儿童肱骨内上髁骨折不同手术切口的比较分析

目的：探讨采用肘关节纵切口与横切口治疗儿童肱骨内上髁骨折的疗效差异。方法：回顾性分析我院手术治疗新鲜的儿童肱骨内上髁骨折并得到随访的106例患儿的资料,男67例,女39例,年龄7.3～16.2 岁,平均年龄１2.7 岁。61例手术采用肘内侧纵切口和45例采用横切口进行切开复位骨折,并用克氏针、空心钉或可吸收钉、棒固定。术后石膏托固定3～5周后行功能训练,待骨折完全愈合后再取出内固定。结果：获得随访106例,随访时间7～60月,平均随访时间25月。纵切口组手术时间50～70 min,平均（60.00±3.60） min;手术切口6～9 cm,平均（7.5０±0.18） cm。横切口组手术时间20～30 min,平均（23.00±2.66） min;手术切口2.0～2.5 cm,平均（2.2０±０.13） cm。1例术后发生骨不连,105例患儿术后2～3月随访X片显示骨折骨性愈合,无迟发性尺神经损伤表现。2种方法各有1例术后出现桡神经损伤症状,拔针后神经损伤很快恢复,症状消失,无需进行二次手术。肘关节内侧无压痛,外观无明显外翻畸形,外翻应力试验稳定。肘关节功能评分：99例优,6例良,1例中。结论：经肘关节２种切口都可以用于儿童肱骨内上髁骨折的手术治疗,但肘内后横切口具有切口小、创伤小、手术易操作、花时少、愈合后瘢痕小的优点,是一种更好的手术入路。     

Nano carriers for drug transport across the blood–brain barrier

Effective therapy lies in achieving a therapeutic amount of drug to the proper site in the body and then maintaining the desired drug concentration for a sufficient time interval to be clinically effective for treatment. The blood–brain barrier (BBB) hinders most drugs from entering the central nervous system (CNS) from the blood stream, leading to the difficulty of delivering drugs to the brain via the circulatory system for the treatment, diagnosis and prevention of brain diseases. Several brain drug delivery approaches have been developed, such as intracerebral and intracerebroventricular administration, intranasal delivery and blood-to-brain delivery, as a result of transient BBB disruption induced by biological, chemical or physical stimuli such as zonula occludens toxin, mannitol, magnetic heating and ultrasound, but these approaches showed disadvantages of being dangerous, high cost and unsuitability for most brain diseases and drugs. The strategy of vector-mediated blood-to-brain delivery, which involves improving BBB permeability of the drug–carrier conjugate, can minimize side effects, such as being submicrometre objects that behave as a whole unit in terms of their transport and properties, nanomaterials, are promising carrier vehicles for direct drug transport across the intact BBB as a result of their potential to enter the brain capillary endothelial cells by means of normal endocytosis and transcytosis due to their small size, as well as their possibility of being functionalized with multiple copies of the drug molecule of interest. This review provids a concise discussion of nano carriers for drug transport across the intact BBB, various forms of nanomaterials including inorganic/solid lipid/polymeric nanoparticles, nanoemulsions, quantum dots, nanogels, liposomes, micelles, dendrimers, polymersomes and exosomes are critically evaluated, their mechanisms for drug transport across the BBB are reviewed, and the future directions of this area are fully discussed.     

Visual targeted therapy of hepatic cancer using homing peptide modified calcium phosphate nanoparticles loading doxorubicin guided by T1 weighted MRI

Effective treatment and real-time monitoring of hepatic cancer are essential. A multifunctional calcium phosphate nanoparticles loading chemotherapeutic agent doxorubicin and magnetic resonance imaging contrast agent diethylenetriaminepentaacetic acid gadolinium (A54-CaP/Gd-DTPA/DOX) was developed for visual targeted therapy of hepatic cancer via T1-weighted MRI in real-time. A54-CaP/Gd-DTPA/DOX exhibited a higher longitudinal relaxivity (6.02?mM^?1?s^?1) than commercial MR contrast agent Gd-DTPA (3.3765?mM^?1?s^?1). The DOX release from the nanoparticles exhibited a pH dependent behavior. The cellular uptake results showed that the internalization of A54-CaP/Gd-DTPA/DOX into BEL-7402 cells was1.9-fold faster than that of HepG2 cells via A54 binding. In vivo experiments presented that A54-CaP/Gd-DTPA/DOX had higher distribution and longer retention time in tumor tissue than CaP/Gd-DTPA/DOX and free DOX, and also displayed great antitumor efficacy (95.38% tumor inhibition rate) and lower toxicity. Furthermore, the Gd-DTPA entrapped in the nanoparticles could provide T1-weighted MRI for real-time monitoring the progress of tumor treatment.     

Awareness of and compliance with recommended dietary supplement among age-related macular degeneration patients

BACKGROUND: The age-related eye disease study suggested that taking zinc and anti-oxidants supplements could reduce the progression of age-related macular degeneration (AMD). In Australia, the available supplement is Macu-Vision. The study aimed to assess the awareness of and compliance with taking this supplement and the public health implication. METHODS: The fundus photograph database of patients aged 55 years and older at the ophthalmology department of a public teaching hospital in Adelaide, Australia was reviewed. In total, 125 patients with category 3 and 4 AMD were identified. A total of 100 patients participated in this cross-sectional study. RESULTS: In total, 53% of participants were aware of the availability of the formulae available in Australia, 38% were taking the supplement and only 1% were taking the correct dose. Of those taking the supplement 95% (36/38) were taking half the recommended dosage. Among those who were aware of the supplement but not taking it, cost was the most common reason (31%). Another 31% were not taking it because of actual side-effects experienced, fear of potential side-effect and/or fear of interaction with other medications. There was no predictive factor for failing to take the formulae available in Australia among age, sex, smoking status, living arrangement and category of AMD. CONCLUSIONS: Clinicians need to emphasize that the recommended dosage is twice that on the supplement label. If the trend demonstrated here of underutilizing the formulae available in Australia among public hospital patients continues, it is unlikely to have any major public health impact in similar settings in Australia.     

疏血通注射液治疗缺血性脑卒中78例

目的 评价疏血通注射液治疗缺血性脑卒中的疗效。方法 将137例缺血性脑卒中患者分为两组，治疗组78例，对照组59例，均予阿司匹林、银杏叶注射液及基础治疗，治疗组加用疏血通8mL静脉滴注，1次／d，分别于治疗前及治疗后第7，14，21天时对患者进行欧洲卒中量表（ESS）评分、日常生活活动能力评定量表（ADL）及常规检查。结果 治疗后第14，21天时，两组ESS及ADL评分有显著差异（P〈0．05）。结论 疏血通能明显改善缺血性脑卒中的预后，且不增加缺血性卒中后出血的风险。     

思维导图在口腔医学技术本科生全口义齿实验课教学中的应用评估

目的:探索思维导图在口腔医学技术本科生全口义齿实验课教学中的应用效果。方法:将重庆医科大学口腔医学技术本科班学生分为三组,分别采用传统实验课教学、思维导图教学和改良思维导图教学进行全口义齿实验课内容讲授;学期末通过实验考核、理论考核及综合考核评分（实验和理论考核加权）的方式评价学生对课程内容的掌握程度;运用SPSS 2...     

利用锥形束CT对不同磨牙关系患者下颌第一磨牙咬合接触情况的研究

目的:利用锥形束CT分析不同磨牙关系患者下颌第一磨牙咬合接触情况,并探索该方法的可行性。方法:选取2013年1月至2013年6月于我院放射科就诊需行锥形束CT检查的患者,按照纳入排除标准遴选出347例患者,按照Ⅰ、Ⅱ、Ⅲ类磨牙关系分别记录患者下颌第一磨牙面上近中、中、远中3部分的A、B、C咬合接触点分布情况,并利用SAS 9.2软件进行统计分析。结果:3类接触点总数比较,Ⅰ类130例(26.62±10.79)、Ⅱ类131例(26.75±10.81)、Ⅲ类86例(19.16±9.14),差异有统计学意义(H=28.346,P=0.000),组间比较Ⅲ类接触点较其余2类均少,差异有统计学意义(P<0.016 7)。近中接触点数目比较,Ⅰ类(5.62±3.56)、Ⅱ类(7.96±4.06)、Ⅲ类(4.47±3.61),差异有统计学意义(H=45.045,P=0.000),组间两两比较差异有统计学意义(P<0.016 7);中部接触点数目比较,Ⅰ类(10.3±4.74)、Ⅱ类(9.24±4.54)、Ⅲ类(6.53±4.04),差异有统计学意义(H=32.390,P=0.000),组间比较Ⅲ类最少,余无统计学差异;远中接触点数目比较,Ⅰ类(10.7±4.89)、Ⅱ类(9.55±5.35)、Ⅲ类(8.16±4.72),差异有统计学意义(H=12.025,P=0.002),其中Ⅲ类数目较Ⅰ类少(P<0.0167),余无统计学差异。A点数目比较,Ⅰ类(10.46±5.75)、Ⅱ类(9.53±5.2)、Ⅲ类(7.83±5.02),差异有统计学意义(H=8.466,P=0.015),组间比较Ⅲ类较Ⅰ类少(P<0.016 7),余无统计学差异;B点数目比较,Ⅰ类(9.66±5.58)、Ⅱ类(10.87±5.08)、Ⅲ类(6.17±4.7),差异有统计学意义(H=39.598,P=0.000),组间比较Ⅲ类数目最少(P<0.016 7),余无统计学差异;C点数目比较,Ⅰ类(6.49±3.46)、Ⅱ类(6.34±4.63)、Ⅲ类(5.16±3.39),差异有统计学意义(H=7.179,P=0.028),组间比较Ⅲ类较Ⅰ类少(P<0.016 7),余无统计学差异。结论:Ⅲ类磨牙关系患者三点式咬合接触点总数、3个部位及B点数目均较其他2类少,牙尖交错位时咬合接触稳定性差;锥形束CT可作为一种新方法分析咬合接触情况。     

种植体周围炎龈沟液中SOD、GP-x、MDA水平的初步研究

目的:检测种植修复患者种植牙及天然牙龈沟液中氧化应激标记物超氧化物歧化酶(superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(glutathione peroxidase,GP-x)和丙二醛(malondialdehyde,MDA)的浓度,探讨种植体周围炎与氧化应激的关系。方法:收集重庆医科大学附属口腔医院修复科完成种植上部修复1年后的患者62名,共计81个种植牙位,实验分为4组:炎症种植体(peri-implantitis group,PI)组,15颗;健康种植体(health implant group,HI)组,66颗;炎症种植体患者口内天然牙(tooth in peri-implantitis group,TPI)组,15颗;健康种植体患者口内天然牙(tooth in health implant group,THI)组,66颗。检查所选牙位的菌斑指数(plaque index,PLI)、探诊深度(pocket depth,PD)、龈沟出血指数(sulcus bleeding index,SBI)/改良龈沟出血指数(modified sulcus bleeding index,m BI)并收集龈沟液;利用ELISA法检测炎症因子白细胞介素-β(IL-lβ)、SOD、GP-x和MDA的浓度。结果:PI组的PLI、PD、m BI、IL-1β值以及龈沟液的量(2.20±0.78,4.63±0.92,2.60±1.12,21.07±2.29,1.34±0.17)较HI组(1.03±0.89,1.76±0.73,1.14±0.97,18.79±2.07,0.83±0.23)高,差异有统计学意义(P=0.000,0.000,0.001,0.000,0.000);较TPI组(1.13±0.92,1.53±0.72,1.00±0.93,18.52±2.37,0.74±0.26)高,差异有统计学意义(P=0.011,0.000,0.001,0.000,0.000)。PI组SOD及GP-x浓度(218.65±16.27,178.66±21.77)低于HI组(243.52±19.71,211.96±21.43),差异有统计学意义(P=0.000,0.000);也低于TPI组(230.63±26.91,213.04±25.75),差异有统计学意义(P=0.016,0.000)。HI组的PLI、PD、m BI、IL-1β、SOD、GP-x值以及龈沟液量与THI组无统计学意义,MDA在各组间无统计学意义。结论:炎症种植体龈沟液内SOD、GP-x的浓度较健康植体、炎症种植体患者口内天然牙均低、MDA浓度无明显改变,提示氧化应激可参与种植体周围炎,抗氧化应激酶可为种植体周围炎的一个临床诊断指标,为种植体周围炎的诊断以及治疗提供一定的理论依据。     

隆突性皮肤纤维肉瘤免疫表型和COL1A1/PDGFB融合基因的临床应用研究

目的：探讨隆突性皮肤纤维肉瘤（dermatofibrosarcoma protuberans,DFSP）诊断中免疫表型和荧光原位杂交（fluores cence in situ hybridization,FISH）检测COL 1A 1/PDGFB 融合基因的应用价值。方法：观察73例DFSP中免疫组织化学标记物vimentin、CD34、CD99、S100、desmin 、SMA 和FISH检测COL 1A 1/PDGFB 融合基因的表达。选取85例非DFSP作为免疫组织化学的对照组,10例非DFSP作为FISH检测COL 1A 1/PDGFB 融合基因的对照组。结果：vimentin、CD34、CD99、S100、desmin 、SMA 在73例DF?SP中阳性率分别是100% 、91.78% 、61.64% 、0、0、6.85% ,在对照组中不同程度表达,其中CD34的表达在鉴别诊断中有意义。COL 1A 1/PDGFB 融合基因在DFSP的阳性率为86.96%（60/ 69）,对照组均阴性。结论：在DFSP的诊断中,COL 1A 1/PDGFB 融合基因是DFSP较为特异性、敏感性的标记,而CD34是DFSP相对理想的标记。