AIM: To test protracted irinotecan infusion plus a low-dose cisplatin in this Phase Ⅱ trial to decrease its toxic-ity. METHODS: The eligibility criteria were: (1) histologi-cally proven measurable gastric cancer; (2)...AIM: To test protracted irinotecan infusion plus a low-dose cisplatin in this Phase Ⅱ trial to decrease its toxic-ity. METHODS: The eligibility criteria were: (1) histologi-cally proven measurable gastric cancer; (2) performance status of 0 or 1; (3) no prior chemotherapy or comple-tion of prior therapy at least 4 wk before enrollment; (4) adequate function of major organs; (5) no other active malignancy; and (6) written informed consent. The regi-men consisted of irinotecan (60 mg/m2) on d 1 and 15 by 24-h infusion and cisplatin (10 mg/m2) on d 1, 2, 3, 15, 16, and 17. Treatment was repeated every 4 wk. RESULTS: Thirty-one patients were registered between April 2000 and January 2001. The response rate for all 31 patients, 20 patients without prior chemotherapy, and 11 patients with prior chemotherapy was 52% (16/31), 60% (12/20), and 36% (4/11), respectively. The median survival time was 378 d. The median number of courses given to all patients was 2. Grade 4 neutropenia oc-curred in 11 (35%) patients, while grade 3 to 4 diarrhea or nausea occurred in 1 (3%) and 3 (10%) patients, respectively. Fatigue was minimal as grade 1 fatigue was found only in 3 (10%) patients. Other adverse events were mild and no treatment-related deaths occurred.CONCLUSION: This regimen showed a high level of ac-tivity and acceptable toxicity in patients with metastatic gastric cancer.展开更多
Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protrac...Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms(PAWS).Methods:A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to an escitalopram with real-EA group(realEA group,patients=31)and an escitalopram with sham-EA group(sham-EA group,patients=31),respectively.In addition to the oral administration of escitalopram for total four weeks,patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks.Both serum homocysteine(Hcy)test and electrophysiological tests,including event-related potentials(ERPs)and exploratory eye movement(EEM)were performed at pre-and post-treatment.Additionally,the global scores of Penn Alcohol Craving Scale(PACS),17-items Hamilton Depression Rating Scale(HAMD-17),and Hamilton Anxiety Scale(HAMA)were used for assessing the subjective emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After four-week treatment,the global scores of PACS and HAMD-17 declined significantly in both groups(both P<0.05).Furthermore,the decline in the real-EA group was superior to that in the shamEA group(P<0.05).Meanwhile,the total scores of HAMA only decreased in the real-EA group(P<0.05)but not in the sham-EA group(P>0.05).According to the parameters of ERPs,significant declines for N2PL,P3PL,and P3amp were observed in both two groups(all P<0.05),and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group(both P<0.05).According to the parameters of EEM,significant increase for NEF was observed only in the real-EA group(P<0.05).Besides,there was a dramatic decline for serum Hcy level only in the real-EA group(P<0.05).One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste,and outcomes of the remaining 61 patients were adopted for analysis.Conclusion:(1)Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence.(2)Escitalopram with EA might improve the alcoholdependence induced cognitive dysfunctions via upregulating the expression of Hcy.展开更多
Objective： To evaluate the orthopedic effects of a new method to treat skeletal crossbite in the early mixed dentition. Methods ：Twenty cases （5.8-7. 5 years old ） with skeletal crossbite were treated by bonding t...Objective： To evaluate the orthopedic effects of a new method to treat skeletal crossbite in the early mixed dentition. Methods ：Twenty cases （5.8-7. 5 years old ） with skeletal crossbite were treated by bonding the bite plate combined with the face mask protracting the upper jaw. Cephalometric radiographs were taken and analyzed before and after treatments. Results： On average, in all 20 cases the maxilla was moved by 2.06 mm forwards the mandible was turned 2.45° downward and backwards the skeletal crossbites were corrected and the facial profiles were improved satisfactorily. The period of treatment was conducted for 1.7 months on average. Conclusion： A good effect can be achieved by bonding bite plate combined with the face mask protracting the upper jaw to treat skeletal crossbite in the early mixed dentition, which will benefit the craniofacial growth and the development of young children.展开更多
Purpose: Radiotherapy with concurrent temozolomide (TMZ), followed by 6 cycles of adjuvant TMZ, is the standard of care for newly diagnosed Glioblastoma Mulltiforme (GBM). However tumor progression is the role with me...Purpose: Radiotherapy with concurrent temozolomide (TMZ), followed by 6 cycles of adjuvant TMZ, is the standard of care for newly diagnosed Glioblastoma Mulltiforme (GBM). However tumor progression is the role with median survival of almost 14 months. With lack of effective second line chemotherapy, many physicians and some guidelines advocate prolonged use of adjuvant TMZ more than 6 months. We conduct this study to test the efficacy of protracted adjuvant conventional dose TMZ over the standard 6 doses of adjuvant TMZ. Material and Methods: This phase II trial enrolled patients newly diagnosed as GBM, older than age 18 years, with a Karnofsky performance score (KPS) of ≥60, Neurological Performance Scale (NPS) of ≤3. Patients were randomly assigned to the standard concurrent chemoradiotherapy (CCRT) followed by 6 cycles of adjuvant TMZ or the same treatment with more than 6 cycles of adjuvant chemotherapy extended as long as the patient in good performance, with no unacceptable toxicity, no signs of disease progression. The primary end point was OS. Results: A total of 59 patients were recruited in the study and were randomized in two arms. 29 patients joined arm 1 aiming at receiving CCRT followed by adjuvant 6 cycles TMZ (6 cycles arm) and 30 joined arm 2 aiming at receiving the same treatment with more than 6 cycles of TMZ (>6 cycles). 16 patients managed to complete the adjuvant 6 cycles in arm 1. 19 patients in arm 2, completed the 6 cycles with additive more doses with a median of 11 cycles (range: 8 - 23 cycles). Median PFS was 12.1 months for (6 cycles) arm, and 18.8 months for (>6 cycles) arm, HR 0.88 (95% CI: 1.185 - 4.901) (P 0.015);the overall survival for (6 cycles) arm was 18.1 months, versus 24.1 months, HR 0.70 (95% CI: 1.007 - 4.037) (P 0.048). No significant added toxicity was notice and the 4 weekly TMZ was well tolerated. Conclusion: This study concluded that protracted adjuvant TMZ after concurrent chemoradiotherapy could be a feasible strategy for GBM. This strategy warrants a large phase III randomized trial.展开更多
The assessment of detrital zircon age records is a key method in basin analysis,but it is prone to several biases that may compromise accurate sedimentary provenance investigations.High to ultrahigh temperature(HT-UHT...The assessment of detrital zircon age records is a key method in basin analysis,but it is prone to several biases that may compromise accurate sedimentary provenance investigations.High to ultrahigh temperature(HT-UHT)metamorphism(especially if T>850℃)is herein presented as a natural cause of bias in provenance studies based on U-Pb detrital zircon ages,since zircon from rocks submitted to these extreme and often prolonged conditions frequently yield protracted,apparently concordant,geochronological records.Such age spreading can result from disturbance of the primary U-Pb zircon system,likewise from(re)crystallization processes during multiple and/or prolonged metamorphic events.In this contribution,available geochronological data on Archean,Neoproterozoic and Palaeozoic HT-UHT metamorphic rocks,acquired by different techniques(SIMS and LA-ICP-MS)and showing distinct compositions,are reassessed to demonstrate HT-UHT metamorphism may result in modes and age distributions of unclear geological meaning.As a consequence,it may induce misinterpretations on UPb detrital zircon provenance analyses,particularly in sedimentary rocks metamorphosed under such extreme temperature conditions.To evaluate the presence of HT-UHT metamorphism-related bias in the detrital zircon record,we suggest a workflow for data acquisition and interpretation,combining a multi-proxy approach with:(i)in situ U-Pb dating coupled with Hf analyses to retrieve the isotopic composition of the sources,and(ii)the integration of a petrochronological investigation to typify fingerprints of the HT-UHT metamorphic event.The proposed workflow is validated in the investigation of one theoretical and one natural example allowing a better characterization of the sedimentary sources,maximum depositional ages,and the tectonic setting of the basin.Our workflow allows to the appraisal of biases imposed by HT-UHT metamorphism and resulting disturbances in the U-Pb detrital zircon record,particularly for sedimentary rocks that underwent HT-UHT metamorphism and,finally,suggests ways to overcome these issues.展开更多
Objective: To investigate the effects of integrated traditional Chinese and Western medicine in treating infantile protracted chronic pneumonia （IPCP）. Methods: One hundred patients of IPCP were divided equally into...Objective: To investigate the effects of integrated traditional Chinese and Western medicine in treating infantile protracted chronic pneumonia （IPCP）. Methods: One hundred patients of IPCP were divided equally into two groups, the TCM-WM group treated with Maqin Qizhu Decoction combining with antibiotics and the control group treated with antibiotics alone. Efficacy of the two groups was compared after 1 course（15）days） of treatment. Results: The total effective rate of the TCM-WM group was better than that of the control group. Moreover, the days needed in curing coughing, dyspnea, rales and X-ray shadow absorption of the former were fewer than those of the latter. Conclusion: The integrated TCM-WM therapy in treating IPCP could both inhibit the pathogens effectively and improve the humoral immunity and resistant ability of organism.展开更多
Modern medicine has been fighting the battle with cancer for near 200 years, achieved substantial progresses but yet to claim the final victory. Author believes that the battle strategy has the profound impact to the ...Modern medicine has been fighting the battle with cancer for near 200 years, achieved substantial progresses but yet to claim the final victory. Author believes that the battle strategy has the profound impact to the result. Since Virchow discovered the cellular origin of cancer in 1863, cancers are being seeing as a localized disease resulting from foreign invasions whereas eradication therapies have been the dominant practices. However, people neglected the overall relationship between cancer and human body therefore overlooked the solutions from transformation, modulation and regulation point of view.展开更多
目的探讨替牙期单侧非综合征唇腭裂男性患者经上颌前方牵引治疗前后其软硬组织的三维变化。方法选择于南京医科大学附属口腔医院正畸科就诊并经上颌前方牵引治疗替牙期单侧非综合征唇腭裂男性患者20例(平均年龄(10.6±1.23)岁),拍...目的探讨替牙期单侧非综合征唇腭裂男性患者经上颌前方牵引治疗前后其软硬组织的三维变化。方法选择于南京医科大学附属口腔医院正畸科就诊并经上颌前方牵引治疗替牙期单侧非综合征唇腭裂男性患者20例(平均年龄(10.6±1.23)岁),拍摄治疗前后的锥形束CT,应用Dolphin 3D 11.95软件进行三维测量分析,采用SPSS 25.0软件包进行统计学分析,采用自身对照配对t检验对单侧唇腭裂男性患者治疗前后的软硬组织变化进行比较,其中ANS点前移量、A点前移量及B点后移量变化采用单样本t检验。结果矢状向骨性变化:∠SNA(P<0.01)、∠ANB(P<0.01)、Y轴角(P<0.05)、ANS点前移量(P<0.01)、A点前移量(P<0.01)和B点后移量(P<0.01)均显著增大,而∠SNB(P<0.05)则显著减小;垂直向骨性变化:∠MP-FH(P<0.01)、∠MP-SN(P<0.05)和ANS-Me线距(P<0.05)显著增加,而∠SN-PP(P<0.01)则显著减小;牙性变化:∠U1-NA(P<0.01)、U1-NA线距(P<0.01)、∠U1-SN(P<0.01)、前牙覆盖(P<0.01)和Wits值(P<0.01)均显著增加;而∠L1-NB(P<0.01)、L1-NB线距(P<0.01)和∠L1-MP(P<0.01)均显著减小;软组织变化:∠S-Ns-Sn(P<0.01)、∠Sn-Ns-Bs(P<0.01)、UL-EP线距(P<0.01)和LL-UL线距(P<0.01)均显著增加。结论对于生长发育期的唇腭裂患者,上颌前方牵引治疗可促进上颌骨向前生长,改善颌间关系及软组织侧貌,但需注意其不良反应。展开更多
目的评估数字化三维打印前方牵引装置联合上颌快速扩缩弓在矫治替牙期骨性Ⅲ类患者中的骨效应、牙效应、软组织侧貌及气道变化。方法选取2018—2023年收治的22例伴有上颌发育不足的骨性Ⅲ类替牙(牙合)患者(平均年龄(11.33±0.88)岁,...目的评估数字化三维打印前方牵引装置联合上颌快速扩缩弓在矫治替牙期骨性Ⅲ类患者中的骨效应、牙效应、软组织侧貌及气道变化。方法选取2018—2023年收治的22例伴有上颌发育不足的骨性Ⅲ类替牙(牙合)患者(平均年龄(11.33±0.88)岁,男9例,女13例)。使用数字化3D打印前方牵引装置进行治疗,同时联合上颌快速扩弓及缩弓矫治。所有患者治疗前后均进行锥形束CT扫描,评估治疗前后的骨性、牙性、软组织及上气道的矫治效果。结果治疗后,硬组织测量指标SNA、ANB、Wits值、Co-A、Co-Gn均明显增加,差异有统计学意义,而SNB、FMA、Occ plane to FH角、Y轴角无统计学意义变化。U1-SN有统计学意义的增加,而U1-NA变化无统计学意义。软组织上唇距E线距离改善,差异有统计学意义,鼻唇角未发生统计学意义的变化。上气道腭后区容积显著增加。结论数字化3D打印前方牵引装置联合上颌快速扩缩弓可以促进上颌发育,抑制下颌发育,基本维持患者的垂直向变化,改善骨性Ⅲ类错(牙合)畸形和侧貌,上气道腭后区容积也得到明显改善。展开更多
文摘AIM: To test protracted irinotecan infusion plus a low-dose cisplatin in this Phase Ⅱ trial to decrease its toxic-ity. METHODS: The eligibility criteria were: (1) histologi-cally proven measurable gastric cancer; (2) performance status of 0 or 1; (3) no prior chemotherapy or comple-tion of prior therapy at least 4 wk before enrollment; (4) adequate function of major organs; (5) no other active malignancy; and (6) written informed consent. The regi-men consisted of irinotecan (60 mg/m2) on d 1 and 15 by 24-h infusion and cisplatin (10 mg/m2) on d 1, 2, 3, 15, 16, and 17. Treatment was repeated every 4 wk. RESULTS: Thirty-one patients were registered between April 2000 and January 2001. The response rate for all 31 patients, 20 patients without prior chemotherapy, and 11 patients with prior chemotherapy was 52% (16/31), 60% (12/20), and 36% (4/11), respectively. The median survival time was 378 d. The median number of courses given to all patients was 2. Grade 4 neutropenia oc-curred in 11 (35%) patients, while grade 3 to 4 diarrhea or nausea occurred in 1 (3%) and 3 (10%) patients, respectively. Fatigue was minimal as grade 1 fatigue was found only in 3 (10%) patients. Other adverse events were mild and no treatment-related deaths occurred.CONCLUSION: This regimen showed a high level of ac-tivity and acceptable toxicity in patients with metastatic gastric cancer.
基金Sponsored by Scientific Research Project,Shanghai Science and Technology Committee:No.16401902600Special Project for Clinical Research,Shanghai Municipal Health Commission:No.20174Y0009。
文摘Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms(PAWS).Methods:A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to an escitalopram with real-EA group(realEA group,patients=31)and an escitalopram with sham-EA group(sham-EA group,patients=31),respectively.In addition to the oral administration of escitalopram for total four weeks,patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks.Both serum homocysteine(Hcy)test and electrophysiological tests,including event-related potentials(ERPs)and exploratory eye movement(EEM)were performed at pre-and post-treatment.Additionally,the global scores of Penn Alcohol Craving Scale(PACS),17-items Hamilton Depression Rating Scale(HAMD-17),and Hamilton Anxiety Scale(HAMA)were used for assessing the subjective emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After four-week treatment,the global scores of PACS and HAMD-17 declined significantly in both groups(both P<0.05).Furthermore,the decline in the real-EA group was superior to that in the shamEA group(P<0.05).Meanwhile,the total scores of HAMA only decreased in the real-EA group(P<0.05)but not in the sham-EA group(P>0.05).According to the parameters of ERPs,significant declines for N2PL,P3PL,and P3amp were observed in both two groups(all P<0.05),and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group(both P<0.05).According to the parameters of EEM,significant increase for NEF was observed only in the real-EA group(P<0.05).Besides,there was a dramatic decline for serum Hcy level only in the real-EA group(P<0.05).One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste,and outcomes of the remaining 61 patients were adopted for analysis.Conclusion:(1)Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence.(2)Escitalopram with EA might improve the alcoholdependence induced cognitive dysfunctions via upregulating the expression of Hcy.
文摘Objective： To evaluate the orthopedic effects of a new method to treat skeletal crossbite in the early mixed dentition. Methods ：Twenty cases （5.8-7. 5 years old ） with skeletal crossbite were treated by bonding the bite plate combined with the face mask protracting the upper jaw. Cephalometric radiographs were taken and analyzed before and after treatments. Results： On average, in all 20 cases the maxilla was moved by 2.06 mm forwards the mandible was turned 2.45° downward and backwards the skeletal crossbites were corrected and the facial profiles were improved satisfactorily. The period of treatment was conducted for 1.7 months on average. Conclusion： A good effect can be achieved by bonding bite plate combined with the face mask protracting the upper jaw to treat skeletal crossbite in the early mixed dentition, which will benefit the craniofacial growth and the development of young children.
文摘Purpose: Radiotherapy with concurrent temozolomide (TMZ), followed by 6 cycles of adjuvant TMZ, is the standard of care for newly diagnosed Glioblastoma Mulltiforme (GBM). However tumor progression is the role with median survival of almost 14 months. With lack of effective second line chemotherapy, many physicians and some guidelines advocate prolonged use of adjuvant TMZ more than 6 months. We conduct this study to test the efficacy of protracted adjuvant conventional dose TMZ over the standard 6 doses of adjuvant TMZ. Material and Methods: This phase II trial enrolled patients newly diagnosed as GBM, older than age 18 years, with a Karnofsky performance score (KPS) of ≥60, Neurological Performance Scale (NPS) of ≤3. Patients were randomly assigned to the standard concurrent chemoradiotherapy (CCRT) followed by 6 cycles of adjuvant TMZ or the same treatment with more than 6 cycles of adjuvant chemotherapy extended as long as the patient in good performance, with no unacceptable toxicity, no signs of disease progression. The primary end point was OS. Results: A total of 59 patients were recruited in the study and were randomized in two arms. 29 patients joined arm 1 aiming at receiving CCRT followed by adjuvant 6 cycles TMZ (6 cycles arm) and 30 joined arm 2 aiming at receiving the same treatment with more than 6 cycles of TMZ (>6 cycles). 16 patients managed to complete the adjuvant 6 cycles in arm 1. 19 patients in arm 2, completed the 6 cycles with additive more doses with a median of 11 cycles (range: 8 - 23 cycles). Median PFS was 12.1 months for (6 cycles) arm, and 18.8 months for (>6 cycles) arm, HR 0.88 (95% CI: 1.185 - 4.901) (P 0.015);the overall survival for (6 cycles) arm was 18.1 months, versus 24.1 months, HR 0.70 (95% CI: 1.007 - 4.037) (P 0.048). No significant added toxicity was notice and the 4 weekly TMZ was well tolerated. Conclusion: This study concluded that protracted adjuvant TMZ after concurrent chemoradiotherapy could be a feasible strategy for GBM. This strategy warrants a large phase III randomized trial.
基金supported by the Australian Research Council(FL160100168)。
文摘The assessment of detrital zircon age records is a key method in basin analysis,but it is prone to several biases that may compromise accurate sedimentary provenance investigations.High to ultrahigh temperature(HT-UHT)metamorphism(especially if T>850℃)is herein presented as a natural cause of bias in provenance studies based on U-Pb detrital zircon ages,since zircon from rocks submitted to these extreme and often prolonged conditions frequently yield protracted,apparently concordant,geochronological records.Such age spreading can result from disturbance of the primary U-Pb zircon system,likewise from(re)crystallization processes during multiple and/or prolonged metamorphic events.In this contribution,available geochronological data on Archean,Neoproterozoic and Palaeozoic HT-UHT metamorphic rocks,acquired by different techniques(SIMS and LA-ICP-MS)and showing distinct compositions,are reassessed to demonstrate HT-UHT metamorphism may result in modes and age distributions of unclear geological meaning.As a consequence,it may induce misinterpretations on UPb detrital zircon provenance analyses,particularly in sedimentary rocks metamorphosed under such extreme temperature conditions.To evaluate the presence of HT-UHT metamorphism-related bias in the detrital zircon record,we suggest a workflow for data acquisition and interpretation,combining a multi-proxy approach with:(i)in situ U-Pb dating coupled with Hf analyses to retrieve the isotopic composition of the sources,and(ii)the integration of a petrochronological investigation to typify fingerprints of the HT-UHT metamorphic event.The proposed workflow is validated in the investigation of one theoretical and one natural example allowing a better characterization of the sedimentary sources,maximum depositional ages,and the tectonic setting of the basin.Our workflow allows to the appraisal of biases imposed by HT-UHT metamorphism and resulting disturbances in the U-Pb detrital zircon record,particularly for sedimentary rocks that underwent HT-UHT metamorphism and,finally,suggests ways to overcome these issues.
文摘Objective: To investigate the effects of integrated traditional Chinese and Western medicine in treating infantile protracted chronic pneumonia （IPCP）. Methods: One hundred patients of IPCP were divided equally into two groups, the TCM-WM group treated with Maqin Qizhu Decoction combining with antibiotics and the control group treated with antibiotics alone. Efficacy of the two groups was compared after 1 course（15）days） of treatment. Results: The total effective rate of the TCM-WM group was better than that of the control group. Moreover, the days needed in curing coughing, dyspnea, rales and X-ray shadow absorption of the former were fewer than those of the latter. Conclusion: The integrated TCM-WM therapy in treating IPCP could both inhibit the pathogens effectively and improve the humoral immunity and resistant ability of organism.
文摘Modern medicine has been fighting the battle with cancer for near 200 years, achieved substantial progresses but yet to claim the final victory. Author believes that the battle strategy has the profound impact to the result. Since Virchow discovered the cellular origin of cancer in 1863, cancers are being seeing as a localized disease resulting from foreign invasions whereas eradication therapies have been the dominant practices. However, people neglected the overall relationship between cancer and human body therefore overlooked the solutions from transformation, modulation and regulation point of view.
文摘目的探讨替牙期单侧非综合征唇腭裂男性患者经上颌前方牵引治疗前后其软硬组织的三维变化。方法选择于南京医科大学附属口腔医院正畸科就诊并经上颌前方牵引治疗替牙期单侧非综合征唇腭裂男性患者20例(平均年龄(10.6±1.23)岁),拍摄治疗前后的锥形束CT,应用Dolphin 3D 11.95软件进行三维测量分析,采用SPSS 25.0软件包进行统计学分析,采用自身对照配对t检验对单侧唇腭裂男性患者治疗前后的软硬组织变化进行比较,其中ANS点前移量、A点前移量及B点后移量变化采用单样本t检验。结果矢状向骨性变化:∠SNA(P<0.01)、∠ANB(P<0.01)、Y轴角(P<0.05)、ANS点前移量(P<0.01)、A点前移量(P<0.01)和B点后移量(P<0.01)均显著增大,而∠SNB(P<0.05)则显著减小;垂直向骨性变化:∠MP-FH(P<0.01)、∠MP-SN(P<0.05)和ANS-Me线距(P<0.05)显著增加,而∠SN-PP(P<0.01)则显著减小;牙性变化:∠U1-NA(P<0.01)、U1-NA线距(P<0.01)、∠U1-SN(P<0.01)、前牙覆盖(P<0.01)和Wits值(P<0.01)均显著增加;而∠L1-NB(P<0.01)、L1-NB线距(P<0.01)和∠L1-MP(P<0.01)均显著减小;软组织变化:∠S-Ns-Sn(P<0.01)、∠Sn-Ns-Bs(P<0.01)、UL-EP线距(P<0.01)和LL-UL线距(P<0.01)均显著增加。结论对于生长发育期的唇腭裂患者,上颌前方牵引治疗可促进上颌骨向前生长,改善颌间关系及软组织侧貌,但需注意其不良反应。
文摘目的评估数字化三维打印前方牵引装置联合上颌快速扩缩弓在矫治替牙期骨性Ⅲ类患者中的骨效应、牙效应、软组织侧貌及气道变化。方法选取2018—2023年收治的22例伴有上颌发育不足的骨性Ⅲ类替牙(牙合)患者(平均年龄(11.33±0.88)岁,男9例,女13例)。使用数字化3D打印前方牵引装置进行治疗,同时联合上颌快速扩弓及缩弓矫治。所有患者治疗前后均进行锥形束CT扫描,评估治疗前后的骨性、牙性、软组织及上气道的矫治效果。结果治疗后,硬组织测量指标SNA、ANB、Wits值、Co-A、Co-Gn均明显增加,差异有统计学意义,而SNB、FMA、Occ plane to FH角、Y轴角无统计学意义变化。U1-SN有统计学意义的增加,而U1-NA变化无统计学意义。软组织上唇距E线距离改善,差异有统计学意义,鼻唇角未发生统计学意义的变化。上气道腭后区容积显著增加。结论数字化3D打印前方牵引装置联合上颌快速扩缩弓可以促进上颌发育,抑制下颌发育,基本维持患者的垂直向变化,改善骨性Ⅲ类错(牙合)畸形和侧貌,上气道腭后区容积也得到明显改善。
