快速康复在腹腔镜全胃根治性切除术后护理干预的效果研究

目的比较传统护理与快速康复护理干预在腹腔镜全胃根治性切除术患者术后恢复中的影响,分析护理特点,提供有效的护理措施,在临床工作中践行快速康复理念。方法随机选取深圳市人民医院胃肠外科2013年1月至2014年6月80例腹腔镜全胃根治性切除术患者,随机分为观察组与对照组,每组40例。对照组采用传统护理;观察组遵循快速康复理念,在留置及拔除胃管时间、术后物理治疗、功能锻炼等方面进行快速康复护理干预;比较两组术后首次排气时间、进食时间、住院时间、短期并发症发生率等指标。结果观察组术后首次排气时间缩短、进食时间提前、住院总时间缩短、消化道不适症状及并发症发生率降低,与对照组比较,差异有统计学意义(P0.05)。结论对腹腔镜全胃根治性切除术患者进行术后快速康复护理干预可提高临床疗效,缩短住院时间,降低术后短期并发症。     

脑性瘫痪的定义、诊断标准及临床分型

在2005年中华医学会儿科学分会神经学组和2007年中国康复医学会儿童康复专业委员会制定发表的《小儿脑性瘫痪的定义、分型和诊断条件》的基础上,《中国脑性瘫痪康复治疗指南》编写委员会参考国外有关小儿脑性瘫痪诊疗指南和最新文献报道,多次组织讨论编写.以便更好地指导临床医师对小儿脑性瘫痪定义的理解,提高脑性瘫痪的诊断和分型水平,与国际接轨.     

Genotypic diversity of Streptococcus mutans in 3- to 4-year-old Chinese nursery children suggests horizontal transmission

OBJECTIVE: The aims of this study were to investigate the colonisation of Streptococcus mutans and to determine the possibility of horizontal transmission in Chinese nursery children. DESIGN: Fifty-six children aged between 3 and 4 years old from a nursery were included in this study. Twenty-four children were from the day and night nursery class, the others were from the day nursery class. Dental plaque samples were collected with sterile toothpicks and cultured on S. mutans-selective tryptone-yeast-cystine agar supplemented with 0.2U/ml bacitracin and 15% sucrose. The typical isolates of S. mutans were identified by classical microbiological methods and genotyped by arbitrarily primed PCR (AP-PCR) and restriction fragment length polymorphism analysis. RESULTS: S. mutans was isolated from 41 of the 56 children. The prevalence of S. mutans was higher in the children from day nursery class, compared with the children from day and night nursery class (P<0.05). A total of 140 S. mutans isolates from 41 children were analysed by AP-PCR, and 88 different amplitypes were identified. Of 41 children with S. mutans isolates, 82.9% carried two or more genotypes. Two genotypes of S. mutans were repeatedly isolated among 13 children in the day and night nursery class, and one genotype was isolated from two children in the day nursery class. CONCLUSION: The presence of matching genotypes of S. mutans among children attending the same nursery suggests the possibility of horizontal transmission.     

Temporospatial expression of vascular endothelial growth factor and basic fibroblast growth factor during mandibular distraction osteogenesis.

OBJECTIVE: Distraction osteogenesis is a vascular-dependent process. This study investigated expression patterns of two major angiogenic factors, vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF), in the distracted calluses following mandibular lengthening in a goat model. MATERIAL AND METHODS: Bilateral mandibular osteotomies were performed in 15 young adult goats. After a latency of 7 days, the mandibles were elongated using custom-made distractors with a rate of 1 mm/day for 10 days. Three animals each were sacrificed at the end of the delay phase, at 0, 7, 14, and 28 days after completion of distraction, respectively. The lengthened mandibles were harvested and processed for histological and immunohistochemical examinations. RESULTS: Elevated cellular expression of VEGF and bFGF, with neovascularization in the distraction gap, was observed following mandibular lengthening. VEGF staining was noted in the endothelial cells and osteoblasts. bFGF staining was seen in the fibroblast-like cells, osteoblasts and immature osteocytes. Their strongest expression was found 0-7 days after the end of distraction, and declined with maturation of the newly formed bone. CONCLUSION: A temporal and spatial expression pattern of VEGF and bFGF was found during distraction osteogenesis in goat mandibles. It suggests that distraction forces can stimulate the production of VEGF and bFGF, which contribute to neovascularization and new bone formation during gradual distraction of the mandible. Application of angiogenic factors may be considered as a potential method to enhance angiogenesis and osteogenesis in osteodistraction, especially in sites without enough vascularization.     

Clinical application of angiography of oral and maxillofacial hemangiomas. Clinical analysis of seventy cases

Angiographic findings in seventy cases of maxillofacial hemangioma are reported. The tumors have been divided into four types: (1) plexiform hemangioma, (2) cavernous hemangioma with venous drainage, (3) cavernous hemangioma without venous drainage, and (4) the so-called "diffuse type" of cavernous hemangioma. The angiographic features of the four types are described, and clinical application is evaluated. The angiograms demonstrate the location, extent, blood supply, and drainage of the tumors and show whether they communicate intracranially, thus providing valuable criteria for planning and determining the mode of treatment.     

切牙管应用解剖研究

目的 :测量切牙管及邻近骨性结构 ,为切牙区种植体植入提供参考依据。方法 :以游标卡尺等测量工具对 73例上颌骨标本的切牙管进行实体定量测量。结果 :(1)切牙管前壁与鼻底平面交角 :114 .80°±11.0 0° ;(2 )上前牙槽骨前壁与鼻底平面交角 :10 7.2 8°± 10 .75° ;(3 )切牙管长度 :男性为 (15 .63± 2 .18)mm ,女性为 (14 .5 9± 1.96)mm ;(4 )切牙管鼻腔开口宽径 :男性为 (4 .92± 1.46)mm ,女性为 (5 .73± 1.5 0 )mm ;切牙管口腔开口宽径 :男性为 (3 .2 3± 0 .60 )mm ,女性为 (3 .83± 0 .92 )mm。 (5 )在鼻底平面 ,切牙管前壁与上前牙槽骨前壁距离 :(6.15± 1.90 )mm。结论 :切牙管区种植体植入方向应与切牙管平行 ,与鼻底平面成约 115°角 ;切牙管前部牙槽骨较薄 ,宜植入直径为 4mm以下的种植体。     

Remineralization effects of casein phosphopeptide-amorphous calcium phosphate crème on artificial early enamel lesions of primary teeth

International Journal of Paediatric Dentistry 2011 Background. Caries in children younger than 72 months is called early childhood caries (ECC). Sixty‐six per cent of Chinese children younger than 5 years old have dental decay, and about 97% of them are untreated. Aims. This in vitro study was conducted to evaluate the remineralization effects of the casein phosphopeptide‐amorphous calcium phosphate (CPP‐ACP) crème on the artificial early enamel lesions of the primary teeth and to assess its caries‐prevention efficiency. Design. Enamel specimens with artificial early lesions were produced and were then randomly divided into Group A: distilled and deionized water, DDW, as negative control; Group B: CPP‐ACP crème, test group; Group C: 500 ppm NaF solution, as positive control. The enamel surface microhardness (SMH) was measured before, after demineralization, and 30 days after remineralization. The results were analysed with the SPSS 13.0 software package. The enamel specimens were analysed by the scanning electron microscope. Results. The CPP‐ACP crème increased SMH of the eroded enamel significantly more than 500 ppm NaF solution did. The morphology of the enamel was different in each group. Conclusions. The CPP‐ACP crème is effective in remineralizing early enamel lesions of the primary teeth, a little more effective than 500 ppm NaF and can be used for the prevention of ECC.