口腔扁平苔藓患者综合护理干预效果评价研究

目的探讨口腔扁平苔藓患者(OLP)实施综合护理干预的效果。方法将104例OLP患者随机分为对照组和干预组各52例,对照组给予常规治疗和护理,干预组在对照组的基础上给予综合护理干预措施,比较2组的总有效率、复发率及生活质量评分。结果实施综合护理干预后,干预组干预6个月的总有效率为88.9%,显著高于对照组的68.1%(P<0.05);干预组6个月的复发率为19.2%,显著低于对照组的44.2%(P<0.01);干预组干预6个月后的情感得分、一般感情指数、健康指数、生活满意度评分均显著高于对照组(P<0.01)。结论 OLP患者实施综合护理干预后,可提高患者的总有效率,降低复发率,改善生活质量。     

口腔扁平苔藓65例临床研究

目的 总结扁平苔藓（OIJP）诊断治疗经验。方法 回顾性分析本院65例OLP患者的诊疗资料。结果89．23％的患者经治疗后,症状有所缓解。结论 中西医结合治疗OLP安全有效。     

口腔扁平苔藓发病相关风险因素的Logistic回归分析

目的:对可能导致口腔扁平苔藓(OLP)发病的相关风险因素进行调查分析,为防治OLP提供理论依据。方法:选取符合条件的OLP患者130例,与近期在我院健康体检的130例非口腔黏膜病患者进行对照研究,将相关调查数据行二分类多因素Logistic回归分析,以筛查OLP发病的相关风险因素。结果:经Logistic回归分析结果显示,心理因素、胃炎、局部理化刺激和植物神经紊乱与OLP发病具有显著相关性。结论:OLP发病及病情进展与多因素有关,临床应有效进行病因治疗以促进OLP的预防及预后。     

多甙冲剂治疗口腔扁平苔藓的临床观察

目的 为探讨多甙冲剂治疗口腔扁平苔藓的临床疗效,选用多甙冲剂进行临床观察。方法 将40例糜烂型口腔扁平苔藓患随分为两组,观察组40例采用多甙冲剂治疗,对照组30例采用复方丹参治疗。结果 两组的痊愈率及复发率比较均有显性差异（P＜0．01）。结论 使用多甙冲从免疫调节及补充微量元素的方向,治疗口腔扁平苔藓的有明确的治疗效果。     

Caspase-3及P53蛋白在口腔扁平苔藓及口腔鳞癌中表达意义

目的探讨Caspase-3及P53蛋白在口腔扁平苔藓及鳞癌癌变过程中的作用。方法采用免疫组织化学方法检测45例口腔扁平苔藓（扁平苔藓组）和46例口腔鳞癌（鳞癌组）和15例正常口腔黏膜组织（对照组）中Caspase-3及P53蛋白的表达情况并进行比较。结果Caspase-3蛋白表达在扁平苔藓组（71．11％）高于鳞癌组（47．83％）（P〈0．05）、但低于对照组（93．33％）（P〈0．05）;P53蛋白在鳞癌组中阳性表达率（78．26％）明显高于对照组（0）和扁平苔藓组（28．89％）（P均〈0．05）;Caspase-3蛋白与P53蛋白呈负相关（r=0．339,P=0．021）。结论Caspase-3蛋白可抑制口腔扁平苔藓和鳞癌的发展,P53蛋白则在其发展中起促进作用。     

人巨细胞病毒编码的miR-UL112-3p在口腔扁平苔藓病人血浆中的变化研究

目的 检测人巨细胞病毒编码的微小核糖核酸miR-UL112-3p在口腔扁平苔藓病人血浆中的水平,探讨其潜在的临床价值。 方法 收集74例口腔扁平苔藓病人血样本,其中13例病人收集全血标本,其余61例病人收集血浆标本;同时收集年龄、性别匹配的健康人全血标本12例和血浆样本51例。采用qRT-PCR方法测定全血标本中外周血白细胞HCMV DNA滴度。用ELISA试剂盒测定血浆中抗-HCMV IgG 和 IgM 抗体含量。用TaqMan qRT-PCR技术分别在初筛组（病人21例,对照18例）和验证组（病人40例,对照33例）中测定血浆样本中miR-UL112-3p水平。结果 口腔扁平苔藓病人外周血白细胞中HCMV DNA滴度为17,319 &amp;#177; 15,311 拷贝/mL,显著高于正常对照组（2,672 &amp;#177; 2,368拷贝/mL）（P&amp;lt;0.001）。两组间血浆抗-HCMV IgG (100% vs. 93.65%) 和 IgM 抗体阳性率无显著差异（0% vs. 0%）。在初筛组中,miR-UL112-3p在病人组中的水平(3.76&amp;#177;0.50)显著高于健康对照组（0.52&amp;#177;0.06）（P&amp;lt;0.001）。进一步在验证组中,病人组miR-UL112-3p水平（2.02 &amp;#177;0.34） 也显著高于对照组（1.23 &amp;#177;0.09）（P&amp;lt;0.05）。多元逻辑回归显示,miR-UL112-3p与口腔扁平苔癣疾病相关（OR=6.00,P&amp;lt;0.01）。结论 人巨细胞病毒编码的miR-UL112-3p在口腔扁平苔藓病人血浆中显著升高,可能是口腔扁平苔藓疾病潜在的血清学指标,值得进一步深入研究。     

Development and exacerbation of oral lichen planus during and after interferon therapy for hepatitis C

Oral lichen planus (OLP) is frequently seen in patients with hepatitis C virus (HCV) infection. To clarify the role of HCV in OLP pathogenesis, we investigated the occurrence and progression of oral lesions in chronic hepatitis C patients treated with interferon. Oral surgeons examined 24 hepatitis C patients (15 men, nine women; mean age 48.1 years) for oral lesions before, during and after interferon (IFN) treatment. OLP was observed in 16.7% (4/24). Two patients had OLP before treatment, one during and one after treatment. Those who developed OLP during or after treatment had neither improvement nor disappearance of OLP even when serum HCV RNA became negative. Leucoplakia was seen in four patients before treatment and oral cancer in one patient 6 months after completing treatment. OLP can occur, exacerbate and persist during IFN treatment for hepatitis C, even when serum HCV RNA becomes negative. The present study suggested that OLP pathogenesis in hepatitis C is due to host factors induced by HCV infection rather than direct HCV participation. Treating physicians should be aware of OLP occurrence or exacerbation by IFN treatment with hepatitis C patients, but IFN therapy is not necessarily contraindicated in these patients.     

他克莫司软膏治疗顽固性糜烂型口腔扁平苔藓的利弊分析

口腔扁平苔藓（orallichenplanus,OLP）是一种常见的口腔黏膜慢性炎性疾病,部分糜烂型OLP对糖皮质激素治疗不敏感甚至无效。他克莫司软膏是一种免疫抑制类局部制剂,学者们用于治疗顽固性糜烂型OLP取得一定疗效,但同时也发现一些值得注意的问题。本文对他克莫司软膏用于治疗顽固性糜烂型OLP的利弊进行分析,为临床医师更合理地应用该类制剂提供参考。     

The quality of patient‐orientated Internet information on oral lichen planus: a pilot study

Objective This study examines the accessibility and quality Web pages related with oral lichen planus. Methods Sites were identified using two search engines (Google and Yahoo!) and the search terms ‘oral lichen planus’ and ‘oral lesion lichenoid’. The first 100 sites in each search were visited and classified. The web sites were evaluated for content quality by using the validated DISCERN rating instrument. JAMA benchmarks and ‘Health on the Net’ seal (HON). Results A total of 109 000 sites were recorded in Google using the search terms and 520 000 in Yahoo! A total of 19 Web pages considered relevant were examined on Google and 20 on Yahoo! As regards the JAMA benchmarks, only two pages satisfied the four criteria in Google (10%), and only three (15%) in Yahoo! As regards DISCERN, the overall quality of web site information was poor, no site reaching the maximum score. In Google 78.94% of sites had important deficiencies, and 50% in Yahoo!, the difference between the two search engines being statistically significant (P = 0.031). Only five pages (17.2%) on Google and eight (40%) on Yahoo! showed the HON code. Conclusion Based on our review, doctors must assume primary responsibility for educating and counselling their patients.     

曲安奈德溶液联合西吡氯铵含片治疗轻中度糜烂型口腔扁平苔藓的临床疗效

目的 观察曲安奈德溶液联合西吡氯铵含片治疗轻中度糜烂型口腔扁平苔藓的临床疗效及安全性。方法 对100例诊断为轻中度糜烂型口腔扁平苔藓的患者,采用局部涂擦曲安奈德溶液联合使用西吡氯铵含片（试验组,50例）或单纯使用曲安奈德溶液（对照组,50例）进行治疗。分别在治疗前、治疗2周后、治疗4周后评估并记录患者的视觉模拟评分法（VAS）评分、临床症状评分及安全性。结果 重复测量资料方差分析显示VAS评分处理效应和时间效应的交互作用（F = 1.680,P = 0.382）以及处理效应（F = 0.749,P = 0.391）无统计学意义,时间效应（F = 190.641,P < 0.001）有统计学意义,治疗后2组VAS评分均呈逐渐降低趋势。临床症状评分处理效应和时间效应的交互作用无统计学意义（F = 1.198,P = 0.296）,处理效应（F = 4.758,P = 0.034）和时间效应（F = 268.249,P < 0.001）均有统计学意义,治疗后试验组临床症状评分低于对照组,且均呈逐渐降低趋势。治疗4周后唾液真菌培养显示对照组白色念珠菌感染率（23.4%）高于试验组（6.1%）,差异具有统计学意义（P = 0.016）。结论 在短期内曲安奈德溶液联合西吡氯铵含片治疗轻中度糜烂型口腔扁平苔藓具有明显的临床疗效和较好的安全性,西吡氯铵可能对真菌感染起到一定的预防作用。     

Quality of life in adults with congenital ichthyosis

BACKGROUND: Little is known about the quality of life of people with congenital and generalized skin diseases. Describing life history and quality of life from an individual perspective could increase understanding of living with generalized congenital ichthyosis for nursing staff and others. AIM: The aim of our study was to illustrate how middle-aged and older people with lamellar ichthyosis or epidermolytic hyperkeratosis describe the effects of their disease on their quality of life. METHODS: Six women and four men aged 56-80 years participated. A global clinical assessment of the severity of the disease was performed. The Nottingham Health Profile (NHP) questionnaire was used to investigate quality of life. Participants were interviewed face-to-face about childhood and adulthood experiences of living with a skin disease. Interview data were analysed using content analysis. RESULTS: Interview data were assigned to two categories, childhood and adulthood, and organized under 16 themes. All interviewees reported that their skin disease had affected them negatively to varying degrees during their entire lives, and that the most problematic period was childhood. Coping strategies used during childhood were hiding of the skin and developing shyness. There were no correlations between objective signs of ichthyosis and the NHP scores. CONCLUSIONS: Congenital ichthyosis appears to affect several aspects of life negatively, and it is hoped that an understanding of the effects of the disease will lead to more efficient nursing care.     

中医辨证施食护理在脾胃湿热型口腔扁平苔藓患者中的应用

目的:探讨中医辨证施食在脾胃湿热型口腔扁平苔藓患者中的临床应用效果。方法:选取2017年1月—2018年12月青岛大学附属青岛市口腔医院中西医结合口腔黏膜诊疗中心就诊的98例脾胃湿热型扁平苔藓患者,采用随机数字表法将其分为试验组和对照组,每组49例。两组采取相同的中西医治疗方法,对照组采用常规护理,试验组在常规护理的基...     

Sema4D通过调节趋化因子和CD8+T细胞募集促进口腔扁平胎癣的发展

目的探讨Sema4D通过调节趋化因子和CD8^+T细胞募集促进口腔扁平胎癣的发展机制。方法回顾性选择宝鸡市人民医院收集的口腔扁平胎癣病理标本34例作为病例组,同期选择正常口腔黏膜组织21例作为对照组。采用免疫组化法检测两组组织CXC类趋化因子受体7(CXCR7)与Sema4D表达情况,采用流式细胞仪检测两组血液CD8^+T细胞,并分析病例组CXCR7、Sema4D表达阳性率与CD8^+T细胞含量的相关性。结果病例组组织的CXCR7与Sema4D表达阳性率分别为82. 4%、88. 2%,显著高于对照组组织的33. 3%和42. 9%(P <0. 05)。病例组的CD8^+T细胞含量显著高于对照组,CD4^+T细胞含量显著低于对照组(P <0. 05)。直线相关分析显示口腔扁平苔藓患者病理组织的CXCR7、Sema4D表达阳性率与CD8^+T细胞含量成显著正相关性,与CD4^+T细胞含量呈显著负相关性(P <0. 05)。COX回归分析显示CXCR7、Sema4D表达阳性率均为影响CD8+T含量的主要因素(P <0. 05)。结论 Sema4D可通过调节趋化因子CXCR7和CD8^+T细胞募集促进口腔扁平胎癣的发展,是监测T细胞免疫功能的关键标志分子,可能在口腔扁平胎癣的发生中发挥重要作用。     

miR-125b inhibits keratinocyte proliferation and promotes keratinocyte apoptosis in oral lichen planus by targeting MMP-2 expression through PI3 K/Akt/mTOR pathway

Oral lichen planus (OLP) is a chronic inflammatory mucosal disease that involves the degeneration of keratinocytes. However, the etiology and mechanisms of OLP pathogenesis have not been fully elucidated. In this study, we used keratinocytes HaCaT stimulated with lipopolysaccharide (LPS) to mimic a local OLP immune environment, and investigated the regulatory role of miR-125b in keratinocyte proliferation and apoptosis under OLP conditions. Immunohistochemical analysis and quantitative real-time PCR (qRT-PCR) assay showed that MMP-2 expression was up-regulated and miR-125b expression was down-regulated in both OLP mucosa tissues and LPS-incubated HaCaT cells. Western blot analysis indicated that miR-125b overexpression suppressed LPS-induced MMP-2 expression in HaCaT cells. Molecularly, our results confirmed that MMP-2 is a target gene of miR-125b in HaCaT cells. The effect of miR-125b on cell proliferation was revealed by CCK-8 assay, BrdU assay and cell cycle analysis, which illustrated that miR-125b overexpression impeded LPS-induced HaCaT cell proliferation. Flow cytometry analysis further demonstrated that miR-125b overexpression promoted HaCaT cell apoptosis. Moreover, these effects were involved in PI3 K/Akt/mTOR activation, as miR-125b overexpression inhibited LPS-enhanced expression of p-Akt and p-mTOR proteins. Taken together, these data confirm that miR-125b might inhibit keratinocyte proliferation and promote keratinocyte apoptosis in OLP pathogenesis by targeting MMP-2 through PI3 K/Akt/mTOR pathway.     

Coexistence of periorbital lichen planus pigmentosus and pemphigus vulgaris: Report of an unusual case and a rare association

Lichen planus pigmentosus is a rare variant of lichen planus with different patterns and manifestations. The coexistence of LPP and PV suggests that there might be a relationship between these two conditions in terms of immunologic mechanisms.     

Assessment of quality of life with the Nottingham Health Profile among patients with coronary heart disease

The aim was to describe the quality of life of people suffering from coronary artery disease. The patients had been treated with medication (n=80), percutaneous transluminal coronary angioplasty (n=100) and coronary artery bypass surgery (n=100). Of the 280 patients, 189 were men and 91 women. The patients who participated in this study were seriously ill, as nearly half of them had three or more stenosed coronary arteries. Male patients were most numerous in the bypass surgery group and female patients in the angioplasty group. The quality of life was evaluated using the Nottingham Health Profile (NHP) instrument relation to an age-and sex-matched general population, the background factors and the severity of the coronary disease. The NHP questionnaire consists of 38 statements on health problems, making up six dimensions of subjective health: physical mobility, pain, sleep, energy, emotional reactions and social isolation. The health-related quality of life of coronary patients before the invasive procedures was significantly poorer on all the six dimensions than the quality of life in an age-and sex-matched general population. The most obvious differences were seen on the following dimensions: energy, pain, emotional reactions, sleep and physical mobility. The smallest differences occurred in social isolation. Both males and females had the lowest value for energy and social isolation in the youngest age group (35–54 years). The index values of emotional reactions in the two youngest groups were significantly higher among females than males, which reflects poor quality of life. The women in the age group of 35–54 years found the manifestation of a serious disease extremely hard to face. Our findings clearly suggest that while choosing the mode of treatment, the patient's quality of life should be considered along with the clinical severity of the disease, especially in the case of young women. From the societal and social points of view, the patient's symptoms and quality of life are even more important than the objective medical outcome. In clinical decision-making, the goal is to integrate the results of health-related quality of life assessments with clinical decisions, and this underlines the need to evaluate whether the treatment given is congruent with the patient's quality of life. On the basis of the present findings, the NHP instrument seems to be applicable to quality of life measurements among coronary patients. It does not, however, necessarily give an accurate and profound view of an individual's overall quality of life.     

The prevalence and severity of disease-related disabilities and their impact on quality of life in neuromuscular diseases

Purpose: People with neuromuscular disease experience lower quality of life levels than people from the general population. We examined the prevalence and severity of a broad range of neuromuscular disease-related disabilities and their impact on health-related quality of life.

Materials and methods: A cross-sectional postal survey study was conducted among patients diagnosed with neuromuscular disease. Patients completed the Neuromuscular Disease Impact Profile, a disease-related disability impact questionnaire, and two generic health-related quality of life questionnaires: the medical outcome study Short Form Questionnaire and the World Health Organization Quality of Life-bref. The impact of disabilities on quality of life was estimated using multiple regression analyses.

Results: Six hundred sixty two patients (68% response rate) completed the questionnaires. There were no differences in quality of life between diagnosis-based subgroups. ‘Impairments in muscle functions’ had the highest prevalence and severity scores in the total sample and diagnosis-based subgroups. Neuromuscular disease-related disabilities showed strong and independent associations with all aspects of health-related quality of life. ‘Impairments in mental functions and pain’ was the most important predictor of health-related quality of life followed by ‘restrictions in participation in life situations’.

Conclusions: Although ‘impairment in muscle functions’ is the most prevalent and severe disability, the ‘impairments in mental functions and pain’ have a strong association with health-related quality of life in patients with a neuromuscular disease.

• Implications for rehabilitation

• Disease-related disabilities have a strong and independent associations with all aspects of health-related quality of life.

• Although health-related domains of quality of life are affected by the neuromuscular disease, the general quality of life is quite good.

• The most prevalent and severe disability in total group and diagnosis-based subgroups is ‘impairments in muscle functions’.

• The most significant predictor in health-related quality of life is ‘impairments in mental functions and pain’.