Effectiveness of Oral Care in Implant Denture Restoration in Chronic Periodontitis

Objective:To explore the effect of observation of oral care in implant denture restoration of chronic periodontitis.Methods:80 patients with chronic periodontitis implant denture restoration admitted from March 2022 to March 2023 in the hospital were selected.They were randomly divided into an observation group and a control group,with 40 cases in each group.Both groups of patients received routine treatment and care.The patients in the control group used routine oral care methods to carry out oral care,the patients in the observation group carried out oral care on the basis of the control group,observation and analysis of the patients'mastery of oral knowledge,as well as the depth of the probing and the level of clinical attachment.Results:The oral knowledge mastery of the observation group was 72.31±6.98 after the nursing intervention,which was significantly higher than the score of 86.12±7.36 of the patients in the control group who used conventional oral care,and the difference was statistically significant at P<0.05;the depth of probing and the clinical attachment level of the observation group were 2.43±0.58 and 4.31±0.86 respectively,which were significantly better than those of the control group.The depth of probing and clinical attachment level scores of the observation group were 2.99±0.54 and 5.36±1.02 respectively,and P<0.05 was considered statistically significant.Conclusion:The combination of conventional treatment and oral care can effectively improve the treatment effect of implant denture prosthesis for chronic periodontitis.However,it is necessary to pay attention to the psychological counseling of the patients in the specific clinical application to ensure that the patients can actively cooperate with the clinical treatment.

Oral alkali therapy and the management of metabolic acidosis of chronic kidney disease:A narrative literature review

Chronic metabolic acidosis is a common complication seen in advanced chronic kidney disease(CKD). There is currently no consensus on its management in the Republic of Ireland. Recent trials have suggested that appropriate active management of metabolic acidosis through oral alkali therapy and modified diet can have a deterring impact on CKD progression. The potential benefits of treatment include preservation of bone health and improvement in muscle function; however,present data is limited. This review highlights the current evidence,available primarily from randomised control trials(RCTs) over the last decade,in managing the metabolic acidosis of CKD and outlines ongoing RCTs that are promising. An economic perspective is also briefly discussed to support decision-making.

Systematic Review and Meta-analysis of Biyuanshu Oral Liquid in the Treatment of Chronic Rhinosinusitis

[Objectives]The objective was to study the clinical efficacy and safety of Biyuanshu oral liquid in the treatment of chronic rhinosinusitis(CRS).[Methods]Randomized controlled trial was adopted to conduct scientific and standardized assessment on the risk of bias in the included papers.With overall effect and incidence of adverse reactions as indices,meta-analysis was performed,and sensitivity and safety analysis was conducted on the included literature.[Results]A total of 15 papers were included,involving 1489 patients.The efficiency of Biyuanshu oral liquid combined with Western medicine was better than that of Western medicine alone.[Conclusions]Biyuanshu oral liquid is safe and effective in treating chronic rhinosinusitis,and is suitable for patients who are not convenient for surgery.However,as the 15 papers included are all low in quality and there is a certain degree of publication bias,the objectivity of the results is affected to some extent.

Efficacy and safety of oral Chinese patent medicine combined with sacubitril/valsartan in the treatment of chronic heart failure:A Metaanalysis

Objective:To systematically evaluate the clinical efficacy of oral Chinese patent medicine combined with sacubitril/valsartan in treating chronic heart failure(CHF).Methods:CNKI,CSPD,CCD,CBM,PubMed,Web of Science,Cochrane Library and EMbase were retrieved to screen out randomized controlled trials Chinese patent medicine and Western medicine in treating CHF.Manual retrieval was also applied as a supplement.The Cochrane Reviewers Handbook 5.1.0 was used to evaluate the bias risk of the included studies and RevMan 5.4 software was used for Meta-analysis.Results:A total of 1301 patients enrolled in the 13 RCTs were included.According to the results of Meta-analysis,a combination of oral Chinese patent medicine and sacubitril/valsartan could further improve total effectiveness rate(RR=1.23,95%CI[1.16,1.30],P<0.001),increase 6 minutes’walk distance(MD=53.04,95%CI[33.43,72.64],P<0.001),improve left ventricular ejection fraction(MD=6.67,95%CI[5.15,8.19],P<0.001)and stroke volume(MD=7.56,95%CI[3.94,11.18],P<0.001),reduce left ventricular end-diastolic dimension(MD=-3.68,95%CI[-4.57,-2.78],P<0.001)and N terminal pro B type natriuretic peptide(MD=-434.08,95%CI[-518.95,-349.22],P<0.001)and no statistically significant difference in drug safety was found between the sacubitril/valsartan-only group and the combined treatment group(RR=0.73,95%CI[0.32,1.65],P=0.45).Conclusion:It’s indicated that a combination of traditional Chinese patent medicine and sacubitril/valsartan had a good clinical efficacy in the treatment of CHF,which had certain guiding significance for clinical practice.

Effects of H pylori therapy on erythrocytic and iron parameters in iron deficiency anemia patients with H pylori-positive chronic gastristis

AIM： To elucidate the influences of Hpylori infection on oral iron treatment for iron deficiency anemia （IDA）.METHODS： A total of 86 patients were divided into two groups： group A, receiving ferrous succinate combined with triple therapy for H pylori eradication, and group B （control）, treated with ferrous succinate only. During treatment of IDA, dynamic changes in hemoglobin （Hb） level, mean corpuscular volume （MCV）, mean corpuscular hemoglobin （MCH）, serum iron （SI）, and serum ferritin （SF） were compared between the groups.RESULTS： Hb was slightly higher in group A at d 14 alter the start of triple therapy for H pylori eradication （P 〉 0.05）. After the therapy, the increase of Hb in group A became significantly faster than that in group B （P 〈 0.05）. At d 56, the mean Hb in group A returned to the normal level, however, in group B, it was lower than that in group A （P 〈 0.05） although it had also increased compared with that before oral iron treatment. The MCV and MCH in group A recovered to the normal level, and were much higher than those in group B （P 〈 0.05） at d 21. In Group B, the MCV and MCH remained at lower than normal levels until d 42 alter the start of therapy. And then, they reached a plateau in both groups and the differences disappeared （P 〉 0.05）. The SF in group A was higher than that in group B （P 〈 0.05） 28 d alter the treatment and its improvement was quicker in group A （P 〈 0.05）, and the difference between the two groups was even more significant （P 〈 0.01） at d 56. The SI in group A was higher than that in group B （P 〈 0.05） at d 14 and this persisted until d 56 when the follow-up of this research was finished.CONCLUSION： Treatment of H pylori can enhance the efficacy of ferrous succinate therapy in IDA patients with Hpylori-positive chronic gastritis.

Treatment effects and periodontal status of chronic periodontitis after routine Er:YAG laser-assisted therapy

BACKGROUND Routine preclinical interventions for patients with chronic periodontitis such as supragingival cleaning and subgingival curettage,establishing a balanced occlusal relationship,and irrigation with 3%hydrogen peroxide can relieve the symptoms to some extent.However,there is room for improvement in the overall effect.For example,Er:YAG lasers can quickly increase the temperature of the irradiated tissue,effectively eliminate dental plaque and calculus,reduce periodontal pockets,adjust periodontal microecology,and reduce the gingival sulcus.The content of factors in the liquid,and then achieve the purpose of treatment.AIM The aim was evaluate the effect of Er:YAG laser-assisted routine therapy on the periodontal status in chronic periodontitis.METHODS Between October 2018 and January 2020,106 patients with chronic periodontitis in our hospital were randomly assigned to either the study or control group,with 53 patients in each group.The control group underwent routine therapy,and the study group underwent Er:YAG laser therapy in addition to routine therapy.We evaluated the treatment outcome in both groups.Periodontal status was determined by clinical attachment loss(CAL),gingival index(GI),periodontal probing depth(PD),dental plaque index(PLI),and sulcular bleeding index(SBI),inflammatory factors in the gingival crevicular fluid,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-8],and colony forming units(CFUs).RESULTS Total effectiveness in the study group(94.34%)was higher than that in the control group(79.25%,P<0.05).The clinical parameters in the study group(PD,5.28±1.08 mm;CAL,4.81±0.79 mm;SBI,3.37±0.59;GI,1.38±0.40;PLI,2.05±0.65)were not significantly different from those in the control group(PD,5.51±1.14 mm;CAL,5.09±0.83 mm;SBI,3.51±0.62;GI,(1.41±0.37;PLI,1.98±0.70)before treatment(P>0.05).However,after treatment,the parameters in the study group(PD,2.97±0.38 mm;CAL,2.71±0.64 mm;SBI,2.07±0.32;GI,0.51±0.11;PLI,1.29±0.34)were lower than those in the control group(PD,3.71±0.42 mm;CAL,3.60±0.71 mm;SBI,2.80±0.44;GI,0.78±0.23;PLI,1.70±0.51)(P<0.05).Differences in crevicular TNF-α,IL-6,and IL-8 levels in the study(TNF-α,7.82±3.43 ng/mL;IL-6,11.67±2.59 ng/mL;IL-8,12.12±3.19 pg/mL)and control groups(TNF-α,9.06±3.89 ng/ml,IL-6,12.13±2.97 ng/mL,IL-8,10.99±3.30 pg/mL)before therapy(P>0.05)were not significant.Following treatment,the parameters were significantly lower in the study group(TNF-α,2.04±0.89 ng/mL;IL-6,4.60±1.26 ng/mL;IL-8,3.15±1.08 pg/mL)than in the control group(TNF-α,3.11±1.07 ng/mL;IL-6,6.25±1.41 ng/mL;IL-8,4.64±1.23 pg/mL,P<0.05).The difference in the CFU of the study group[(367.91±74.32)×104/mL and control group(371.09±80.25)×104/mL]before therapy was not significant(P>0.05).The CFU decreased in both groups following therapy,however,the CFU values were lower in the study group[(36.09±15.26)×104/mL]than in the control group[(45.89±18.08)×104/mL](P<0.05).CONCLUSION Combining Er:YAG lasers with routine measures significantly improved the overall periodontal therapy outcomes by improving periodontal status and reducing oral levels of inflammatory factors and CFUs.

Development and validation of a self-management ability questionnaire for patients with chronic periodontitis

Objective: This study aimed to develop and validate a self-management ability questionnaire for patients with chronic periodontitis.Methods: A questionnaire was developed through theoretical research,literature review,semistructured interview,and expert consultation.A total of 231 patients with chronic periodontitis from the Department of Periodontics in the Stomatological Hospital of Tianjin Medical University were recruited by convenient sampling.Validity and reliability were analyzed.Results: The questionnaire consisted of 24 items.Exploratory factor analysis identified three principal factors,which explained 66.949% of the total variance.The item-level content validity was between 0.800 and 1.000,and the scale-level content validity was 0.969.The coefficient of correlation between the gold standard and the whole questionnaire was 0.869.Cronbach's α of the whole questionnaire was 0.931,and the test-retest reliability coefficient was 0.825.Conclusion: The questionnaire developed in this study satisfies the measurement standard and has good reliability and validity.It is useful for clinical work to measure self-management among patients with chronic periodontitis.

Dysbiosis of the Oral Microbiome: Association with and Prevention of Human Diseases

Oral diseases are associated with systemic diseases;such as type II diabetes, cardiovascular disease, rheumatoid arthritis (RA), and neurological diseases. Coincidentally, the oral microbiome (fluids or extracts) is readily accessible and easily sampled;therefore, serving as a diagnostic or prognostic tool for health status. The oral microbiome is a useful research model for studying fundamental questions of the human microbiome. In this narrative literature review, we examine the characteristics of oral microorganisms, the relationship between oral microorganisms and human diseases, and the important role of oral microorganisms in disease prevention. Also, we illustrate the usefulness of sampling the oral microbiome in developing the diagnosis and prognostic treatment strategies for oral and systemic diseases to accelerate their clinical application. Selective saliva biomarkers and microbiome can serve for useful indices to oral diseases and systemic diseases, and as a model research tool, the oral cavity has many uses in the clinical and research environment. The relationships between oral health and systemic diseases are quite profound, and future research will illuminate opportunities for fruitful preventative measures and therapeutics.

Research progress of compound Baiyu powder in treatment of chronic refractory wounds

Chronic refractory w ounds are common and frequently-seen diseases in surgery.Due to their long course of disease and complex pathogeneses,chronic refractory w ounds arouse high attention in clinic.With the preliminary results of clinical research of their pathogeneses and new treatments achieved,traditional Chinese medicine(TCM),w ith its unique concept,breaks the limitation commonly existing in the methods of w estern medicine,especially obtaining certain achievements in chronic refractory w ounds.This paper review ed the therapeutic effects of compound Baiyu pow der in the treatment of chronic refractory w ounds to prove to be effective,convenient to use and save medical costs.

Tailoring of therapy for chronic inflammatory demyelinating polyneuropathy

Chronic inflammatory demyelinating polyneuropathy （CIDP） is a treatable immune-mediated disorder, which causes in its typical form, symmetric proximal and distal weakness with large fibre sensory impairment involving the four limbs. There are currently three main first-line therapeutic options for CIDP. These consist of corticosteroids, immunoglobulins and plasma exchanges （PE） which have all been found effective in a number of trials conducted over the past several years （Van den Bergh and Rajabally, 2013）. No immunosuppressant therapy has shown benefit in CIDP, although they are utilized by many clinicians in various circumstances despite absence of an evidence base.

Effectiveness and safety of apixaban and rivaroxaban vs warfarin in patients with atrial fibrillation and chronic kidney disease

BACKGROUND Randomized controlled trials(RCTs)of direct oral anticoagulants(DOACs)included a low proportion of atrial fibrillation(AF)patients with chronic kidney disease(CKD),and suggested that DOACs are safe and effective in patients with mild-to-moderate CKD.In a metanalysis of RCTs and observational studies,DOACs were associated with better efficacy(vs warfarin)in early CKD and had similar efficacy and safety profiles in patients with stages IV-V CKD.But few studies have provided data on the safety and effectiveness of each DOAC vs warfarin in patients with stage III CKD.The effectiveness and safety of DOACs in those patients are still subject to debate.AIM To assess and compare the effectiveness and safety of apixaban and rivaroxaban vs warfarin in this patient population.METHODS A cohort of patients with an inpatient or outpatient code for AF and stage III CKD who were newly prescribed apixaban and rivaroxaban was created using the administrative databases from the Quebec province of Canada between 2013 and 2017.The primary effectiveness outcome was a composite of ischemic stroke,systemic embolism,and death,whereas the primary safety outcome was a composite of major bleeding within a year of DOAC vs warfarin initiation.Treatment groups were compared in an under-treatment analysis using inverse probability of treatment weighting and Cox proportional hazards.RESULTS A total of 8899 included patients filled out a new oral anticoagulation therapy claim;3335 for warfarin and 5564 for DOACs.Compared with warfarin,15 mg and 20 mg rivaroxaban presented a similar effectiveness and safety composite risk.Apixaban 5.0 mg was associated with a lower effectiveness composite risk[Hazard ratio(HR)0.76;95%confidence interval(CI):0.65-0.88]and a similar safety risk(HR 0.94;95%CI:0.66-1.35).Apixaban 2.5 mg was associated with a similar effectiveness composite(HR 1.00;95%CI:0.79-1.26)and a lower safety risk(HR 0.65;95%CI:0.43-0.99.Although,apixaban 5.0 mg was associated with a better effectiveness(HR 0.76;95%CI:0.65-0.88),but a similar safety risk profile(HR 0.94;95%CI:0.66-1.35).The observed improvement in the effectiveness composite for apixaban 5.0 mg was driven by a reduction in mortality(HR 0.61;95%CI:0.43-0.88).CONCLUSION In comparison with warfarin,rivaroxaban and apixaban appear to be effective and safe in AF patients with stage III CKD.

基于气络学说运用芪归通络口服液联合艾灸治疗气虚血瘀型慢性疲劳综合征的临床观察

【目的】观察基于气络学说,运用芪归通络口服液(广东省第二中医院院内制剂,由黄芪、当归、三七、赤芍、牛膝、鸡血藤、丹参、地龙等中药组成)联合艾灸治疗气虚血瘀型慢性疲劳综合征(chronic fatigue syndrome,CFS)的临床疗效。【方法】采用回顾性研究方法,根据治疗方法的不同将60例气虚血瘀型CFS患者分为观察组和对照组,每组各30例。对照组给予艾条温和灸神阙穴治疗,观察组在对照组的基础上联合芪归通络口服液治疗,疗程为4周。观察2组患者治疗前后中医证候积分、疲劳量表-14(FS-14)评分、血清免疫球蛋白IgA、IgM、IgG含量及皮质醇(COR)水平的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)疗效方面,治疗4周后,观察组的总有效率为96.67%(29/30),对照组为80.00%(24/30),组间比较,观察组的临床疗效明显优于对照组(P<0.05)。(2)量表评分方面,治疗后,2组患者的中医证候积分、FS-14评分均较治疗前明显降低(P<0.01),且观察组对中医证候积分、FS-14评分的降低作用均明显优于对照组(P<0.01)。(3)实验室指标方面,治疗后,2组患者血清IgA、IgG水平以及观察组血清IgM、COR水平均较治疗前明显升高(P<0.01),且观察组对血清IgA、IgM、IgG及COR水平的升高作用均明显优于对照组(P<0.05或P<0.01)。(4)安全性方面,治疗过程中,2组患者均未发生明显不良反应。【结论】基于中医气络学说,以正虚络阻为CFS核心病机,运用补虚通络法,采用芪归通络口服液联合艾灸治疗气虚血瘀型CFS患者疗效确切,能明显缓解患者的临床症状,提高患者的免疫力水平,调节患者的神经-内分泌-免疫(NEI)网络。

慢性牙髓炎患者血清炎症递质水平与口腔健康相关生活质量的关系

目的 分析慢性牙髓炎患者血清炎症递质水平与口腔健康相关生活质量的关系。方法 将116例慢性牙髓炎患者设为研究组,另选取同期健康体检者116名设为对照组。比较两组被试者血清炎症递质[白介素-1β(IL-1β)、白介素-6(IL-6)、白介素-8(IL-8)、白介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、前列腺素E2(PGE2)、P物质(SP)]水平与口腔健康影响程度量表中文版(OHIP-14)评分,采用Pearson相关系数评估慢性牙髓炎患者血清炎症递质水平与OHIP-14评分的相关性。结果 研究组患者血清IL-1β、IL-6、IL-8、IL-17、TNF-α、CRP、PGE2、SP水平,OHIP-14总分及各领域评分均高于对照组(P<0.01)。研究组患者血清IL-1β、IL-6、IL-8、IL-17、TNF-α、CRP、PGE2、SP水平与OHIP-14总分均呈正相关(r=0.659、0.623、0.678、0.611、0.697、0.683、0.725、0.713,P<0.01)。结论 慢性牙髓炎患者血清炎症递质水平较高,明显影响患者生活质量与心身健康,临床实践中要给予适当干预。

通关藤口服液治疗肺癌合并慢性支气管炎回顾性研究

目的 分析通关藤口服液对肺癌合并慢性支气管炎患者临床疗效的影响。方法 采用回顾性研究方法,收集2018年1月—2020年2月黑龙江中医药大学附属第一医院肿瘤科门诊治疗的38例肺癌合并慢性支气管炎患者的临床资料,根据用药情况分为通关藤组19例和脾氨肽组19例。其中,通关藤组予通关藤口服液治疗,脾氨肽组予脾氨肽口服冻干粉治疗。比较两组患者治疗后的CAT评分、中医证候(咳嗽、咳痰、喘息)评分、C-反应蛋白(CRP)、中性粒细胞计数/淋巴细胞计数比值(NLR)、治疗后1年内慢性支气管炎急性加重次数。结果 治疗后,两组患者CAT评分、中医证候(咳嗽、咳痰、喘息)评分、CRP、NLR均显著降低(P<0.05)。组间相比,通关藤组CAT评分、咳嗽和喘息评分、CRP、NLR均低于脾氨肽组(P<0.05)。通关藤组治疗后1年内慢性支气管炎急性加重次数为(1.21±0.89)次,少于脾氨肽组的(2.84±1.66)次(P<0.05)。结论 通关藤口服液可以显著改善肺癌合并慢性支气管炎患者咳嗽、喘息症状,减少慢性支气管炎急性加重次数,可能与改善机体炎症状态有关。

从气血同治探讨慢性气道疾病的异病同治

支气管哮喘和慢性阻塞性肺疾病(简称慢阻肺)同属慢性气道炎症疾病,在病机和治法上有一定的相似性,其都可通过调节气血以恢复肺气宣肃,行使正常生理功能。针对肺的生理功能和气血的关系,探讨支气管哮喘和慢阻肺的共同病机:支气管哮喘的基本病机是痰伏于肺,外邪引动,痰气互结,肺失宣降,并可兼有瘀血阻络之象;慢阻肺的病机以久病肺虚为本,加之痰浊、水饮、瘀血等病理产物,使得肺失宣降,本虚标实的病机随病程持续进展;进而从气血同治角度探讨支气管哮喘和慢阻肺2种慢性气道疾病的异病同治,得出“气血同治,畅通气道”的治疗理念。结合成药的应用,分析以此病机为指导的丹龙口服液组方特点和功效主治,为丹龙口服液异病同治2种气道疾病提供理论依据。

基于动机访谈的健康教育联合系统口腔护理对慢性牙周炎患者维护期口腔状况的影响

目的研究基于动机访谈的健康教育联合系统口腔护理对慢性牙周炎患者维护期口腔状况的影响.方法选取2022年1-12月山西医科大学第二医院收治的342例慢性牙周炎患者为研究对象,随机将其分为观察组及对照组,每组171例.对照组采用系统口腔护理,观察组采用基于动机访谈的健康教育结合系统口腔护理.对比两组患者的自我效能、口腔卫生状况及知信行水平.结果护理后,观察组的口腔保健自我效能量表评分为(70.14±5.88)分,高于对照组的(54.26±6.11)分,差异有统计学意义(P<0.05).护理后,观察组的菌斑指数、龈沟出血指数、牙龈指数评分均低于对照组,差异有统计学意义(P<0.05).护理后,观察组的各项知信行水平问卷评分均高于对照组,组间差异有统计学意义(P<0.05).结论慢性牙周炎患者采用动机访谈式健康教育联合系统口腔护理,能明显增强其自我效能和意识,促使其自觉保持口腔清洁度,从而改善个人卫生状况.

老年慢性牙周炎患者口腔健康自我效能现状及影响因素分析

目的:调查老年慢性牙周炎患者口腔健康自我效能现状并分析其影响因素。方法:采用便利抽样的方法,应用一般情况调查表、中文版口腔健康自我效能量表(GSEOH)和牙科恐惧量表(DFS)对288例老年慢性牙周炎患者进行调查。结果:老年慢性牙周炎患者的GSEOH的得分为(57.84±4.28)分,DFS得分为(37.69±9.78)分;老年慢性牙周炎患者牙科恐惧水平与GSEOH总分呈负相关(r=-0.457,P<0.001);多元回归分析显示,年龄、教育程度、月收入、居住地、牙周炎严重程度、牙科恐惧水平是老年慢性牙周炎患者口腔健康自我效能的影响因素(P<0.05)。结论:老年慢性牙周炎患者的口腔健康自我效能水平有待提高,护士应评估患者的相关影响因素,并采取针对性的护理干预,以提升其口腔健康自我效能。

儿童苔藓样肉芽肿性口炎1例报道及文献回顾

目的探讨口腔苔藓样损害的分类、临床表现、诊断、鉴别诊断及治疗,为临床提供参考。方法获得医院伦理审批及患者知情同意,报道1例儿童口腔苔藓样损害病例,结合文献对口腔苔藓样损害的诊疗进行回顾分析。结果患儿舌背反复破溃伴疼痛3年余,舌背大面积糜烂面,形状不规则,糜烂周围见珠光白色纹,左侧糜烂区伴组织增生,约1.5 cm×2.0 cm,质地韧,宽蒂。舌背白色网纹组织切取活检病理诊断为苔藓样损害;舌背增生物切除活检病理诊断为苔藓样损害伴肉芽肿性炎。根据患者口内损害特征、系统病史、用药史、组织病理学检查结果,最终诊断为苔藓样肉芽肿性口炎。文献回顾表明,口腔苔藓样损害病因不明,临床上需与口腔扁平苔藓、口腔苔藓样药物反应、口腔苔藓样接触性损害、慢性溃疡性口炎等疾病鉴别。临床上治疗口腔苔藓样损害以糖皮质激素的局部和/或全身使用为主。结论目前口腔苔藓样损害的分类和诊断仍无统一标准,主要依靠病史询问、临床表现和组织病理学检查结果,治疗方法主要为糖皮质激素的局部和/或全身使用。

口腔主动健康与肥胖

口腔健康与全身健康息息相关。常见的口腔慢性疾病,如牙周炎和根尖周炎,一方面可影响牙槽骨和牙龈等口腔软硬组织健康,另一方面还可能引起全身慢性低度炎症、氧化应激水平升高和菌群失调等全身症状,而这些全身健康状况的改变可加剧肥胖进展。因此,通过口腔主动健康干预,如保持良好的口腔卫生习惯、改变饮食结构、主动寻求口腔检查等,不仅可有效预防和治疗口腔炎症性疾病,还可能通过改善全身健康状态从而解决肥胖问题。本文深入探讨口腔炎症性疾病对肥胖的影响及其内在机制,定义了“口腔主动健康”概念,并系统总结其对口腔炎症性疾病的防治作用,讨论通过口腔主动健康策略改善肥胖的可能性。

住院老年慢性病共病患者营养不良的影响因素及预测模型构建

目的 探讨住院老年慢性病共病患者营养不良的影响因素及预测模型构建。方法 采用便利抽样法选取2023年1月—2024年2月在苏州大学附属苏州九院老年医学科住院的老年慢性病共病患者426例为研究对象。以微型营养评定简表(MNA-SF)评分<8分且白蛋白<34.0 g/L或前白蛋白<200 mg/L为营养不良依据,将患者分为营养不良组和无营养不良组。比较2组一般资料、口腔状况[采用口腔健康评估量表(OHAT)评估]、膳食炎症指数(DII,采用食物频率问卷表评估)、日常活动能力[采用Barthel指数(BI)评估]。采用多因素Logistic回归分析对老年慢性病共病患者营养不良的影响因素进行探讨,并构建模型公式。采用R软件运行梯度提升机(GBM)算法构建GBM预测模型。采用受试者工作特征(ROC)曲线分析2个模型的预测效能,采用Delong检验比较2个模型的曲线下面积(AUC)的差异。结果 92例被诊断为营养不良(营养不良组),334例患者无营养不良(无营养不良组)。营养不良组与无营养不良组年龄、慢性病共病种类、多重用药种类、OHAT评分、DII、BI评分比较,差异有统计学意义(P<0.05)。年龄大、慢性病共病种类多、多重用药种类多、OHAT评分高、DII高、BI评分低均是老年慢性病共病患者营养不良的影响因素(P<0.05)。ROC曲线显示,GBM模型的AUC为0.901,Logistic回归模型的AUC为0.874。Delong检验提示,GBM模型的预测效能优于Logistic回归模型(P<0.05)。结论 住院老年慢性病共病患者营养不良与年龄、慢性病共病种类、多重用药种类、OHAT评分、DII、BI评分有关,以此构建GBM模型可有效评估患者营养不良的发生风险。