الملخص
Objective:To investigate the clinical application effect of double-layer soft tissue(DLST)suture closure technique in patients with mandible medication-related osteonecrosis of the jaw(MRONJ)of early and medium stages resulted in application of anti-bone-resorptive drugs.Methods:Early to me-dium stage mandible MRONJ patients who underwent surgical treatment in the fourth ward of Peking Uni-versity School and Hospital of Stomatology from October 2021 to September 2022 were included.Clinical information of the patients were collected,including primary disease,concomitant disease,medication regimen(drug type,duration of medication),MRONJ stage,clinical symptoms,imaging manifestations,etc.During surgery,after using marginal mandibulae resection to remove the necrotic bone,the wound was closed using DLST closure technique.Regular post-operative follow-up was performed to evaluate the therapeutic effect and complications of the DLST technique,the pain score and functional status of the patiens were evaluated.Results:This study totally included 13 patients,12 women and 1 man,aged(66.69±13.14)years.Seven patients had osteoporosis,2 had lung cancer,3 had breast cancer and 1 had prostate cancer among their primary diseases;7 had no concomitant diseases,2 had diabetes melli-tus,2 had cardiovascular disease and 1 had dry syndrome.Intravenous zoledronic acid were used in 9 patients,the average duration was(37.7±20.0)months,and other drugs,such as letrozole tablets were taken in 7 patients at the same time;Denosumab injection was used in 3 patients for an average of(10.3±11.9)months;Alendronate sodium tablets were taken in 5 patients for an average of(55.20± 27.20)months,and prednisone acetate tablets or acarbose tablets were taken to varying degrees in 2 pa-tients.The average post-operative follow-up was 11.9 months(9 to 17 months),and all the 13 patients were cured without complications,such as pus overflow and so forth.The pre-operative score of Karnof-sky performance status(KPS)in the patients was 68.46±14.05,and the post-operative score was 82.31±15.36,and the difference was statistically significant(P＜0.05).The pre-operative score of visual analogue scale(VAS)in the patients was 5.77±0.73 and the post-operative score was 0.38±0.51,and the difference had statistical significance(P＜0.001).Conclusion:The double-layer soft tissue suture closure technique can achieve good clinical results in patients with MRONJ of the man-dible using anti-bone-resorptive drugs alone,and can provide clinical treatment ideas for MRONJ patients with more complicated drug use.
الملخص
Herpes zoster of trigeminal nerve was a common skin disease caused by varicella-zoster virus infection.Simple involvement of the third branch of trigeminal nerve was rare,and so were oral complica-tions such as pulpitis,periodontitis,spontaneous tooth loss,bone necrosis,etc.This article presented a case of herpes zoster on the third branch of the left trigeminal nerve complicated with left mandibular osteonecrosis.We reported the case of a 64-year-old man with sudden pain in the left half of the tongue 1 month ago,and then herpes on the left facial skin appeared following with acute pain.The local hospital diagnosed it as herpes zoster and treated it with external medication.A few days later,he developed gum pain in the left mandibular posterior tooth area.He was admitted to Peking University School and Hospital of Stomatology one week ago with loose and dislodged left posterior tooth accompanied by left mandibular bone surface exposure.Clinical examination showed bilateral symmetry and no obvious restriction of mouth opening.Visible herpes zoster pigmentation and scarring on the left side of the face appeared.The left mandibular posterior tooth was missing,the exposed bone surface was about 1.5 cm x0.8 cm,and the surrounding gingiva was red and swollen,painful under pressure,with no discharge of pus.The re-maining teeth in the mouth were all m degree loosened.Imageological examination showed irregular low-density destruction of the left mandible bone,unclear boundary,and severe resorption of alveolar bone.The patient was diagnosed as left mandibular osteonecrosis.Under general anesthesia,left mandibular le-sion exploration and curettage+left mandibular partial resection+adjacent flap transfer repair were performed.The patient was re-exmained 6 months after surgery,there was no redness,swelling or other abnormality in the gums and the herpes pigmentation on the left face was significantly reduced.Unfortu-nately,the patient had complications of postherpetic neuralgia.This case indicate that clinicians should improve their awareness of jaw necrosis,a serious oral complication of trigeminal zoster,and provide ear-ly treatment.After the inflammation was initially controlled,surgical treatment could be considered to remove the necrotic bone,curettage the inflammatory granulation tissue,and extraction of the focal teeth to avoid further deterioration of the disease.
الملخص
Objective:To study the stability and influencing factors of potassium iodate iodized salt that can be sold in Jilin Province.Methods:In November 2020, 10 large supermarkets were randomly selected in Jilin Province, and two kinds of potassium iodate iodized salts were randomly selected in each supermarket, with five copies of each kind, a total of 100 samples of iodized salt, and the iodine content was determined by spectrophotometry (iodide-starch blue light method). Iodized salt samples were classified according to different salt species (mine salt, sea salt and lake salt) and different production processes (refined salt and non-refined salt). The salt was stored at room temperature, and the iodine content in the salt was measured at 0, 10 and 20 days after opening the packaging. The iodine content attenuation rates of different salt species and different production processes were compared.Results:The mine salt, sea salt and lake salt in iodized salt samples were 45, 45 and 10 portions, respectively. The iodine contents of the 0th day of storage [(19.89 ± 1.38), (20.62 ± 1.91), (19.78 ± 1.01) mg/kg] were compared, and the difference was not statistically significant ( F = 2.57, P = 0.093). On the 10th day, the iodine content of mine salt was lower than that of sea salt and lake salt, and the differences were statistically significant ( P < 0.05); on the 20th day, the iodine content of mine salt was lower than that of sea salt, and the difference was statistically significant ( P < 0.05). There was a significant difference in the iodine content of mine salt stored at 0, 10 and 20 days ( F = 90.62, P < 0.001). The iodine content of sea salt and lake salt on the 20th day was significantly lower than that on the 0th and 10th day, and the differences were statistically significant ( P < 0.05). The iodine content attenuation rates of mine salt, sea salt and lake salt on the 0 - 10 days was compared with that on the 10 - 20 days, and the differences were statistically significant ( Z = 2.24, 2.94, 2.80, P < 0.05). There was a significant difference in the iodine content attenuation rates of mine salt, sea salt and lake salt during the 0 - 10 days of storage ( Z = 24.05, P < 0.001), there was no statistically significant difference in the iodine content attenuation rates on 10 - 20 days ( Z = 5.86, P = 0.053). There was no significant difference in iodine content attenuation rates between refined salt and non-refined salt on 0 - 10, 10 - 20 days ( Z = 1.16, 0.28, P > 0.05). There was no statistical significant difference in the iodine content attenuation rates of refined salt and non-refined salt on the 0 - 10 days compared with those of 10 - 20 days ( Z = 0.76, 1.90, P > 0.05). Conclusions:Iodine loss occurs at 20 days after opening the packaging of iodized salt in Jilin Province. The attenuation of iodine content is less affected by salt species and production processes. It is recommended to eat iodized salt within 20 days after opening the packaging.
الملخص
Objective To investigate the influence of family nursing intervention on daily life ability of senile dementia patients? Methods Eighty senile dementia patients were equally randomized into two groups: the control group and the observation group? The controls received conventional home nursing instruction and health education and those in the latter group were managed with home nursing intervention? The activity of daily living scale(ADL)was used to assess their daily life ability? Result After nursing intervention,the daily life ability of observation group was better than control group(Z = 18?914,P < 0?05)? Conclusions The family nursing intervention is effective in directing the dementia patients with exercises of daily living ability? Thus it may improve their ability in daily life?
الملخص
By analyzing 94 questionnaires of majors in medical imaging technology on medical ethics teaching,we found that some teaching models will help students realize the necessity of studying medical ethics and case teaching,including increasing the expansion of case teaching,selecting certain videos and short films into case teaching,expanding case-study model and case-exploration model,strengthening teachers' after-case-teaching summary to advance and further ethical themes.These models will also improve students' ability in ethical analysis and their sense of ethics,and will surely apply the theoretical principles into practice once they are interested in studying medical ethics.