Protective Role of Withaferin-A on Red Blood Cell Integrity During 7,12-Dimethylbenz[a]anthracene Induced Oral Carcinogenesis

The aim of the present study was to investigate the protective effect of Withaferin-A on red blood cell integrity during 7,12-dimethylbenz[a]anthracene (DMBA) induced oral carcinogenesis. The protective effect of Withaferin-A was assessed by measuring the status of glycoconjugates, membrane bound enzyme activity and red blood cell osmotic fragility. Oral squamous cell carcinoma was induced in the buccal pouch of Syrian golden hamsters by painting with 0.5% DMBA in liquid paraffin thrice a week for 14 weeks. The levels of glycoconjugates, membrane bound enzyme activity, osmotic fragility and thiobarbituric acid reactive substances (TBARS) were analyzed by using specific colorimetric methods. We observed 100% tumor formation in DMBA painted hamsters. Increase in plasma glycoconjugates at the expense of red blood cell membrane glycoconjugates levels were observed in DMBA painted hamsters as compared to control hamsters. Erythrocytes from DMBA painted hamsters were more fragile than those from control hamsters. The activity of membrane bound enzyme (Na⁺ K⁺ ATPase) decreased whereas TBARS level was increased in DMBA painted hamsters as compared to control hamsters. Oral administration of Withaferin-A at a dose of 20mg kg⁻¹ bw significantly prevented the tumor formation as well as normalized the biochemical variables in DMBA painted hamsters. Our results thus demonstrate the protective effect of Withaferin-A on red blood cell integrity during DMBA induced oral carcinogenesis.     

甘草油口腔干预护理预防危重患者口腔感染的效果观察

目的 探讨甘草油口腔干预护理预防危重患者口腔感染的效果。方法 选取2015年1月~2017年12月在我院住院的危重患者96例,随机分为甘草油护理组和常规护理组,各48例。常规护理组采用生理盐水擦拭、漱口;甘草油护理组采用甘草油涂于口腔内。比较两组患者口腔异味、真菌感染、退苔例数及牙周健康状况,观察两组患者干预前后口腔pH值、口腔评分。结果 甘草油护理组发生异味、真菌感染例数少于常规护理组,退苔例数多于常规护理组,差异有统计学意义（P＜0.05）;甘草油护理组菌斑指数、牙龈指数为（1.27±0.34）、（1.14±0.21）,低于常规护理组的（2.93±0.42）、（2.26±0.37）,差异有统计学意义（P＜0.05）;甘草油护理组口腔pH值、口腔评分为（7.01±0.43）、（10.02±2.01）分,高于于常规护理组的（6.37±0.36）、（6.85±2.61）分,差异有统计学意义（P＜0.05）。结论 应用甘草油对危重患者进行口腔护理,可有效维护患者口腔健康,降低口腔感染、异味发生率,改善患者牙周健康状况,值得临床应用。     

山楂代用茶对大鼠经口急性毒性实验

目的 通过大鼠经口急性毒性动物实验评价山楂代用茶的安全性。方法 选择20只SD大鼠,随机分为实验组和对照组,各10只（雌雄各半）,实验组给予山楂代用茶最大浓度0.3 g/ml、3 ml/只、2次/d灌胃,对照组给予生理盐水3 ml/只、2次/d灌胃,连续观察7 d。比较两组大鼠一般情况、有无死亡、血液生化、脏器系数及病理组织。结果 ①一般情况:两组大鼠排尿、粪便、活动度均正常,两组第1、3、5、7 天进食量及体重比较,差异均无统计学意义（P＞0.05）;②两组均无大鼠死亡;③血液生化指标:两组ALT、AST、AST/ALT、TP、ALB、GLO、TBIL、ALP、Urea、UA及Crea比较,差异均无统计学意义（P＞0.05）;④大体解剖:解剖后肉眼观察到两组心、肝、肾、肺体积、颜色、质地均无异常。脏器系数结果显示,两组雌性、雄性大鼠心、肝、脾、肺、肾系数比较,差异均无统计学意义（P＞0.05）,且皆符合相应月龄大鼠的脏器系数;⑤病理观察:两组肝脏均正常,仅见肝细胞中央汇管区有少量的炎细胞浸润;两组肾小管结构正常,皮髓质分界清,肾小管上皮、淋巴细胞未见病理性改变。结论 山楂代用茶对大鼠的日累积剂量为临床成人（按 60 kg计算）拟推荐日用剂量的108倍,在此剂量下大鼠一般情况、血液生化指标、肝脏、肾脏的病理组织均无毒性反应,提示山楂代用茶对小鼠无急性毒性作用。     

氨磷汀联合精准护理治疗口腔癌放疗的临床效果

目的 探讨氨磷汀联合精准护理治疗口腔癌放疗的效果。方法 选择2015年1月~2017年12月我院收治的口腔癌根治性放化疗患者104例,随机分为观察组（n=43）和对照组（n=52）,两组患者均实施精准护理,观察组配合使用氨磷汀,对照组未使用。比较两组患者放射性口腔黏膜炎发生情况及氨磷汀的消化道反应情况。结果 观察组Ⅳ度放射性黏膜炎5例,愈合时间中位数为28 d,对照组Ⅳ度放射性黏膜炎12例,愈合时间中位数为35 d。观察组出现Ⅳ度黏膜炎比例更低,且愈合时间更快,差异均有统计学意义（P＜0.05）;观察组Ⅰ度消化道反应19例（44.19%）、Ⅱ度消化道反应10例（23.26%）,对照组Ⅰ度消化道反应20例（38.46%）、Ⅱ度消化道反应11例（21.15%）,两组均无Ⅳ度消化道反应出现,观察组Ⅰ~Ⅱ度消化道反应发生率高于对照组,但差异无统计学意义（P＞0.05）。结论 采用氨磷汀治疗口腔癌放疗患者的同时配合精准护理,降低了放射性口腔黏膜炎的发生率,缩短愈合时间,同时氨磷汀的消化道反应未影响患者的生活质量。     

尼妥珠单抗联合化疗药物对人结肠癌细胞株LoVo的实验研究

目的探讨表皮生长因子受体（EGFR）的单克隆抗体尼妥珠单（nimotuzumab，h-R3）与化疗药物联合对结肠癌细胞株kvo的作用，初步探讨其可能的作用机制。方法采用MTT法测定不同药物单药、两药联合分别对结肠癌细胞株LoVo的IC50值；计算不同药物联合的q值，以确定药物联合的作用；流式细胞仪检测不同药物单药或者联合对细胞周期分布及凋亡比例的影响。结果联合h-R3能显著提高伊立替康对LoVo细胞的细胞抑制率，诱导更多肿瘤细胞发生凋亡以及产生G0／G1期、G2／M期阻滞，与5-氟尿嘧啶联合具有类似的作用，但较伊立替康不明显，而与奥沙利铂联合无明显增效作用。结论h-R3通过协同或相加作用提高伊立替康、氟尿嘧啶的细胞杀伤作用．其机制与促进细胞凋亡和影响细胞周期分布有关，奥沙利铂联合对LoVo细胞无明显增效作用。为进一步的体内及体外实验提供了一定的指导作用。     

铜,锰对二乙基亚硝胺诱发大鼠肿瘤的影响

本文报告了微量元素铜、锰对二乙基亚硝胺(DEN)诱发大鼠肿瘤作用的影响。实验结果表明:铜、标对DEN的致肝肿瘤效应有抑制作用。两者合用时,抑制作用更为明显(P<0.05);但在肺脏,铜、锰分别或共同与DEN作用,可诱发大鼠肺癌,且合用组的肺癌发生率更高(P<0.01)。本实验结果提示:铜、锰对DEN诱发肿瘤效应确有影响。     

硒对大鼠胃癌形成的作用及其与5-HT的关系

目的　探讨硒对MNNG(N甲基 N 硝基 N亚硝胍)诱导Wistar大鼠胃癌形成的作用及其与5 羟 色胺(5 HT)的关系。方法　用MNNG(20mg·kg-1)给大鼠灌胃,以诱导大鼠胃癌模型形成。用HE染色、显 微镜观察和AB PAS反应方法比较硒在MNNG诱导Wistar大鼠胃癌形成过程中的作用,用免疫组织化学SP 法和显微图像分析胃粘膜5 HT细胞的变化。结果　饮水中补充2mg·L-1和4mg·L-1的亚硒酸钠可以加 重胃粘膜的糜烂、出血,促进胃粘膜的肠上皮化生;在MNNG诱癌过程中发生了浆膜下平滑肌瘤,且亚硒酸钠 可以增加平滑肌瘤的发生率(P<0.05)。5 HT内分泌细胞的面数密度(NA)实验各组之间无显著差异,但是 低硒组平均光密度(MOD)明显高于正常对照组(P<0.01)。结论　在MNNG所致胃癌形成过程中亚硒酸钠 并不能降低大鼠胃癌的发生,其机制可能与胃粘膜5 HT的分泌成正相关。     

综合护理干预对牙科焦虑患者口腔修复效果的影响研究

目的 探讨综合护理干预在牙科焦虑患者口腔修复过程中的应用效果。方法 将2014年12月~2016年12月我院修复门诊收治的60例牙科焦虑症患者作为研究对象,按就诊时间先后分组,每组30例。对照组给予常规口腔修复护理;干预组在常规护理基础上给予综合护理干预,采用牙科焦虑量表、牙科畏惧量表、自设满意度问卷及初次治疗后1年内的返工人次评价两组患者治疗前后的焦虑情况、护理满意程度及修复效果。结果 ①两组患者在治疗前的DAS评分均>13分,符合高度牙科焦虑症。两组治疗前得分对比,差异无统计学意义（P＞0.05）;两组治疗后得分对比,治疗后干预组患者DAS得分低于对照组,差异有统计学意义（P<0.05）;治疗后干预组患者DFS得分与对照组患者得分,差异无统计学意义（P＞0.05）。②干预组患者的满意度得分均高于对照组,其中“治疗体验”方面,干预组高于对照组,差异有统计学意义（P<0.05）。③初次治疗后1年内,干预组30例患者,无返工情况,对照组中有2例因冠脱落与咬合问题返工。结论 对需要口腔修复的牙科焦虑症患者给予心理、环境、用药等多方面护理,能够缓解患者的焦虑、畏惧心理,提升患者的修复效果及护理满意度,值得应用推广。     

微创术不翻瓣技术在口腔种植术中的效果

目的 分析微创术不翻瓣技术在口腔种植术中的临床效果。方法 选择2018年2月~2019年2月在我院进行口腔种植的患者116例,采用随机数字表法分为观察组和对照组,各58例。对照组采用常规翻瓣种植治疗,观察组采用微创术不翻瓣技术治疗,比较两组种植成功率、种植时间、术后疼痛时间、术后肿胀时间、术后牙槽嵴骨吸收量及有效角化黏膜宽度。结果 观察组种植成功率（94.83%）高于对照组（81.03%）,差异有统计学意义（P＜0.05）;观察组种植时间（22.67±2.54）min、术后疼痛时间（23.90±5.78）h、术后肿胀时间（36.24±3.72）h分别短于对照组的（40.22±3.87）min、（54.91±4.32）h、（73.20±5.17）h,差异有统计学意义（P＜0.05）;观察组术后牙槽嵴骨吸收量[（0.15±0.01）mm]少于对照组[（0.20±0.03）mm],有效角化黏膜宽度[（2.87±0.44）mm]宽于对照组[（1.98±0.47）mm],差异均有统计学意义（P＜0.05）。结论 微创术不翻瓣技术在口腔种植术中应用效果理想,可提高种植成功率,缩短种植时间,且术后恢复快,值得借鉴。     

铸瓷贴面和烤瓷全冠在口腔美容修复中的效果比较

目的 对比铸瓷贴面和烤瓷全冠在口腔美容修复中的效果。方法 选取2013年1月~2017年9月于我院治疗的124例有活髓牙牙体缺损患者为主要研究对象,随机进行分组,对照组73例用钴铬烤瓷全冠修复,观察组51例用e-max铸瓷贴面修复,对两组患者满意度,并发症等对比分析。结果 观察组患者的美容满意度为96.08%,对照组患者的满意度为80.82%,两组差异对比,有统计学意义（P＜0.05）;观察组随访期间的并发症发生率为7.84%,对照组的并发症发生率为17.81%,两组差异对比,有统计学意义（P＜0.05）。结论 在口腔美容的修复治疗上,铸瓷贴面的修复效果优于烤瓷全冠,可有效提高牙齿的美观度,且并发症发生率低,长期治疗效果颇为理想。     

Documentation of Ultrastructural Changes in Nucleus and Microvilli by Fish Oil in Experimental Colon Carcinogenesis

Fish oil (FO) exerts a chemopreventive effect by regulating apoptosis in colon carcinogenesis. The present study reports the ultrastructural changes in various organelles on supplementation of FO in experimental colon carcinogenesis. The carcinogen treatment led to abnormal nuclear shape and alteration in microvilli number indicating cancer establishment. On the other hand, different ratios of FO and corn oil increased chromatin condensation along with an extensive loss of microvilli in a dose- and time-dependent manner which depicts an increase in apoptosis. The associated ultrastuctural alterations support the facilitation of apoptosis by FO as a mechanism for its beneficial effect in colon carcinogenesis.     

红细胞在保护剂添加和洗涤时的非平衡渗透响应实验研究

在红细胞低温保存或冻干保存中，高浓度保护剂的添加和洗涤会使细胞体积收缩或膨胀，造成溶血损失，但其体积并非单调收缩或膨胀到最后平衡体积，而是要经历更严重的体积变化后再趋于平衡。本研究以NaCl溶液来模拟保护剂的添加与洗涤过程．将38种不同浓度的NaC;溶液，以一步直接法、4步等体积法或4步等摩尔浓度变化法添加到红细胞中，测定其溶血率。若以溶血率10％为标准，红细胞所能承受的最小渗透压在161mOsmol／k附近，而最大渗透压与溶液添加方式有关，等体积添加法效果较好（其值约为5680mOsmol／kg）。研究中还将12％、18％NaCl溶液以4步等体积法加到红细胞中，再用生理盐水以三种方式洗涤，发现等摩尔浓度变化法洗涤效果最好；洗涤后溶血率大大增加，说明很多细胞虽然在保护剂添加时未溶血，但膜脆性已改变，难以恢复到等渗时体积。     

Assessment of Hepatic Fibrosis Regression by Transient Elastography in Patients with Chronic Hepatitis B Treated with Oral Antiviral Agents

Transient elastography (TE) has been used as a non-invasive method for liver stiffness measurement (LSM) in patients with chronic liver disease. This study was performed to assess the change of LSM by TE and to assess its clinical usefulness during long-term oral antiviral therapy in patients with chronic hepatitis B (CHB). We retrospectively reviewed 83 CHB patients. The mean interval between two LSM was 411.5 ± 149.5 days. Initial and follow-up LSM was 16.15 ± 12.41 kPa and 11.26 ± 7.36 kPa, respectively (P < 0.001). The degree of regression of liver stiffness was -2.03 ± 0.36% per month. The fibrosis stage classified by LSM value improved in 37 (44.6%) patients during oral antiviral therapy. Of the 30 (36.1%) patients with LSM ≥ 14.1 kPa (cirrhosis) at 1st LSM, 12 (40%) proved to no longer have cirrhosis (≥ 1 decrease in fibrosis stage) at 2nd LSM. LSM significantly decreased in both baseline high (> upper limit of normal [ULN] × 2) and low (≤ ULN × 2) alanine aminotransferase groups during antiviral therapy (P < 0.001; P = 0.001, respectively). Long-term oral antiviral therapy resulted in the improvement of liver stiffness in a substantial portion of patients with CHB. TE may be used a useful clinical tool to assess disease progression in CHB patients.

Graphical Abstract

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口服疫苗与肠粘膜免疫效应机制

口服疫苗可有效激发肠粘膜免疫,给药途径简单、安全,且种类繁多,主要包括菌苗、病毒疫苗、蛋白质亚单位疫苗、合成肽疫苗、基因缺失疫苗、DNA疫苗及转基因植物疫苗等,口服疫苗运载体由病毒运载体、细菌运载体和微粒子运载体组成,口服疫苗佐剂在粘膜免疫中发挥重要作用。口服疫苗首先要克服的障碍就是口服无反应性,口服疫苗产生的免疫力可以通过共同膜机制遍布全身膜系统,可明显刺激全身性的细胞免疫和体液免疫应答。     

Safety and Efficacy of Oral Transmucosal Fentanyl Citrate Compared to Morphine Sulphate Immediate Release Tablet in Management of Breakthrough Cancer Pain

Aim:

To compare the efficacy and safety of oral transmucosal fentanyl citrate (OTFC) and oral morphine in Indian patients with breakthrough episodes of cancer pain.

Materials and Methods:

In this randomized, open label, active controlled, clinical study, total 186 patients who regularly experienced 1-4 episodes of breakthrough cancer pain (BTCP) daily, over the persistent pain controlled by taking oral morphine 60 mg/day or its equivalent were randomized to receive either OTFC 200 mcg or oral morphine 10 mg for the treatment of BTCP for 3 days. Improvement in pain as determined by numerical rating scale (NRS) at 5, 15, 30, and 60 minutes of drug administration and percentage of BTCP episodes showing reduction in pain intensity by >33% at 15 minutes were primary efficacy endpoints. Secondary efficacy endpoints were requirement for rescue analgesia and global assessment by physician and patient. Data of both treatment groups were analysed by appropriate statistical test using software, STATISTICA, version 11.

Results:

Patients treated with OTFC experienced significantly greater improvement in pain intensity of breakthrough episodes compared to those treated with oral morphine at all assessment time points (P < 0.0001). 56% of breakthrough pain episodes treated with OTFC showed a greater than 33% reduction in pain intensity from baseline at 15 minutes compared to 39% episodes treated with oral morphine (P < 0.0001). Patient''s and physician''s global assessment favoured OTFC than oral morphine (P < 0.0001). Requirement of rescue analgesia in both the study groups was similar (P > 0.05). Both study drugs were well tolerated.

Conclusions:

OTFC was found to provide faster onset of analgesic effect than immediate release oral morphine in management of breakthrough cancer pain.     

接触乙烯类或苯类对孕妇及新生儿姊妹染色单体交换和微核的影响

取因职业而接触乙烯类或苯类的孕妇静脉血和他们新生儿脐带血进行ＳＣＥ和ＭＮ测定。发现接触乙烯类或苯类的母血ＳＣＥ（８．５５±０．８４，９．４４±１．１２）均高于对照组（７．６８±１．４０），他们新生儿脐带血ＳＣＥ（８．９４±１．４３，８．７５±０．８８）也高于对照组（６．７１±１．２７）。接触乙烯类和苯类的母血微核率（０．８３３‰，０．７２７‰），高于对照组（０．２６７‰），他们新生儿脐血微核率（０．７５‰，０．８１８‰）也高于对照组（０．２６７‰）。我们还发现母亲孕期被动吸烟增强了这两类诱变剂对他们后代的遗传毒性。     

Glutathione S-transferase P1 Ile105Val Polymorphism and Oral Cancer Risk: A Meta-Analysis

Objective The glutathione S-transferase P1 (GSTP1) gene has been suggested to play an important role in the pathogenesis of oral cancer. However, the results have been inconsistent. In this study, we performed a meta-analysis to clarify the association of GSTP1 Ile105Val polymorphisms with oral cancer risk.Methods Published literature from PubMed and EMBASE were retrieved. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated using fixed- or random-effects model.Results 13 studies (1803 oral cancer cases and 2998 controls) for GSTP1 Ile105Val polymorphism were included in the meta-analysis. The results indicated that there was no significant association between GSTP1 Ile105Val polymorphism and oral cancer in the overall population (OR=1.30, 95%CI=0.92-1.38, I²=48.0%, p for heterogeneity=0.027). Further subgroup analysis by ethnicity suggested that GSTP1 Ile105Val polymorphism was significantly associated with oral cancer only in East Asians (OR=1.64, 95%CI=1.16-2.31, I²=0.0%, p for heterogeneity=0.525), but not in Caucasians (OR=1.16, 95%CI=0.73-1.82, I²=7.5%, p for heterogeneity=0.299), Africans (OR=1.10, 95%CI=0.37-3.28), South Asians (OR=1.20, 95%CI=0.69-2.08, I²=74.3%, p for heterogeneity=0.021) and mixed population (OR=0.91, 95%CI=0.70-1.20, I²=39.7%, p for heterogeneity=0.174).Conclusions The present meta-analysis has limited evidence to support the association of GSTP1 Ile105Val polymorphism with HCC risk in the overall population. However, GSTP1 Ile105Val polymorphism might be associated with risk of oral cancer in East Asians.     

灵芝孢子粉对荷HAC肝癌小鼠抗肿瘤的实验性研究

本文通过荧光细胞检测技术、体外细胞毒试验以及肿瘤抑瘤率的测定 ,观察了灵芝孢子粉对荷HAC小鼠T细胞表面分化抗原 ,体外细胞杀伤功能以及肿瘤抑瘤率的影响。结果显示灵芝孢子粉治疗组中总T细胞的百分率 (6 3 4% )高于对照组 (5 6 3% ) ,其中对总T细胞、T辅助细胞的上调较为明显。在对HAC、YAC 1和P815肿瘤细胞的杀伤活性中灵芝孢子粉组的杀伤活性分别为 2 7 3%、 2 3 4%和 2 0 0 % ,高于对照组。灵芝孢子粉组的总抑瘤率为 42 2 %。结果表明灵芝孢子粉是一种能激活和提高特异性 (CTL )和非特异性杀伤细胞 (NK、LAK )的抗肿瘤作用 ,抑制肿瘤细胞的增殖以及调控机体免疫功能的中药。     

甘精胰岛素与格列美脲联合治疗口服降糖药控制不佳 2型糖尿病的疗效

目的 观察甘精胰岛素与格列美脲联合治疗口服降糖药控制不佳2型糖尿病的疗效。方法 选择2018年6月~2019年3月在我院诊治的90例口服降糖药控制不佳2型糖尿病患者作为研究对象,随机分为对照组和观察组,各45例,对照组采用格列美脲治疗,观察组在对照组基础上联合甘精胰岛素治疗,对比两组临床治疗疗效、空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）水平以及低血糖发生情况。结果 治疗后,观察组治疗总有效率（93.33%）与对照组治疗总有效率（91.11%）比较,差异无统计学意义（P＞0.05）。治疗后两组FPG、2hPG、HbA1c水平均较治疗前降低,差异有统计学意义（P＜0.05）;观察组FPG、2hPG与对照组比较,差异无统计学意义（P＞0.05）;观察组HbA1c与对照组比较,差异有统计学意义（P＜0.05）;观察组低血糖发生率（17.78%）低于对照组（35.56%）,差异有统计学意义（P＜0.05）。结论 口服降糖药控制不佳2型糖尿病患者采用甘精胰岛素联合格列美脲治疗疗效理想,且可降低治疗期间低血糖发生率,安全性高,值得临床应用。