目的 探讨高速改良涡轮手机拔除下颌阻生第三磨牙的临床疗效。方法 回顾性分析2013年12月—2016年12月于本科室拔除下颌阻生第三磨牙600例临床案例,按拔除方式不同,将其分为高速涡轮手机组和传统凿骨劈冠组,各300例。其中高速涡轮手机组给予高速涡轮手机拔除法拔除下颌第三磨牙,传统凿骨劈冠组给予传统凿骨劈冠拔除法拔除下颌第三磨牙。统计分析两组患者拔出后疗效情况、拔除使用时间、以及拔除后疼痛度及张口受限度情况。结果 高速涡轮手机组患者拔牙优良率明显高于传统凿骨劈冠组,差异有统计学意义(P<0.05),而疗效差发生率明显低于传统凿骨劈冠组,差异有统计学意义(P<0.05);高速涡轮手机组患者拔牙时间在30min内人数明显多于传统凿骨劈冠组,差异有统计学意义(P<0.05),而在30min以上的人数明显少于传统凿骨劈冠组,差异有统计学意义(P<0.05);高速涡轮手机组患者拔牙后疼痛度1级和张口受限度1级人数明显多于传统凿骨劈冠组,差异有统计学意义(P<0.05),而术后疼痛度2级、3级和张口受限度2级、3级均明显少于传统凿骨劈冠组,差异有统计学意义(P<0.05)。结论 高速改良涡轮手机拔除下颌阻生第三磨牙具有创口小,伤口愈合较良好,用时短以及能促进患者术后舒适。

目的 观察镜像视觉反馈和改良强制性运动治疗对脑卒中偏瘫患者上肢功能的影响。方法 前瞻性纳入2013年12月—2016年10月在我院收治的、临床资料完整的脑卒中偏瘫患者117例,随机将患者分4组:A组30例,B组29例,C组28例和D组30例,所有患者均接受常规综合康复治疗,连续治疗4周。在常规综合康复治疗的基础上,B组和C组分别增加镜像视觉反馈训练和改良强制性运动治疗,D组则同时另加镜像视觉反馈和改良强制性运动治疗。主要观察指标包括治疗前、后的Fugl-Meyer量表(FMA)、上肢功能测试(upper extremity function test, UEFT)和改良Barthel指数(MBI)的评分。结果 4组患者治疗后的FMA、UEFT和MBI评分分别为:A组(26.37±3.44)、(43.30±3.46)、(56.27±4.76),B组(29.17±2.82)、(45.41±3.40)、(58.72±4.48),C组(29.46±3.16)、(45.71±2.37)、(58.82±3.89),D组(31.93±2.74)、(48.83±3.57)、(62.17±4.51),与治疗前组内相比,配对t检验显示差异有统计学意义(P＜0.05);单因素方差分析发现,D组明显优于A、B、C 3组,差异有统计学意义(P＜0.05);B、C 2组均优于A组,差异有统计学意义(P＜0.05);B、C 2组间比较,差异无统计学意义(P＞0.05)。结论 在常规综合康复训练基础上,单独联合镜像视觉反馈或改良强制性运动治疗均能改善脑卒中偏瘫患者上肢运动功能和日常生活自理能力,但同时联合应用两种疗法,疗效更佳。

Objective To investigate the effects of mirror visual feedback (MVF) and modified constraint-induced movement therapy (mCIMT) on upper extremity function in post-stroke hemiplegics. Methods 117 patients with hemiplegia post-stroke were collected prospectively from December 2013 to October 2016, and randomly divided into the following four groups: group A (n=30), group B (n=29), group C (n=28) and group D (n=30). All patients were trained with conventional comprehensive rehabilitation therapy for four weeks, while the group B and group C were respectively trained with MVF and mCIMT based on conventional comprehensive rehabilitation therapy. Finally, the group D was simultaneously trained with MVF and mCIMT. The investigation duration was set as four weeks for all groups. The Fugl-Meyer Assessment (FMA) score, Upper Extremity Function Test (UEFT) score, and Modified Barthel Index (MBI) score were used as main index of clinical effects. Results After treatment, the scores of FMA, UEFT and MBI were respectively (26.37±3.44),(43.30±3.46),(56.27±4.76) in group A, (29.17±2.82), (45.41±3.40), (58.72±4.48) in group B, (29.46±3.16), (45.71±2.37), (58.82±3.89) in group C, (31.93±2.74), (48.83±3.57), (62.17±4.51) in group D.Comparing with the scores before treatment, the paired-sample t test showed that there were significant differences (P<0.05). The single factor variance test showed that the scores of the group D were significant better than those scores in group A, group B and group C (P<0.05); furthermore the scores of the group B and group C were significant better than the group A (P<0.05). However, there were no difference at those scores between the group B and group C (P＞0.05). Conclusion Based on conventional comprehensive rehabilitation, single combined with MVF or mCIMT may significantly improve the function of upper limb and activities of daily living (ADL) in post-stroke patients with hemiplegia. However, simultaneous combined with MVF and mCIMT will be more effective than the single one.

目的 探讨改良型音乐治疗对慢性精神分裂症患者临床康复效果的影响。方法 选取2010年4月—10月在我院住院的病情稳定的慢性精神分裂症患者76例,随机分为研究组和对照组各38例,两组患者在同等环境下维持原来的药物治疗和护理,研究组同时予以改良型音乐治疗,观察6个月,采用护士用住院病人观察量表(NOSIE)对两组进行评估。结果 两组经过治疗后,NOSIE各项因子分均较前有明显提高,差异有统计学意义;研究组 NOSIE总积极分、社会能力、社会兴趣、个人整洁等得分较对照组有明显提高,差异有统计学意义;总消极分激惹、精神病表现、迟缓、抑郁较对照组有较明显降低,差异统计学意义。结论 改良型音乐治疗,对慢性精神分裂症患者的临床康复有积极的促进作用。

Objective To explore the effect of modified music therapy on the rehabilitation of patients with chronic schizophrenia. Methods 76 patients with chronic schizophrenia who were hospitalized in our hospital from October to April of 2010 were randomly divided into study group and control group (38 cases). The patients in the two groups were treated with the same environment. The research group was treated with modified music. The two groups were evaluated by using the observation scale (NOSIE). Results Two groups after treatment, the NOSIE of the factors were significantly improved, the difference was statistically significant; the study group NOSIE total score, social ability, social interest, personal cleanliness, etc, compared with the control group were significantly improved. The difference was statistically significant; the total negative score, mental disease, depression, and the control group were significantly lower than the control group, the difference was statistically significant. Conclusion Modified music therapy has a positive effect on the rehabilitation of patients with chronic schizophrenia.

目的 探寻改良内眦赘皮、重睑组合手术并观察美学效果。方法 选取40例有内眦赘皮、重睑手术需求的患者,分为对照组和观察组,对照组采用传统内眦赘皮、重睑组合手术,观察组采用改良内眦赘皮、重睑组合手术,比较两组患者满意度、美学效果。结果 对照组患者满意度为60. 0%,观察组患者满意度为95. 0%,观察组患者满意度高于对照组(P<0. 05)。观察组美学效果优于对照组(P<0. 05)。结论 改良内眦赘皮、重睑组合手术能够充分矫正内眦赘皮的异常结构,更好暴露泪阜, 能成形鼻眶窝,使鼻根部具有起伏协调之曲线美感,具有较好美学效果的手术方法之一。

目的 观察改良INP方案对肺腺癌伴有脑转移患者的临床疗效及毒副作用,并探讨该方案疗效与Ⅲ型β微管蛋白(β-tubulin-Ⅲ)在肺癌组织中表达水平的关系。方法 收集2010年4月—2013年1月广州医科大学附属第一医院胸外科收治的15例肺腺癌伴有脑转移患者的临床资料。所有患者均采用改良INP方案治疗,使用RECIST 1.0标准进行判定。结果 脑转移瘤取得CR 1例(1/15),PR 5例(5/15),SD 4例(4/15),PD 5例 (5/10),该方案对脑转移瘤的总缓解率(overall response rate,ORR)为40%,疾病控制率(disease control rate,DCR)达66.7%,毒副作用轻度可控;Ⅲ型β微管蛋白低表达对该方案的疗效有优于高表达的趋势。结论 肺腺癌伴有脑转移患者采用改良INP方案进行化疗,脑转移瘤临床疾病控制率较高,耐受性良好;肿瘤组织β-tubulin-Ⅲ表达水平可能与该方案的疗效相关。

Objective To investigate the efficacy and toxicity of chemotherapy of modified INP regimen in the treatment of adenocarcinoma with brain metastases. At the same time,to explore the relationship between expression of β-tubulin-Ⅲ in NSCLC biopsies and sensitivity to this modified INP regimen. Methods The clinical data of 15 adenocarcinoma with brain metastases patients who had been admitted to the first affiliated hospital of Guangzhou medical university from April 2010 to January 2013 were retrospectively analyzed. All patients received modified INP regimen.RECIST 1.0 was taken to know the result. Results For brain metastasis of the 15 patients, complete response (CR) and partial response(PR) were 1 and 5 patients, respectively. 4 patients were stable disease (SD) and progression disease(PD) in 5 patients. The overall response rate(ORR) was 40% and the disease control rate(DCR) was 66.7%. The toxicity was mild. Furthermore, we found NSCLC patients with low β-tubulin-Ⅲexpression had better ORR than those with high expression. Conclusion The modified INP regimen is effective and well-tolerable for brain metastases of adenocarcinoma. The β-tubulin-Ⅲ expression may be associated with the efficacy of this regimen.

目的 比较改良LIFT术(经括约肌间瘘管结扎术)和常规LIFT术治疗单纯性经括约肌型肛瘘的临床疗效。方法 2013年1月—2014年12月,86例单纯性经括约肌型肛瘘患者,随机分成A组和B组,分别接受改良LIFT 术(A组)与常规LIFT术(B组)42例和44例。通过比较两组病例的手术时间、术后疼痛VAS评分、伤口愈合时间、住院时间及治愈率评估两种手术方法的临床疗效。所有随访患者于术后第3个月均测定肛门直肠压力和进行盆底肌电图检查以评估肛门功能。结果 所有患者均获得随访3个月～26个月,平均(8.73±7.15)月。两组患者的手术时间、术后24 h VAS疼痛评分和住院时间比较,差异无统计学意义(P>0.05)。两组患者的伤口愈合时间比较,差异无统计学意义(P>0.05)。但A组治愈率为88.10%,高于B组治愈率63.63%,差异有统计学意义(P<0.05)。两组患者术前和术后3个月的肛门直肠压力无变化,差异无统计学意义(P>0.05);两组患者术前和术后3个月的内、外括约肌和耻骨直肠肌MUP 平均时限比较,差异均无统计学意义(P>0.05)。结论 改良LIFT术较常规LIFT术提高治愈率,是治疗单纯性经括约肌型肛瘘的有效术式。

       目的   基于最佳矫正视力（BCVA）、角膜水肿程度对比改良与常规小梁切除术治疗急性闭角型青光眼（AACG）的疗效。方法   回顾性收集2021年12月—2023年6月期间信阳爱尔眼科医院收治的112例AACG患者作为研究对象，依据1∶1匹配原则，将接受常规小梁切除术的56例患者作为对照组，接受改良小梁切除术的56例患者作为观察组，统计两组围术期BCVA、眼压、术后浅前房形成状况、角膜水肿程度以及并发症状况。结果   术后3个月，观察组视力为（0.63±0.04）logMAR，高于对照组（0.50±0.03）logMAR，眼压为（16.22±2.28）mmHg，低于对照组（19.95±2.31）mmHg（t=19.457、8.600，均P＜0.05）；观察组浅前房发生率为8.93%，低于对照组的26.79%（χ ² =6.087，P=0.014）；观察组角膜水肿状况优于对照组（Z=2.737，P=0.006）；观察组脉络膜脱离率、滤道阻塞率、前房积血率、虹膜炎症率依次为1.79%、5.36%、16.07%、10.71%，均低于对照组17.86%、23.21%、32.14%、35.71%（χ ² =8.166、7.292、3.953、9.818，均P＜0.05）。结论   较常规小梁切除术，改良小梁切除术治疗AACG患者，有助于改善视力、降低眼压、减轻角膜水肿、减少浅前房发生，且安全性较高。

       Objective  To compare the efficacy of modified and conventional trabeculectomy in the treatment of acute angle-closure glaucoma（AACG）based on best-corrected visual acuity（BCVA）and degree of corneal edema．Methods  A total of 112 patients with AACG admitted to the hospital during December 2021 to June 2023 were retrospectively selected as study objects．According to the 1∶1 matching principle，56 patients receiving conventional trabeculectomy were selected as control group，and 56 patients receiving modified trabeculectomy were selected as observation group．Perioperative BCVA，intraocular pressure，postoperative shallow anterior chamber formation，degree of corneal edema and complications were analyzed．Results  At three months postoperatively，visual acuity in the observation group was（0.63±0.04）logMAR，which was higher than that in the control group（0.50±0.03）logMAR，and intraocular pressure was（16.22±2.28）mmHg，which was lower than that in the control group（19.95±2.31）mmHg（t=19.457，8.600，P＜0.05）；the incidence of shallow anterior chamber in the observation group was 8.93%，which was lower than that of the control group（26.79%）（χ ² =6.087，P=0.014）；the corneal edema status in the observation group was better than that of the control group（Z=2.737，P=0.006）；the rates of choroidal detachment，filtering channel obstruction，hyphema，and iris inflammation in the observation group were 1.79%，5.36%，16.07%，and 10.71%，respectively，which were lower than those of the control group（17.86%，23.21%，32.14%，and 35.71%）（χ ² =8.166，7.292，3.953，and 9.818，P＜0.05）．Conclusions  Compared with conventional trabeculectomy，modified trabeculectomy can improve visual acuity，reduce intraocular pressure，relieve corneal edema，and reduce the occurrence of shallow anterior chamber in patients with AACG，with higher safety．

       目的   针对目前常规使用的玻璃体腔注射针头容易引起注射后小鼠眼内出血和损伤晶状体的缺陷，本研究采用直径仅0.08 mm的玻璃毛细管作为实验用小鼠眼内注射针头进行玻璃体腔注射，并评估其安全性和可行性。方法  选取12只6-8周的C57BL/6J雄性小鼠，左眼注射磷酸盐缓冲液为实验组，右眼不做特殊处理为对照组。6只小鼠玻璃体腔注射后立即腹腔注射伊文思蓝，检测视网膜血管渗漏情况；另外6只小鼠玻璃体腔注射后24 h处死，视网膜铺片免疫荧光染色小胶质细胞特异性抗体抗离子钙接头蛋白1，分析小胶质细胞的形态变化。结果  实验组和对照组血管与周围荧光强度比值分别为（4.45±0.30）和（4.51±0.24），小胶质细胞数量分别为（131.00±5.38）个/mm2 和（133.00±5.99）个/mm2 ，小胶质细胞胞体面积分别为34.02（27.82，40.54）μm2 和34.70（26.09，40.54）μm2 ，小胶质细胞分支长度分别为198.80（171.30，258.80）μm和223.30（178.20，278.30）μm，两组相比差异均无统计学意义（均P＞0.05）。结论   经改良的玻璃毛细管直径更细，损伤更小，可以替代传统的注射针头，可作为实验用小鼠眼内注射针头进行玻璃体腔注射。

       Objective  To assess the safety and feasibility of employing an enhanced glass capillary，with a diameter of 0.08 mm，as an intraocular needle for intravitreal injections in experimental mice eyes．Methods  Twelve male C57BL/6J mice，aged 6-8 weeks，were utilized in this investigation．Phosphate buffered saline（PBS）was administered via intravitreal injection into the left eye of each mouse（experimental group），while the right eye received no special treatment（control group）．Six mice received an intraperitoneal injection of Evans blue immediately following intravitreal injection to detect retinal vessel leakage．The remaining six mice were euthanized 24 hours after intravitreal injection，and the retinas were subjected to immunofluorescence staining using a microglia-specific antibody to analyze morphological changes in microglia．Results  In both the experimental and control groups，the ratio of vascular to peripheral fluorescence intensity was（4.45±0.30）and（4.51±0.24），respectively．The number of microglia was（131.00±5.38）/mm2  and（133.00±5.99）/mm2 ，the cell body area of microglia was 34.02（27.82，40.54）μm2  and 34.70（26.09，40.54）μm2 ，and the branch length of microglia was 198.80（171.30，258.80）μm and 223.30（178.20，278.30）μm，respectively．There were no statistically differences observed in any of the above indicators between the two groups（all P＞0.05）．Conclusions  The use of this glass capillary，characterized by a narrower diameter，reduces tissue damage，demonstrates its potential to replace traditional injection needles for performing intravitreal injections in experimental mice．