Ki-67、 PI3K、 Beclin1在口腔鳞癌组织中的表达及意义

目的：检测Ki-67、磷酸肌醇-3-激酶（PI3K）、Beclin1在口腔鳞癌组织中的表达及意义。方法：选取2017年1月—2018年12月南京市口腔医院收治的口腔鳞癌患者30例,取所有手术切除癌组织及癌旁组织标本,进行免疫组织化学染色处理,并检测Ki-67、PI3K、Beclin1的表达,采用Pearson分析TMSG-1、Ki-67、Pgp1之间的相关性。采用SPSS 20.0软件包对数据进行统计学分析。结果：口腔鳞癌癌组织中Ki-67、PI3K阳性表达率显著高于癌旁组织,Beclin1阳性表达率显著低于癌旁组织（P<0.05）。Ki-67、PI3K、Beclin1在高分化口腔鳞癌中的阳性表达率显著高于中分化、低分化口腔鳞癌（P<0.05）。Ki-67、PI3K在有淋巴结转移的口腔鳞癌中的阳性表达率显著高于无淋巴结转移的口腔鳞癌,Beclin1在有淋巴结转移的口腔鳞癌中的阳性表达率显著低于无淋巴结转移的口腔鳞癌（P<0.05）。Ki-67、PI3K、Beclin1在Ⅰ+Ⅱ期、Ⅲ+Ⅳ期口腔鳞癌中的阳性表达率无统计学差异（P>0.05）。Ki-67与PI3K的表达呈正相关（r=0.391,P=0.032）,Ki-67与Beclin1的表达呈负相关（r=-0.525,P=0.02）,Beclin1与PI3K的表达呈负相关（r=-0.367,P=0.045）。结论：Ki-67、PI3K、Beclin1的表达具有相关性,与患者有无淋巴结转移、病理分期有关,可能参与口腔鳞癌发生与发展。     

中西医结合治疗功能性消化不良的临床研究

目的：观察中西医结合治疗功能性消化不良（FD）的效果。方法：给予雷尼替丁、吗西啉、多虎平配合自拟中药方剂内服4周继服人参健脾丸3个月，同时与疗程相同的雷尼替丁、吗西啉、多虑平、谷维素、维生素B1组的疗效进行对比。结果：中西医结合的治疗组效果明显优于单纯西药治疗组，两组相比，差异有显性（P＜0．05），尤其是其复发率明显较对照组为低。结论：中西医结合治疗FD具有较好的近期效果。     

个性化愈合基台对后牙种植修复患者的疗效及对食物嵌塞症状的改善作用

目的 观察个性化愈合基台对后牙种植修复患者的治疗效果,以及对种植体稳定性、食物嵌塞等的影响。方法 选取2013年6月—2018年6月在江苏省口腔医院接受后牙种植的80例患者为研究对象,根据其愈合基台使用情况分为传统手术组（40例）和实验组（40例）,实验组在传统种植牙的基础上采用个性化愈合基台。比较2组患者种植修复完成后种植牙的稳定性、食物嵌塞评分、咀嚼效能和并发症发生率的差异。采用SPSS 13.0软件包对数据进行统计学分析。结果 术后1、3和6个月,实验组患者种植牙稳定性均显著高于对照组（P<0.01）;术后1、3和6个月,实验组患者食物嵌塞评分均显著低于传统手术组（P<0.01）;治疗前2组患者的咀嚼效能无差别,治疗后实验组患者的咬合力和咀嚼效率均显著高于传统手术组（P<0.05）;实验组患者牙松动、牙周炎等并发症发生率显著低于传统手术组（P<0.05）。结论 个性化愈合基台对后牙种植修复患者的治疗效果较好,可明显改善食物嵌塞和并发症发生率,具有良好的应用价值。     

种植义齿修复10年临床效果评价

目的:评价种植义齿的中、长期临床效果。方法:1995年6月至2005年6月,为1121例患者植入了1786颗种植体并完成上部结构修复,种植体系统分别为Br nemark系统92颗、ITI系统108颗、Replace系统21颗、Lifecore系统79颗、BLB系统1486颗。其中,单牙螺丝固定修复510例,单牙粘结固定修复413例,固定桥修复175例,种植体支持的覆盖义齿23例。随访9～122个月,观察方法为X线片、临床观察、患者满意度调查。应用寿命表法计算10年累计存留率,应用SAS9.1.3软件对数据进行配对t检验。结果:1102例患者的1760颗种植体完成骨整合。19例患者的26颗种植体松动脱落,10年累计存留率为98.1%。510例烤瓷冠螺丝固定患者中,39例发生螺丝松动,2例折断;413例烤瓷冠粘结患者中,17例崩瓷,5例冠脱落。X线片比较检查种植体周围骨吸收状况,结果无显著性差异。患者对美观、发音满意度和固位、咀嚼能力在种植治疗后明显提高,并具有统计学差异。结论:种植义齿是修复缺失牙的有效方法,本组病例10年累计存留率为98.1%。     

Improved bond performances of self-etch adhesives to enamel through increased MDP–Ca salt formation via phosphoric acid pre-etching

ObjectivesThe chemical affinity between 10-methacryloyloxydecyl dihydrogen phosphate (MDP) and hydroxyapatite (HAp) is an important factor in the enamel bonding provided by MDP-based self-etch (SE) adhesives, besides microinterlocking mechanisms. This study aimed to investigate how phosphoric acid pre-etching affects MDP–Ca salt formation in the application of MDP-based SE adhesives.MethodsSingle Bond Universal (SBU), All Bond Universal (ABU), Clearfil Universal Bond Quick (CBQ), and a MDP-based all-in-one adhesive (EXP) were used in both SE and etch-and-rinse (ER) modes, along with Clearfil SE Bond and untreated enamel (UE) as controls. The MDP–Ca salts produced with or without etching were examined by nuclear magnetic resonance, Raman spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction, and Fourier-transform infrared spectroscopy. Zeta potential, contact angle, and scanning electron microscopy measurements were employed to elucidate the mechanism behind the changes in MDP/HAp chemical affinity upon pre-etching.ResultsThe percentage of MDP–Ca salt in EXP_ER (73.13%) was higher than that in EXP_SE (43.27%). Characteristic CH₂ (1130, 1441, 2853, and 2909 cm^?1), CC (1641 cm^?1), and CO (1718 cm^?1) bands were observed in the Raman spectra of EXP_ER. Pre-etching increased the negative zeta potential of the enamel surface compared to that of UE (P < 0.001). The contact angles of MDP-based adhesives applied to pre-etched enamel were significantly lower than those of the self-etched surface (P < 0.05).SignificanceThe increased MDP–Ca salt formation is a significant advantage of phosphoric acid pre-etching, improving the MDP/HAp chemical affinity in addition to increasing surface wettability.     

镍铬合金烤瓷冠过敏症:4例报道

分析报道4例镍铬合金烤瓷冠过敏症病例的临床表现、发病原因及诊断、处理方法，为类似病例的预防、诊断和治疗提供经验。     

lncRNA UCA1对口腔鳞状细胞癌细胞增殖、凋亡的影响及其机制研究

目的 探究长链非编码RNA尿路上皮癌相关基因1（lncRNA UCA1）通过靶向miR-206调控Yes相关蛋白1（YAP1）的表达,介导口腔鳞状细胞癌（OSCC）细胞增殖、凋亡的分子机制。方法 通过实时荧光定量聚合酶链反应（qRT-PCR）检测人正常口腔角质细胞系HOK和人口腔鳞状细胞癌细胞株TSCCA、SCCl5、HN13、CAL27、HSC3和SCC9中lncRNA UCA1和microRNA-206（miR-206）的表达;在HN13细胞中敲除IncRNA UCA1,采用CCK-8法和流式细胞术检测其对HN13细胞增殖和细胞凋亡的影响;通过生物信息学网站starBase预测IncRNA UCA1、YAP1与miR-206的互补结合位点,并通过双荧光素酶实验验证它们之间的结合关系;Western blotting检测YAP1蛋白的表达。结果 qRT-PCR结果显示,相比于人正常口腔角质细胞系HOK,6种OSCC细胞中lncRNA UCA1 mRNA相对表达量上调（P <0.05）,而miR-206 mRNA相对表达量均降低（P <0.05）。与转染siNC的对照组相比,siUCA1组细胞活力下降,凋亡比例升高（P <0.05）。生物信息学预测结合双荧光素酶实验证实miR-206与lncRNA UCA1、YAP1均存在互补结合。qRT-PCR和Western blotting检测结果显示,siUCA1组miR-206 mRNA相对表达量较对照组升高（P <0.05）,YAP1 mRNA相对表达量较对照组降低（P <0.05）,而同时转染siUCA1和miR-206 inhibitor则抑制miR-206表达,恢复YAP1的表达（P <0.05）。结论 lncRNA UCA1在OSCC细胞中高表达,通过抑制miR-206的表达,上调YAP1,从而促进OSCC细胞增殖,抑制凋亡。     

Preoperative systemic immune-inflammation index predicts prognosis of patients with oral squamous cell carcinoma after curative resection

Background

Deregulated inflammation and immune deficit both intricately associate with cancer initiation and progression, which have been increasingly exploited as prognostic biomarkers and therapeutic targets. Recently, systemic immune-inflammation index (SII) based on peripheral neutrophil, lymphocyte and platelet counts serves as a novel and powerful cancer biomarker with prognostic significance in multiple types of malignancies. Here, we sought to evaluate the prognostic value of preoperative SII in patients with primary oral squamous cell carcinoma (OSCC) after curative resection.

Methods

Two independent cohorts with a total number of 309 patients with OSCC from two tertiary referral hospitals were included and defined as training (Nanjing, 138) and validation (Wuxi, 171) cohort, respectively. Preoperative SII in both cohorts was calculated and its optimal cutoff value was initially determined by X-tile software in the training cohort and then verified in the validation cohort.

Results

Our data indicated that high SII (≥?484.5) was significantly associated with larger tumor size (P?<?0.05, Chi square test), reduced overall and disease-free survival (Kaplan–Meir, P?<?0.05, Log-rank test). Univariate and multivariate analyses further revealed that SII was an independent prognostic predictor for patient survival. Moreover, the area under receiver operating characteristic curve of SII for survival was significantly greater or comparable to other well-established prognostic parameters, indicative of its satisfactory prediction accuracy and specificity.

Conclusions

Our findings reveal that high preoperative SII associates with poor outcome and serves as a non-invasive, low-cost and powerful prognostic predictor for patients with OSCC. This inflammation/immune-related biomarker holds translational potentials to supplement currently prognostic regime to better stratification of patients and treatment planning.

     

高频率使用多乐氟预防正畸患者牙脱矿的效果研究

目的 研究高频率使用多乐氟预防口腔正畸固定矫治器患者牙脱矿的作用。方法 采用方便抽样法,选取2021年6月—12月在南京医科大学附属口腔医院口腔正畸科行固定矫治的50例患者,按照随机数字法分为试验组和对照组。试验组单侧上颌侧切牙接受高频氟化物治疗,对侧不接受治疗,对照组单侧上颌侧切牙接受安慰剂治疗,对侧不接受治疗。对每位患者进行6个月的追踪,观察对比患者上颌侧切牙初始及最终照片并进行评分,确定各组平均脱矿进展指数。结果 各组平均脱矿进展指数比较,差异具有统计学意义(P<0.05),多乐氟处理组脱矿进展指数最低(0.960±0.465),其次分别为不含氟对照组(1.213±0.713),安慰剂对照组(1.267±0.720)和安慰剂治疗组(1.307±0.713)。结论 高频率使用多乐氟可有效降低固定矫治患者的脱矿发生率。     

成果导向教育理念指导《牙周病学》本科教学改革的经验探索

目的 总结基于成果导向教育（outcome-based education,OBE）理念的混合式教学在《牙周病学》本科生课程教学中的探索和经验。方法 教学团队通过深入学习OBE教育理念,寻找改革重点问题,重塑教学目标,重构教学体系,开展以理论授课为主,辅以慕课、三维动画、案例教学以及小型研讨会等方式的教学改革。结果 牙周病学课程改革激发了青年教师的创造性、学生的学习主动性,丰富了课程教学资源,使学生学习效果显著提高。结论 OBE理念在牙周病学课程教学改革中起到了正向推动作用。教学团队将逐步深化教改,建立立体化、多载体的课程体系,以培养具备岗位胜任力的应用型口腔医学人才。