牛病毒性腹泻病毒遗传多样性与防控研究进展

牛病毒性腹泻(Bovine viral diarrhea)是由黄病毒科瘟病毒属的牛病毒性腹泻病毒(BVDV)感染引起牛的一种传染病,在全球范围内广泛流行,导致严重的经济损失。BVDV可分为BVDV-1、BVDV-2和BVDV-3基因型和众多的基因亚型,宿主范围比较广泛,而且可形成持续感染,抑制宿主固有免疫和适应性免疫应答,给防控带来困难。虽然在北欧一些国家利用监测淘汰实现了BVD净化,但在BVD流行率较高的地区,免疫控制策略现实可行。目前我国各地均有BVD报道,基于BVDV-1毒株的灭活疫苗已用于该病的防控,但用于预防多病原引起牛腹泻或牛呼吸道综合征的联合疫苗匮乏,多联多价疫苗的创制将有助于我国BVD防控和净化。

入侵贵州贵阳草地贪夜蛾的分子鉴定及适应性研究

【目的】贵州省为草地贪夜蛾(Spodoptera frugiperda)的周年繁殖区,采用分子标记鉴定贵州贵阳草地贪夜蛾的种群生物型,并对其在玉米、高粱、水稻上的适应性进行研究,以明确入侵贵州贵阳的草地贪夜蛾的种群生物型并了解其特性。【方法】采用COⅠ和Tpi两种分子标记,对贵州贵阳3个县市共32个草地贪夜蛾样本进行PCR扩增、测序和比对分析,明确入侵贵州贵阳的种群生物型。记录草地贪夜蛾各龄期幼虫取食3种寄主植物(玉米、高粱、水稻)后的发育历期、成虫羽化率和存活时长,评估草地贪夜蛾对3种寄主植物的适应性。【结果】基于线粒体COⅠ基因分析结果显示,32个草地贪夜蛾样本中,93.75%为水稻型、6.25%为玉米型,且其序列特征与相应生物型的草地贪夜蛾种群具有较高的一致性;而基于核基因组Tpi基因分析的结果表明,32个样本的单倍型特点均表现为玉米型。适应性研究结果显示,入侵贵阳的草地贪夜蛾在玉米上的幼虫期最短(13.22 d)、成虫存活时间最长(16.42 d)、羽化率最高(95.14%),在高粱上次之,在水稻上的幼虫期最长(16.59 d)、成虫存活时间最短(8.56 d)、羽化率最低(75.15%)。【结论】利用COⅠ分子标记方法鉴定入侵贵州贵阳的草地贪夜蛾种群生物型时,93.75%为水稻型、6.25%为玉米型,而利用Tpi分子标记的结果为100%玉米型。以玉米为食的雌性草地贪夜蛾寿命明显高于以水稻、高粱为食的雌性草地贪夜蛾。研究结果有助于分析入侵贵州省的草地贪夜蛾来源,可为高粱的草地贪夜蛾防控提供一定的基础。

应用激光散斑衬比成像探究牙龈生物型对正畸加力下牙龈血流变化的影响

目的:应用激光散斑衬比成像(laser speckle contrast imaging,LSCI)探究牙龈生物型对正畸加力下牙龈血流变化的影响。方法:招募24例符合纳入标准的受试者参与研究,包括薄龈型组12例,厚龈型组12例,随机在每例受试者上颌左侧或右侧的尖牙至第一磨牙间施加150 g的力,并在施力前、施力30 min、1 d、3 d、7 d、14 d分别使用LSCI动态监测施力侧尖牙区牙龈血流灌注。结果:组间比较,薄龈型组与厚龈型组各时间点的血流值比较均存在显著差异,厚龈型血流值显著高于薄龈型(P<0.05);组内比较,每组各时间点的血流值比较也存在显著差异(P<0.05),施力后,局部血流灌注在30 min~1 d内降至最小值,7 d左右上升至最大值,14 d时基本恢复到基线。在没有力值加载的静息状态下,游离龈与牙间乳头的血流值比较存在显著差异(P<0.05),游离龈血流值显著低于牙间乳头。结论:LSCI是正畸加力过程中实时监测牙龈血流灌注的良好工具,薄龈型血液供应显著低于厚龈型。

用于区分棉蚜种群的分子标记方法

棉蚜(Aphis gossypii Glover)是种内种群分化明显的重要农业害虫,种群分化给棉蚜生物学及分子生物学的研究带来挑战。通过高通量数据比对,从棉花型和黄瓜型棉蚜线粒体基因组中鉴定出一段包含多态性位点的区域,该区域位于线粒体Cyt b基因上,命名为Hap577。与其他蚜虫相比,棉蚜中Hap577包含的多态型位点具特异性。采集自7种不同寄主的1031个棉蚜样品,基于Hap577鉴定出60个棉蚜单倍型(Hap1-Hap60),其中87.9%为Hap1、Hap3、Hap4和Hap17;采自西葫芦和黄瓜上棉蚜的单倍型92.2%为Hap1、Hap3、Hap4和Hap17;采自花椒、木槿、石榴和棉花上棉蚜的单倍型87.1%为Hap1和Hap4;采自甜瓜上棉蚜的单倍型69.8%为Hap3。对53个发布在NCBI数据库的棉蚜转录组数据进行分析,鉴定出其单倍型与采集寄主的对应关系与上述研究结果一致。这一研究建立了基于稳定多态性位点对棉蚜进行种群划分的分子标记方法,可为探索不同种群棉蚜发生规律、抗药性机制及植物抗虫机制奠定基础。

北京市猫冠状病毒流行特征及S基因遗传进化分析

为了解北京市猫冠状病毒(feline coronavirus,FCoV)的生物型、血清型、遗传进化情况及其流行特征,对2023年在北京市动物医院收集的24份疑似FCoV感染猫的粪便或肛拭子样品进行RT-PCR检测、S基因扩增测序分析,并依据检测结果分析了来源猫年龄和采样季分布特征。结果显示:24份疑似样品中,检出11份FCoV阳性,其S基因核苷酸序列同源性为86.7%~98.5%,与日本、德国分离株同源性较高;11份阳性样品的血清型均为FCoV-I型,生物型均为猫肠道冠状病毒(FECV);猫只年龄与FCoV感染率呈负相关,季节变化与FCoV感染率不相关。结果表明:北京市2023年猫只感染的FCoV毒株属于同一血清型与生物型,且幼猫更易感染,一年四季皆可流行,同时提示毒株可能由入境宠物猫传入。因此在加强FCoV感染防控的同时,应重视出入境宠物猫FCoV的检测。

生物型加长柄半髋关节置换术对老年股骨粗隆间骨折患者HHS及并发症的影响

目的:探讨生物型加长柄半髋关节置换术对老年股骨粗隆间骨折患者Harris髋关节评分(HHS)及并发症的影响。方法:选取2022年1月—2023年1月景德镇市第一人民医院收治的老年股骨粗隆间骨折患者94例,采用随机数字表法分为两组,各47例。对照组实施骨水泥型加长柄半髋关节置换术治疗,观察组实施生物型加长柄半髋关节置换术治疗。比较两组围手术期指标(手术时间、总失血量、住院时间、术后次日扶患者下地负重站立时间、术后引流量)、HHS、骨密度、并发症发生情况。结果:观察组手术时间、骨折愈合时间均较对照组短,术后次日扶患者下地负重站立时间早于对照组,总失血量及术后引流量均较对照组多,差异均有统计学意义(P<0.05)。两组HHS的时点、组间、交互作用比较,差异均有统计学意义(P<0.05);两组术前HHS比较,差异无统计学意义(P>0.05);观察组术后各时点HHS均高于对照组(P<0.05);两组术后各时点均较术前升高,差异均有统计学意义(P<0.05),术后3个月均较术后6周升高,差异均有统计学意义(P<0.05),术后6个月均较术后3个月升高,差异均有统计学意义(P<0.05)。两组各部位骨密度时点、组间比较,差异均有统计学意义(P<0.05);两组术前比较,差异均无统计学意义(P>0.05),观察组术后各时点均高于对照组,差异均有统计学意义(P<0.05);两组术后各时点均较术前升高,差异均有统计学意义(P<0.05),术后3个月均较术后6周升高,差异均有统计学意义(P<0.05),术后6个月均较术后3个月升高,差异均有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:生物型加长柄半髋关节置换术可缩短老年股骨粗隆间骨折患者手术时间,促进患者术后恢复,改善患者髋关节功能及骨密度,降低并发症发生风险,但该术式也存在失血量及术后引流量较多的问题。

牙龈生物型对上颌单颗后牙种植体周围骨组织、软组织健康及龈乳头美学效果的影响

目的:探讨牙龈生物型对上颌单颗后牙种植体周围骨组织、软组织健康及龈乳头美学效果的影响。方法:选择2019年5月—2022年9月收治的78例行上颌单颗后牙种植术患者,共植入78颗种植体。种植修复后1个月,根据牙周探诊结果分为薄龈生物型组(n=32)与厚龈生物型组(n=46),比较种植修复后6个月的颊侧角化龈宽度(keratinized mucosa width,KMW)、骨吸收量(implant bone loss,IBL)、改良菌斑指数(modified plaque index,mPLI)、种植体改良出血指数(modified bleeding index,mBLI)、种植体探诊深度(probing pocket depth,PPD)、龈乳头指数(papilla index Score,PIS)、食物嵌塞、牙龈边缘颜色满意度指数(gingival margin color satisfaction index,GMCS)。通过Pearson分析评估牙龈生物型及角化龈宽度与种植体周围骨组织、软组织健康及龈乳头美学效果的相关性,比较不同牙龈生物型及角化龈宽度患者发生黏膜退缩的情况。采用SPSS 27.0软件包对数据进行统计学分析。结果:厚龈组KMW高于薄龈组,差异有统计学意义(P<0.05)。Spearman相关性分析显示,牙龈生物型与KMW呈正相关(r=-0.416,P=0.000)。薄龈组IBL显著高于厚龈组,薄龈组种植体PPD显著小于厚龈组,薄龈组PES评分显著低于厚龈组(P<0.05)。Pearson相关分析显示,牙龈生物型与PIS、GMCS、mBLI、PPD呈负相关,与食物嵌塞、IBL、mPLI呈正相关(P<0.05);KMW与PIS、GMCS、mBLI、PPD呈正相关,与食物嵌塞、IBL、mPLI呈负相关(P<0.05)。KMW>2 mm时,薄龈组和厚龈组相比有统计学差异(P<0.05)。KMW≤2 mm和>2 mm时,厚龈组差异有统计学意义(P<0.05)。结论:牙龈生物型对上颌单颗后牙种植体周围骨组织、软组织健康及龈乳头美学效果存在影响,对于预测种植体长期成功及美学效果具有指导意义。

埋伏上切牙正畸牵引的临床分析

目的 探讨埋伏阻生上切牙正畸牵引对牙根、牙周软硬组织的影响。方法 本研究已通过单位伦理委员会审查批准,并获得患者知情同意。选取2018年01月—2022年12月完成阻生上切牙正畸牵引的患者40例,选择对侧同名牙根尖孔未发育完成的为A组(23例),对侧同名牙根尖孔发育完成的为B组(17例)。利用锥形束CT(cone beam CT,CBCT)测量A、B组埋伏的上切牙牵引前后的牙根长度,比较患牙牵引后与对侧同名牙以及1年后患牙的牙槽骨(牙槽骨宽度、唇侧骨板厚度、牙槽骨高度)及角化龈宽度变化。结果 埋伏上切牙牵引后牙根长度较牵引前均有所增长(P<0.05);A组牵引后的牙槽骨宽度接近对侧同名牙牙槽骨宽度(P>0.05),而B组牵引后的牙槽骨宽度无法达到对侧同名牙厚度,差异具有统计学意义(P<0.05),A、B组牵引后的唇侧骨板均无法达到对侧同名牙的高度及厚度(P<0.05),角化龈宽度也显著小于对侧同名牙(P<0.05);但A组1年后的回访中,角化龈宽度显著增长(P<0.05)。结论 对埋伏上切牙牵引,有利于埋伏的上切牙牙根生长、牙槽骨的改建和角化龈的生长,但仍无法达到与对侧同名牙完全对称的状态。

The biotypes and host shifts of cotton-melon aphids Aphis gossypii in northern China

Aphis gossypfi is a globally distributed species and therefore has a highly variable life cycle. Populations of A. gossypii in northern China exhibit greater genotypic diversity and a broader host range, yet the details of life cycles of different biotypes is still unclear. In this study, the Cytb and 16S gene regions of A. gossypfi collected from 5 common summer hosts and 4 primary hosts were analyzed. A total of 57 haplotypes were obtained from 1 046 individual A. gossyp# sequences. The sequence included 44 variable sites, 27 of which were parsimony informative sites and 17 of which were singleton variable sites. The most frequent 3 haplotypes were found in 896 individuals, representing a total of 85.7% of all individuals and 36 haplotypes were found in 1 individual. A neighbor-joining tree was constructed using 21 haplotypes that were found in more than 2 individuals. Considering the individual host plant, 5 biotypes were identified. Type 1 corresponded exactly to the cucurbit host-race and the other 4 biotypes were found as cotton host-races. Type 3 was the most abundant biotype in cotton fields in northern China.

Comparative Analysis of Population Genetic Structure in Bemisia tabaci(Gennadius) Biotypes B and Q Based on ISSR Marker

Bemisia tabaci （Gennadius） biotypes B and Q are two invasive biotypes in the species complex. The comparison of the population genetic structure of the two biotypes is of significance to show their invasive mechanism and to their control. The intersimple sequence repeats （ISSR） marker was used to analyze the 16 B-biotype populations and 4 Q-biotype populations worldwide with a Trialeurodes vaporariorum population in Shanxi Province, China, and a B. tabaci non-B/Qbiotype population in Zhejiang Province, China, was used as control populations. The analysis of genetic diversity showed that the diversity indexes of biotype Q including Nei＇s gene diversity index, Shannon informative index, and the percentage of polymorphic loci were higher than those of biotype B. The high genetic diversity of biotype Q might provide the genetic basis for the excellent ecological adaptation. Cluster analysis suggested that the ISSR could not be used in the phylogenetic analysis though it could easily distinguish the biotypes of B. tabaci. The difference of the population genetic structure between the biotype B and the biotype Q exists based on the ISSR marker. Meanwhile, the results suggested that the molecular marker has its limitation in the phylogenetic analysis among the biotypes of B. tabaci.

Comparative Morphology and Morphometry of Six Biotypes of Bemisia tabaci (Hemiptera: Aleyrodidae) from China

Morphology and morphometry of six biotypes （B, Q, Cv, ZHJ-1, ZHJ-2 and ZHJ-3） of Bemisia tabaci （Gennadius） from China on cotton plants were studied by using microscopes. Nymphal body sizes and characters were measured and observed, especially on the 4th instar （pupal case）, including the vasiform orifice, operculum, lingula, length and thickness of anterior and posterior wax margins, width of thoracic tracheal combs. Adult characters of both sexes were investigated including the body size, compound eyes, antennal segments, vasiform orifice, hind tarsi and genitals. The results indicated that differences of some morphological characters or morphometrics were significant among the six biotypes of B. tabaci in China： （1） Pupal sizes of the exotic biotypes （B and Q） were significantly larger than the indigenous biotypes with the following order as B〉Q〉ZHJ-I〉Cv〉ZHJ-3〉ZHJ-2; （2） for both male and female adults, sizes of all characters investigated in the invading biotypes （B and Q）, especially B, were much larger than those of the indigenous ones.

Studies on the Host Biotypes and Its Cause of Cotton Aphidin Nanjing,China

The fitness of cotton aphid, Aphis gossypii Glover, on different host plants was studied. The results showed that the cotton aphid population in Nanjing formed host preference bio-types on cucumber and cotton. The aphids from cotton and cucumber could not inter-transplant successfully between the two host plants. The apterous and alate offspring of stem mother from hibiscus could not survive, reproduce and form population normally when they were transplanted to cucumber and water melon, but they could form normally when transplanted to cotton and muskmelon. There was no significant difference between the stylet length of cotton aphids from cucumber and cotton, so the stylet length was not the cause of the host preference. When the aphids originated on hibiscus were transplanted to cotton, water melon and muskmelon, the stylet could reach host phloem to absorb host plant’s nutrients, but it couldn’t when transplanted to cucumber. Cotton aphid can feed on muskmelon without secretion of water-soluble saliv

Bemisia tabaci Biotype Dynamics and Resistance to Insecticides in Israel During the Years 2008-2010

The sweetpotato whitefly Bemisia tabaci（Hemiptera：Aleyrodidae）is an extremely polyphagous insect pest that causes significant crop losses in Israel and worldwide.B.tabaci is a species complex of which the B and Q biotypes are the most widespread and damaging worldwide.The change in biotype composition and resistance to insecticide in Israel was monitored during the years 2008-2010 to identify patterns in population dynamics that can be correlated with resistance outbreaks.The results show that B biotype populations dominate crops grown in open fields,while Q biotype populations gradually dominate crops grown in protected conditions such as greenhouses and nethouses,where resistance outbreaks usually develop after several insecticide applications.While in previous years,Q biotype populations were widely detected in many regions in Israel,significant domination of the B biotype across populations collected was observed during the year 2010,indicating the instability of the B.tabaci population from one year to another.Reasons for the changing dynamics and the shift in the relative abundance of B.tabaci biotype,and their resistance status,are discussed.

Species and Biotype Analysis of Brucella Strains Isolated from Cattle and Sheep in Xinjiang

[ Objective] The paper aimed to understand the epidemiological characteristics of Brucella strains in Xinjiang and then provide an available integrated measure to prevent and control brucellosis. [ Method ] Eleven suspected Brucella strains were isolated by traditional methods, which were further identified by AMOS-PCR assay. Conventional biochemical tests were carried out to identify the biological subtype of sheep Brucella. [ Result] Nine strains were all B. meliten- s/s, and biological test indicated that all of them were B. melitensis biotype 3. [ Conclusion] B. melitensis biotype 3 was the predominant strain of Brucella in Xin- jiang, and AMOS-PCR assay could be applied safely and quickly as an assistant tool to detect Brucella. The results of molecular epidemiology laid a foundation for updating prevention and control strategy against brucellosis in Xinjiang.

Impact of Rice Stem Borers and Identification of <i>Orseolia oryzivora</i>Harris &Gagné, 1982 (Diptera: Cecidomyiidae) Biotypes in the Southern Cameroon

The study compares the impact due to rice stem borers in two sites (Yaoundé and Ntui). It also shows the diversity of the African Rice Gall Midge (AfRGM) biotypes in southern Cameroon (Santchou, Ndop, Tonga, Ebolowa, Ba?gom, Yaoundé and Ntui). The New Rice for Africa (NERICA) varieties 3, 8, 9 and 13 sown in Ntui were less attacked than those sown in Yaoundé. At both sites, damages ranged from 0.78% to 2.7%. In terms of diversity, the main stem-borer species were O. oryzivora, Diopsis apicalis, D. longiconis and Chilo zacconius. Molecular analyses of Orseolia oryzivora larvae collected in the localities of Santchou, Ndop, Tonga, Ebolowa, Ba?gom and Yaoundé showed the existence of more than one O. oryzivora biotype in southern Cameroon’s rice basins.

Gingival biotype: The probe test utility

Purpose: To evaluate the relevance of the probe test in classifying the gingival biotype and to determine if differences exist between maxillary and mandibular gingival biotypes in the same patient. Materials and Methods: 53 subjects were included. The gingival thickness was evaluated as thick or thin. This evaluation was based on the transparency of the periodontal probe through the gingival margin while probing the sulcus. In another hand, 124 clinicians were asked to identify the gingival biotype in the same 53 subjects based on visual inspection on pictures. For each examiner, the accuracy in identifying the gingival biotype was assessed using the percentage of cases correctly identified. Results: the percentile of agreement is greater than 70% in maxilla as well as in mandible. An imbalance was observed on the maxillary pictures concerning the gingival biotype and on the thin biotype between maxilla and mandible despite there being no statistical difference (p < 0.0001). The percentile of agreement is quite similar in the mandible for both thin (74%) and thick (70%) gingival biotypes. Agreement between mandibular probe and maxilla probe results demonstrates a weak percentile of agreement of gingival biotypes between maxillary and mandibular anterior teeth (57%). Conclusion: The use of probe transparency through the gingival margin is an accurate and simple method for gingival biotype diagnosis to discriminate a thin gingival from a thick gingival. Furthermore, individualizing the gingival biotype for each of the arches appears to be a new outcome that needs further investigation.

Prevalence of Gingival Biotype in a Syrian Population and Its Relation to Tooth Shapes: A Cross-Sectional Study

Background: Gingival biotype is one of the most important factors that impede success in dental treatments;it affects the outcomes of periodontal surgery, and restorative treatments. Researchers classified gingival biotypes into thin biotype and thick biotype. It is crucial to identify tissue biotype before treatment. Aim of Study: To determine the prevalence of gingival biotypes in a Syrian population, in addition, to study the distribution of gingival biotypes according to gender and tooth shape. Material and Methods: This cross sectional study included 500 volunteers (300 males and 200 females) from the patients who had visited the department of periodontology-dental faculty at Damascus University. Gingival thickness was assessed to determine the gingival biotype for the maxillary central incisors using the direct measurement technique (Trans-gingival probing). Shapes of the maxillary incisors were recorded. A written informed consent was taken from each patient. Statistical analysis was done using test k2 p < 0.05. Results: The mean age was 26.8 ± 4.4 years. Thick gingival biotype was detected in 58.4% of the sample and most of patients are men while the prevalence of thin gingival biotype was 41.6% of the sample. It was also observed that patients with thin gingival biotype had triangular tooth shape in 99.5% (p < 0.05). Conclusion: Thick gingival biotype was observed to be more prevalent in a Syrian population than thin biotype. Most Syrian males had thick gingival biotype with square tooth shape while females had thinner biotype and triangular tooth shape.

Effects of Crown Lengthening on Bi, PLI and PD Levels in Patients with Different Periodontal Biotypes

Objective:To investigate the effect of crown lengthening on patients with different periodontal biological types.Methods:60 patients with different periodontal biotypes treated in our hospital from May 2017 to February 2019 were retrospectively analyzed.According to the different periodontal biotypes,the above-mentioned patients were further divided into control group(thin fan type,30 cases)and observation group(thick flat type,30 cases).The periodontal probing depth(PD),plaque index(PLI),bleeding index(BI)and gingival margin position at 1 week,1 month,2 months and 3 months after operation were compared between the two groups.Results:The PD,Bi and PLI values of the two groups after treatment were lower than those before treatment(P<0.05);There was no significant difference in gingival margin position between the two groups after 1 week to 1 month and 1 month to 2 months(P>0.05);After 2 months to 3 months of treatment,the gingival margin distance of the observation group was larger than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:Crown lengthening can effectively improve the periodontal indexes of different periodontal biotypes,and the gingival margin of thick and flat type patients moves more toward the crown.

Measurement and Clinical Significance of Gingival Biotype in Anterior Teeth

The morphological characteristics of periodontal tissue and tooth tissue in gingival biotype are one of the indicators reflecting the individual differences of periodontal tissue in patients.Gingival biotypes of anterior teeth are often related to the prognosis of smile aesthetic treatment,which is one of the reference indexes for predicting the success rate of aesthetic treatment such as restoration,implant,periodontal,orthodontic and so on.Gingival biotypes have individual differences,so different gingival biotypes have different responses to different external stimuli.In the current clinical work,the correct evaluation of gingival biotype,especially the accurate measurement of gingival thickness,is the basis of reasonable choice of treatment and prognosis evaluation.

牙周辅助加速成骨正畸治疗:历史、原理、临床应用和展望

我国人群中薄牙周生物型较多,明显限制了正畸牙移动界限。牙周辅助加速成骨正畸治疗(periodontal accelerated osteogeni corthodontics,PAOO)不仅可以通过骨皮质切开加速牙齿移动,而且可以通过增加牙槽骨量扩大正畸牙移动范围,减少正畸治疗的牙周并发症。PAOO的发展经过了曲折漫长的历史过程:从基于“移动骨块”的截骨术到后来基于“局部加速现象”的骨皮质切开术,再到目前基于“骨组织工程学”的PAOO,已有百余年。纵观其发展史,对原理的认识决定了临床技术的发展。因此,对于PAOO应立足于基础研究,在实际临床工作中根据骨组织改建和再生的原理进行相应操作,思考手术改良。根据目前的循证证据,如行单纯的骨皮质切开术,建议选择超声骨皮质切开术或者激光辅助骨皮质切开术,并首选采用外科导航技术或在3D打印的外科导板辅助下进行;如需骨增量,尤其是大量骨增量,翻瓣的PAOO仍是首选。术区稳定、无感染是愈合的关键,因此,除了感染控制,还应保护术区免受外力干扰。目前,关于PAOO的高质量临床研究较少,未来还需要大样本、多中心的随机对照临床试验,来评价不同术式PAOO的临床疗效。本文在介绍PAOO的发展史、原理及手术注意事项的同时,展望其未来发展方向,以期为临床工作提供参考。