目的:探讨基础转录因子 3(basic transcription factor 3,BTF3)在口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)组织中的表达及其与PINCH的相关性.方法:采用免疫组织化学法检测BTF3 在 73对OSCC组织及相邻癌旁正常组织(45 例伴淋巴结转移)中的表达,并通过肿瘤基因组图谱(the Cancer Ge-nome Atlas,TCGA)数据库分析BTF3、PINCH在OSCC组织及相邻癌旁正常组织中的表达以验证免疫组织化学检测结果.分析BTF3 表达与患者年龄、性别、肿瘤分化程度及淋巴结转移等临床病理参数的关系及其与PINCH在OSCC中表达的相关性.结果:免疫组织化学检测结果显示,BTF3 在OSCC组织中的表达明显高于相邻癌旁正常组织(60.27%vs 39.73%,P =0.013);TCGA数据库分析显示,OSCC组织中BTF3、PINCH的阳性表达率均显著高于二者在相邻癌旁正常组织中的阳性表达率.在OSCC中,BTF3 在淋巴结转移组中的阳性表达率明显高于其在无淋巴结转移组中的阳性表达率(71.11%vs 42.86%,P =0.016);BTF3 在低分化组OSCC中的阳性表达率明显高于其在高分化组 OSCC 中的阳性表达率(71.43%vs 45.16%,P =0.023);BTF3 的表达与患者性别、年龄、肿瘤大小和部位无相关性(P>0.05);BTF3 和PINCH在OSCC中的表达呈正相关(r =0.286,P =0.015).结论:BTF3 与OSCC的发生、发展及淋巴结转移有关,有望成为判断OSCC发生、发展及预测淋巴结转移的潜在分子标志物,其机制可能与PINCH正协同作用有关.

目的 研究Tafazzin在口腔鳞状细胞癌(OSCC)中的表达及其与MAC30的相关性.方法 采用免疫组化ABC法检测Tafazzin在24例正常口腔黏膜和59例OSCC组织中的表达,分析其与患者年龄、性别、肿瘤分化程度及淋巴结转移等临床病理特征的关系及其与MAC30在OSCC中的相关性.结果 Tafazzin在OSCC中的阳性表达率明显高于其在正常口腔黏膜中的表达率,差异有统计学意义(66.1％vs8.3％,P=0.000);在OSCC中,Tafazzin在低分化患者中的阳性表达率明显高于其在高分化患者中的阳性表达率(88.9％vs56.1％,P=0.014);其在伴淋巴结转移患者中的阳性表达率高于其在无淋巴结转移患者中的阳性表达率(86.4％vs 54.1％,P=0.011);Tafazzin的表达与患者性别、年龄、部位、肿瘤大小无相关性(P＞0.05).Tafazzin与MAC30在OSCC中的表达呈正相关(r=0.492).结论 Tafazzin可能在OSCC的发生、发展及淋巴结转移中起重要的作用,有望成为预测OSCC发生、发展及预测淋巴结转移的新的潜在生物标志物,其作用机制可能与MAC30在OSCC中的正协同作用有关.

通用转录因子 3(basic transcription factors,BTF3)是一种通用的近端启动区元件转录因子,与RNA聚合酶Ⅱ结合参与转录活动.BTF3在促进细胞增殖、抑制凋亡方面发挥重要作用,可能导致恶性肿瘤早期事件[1-3].BTF3在多种恶性肿瘤中过表达[4-5].乳腺癌是女性最常见的恶性肿瘤,本研究拟检测BTF3在非特殊型浸润性导管癌中的表达,分析其与肿瘤进展、预后的相关性.

目的 检测肌球蛋白轻链激酶3(myosin light chain kinase 3,MYLK3)在口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)及正常口腔粘膜中的表达,分析其临床病理意义.方法 采用免疫组织化学法对65例OSCC和30例正常口腔上皮粘膜石蜡存档标本进行检测,并分析其与临床病理指标的关系.结果 正常口腔粘膜中MYLK3少量表达(10％),而在OSCC中的表达明显增加(35％),结果有显著差异(P＜0.05);淋巴结转移组阳性表达率80％(8/10),无淋巴结转移组阳性表达率27％(15/55),结果有显著差异(P＜0.05);低分化组中MYLK3阳性表达率67％(10/15),高分化组阳性表达率26％(13/50),结果有显著差异(P＜0.05);MYLK3表达与患者的性别、年龄、肿瘤大小和部位无相关性(P＞0.05).结论 MYLK3可能在OSCC的发生及进展等方面起着重要作用,MYLK3也可能是一个预测OSCC淋巴结转移的新型生物学标志物.

目的:探讨eRF3a/GSPT1和CyclinD1在甲状腺乳头状癌(papillary thyroid carcinoma,PTC)及周边正常甲状腺组织中的表达,分析eRF3a/GSPT1和CyclinD1表达在PTC中的相关性及临床病理意义.方法:采用免疫组化检测eRF3a/GSPT1和CyclinD1在80例PTC及72例周边正常甲状腺组织中的表达情况,分析eRF3a/GSPT1和CyclinD1表达水平与PTC临床病理特征的关系及两者表达的相关性.结果:eRF3a/GSPT1和CyclinD1在PTC组织中的表达明显高于周边正常甲状腺组织;eRF3a/GSPT1的表达差异在肿瘤大小、甲状腺被膜侵犯中具有统计学意义;CyclinD1的表达差异在多灶发生、淋巴结转移中具有统计学意义;在PTC中eRF3a/GSPT1与CyclinD1的表达呈现正相关.结论:eRF3a/GSPT1和CyclinD1在PTC组织中高表达,可能成为PTC潜在的诊断标志物;eRF3a/GSPT1的表达与肿瘤大小和甲状腺被膜侵犯有关,可能促进PTC的发生、发展,CyclinD1对PTC淋巴结转移有提示作用;eRF3a/GSPT1和CyclinD1可能协同促进PTC的发生、发展.

MSH3基因由Valle等[1]于1991年发现并命名,其产物MSH3蛋白在细胞核内负责修复错误的碱基配对及插入/删除,并可与MSH2蛋白结合形成异质二聚体MutS β,进而修复较长的碱基插入/删除错误,此二聚体还可在基因转换过程中移除非同源DNA末端.MSH3表达降低或缺失可导致结直肠癌及鼻咽癌等恶性肿瘤的发生、发展[2,3],同时也和舌癌及进展期非小细胞肺癌等恶性肿瘤的治疗有关[4,5].现就MSH3基因的结构、功能及其在恶性肿瘤方面的研究作一综述.

目的 探讨CBCT在口腔专科生根管治疗术实习过程中结合渐进式教学的效果.方法 选择62名口腔专科实习生,随机分为试验组(CBCT)和对照组(根尖片组),实习初期和实习中期进行理论学习和观摩根管治疗流程,实习后期进行根管治疗术临床实践,对患者上颌中切牙、上颌第一前磨牙和下颌第一磨牙进行根管治疗,对比两组实习生读片准确性和根管治疗操作合格率,比较两组操作时间和治疗后疼痛.结果 两组学生对上颌中切牙读片、根管治疗操作合格率、操作时间和治疗后疼痛未见统计学差异(P＞0.05);而对上颌第一前磨牙和下颌第一磨牙,2组学生在所有评估指标上都存在差异(P＜0.05).结论 对于较复杂根管系统的牙位进行根管治疗时,CBCT可有效提高口腔专科生读片准确率和治疗成功率,缩短治疗操作时间,减轻治疗后疼痛.

细胞周期蛋白依赖性激酶8(CyClin-dependent kinase 8, CDK8)基因产物属于细胞周期蛋白依赖性激酶家族成员,具有促进细胞周期时相转变、启动DNA合成及调控细胞转录等功能,在细胞的增殖及分化中起重要作用,其异常表达可加速细胞周期的运行,并与子宫颈癌、结直肠癌、胃癌、恶性黑色素瘤等恶性肿瘤的发生、发展及预后相关.现就CDK8基因的结构、功能及在恶性肿瘤的研究进展作一综述.

Objcctive To investigate the effects of enteral nutrition with probiotics and traditional enteral nutrition on intestinal flora and prognosis in elderly patients with bone fracture after surgery.Methods Fifty-eight elderly patients with bone fracture whose MNA-SF scores were 0~7 points were randomly divided into two groups: enteral nutrition with probiotics group (experiment group,n=28) and routine enteral nutrition group (control group,n=30).The patients in both groups were given the same amount of nitrogen and protein (=1.5g·kg-1·d-1) and calories (=105kJ·kg-1·d-1).In addition to that, the patients in experimental group were given probiotics powder.The faeces samples of patients were collected for three time points:the last excretion before surgery,the first excretion after surgery and on 10d after surgery.The changes of intestinal flora,incidence rate of infection and uncomfortable feelings in digestive tract were observed and compared between two groups.Results In experiment group,there was significant difference in the number of bifidobacterium and lactobacillus inside intestinal tract in different time points (P<0.05),moreover, there was significant difference in the number of bifidobacterium and lactobacillus between last excretion before surgery and on 10d after surgery as well as between the first excretion after surgery and on 10d after surgery (P<0.05).In control group, there was significant difference in the number of clostridium perfringens inside intestinal tract in different time points (P<0.05),moreover, there was significant difference in the number of clostridium perfringens between last excretion before surgery and on 10d after surgery (P<0.05).Moreover there was significant difference in the number of bifidobacterium, lactobacillus and clostridium perfringens inside intestinal tract on 10d after surgery between two groups (P<0.05).Besides there were significant differences in the incidence rates of abdominal distension and constipation between two groups (P<0.05).The incidence rate of infection in experiment group was lower than that in control group, but there was no significant difference between two groups (P>0.05).Conclusion The probiotics enrichment enteral nutrition can regulate intestinalflora function of elderly patients with bone fractureand can promote postoperative recovery,moreover,which can decrease the incidence rates of abdominaldistension and constipation ofpatients.

成骨细胞作为骨组织中的应力感受及效应细胞,在骨的生长、修复和改建中发挥重要作用,因此,研究不同应力刺激对成骨细胞的影响及其机制具有重要意义.成骨细胞在机体内可受到牵张力、流体剪切力及压应力等多种应力作用,目前对各种应力环境下成骨效应的研究也逐渐增多.本文就近年来不同应力刺激对成骨细胞功能的影响、成骨细胞对外力刺激的应答及信号传导通路等方面作一综述.

Objective Purpose To detect basic transcription factor 3(BTF3)expression in squamous cell carcinoma of esophagus and analyzed its relationships with clinicopathological variables.Methods The expression of BTF3 was determinated in 85 cases of squamous cell carcinoma and 15 cases of normal tissue by immunohistochemistry and analyzed its relationships with clinicopathological variables.Results Our results showed that BTF3 expression significantly increased from normal tissue to esophageal squamous cell carcinoma(62％vs.0％;P＜0.01).Cancers with worse differentiation had a higher expression than those with better differentiation(79％vs.54％;P＜0.05).BTF3 also showed stronger staining in esophageal squamous cell carcinoma in stageⅢandⅣthan those in stageⅠandⅡ(74％vs.46％;P＜0.01).Conclusion BTF3 may play an important role in the malignant tumorigenesis and progression of esophageal squamous cell carcinoma.Detecting the expression of BTF3 in esophageal squamous cell carcinoma can provide some information in the treatment and predicting the prognosis.

目的:探讨乳清蛋白粉对颌面部骨折内固定术后病人营养状况和临床结局的影响. 方法:选取颌面部骨折内固定术后病人65例,分为试验组(n=32)和对照组(n=33).两组病人均经鼻胃管行营养支持,营养配餐按照热量125.5 kJ(30 kcal)/(kg·d)、蛋白质1.6 g/(kg·d)给予.肠内营养(EN)配方选择普通匀浆膳,不足部分蛋白质以蛋白粉补充.试验组病人给予乳清蛋白粉,对照组给予大豆复合蛋白粉.分别于手术后第1和第10天清晨空腹抽取外周静脉血,测定血红蛋白(Hb)、血清转铁蛋白(TF)、前清蛋白(PA)、清蛋白(ALB),体液免疫指标(IgA、IgG、IgM);监测人体成分分析(骨骼肌、蛋白质、体脂肪和无机盐);记录术后感染发生率. 结果:术后第10天,试验组与对照组比较,TF、Hb、IgA和骨骼肌,差异均有显著性统计学意义(P＜0.05).试验组病人术后第10天,TF、PA、Hb、IgA、IgM和骨骼肌水平均高于术后第1天,且差异有显著性统计学意义(P＜0.05).对照组术后第10天PA高于第1天,差异有显著性统计学意义(P＜0.05). 结论:乳清蛋白粉强化的EN可明显改善颌面部骨折内固定术后病人的营养状况.

核孔蛋白88(nucleoporin88, Nup88)是位于细胞核膜表面的核孔蛋白,与其他蛋白一同构成核孔复合体( NPC)。NPC作为调控细胞膜内外物质转运的重要结构,对生命体生长发育的重要作用已被广泛认可。 Nup88作为核孔复合体中的一员,不仅参与细胞内核质转运,在调节细胞生长、分化、增殖、发育过程中发挥重要作用,并且其适度表达是防止非整倍染色体的形成及肿瘤发生的关键。研究发现,多数恶性肿瘤中Nup88表达较正常组织高,且其表达部位与肿瘤的分化程度、转移及预后相关。该文就Nup88的分子结构、功能及在临床方面的研究作一综述。

Objective: The effects of different doses of arginine the serum arginine content were observed in severe trauma patients. Methods: 72 cases were randomly divided into group A,group B,group C and group D,acording to the L-arginine dose 0,10,20 and 30 g /d. After using isocaloric nutrition support,the serum levels of arginine were examined on the first,seventh and fourteenth day. Statistical analysis was performed using SPSS18. 0. Results: On the seventh and 14 th days after operation,serum levels of the arginine increased in group C and group D and showed the significant differences(P 0. 05) when compared with group A and B. Conclusion: The oral dose of L-arginine 20 g /d or 30 g /d is needed for maintaining the serum levels of L-arginine in severe trauma patients.

Objective:To investigate the effect of clinical nursing pathway in perioperative nursing care of patients with tongue cancer . Methods:38 tongue cancer patients who received oral and maxillofacial surgery in our hospital were randomly divided into the experimental group and the control group(19 cases in each group).The conventional treatment and nursing care was used in the control group and the treatment and nursing care was given to the patients according to clinical nursing pathway and the systematic rehabilitation training on tongue function was provided for the patients in the experimental group .The language,chewing,swallowing function recovery and satisfac-tion of the postoperative patients ,hospitalization time and cost were compared between the two groups .Results:The language,chewing func-tion and satisfaction of the postoperative patients were much better in the experimental group than the control group (P<0.05);the hospi-talization time and cost was significantly shorter and lower in the experimental group than the control group (P<0.05).Conclusion:The nursing intervention can significantly improve the language and masticatory function recovery in postoperative patients with tongue cancer , it can also improve the quality of life of the patients ,shorten and reduce hospitalization time and costs ,improve patient satisfaction and en-hance their health awareness .

目的 探讨CD147在葡萄胎发生发展以及侵袭转移中作用,以确定其是否能成为预测葡萄胎恶变的重要指标.方法 收集清宫术后病理诊断为葡萄胎的患者首次清宫组织27例,并收集正常早孕(6～8周)无其他疾病,要求终止妊娠患者的绒毛组织20例作为对照.将组织分为正常绒毛组20例、葡萄胎组24例、侵葡组3例,采用免疫组化方法检测CD147在各组的表达.结果 CD147在侵葡组、葡萄胎组以及正常绒毛组的灰密度值依次为69.21±3.21,91.83±13.01和108.14±19.82,侵葡组灰密度值明显高于正常绒毛组和葡萄胎组(P均<0.05);葡萄胎组灰密度值明显高于正常绒毛组(P<0.05).结论 CD147高表达可能在葡萄胎、侵蚀性葡萄胎发生发展过程中发展有促进作用,且可促进葡萄胎组织恶变.

目的探讨髁突颈骨折经颌后入路,直视下解剖复位内固定新方法及疗效。方法对28例36侧髁突颈骨折患者行颌后切口入路,穿过腮腺,解剖面神经,直视下暴露髁颈骨折线,解剖复位并行坚固内固定,术后1、3、6个月复诊。结果经过6个月复诊,所有患者均取得良好的咬合关系及开口度,双侧面部对称,面部瘢痕不明显,3例患者出现面神经不同程度损伤,但6个月后基本恢复,出现腮腺瘘1例。结论经颌后入路直视下解剖复位内固定髁突颈骨折,具有切口隐蔽性、术中视野暴露好、便于坚固内固定操作、术后瘢痕小等优点,是一种良好的恢复解剖形态及功能的疗效方法 。

<正>颈髓损伤患者急性期即早期常合并腹胀和便秘,应激性溃疡、晚期发生便失禁等消化系统并发症[1]。严重腹胀使膈肌升高,更加重了颈髓损伤患者的呼吸困难,便秘影响患者的食欲,不利于患者康复。应激性溃疡是颈髓损伤患者一种严重并发症,护理不当,造成病情加重,甚至死亡。对急性颈髓损伤患者,我院采用亚低温治疗,效果满意,为进一步推进优质化护理,我们借鉴临床护理路径应用原则,为急性颈髓损伤患者建立了临床护理路径,为患者的早日恢复起到了保障作用。

下颌骨占据面下1／3，极易受意外打击，发生在下颌骨的骨折约占颅面骨折病例的近2／3［1］，目前下颌骨骨折主要采用手术切开复位内固定术和牙弓夹板固定术，手术治疗适合复杂性、多发性、粉碎性骨折，具有效果好、骨折愈合快等优点，但手术创伤大，需二次手术取出内固定物，面部切口易留瘢痕，儿童可能损伤牙胚及费用昂贵等使很多患者望而却步。而外固定法主要为牙弓夹板颌间固定、小环结扎及骨间螺钉颌间固定，普通牙弓夹板均为金属板条制成，具有固位不稳，易造成骨折延期愈合及错位愈合；需按牙弓形态现场弯制夹板，费时、费力尤其是牙冠短小、乳牙，新生恒牙容易滑脱，结扎丝易刺破黏膜等缺点［2-5］，骨间螺钉颌间固定及小环结扎有复位固定力不足，且多用于坚固内固定术后辅助治疗［6-8］，针对以上不足，我们应用模型外科方法制作牙合板，对下颌骨骨折作单颌外固定术，恢复正常咬合关系。

>重度创伤患者伤后机体的高分解代谢及免疫紊乱可直接导致机体营养不良和免疫抑制,因此必须尽早改善此类患者的营养状况,恢复其免疫功能。由于精氨酸及其代谢产物如一氧化氮(nitric oxide,NO)等在免疫防御、免疫调节、促进创伤愈合、维持和保护肠道黏膜功能的非特异性免疫等方面具有重要作用,精氨酸已成为临床营养研究的焦点之一。本研究采用前瞻性随机对照方法,观察不同剂