Objective To analyze the relationship between the levels of positive pentameric protein 3（PTX3） and neuregulin-4（Nrg4） in gingival crevicular fluid（GCF） and the prognosis of implants in patients with oral bone incremental implant repair. Methods Ninety-two patients with oral bone augmentation implant repair admitted to the Department of Stomatology, Tongji Medical College Affiliated Hospital, Huazhong University of Science and Technology from April 2021 to April 2022 were selected as the research group. Based on the X-ray examination results at the follow-up one month after implantation, they were divided into a subgroup of 56 patients with poor prognosis and a subgroup of 36 patients with good prognosis; During the same period, 92 periodontal health volunteers underwent physical examination in the hospital as a healthy control group. The expression levels of PTX3 and Nrg4 in gingival crevicular fluid were measured using enzyme-linked immunosorbent assay（ELISA）. Pearson correlation analysis was used to investigate the correlation between the expression levels of PTX3 and Nrg4 in gingival crevicular fluid of patients with oral bone augmentation implant repair, and logistic regression analysis was used to analyze the factors affecting the prognosis of dental implants in patients with bone augmentation implant repair. Results Compared with the healthy control group, the study group showed CRP, TNF-α, PTX3’s expression level in gingival crevicular fluid increased（t/P=30.695/＜0.001, 18.994/＜0.001, 8.383/＜0.001）, while the expression level of Nrg4 decreased（t/P=10.988/＜0.001）. Compared with the subgroup with good prognosis, the subgroup with poor prognosis’ PTX3, CRP, TNF-α increased（t/P=4.706/＜0.001, 17.480/＜0.001, 9.410/＜0.001）, while the expression level of Nrg4 decreased（t/P=9.033/＜0.001）. The expression levels of PTX3 and Nrg4 in gingival crevicular fluid of patients with bone augmentation implant repair were negatively correlated（r/P=-0.349/0.001）. Logistic regression analysis showed that high PTX3, low Nrg4, and high CRP were risk factors for implant prognosis in patients with incremental bone implant repair [OR（95%CI）=3.542（1.742 to 7.201）, 2.524（1.121 to 5.682）, 4.767（2.056 to 11.051）].Conclusion PTX3 is highly expressed in the gingival crevicular fluid of patients with oral bone augmentation implant repair, while Nrg4 is low in expression, both of which are related to implant prognosis.

目的 探讨鞣花酸对口腔鳞癌HSC3细胞增殖、迁移和侵袭的影响及可能机制.方法 体外培养HSC3细胞,用不同剂量(2、4、8μg/ml)鞣花酸干预24 h后,CCK-8法和克隆形成实验检测细胞增殖、划痕实验和Transwell分别检测细胞迁移和侵袭,蛋白质印迹法检测细胞中E-cadherin和N-cadherin蛋白表达,qRT-PCR法检测细胞中miR-1254表达.收集39例口腔鳞癌患者癌组织和癌旁组织,RT-PCR法检测组织中miR-1254表达.转染miR-1254模拟物至HSC3细胞,或转染miR-1254抑制剂至HSC3细胞后再用8μg/ml鞣花酸干预24 h,然后采用上述相同方法检测细胞增殖、迁移和侵袭.结果 与对照组比较,不同剂量鞣花酸提高了HSC3细胞增殖抑制率和E-cadherin蛋白表达(P<0.05),降低了细胞克隆形成数、划痕愈合率、侵袭数及N-cadherin蛋白表达(P<0.05).同时,与对照组比较,不同剂量鞣花酸促进了HSC3细胞中miR-1254表达(P<0.05).口腔鳞癌组织中miR-1254表达低于癌旁组织(P<0.05).过表达miR-1254后,HSC3细胞增殖抑制率和E-cadherin蛋白表达升高(P<0.05),细胞克隆形成数、划痕愈合率、侵袭数及N-cadherin蛋白表达降低(P<0.05).过表达miR-1254逆转了鞣花酸对HSC3细胞增殖、迁移和侵袭的影响.结论 鞣花酸可能通过上调miR-1254抑制口腔鳞癌HSC3细胞增殖、迁移和侵袭.

目的探讨改善口腔癌患者营养实践的方案,提高其营养管理效果.方法以基于证据的持续质量改进模型为研究框架,通过证据提取、现况审查、证据引入和效果评价4个阶段将循证证据应用于口腔癌患者,并采用中断时间序列设计,比较循证实践前(96例患者实施常规营养管理方法)、循证实践后(98例患者)体重指数、营养评分、首次离床时间及术后住院时间.结果 最终纳入18条证据,制订10条审查指标.与循证实践前患者比较,循证实践后患者出院前体重指数显著增加,营养评分显著降低,首次离床活动时间及术后住院时间显著缩短(均P＜0.01).结论基于证据的循证实践能降低口腔癌患者营养风险的发生,促进患者康复.

目的:调查癌症患者照顾者的未满足需求及影响因素。方法:使用中文版癌症患者照顾者需求评估表对304例住院癌症患者的照顾者进行调查。结果:心理社会维度需求的未满足程度受照顾者年龄、居住地、文化程度、患者诊断等因素影响（P＜0.05）;照顾者文化程度越高、患者医保报销比例越高,其未满足医疗需求越高;无宗教信仰的照顾者未满足医疗需求更高;患者癌症分期越晚,照顾者的未满足医疗需求程度越高（P＜0.05）。在经济需求维度,医保报销比例越低,照顾者的未满足经济需求越高（P＜0.05）。日常活动方面,未满足的需求受照顾者年龄、患者诊断的影响（P＜0.05）。结论:照顾者不同维度的需求满足程度不尽相同,且受多种因素影响,医务人员应给予重视。

目的:探讨贝克认知疗法在骨转移病人治疗依从性中的作用.方法:将204例恶性肿瘤骨转移病人随机分为观察组和对照组,对照组单纯给予肿瘤对症支持治疗,观察组在此基础上给予贝克认知疗法,分别采用疼痛数字评分法(NRS)评分、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评价治疗前后病人的心理状况.结果:2组病人治疗前NRS、HAMD和HAMA评分差异无统计学意义(P>0.05);治疗后观察组NRS、HAMD和HAMA评分均低于对照组(P<0.01).经过贝克认知疗法干预后,2组病人在本疗程中按时用药差异无统计学意义(P>0.05),在按时行下周期治疗、指定动作和满意度上,观察组高于对照组(P<0.05～P<0.01).结论:贝克认知疗法能够明显缓解恶性肿瘤骨转移病人的疼痛、焦虑和抑郁程度,提高其治疗依从性,改善病人生活质量,值得在临床工作中推广应用.

目的 晚期女性乳腺癌患者往往面临严重的心理问题,本文将探讨合理情绪疗法在患者心理干预中的作用,以期提高其心理压力应对能力及生活质量.方法 对126例晚期女性乳腺癌患者按随机数字表法分为实验组和对照组,对照组给予肿瘤科常规干预,实验组另给予合理情绪疗法作心理干预,分别采用症状自评量表、艾森克个性问卷和世界卫生组织生活质量量表评价心理干预前后患者的心理状况、人格和生活质量.结果 合理情绪行为疗法明显改善了患者在躯体化、强迫、人际敏感、抑郁、焦虑和恐怖等6个方面的心理状态,SCL-90量表中实验组阳性项目数较干预前减少(3.2±1.4)个,而对照组仅减少了(2.0±0.9)个,实验组总均分改善了1.7±0.6,而对照组仅改善了0.7±0.4,同时在一定程度上改善患偏于内向、情绪不稳和精神质等不良个性,并且提高了患者在心理、独立性、社会关系和精神支持等5个方面的生活质量,WHOQOL-100量表实验组总分为43.1±7.2,而对照组仅为27.2±8.3.结论 合理情绪不仅可以改善晚期女性乳腺癌患者的心理状态,提高其对心理压力的应对能力,同时提高了患者的生活质量,值得推广应用.

Objective To investigate different time intervals by positive pressure connector type in?dwelling needle in patients with musculoskeletal tumor, and their effects on blood return, incidence of plugging and costs. Methods One hundred and eighty patients with musculoskeletal tumors were randomly divided into 8?h group, 12?h group and 16?h group. The differences in blood return, plugging, average time of indwelling and average cost were observed among these groups. Results As compared with 8?h group, 12?h group had similar incidence of blood return and plugging, but 16?h group had a higher incidence of blood return and plugging, and 12?h group had longer indwelling times under the condition of similar cost. Conclusion Twelve?h time inter?val is much better than the other two choices, which has optimal time?cost effect and is worth popularizing and applying on clinic.