国内复发性口腔溃疡治疗的循证医学分析

目的 分析国内近5年复发性口腔溃疡药物治疗的疗效情况及研究质量。方法 检索中国期刊网全文数据库和中国生物医学数据库，收集发表时间在1999-2003年治疗复发性口腔溃疡疗效观察的中文文献，对符合标准的文献进行META分析和循证医学分析。结果 共检索到281篇文章，符合纳入标准的有18篇，治疗方法共13种，对其中的3篇进行META分析，证明碱性成纤维细胞生长因子治疗组与口服维生索B、C对照组具有显著差异，其95％的可信区间为0．432-0．656。结论 1999-2003年期间国内治疗复发性口腔溃疡的论著数量较多，但高质量研究较少，本研究显示碱性成纤维细胞生长因子局部喷雾剂在缓解疼痛和促进愈合方面疗效确切，值得临床推广使用。     

The porphyromonas gingivalis prtP/kgp homologue exists as two open reading frames in strain 381

P- gingivalis is considered to be a major pathogen of adult periodontitis. Among its cadre of putative virulence factors are hemagglutinins (adhesins) and proteases. We here report the cloning, sequencing and characterization of two genes, designated kgp(381) and hagD. Kgp(381), an open reading frame (ORF) of 1095 bp encoding a 40.1 kda protein, has high homology to the proteolytic domain of cysteine protease/hemagglutinin genes. HagD, an ORF of 4077 bp encoding a 147.1 kda protein, contains one HArep sequence which establishes it as an additional member of the HArep multigene family. Although similar in sequence to kgp and prtP which were identified from strains HG66 and W12, respectively, the kgp(381)-hagD genes have several characteristics which distinguish them from kgp and prtP. Foremost among these is a single base difference which produces a termination codon and an immediate frame shift resulting in two ORFs in strain 381 as compared to one ORF in strains HG66 and W12. In addition, a 172 amino acid sequence near the C-terminal end of hagD has very low identity (20.5–27.8%) to the corresponding region of kgp and prtP. These demonstrate that the homologue of kgp and prtP in strain 381 occurs as two separate genes which may genetically separate the adhesive and enzymatic domains of Kgp and PrtP proteins. Reverse polymerase chain reaction (PCR) analysis indicates that hagD expression is regulated by hemin concentration.     

Carnoy液对金黄地鼠颊囊作用的研究

目的了解Carnoy液对粘膜组织损伤的性质，为其用于临床治疗提供理论依据。方法以金黄地鼠颊囊作为模型，以Carnoy液作为涂布试剂，药液作用时间为4min，于术后不同时期处死动物，切取标本，进行光镜和透射电镜观察。结果Carnoy液可引起颊囊粘膜上皮坏死脱落，溃疡形成，穿透深度约0.3mm。术后第3周坏死区上度重新形成，胶原纤维及成纤维细胞明显增多。结论Carnoy液是一种烧灼性质较强的物质，将其用于上皮性囊肿治疗，可因上皮破坏而治愈囊肿或降低其复发率。     

Metastases to lingual lymph nodes from squamous cell carcinoma of the tongue

The diagnosis of squamous cell carcinoma (SCC) of the tongue metastasising to the lingual lymph nodes is rare. Until now lingual lymph nodes have not been mentioned in any system of lymph node classification. We report a case of SCC of the tongue with metastases to the lymph nodes in the superficial floor of the mouth, and to levels I and II lymph nodes. We provide evidence of the existence of lingual lymph nodes, and validate the practice of removing the lymph node-bearing-tissue of the floor of the mouth during neck dissection in cancers of the oral cavity.     

Heterotrophic ossification on a skin graft in a postburn scar of the chin

Some patients who have heterotrophic ossification (HO) in a postburn scar are occasionally seen in the clinic. The occurrence of HO following hip and abdominal surgery is common in males, whereas females are frequently affected following burns. The HO of skin grafts in burn scars of the superior body parts is uncommon, especially on the face. We report a recent case of a male patient in whom HO arose on skin grafts on his chin. The patient presented with a history of a painless chin mass for 48 years. Computed tomography scan suggested that the mass was located within subcutaneous tissue away from the lower jaw. The density of the mass was almost the same as the cortical bone of the lower jaw. The mass was completely resected under general anesthesia. It was a rectangular mass of 3× 0.5× 0.3 cm. Histological examination gave the diagnosis of HO, which was also confirmed by immunohistochemical stainings for vimentin. Recurrence was not found in this case by clinical and radiologic follow-up at 1 year after surgery.     

Concurrence of replicative senescence and elevated expression of p16(INK4A) with subculture-induced but not calcium-induced differentiation in normal human oral keratinocytes

Primary normal human oral keratinocytes (NHOKs) undergo differentiation in the presence of calcium concentrations higher than 0.15 mM in vitro, which is useful in investigating the mechanisms involved in the differentiation of epithelial cells. Serial subculture of NHOKs to the postmitotic stage also induces terminal differentiation. However, the detailed mechanisms of both differentiation processes remain substantially unknown. To investigate the molecular differences in these processes, NHOKs were induced to differentiate by exposure to 1.2 mM of calcium and by serial subculture to the postmitotic stage. To study whether the cells were induced to differentiate and to undergo replicative senescence, the amount of cellular involucrin and the expression of senescence-associated beta-galactosidase (SA-beta-gal) were measured respectively. The expression of replicative senescence-associated genes and the activity of telomerase from the differentiated cells were also determined. Both calcium treatment and serial subculture to the postmitotic stage notably elevated the cellular involucrin. The percentage of SA-beta-gal-positive cells was significantly elevated by the continued subculture, but such changes were not observed in keratinocytes exposed to calcium. The concentration of cellular p16(INK4A) protein was progressively increased by the continued subculture but was not changed by calcium treatment. On the other hand, the concentrations of cellular p53 were similar in both differentiation processes. However, telomerase activity was lost in NHOKs that had undergone differentiation by both calcium treatment and serial subculture. The results indicate that calcium-induced differentiation of NHOKs has similar characteristics to their serial subculture-induced differentiation, but that the differentiation processes are not identical, because calcium-induced differentiation does not concur with either replicative senescence or the gradually increased concentration of p16(INK4A).     

Wnt信号通路与牙胚发育

牙齿的发生、分化是牙源性上皮与外胚间充质相互诱导、相互作用的结果。牙胚发育过程中复杂的信号调控体系是近年来口腔科学研究领域的难点和热点。现已初步证实Wnt信号通路是参与牙胚发育过程重要的分子信号调控因子。在牙胚发育过程中,随着Wnt信号通路调控机制的阐明,必将为牙再生的研究提供理论基础。该文就近几年对Wnt信号通路与牙胚发育关系的研究作一综述。     

X连锁无汗性外胚叶发育不全家系ED1基因的突变检测

目的探讨国内X连锁无汗性外胚叶发育不全家系中ED1基因的突变情况，为该病的遗传咨询、产前诊断、确诊携带者提供依据。方法收集2个X连锁无汗性外胚叶发育不全家系及1个散发患者的外周血样本，盐析法提取基因组DNA，采用聚合酶链反应（polymerase chain reaction，PCR）和直接测序对ED1基因进行突变检测。结果家系一患者ED1基因第9外显子发生错义突变（1045G〉A），家系二和散发患者ED1基因第3外显子发生错义突变，分别为467G〉A和466C〉T。结论ED1基因的错义突变可导致X连锁无汗性外胚叶发育不全。这3个突变与国外学者的报道一致。     

Stress corrosion cracking of NiTi in artificial saliva.

OBJECTIVES: This paper aimed to study the mechanism of the cracking of orthodontic NiTi wire. METHODS: Two orthodontic NiTi wires were subjected: (1) optical and scanning electron microscopy (SEM) to observe the fracture surface; (2) energy dispersive X-ray spectroscopy to determine the composition of the surface product; (3) anodic polarization to remove the surface product. Samples of NiTi alloy were subjected to the constant loading test to study the stress corrosion cracking (SCC) behavior of NiTi shape memory alloy in artificial saliva. RESULTS: The results showed that there were three typical areas at the fracture surface of NiTi orthodontic wire. Area '1' was a tool-made notch. Crack initiated from the root of this notch and propagated to form Area '2', which was perpendicular to the wire axis and covered by surface film. This film consisted of Na, K, Cl, P, S and O except Ni and Ti. The cracking process of NiTi alloy under the constant loading test depended on the pH of saliva and applied stress. The crack length was about 262microm, the longest at 300MPa and pH 3.0. SIGNIFICANCE: A tool-made notch in orthodontic NiTi wires can cause SCC. At high stress and low pH, this NiTi alloy was most sensitive to cracking.     

种植义齿系统工程的概念及修复环节在其中的位置

种植义齿治疗是一个系统工程，需要医学专家、理工专家和患者的共同努力。其中，修复专家占有重要地位。他们需要根据患者的意愿和条件确定种植义齿是否可行，以及是否能给患者带来最大的利益。需要设计植入体的数量、部位和植入角度。需要根据种植体界面的特殊条件在义齿的设计制作中作相应的处理。还需要对患者作咨询教育，使之对种植义齿抱有合理的期望并遵医嘱执行保健措施。