腮腺复发性多形性腺瘤的临床分析--附22例报告

目的：探讨腮腺多形性腺瘤复发、恶变的原因及临床治疗方法。方法：对22例腮腺多形性腺瘤复发患者进行回顾性分析和追踪调查。结果：多数腮腺多形性腺瘤复发病例肿块呈多灶性（18／22），手术越简单其复发率越高，复发间期越短（P＜0．05）。22人中有7例发生恶变，占31．8％，恶变与初发年龄较大有关（P＜0．05），与手术次数关系不大。末次手术分别采用浅叶切除术，腮腺全切术、扩大切除术，对7例有恶变者于术后辅以放射治疗。术后平均追踪54月，除1例多形性腺瘤恶变者于术后30月时肿瘤复发外，其余均未见复发。结论：不恰当的手术方式是导致腮腺性多形性腺瘤复发的直接原因。     

34例腮腺多原发性肿瘤临床分析

目的探讨腮腺多原发肿瘤临床特点、病理类型、治疗方法及生存现状。方法回顾分析34例腮腺多原发肿瘤临床资料,分析肿瘤病理类型、患者性别、年龄、生活习惯、治疗方案等。结果腮腺多原发肿瘤中沃辛瘤占79%(27例),多形性腺瘤占24%(8例)。单侧22例,双侧12例,同时性肿瘤28例,异时性肿瘤6例,男女比例为2.4∶1,年龄25~81岁,平均年龄58岁,27例嗜好吸烟。85%采用保留面神经的瘤体及腮腺浅叶切除术。结论腮腺多原发性肿瘤大多数为沃辛瘤,其次为多形性腺瘤,男性好发,吸烟是该病重要致病因素之一,保留面神经的瘤体及腮腺浅叶切除术是一种较好的治疗方式。     

CD44v6在腮腺多形性腺瘤中的表达

初步研究CD44v6在腮腺多形性腺瘤中的表达情况及其与肿瘤复发的关系.采用免疫组织化学SP法对初次手术后复发,又再次入院行复发灶切除术的多形性腺瘤病例10 例2 次术后石蜡标本及10 例正常腮腺组织石蜡标本进行CD44v6检测,分析其与腮腺多形性腺瘤复发关系.结果表明CD44v6在肿瘤组织中的表达高于正常腮腺组织,在复发多形性腺瘤中呈现低表达.CD44v6的表达变异可能与腮腺多形性腺瘤的复发有关.     

腮腺多形性腺瘤并腺体区域性切除边界的界定

目的:观察腮腺多形性腺瘤手术标本,为腮腺多形性腺瘤并腺体区域性切除提供病理学与免疫组织化学依据.方法:通过对80例原发腮腺多形性腺瘤进行连续病理切片的观察,重点观察和测量腺瘤包膜外浸润、出芽生长情况,并比较距瘤体外0.5～1.0 mm腮腺组织与瘤体及正常腮腺组织增殖细胞核抗原(Proliferating Cell Nuclear Antigen,PCNA)的表达.结果:①包膜外浸润及出芽生长的具体扩展范围为:0.113～0.221 mm.②距瘤体外0.5～1.0 mm腮腺组织与瘤体PCNA的阳性表达有显著差异,与正常腮腺组织无显著差异.结论:腮腺多形性腺瘤区域性切除,可以达到腺叶全切术的相同疗效.     

Cyclin D1在腮腺多形性腺瘤及瘤旁涎腺组织中的表达

目的:检测Cyclin D1在腮腺多形性腺瘤及瘤旁涎腺组织中mRNA和蛋白水平的表达,探讨其在腮腺多形性腺瘤发生发展中的作用。方法:分别通过RT-PCR和Western blot方法检测Cyclin D1在原发腮腺多形性腺瘤与瘤旁涎腺组织中mRNA和蛋白水平的表达情况;另外采用免疫组化法检测Cyclin D1在原发腮腺多形性腺瘤以及瘤旁涎腺组织石蜡组织标本中蛋白水平的表达情况。结果:RT-PCR和Western blot检测结果显示,CyclinD1在组织标本中mRNA和蛋白水平不仅在于肿瘤组织中有较强的表达,而且瘤旁涎腺组织中Cyclin D1也有一定量的表达。免疫组化检测结果显示,Cyclin D1在腮腺多形性腺瘤组织中有较高的表达,而在瘤旁涎腺组织中未见明显表达。结论:Cyclin D1可能参与腮腺多形性腺瘤的发生发展,有助于为临床诊断治疗提供一定的参考依据。     

人腮腺多形性腺瘤细胞的体外培养

目的:建立人腮腺多形性腺瘤有限细胞系.方法:取腮腺多形性腺瘤患者原发肿瘤进行原代培养.观察细胞的形态特征,绘制细胞生长曲线,采用免疫细胞化学检测细胞内特异性抗原标志物,对细胞进行鉴定.结果:多形性腺瘤细胞体外培养时间约为80d,传代至16代,细胞呈短梭形、多边形,肿瘤性腺上皮细胞角蛋白弱阳性,肿瘤性肌上皮细胞肌动蛋白阳性、波形蛋白阳性.结论:多形性腺瘤细胞在体外培养连续传代,为永生化腮腺多形性腺瘤细胞系的建立奠定了基础.     

PTEN基因在腮腺多形性腺瘤中的表达及意义

目的:探究PTEN基因在腮腺多形性腺瘤的发生中基因水平上的作用。方法:将手术切除并经病理检查确诊的腮腺多形性腺瘤、腮腺多形性腺瘤瘤旁1cm腺体组织和舌下腺组织(舌下腺结石摘除的腺体)标本各30例,采用免疫组化法分析各组之间PTEN表达水平的差异性。结果:PTEN在腮腺多形性腺瘤中表达的阳性率低于腮腺多形性腺瘤瘤旁1 cm腺体组织,差异有统计学意义(P<0.05);PTEN在腮腺多形性腺瘤中表达的阳性率低于舌下腺组织,差异有统计学意义(P<0.05);腮腺多形性腺瘤瘤旁1 cm腺体组织与舌下腺组织两组比较,差异无统计学意义(P>0.05)。结论:PTEN基因的阳性表达对腮腺多形性腺瘤的发生有抑制作用。     

腮腺多形性腺瘤术后复发11例临床分析

目的:探讨腮腺多形性腺瘤术后复发的相关因素及临床治疗方法。方法:对11例腮腺多形性腺瘤术后复发病例进行回顾性分析。结果:11例复发病例第2次手术分别采用浅叶切除术、腮腺全切术、扩大切除术。11例中有5例首次术后病理报告为富有细胞型多形性腺瘤,占45.5%;有2例恶变(18%)者术后已辅以放疗。二次手术后随访3～15年,除1例多形性腺瘤恶变者第2次手术后5年复发,其余病例二次术后均未见复发。腮腺多形性腺瘤复发与组织学类型及术式关系密切,富于细胞者易复发,手术越简单其复发率越高。结论:不规范的手术方法是导致腮腺多形性腺瘤复发的直接原因。     

同侧腮腺多形性腺瘤合并淋巴上皮癌1例报告及文献复习

同侧腮腺良、恶性多原发肿瘤极为罕见。本文报告同侧腮腺同时性多形性腺瘤和淋巴上皮癌1例,结合文献回顾,分析腮腺多原发肿瘤临床诊治过程中应注意的问题,并提出病理诊断的必要指征。     

Ki-67在腮腺多形性腺瘤和瘤旁组织中差异表达的研究

目的：通过检测Ki-67在腮腺多形性腺瘤及瘤旁组织（肿瘤外1.0cm）中的差异表达,探讨其作为界定多形性腺瘤安全切除边界指标的可行性。方法：采用Real-time PCR、RT-PCR和Western blot检测Ki-67在原发多形性腺瘤与瘤旁组织中mRNA和蛋白水平的表达情况;采用免疫组化检测原发腮腺多形性腺瘤石蜡组织标本中Ki-67蛋白的表达情况。结果：RT-PCR和Real-time PCR结果显示：Ki-67在瘤旁组织中的表达显著低于肿瘤组织中的表达;免疫组化和Western blot结果显示Ki-67在瘤旁组织中未见明显表达。结论：多形性腺瘤瘤旁组织中Ki-67的表达明显低于肿瘤组织,提示肿瘤外1.0cm为安全切除边界。     

Evidence of the validity of a model of determinants of quality of restorative dental care

A model describing the relationship between self-reported quality of restorative dentistry and dentist characteristics for 119 Montana general dentists is presented. The best predictors formed a significant model explaining 22% of the variance of the quality measure. Results are contrasted with a previous estimation of the model for 102 Washington general practitioners. Evidence for the external validity of the model is presented.     

Experimental evidence of formation of imines in the course of reduction of hydrazones

The reduction of hydrazones is generally suggested to proceed through a reductive cleavage of the nitrogen–nitrogen bond followed by a reduction of the carbon–nitrogen bond. This sequence of reduction processes is here supported for fluorenone (V) and benzophenone (VI) hydrazones as well as by a comparison of the reduction of fluorenone and benzophenone hydrazonium ions (I,III) with corresponding imines (II,IV). Another proof of the presence of imines as intermediates is the splitting of four-electron waves of hydrazones V and VI and hydrazonium ions I and VIII into two waves at pH < 2. This has been interpreted as due to differences in slopes dE_1/2/dpH and pK_a-values of protonated hydrazine derivatives on one side and corresponding imines on the other. In this pH-range imines formed in reductions of VI and VIII are reduced in a single two-electron wave, those of I and V in two one-electron steps. Fluorenone imine (II) is sufficiently stable to allow recording of time-independent current–voltage curves between pH 6 and 11. In this pH-range the imine (II) is reduced in two one-electron steps. Benzophenone imine (IV) has been found stable between pH 4.6 and 12. At pH 4.6–8 the reduction of the imine IV takes place in a single two-electron step, at pH 8–12 in two one-electron steps. Final proof of the initial cleavage of the N–N bond is presented by comparison with the reduction of nitrones.     

不同剂型玻璃离子水门汀溶解性比较研究

目的:研究、比较不同剂型玻璃离子水门汀的溶解性和表面微观形态改变,为临床使用提供依据.方法:将3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)及GC玻璃离子水门汀(双糊剂型)分别在人工唾液中浸泡30 d,冷热循环15000次,烘干测重,比较前后质量变化,计算溶解率,并用扫描电镜观察表面微观改变.结果:不同剂型的玻璃离子水门汀溶解率由高到低分别为3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(双糊剂型).3种玻璃离子水门汀经浸泡溶解后,SEM扫描表面微观形态可观察到GE玻璃离子水门汀(双糊剂型)表面形态改变较少,其他2组玻璃离子水门汀表面微观改变较多.结论:双糊剂型玻璃离子水门汀理化性能及溶解率均低于传统水粉剂型,是未来临床修复治疗的的良好选择.     

Design of clinical trials of traditional therapies of periodontitis

The present paper on the design of clinical trials of periodontal therapy first addresses the issue of the etiology of periodontal disease. It is suggested that most if not all forms of destructive periodontal disease are caused by microorganisms and that there are different forms of disease with different microbial etiologies. The progressive nature of destructive periodontal disease is subsequently discussed and it is emphasized that, in a given patient, periodontal sites which show signs of inflammation and attachment loss may not over a period of several months and years show further sign of attachment loss. The present methods of assessing periodontal disease do not allow us to discriminate between potentially active and inactive sites in untreated patients. The significance and variability of indicators of periodontal disease such as bleeding on probing, probing pocket depth and probing attachment level measurements are discussed. The errors inherent in the various measurements are analyzed and suggestions are presented describing how alterations in any of the above parameters could be identified and presented in a clinical trial. Of concern for the statistical analysis of clinical data of periodontal disease is the definition of the "experimental unit". For a number of years, the "experimental unit" in periodontal trials was the patient. It is clear, however, that different sites within the same individual show different patterns of disease progression and lesion morphology and often respond differently to periodontal therapy. Statistical analyses must consequently be designed which recognize differences in site-to-site infection and lesion morphology within a common host. Until such analyses are available, the investigator should be wary of pooling data within the same individual, since such pooling may obscure meaningful alternatives which may take place in individual periodontal sites. Some goals of periodontal therapy are subsequently identified. 4 goals are discussed more in detail, namely: to establish conditions which will allow the patient to maintain a dentition without further breakdown of the periodontium; to reduce pocket depth to establish an anatomy in the dentogingival region which with proper maintainance care will prevent the re-establishment of the subgingival infection; to gain attachment as a result of treatment; to assess the effect of a certain chemotherapeutic agent on periodontal disease.     

Evaluation of efficacy of chemiluminescence for diagnosis of leukoplakia

ObjectiveLeukoplakia is the most common potentially malignant disorder preceding oral cancer. Chemiluminescence has been developed as an adjunct to conventional examination for the diagnosis of these potentially malignant disorders. This study was conducted to assess the efficacy of chemiluminescence in the diagnosis of leukoplakia and to compare the results with histopathological examination.Study designA total of 50 patients with leukoplakia were included from the outpatients attending the Department of Oral Medicine and Radiology, Dental Hospital, Bengaluru, Karnataka, India. These patients were subjected to conventional oral examination followed by chemiluminescent examination with Vizilite (Zila, Fort Collins, CO, USA) and biopsy for histopathological confirmation.ResultsThe sensitivity, specificity, positive predictive value, and negative predictive value of chemiluminescence were 93.75%, 55.56%, 78.95%, and 83.3%, respectively. The overall accuracy of chemiluminescence was 80%. A statistically significant association was observed between histopathology results and chemiluminescence results.ConclusionAlthough it is an easy, safe, minimal time consuming, and noninvasive technique, it has only adjunctive utility and it does not replace biopsy for the diagnosis of leukoplakia.     

颌骨动静脉畸形的栓塞治疗

目的：总结直接穿刺结合经血管内介入栓塞治疗颌骨动静脉静脉畸形的经验。方法：收治凳骨动静脉畸形患者6例,均进行了介入栓塞治疗。采用的栓塞材料为附凝血棉纤毛的螺圈,聚乙烯醇泡沫微粒和二氰基丙烯酸对丁酯。数字减影颈动脉造影在PHILIPSV300下完成。结果6例颌骨动静脉畸形患者中4,例急性出血得到了快速、有效控制,1例慢性渗血的右下 骨动静脉畸形患者,介入栓塞治疗,拔除松动的右下凳第一磨牙,有效地控制了出血,另1例伴局部软组织搏动性膨隆的上凳骨动静脉畸形患者,介入治疗后膨隆的搏动性得到明显改善,栓塞治疗后分别随访3－24个月,均未发现有口腔内渗血或出血。随访的X线片上,病灶区可见新骨形成。结论：局部穿刺结合经血管内介入栓塞治疗颌骨动静畸形是一种安全、有效的治疗方法。     

正畸患者切牙影像失真发生情况分析

目的研究正畸患者曲面体层片上的切牙影像失真发生情况，并分析其原因。 方法从中山大学附属口腔医院放射科影像数据库中选取500例正畸患者的曲面体层片和头影测量侧位片，所有曲面体层片均采用咬合杆投照，分别从切牙牙体影像放大、缩小、牙根变短、根尖模糊等评价指标分析上下颌切牙影像失真的发生情况，在头影测量侧位片上测量中切牙根尖-对颌切牙切缘的距离，探讨切牙影像失真发生的原因。采用SPSS 19.0统计软件对所得数据进行统计学检验。 结果500例患者中，切牙牙体影像正常者共417例，切牙牙体影像失真者共83例，影像失真发生率16.6%，其中切牙牙体影像放大17例、牙体影像缩小0例、牙根变短30例，牙根影像变短伴模糊36例。影像失真患者的根尖-切缘距离大于影像正常的患者，差异有统计学意义（F = 5 187.18，P = 0）；影像失真患者的覆盖值大于影像正常的患者，差异有统计学意义（F>477，P = 0）。 结论严重牙颌面畸形如反 、深覆盖是导致曲面体层片的切牙影像失真的主要原因之一。     

正常青年Monson球面半径的测量研究

目的测量正常青年Monson球面半径。方法选择60名(男30名,女30名)正常青年制取全口印模,应用立体摄影成像的原理与方法对Monson球面半径进行测量和统计学处理。结果Monson球面的半径平均为10.173 cm,大于理论值10.160 cm,差异有显著性(P<0.01);男、女性球面半径差异无显著性。结论本实验所得到的数据可作为全口义齿修复中记录颌位关系的一个参量。     

鼻测量法的进展

唇裂术后继发畸形是指唇裂修复术后,仍遗留或继发于手术操作和生长发育变化而表现出来的一类畸形[1]。包括唇畸形、鼻畸形和颌骨畸形。其修复较原发性唇裂修复更复杂,更灵活多变。而导致其修复复杂性的一个重要原因即是局部组织结构复杂变异和缺乏可靠的三维测量手段[2],鼻畸形