一次完成与分次完成龈下刮治的短期疗效观察

目的：比较一次完成和分次完成龈下刮治治疗牙周炎的短期临床疗效。方法：30例中度牙周炎患者，进行洁治和口腔卫生指导后随机分为两组，实验组为一次性完成龈下刮治，洗必泰含漱；对照组为传统的分4次完成龈下刮治，每次间隔1周。记录各组刮治前，治疗后6周的改良龈沟出血指数（SBI）、探诊深度（PD）、附着丧失（AL）等相关指标。结果：一次性和分次完成龈下刮治均使SBI、PD、AL等指标明显改善，但实验组与对照组相比较SBI、PD、AL等指标明无统计学差异。结论：一次和分次完成龈下刮治治疗牙周炎疗效肯定，一次性龈下刮治较传统的分次法治疗周期短，复诊次数少，提高患者的依从性，值得在临床上推广。     

重症肺结核患者T细胞免疫球蛋白黏蛋白分子的表达及其预后意义

目的 探讨重症肺结核患者T淋巴细胞亚群、T细胞免疫球蛋白黏蛋白分子(TIM-1,TIM-3)的表达及其预后意义。方法 回顾性分析2019年1月至2021年6月在我院收治的1 056例重症肺结核患者为研究对象,并将其定义为重症肺结核组,另选同期在我院进行治疗的1 000名轻症肺结核患者作为轻症肺结核组。比较两组患者TIM-1、TIM-3以及外周血T细胞亚群(CD4⁺、CD8⁺)水平;检测并比较外周血单个核细胞中TIM-1、TIM-3的mRNA水平;分析重症肺结核患者外周血T细胞亚群、TIM-1、TIM-3与患者预后的关系。结果 重症肺结核组CD8⁺、TIM-1和TIM-3水平均高于轻症肺结核组,CD4⁺水平低于轻症肺结核组(均P<0.001)。重症肺结核组TIM-1 mRNA和TIM-3 mRNA水平均高于轻症肺结核组(均P<0.001)。死亡组CD8⁺、TIM-1和TIM-3水平均高于存活组,CD4⁺水平低于存活组(均P<0.001)。相关性分析发现:存活组患者TIM-1、TIM-3与CD4⁺均呈负相关(r值分别为-0.114和-0.211,P<0.05),而与CD8⁺均呈正相关(r值分别为0.571和0.680,P<0.05)。结论 重症肺结核患者免疫功能紊乱可能与其体内外周血T细胞亚群水平异常以及TIM-1、TIM-3 表达水平升高有关。     

CT CARE kV低管电压扫描联合CPR技术术前评估面神经管骨折

目的 探讨智能最佳管电压(CARE kV)低剂量CT扫描及CPR技术在术前评估面神经管骨折中的价值。方法 收集头部外伤伴单侧面瘫患者,采用CARE kV技术进行颞骨HRCT扫描,按就诊先后分4组:A组108例(CARE kV On),管电压120 kVp,B~D组分别为114、105、109例(CARE kV Semi),管电压分别为120 kVp、100 kVp、80 kVp;观察CPR图像面神经管,比较4组患者面神经管骨折发生率、发生部位并与手术结果对照;比较4组间图像质量客观评价指标,包括CT值、噪声(SD)、SNR、CNR及辐射剂量参数[容积CT剂量指数(CTDIvol)、剂量长度乘积(DLP)、有效剂量(ED)]。结果 共纳入436例患者,面神经管骨折174例(174/436,39.91%)。A~D组骨折发生率分别为43.52%(47/108)、39.47%(45/114)、37.14%(39/105)、39.45%(43/109);术前HRCT诊断面神经管骨折与手术结果具有较好的一致性(Kappa>0.5);膝状窝骨折发生率最高(100/174,57.47%),迷路段最低(5/174,2.87%)。A~D组SD、SNR、CNR差异有统计学意义(P<0.05),两两比较除A、B组外余各组间比较差异均有统计学意义(P均<0.05);A~D组CTDIvol、DLP、ED、有效电流差异有统计学意义(P<0.05),经两两比较除A、B组外余各组间比较差异均有统计学意义(P均<0.05)。结论 CARE kV联合CPR术前能够准确评估面神经管骨折情况,并可在满足诊断的前提下降低辐射剂量。     

头颈鳞癌与中心碳代谢通路研究

目的:探究头颈鳞癌代谢重编程机制。方法:通过对头颈鳞癌和癌旁组织进行真核有参转录组学、TMT标记定量蛋白质组学和非靶向代谢组学分析,找到差异表达基因、蛋白质和代谢物,进行基因本体（GO）富集分析和京都基因和基因组百科全书（KEGG）富集分析等生物信息学分析,两两组学联合分析预测参与头颈鳞癌代谢重编程的重要代谢通路。然后进行平行反应监测（PRM）验证通路重要蛋白,找到差异表达蛋白及代谢通路。结果:联合分析结果提示,肿瘤中心碳代谢和蛋白质消化吸收途径可能与肿瘤有关。PRM结果表明,表皮生长因子受体（EGFR）、乳酸脱氢酶A（LDHA）、磷酸甘油酸酯转位酶1（PGAM1）、己糖激酶3（HK3）和磷酸果糖激酶（PFKP）在肿瘤中表达升高并参与肿瘤中心碳代谢途径。结论:肿瘤中心碳代谢通路及相关蛋白EGFR、 PGAM1、 LDHA、 HK3、 PFKP在头颈鳞癌发生、发展中起关键作用。     

综合医院口腔科“四期”临床教学模式探讨

目的探讨综合医院口腔科实习学生的临床教学方法。方法采用＂四期＂临床教学模式：学生经过技术培训期、临床前见习期、临床操作期和操作后总结期来完成整个实习过程。结果 ＂四期＂临床教学模式可以增加学生临床＂上手＂的机会;使学生掌握目前最新的＂四手操作＂技术;有利于提高学生的临床应变能力;尽快进入临床工作状态。结论 ＂四期＂临床教学模式是综合医院口腔科实习学生较好的临床教学方法。     

缝隙连接蛋白与前列腺癌的相关性研究

缝隙连接蛋白被认为是一种抑癌基因,在众多肿瘤的的发生、生长、侵袭及转移过程中有重要意义。通过其介导的细胞缝隙连接通讯和缝隙连接蛋白本身的独立作用两条途径对肿瘤产生抑制作用,同时降低癌细胞对抗肿瘤药物的抵抗性,降低肿瘤细胞的迁徙和侵袭力。现就缝隙连接蛋白在前列腺癌方面的研究进展作一综述。     

Differential influence of selective 5-HT5A vs 5-HT1A, 5-HT1B,or 5-HT2C receptor blockade upon light-induced phase shifts in circadian activity rhythms: Interaction studies with citalopram

Though serotonergic mechanisms modulate circadian rhythms, roles of individual serotonin (5-HT) receptors remain uncertain since data are lacking for antagonists. Herein, both the 5-HT_5A receptor antagonist, A843277 (10 mg/kg), and the 5-HT_1B antagonist, SB224289 (1 mg/kg), inhibited light-induced phase advances in hamster circadian wheel-running rhythms. Conversely, though 5-HT_1A and 5-HT₇ receptors are likewise implicated in circadian scheduling, their blockade by WAY100635 (0.5 mg/kg) and SB269970 (1 mg/kg), respectively, was ineffective. Since actions of 5-HT reuptake inhibitors are modified by antagonists, we evaluated their influence on suppression of phase advances by citalopram (10 mg/kg). Its action was potentiated by WAY100635 and the 5-HT_2C antagonist, SB242084 (1 mg/kg), but not by A842377, SB224289, SB269970, and antagonists at 5-HT_2A (MDL100907) and 5-HT₆ (SB399885) receptors. In conclusion, this is the first in vivo evidence for an influence of 5-HT_5A receptors upon circadian rhythms, but no single class of 5-HT receptor mediates their control by citalopram.     

Comparison of efficacy of conbercept, aflibercept, and ranibizumab ophthalmic injection in the treatment of macular edema caused by retinal vein occlusion: a Meta-analysis

AIM: To evaluate and compare the anatomical and functional outcomes and negative effects of the three anti-vascular endothelial growth factor (VEGF) drugs in the treatment of macular edema (ME) due to retinal vein occlusion (RVO) based on the evidence pooled from current clinical trials and observational studies. METHODS: A systematic literature search was conducted on nine online databases from inception until April 30, 2022. The main endpoints were best corrected visual acuity (BCVA), central macular thickness (CMT), and adverse events (AEs). Cumulative Meta-analysis was conducted to synthesize the outcomes of the drugs. The retrieved data were analyzed using Stata software (version 12.0). RESULTS: A total of 20 studies comprising 1674 eyes met the inclusion criteria to the Meta-analysis. It was observed that conbercept and aflibercept had better visual acuity effects compared with ranibizumab at 1mo [weight mean difference (WMD)=-0.03, P=0.001; WMD=-0.05, P=0.019], but the effects were not different from that of ranibizumab at 6mo. Moreover, there was not statistically significant difference in the proportion of patients gaining ≥15 letters at 12-24mo between aflibercept and ranibizumab [odds ratio (OR)=1.16, P=0.427]. Conbercept had higher mean CMT change effects at 1mo (WMD= -14.43, P=0.014) and 6mo (WMD=-35.63, P≤0.001) compared with ranibizumab. Meanwhile, the mean CMT change effects at 1mo (WMD=-10.14, P=0.170), 6mo (WMD=-26.98, P=0.140) and 12-24mo (WMD=-12.34, P=0.071) were comparable among the groups. Similarly, AEs were not significantly different among the treatments (OR=0.75, P=0.305; OR=1.04, P=0.89). The stability of effect size of mean BCVA and CMT improved with the increase in sample size. Aflibercept and conbercept required fewer injections compared with ranibizumab. CONCLUSION: This is the first study to evaluate the efficacy and AEs of intravitreal administration of conbercept, ranibizumab, and aflibercept in the treatment of RVO-ME. Intravitreal aflibercept or conbercept results in better mean change in vision and CMT reduction compared with ranibizumab. Conbercept can be considered to be a promising and innovative drug with good anti-VEGF effects.     

以提高生存质量为目的的老年慢性病患者护理研究

目的通过老年慢性病患者护理的实践,探讨提高老年慢性病患者生存质量的护理方式。方法以2010年上半年的301例老年慢性病患者作为对照组施行传统的护理方式。以2010年下半年住院老年慢性病人297例作为观察组,施行改良的护理方式。出院时利用Corry评分对老年患者生存质量进行评价,并通过问卷调查患者满意度。对结果进行统计学处理。结果观察组生命质量评价参数明显优于对照组,对护理的满意率也明显高于对照组(P﹤0.05)。结论改良的护理方式有利于提高患者的生存质量及医护关系的改善。