舍格伦综合征亚临床型

目的进一步观察舍格伦综合征（Ｓｊ¨ｏｇｒｅｎ＇ｓｓｙｎｄｒｏｍｅ，ＳＳ）亚临床型的各种表现及治疗。方法对２４例ＳＳ亚临床型患者长期临床观察，并行实验室、腮腺造影及肌内注射胸腺肽治疗。结果２４例患者在出现口干、眼干之前有腮腺反复肿胀史２～１７年（平均７年），均误诊为“慢性化脓性腮腺炎”或“腮腺腺炎”，追踪观察均为典型的ＳＳ。２４例中有１０例患者同时伴有脉管炎或出血性紫癜，占４０％，脉管系统受累较普遍。腮腺造影以末梢导管扩张伴主导管扩张及边缘粗糙为主，１２／２４例，占７０％。肌内注射胸腺肽能明显减少腮腺反复肿胀发作频率。结论提出ＳＳ亚临床型对澄清慢性腮腺炎症命名及分类上的混乱有实际意义，并对早期诊治ＳＳ有指导意义。肌内注射胸腺肽能减少肿胀发作频率。     

Digital subtraction arthrography and arthrofluoroscopic dynamic observations on TMJ dysfunction syndrome

Digital subtraction arthrography and arthrofluoroscopic dynamic observation were performed for seventy cases with TMJ dysfunction syndrome. A comparative study between the findings of digital subtraction arthrography and the operative findings was carried out for eleven cases who underwent surgery. It has been found that digital subtraction arthrography can overcome the disadvantages of conventional arthrography and has important diagnostic value for TMJ dysfunction syndrome, especially for disc perforation. In addition. The procedure of digital subtraction arthrography, the normal and abnormal manifestations of digital subtraction arthrograms were described in the present study.     

Chronic obstructive parotitis. Report of ninety-two cases.

Clinical, sialographic, and sequential quantitative scintigraphic characteristics of 92 cases of chronic obstructive parotitis (in 117 diseased parotid glands) are reported, and the treatment investigated. The cardinal feature of this disease is obstruction or retarded salivary flow resulting in recurrent swellings and retrograde infection. The main characteristic seen in sialograms is irregular dilation of the main and branching ducts. On the basis of sialographic findings, the ducts are classified into four types. This classification reflects the severity of the disease and can also be used as a guide to treatment.     

牵张成骨延长一侧下颌骨对颞下颌关节的影响

目的：研究牵张成骨（DO）延长一侧下颌骨对双侧颞下颌关节（TMJ）的影响。方法：用DO技术将8只山羊的一侧下颌骨延长10mm，在牵张完成后第8和16周分别处死4只动物，取双侧关节作组织学和扫描电镜研究。结果：下颌一侧DO术后双侧髁状突发生适应性改建，髁突表面超微结构正常。结论：在适当的牵张条件下延长一侧下颌骨不会对TMJ造成病理性损害。     

上颌牙弓反复快速扩缩的动物模型的建立及初步研究

目的建立上颌牙弓反复快速扩缩的动物模型并进行初步研究。材料和方法选择6周龄健康雄性SD大鼠22只，随机分成3组：实验一组（单纯扩弓组）9只，连续扩弓5天；实验二组（反复扩缩组）9只，先扩弓5天，再缩弓5天，然后再扩弓5天…，如此反复25天，扩三次，缩两次；对照组4只，不进行任何处理。实验组在实验前、扩弓结束、缩弓结束时，拍腭中缝X线片，取大鼠上颌石膏模型。结果大鼠上颌咬合片中可以看到：扩弓后，大鼠腭中缝被打开，而缩弓结束后，腭中缝回复到扩弓前水平。模型测量发现：单纯扩弓组扩弓结束时中切牙间距离及第一磨牙间的距离比扩弓前增大（P〈0．05）。反复扩缩组每次扩弓结束时中切牙间距离及第一磨牙间的距离均增大（P〈0．05）；每次缩弓结束时，中切牙间距离及第一磨牙间的距离均缩小，与扩弓前水平相当（P〉0．05）。对照组腭中缝宽度、中切牙间距离及第一磨牙间的距离均无变化。结论本研究利用扩弓和缩弓装置成功建立了上颌牙弓反复快速扩缩的动物模型；腭中缝宽度、中切牙间距离及第一磨牙间的距离随着扩弓或缩弓而增大或回复，并且随着扩弓次数的增加，每次扩弓后中切牙间距离及第一磨牙间的距离均比前一次扩弓增大，第一扩弓和第三次扩弓的差异有显著性。     

二单位式与四单位式种植牙周骨界面应力分布规律差异的三维有限元分析

为了探讨人工种植牙的数目、上部结构对种植牙周骨界面应力分布的影响，本实验应用三维有限元分析方法，对二单位和四单位式杆式覆盖种植义齿种植牙周骨界面的应力分布规律进行了探讨。结果表明：最大压应力、最大拉应力二单位式与四单位式均位于颈周密质骨，二单位式大于四单位式，两者有显著差异性，（Ｐ＜０．００１）。四单位式最大拉、压应力，远中种植牙要大于近中种植牙。最大位移运动二单位式小于四单位式，四单位式近中种植牙大于远中种植牙。二单位式与四单位式位、压应力主要集中于颈部，其它部位与颈部相比有非常显著的差异性，（Ｐ＜０．０００１）。结论：种植牙数目的增加，可以减小种植牙周颈部密质骨内的最大应力值。四单位式种植义齿颈周骨内应力要小于二单位式种植牙，从这点上看，四单位式种植义齿要优于二单位式种植义齿。多个种植牙种植时，杆的连接，改变了种植牙周骨内的应力分布规律，其应力主要由种植牙颈周密质骨来承担     

Heterotrophic ossification on a skin graft in a postburn scar of the chin

Some patients who have heterotrophic ossification (HO) in a postburn scar are occasionally seen in the clinic. The occurrence of HO following hip and abdominal surgery is common in males, whereas females are frequently affected following burns. The HO of skin grafts in burn scars of the superior body parts is uncommon, especially on the face. We report a recent case of a male patient in whom HO arose on skin grafts on his chin. The patient presented with a history of a painless chin mass for 48 years. Computed tomography scan suggested that the mass was located within subcutaneous tissue away from the lower jaw. The density of the mass was almost the same as the cortical bone of the lower jaw. The mass was completely resected under general anesthesia. It was a rectangular mass of 3× 0.5× 0.3 cm. Histological examination gave the diagnosis of HO, which was also confirmed by immunohistochemical stainings for vimentin. Recurrence was not found in this case by clinical and radiologic follow-up at 1 year after surgery.     

下颌神经高效切断术的临床应用研究（附19例报告）

Trigeminal neuralgia is a common disease in clinical practice. The recurrence rate after avulsion is relatively high. In order to reduce the recurrence rate, the author developed a new method and operated on 19 cases with intraoral high level trigeminal neurotomy based on 21 cases of adult human skull anatomy. The method is simple, safe and in good condition. The author emphasized that the proper management of the buccal branch during operation may have a close relation with the post-operative recurrence rate.     

激素受体阳性乳腺癌的内分泌治疗

乳腺癌是我国女性最常见的恶性肿瘤之一,也是一种激素依赖性肿瘤.近年来,针对乳腺癌内分泌激素通路的药物陆续得到开发和应用,一些药物已被证明可以改善乳腺癌患者的预后.内分泌治疗在乳腺癌中取得了良好的效果,对于乳腺癌患者的治疗方案正在迅速改变,内分泌治疗已成为激素受体阳性乳腺癌患者的主要治疗手段.本文对乳腺癌患者内分泌治疗的机制、副反应、耐药问题及正在进行的临床研究进行综述.     

HPV感染与特殊类型宫颈腺癌预后相关性分析

目的:本研究将宫颈特殊类型腺癌分为人乳头瘤状病毒(human papillomavirus,HPV)感染相关型和非HPV感染相关型,探讨不同分型与预后的关系.方法:收集美国SEER数据库共468例宫颈特殊类型腺癌患者的临床资料进行回顾性分析,将其分为 HPV 感染相关型(HPV-associated adenocarcinoma,HPVA)组和非 HPV 感染相关型(non-HPV-associated adenocarcinoma,NHPVA)组,采用卡方检验、Fisher检验、K-M法、log-rank检验、Cox回归模型进行统计学分析.结果:组间比较结果显示2组患者在分期、肿瘤分化程度方面有明显统计学差异.NHPVA组比HPVA组期别更晚(P=0.001),肿瘤分化更差(P＜0.05).肿瘤相关死亡率在NHPVA组(70/205,34.1％)明显高于HPVA组(53/263,20.2％),NHPVA组总体预后差于HPVA组(P=0.001).5个病理亚型间预后差异有明显统计学意义(P=0.002),浆液性癌预后最差.结论:基于是否感染HPV对宫颈特殊类型腺癌进行分类能预测患者预后,从而采取相应治疗措施,将对临床工作产生一定指导意义.