2 356名作业人员口腔面部病损检出情况分析

目的 明确职业健康监护中口腔科常规检查方法和内容, 及时发现职业人群的口腔面部病损, 为实施早期干预做参考。
方法 在2017年4月-6月对19家企业和部分事业单位在岗人员共2 356人进行职业健康体检, 采用口腔基本检查方法, 按程序检查口腔不同部位和组织, 以口腔科常见病、系统性疾病的口腔面部病损、职业病危害因素致口腔面部病损为检查重点内容; 结合受检者接触的职业病危害因素, 对结果进行分析。
结果 2 356名受检者中, 自述口腔局部不适52人, 占2.21%;口腔面部单项病损累计达1 213例, 可能与所接触职业病危害因素相关的病损有296例。噪声作业人员牙周结石、牙周炎检出率8.94%, 口腔黏膜溃疡检出率0.99%;粉尘作业人员牙周结石、牙周炎检出率19.10%, 粉尘作业与噪声作业人员牙周结石、牙周炎检出率比较, 差异有统计学意义(P < 0.01)。酸酐、硫酸、三氧化硫作业人员口腔黏膜溃疡检出率12.22%, 高于噪声作业人员检出率(P < 0.01)。接触粉尘作业人员口腔面部病损检出率为18.83%, 接触化学物质作业人员口腔面部病损检出率为14.97%, 两者差异有统计学意义(P < 0.05)。两组人员口腔面部病损检出率均有随工龄增加而增长的趋势(P < 0.05)。
结论 多种职业病危害因素均能影响职业人群口腔组织健康。体检人员检查时应规范化操作, 了解受检者的职业病危害接触史, 综合评价职业相关口腔面部病损, 以提高职业健康监护的质量。
     

SOD酶模型化合物对口腔颊黏膜细胞DNA的影响

目的　探讨超氧化物歧化酶模型化合物 (m odel of superoxide dism utase,MSOD) (Cu2 C2 1 N1 4H2 7Cl1 3)作用于正常口腔颊黏膜细胞的安全剂量范围。方法　用单细胞凝胶电泳法 ,通过观察 Tail Mom ent和Tail DNA %这两项指标的变化情况检测染毒后口腔颊黏膜细胞的 DNA损伤情况。结果　测试结果表明 2 5、5 0、1 0 0μg/ m l MSOD处理组相互之间、与阴性对照组之间均无显著性差异 ,但与阳性对照组之间有极显著性差异。结论　当 MSOD浓度 <1 0 0μg/ ml时 ,没有发现 MSOD对口腔颊黏膜细胞 DNA的明显损伤作用     

老年口腔黏膜病变782例临床病理分析

目的通过对老年人口腔分泌物检查,了解老年黏膜病变的规律及特点,为防治老年口腔疾病的提供参考。方法分析某院2008年6月～2011年6月4250例老年门诊及住院患者口腔黏膜检查报告,其中186例口腔黏膜活检检验报告。结果 4250例老年门诊及住院患者口腔检查及活检情况显示,共检出口腔黏膜病变782例,占18.4%;从病变情况显示,以念珠菌口腔炎为主,占9.69%,其排列顺位依次是念珠菌口腔炎、口腔溃疡、口腔黏膜白斑、口腔黏膜慢性炎症、口腔扁平苔藓、口腔黏膜囊肿、灼口综合症、白色角化病、幽门螺杆菌感染、口腔癌。从各年龄段老年口腔黏膜病变情况显示,口腔黏膜病变与年龄无关,各年龄段发病率差异无统计学意义(P﹥0.05)。吸烟、饮洒患者中口腔黏膜病变发病率明显高于不吸烟、不饮洒患者,且差异有统计学意义(P﹤0.05)。结论老年口腔黏膜病变病理变化复杂多样。在老年人群中发病率高,为减少老年口腔黏膜病变的发病率,应加强口腔健康教育,养成良好的口腔卫生习惯和生活习惯、戒烟、戒酒等可有效预防口腔黏膜病变的发生。     

某新能源材料厂作业人员口腔面部健康状况分析

目的 探讨某新能源材料厂职业病危害因素对作业人员口腔面部健康的影响。方法 以某新能源材料厂436名在岗作业人员为接触组,另外8家企业不接触职业病危害因素的418名行政、后勤人员为对照组,比较两组人员的口腔面部病变检出率和身体其他项目的异常检出率。结果 该新能源材料厂生产过程中存在镍及其化合物、钴及其化合物、硫酸、盐酸、硫化氢等职业病危害因素,各采样点检测值均低于国家职业接触限值。接触组人员口腔面部阳性体征检出率54.36%,对照组人员口腔面部阳性体征检出率12.44%,差异有统计学意义(P <0.01)。接触组面部皮肤、口腔、眼鼻、口咽部以及其他体检指标大多数项目的体检异常率均高于对照组,差异有统计学意义(P <0.05)。接触噪声、镍、钴、硫酸、氢氧化钠、二氧化硫、硫化氢、过氧化氢等多种危害因素的作业人员口腔面部组织异常检出率高于其他作业人员(P <0.05)。随着工龄增长,接触组作业人员口腔面部异常检出率逐渐升高(P <0.05)。结论 新能源材料厂生产过程中存在镍、钴及其化合物等多种职业病危害因素,可对人体口腔面部组织、呼吸系统及身体其他器官组织造成损害。...     

谨防颊黏膜癌

颊(俗称腮帮)黏膜位居口腔之内,是通向呼吸道和消化道的"交通"要道,与外界接触的机会多,容易遭受各种不良因素的侵害,因而发生癌的机会比较多。据统计,约75%以上的口腔癌发生在60岁以上年龄组,而这些老年人中,又以患颊黏膜癌为多见。为什么颊黏膜癌好发于老年人身上?首先,是因为老年人的颊黏膜粗糙、干燥,缺乏弹性,唾液分泌较少,所以经常感到口干,影响到说话和咀嚼食物,以致容易出现"咬腮"———咬伤颊黏膜。而动物实验表明,将两组大鼠同时暴露于致癌物环境中,结果失去分泌唾液功能的一组,比正     

全腭岛状瓣在颊黏膜肿瘤切除后修复中的应用

颊黏膜肿瘤切除后的缺损小面积可直接拉拢缝合，但面积大的缺损往往给修复带来一定的困难。多年来颊黏膜缺损用舌瓣、额瓣和皮片移植修复，但不同程度影响外观、功能或出现术后挛缩、开口受限等无法克服的困难。作者通过12例全腭岛状瓣修复颊黏膜肿瘤切除术缺损，效果较满意。现分析报告如下。     

SOD模拟化合物对人体口腔颊黏膜细胞DNA的损伤作用

目的　探讨 SOD模拟化合物 (m im ics of SOD,MSOD)〔 Mn(EDTB)〕(AC)作为抗癌药物应用于临床的可行性。方法　以人体口腔颊黏膜细胞为材料 ,用彗星实验 ,通过观察尾距和尾部 DNA百分率这两项指标的变化情况检测染毒后口腔颊黏膜细胞 DNA的损伤情况。结果　检测结果表明 2 0、4 0、6 0、80 μg/ m lMSOD处理组与阴性对照组有极显著差异 (P<0 .0 1)。结论　该化合物对人体口腔颊黏膜细胞 DNA有较明显的损伤作用 ,对于它作为新的抗癌药物应用于临床应持慎重态度。     

网吧环境和槟榔致口腔颊黏膜细胞DNA损伤研究

目的 研究网吧环境和槟榔对口腔颊黏膜细胞DNA的损伤。方法 通过系统抽样抽取长沙市岳麓区5家网吧,在网吧内及网吧所在社区通过单纯随机抽样的方法选取无吸烟、饮酒等习惯的18~40岁健康男性,分别作为对照组(n=50)、网吧上网组(n=41)、咀嚼槟榔组(n=47)、网吧上网且咀嚼槟榔组(n=58)。收集受试者口腔颊黏膜细胞标本,采用单细胞凝胶电泳(single cell gel electrophoresis, SCGE)及颊细胞微核试验(buccal micronucleus cytome, BMCyt)检测DNA损伤情况。结果 网吧上网组和咀嚼槟榔组较对照组SCGE尾部DNA百分含量(%Tail DNA)及BMCyt微核频率(‰MN)显著增高(P＜0.05)。网吧上网且咀嚼槟榔组较网吧上网组和咀嚼槟榔组%Tail DNA及‰MN均显著增高(P＜0.05)。DNA损伤程度与网吧上网累积时间和槟榔咀嚼量呈剂量效应关系。结论 网吧环境和槟榔可分别导致口腔颊黏膜细胞DNA损伤,两者同时暴露会进一步增加DNA损伤程度。     

自体口腔颊黏膜修复重度尿道狭窄

前尿道狭窄是膀胱手术后常见的并发症。成都华西医院泌尿外科运用口腔颊黏膜修复重建尿道，成功的为患者解除了前尿道狭窄的痛苦。患者赵某13年前因膀胱结石，行膀胱切开取石并安置临时导尿管后，出现前尿道狭窄。13年来，曾反复多次到医院进行尿道扩张，并3次进行手术修复，始终未见效果，不能自主排尿，因而不得不长期行耻骨上膀胱造瘘带尿管解决排尿问题。不久前，他慕名来泌尿外科的王坤杰副教授检查发现，     

老年2型糖尿病患者口腔黏膜病变及危险因素

目的 了解老年2型糖尿病(T2DM)患者口腔黏膜病变状况及其危险因素,为实施干预提供依据.方法 2011年1月至2012年3月,将纳入某市综合医院门诊的105例老年T2DM患者作为病例组,按照1:1配对的原则,将105例健康老年体检者作为对照组,进行问卷调查,调查内容包括人口学特征、糖尿病史等,并进行口腔黏膜临床检查.结果 病例组有口腔黏膜病变倾向者占86.7％,对照组占l9.0％;病例组患潜在恶性疾病(PMD)者占38.1％,对照组占7.6％;病例组真菌感染者占21.9％,对照组占6.7％;两组上述指标的差异均有统计学意义(x2值分别为18.963、18.976、15.642,P＜0.01).多因素条件logistic回归分析结果显示,T2DM并发症(OR=10.607,95％ CI:5.027～18.796)、吸烟(OR =3.531,95％CI:1.393～8.788)可增加老年T2DM患者口腔黏膜病变的机会.结论 T2DM并发症和吸烟是老年T2DM患者口腔黏膜病变的危险因素,应定期进行临床检查,以确保老年T2DM患者口腔黏膜病变的早期诊断和及时处理.     

Prevalence of oral cancer,oral potentially malignant disorders and other oral mucosal lesions in Cambodia

Objectives: To obtain data on the prevalence of oral mucosal lesions (OMLs) among Cambodians, and to assess the relationship between known risk habits of oral diseases with prevalence of oral potentially malignant disorders (OPMDs).

Design: This was a population-based, cross-sectional study whereby subjects were adults aged 18 years old and above. A workshop on the identification of OML was held to train and calibrate dental officers prior to data collection in the field. Sociodemographic and risk habits data were collected via face-to-face interview, whilst presence of OML and clinical details of lesions such as type and site were collected following clinical oral examination by the examiners. Data analysis was carried out using the Statistical Package for Social Science (SPSS) version 12.0. The association between risk habits and risk of OPMD was explored using logistic regression analysis.

Results: A total of 1634 subjects were recruited. Prevalence of OML for this population was 54.1%. Linea alba was the most common lesion seen (28.7%). This study showed an overall OPMD prevalence of 5.6%. The most common type of OPMD was leukoplakia (64.8%), followed by lichen planus (30.8%). Subjects who only smoked were found to have an increased risk for OPMD of almost four-fold (RR 3.74, 95%CI 1.89–7.41). The highest risk was found for betel quid chewers, where the increased risk observed was more than six times (RR 6.75, 95%CI 3.32–13.72). Alcohol consumption on its own did not seem to confer an increased risk for OPMD, however when practiced concurrently with smoking, a significant risk of more than five times was noted (RR 5.69 95%CI 3.14–10.29).

Conclusion: The prevalence of OML was 54.1%, with linea alba being the most commonly occurring lesion. Smoking, alcohol consumption and betel quid chewing were found to be associated with the prevalence of OPMD, which was 5.6%.     

beta-Carotene and alpha-tocopherol concentration and antioxidant status in buccal mucosal cells and plasma after oral supplementation

The uptake of alpha-tocopherol and beta-carotene and their antioxidative effect in plasma and buccal mucosal cells after oral application in twelve subjects is demonstrated in our study. The effect on the antioxidative status was evaluated using a modified thiobarbituric acid-reactive substance (TBARS) method. As expected, the supplement of 134.2 mg alpha-tocopherol/d and 25 mg beta-carotene/d for 7 d resulted in a significant increase of alpha-tocopherol and beta-carotene concentration in plasma (P<0.05). In buccal mucosal cells, the concentration of beta-carotene increased after supplementation (P<0.05), whereas the concentration of alpha-tocopherol remained constant. A decrease in TBARS (P<0.05) was found in buccal mucosal cells but not in plasma. In conclusion, an uptake of the supplemented antioxidants was detected in plasma and in buccal mucosal cells. There was significant change in beta-carotene concentration and oxidative stress as measured using a modified TBARS test in buccal mucosal cells, but not in the plasma.     

Exhaled carbon monoxide levels correlate with incidence of oral mucosal lesions independent of smoking status

Carbon monoxide (CO) is an important component of tobacco smoke, but also environmental toxicity. This study analyzed possible correlation between exhaled CO level and oral health indicators in two geographically distributed populations during health-promoting public events organized for local communities in cities with high and low environmental pollution in Poland (907 patients). Self-reported, instructor-led, oral health questionnaire was developed to monitor current and previous mucosal lesion incidence. Exhaled CO correlated with subjects smoking status and environmental CO exposure: highest in smoking inhabitants of Krakow (12 ppm), with lower levels in smokers from Kozienice (6.5 ppm) and non-smokers from Krakow (6 ppm), and lowest for Kozienice non-smokers (2 ppm) (p < 0.001). After propensity score matching and adjustment for smoking status, demography and comorbidities odds ratio for mucosal lesion incidence was 1.46 (1.31–1.63), p < 0.001) per 1 ppm increase of exhaled CO level. This result might implicate a possible role of environmental pollution factors in oral health pathology.     

Clinical evaluation of alpha-tocopherol in buccal mucosal cells of children

1. Tocopherol concentrations in plasma, red blood cells (RBCs), and buccal mucosal cells were examined in newborn infants (before feeding), children (2-15 years old), and adults. Tocopherol concentrations in adults and newborn infants showed the greatest difference in plasma and the smallest difference in RBC. Buccal cell tocopherol concentrations in adults were 2.3 times higher than those in infants. The majority of newborn infants had RBC tocopherol levels below the normal limit (115 micrograms/100 ml of packed cells). Also, more than one third of buccal cell tocopherol levels determined in newborn infants were below a level of 15 ng/mg protein, which was determined as the lower limit of normal in healthy children on the basis of the testing of 97 samples. 2. After administration of a daily dose of 600 mg of RRR-alpha-tocopherol for three months to young adults, tocopherol levels in buccal mucosal cells reached a level of more than 4 times the basal level after rising throughout the 3-month period, while levels in RBC and plasma showed less than a 3-fold increase and reached a maximum within one month. Buccal cell tocopherol levels showed a poor correlation to the RBC and plasma tocopherol levels, while the tocopherol/lipid ratio was closely correlated with RBC and plasma tocopherol levels. After a single dose of 600 mg of RRR-alpha-tocopherol, RBC and plasma tocopherol concentrations reached a maximum within 24 hours, while buccal cell tocopherol did so 4 to 6 days later. 3. Very obese children and hyperlipemic obese children showed lower buccal cell tocopherol levels, accompanied by lower RBC tocopherol levels and higher plasma tocopherol levels, when compared with non-obese children and normolipemic obese children.     

Naa10p、TSGF及RUNx2在口腔黏膜癌前病变、口腔鳞癌中的应用

目的分析N端α位乙酰基转移酶10蛋白(Naa10p)、肿瘤特异性生长因子(TSGF)及人侏儒相关转录因子2(RUNx2)联合检测在口腔黏膜癌前病变、口腔鳞癌(OSCC)诊断及鉴别诊断中的应用价值。方法选取2018年4月至2020年4月本院口腔科收治的65例OSCC患者,最终62例满足纳入标准,作为OSCC组。选取同期收治的50例癌前病变(扁平苔藓、白斑、红斑、慢性溃疡长期不愈)患者为癌前病变组,同时选取同期体检的40例健康者为正常对照组。收集所有研究对象临床资料,比较OSCC组、癌前病变组及正常对照组Naa10p、TSGF及RUNx2表达水平差异,分别对比Naa10p、TSGF及RUNx2单独及联合用于诊断OSCC的临床诊断性能(灵敏度、特异性及准确度);比较不同临床分期OSCC患者Naa10p、TSGF及RUNx2表达情况,采用ROC曲线分析Naa10p、TSGF、RUNx2单项及联合检测水平对OSCC的预测价值。结果三组Naa10p、TSGF水平及RUNx2阳性率比较:OSCC组>癌前病变组>正常对照组,差异具有统计学意义(P<0.05)。Naa10p、TSGF及RUNx2联合检测的敏感性、准确性均高于任何单一血清检测,差异有统计学意义(P<0.05)。Ⅲ、Ⅳ期Naa10p、TSGF水平及RUNx2阳性率高于Ⅰ、Ⅱ期患者,差异具有统计学意义(P<0.05)。采用ROC曲线分析Naa10p、TSGF、RUNx2单项及联合检测OSCC的预测价值,Naa10p、TSGF、RUNx2单项及联合检测曲线下面积分别为0.694、0.677、0.830、0.883,各指标曲线下面积以联合检测最大。结论 Naa10p、TSGF及RUNx2表达在OSCC患者显著升高,且与患者临床分期密切相关,联合三者检测可作为预测OSCC发生的有效手段,临床上应重视三者水平的检测,进而改善患者预后。     

Determination of alpha-tocopherol in buccal mucosal cells using an electrochemical detector

Using HPLC with an electrochemical detector, tocopherol concentration in human buccal mucosal cells was determined, and compared with that in plasma, RBCs, and platelets. The values were expressed on the basis of protein concentration. The reproducibility and recovery were enough to be used clinically. In healthy young male adults, tocopherol concentration in buccal cells was 46.4 ng/mg protein, and this increased three fold, after daily administration of 600 mg of d-alpha-tocopherol for one month. Comparison of correlations between all the measurements showed that the highest correlations were between RBC tocopherol level and the tocopherol/lipid ratio in plasma, and between platelet tocopherol level and the tocopherol/lipid ratio. Tocopherol concentration in buccal cells correlated at r = 0.66 (p less than 0.03) with RBC tocopherol, r = 0.65 (p less than 0.03) with the tocopherol/lipid ratio, and r = 0.60 with platelet tocopherol concentration, respectively.