口腔癌的诊断

口腔癌于早期发现可治性高,当癌瘤增大侵及邻近结构,而尤其转移到颈淋巴结时治愈机会减少。每个医生,应当熟悉检查口腔的方法和良性及恶性肿瘤在口腔中的表现。口腔癌的确诊靠细胞学的检查或活检术。症状学:很多口腔癌在早期没有症状,一个机警的患者可能首先注意到口里一个白斑,一个疮或一个肿块,凡此,医生应进行仔细检查。口腔癌的早期症状很少有疼痛,当     

代谢组学在口腔癌及口腔癌前病变标志物研究中的应用

口腔癌是最常见的头颈部恶性肿瘤,可由口腔白斑等口腔癌前病变发展而来。因为缺少早期筛查及检测的肿瘤生物标记物,50%以上的口腔癌患者在晚期阶段才能得到确诊,发现可用于口腔癌早期诊断的肿瘤标志物正成为研究热点。基于代谢组学技术的分析方法具有发现肿瘤相关标志物的潜能,越来越多的用于重大疾病的风险预评估及早期诊断等方面的研究。该文对代谢组学的理论基础、检测技术及其在口腔癌和癌前病变标志物研究中的应用作一综述。     

口腔癌淋巴结转移的早期诊断新进展

对口腔癌早期颈淋巴转移进行准确诊断将有助于提高诊断的准确率,提高患者的生存质量.随着癌症发病机制研究的不断深入及分子生物学技术的飞速发展,人们开始尝试从基因水平上预测口腔癌早期的淋巴转移.本文从临床检查、影像学检查、前哨淋巴结病理检测和基因蛋白分子检测及联合应用等方面对近几年来口腔癌早期淋巴转移的诊断方法做一综述.     

刷拭活检在口腔癌筛查中的应用

无论在发达国家还是发展中国家，口腔癌的发病率都较高，而且口腔癌的死亡率是全球关注的问题。大多数口腔癌在晚期才被发现，需要复杂的，昂贵的治疗。早期发现和诊断口腔癌及其癌前病变可以明显降低口腔癌的发病率和死亡率。刷拭活检（brush biopsy）是在所检查部位用小刷子对有疑问的组织或损害擦拭以获得细胞或组织进行活检的一种方法。刷拭活检广泛应用于肺癌、食管癌、胰腺癌等癌症的早期发现和诊断。     

蛋白质组学在口腔磷癌研究中的应用进展

蛋白质是生命活动的基本单位,利用蛋白质组学研究方法从总体上对蛋白质组进行分析,可以为口腔癌的早期诊断及早期治疗提供重要的信息。蛋白质组学是近年来发展的一种研究方法,具有高通量、重复性好、灵敏度高等优点,已广泛应用于生命科学领域,在口腔癌中的应用也越来越多,本文对蛋白质组学在口腔癌研究中的应用进行综述。     

早期口腔癌检查及诊断方法的研究进展

过去几十年,口腔癌的治疗方法取得了很大进步,但中晚期口腔癌的预后并未碍到明显改善,早期诊断、早期治疗仍然是提高治愈率的关键措施.早期确诊的主要方法是切取活检,但该方法有创,且异常增生与早期口腔癌的区分过于依赖病理医师的临床经验.为诊断口腔异常增生和早期口腔癌,迫切需要可在门诊条件下操作简便、实用且无创的诊断工具.目前发展迅速的早期口腔癌检测方法包括光学系统检查、活组织染色、唾液检测、刷取活检、DNA分析等.本文对这些方法诊断口腔鳞癌及癌前病损的价值进行回顾与评价.     

脱落细胞用于口腔癌变早期诊断的研究进展

口腔癌具有高复发和易转移等特点,临床亟待一种非损伤性的用于口腔癌前病变和口腔癌早期诊断与筛查的有效技术.口腔脱落细胞技术作为一种方便快速和非损伤的检测方法,被广泛用于口腔癌前病变和口腔癌的早期筛查、风险评估、分子标志物检测等研究中.本文就口腔脱落细胞的采集技术、口腔脱落细胞的分析以及存在问题与展望等作一综述.     

口腔癌患者外周血肝细胞生长因子、乳酸及淋巴细胞计数的检测

目的 探讨外周血肝细胞生长因子(HGF)、乳酸(LA)和淋巴细胞计数水平在口腔癌发生及发展中的参考意义.方法 选取北京口腔医院口腔癌住院患者55例作为实验组,健康陪护家属77例作为对照组.检测实验组与对照组、口腔癌早期与晚期患者外周血HGF、LA水平及淋巴细胞计数差异.结果 实验组外周血HGF、LA水平显著高于对照组(P<0.01),淋巴细胞计数水平显著低于对照组(P<0.01);晚期口腔癌患者外周血HGF、LA水平显著高于早期患者(P<0.01),淋巴细胞计数水平在早、晚期口腔癌中无显著性差异(P>0.05).HGF与LA水平显著正相关.结论 口腔癌患者外周血HGF和LA水平显著升高,与口腔癌的发生及发展相关,是潜在的口腔癌早期诊断和病情进展的判断指标.     

口腔癌的预防

口腔癌是头颈部较常见的恶性肿瘤之一,其发生与多种内、外因素有关,包括吸烟、饮酒、病毒感染、营养不良、饮食习惯和局部刺激等,其中尤以吸烟、饮酒的危险性最大。尽管采用手术、放疗、化疗、生物治疗等治疗口腔癌取得了长足进展,但口腔癌的5年生存率仍然徘徊在64%左右,晚期患者的预后更差。因此,要提高口腔癌患者的生存率和生存质量,必须坚定不移地贯彻执行＂预防为主＂的卫生工作方针,力争做到早期发现、早期诊断和早期治疗。作者就目前口腔癌三级预防的相关问题进行了讨论。     

口腔癌和癌前病变临床检测的现状

口腔癌是世界上第六位常见肿瘤,尽管近年对口腔癌的外科手术、放疗及化疗技术在不断进步,但患者的5年存活率仍然不到50%。因此如何争取早期发现口腔癌变的蛛丝马迹就成为众多学者研究的热点。本文就口腔癌和癌前病变临床检测的现状作一综述。     

柠檬精油对牙周致病菌抑制作用及其安全性初步研究

目的:探讨柠檬精油对牙周致病菌的体外抗菌活性及对细胞增殖的影响。方法:采用微量液体稀释法测定柠檬精油对Pg、Fn、Aa、Pi的最小抑菌浓度(minimal inhibitory concentration,MIC)及最小杀菌浓度(minimum bactericidal concentration,MBC);以较低浓度的MIC为标准稀释LEO作为实验组,采用MTT法测定柠檬精油对HUVECs的毒性作用,明确抑菌浓度下LEO的安全性。结果:柠檬精油对牙周主要致病菌均有抑菌作用,Pg、Fn、Aa、Pi的MIC分别是9.0 g/L、4.5 g/L、4.5 g/L、9.0 g/L,Aa、Fn的 MBC是9.0 g/L,Pg、Pi的MBC未测得。1/2MIC、1/20MIC浓度的LEO能够抑制人脐静脉内皮细胞的生长,而低于1/200MIC浓度的LEO则对人脐静脉内皮细胞的生长没有影响,其中1/200MIC浓度的LEO作用明显优于0.02%的CHX。结论:体外环境中,柠檬精油对牙周致病菌Pg、Fn、Aa、Pi具有抗菌活性,低浓度应用对机体相对安全。     

Oral cancer: molecular technologies for risk assessment and diagnosis

Purpose: The effective biomarkers related to diagnosis, metastasis, drug resistance and irradiation sensitivity of oral cancers will help the pathologist and oncologist to determine the molecular taxonomy diagnosis and design the individualization treatment for the patients with oral cancers.     

Stimulated whole saliva components in children with Down syndrome

The authors report on the components of stimulated whole saliva from children with Down syndrome—including pH, flow rate, sialic acid and protein concentrations, and amylase and peroxidase activity. Saliva samples were collected from 35 children aged 6–10 years. Of the participants, 17 had Down syndrome and 18 did not. To stimulate saliva production, the children chewed a piece of parafilm for 10 minutes before the sample was collected. Soon after collecting the saliva sample, the authors measured pH using a portable pH-meter. Sialic acid levels were determined with a thiobarbituric acid assay. Protein content was determined with Folin's phenol reagent. Amylase was assayed and the authors measured the maltose produced by the breakdown of starch and peroxidase using ortho-dianisidine.
No statistically significant difference was observed in levels of sialic acid (free and total) between the two groups. Protein concentration was about 36% higher in the group with Down syndrome. However, the salivary flow rate, pH, and amylase and peroxidase activities were lower among the children with Down syndrome.     

Computer-assisted planning for maxillofacial prosthodontic rehabilitation

Computerized tomography (CT) planning and the use of CT derived surgical templates for implant placement have shown promise for restoring function within months after surgical reconstruction of acquired post-oncologic defects.     

牙髓再生的研究现状

目前,根管治疗术在临床上已得到了广泛的应用并成功的保存了患牙,但其仍有许多术后并发症。随着组织工程技术在口腔领域的应用,构建一种组织工程化牙髓进行牙髓-牙本质复合体的再生治疗成为可能。近年来国内外已有很多关于牙髓再生的研究,并且已经取得了一定成果。本文将对目前国内外牙髓再生的研究进展现状作一综述。     

Effect of Pingyangmycin on human venous malformation endothelial cells

Purpose: Venous malformations are common vascular anomalies with a propensity of the head and neck. Intralesional injection of Pingyangmycin (PYM, bleomycin A5 hydrochloride) is a widely used sclerotherapy method for the treatment of venous malformation.     

Oropharyngeal dysphagia in amyotrophic lateral sclerosis alters quality of life

Dysphagia is one of the most important complications encountered in amyotrophic lateral sclerosis (ALS). Our aim was to determine whether oropharyngeal dysphagia impacted the quality of life (QoL) of patients with ALS. Thirty consecutive patients were recruited (31–82 years, 18 men). Swallowing function was evaluated using a standardised videofluoroscopic barium swallow. All the patients completed a specific questionnaire on quality of life in dysphagia (SWAL‐QoL) immediately after the videofluoroscopy. The results of dysphagia outcome severity scale separated 14 patients with oropharyngeal dysphagia and 16 with normal swallowing function. There was no difference in the average age, weight and body mass index of the two groups (dysphagic patients: 68 ± 11 kg versus non‐dysphagic patients: 69 ± 14 kg). Most of the dysphagic patients had a bulbar affection based on their Norris scores which determine the importance of cranial nerves illness (20 ± 8), significantly lower than those of the non‐dysphagic patients (35 ± 5) (P < 0·0001). There was no difference in the neurological peripheral symptoms evaluated by Amyotrophic Lateral Sclerosis Functional Rating Scale scores (dysphagic patients: 26 ± 7 versus non‐dysphagic patients: 27 ± 8) (ns). The swallowing quality of life questionnaire revealed that the dysphagic patients had significant burden (P < 0·001). They were affected by the necessity to applied a food selection (P < 0·01), by the increase in eating duration (P < 0·05) and described a decrease in eating desire (P < 0·05). They complained of fear regarding the risk of dysphagia (P < 0·05). They also described difficulties with oral communication (P < 0·001). All of those complained about dysphagia which impacted directly mental health (P < 0·05) and social life (P < 0·05). In conclusion, oropharyngeal dysphagia is a common symptom accompanying ALS, which alters the patient's QoL, especially social health.     

拔牙位点保存用复合温敏凝胶的构建及体外表征

目的:制备多壁碳纳米管/羟基磷灰石/壳聚糖复合温敏凝胶,探讨其作为拔牙位点保存材料的理化性能。方法:采用原位沉积方法制备多壁碳纳米管/羟基磷灰石(MWNT/ HA简称HAC)复合无机材料,将其分散至壳聚糖温敏凝胶中,制备壳聚糖/多壁碳纳米管/羟基磷灰石(CS /MWNT/HA简称CS/HAC)复合温敏凝胶,以成胶时间、孔径、孔隙率、机械强度及降解性能为指标优化配方设计,并表征复合温敏凝胶的微观形貌及理化性能。结果:以10 g/L的HAC作为补强成分加入到壳聚糖溶液中,能够在不影响成胶并保证一定孔隙率(84%)的前提下,提高材料的机械性能(抗压强度0.441 MPa),所获复合温敏凝胶具有适宜的临床操作时间(12 min),并具有可控的降解速率。结论:负载HAC的复合温敏凝胶具有良好的成型性,并具有较好的机械性能,在拔牙位点保存领域具有良好的应用前景。     

Interventional neuroradiologic procedures in the head and neck

Interventional radiology and interventional neuroradiology are evolving specialties which can aid the head and neck surgeons in the clinical management of patients with complex vascular lesions.