淀粉样变性55例口腔临床病理观察

目的:探讨淀粉样变性在口腔颌面部的临床病理特点及口腔组织活检于淀粉样变性诊断的意义。方法:回顾性分析55例淀粉样变性的口腔临床特点和活检切片的HE染色,刚果红特染,光镜和偏光镜观察,免疫组织化学染色和一淀粉样变性肾组织活检的电镜检查。结果:在总计55例中,46例口腔组织(牙龈、舌、下唇、唇腺)活检切片可见淀粉样物质沉积。口腔组织的活检阳性率为84%。口腔组织切片检查可见黏膜基底膜下、舌肌间粉红均质淀粉样物质沉积,刚果红特染呈砖红色。透色电镜观察淀粉样蛋白为排列不规则,不均匀的絮状结构。结论:淀粉样变性在口腔组织表现主要呈舌体增大、质硬、溃疡。口腔组织活检可提供淀粉样变性病诊断重要依据。     

口腔颌面部淀粉样变性病的临床病理研究

目的探讨全身系统性淀粉样变性病在口腔颌面部的临床病理特点。方法对１４例口腔颌面部淀粉样变性病的活检切片ＨＥ及刚果红等特殊染色、免疫组化、光镜和偏光显微镜超微结构观察。结果１４例的活体组织检查发现肿物为软组织和血管壁有粉红均质的淀粉样蛋白沉积，刚果红等特殊染色阳性，结合免疫组织化学染色可鉴别原发和继发性病，透射电镜观察淀粉样蛋白呈毛毡样的细丝状物。结论淀粉样变性病在口腔主要损害舌，其次为颊唇粘膜及涎腺     

口腔活组织检查在诊断淀粉样变性中的应用

目的:探讨口腔组织(如牙龈、舌、下唇和唇腺)活检,对诊断淀粉样变性的临床意义。方法:对2010-05-2012-04期间,38例疑诊为淀粉样变性的病例行口腔组织活检。其中牙龈活检30例(含同时行唇腺活检2例),舌活检7例,下唇活检1例。所有活检标本送病理科,行HE染色和刚果红特染。结果:经口腔组织活检确定淀粉样变性阳性标本13例。在阳性病例中,活检部位牙龈6例、舌5例、下唇组织1例、唇腺1例。阳性的淀粉样变性病理诊断可提供淀粉样变性确诊依据。在25例阴性病例中,仍有2例通过腹壁脂肪活检、1例经前臂脂肪活检和1例经肾活检电镜观察后,其淀粉样变性诊断得以确定。结论:口腔组织活检具有易于取材、创伤小、恢复快的优点,可作为淀粉样变性的一个重要诊断依据。     

舌淀粉样变性1例报道

淀粉样变性是一种少见的全身代谢类疾病,偶发于口腔,主要表现为舌淀粉样变性.本文报告口腔黏膜科首诊的舌淀粉样变性1例.患者因舌广泛性肿胀、多发性血疱就诊,伴舌根黏膜下结节及双颊、舌黏膜糜烂和疼痛.骨髓穿刺查见浆细胞显著增加,血液科检查提示浆细胞增多症及骨髓瘤.本文复习相关文献并讨论该病的病理机制,提示对临床原因不明的舌部广泛肿胀和血疱应警惕该病的可能,以对舌淀粉样变性做出及时诊断,这对早期发现和治疗其他脏器的淀粉样变性具有重要意义.     

肿瘤-睾丸抗原NY-ESO-1在舌鳞状细胞癌中的表达及意义

目的：检测NY-ESO-1蛋白在舌鳞癌（tongue squamous cell carcinoma,TSCC）中的表达情况,分析其与肿瘤临床病理参数的关系,并探讨其作为TSCC免疫治疗靶标的可能性。方法：采用免疫组织化学EnVision法检测53例TSCC标本及10例正常舌黏膜中NY-ESO-1蛋白的表达,SPSS统计软件分析所得数据。结果：53例TSCC标本中13例NY-ESO-l阳性表达（24.5%）,定位于细胞浆,而10例正常舌黏膜无表达。NY-ESO-1蛋白的表达与肿瘤大小及临床病理分级有关（P〈0.05）,但与肿瘤浸润深度及有无淋巴结转移无关。结论：NY-ESO-1蛋白在中高分化TSCC组织中的表达较高,可以进一步研究其作为TSCC免疫治疗靶点的可行性。     

舌鳞状细胞癌中Cyclin D1和CDK4的表达及意义

目的:分析细胞周期素D1(CyclinD1)和细胞周期素依赖激酶4(CDK4)在舌鳞状细胞癌中的表达及意义.方法:用免疫组织化学方法检测CyclinD1和CDK4在39例舌癌和15例正常舌黏膜中的蛋白表达,及其与组织学分级和颈部淋巴结状态之间的关系.应用χ2检验分析舌癌中CyclinD1和CDK4与在正常舌黏膜中表达的差异,应用Spearman等级相关分析CyclinD1和CDK4的表达关系.结果:CyclinD1、CDK4在舌癌中的阳性表达率分别为69.2%、61.5%,均高于正常舌黏膜,有显著性差异(P<0.01),CyclinD1和CDK4在舌癌中的表达成正相关(P<0.05),伴有颈部淋巴节转移组的阳性表达率高于无转移组,有显著性差异(P<0.05).结论:CyclinD1和CDK4在舌癌组织中呈过表达,并与其发生、发展密切相关.     

HMGB1在不同转归结果的舌癌病理标本中的表达

目的:探讨舌鳞癌病理标本中高迁移率族蛋白1(HMGB1)的表达对肿瘤疾病转归的影响.方法:收集资料完整的舌鳞癌患者首次手术病理标本,选择生存期2年以内的病例22例,5年以上的病例10例.采用免疫组织化学染色法观察各标本HMGB1、血管内皮因子(VEGF)的阳性表达及微血管密度,分析比较组间差异.结果:两组不同转归结果的舌癌组织中HMGB1、VEGF阳性表达及微血管密度存在显著差异(P＜0.01).HMGB1表达高的组织有更高的VEGF表达和微血管密度.结论:舌鳞状上皮癌组织中HMGB1的表达与疾病转归有关.HMG1的表达在一定程度上可用作反映舌鳞状上皮癌预后的的重要生物学指标.     

Livin、Bcl-2在舌癌中的表达及临床意义

目的:探讨舌癌组织中Livin蛋白的表达及其与Bcl-2蛋白表达的相关性。方法:采用免疫组织化学法(SABC法)检测Livin、Bcl-2在舌癌和正常舌黏膜组织中的表达。应用SPSS 13.0统计软件对数据进行统计学分析。结果:舌癌与正常舌黏膜组织中Livin蛋白阳性表达率分别为68.89%和10%,二者有非常显著的差异(P<0.01);Livin的高表达与舌癌组织学分化程度相关(P<0.05),与颈淋巴结转移密切相关(P<0.05)。舌癌与正常舌黏膜组织中Bcl-2蛋白阳性表达率分别为60.0%和0,二者有非常显著的差异(P<0.01);经Spearman等级相关分析,Livin与Bcl-2之间呈正相关(r=0.353,P=0.027)。结论:Livin蛋白在舌鳞癌组织中高表达,显著高于正常舌黏膜组织:Bcl-2蛋白在舌鳞癌组织中高表达,而在正常舌黏膜组织中无表达:在舌鳞癌组织中Livin与Bcl-2蛋白表达呈正相关。     

口腔颌面部淀粉样变性(附3例报告)

淀粉样变性是一种由淀粉样物质沉积于人体组织中引起的少见疾病 ,而仅限于口腔颌面部都更为少见 ,现将作者所见 3例报告如下。1　病例介绍病例 1 ,女 ,2 8岁 ,回族 ,舌背部肿物 5年 ,生长增快伴疼痛半月 ,检查见舌背部有多个结节状增生物 ,色桔黄 ,触硬 ,表面光滑 ,舌两侧边缘有明量齿痕 ,无破溃 ,沟纹舌 ,舌运动自如 ,收住院。入院后查全身各系统无异常 ,心电图、肝肾肺功能正常。舌背病变处切取活检 ,病理报告为舌淀粉样变 (甲基紫染色 )。病例 2 ,男 ,62岁 ,维族 ,舌体肿大发硬一年伴疼痛溃烂半年余 ,检查见口腔卫生差 ,舌居中 ,活动受限…     

舌鳞状细胞癌中NF-κB和COX-2的表达

目的:研究核转录因子-κB(nuclear factor-κB,NF-κB)和环氧化酶-2(cyclooxygenase-2,COX-2)在舌鳞状细胞癌(tongue squamous cell carcinoma,TSCC)发生、发展中的作用及两者间的关系.方法:取经手术病理证实的舌鳞状细胞癌标本50例,采用SP免疫组化法检测舌鳞状细胞癌组织中NF-κB和COX-2的表达情况.应用SPSS11.0软件包,采用x2检验分析NF-κB和COX-2表达的关系及其与临床病理特征的关系.结果:低分化TSCC组织中NF-κB的阳性表达率为48%,显著高于中、高分化的癌组织(P＜0.05);有淋巴结转移的TSCC组织中,NF-κB的阳性表达率为42.3%,显著高于无淋巴结转移的患者(P＜0.05).低分化TSCC组织中,COX-2的阳性表达率为68.0%,显著高于中、高分化者(P＜0.05);有淋巴结转移组,COX-2的阳性表达率为61.5%,高于无淋巴结转移组(P＜0.05).在COX-2阴性表达的患者中,NF-κB阳性表达率为3.8%(1/26),显著低于COX-2阳性表达的患者中NF-κB阳性表达的比率(P＜0.05).结论:NF-κB和COX-2在低分化及有淋巴结转移的舌鳞状细胞癌中的阳性表达率均高于中、高分化及无淋巴结转移的病例,且两者间的表达具有相关性,NF-κB和COX-2可能参与了舌鳞状细胞癌的发生与发展.     

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.     

牙槽骨再生正畸治疗伴牙槽骨缺损的成人错畸形远期疗效评价

目的：评价牙槽骨再生正畸治疗伴牙槽骨缺损的成人错畸形的远期疗效。方法伴牙槽骨缺损的成人错畸形3例,平均年龄29岁。经正颌-正畸联合会诊制订治疗计划,按照牙槽骨再生正畸及正颌-正畸联合治疗模式,分别进行系统治疗并随访2~3 a。结果3例患者均顺利完成治疗,面型及咬合关系获得良好改善;牙槽骨缺损区正畸牙移动到位且未见医源性牙周并发症,牙槽骨缺损区骨量增加明显且远期效果稳定。结论针对伴牙槽骨缺损的成人患者,牙槽骨再生正畸是一种较为理想的技术。     

Management of acute open flexor tendon injuries of the hand and wrist: basic sciences,surgical factors and rehabilitation pertinent to optimizing outcome

Flexor tendon injuries to the hand and wrist represent a significant resource burden to the UK NHS. A good understanding of tendon basic science and repair techniques is crucial for the surgeon undertaking their repair and rehabilitation. Furthermore, this is a common topic assessed in the FRCS(Orth) examination. This article will summarize the basic science relating to tendon structure, physiology and injury. Additionally, it will present key surgical and rehabilitation factors relevant to clinical outcomes.     

伴囊肿的上颌埋伏阻生中切牙早期引流助萌治疗

目的:探讨采用引流助萌的方法对伴囊肿的上颌埋伏阻生中切牙的早期治疗。方法:选取单侧上颌中切牙埋伏阻生、处于替牙早期伴囊肿的患者8例。外科囊肿切除同时对埋伏阻生上颌中切牙引流助萌治疗。治疗前后拍摄CBCT,Dolphin11.0软件测量矫治前后阻生牙及对侧正常同名牙的冠根长度。结果:8例患者的埋伏阻生上颌中切牙平均矫治时间6.7个月。矫治后阻生牙和对侧正常同名牙的冠根长度均有生长。阻生牙冠根长度较对侧正常同名牙明显短(P<0.05)。结论:本研究所采用引流助萌方法为埋伏阻生牙的矫治提供了一个安全、有效的新途径。     

In vitro calibration and validation of a digital subtraction radiography system using scanned images

OBJECTIVES: To calibrate and validate a digital subtraction radiography system using scanned images for quantification of alveolar bone changes by means of computer-assisted densitometric image analysis (CADIA) in vitro. MATERIALS AND METHODS: Noise levels were determined using 10 standardized periapical radiographs of the same lower molar region in a human dry skull. For validation of the system, radiographs were taken before and after bovine bone particles in measures with increments of 2 mg weighing from 2 to 20 mg were added into each socket of three dry skulls. Radiographs were developed and scanned into a computer with a flatbed scanner. After digitization, the images were subjected to alignment, normalization and subtraction. Appropriate regions of interest (ROIs) were selected and their CADIA values were calculated for the determination of noise levels, and correlations between the CADIA values and the actual bone mass were performed. RESULTS: When the threshold value was 7, the percentage of pixels deviating from the set threshold value was small (0-11.3%). There were statistically significant correlations between the actual bone mass and the CADIA value for anterior sockets (p<0.001, r2=0.89) and posterior sockets (p<0.001, r2=0.9). For pooled data of both anterior and posterior sockets, the correlation was also statistically significant (p<0.001, r2=0.88). CONCLUSIONS: A high and statistically significant correlation between the actual bone mass and CADIA value was obtained, which suggests that the system could be suitable for the detection of small alveolar bone changes.     

CBCT与RVG对下颌恒切牙根管形态评估的对比研究

目的:对比CBCT法与数字化X线成像法(RVG)对下颌恒切牙根管形态评估的差异。方法:对101颗离体牙进行唇舌向及近远中向数字化X线片拍摄和CBCT高清牙列模式扫描,对图像进行根管数目、Vertucci根管分型、根管钙化和根尖口开口位置的评估,并通过CBCT图像建立偏角度投照的三角函数模型,计算偏向投照的角度。结果:CBCT法显示有30颗为双根管,RVG近远中向投照显示有36颗为双根管,卡方检验显示对根管数目和Vertucci根管分型两种方法均具有显著性差异(P<0.05)。两种方法对根管钙化和根尖口开口位置的评估均不具有显著性差异。30颗双根管牙中下颌恒切牙唇舌向双根管的最大距离(LaL)在0~1.5 mm之间的,85.7%的为Vertucci III型,LaL在1.5~2 mm之间的,66.7%为Vertucci IV和V型。以根尖片上双根管显示距离为1 mm计算,LaL在1~2 mm之间的,偏向投照角度为26.6°~45.0°,LaL在0.1~1 mm之间的,偏向投照角度为45.0°~84.3°。结论:CBCT高清牙列模式扫描和RVG投照对于根管数目和Vertucci根管分型的评估具有显著性差异,对于根管钙化和根尖口开口位置的评估不具有显著性差异。LaL在1~2 mm之间时,偏角度投照的临床可操作性较强。     

Fabrication and characterisation of a novel biomimetic anisotropic ceramic/polymer-infiltrated composite material

Objective

To fabricate and characterise a novel biomimetic composite material consisting of aligned porous ceramic preforms infiltrated with polymer.