Detection and analysis of T cell subsets, T cell cytokine and immunoglobulin in patients with oral cancer before and after operation

Objective:To investigate the changes of T cell subsets, T cell cytokine and immunoglobulin in patients with oral cancer before and after operation.Methods:A total of 40 cases of oral cancer treated in our hospital from January 2017 to December 2017 were selected as the observation group, and 40 healthy volunteers in our hospital were selected as the control group. The levels of T cell subsets, T cell cytokine and immunoglobulin in the observation group before and after operation were detected and compared with those in the control group.Results:The CD3+, CD4+ and CD4+/ CD8+ of the observation group before operation were lower than those of the control group, and CD8+ was higher than that of the control group, the differences were statistically significant. The CD3+, CD4+ and CD4+/CD8+ after operation in the observation group were (64.98 ± 3.88)%, (42.40 ± 3.53)% and (1.56 ± 0.41) respectively, which were all higher than those before the operation, but still lower than those in the control group. The CD8+ of the observation group was (27.25 ± 3.54)% lower than that before operation, but it was still higher than that of the control group. In the observation group, the levels of INF-γ+, CD4+/INF-γ+, IL-2+, and CD4+/IL-2+ before operation were lower in the observation group than those in the control group. In the observation group, INF-γ+, CD4+/INF-γ+, IL-2+, and CD4+/IL-2+ after surgery were (0.15±0.06)%, (0.07±0.03)%, (0.47±0.13)%, (0.16 ± 0.11)%, were higher than those before surgery, but still lower than those in the control group. The IgA and IgG before and after the surgery in the observation group were (2.01±0.13) g/L, (1.81±0.12) g/L, (10.53±3.12) g/L, and (8.41±2.01) g/L, respectively, compared with the control group, the difference was statistically significant. There was no significant change in IgA, IgG and IgM in the observation group before and after operation.Conclusion:Surgery can effectively improve the T lymphocyte subsets and T cell cytokine levels in oral cancer patients, and has a positive effect on improving immune function.

Early Post-Operative Complications in Surgeries Pertaining Oral and Maxillofacial Region in MNH, Tanzania

The Oral and maxillofacial region is one of the complex regions of the body considering the vast anatomical structures that are found in this region;head and neck surgery has potential for many complications, yet inadequate information on occurrence of post-operative complications in oral and maxillofacial surgeries in our setting has been documented. The aim of this study was to determine the occurrence of common early post-operative complications after oral and maxillofacial surgery in relationship to the underlying systemic condition. A descriptive postoperative study was done whereby patients who underwent oral and maxillofacial surgery were included. The included patients were those who underwent surgery for different pathological conditions, trauma, developmental/congenital conditions and inflammatory conditions to mention few. Demographic data, complications developed within one week post operative, and underlying systemic comorbidities before and after surgery were documented and analysed. A total of 102 patients were included in the study. The mean age of participants was 30.00 ± 17.01 years with a range of 2 to 81 years. Majority 43.1% (n = 44) had benign tumors with a leading diagnosis of ameloblastoma. In general, the most common complications which were noted in the cases included Pain 98% (n = 100) and Post-operative Swelling 97.1% (n = 99). The presence of underlying systemic comorbid conditions has a significant role in occurrence of some severe complications. The occurrence of complications does increase the duration of stay in the hospital hence increasing cost of treatment for which bearers are both patients and the hospital.

一分钟椅旁教学法结合微课在护理规培生口腔四手操作教学中的应用

目的:探讨一分钟椅旁教学法结合微课在护理规培生口腔四手操作教学中的应用效果。方法:选取护理规培生94人,随机分为两组,对照组47人,试验组47人,分别应用传统教学法、一分钟椅旁教学法结合微课进行口腔四手操作教学,比较两组教学效果并进行统计学分析。结果:试验组的口腔四手操作理论和实践考核成绩、口腔医生和患者对护理规培生的满意度均显著高于对照组(P<0.05)。结论:一分钟椅旁教学法结合微课优于传统教学法,应用于口腔四手操作教学中有利于提高护理规培生的理论和实践考核成绩,增加医生及患者对护理规培生的满意度。

不同皮瓣修复术对口腔颌面部肿瘤术后缺损手术时间及口腔功能指标的影响

目的:分析口腔颌面部肿瘤术后缺损患者行不同皮瓣修复术治疗的效果。方法:选择口腔颌面部肿瘤术后缺损患者58例,随机分为对照组和观察组,各29例。两组均施以皮瓣修复手术治疗,对照组胸大肌位置选择皮瓣,观察组为股前外侧皮瓣,比较不同部位皮瓣的效果差异。结果:观察组并发症总发生率低于对照组;手术时间、拔除胃管时间、经口进食时间、皮瓣愈合时间短于对照组;皮瓣制作+显微吻合时间长于对照组;外形修复、正常进食、口腔开合功能、口腔容纳水测试、正常吞咽、咀嚼功能、语言表达能力、正常咬合功能分数,皮瓣成活率和修复满意度高于对照组(P<0.05)。结论:口腔颌面部肿瘤术后皮瓣修复患者行不同皮瓣修复术的效果存在差异,股前外侧皮瓣相对比胸大肌皮瓣更具备优势,可缩短手术时间,改善口腔功能,安全度、患者满意度较高。

四手操作联合全程精细化护理在口腔修复中的应用价值及对不良反应、护理满意度的影响

目的探究四手操作联合全程精细化护理在口腔修复中的应用价值及对不良反应、护理满意度的影响。方法选取2022年7月至2023年7月本院收治的口腔修复患者94例,按护理方案分组,对照组52例病人采用常规护理方案,观察组42例病人采用四手操作联合全程精细化护理方案。比较两组的临床效果、舒适度、不良反应发生情况以及护理满意度。结果干预前两组GCQ各维度评分差异均不显著(P>0.05)。干预后,观察组临床总有效率、GCQ各维度评分、护理总满意度均显著高于对照组(P<0.05);不良反应总发生率显著低于对照组(P<0.05)。结论四手操作联合全程精细化护理在口腔修复中具有较好的临床效果,可显著改善病人的口腔症状,有效提高病人舒适度和护理满意度,同时不良反应发生率较低,具有较高的安全性,值得临床广泛应用。

Role of digital single-operator cholangioscopy in the diagnosis and treatment of biliary disorders

Due to the need for improvement in the diagnosis and minimally invasive therapy of the bile duct disorders new technologies for cholangioscopy have been recently developed. Per-oral cholangioscopy has become an important diagnostic and therapeutic tool leading to avoidance of aggressive and unnecessary surgery in many clinical scenarios. This paper focuses on the newly developed SpyGlass DS technology, its advantages, and the technique of single-operator cholangioscopy(SOC), biliary indications and possible adverse events. We also review the available literature; discuss the limitations and future expectations.Digital SOC(D-SOC) is a useful technique, which provides endoscopic imaging of the biliary tree, optical diagnosis, biopsy under direct vision and therapeutic interventions. The implementations are diagnostic and therapeutic. Diagnostic indications are indeterminate biliary strictures, unclear filling defects, staging of cholangiocarcinoma, staging of ampullary tumors(extension into the common bile duct), unclear bile duct dilation, exploring cystic lesions of the biliary tree,unexplained hemobilia, posttransplant biliary complications. Therapeutic indications are lithotripsy of difficult stones, retrieval of migrated stents, foreign body removal, guide wire placement, transpapillary gallbladder drainage and endoscopic tumor ablative therapy. Most studied and established indications are the diagnosis of indeterminate biliary stricture and intraductal lithotripsy of difficult stones. The adverse events are not different and more common compared to those of Endoscopic retrograde cholangiopancreatography(ERCP)alone. D-SOC is a safe and effective procedure, adjunct to the standard ERCP and the newly available digital technology overcomes many of the limitations of the previous generations of cholangioscopes.

Platelets Levels before and after Surgical Intervention in Patients with Oral and Maxillofacial Tumors at MNH, Tanzania

Background: There are documented effects of platelets on the solid tumors which need further study. The elevated platelet counts have been described for majority of cancers. There is inadequate information of effect of benign and malignant oral and maxillofacial tumors on the regulation of platelets. The aim of this study was to investigate the changes in platelet counts among patients with oral and maxillofacial benign and malignant tumors following surgical interventions. Methods: A descriptive postoperative study was done whereby patients with benign and malignant oral and maxillofacial tumors who met the inclusion criteria were included. The included patients were those who had no history of blood transfusion prior, during or after surgery, not on haemoglobin-boosting or bone marrow suppressing medications, not seropositive to human immunodeficiency virus also without clinical findings suggestive of lymphadenopathy, splenomegaly, ecchymosis and petechiae. Demographic data, Platelet counts and haemoglobin levels before and after surgery were documented and analysed by chi-square test and values were considered to be significant if p < 0.05. Results: A total of 61 patients were included in the study. The mean age of participants was 37.03 ± 16.6 years with range of 7 to 77 years. Majority 82.5% (n = 52) had benign tumors with a leading diagnosis of ameloblastoma followed by ossifying fibroma. In general there was an increase of platelet counts following surgery from the mean of 276.38 ± 109.40 K/uL to 308.51 ± 117.24 K/uL. Looking at benign and malignant separately, following surgery there was an increase of platelet counts for benign tumors (278.87 ± 106.37 to 305.96 ± 123.12) but a decrease for malignant tumors group (282.33 ± 147.03 to 232 ± 78.48). The haemoglobin level changed from the mean of 12.60 ± 1.71 g/dl before surgery to 11.69 ± 1.70 g/dl after surgery. Conclusion: The mean postoperative increase in platelet counts in benign and malignant tumors was due to healing process of the wound following surgery while the postoperative decrease in platelets counts in malignant tumors was due to effect of tumor removal which diminished the production of platelets activating factors. Malignant tumors produce platelets activating factors which are necessary for them to grow. Also, the difference in postoperative platelets counts in benign and malignant oral and maxillofacial tumors could be attributed by different biological behavior of benign and malignant tumors and hence different interactions of platelets to these tumors.

基于时机理论口腔癌同期皮瓣移植术患者出院准备服务方案的构建

目的构建口腔癌同期皮瓣移植术患者出院准备服务方案,为临床护理实践工作提供参考依据。方法以时机理论为指导,通过文献回顾拟定方案初稿,经过2轮德尔菲专家函询对专家意见进行修改确定最终干预方案。结果2轮函询专家积极性均为100%,专家权威系数Cr均>0.7,第2轮函询条目重要性及可行性的肯德尔和谐系数分别为0.140和0.128(P<0.05);最终方案包括5个一级指标、15个二级指标、52个三级指标。结论通过德尔菲法构建基于时机理论的口腔癌同期皮瓣移植术患者出院准备服务干预方案具有科学性和可靠性,可为临床出院准备服务提供参考。

手术室综合护理干预对口腔颌面全麻手术患者苏醒期躁动的影响

目的探讨手术室综合护理干预对口腔颌面全麻手术患者苏醒期躁动(EA)的影响。方法选取择期行口腔颌面全麻手术的88例患者为研究对象,按照随机数字表法将患者分为对照组和观察组,各44例。对照组实施手术室常规护理,观察组在常规护理基础上实施手术室综合护理。比较两组EA发生率、苏醒时间及拔气管插管时间、苏醒期心率及血压情况,采用简易心理状况评定量表Kessler 10评估干预前后心理状态,并记录苏醒期其他并发症情况。结果观察组EA发生率6.82%(3/44),低于对照组的22.73%(10/34),差异有统计学意义(P<0.05)。观察组苏醒时间及拔气管插管时间均短于对照组(P<0.01)。进入麻醉恢复室30min后,观察组心率、收缩压及舒张压均低于对照组(P<0.01)。干预后,两组Kessler 10量表评分均较干预前降低,且观察组低于对照组(P<0.01)。观察组其他并发症总发生率为9.09%(4/44),低于对照组的25.00%(11/44),差异有统计学意义(P<0.05)。结论对口腔颌面全麻手术患者实施手术室综合护理干预,能有效减少EA的发生,提高苏醒质量。

以案例为基础的PBL教学法在口腔种植教学中的应用

目的评定以案例为基础以问题为导向的教学法(problem-based learning,PBL)在口腔种植学教学中的效果。方法选取2020年1—12月在福建医科大学附属口腔医院学习的口腔种植医学生20名作为对照组,选取2021年1—12月在福建医科大学附属口腔医院学习的口腔种植医学生20名作为试验组。对照组予以常规教学方案,试验组予以案例为基础PBL教学方案。评定医学生考核成绩与教学方法满意度指标两组间存在的差异状况。结果经考核成绩评定:试验组综合成绩、临床操作技能成绩、理论知识成绩均高于对照组,差异有统计学意义(P<0.05);经满意度评定:试验组调动学习主动性、掌握临床基础知识、提高临床操作技能、教学方法等满意率高于对照组,差异有统计学意义(P<0.05);经判断性思维评定:试验组求知欲、分析能力、寻找真相及总分等高于对照组,差异有统计学意义(P<0.05)结论开展口腔种植教学中施以案例为基础PBL教学方案,能取得较好的教学成绩,促使学生更加满意教学方案,且可更好地培养医学生的判断性思维,意义重大。

PBL教学法联合标准化操作在种植住培带教中的应用研究

目的 探讨PBL教学法(problem-based learning,PBL)联合标准化操作在种植住院医师规范化培训(简称“住培”)中的应用效果。方法 2021年1月—2022年6月,将40名种植科住培医师随机分为试验组(n=20)和对照组(n=20)。试验组以标准化操作为对象和切入点进行PBL教学,包括种植治疗流程各环节的照片和影像资料。对照组采取常规模式教学。在教学结束后,比较两种教学法的效果。结果 试验组学生在医患沟通、操作技能、整体表现评分等方面评分均明显高于对照组,差异有统计学意义(P <0.05)。试验组对临床教学安排、学生参与度、师生互动的满意度均明显高于对照组,差异有统计学意义(P <0.05)。结论 PBL教学法联合标准化操作使学生在掌握种植操作中的重点和难点的同时,临床思维能力、查阅资料和解决问题的能力也得到了锻炼和提高,从而获得更好的教学效果。

改良呼吸训练操对食管癌术后患者恶心呕吐的影响

目的探讨改良呼吸训练操对食管癌术后患者经口进食期间恶心呕吐的影响。方法将57例择期行食管癌根治术患者分为对照组29例和观察组28例,对照组给予围手术期常规护理,观察组在此基础上采用改良呼吸训练操进行功能锻炼,入院时即开始,每天训练4次,每次20 min,共训练8周,术后1周、2周、4周及8周采用罗德恶心呕吐指数量表和呕吐生活功能指数量表评价干预效果。结果术后1周、2周、4周和8周观察组经口进食期间恶心呕吐症状及生活功能评分显著优于对照组(均P<0.05)。结论改良呼吸训练操可改善食管癌患者术后经口进食期间恶心呕吐症状,提高患者术后生活质量。

人工智能在根尖周囊肿病理诊断中的初步应用

目的研究人工智能应用于根尖周囊肿病理诊断的效果,初步探索人工智能在口腔病理学领域中的应用。方法以87例根尖周囊肿的病理图像作为研究对象,构建U-net型结构的神经网络,将87幅根尖周囊肿的HE图像和标注图像分为训练集72幅图和测试集15幅图,分别用于训练模型和测试模型,最后利用目标级指标F1分数和像素级指标Dice系数以及受试者工作特征(receiver operating characteristic,ROC)曲线评价U-net网络模型在根尖周囊肿上皮识别中的能力。结果U-net网络模型识别根尖周囊肿上皮的性能:F1分数为0.75,Dice系数为0.685,ROC曲线下面积为0.878。结论通过人工智能构建的U-net网络模型在识别根尖周囊肿上皮时具有较好的分割结果,能够初步应用于根尖周囊肿的病理诊断,有望进一步大样本验证后逐步推广于临床。

Effect of Simotang (四磨汤) Oral Liquid on Anal Exhaust in Patients after Abdominal Gynecological Operation

Objective： To study the effect of Simotang （四磨汤） oral liquid and glycerin enema on the patients＇ bowel sound （BS） restoration and anal exhaust after abdominal gynecological operation. Method： Ninety patients with benign tumor who had undergone gynecological operation were randomly divided into the Simotang group, treated after operation with Simotang oral liquid; the enema group, treated with glycerin enema, and the control group, non-treated. The restoration time of BS and anal exhaust were observed. Resuits： Compared with the control group, the restoration time of BS and anus exhaust were both significantly shorter in the Simotang group and the enema group, showing statistical significance （P〈0.05）; but the difference between the two treated groups was insignificant （ P〉0.05）. Conclusion： Simotang oral liquid and glycerine enema both could benefit the restoration of anal exhaust and BS after abdominal operation.

分散式教学法在外科ICU实习生口腔护理操作技能培训中的应用研究

针对分散式教学法在外科ICU实习生口腔护理操作技能培训中的应用价值展开分析。选取2022年1月—2023年1月期间在中山市人民医院外科ICU进行口腔护理操作技能培训的82名实习生作为研究对象,随机分为对照组和研究组,每组各41名,对照组采用常规教学方法,研究组给予分散式教学法,比较两组实习生培训效果、核心能力、口腔护理操作技能培训满意度及学习积极性。结果显示,研究组实习培训效果优于对照组(P<0.05);研究组核心能力评分高于对照组(P<0.05);研究组口腔护理操作技能培训满意度评分高于对照组(P<0.05);研究组学习积极性的各项指标均优于对照组(P<0.05)。研究发现,在外科ICU实习生口腔护理操作技能培训中应用分散式教学法,有助于促进实习生主动学习,提高实习生学习能力及学习效果,实习生在外科ICU口腔护理操作技能培训中的满意度较高,值得临床推广与应用。

基于“双减”的语文口语交际作业设计研究

口语交际作业是语文作业体系中的一道独特风景,侧重于引导学生运用流利的语言充分表达个人思想,是一种凸显实践性、开放性、综合性的作业形式。基于“双减”政策减轻学生课业负担的要求,教师要积极创新语文口语交际作业设计形式,使学生形成相应的语感,逐步提升口语表达能力。在教学中,教师可巧借课后习题、口语交际模块,训练学生“说话”的能力,设计趣味化作业、分层式作业、生活化作业、单元化作业、实践化作业、变通化作业,逐步提高学生的语言素养。

基于CiteSpace的口腔癌患者术后护理研究热点与趋势分析

目的 应用可视化方法分析近20年国内口腔癌患者术后护理研究热点及趋势。方法 以“口腔癌”“手术”“护理”等为研究主题,检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(Sino Med)2002年1月1日~2022年1月1日的文献,采用Cite Space6.1.R6软件对纳入文献的作者、机构、关键词进行可视化分析。结果 共纳入文献584篇,文献发文量呈逐渐上升趋势;发文量前三的作者是黄秋雨、张丽萍和何杏芳,发文量前三的机构是中山大学孙逸仙纪念医院、四川大学华西口腔医院和中山大学第二附属医院;关键词共现网络中心性前三位(去除检索词)的关键词为“并发症”“生活质量症”“围手术期”;关键词共形成10个聚类,22个突现词。结论 知识图谱近20年国内口腔癌患者术后护理研究的内容丰富,主要体现在分级护理、心理干预来舒缓术后疼痛感受、调节负面情绪、改善进食体验及提高生活质量等方面。目前研究热点为质性研究及心理干预研究,研究趋势为心理干预研究。

新型催眠药物MT5022口腔崩解片的制备与质量评价

目的研制MT5022口腔崩解片。方法采用正交试验对MT5022口腔崩解片的处方进行筛选得到最优处方,并对其进行制剂质量评价。结果MT5022口腔崩解片各组分按质量百分比计算的最优处方为MT5022(4.2%)、羧甲基淀粉钠(2.0%)、低取代羟丙基纤维素(2.0%)、微晶纤维素(30.0%)、阿斯巴甜(1.0%)、硬脂酸镁(1.0%)、甘露醇(59.8%)。制剂质量评价结果表明,所制备的MT5022口腔崩解片的外观性状、崩解时限、脆碎度、溶出度和含量均匀度等均符合《中国药典》中口腔崩解片的相关要求。结论成功制备了MT5022口腔崩解片,为将候选药物MT5022研制成适合军事作业环境使用的新型军用催眠药物奠定基础,也为药物的临床研究提供实验支持。

橡皮障联合四手操作护理在口腔根管治疗中的应用效果

目的探讨橡皮障联合四手操作护理在口腔根管治疗中的应用效果。方法选取2020年5月至2022年5月于厦门医学院附属口腔医院急诊综合科行口腔根管治疗的316例患者作为研究对象,采用随机数字表法将其分为对照组(158例)和观察组(158例)。对照组行常规护理,观察组接受橡皮障联合四手操作护理。比较两组的心理状态、疼痛程度、舒适度、生活质量和护理满意度。结果观察组护理后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均低于对照组,差异有统计学意义(P<0.05)。观察组疼痛程度轻于对照组,差异有统计学意义(P<0.05)。观察组护理后舒适状况量表(GCQ)中心理、生理、环境舒适、社会文化维度评分高于对照组,差异有统计学意义(P<0.05)。观察组护理后健康调查简表(SF-36)评分高于对照组,差异有统计学意义(P<0.05)。观察组护理满意度中操作方式、护理服务、沟通态度、护理效果、健康教育、安全管理评分均高于对照组,差异有统计学意义(P<0.05)。结论橡皮障联合四手操作护理可缓解口腔根管治疗患者消极心理状态,减轻患者疼痛,提高其舒适度和生活质量,从而获得更高的护理满意度。

显微超声技术结合CBCT诊治恒牙变异根管的临床疗效观察

目的:探讨显微超声技术结合锥形束CT(Cone beam computed tomography,CBCT)在恒牙变异根管诊治中的临床疗效。方法:分析83例常规治疗失败的变异根管经显微根管再治疗过程及愈后,主要通过术前分析CBCT影像中变异根管的数量、位置、钙化程度、弯曲方向,在口腔手术显微镜下应用超声治疗仪探寻变异根管,镍钛预备、热牙胶垂直加压充填。总结变异根管类型及治疗并发症,评价治疗效果。结果:83例变异根管中,80例成功寻及并疏通,1例发生带状穿孔,MTA即刻修补,2例未疏通至根尖,经0.5~2年复查无临床症状及体征,X线表现无异常。结论:应用显微超声技术结合CBCT能有效定位、疏通恒牙变异根管,提高治疗成功率。