目的:舌癌根治术同期行舌缺损游离皮瓣修复重建,评价术后其语言、咀嚼、活动、吞咽等功能恢复效果,以期为舌癌根治切除舌缺损修复重建提供理论依据.方法:选择我院颌面头颈外科2010～2018年间共80例舌癌根治术同期行舌缺损游离皮瓣修复重建患者,按舌缺损范围分为A组,半舌缺损;B组,舌根缺损或部分舌根缺损;C组,半舌缺损及手术涉及同侧口底、颌骨.有2.5年以上跟踪随访时间.经语言清晰度、咀嚼效率、舌运动范围、吞咽造影剂透视显示吞咽模式等测定,对舌修复重建后的舌形态及运动、语言、咀嚼、吞咽功能进行效果评价.结果:80例舌癌扩大切除舌缺损同期前臂皮瓣修复重建后,患者语音尚清晰,并且修复的部位及范围不同与患者术后语音清晰度有明显差异,且差异具有统计学意义(P＜0.05);C组与A、B两组相比舌侧伸和抬举运动受限较明显,但咀嚼效率及吞咽功能差异不具有统计学意义(P＞0.05).结论:舌癌扩大切除舌缺损前臂皮瓣修复重建后其形态与功能可获得较为良好的恢复,但舌根癌修复后其伸展功能较差.
目的 通过头颅侧位片及数字化三维(Three Dimensional 3D)牙模的测量,分析上颌牙弓狭窄的患者经过外科辅助上颌骨快速扩弓(surgically assisted rapid maxillary expansion,SARME)后牙-上颌骨的变化,从而为临床的治疗提供一定的理论依据.方法 收集2012年8月～2013年8月上海交通大学医学院附属第九人民医院口腔颅颌面外科经过SARME术的患者15例,无相关颅颌面综合征.术前一周及术后六个月扩弓器拆掉即刻拍摄头颅侧位片及制取石膏牙模,并将石膏牙模进行激光扫描,获取3D牙模.将所得资料进行测量分析,得出患者术后的变化.测量结果采用SPSS17.0统计包中的配对t检验进行检验.结果 头颅侧位片示:SNA、NA-FH减小,术前、术后的差异具有统计学意义.3D牙模分析:ANGLE 4、ANGLE 5、ANGLE 6、R3-L3、R41-L41、R51-L51、R61-L61都明显增大,所有改变都具有统计学意义.结论 SARMR后A点后退,10例患者上颌骨发生顺时针旋转,5例患者上颌骨逆时针旋转.双侧第一前磨牙及第一磨牙发生明显的倾斜,平均倾斜角度约为3.57°、3.59°.第一前磨牙、第二前磨牙、第一磨牙扩宽的距离分别是:7.36mm、7.07mm、6.59mm.
_ Objective_ To examine the association between sleep duration, TV watching time, and the incidence of metabolic syndrome in people aged 40 or older in Guiyang city. Methods Data were obtained at the baseline examination of"The epidemiological study on the risk of cancer in patients with type 2 diabetes in China" in 2011. Follow-up study was conducted in 2014 to 2015. A total of 4 392(female 2 987, male 1 405)were included in the analysis. Results According to diagnostic criteria of International Diabetes Federation(IDF)in 2005, 1 035(812 women, 223 men) of the cohort developed metabolic syndrome during an average follow up for 3 years. Sleep duration was classified as≤7 h/d, 7-9 h/d,≥9 h/d, the incidence of metabolic syndrome was 24. 46%, 22. 43%, 23. 65%, respectively. TV watching time was divided into 0-1 h/d, 1. 1-2 h/d, 2. 1-4 h/d,>4 h/d, the incidence rates were 20. 67%, 22. 91%, 24. 61%, 25. 76%, respectively. In multivariate logistics regression analysis, compared with 0-1 h/d, the RR values of women with TV watching time during 1. 1-2 h/d, 2. 1-4 h/d,>4 h/d were 1. 098(95%CI 0. 789-1. 528), 141. 6(95% CI 1. 052-1. 906), 1. 559(95% CI 1. 090-2. 233), respectively. Conclusion The standardized incidence rate of metabolic syndrome in the general population was 23. 12%, the crude rate was 23. 57%. The incidence of metabolic syndrome was unrelated to the sleep duration and TV watching time as a whole or in men. TV watching time more than 2 hours a day may increase the risk of the metabolic syndrome in women.
