影响糖尿病患者口腔颌面部多间隙感染治疗结果的因素分析

目的:分析影响口腔颌面部多间隙感染患者治疗结果 (住院天数和并发症)的转归因素,并比较糖尿病患者与非糖尿病患者口腔颌面部多间隙感染的临床特征。方法:对2007—2010年间收治的117例口腔颌面部多间隙感染病例进行回顾分析。研究变量包括一般资料、病因学、临床指标(症状发作到入院治疗的时间、受累间隙的种类和数量)和实验室检查(细菌学、入院时血糖水平、入院时血白细胞总数和中性粒细胞百分比),结果变量为患者住院天数和并发症。采用SAS8.0软件包对数据进行t检验、卡方检验、方差分析、Logistic回归和线性回归分析。结果:糖尿病口腔颌面部多间隙感染患者与非糖尿病患者相比,前者受累的间隙更多,住院时间更长,全身各种并发症情况更多见,严重者可导致死亡。糖尿病存在与否与口腔颌面部多间隙感染的治疗转归(住院时日和并发症)直接相关。入院时血糖水平是影响口腔颌面部多间隙感染并发症严重程度的主要因素。结论:糖尿病患者与非糖尿病患者口腔颌面部多间隙感染的临床特征和转归不同,为临床上治疗糖尿病口腔颌面部多间隙感染提供了重要的参考依据。     

口腔颌面部多间隙感染老年患者与中青年患者的临床比较

目的:通过与中青年患者的比较,分析口腔颌面部多间隙感染老年患者的临床特征。方法:对上海第九人民医院口腔颌面外科收治的242例诊断为口腔颌面部多间隙感染的病例进行回顾性分析。所有病例根据年龄分为老年组和中青年组。研究内容包括一般资料、临床指标(全身系统性疾病、病因、症状发作到入院治疗的时间、受累间隙的数量和分布)、实验室检查(细菌学、入院时血糖水平、入院时白细胞总数和中性粒细胞百分比)和治疗结果(切口数量、住院天数和并发症)。采用SAS 8.0软件包对数据进行t检验、Fisher’s确切概率和χ2检验分析。结果:与中青年患者相比,老年患者患有更多的系统性疾病(P=0.0002),住院时程更长(P=0.02),全身各种并发症情况更多见(P=0.04)。结论:通过与中青年患者比较,揭示了口腔颌面部多间隙感染中的老年患者的临床特征,为临床上治疗老年口腔颌面部多间隙感染提供了重要的参考依据。     

糖尿病患者口腔颌面部多间隙感染的临床特征分析

目的:通过与非糖尿病患者的比较,分析口腔颌面部多间隙感染的糖尿病患者的临床特征.方法:对上海第九人民医院口腔颌面外科收治的191例诊断为口腔颌面部多间隙感染的病例进行回顾分析.根据有无罹患糖尿病分为糖尿病组和非糖尿病组.研究内容包括一般资料、病因学、临床指标(症状发作到入院治疗的时间、受累间隙的数量和分布)、实验室检查(细菌学、入院血糖水平、入院血白细胞总数和中性粒细胞百分比)和治疗结果(切口数量、住院天数和并发症).采用SAS8.0软件包对数据进行t检验、x2检验和方差分析.结果:2组患者中,牙源性感染是最常见的病因,最容易受累的间隙是下颌下间隙.糖尿病组分离出的最常见的细菌是肺炎克雷伯菌,而非糖尿病组是链球菌.与非糖尿病相比,口腔颌面部多间隙感染的糖尿病患者受累的间隙更多,切开引流的切口数量更多,住院时间更长,全身各种并发症更多见,严重者可导致死亡.结论:通过与非糖尿病患者比较,本研究揭示了口腔颌面部多间隙感染中的糖尿病患者的临床特征,为临床上治疗糖尿病口腔颌面部多间隙感染提供了重要的参考依据.     

以颌面部蜂窝织炎为首发症状的非何杰金氏淋巴瘤1例

非何杰金氏淋巴瘤(NHL)是原发于淋巴结或其他淋巴组织的恶性肿瘤,其发病可能与病毒感染、机体免疫缺陷有关,临床表现为淋巴结无痛性进行性肿大及肝、脾肿大,但以颌面部蜂窝织炎为首发症状罕见,现报道1例。患者,女,17岁,学生,住院号617831,病理号619771,因双侧颌面部、颈部渐进性肿胀10 d入院。患者10 d前出现左侧耳下区肿大,经外敷中草药3 d后出现双侧颌下区肿胀,并伴疼痛,抗炎治疗无效。入院时患者神智清楚,T37.7℃,P100次/m in,R24次/m in,BP130/75 mmHg,双侧颌面部、颈部广泛肿胀,凹陷水肿,皮肤潮红,紧张,皮下无捻发音。张口中度受限…     

评定颌面部感染患者毒血症的实验室指标

检查颌面部感染患者40例(脓肿12例,蜂窝织炎28例),男27例,女13例;年龄15～64岁。均无伴发病。为评定感染性毒血症的严重程度,在患者入院时,综合治疗(消炎,抗菌、切开引流等)5～6天以后,检测红细胞吸附力、血液的中分子肽水平和循环免疫复合物含量,对照组是25例健康人。 检查结果 健康人:红细胞吸附力20.62条件单位,中分子肽水平0.272条件单位,循环免疫复合物含量0.132条件单位。颌面部脓肿患者;入院时,红细胞吸附力、中分子肽水平和循环免疫复合物含量比对照组增高51.5％;综合治疗5～6天以后,这些指标恢复正常。颌面部蜂窝织炎患者:入院时,红细胞吸附力比健康人增高113.1％,中分子肽水平增高77.6％,循环免疫复合物含量增高177.6％;综合治疗5～6天以后,随着全身情况的好转,这些指标有些降低,但仍高于健康人,红细胞吸附力高62.2％,中分子肽水平高     

口腔颌面部恶性肿瘤患者血浆PT、APTT、TT及Fib检测

目的探讨口腔颌面部恶性肿瘤患者出、凝血功能变化,为临床诊疗提供有价值的检测指标。方法采用日本SysmexCA-50四通道自动血凝仪及DadeBehring公司生产的相应试剂和质控物,检测93例口腔颌面部恶性肿瘤患者血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及纤维蛋白原(Fib),与健康对照组,口腔颌面部良性肿瘤组进行对比分析。结果口腔颌面部恶性肿瘤患者与健康对照组及口腔颌面部良性肿瘤组相比血浆APTT缩短,经统计学处理P<0.01;而血浆PT、TT和Fib3组之间无显著性变化,经统计学处理P>0.05。结论口腔颌面部恶性肿瘤患者血浆APTT缩短,而PT、TT和Fib无显著变化。     

口腔颌面部恶性肿瘤患者血清中透明质酸含量的检测

目的　检测口腔颌面部恶性肿瘤患者血清中透明质酸(HA)的含量,探讨HA对口腔颌面部恶性肿瘤辅助诊断和治疗效果监测的价值。方法　选择住院治疗的口腔颌面部恶性肿瘤患者44例,健康人24例。肿瘤患者于手术前或化疗开始前采血,其中20例患者于手术后或化疗结束后再次采血;24例健康人于常规体检时采血。用放射免疫试验测定所有标本血清中的HA浓度。结果　治疗前口腔颌面部恶性肿瘤患者血清中HA含量显著高于健康人(P<0·05),口腔颌面部鳞癌患者血清中HA含量显著高于健康人(P<0·05),涎腺腺样囊性癌患者血清中HA 含量与健康人无显著差异(P>0·05)。口腔颌面部恶性肿瘤Ⅲ、Ⅳ期患者血清中HA含量显著高于Ⅰ、Ⅱ期患者和健康人(P<0·05)。口腔颌面部恶性肿瘤患者治疗后血清中HA含量低于治疗前,但差异不显著(P>0·05)。结论　HA含量测定对口腔颌面部恶性肿瘤可能有辅助诊断价值。血清中HA的含量变化可作为肿瘤分期和判断肿瘤预后的参考,但不能用于治疗效果的监测。     

糖尿病患者颌面部间隙感染的临床特点与治疗

目的:探讨糖尿病患者并发颌面部间隙感染的临床特点和治疗方法。方法:比较糖尿病(67例)与非糖尿病(70例)患者颌面部间隙感染的严重程度、疗程长短和治疗措施。结果:糖尿病患者颌面部间隙感染的疗程明显延长;易累及多个间隙;应用同等抗生素,疗效不及非糖尿病患者。结论:糖尿病并发颌面部间隙感染好发于中老年人,临床症状严重,感染反复,病程迁延。治疗应同时控制感染和血糖,积极处理病灶及全身支持治疗。     

口腔颌面部恶性肿瘤患者血清中可溶性CD44v6含量的研究

目的 :检测口腔颌面部恶性肿瘤患者血清中可溶性CD44v6(solubleCD44v6,sCD44v6)的含量及其含量在恶性肿瘤不同分期和治疗前后的变化。方法 :选择住院治疗的口腔颌面部恶性肿瘤患者 2 8例 ,正常对照组 2 8例。患者于手术或化疗开始前第一次采取空腹静脉血 ,手术或化疗结束后 1周第二次采取空腹静脉血 ,正常对照组于常规体检时采取空腹静脉血。采用定量酶联免疫吸附实验 (enzyme linkedimmunosorbentassay ,ELISA)检测血清中sCD44v6的含量。 结果 :治疗前口腔颌面部恶性肿瘤患者血清中sCD44v6含量与健康对照组无显著差异 (P >0 .0 5 ) ,口腔颌面部鳞癌、涎腺腺样囊性癌患者血清中sCD44v6含量分别与健康对照组无显著差异 (P >0 .0 5 )。口腔颌面部恶性肿瘤Ⅲ、Ⅳ期患者血清中sCD44v6含量高于Ⅰ、Ⅱ期和健康对照组 ,但差异无显著性 (P >0 .0 5 )。经配对t检验 ,口腔颌面部鳞癌患者治疗后血清中sCD44v6含量显著低于治疗前含量 (P <0 .0 5 )。结论 :血清中sCD44v6含量不能作为口腔颌面部恶性肿瘤诊断的肿瘤标志物 ,但可能对口腔颌面部鳞癌治疗效果的监测有参考价值     

颌面部金属杆贯通伤1例报告

<正>1病例报告患者,男,32岁,主诉颌面部嵌入一巨大金属杆5 h急诊入院。患者于2008年10月13日下午5时在矿井下作业时,因高速转动的金属钻杆突然折断,其尾部(六角形,长60cm,直径2.5 cm)自患者右颌下穿入,斜向左侧经舌根、软硬腭、左侧鼻旁、眶下穿出。     

Oral cancer: molecular technologies for risk assessment and diagnosis

Purpose: The effective biomarkers related to diagnosis, metastasis, drug resistance and irradiation sensitivity of oral cancers will help the pathologist and oncologist to determine the molecular taxonomy diagnosis and design the individualization treatment for the patients with oral cancers.     

Stimulated whole saliva components in children with Down syndrome

The authors report on the components of stimulated whole saliva from children with Down syndrome—including pH, flow rate, sialic acid and protein concentrations, and amylase and peroxidase activity. Saliva samples were collected from 35 children aged 6–10 years. Of the participants, 17 had Down syndrome and 18 did not. To stimulate saliva production, the children chewed a piece of parafilm for 10 minutes before the sample was collected. Soon after collecting the saliva sample, the authors measured pH using a portable pH-meter. Sialic acid levels were determined with a thiobarbituric acid assay. Protein content was determined with Folin's phenol reagent. Amylase was assayed and the authors measured the maltose produced by the breakdown of starch and peroxidase using ortho-dianisidine.
No statistically significant difference was observed in levels of sialic acid (free and total) between the two groups. Protein concentration was about 36% higher in the group with Down syndrome. However, the salivary flow rate, pH, and amylase and peroxidase activities were lower among the children with Down syndrome.     

柠檬精油对牙周致病菌抑制作用及其安全性初步研究

目的:探讨柠檬精油对牙周致病菌的体外抗菌活性及对细胞增殖的影响。方法:采用微量液体稀释法测定柠檬精油对Pg、Fn、Aa、Pi的最小抑菌浓度(minimal inhibitory concentration,MIC)及最小杀菌浓度(minimum bactericidal concentration,MBC);以较低浓度的MIC为标准稀释LEO作为实验组,采用MTT法测定柠檬精油对HUVECs的毒性作用,明确抑菌浓度下LEO的安全性。结果:柠檬精油对牙周主要致病菌均有抑菌作用,Pg、Fn、Aa、Pi的MIC分别是9.0 g/L、4.5 g/L、4.5 g/L、9.0 g/L,Aa、Fn的 MBC是9.0 g/L,Pg、Pi的MBC未测得。1/2MIC、1/20MIC浓度的LEO能够抑制人脐静脉内皮细胞的生长,而低于1/200MIC浓度的LEO则对人脐静脉内皮细胞的生长没有影响,其中1/200MIC浓度的LEO作用明显优于0.02%的CHX。结论:体外环境中,柠檬精油对牙周致病菌Pg、Fn、Aa、Pi具有抗菌活性,低浓度应用对机体相对安全。     

Computer-assisted planning for maxillofacial prosthodontic rehabilitation

Computerized tomography (CT) planning and the use of CT derived surgical templates for implant placement have shown promise for restoring function within months after surgical reconstruction of acquired post-oncologic defects.     

牙髓再生的研究现状

目前,根管治疗术在临床上已得到了广泛的应用并成功的保存了患牙,但其仍有许多术后并发症。随着组织工程技术在口腔领域的应用,构建一种组织工程化牙髓进行牙髓-牙本质复合体的再生治疗成为可能。近年来国内外已有很多关于牙髓再生的研究,并且已经取得了一定成果。本文将对目前国内外牙髓再生的研究进展现状作一综述。     

Effect of Pingyangmycin on human venous malformation endothelial cells

Purpose: Venous malformations are common vascular anomalies with a propensity of the head and neck. Intralesional injection of Pingyangmycin (PYM, bleomycin A5 hydrochloride) is a widely used sclerotherapy method for the treatment of venous malformation.     

Clinical and pathological aspects on some odontogenic tumors

Odontogenic tumors constitute a very diverse group of lesions that reflects the complex processes of odontogenesis. Controversies over their classification/subtyping, terminology and diagnosis have been persisted, which has direct bearings on therapeutic and/or prognostic implications.     

Can you be too old for oral implants? An update on ageing and plasticity in the oro‐facial sensorimotor system

This review focuses on the capacity of the brain for plasticity and the utility and efficacy of oral implants in helping to restore oro‐facial sensorimotor functions, especially in elderly patients. The review first outlines the components of the oro‐facial sensorimotor system which encompasses both oro‐facial tissues and a number of brain regions. One such region is the sensorimotor cortex that controls the activity of the numerous oro‐facial skeletal muscles. These muscles are involved in a number of functions including reflexes and the more complex sensorimotor functions of mastication, swallowing and speech. The review outlines the use by the brain of sensory inputs from oro‐facial receptors in order to provide for exquisite sensorimotor control of the activity of the oro‐facial muscles. It highlights the role in this sensorimotor control played by periodontal mechanoreceptors and their sensory inputs to the brain, and how oral implants in concert with the plastic capacity of the brain may, at least in part, compensate for reduced sensorimotor functioning when teeth are lost. It outlines findings of ageing‐related decrements in oro‐facial sensorimotor functions and control. The changes in oro‐facial tissues and the brain that underlie these ageing‐related functional alterations are also considered, along with adaptive and compensatory processes that utilise the brain's capacity for plasticity. The review also notes the evidence t hat rehabilitation that incorporates adjunctive approaches such as sensorimotor training paradigms in addition to oral prostheses such as implants may enhance these processes and help maintain or facilitate recovery of sensorimotor functioning in the elderly.     

Tumor microenvironment in oral cancer: novel approaches for immunotherapy

Squamous cell carcinoma of the head and neck (SCCHN), which arises from the squamous mucosal epithelium of the oral cavity, pharynx and larynx, is a major health problem in the US and other parts of the world, especially in developing countries.