口腔鳞状细胞癌组织中RACK1与M2/M1联合检测与预后的相关性分析

目的: 探讨口腔鳞状细胞癌（OSCC）组织中活性蛋白激酶C受体1（RACK1）与M2和M1型巨噬细胞的比值（M2/M1）联合检测与预后的关系。方法: 选择2017年2月—2018年5月南通大学附属医院收治的OSCC患者129例,检测并对比癌组织、癌旁组织中RACK1及M2/M1情况,分析癌组织中RACK1表达、M2/M1与临床病理因素及预后的关系。采用SPSS 18.0软件包对数据进行统计学分析。结果: 癌组织中RACK1阳性表达率、M2/M1值显著高于癌旁组织（P<0.05）。Ⅲ~Ⅳ期、有淋巴结转移、累及脉管患者癌组织中RACK1阳性表达率分别高于Ⅰ~Ⅱ期、无淋巴结转移、无累及脉管患者（P<0.05）,Ⅲ~Ⅳ期、低分化、有淋巴结转移患者癌组织中M2/M1值显著高于Ⅰ~Ⅱ期、中高分化、无淋巴结转移患者（P<0.05）。Cox回归分析显示,肿瘤分期、淋巴结转移、RACK1阳性表达率、M2/M1是影响总生存率的独立预后因素（P<0.05）。ROC曲线显示,癌组织RACK1、M2/M1及两者联合预测OSCC患者预后的AUC分别为0.743、0.718、0.875。RACK1阳性表达患者生存率为62.24%,RACK1阴性表达患者生存率为92.31%;RACK1阳性与阴性表达患者的总生存率曲线相比,差异有统计学意义（P<0.05）。M2/M1≥2.06患者的存活率为61.70%,M2/M1<2.06患者的生存率为88.24%;M2/M1≥2.06与M2/M1<2.06患者的总生存率曲线相比,差异有统计学意义（P<0.05）。结论: OSCC患者癌组织中RACK1、M2/M1异常高表达,并与患者病理情况和预后相关,两者联合预测患者预后具有一定效能。     

Analysis of the calcification caused by rapid expansion of interpremaxillary suture in growing rats

Changes in the bone mineral density and the speed of mineralization were evaluated when the interpremaxillary suture received a physiological or orthodontic force in rats' growth period. Wistar rats (N = 30), 6 weeks of age at the beginning of the experiment, were used for this study. A rapid expansion appliance was set on the maxillary incisors of the rats in the experimental groups (1.5 mm expansion and 2.0 mm expansion groups), while the same appliance without activation was placed in the control group animals. The three groups were additionally divided into the following subgroups (five rats in each subgroup): the fed for 10 days subgroup and the fed for 24 days subgroup.Evaluation of bone mineral density by peripheral quantitative computed tomography (pQCT) in rats' transverse and frontal sections which include the interpremaxillary suture showed that bone mineral density in the 1.5 mm expansion group and in the 2.0 mm expansion group did not recover to the level in the control group. Bone formation seemed to be accelerated in the 2.0 mm expansion group among the rats fed for 24 days, though bone mineral density did not recover to the level in the control group. These results suggest that it is essential to observe retrace and bone formation enough after expansion.However, in the observation using calcein staining, the speed of calcification in the interpremaxillary suture in the 2.0 mm expansion group was more rapid than in the control and the 1.5 mm expansion groups, which indicated the effectiveness of rapid expansion in puberty.     

New methodology for facial nerve monitoring in extracranial surgeries of vascular malformations

ObjectiveTo develop a more reliable methodology for monitoring the facial nerve in surgeries of vascular malformations where the extracranial segment of the nerve is at risk.MethodsOur methodology comprises: (1) preoperative mapping to identify the anatomical location of the nerve branches, (2) continuous intraoperative monitoring of the compound muscle action potential (CMAP) by stimulating the facial nerve extracranially, in close proximity to where the trunk of the facial nerve exits the skull at the stylomastoid foramen, (3) intraoperative mapping to identify the nerve branches during surgical dissection and quantify the innervating contribution of each branch to the target muscle.ResultsOnly three out of 201 surgeries (1.5%) had complete facial nerve trunk injury as a consequence of facial vascular malformation surgery.ConclusionsWe developed a new method to continuously stimulate the facial nerve extracranially eliciting an objective parameter—the CMAP amplitude—to constantly measure changes in the muscle responses throughout surgery, alerting the surgeon before the facial nerve is severely injured. Our methodology notably reduces the complete facial nerve injury during extracranial surgery of facial vascular malformations.SignificanceThis comprehensive methodology may also be a valuable tool to prevent facial nerve injury during other types of extracranial surgeries where radical excisions are required.     

眶下孔周围注射滑石粉制作新型大鼠三叉神经痛动物模型的实验研究

目的: 应用滑石粉悬液进行眶下孔周围注射,建立一种新型大鼠三叉神经痛（trigeminal neuralgia,TN）动物模型。方法: 选取Wistar雄性大鼠30只,随机分为2组,一组在眶下神经孔周围注射30%滑石粉混悬液0.3 mL,另一组注射同等剂量的生理盐水,于术前3 d、术后3 d及术后1、2、3、4、6、8、12周分别进行行为学观察,Von Frey纤维测定大鼠机械性刺激反应阈值,利用方差分析对机械刺激阈值进行统计学分析。于术后3 d及术后4、8、12周取眶下孔周围组织作组织病理学观察,应用免疫组织化学的方法检测眶下区组织肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)的表达,采用SPSS16.0软件包对各检测值进行分组t检验。结果: 实验组大鼠术后3 d眶下神经支配区域机械痛反应阈值与术前及对照组相比显著降低（P<0.01),大鼠易激惹,具有搔抓面部或攻击行为。直到术后12周,机械痛阈值仍然显著低于对照组。实验组术后3 d组织病理学观察主要呈炎症表现,炎性因子表达减少;术后1周炎症更剧烈,炎性因子表达。术后4周,局部出现炎性肉芽组织增生,炎性因子表达最高;4~12周炎性反应逐渐减轻,炎性因子表达逐渐减少,局部瘢痕形成并逐渐加重,可见瘢痕压迫眶下神经。结论: 眶下孔周围注射滑石粉悬液可以建立稳定的TN动物模型,该造模方法简单易行,为进一步研究TN发病机制和模拟临床治疗提供了一种可靠、有效的动物模型。     

细胞色素P450酶2A6基因多态性与123例汉族吸烟人群牙周炎及炎性细胞因子表达水平的关系

目的: 检测细胞色素P450酶2A6（CYP2A6）基因多态性与汉族吸烟人群牙周炎及炎性细胞因子表达水平的关系。方法: 收集2018年10月—2019年10月常州市口腔医院收治的123例吸烟牙周炎患者为实验组,同期125例非吸烟牙周炎患者为对照组。收集患者一般资料,包括年龄、性别、体质量指数（BMI）、咀嚼、刷牙习惯和磨牙情况;检测菌斑指数（PLI）、牙龈出血指数（BI）、牙周探诊深度（PD）和附着丧失（AL）。采用PCR扩增CYP2A6;酶联免疫吸附试验（ELISA）检测龈沟液中炎性细胞因子白介素（IL）17、IL-1、IL-6、IL-23和肿瘤坏死因子α（TNF-α）水平。采用SPSS 25.0软件包对数据进行统计学分析。结果: 2组性别,PLI,龈沟液中IL-17、IL-1、IL-6、IL-23、TNF-α水平存在显著差异（P<0.05）。对所有样品进行PCR扩增,未扩增出的23例判定为CYP2A6缺失型（CYP2A6del）,其中,实验组5例、对照组18例;扩增出的225例判定为CYP2A6野生型（CYP2A6wt）,其中,实验组118例、对照组107例。2组CYP2A6基因型存在显著差异（P<0.05）。实验组不同CYP2A6基因型IL-1水平、PLI存在显著差异（P<0.05）;对照组不同CYP2A6基因型IL-17水平、PLI存在显著差异（P<0.05）。结论: CYP2A6基因型在汉族人群牙周炎患者是否吸烟中存在差异,但与炎性细胞因子水平的关系尚不明确。     

Adenoid cystic carcinoma of the maxillary sinus: a clinical–pathological report of 10 years of experience from a single institution

Adenoid cystic carcinoma (ACC) is the most common malignant salivary gland tumour of the maxillary sinus. The present study describes 24 cases seen over a period of 10 years at the Brazilian National Cancer Institute. Socio-demographic, clinical, pathological, and follow-up data were retrieved from the medical files for the period 1997–2006. The mean age of the patients was 51.1 years. Twenty-one (87.5%) presented advanced tumours. The main signs and symptoms found were a tumour mass (87.5%), pain (50%), nasal obstruction (25%), and epistaxis (20.8%). Most cases (62.5%) were treated with surgery and radiation therapy. Follow-up data showed two patients (8.3%) with residual disease, local recurrences in four (16.7%) patients, and distant metastasis in five (20.8%). The overall 5- and 10-year survival rates were 72.61% and 62.11%, respectively. Maxillary sinus ACC has an aggressive but indolent behaviour, typically presenting at an advanced T stage that reflects a poor prognosis for patients.     

两种不同波长的激光在伴2型糖尿病牙周炎患者牙周非手术治疗中的效果分析*

目的：比较Er-YAG及Nd-YAG激光辅助牙周基础治疗技术在伴2型糖尿病牙周炎患者非手术治疗中的疗效;观察牙周非手术治疗对伴2型糖尿病牙周炎患者血糖水平的影响。方法：纳入30例伴2型糖尿病牙周炎患者,采用自身对照设计,分区法使用Er-YAG激光、Nd-YAG激光联合常规牙周基础治疗,对照组常规牙周基础治疗,分别于基线、治疗后6周、12周检查牙周探诊深度(probing depth, PD)、临床牙周附着水平(clinical attachment level, CAL)、龈沟出血指数(sulcus bleeding index, SBI)、牙松动度(tooth mobility, TM)以及空腹血糖(fasting plasma glucose, FPG)、糖化血红蛋白(glycosylated hemoglobin, HbA1c)等,记录两种不同波长激光术中疼痛感、软组织恢复期,进行临床统计和比较。结果：3组治疗后的PD、CAL、SBI、TM均较治疗前显著改善;Er-YAG激光组、Nd-YAG激光组的PD、CAL、SBI、TM指标在治疗后6周、12周时均较对照组改善显著(均P＜0.05);同一时间点Er-YAG激光组、Nd-YAG激光组间的临床指标改善差异无统计学意义(P＞0.05);Er-YAG激光组术中疼痛感更轻、软组织恢复期更短(P＜0.05);患者的HbA1c水平在治疗后6周、12周呈现持续改善。结论：两种不同波长的激光对伴2型糖尿病牙周炎患者非手术治疗均有显著疗效;Er-YAG激光在辅助牙周基础治疗中对软组织的创伤更小,更适宜牙周治疗。     

MicroRNA-29a upregulates MMP2 in oral squamous cell carcinoma to promote cancer invasion and anti-apoptosis

Abnormal microRNA expression is a common and important feature of human malignancies. Matrix metalloproteinase 2 (MMP2), which has been reported in several cancers, plays important roles in cancer progression. However, the microRNA regulatory mechanism on MMP2 expression remains unclear. In this study, we first detected MMP2 and microRNA-29a (miR-29a) expression in oral squamous carcinoma (OSCC) specimens, which showed that MMP2 was higher in OSCC cancer tissues than adjacent tissues but that miR-29a was lower in OSCC cancer tissues than adjacent tissues. Then, we confirmed that miR-29a, which directly targeted 3′-UTR of MMP2 gene, negatively regulated MMP2 expression by miR-29a transfection and luciferase reporter assay. Exogenous overexpression of miR-29a inhibited OSCC cell invasion and anti-apoptosis significantly in vitro. Whereas, knockdown of miR-29a promoted OSCC cell invasion and induced drug-resistance in vitro. This study suggests that miR-29a plays an inhibiting role in the progression of OSCC, which may be a potentially therapeutic approach in the future.     

舌侧集中[牙合]全口义齿修复低矮牙槽嵴的临床体会

目的:观察分析舌侧集中[牙合]义齿修复低矮牙槽嵴的临床效果。方法:选取2017年8月~2019年10月我院口腔科门诊诊治的14例无牙[牙合]患者,予以舌侧集中[牙合]义齿修复。统计患者对修复效果的主观满意度及随访3个月后的修复效果。结果:14例患者中,3例经过1周、11例经过2~4周练习后,义齿固位良好,咀嚼功能得到了较好的恢复;随访3个月后,10例满意,4例基本满意,主观满意率为100%。随访过程中,14例患者在第3周对修复外观和心理状况方面满意;在第4周对发音和咀嚼效率方面满意;3个月后对义齿固位和舒适性满意。结论:舌侧集中牙合全口义齿修复方式可有效改善低矮牙槽嵴无牙[牙合]患者的咀嚼效能,具有制作简便、固位稳定、舒适、美观的优势,值得临床推广应用。