successive patients referred for herniography by the department of general surgery in a single UK district general hospital over an 18-month period were reviewed. Eighty-seven completed examinations were analysed in which 23 hernias were diagnosed in 20 patients. Thirteen patients have undergone hernia repair with resolution of symptoms. There were no false positive examinations, although two inguinal hernias were incorrectly diagnosed radiologically as femoral hernias; there were two false negative examinations where additional hernias were found at laparoscopic repair. There were no reported complications. Twenty-four patients were discharged directly from the surgical clinic after a negative herniogram. Thirty patients were referred to other specialities. No patient had undergone groin exploration after a negative herniogram. Herniography is a useful tool in assessing obscure groin pain and potential occult herniation. It can reliably rule out the presence of a hernia and avoid the need for surgical exploration. Many patients with a negative herniogram can be reassured and discharged, whilst others may be referred on to other specialities safe in the knowledge that an occult hernia has been excluded.     

Occult spinal dysraphism in children: need for early neurosurgical referral

The natural history of occult spinal dysraphism in children is one of progressive and unpredictable neurological deficit. The modern role of neurosurgery is in the prevention of deterioration rather than correction of established disability. A prospective study was carried out on 40 consecutive patients to analyse the referral pattern of children with this condition. The age, reason for referral, clinical history and source of referral was recorded in each case. The reason for referral varied with age. Of the 40 patients studied, only 12 were found to be without neurological deficit at the time of referral. The incidence of progressive neurological deterioration increased with increasing age. The referral source in different age groups varied, but in all age groups relatively few were referred by the general paediatricians or paediatric neurologists. For optimum surgical results, early referral and treatment is desirable and should become our objective.     

龈沟液隐血试验与牙龈出血指数、龈下菌群的关系

目的 探索一种无创性的牙龈出血检测方法－－龈沟液隐血试验（GCFobt），并分析牙龈出血与微生物之间的内在联系。方法 用隐血试纸进行102例唾液标本的唾液隐血（Sobt）检查，1600个位点的GCFobt、牙龈出血指数（SBI）、探诊深度（PD）检测，分别对79、32个龈下细菌标本作涂片检查和厌氧培养，分析临床指数与龈下细菌的关系。结果 GCFobt具较高灵敏度（68.05）和特异度（80.5%），较Sobt更能说明局部牙周炎症状况，与SBI有非常显著相关关系（P＜0.001）；GCFobt阳性与阴性部位螺旋体、杆菌、球菌百分含量有非常显著差异（P＜0.001）；在0与3之间黑色菌检出率有非常显著差异（P＜0.01），在0与2、3之间梭杆菌检出率有显著差异（P＜0.05）。结论 GCFobt是一种快速、简便、无创伤的检测牙龈出血新方法，可以作为牙周病临床检查的一项客观指标。     

隐性腕背腱鞘囊肿的超声诊断与治疗

目的初步探讨隐性腕背腱鞘囊肿超声诊断的准确性及手术疗效。方法对慢性腕关节背侧疼痛的患者,应用超声检查诊断出隐性腕背腱鞘囊肿7例,对其中5例采取手术治疗,2例保守治疗。结果5例手术患者中,其中4例术中发现舟月间隙有腱鞘囊肿,与术前超声诊断相符,1例未发现肿块。4例行囊肿切除,1例行腱鞘松解术;术后随访2～6个月,术后腕背疼痛症状完全消失,关节活动正常,握力较术前明显改善。2例保守治疗患者,经6～12个月的随访,腕背症状无明显缓解。结论隐性腕背腱鞘囊肿手术疗效可靠,超声诊断作为一种简便、无创的检查方法,对慢性腕关节背侧疼痛的临床诊断提供了新的检测手段。     

2016—2019年常州地区无偿献血者酶免和核酸平行检测结果分析

目的分析ELISA和NAT平行的血液筛查模式对降低经输血感染病原体风险的有效性。方法收集常州市2016—2019年270215例无偿献血者血液标本,采用两次ELISA并行检测HBsAg、抗HCV、抗HIV和抗TP。268264例ELISA双阴性标本采用6人份混样(pool)NAT进行HBV DNA、HCV RNA和HIV RNA的检测,核酸阳性的pool进行拆分单检。结果270215例无偿献血者HBsAg、抗HCV、抗HIV和抗TP的阳性率分别为2.58‰(697例)、1.49‰(402例)、0.23‰(61例)和3.06‰(827例)。268264例酶免阴性无偿献血者HBV DNA、HCV RNA和HIV RNA阳性率分别为0.86‰(230例)、0.01‰(3例)和0.01‰(2例)。结论ELISA与NAT两种检测方法能相互补充,极大降低了输血感染病原体的残余风险,保障输血安全。NAT能进一步缩短血液传染性病毒的检测“窗口期”,检出隐匿性病毒。     

反向被动血凝试验检测人胃液潜血的探讨

目的：研究一种检测微量胃液潜血的新方法。方法：建立用反向被动血凝试验（ＲＰＨＡ）检测人胃液潜血的方法,检测正常人和胃癌及其癌前疾病等患者共１８５份胃液标本。结果：ＲＰＨＡ法检测血红蛋白（Ｈｂ）的最低浓度为０．６μｇ／ｍｌ,最低检出量为１５ｎｇ。以胃癌和不典型增生阳性率最高（１００％）,其次是萎缩性胃炎（８４．６２％）。正常空腹胃液（ｐＨ１．５）对Ｈｂ的抗原性仅有轻度影响。结论：本ＲＰＨＡ法具有特异性强、敏感性高、方法简便、抗体用量少、无需特殊仪器、结果易观察等优点。适于在胃癌及其癌前疾病的人群筛检中推广应用