目的 研究海南省口腔黏膜疾病发病规律,为临床预防及诊疗提供流行病学依据.方法 选取2011年10月至2020年5月中南大学湘雅医学院附属海口医院就诊的口腔黏膜疾病患者4 347例,收集临床资料,对患者发病情况、病种分布、性别、年龄及民族构成进行分析.结果 4 347例患者中男女比例接近1∶1,21～30岁年龄段口腔黏膜疾病最多发,疾病分类中占比前3位的分别为唇舌疾病(1 515例次,31.05％),溃疡类疾病(1 492例次,30.57％)和斑纹类疾病(1 282例次,26.27％).常见的口腔黏膜伴发类疾病为口腔黏膜下纤维性变伴发口腔白斑,伴发率51.6％.结论 海南地区唇炎发病率较高,黏膜下纤维性变高发于年轻男性,需进行针对性预防工作.

目的 分析耐碳青霉烯类肺炎克雷伯菌(CRKP)感染患者的全因死亡率.方法 用循证学方法,系统检索PubMed、EMBase、Web of Knowledge数据库、中国生物医学文献数据库、中国期刊全文数据库、万方数据库、维普中文科技期刊数据库,文献检索时间建库至2018年4月,纳入分析CRKP感染患者全因死亡率的研究,用RevMan 5.3软件对患者死亡率进行Meta分析.结果 共检出132篇文献,最终纳入22项研究,纳入患者3071例,其中试验组1154例(CRKP感染),对照组1917例.Meta分析结果显示,CRKP感染患者和无CRKP感染患者的全因死亡率分别为46.10％(532例/1154例)和22.59％(433例/1917例),CRKP血流感染患者和无CRKP血流感染患者的全因死亡率分别为46.41％(226例/487例)和17.49％(159例/909例),CRKP感染移植患者和无CRKP感染移植患者的全因死亡率分别为53.03％(35例/66例)和15.01％(53例/353例),差异均有统计学意义(P ＜0.001,P＜0.01).结论 CRKP感染的移植患者较非CRKP感染的患者的死亡率高,由于纳入研究样本量较小,质量一般,该结论尚需高质量的临床对照研究进一步验证.

[目的]探讨医护合作模式在重症监护室(ICU)连续性血液净化病人中的应用效果.[方法]选取2015年7月-2016年6月500例连续性血液净化病人为对照组,2016年7月-2017年6月593例连续性血液净化病人为观察组,对照组病人实施常规护理,观察组在常规护理基础上采用医护合作一体化工作模式.比较两组病人非计划性下机以及并发症发生情况,比较两组医护人员在实践医护合作一体化前后对当前医护合作关系的满意度.[结果]观察组病人非计划性下机发生率低于对照组(P＜0.01),各并发症的发生率低于对照组(P＜0.05);观察组实施医护合作一体化工作模式的医护人员满意度高于对照组(P＜0.05).[结论]在ICU连续性血液净化病人中应用医护合作一体化工作模式可降低非计划性下机发生率以及并发症发生率,提高医护人员对医护关系的满意度.

目的 探讨重症监护病房(Intensive care unit,ICU)护士医护合作、情绪智力、工作投入之间的关系,并分析情绪智力在医护合作与工作投入之间的作用.方法 采用一般资料调查问卷、医护合作量表(nurse-physician collaboration scale,NPCS)、情绪智力量表(emotional intelligence scale,EIS)、Utrecht工作投入量表(Utrecht work engagement scale,UWES)对500名ICU护士进行调查,并分析三者之间的相关性.结果 ICU护士NPCS、EIS、UWES总分分别为(72.02±15.33)分、(76.93±13.18)分、(70.12±14.92)分.ICU护士医护合作与情绪智力、工作投入之间均呈正相关关系(P<0.01).情绪智力在医护合作对工作投入的预测中起到部分中介作用,情绪智力的中介效应对总效应的贡献率为20.2％.结论 ICU医护合作状况及护士情绪智力和工作投入处于中等偏上水平,情绪智力在医护合作关系和工作投入之间具有中介作用.建立和谐团结的医护合作关系和提高护士情绪智力,可提高ICU护士工作投入水平,从而提高ICU护理质量.

目的:探讨齿槽医用冰帽应用于下颌阻生智齿拔除术后的临床疗效.方法:选取60例下颌阻生智齿患者,随机分为实验组与对照组,术前测量张口度、眼外眦至同侧耳屏中点距离、口角至同侧耳屏中点距离、颏前点至同侧耳根距离,手术采用切开、翻瓣、去骨及分冠手术步骤.术后实验组术区齿槽医用冰帽咬敷,对照组纱布压迫止血,冰袋外敷.术后48 h再次测量以上各面部标记点间距离并记录术后疼痛VAS评分,对比齿槽医用冰帽和冰袋的临床效果.结果:两组患者在术后疼痛、面部肿胀方面有统计学差异(P＜0.05),在张口度方面无统计学差异(P＞0.05).结论:齿槽医用冰帽对下颌阻生智齿术后反应有疗效,优于面部冰敷.

Objective To evaluate the clinical effectiveness of salvianolic acid B (SA-B) and triamcinolone acetonide (TA) by means of combined intralesional injection in the treatment of oral submucous fibrosis (OSF). Methods According to clinical findings and symptoms, TA combined with SA-B were consecutively applied intralesionally 1 time weekly for 30 times. Mouth opening degree, color change of the buccal mucosae and numeral increase of the capillary vessels were determined by degree Ⅰ-Ⅳvisual analog scale were evaluated at 12, 24, and 36 months, respectively. Results One hundred and fourteen subjects fulfilled the study without obvious adverse reactions. After treatment for 1 year, the net gain in mouth opening of the early stage group was (5.5 ± 1.5) mm at 12 months, (8.8 ± 1.6) mm at 24 months and (12.0±1.2) mm at 36 months. The net gain in mouth opening of the middle stage group were (5.3±1.7) mm at 12 months, (10.5±1.5) mm at 24 months and (14.5±2.4) mm at 36 months. The net gain in mouth opening of the advanced stage group were (5.7±1.3) mm at 12 months, (13.7±1.3) mm at 24 months and (15.5±1.5) mm at 36 months. The effective rates of color change of the buccal mucosae and numeral increase of the capillary vessels after treatment for 36 months were 100% in early stage group, 93% (51/55) in middle stage group and 90% (36/40) in advanced stage group. Conclusions TA and SA-B combined intralesional injection in the treatment of oral submucous fibrosis is effective.

目的：评价 PDCA（plan －do －check －action）循环在神经内科护理本科临床教学中的应用效果。方法：随机选取2014年8月至2015年8月在该院神经内科实习的护理专业本科学生45例为本次研究的观察组。同时随机选取2013年1月至2014年1月在该院神经内科进行实习的护理本科生42例为对照组。对照组实习生为传统的示范讲授型带教模式，观察组学生运用 PDCA 循环带教模式，观察期为1个月，对比两组实习生实习前后的理论和技能考核成绩。结果：两组实习生进入神经内科实习前一般资料（含性别、年龄、教育背景等）、操作技能、理论知识及老师满意度评分无明显差异（P ＞0.05）；经过1个月实习后，两组学生的成绩较实习前明显提升（P ＜0.05），其中，实行 PDCA 带教的观察组实习生的成绩明显优于对照组学生（P ＜0.05）。结论：将 PDCA 循环应用于神经内科护理本科临床教学中，能使学生更好地掌握神经内科专科操作技能与理论知识，值得在临床教学中推广应用。

Objective To explore the influential facts of betel quid chewing for patients with oral submucous fibrosis (OSF) in Haikou,Hainan Province.Methods One hundred and twenty three patients in the Haikou City People's hospital were investigated regarding their clinical information,including age,sex,origins,kinds and time of betel nut chewing,obvious clinical features,cognition for its harmfulness and so on.Results (1)The mean age was 36.5 years old,the most common patients were the group between the ages of 30 and 50 among 123 patients,male preferred to chewing betel nut,the female fond of betel nut were mostly Li minority women.(2)People chewing the dry betel nut had the higher incidence than the ones who prefer the fresh in five years.The both were significant difference (x2 =18.79,P ＜0.01),however,the incidence difference between the patients at the same time and the ones chewing kinds of betel nut was not significant (P ＞ 0.05).(3)The early clinical features of some OSF patients included stimulating pain,mucosal blanching,gradual inability to open the mouth and fibrous bands.(4)Although 61 patients (49.59％) knew about the harmfulness of betel nut chewing for their oral health,they could not change their lifestyle.Conclusions Male prefers to chewing betel nut,the female fond of betel nut are mostly Li minority women in Haikou area,the parts of patients could not overcome the habit ofchewing betel nut; people chewing the dry betel nut has the higher incidence than the ones who prefer the fresh's at early period,and of the two the former prone to disease than the latter.

PubMed,Nature database,ScienceDirect database and China National Knowledge Infrastructure (from year 2009 to 2013) were searched.The journal articles on correlation between gene polymorphism and adverse drug reactions were collected and analyzed.This article reviews the articles on correlation between adverse drug reactions and pleomorphic gene of metabolic enzymes,transporters,immune molecule and receptors.The metabolic enzymes mainly included cytochrome P450 2C9,N-acetyltransferase 2,uridine diphosphate glucuronosyl transferase 1A6,methylenetetrahydrofolate reductase,matrix metalloproteinase-9 and dihydropyrimidine dehydrogenase.The transporters mainly included solute carrier family 22 member 2,calcium channel,voltage-dependent,gamma subunit 6,solute carrier family 6 member 12,and ATP-binding cassette B1.The immune molecules mainly included human lymphocyte antigen (HLA) for instance HLA-B,HLA-A and HLA-C.The receptors mainly included dopamine 2 receptors/ankyrin repeat and kinase domain containing 1 Taq IA,chemokine receptor 3,orphan nuclear receptor NR4A1,pregnane X receptor and interleukin-4-receptor alpha.Understanding the relationship between gene polymorphism and adverse drug reactions is helpful to facilitate individualized drug administration and avoid or reduce the occurrence of adverse reactions.

Objective: To investigate the effect of surgical crown lengthening for ceramic front teeth marginal gingivitis because of insufficient biological width.Methods: 38 ceramic front teeth marginal gingivitis were underdone periodental non-surgical treatment,and flap operation was done after inflammation of teeth were controlled.Surgical crown lengthening was done from cervical margin of porcelain crown margin to inflamed socket ridge to form a 3-4mm interval.Therapeutic efficacy of marginal gingivitis was followed up for 3-4 years respectively.Results: Therapeutic efficacy was well in all 38 cases.1 case had light inflammation,37 cases had no inflammation.Conclusion: Ceramic front teeth marginal gingivitis because of insufficient biological width can be controlled with surgical crown lengthening.

In this paper,a series of polyamidoamine(PAMAM dendrimers of 0.5～6.0 generation) were synthesized by divergent method using ethylenediamine as a raw material,Their structure were characterized by means of elemental analysis and potentiometric titration.With the respective experiments of different generation and at the different additions,the surface tension and electric conductivity of the sodium aluminate solution were especially examine.It has shown that the architecture of PAMAM dendrimers was much more perfect at that condition,and with the increasing of the dosage of PAMAM,surface tension of sodium aluminate solution sharp reduce,It is found that the half generation PAMAM dendrimers,which are expected to be a kind of novel Surfacant,have fine surface activity.The integrated generation PAMAM dendrimers also have some surface activity.PAMAM is a non-ionic surfactant,with the additive of PAMAM,the electric conductivity of sodium aluminate solution change very small.

目的评价派丽奥局部应用辅助治疗逆行性牙髓炎的临床效果。方法将我院口腔医学中心收治的逆行性牙髓炎患者46例随机分为观察组和对照组,每组23例,均同时进行牙髓治疗和牙周治疗,观察组牙周袋内注入派丽奥软膏、对照组牙周袋内注入碘甘油,1次/周、共4次。比较分析两组的治疗效果。结果治疗后两组患者的菌斑指数、牙周袋深度、牙周附着水平、探针出血指标均有显著性差异。结论派丽奥局部应用辅助治疗逆行性牙髓炎有较好的临床效果。

Objective: To investigate the therapeutic effect of Vitapex iodoform paste used for root canal filling of primary teeth.Methods: To fill the root canals of the primary teeth using two different material,one group was filled with Vitapex iodoform paste and the other was filled with ZOE iodoform paste.Results:The research group got the even effective rate of 83.33 %,and the control group 81.03%,therewas no significant difference between the two groups(P0.05).Conclusion:Vitapex iodofrom paste is a good material for root canal filling of primary teeth.

目的:了解海口市学龄儿童龋病的充填情况及其影响因素。方法:抽查海口市526名7～12岁儿童患龋情况及充填情况,并采用问卷调查方法收集父母亲的文化程度、家庭经济收入以及其它相关影响因素。结果:526名儿童中龋病发病率为73.76%,龋均为2.24,充填率为17.01%。父母亲的文化程度、家庭经济收入、患儿的恐惧心理、就诊时间问题、医疗费用等对儿童龋病的充填均有影响。结论:海口市学龄儿童龋病发病率高,但充填率较低,主要影响因素有:父母的文化程度、家庭经济收入、患儿的恐惧心理、就诊时间问题、医疗费用等,我们应根据具体因素采取相应的措施,以提高儿童龋病的充填率。

笔者总结了365例老年高血压患者的特点和护理体会,认为对高血压病患者进行精心的护理能有效地减少高血压引起的各种不良后果.