• 文章类型: Journal Article
    本研究的目的是探讨异位脑胺的保护作用和潜在机制,一种天然的渗透保护剂,干眼症眼表粘蛋白的产生。
    在暴露于干燥应激(DS)的C57BL/6小鼠中建立干眼模型,未处理(UT)小鼠作为对照。DS小鼠用2.0%艾克托因或PBS载体局部处理。通过俄勒冈绿葡聚糖(OGD)荧光染色评估角膜上皮缺损。结膜杯状细胞,眼粘蛋白,和T帮助(Th)细胞因子通过免疫荧光染色或ELISA进行评估,和RT-qPCR。
    与UT小鼠相比,角膜上皮缺损被检测为强点OGD荧光染色DS小鼠与载体,而ectoine治疗将OGD染色大大降低至接近正常水平。DS小鼠结膜杯状细胞密度和细胞大小明显下降,但通过艾克托因治疗显着恢复。两种凝胶分泌型MUC5AC和MUC2的蛋白质产生和mRNA表达,以及4种跨膜粘蛋白,MUC1,MUC4,MUC16和MUC15在DS小鼠中大幅下降,但是被ectoine修复了。此外,Th2细胞因子IL-13被抑制,而Th1细胞因子IFN-γ在DS小鼠的结膜和引流颈淋巴结(CLN)中的蛋白质和mRNA水平受到刺激,导致IL-13/IFN-γ比值降低。有趣的是,2.0%的埃托因逆转了它们的交替,并恢复了IL-13/IFN-γ平衡。
    我们的研究结果表明,外用外用能显著减少角膜损伤,并通过恢复小鼠干眼模型中不平衡的IL-13/IFN-γ信号传导来增强杯状细胞密度和粘蛋白产生。这表明天然渗透保护剂艾托因治疗干眼病的潜力。
    UNASSIGNED: This study aimed to explore protective effects and potential mechanism of ectoine, a natural osmoprotectant, on ocular surface mucin production in dry eye disease.
    UNASSIGNED: A dry eye model was established in C57BL/6 mice exposed to desiccating stress (DS) with untreated (UT) mice as controls. DS mice were topically treated with 2.0% ectoine or PBS vehicle. Corneal epithelial defects were assessed by Oregon Green Dextran (OGD) fluorescent staining. Conjunctival goblet cells, ocular mucins, and T help (Th) cytokines were evaluated by immunofluorescent staining or ELISA, and RT-qPCR.
    UNASSIGNED: Compared with UT mice, corneal epithelial defects were detected as strong punctate OGD fluorescent staining in DS mice with vehicle, whereas ectoine treatment largely reduced OGD staining to near-normal levels. Conjunctival goblet cell density and cell size decreased markedly in DS mice, but was significantly recovered by ectoine treatment. The protein production and mRNA expression of two gel-forming secreted MUC5AC and MUC2, and 4 transmembrane mucins, MUC1, MUC4, MUC16, and MUC15, largely decreased in DS mice, but was restored by ectoine. Furthermore, Th2 cytokine IL-13 was inhibited, whereas Th1 cytokine IFN-γ was stimulated at protein and mRNA levels in conjunctiva and draining cervical lymph nodes (CLNs) of DS mice, leading to decreased IL-13/IFN-γ ratio. Interestingly, 2.0% ectoine reversed their alternations and restored IL-13/IFN-γ balance.
    UNASSIGNED: Our findings demonstrate that topical ectoine significantly reduces corneal damage, and enhances goblet cell density and mucin production through restoring imbalanced IL-13/IFN-γ signaling in murine dry eye model. This suggests therapeutic potential of natural osmoprotectant ectoine for dry eye disease.
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  • 文章类型: Journal Article
    针对干燥综合征(SS)的靶向治疗已成为临床医生的重要关注点。多组学广泛的孟德尔随机化(MR)分析为识别潜在的药物靶标提供了新思路。
    我们进行了基于汇总数据的孟德尔随机化(SMR)分析,以通过整合DNA甲基化来评估与SS相关的治疗靶标,基因表达和蛋白质数量性状基因座(mQTL,eQTL,和pQTL,分别)。与SS的遗传关联来源于FinnGen研究(发现)和GWAS目录(复制)。采用共定位分析来确定两种潜在相关表型在给定区域中是否共享相同的遗传因素。此外,深入研究DNA甲基化之间的潜在调控,基因表达,和蛋白质丰富,我们进行了MR分析,以探讨候选基因甲基化与表达之间的因果关系,以及基因表达和蛋白质丰度之间。进一步采用药物预测和分子对接来验证候选药物靶标的药理活性。
    在整合多组数据后,我们确定了与SS风险相关的三个基因:TNFAIP3,BTN3A1和PLAU.BTN3A1中cg22068371的甲基化与蛋白水平呈正相关,与cg22068371甲基化对SS风险的负面影响一致。此外,PLAU(cg04939496)基因甲基化与表达呈正相关,以及表达和蛋白质水平之间。这种一致性阐明了PLAU在DNA甲基化时对SS风险的促进作用,基因表达,和蛋白质水平。在蛋白质水平,遗传预测的TNFAIP3(OR2.47,95%CI1.56-3.92)与SS风险呈正相关,而BTN3A1(OR2.96E-03,95%CI2.63E-04-3.33E-02)与SS风险呈负相关。分子对接显示候选药物和靶蛋白的稳定结合。
    我们的研究揭示了治疗SS的有希望的治疗目标,为SS的靶向治疗提供有价值的见解。然而,有必要通过未来的实验进一步验证.
    UNASSIGNED: Targeted therapy for Sjögren\'s syndrome (SS) has become an important focus for clinicians. Multi-omics-wide Mendelian randomization (MR) analyses have provided new ideas for identifying potential drug targets.
    UNASSIGNED: We conducted summary-data-based Mendelian randomization (SMR) analysis to evaluate therapeutic targets associated with SS by integrating DNA methylation, gene expression and protein quantitative trait loci (mQTL, eQTL, and pQTL, respectively). Genetic associations with SS were derived from the FinnGen study (discovery) and the GWAS catalog (replication). Colocalization analyses were employed to determine whether two potentially relevant phenotypes share the same genetic factors in a given region. Moreover, to delve deeper into potential regulation among DNA methylation, gene expression, and protein abundance, we conducted MR analysis to explore the causal relationship between candidate gene methylation and expression, as well as between gene expression and protein abundance. Drug prediction and molecular docking were further employed to validate the pharmacological activity of the candidate drug targets.
    UNASSIGNED: Upon integrating the multi-omics data, we identified three genes associated with SS risk: TNFAIP3, BTN3A1, and PLAU. The methylation of cg22068371 in BTN3A1 was positively associated with protein levels, consistent with the negative effect of cg22068371 methylation on the risk of SS. Additionally, positive correlations were observed between the gene methylation of PLAU (cg04939496) and expression, as well as between expression and protein levels. This consistency elucidates the promotional effects of PLAU on SS risk at the DNA methylation, gene expression, and protein levels. At the protein level, genetically predicted TNFAIP3 (OR 2.47, 95% CI 1.56-3.92) was positively associated with SS risk, while BTN3A1 (OR 2.96E-03, 95% CI 2.63E-04-3.33E-02) was negatively associated with SS risk. Molecular docking showed stable binding for candidate drugs and target proteins.
    UNASSIGNED: Our study reveals promising therapeutic targets for the treatment of SS, providing valuable insights into targeted therapy for SS. However, further validation through future experiments is warranted.
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  • 文章类型: Journal Article
    背景和目的:干眼症(DED)是一种慢性疾病,其特征是泪膜不稳定和眼表破坏,显著影响患者生活质量。本研究旨在为脱水羊膜(dAM,Omnigen®)通过专用绷带隐形眼镜(sBCL,OmniLenz)用于管理中度至重度DED。材料和方法:这项随机对照试验(NCT04553432)涉及93名中度至重度DED患者,随机接受为期1周的双侧dAM治疗(直径17mm,中央窗口6mm),应用于sBCL或单独的sBCL。参与者在基线时进行评估,并在治疗后1、3和6个月进行随访。结果包括症状学的变化,泪膜和眼表测量,角膜神经参数和角膜树突状细胞(CDC)计数的体内共聚焦显微镜成像。结果:dAM-sBCL组在6个月时OSDI评分降低了65%(p<0.001),88%的参与者在1个月时表现出改善。两组角膜染色均明显降低。dAM-sBCL在1个月时提供了角膜神经参数的显着改善,持续3个月的积极趋势。此外,dAM-sBCL显着减少成熟的CDC计数,表明有抗炎作用.结论:用dAM-sBCL治疗仅1周显著且快速改善干眼症状以及眼表体征至少3个月。它还可以增强角膜神经健康,同时减少激活/成熟的角膜炎症细胞数量,为中度至重度DED提供安全且有希望的新疗法。
    Background and Objectives: Dry Eye Disease (DED) is a chronic condition characterised by tear film instability and ocular surface disruption, significantly impacting patients\' quality of life. This study aimed to provide top-level clinical evidence for the long-term efficacy of dehydrated amniotic membrane (dAM, Omnigen®) delivered via a specialised bandage contact lens (sBCL, OmniLenz) for managing moderate-to-severe DED. Materials and Methods: This randomised controlled trial (NCT04553432) involved 93 participants with moderate-to-severe DED, randomised to receive a 1-week bilateral treatment of either dAM (17 mm diameter with 6 mm central \'window\') applied under a sBCL or sBCL alone. Participants were assessed at baseline and followed up at 1, 3, and 6 months post-treatment. Outcomes included changes in symptomatology, tear film and ocular surface measurements, and in vivo confocal microscopy imaging of corneal nerve parameters and corneal dendritic cell (CDC) counts. Results: The dAM-sBCL group demonstrated a 65% reduction in OSDI scores at 6 months (p < 0.001), with 88% of participants showing improvement at 1 month. Corneal staining was significantly reduced in both groups. dAM-sBCL provided significant improvements in corneal nerve parameters at 1 month, with sustained positive trends at 3 months. Additionally, dAM-sBCL significantly reduced mature CDC counts, suggesting an anti-inflammatory effect. Conclusions: Treatment with dAM-sBCL for just 1 week significantly and rapidly improved dry eye symptoms as well as ocular surface signs for at least 3 months. It also enhanced corneal nerve health while reducing activated/mature corneal inflammatory cell numbers, presenting a safe and promising new treatment for moderate-to-severe DED.
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  • 文章类型: Case Reports
    暂无摘要。
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  • 文章类型: Journal Article
    唾液腺生物加工代表了再生医学的一个有希望的途径,旨在解决由自身免疫性疾病和放疗等多种因素引起的唾液腺功能障碍的挑战。这篇综述探讨了生物打印技术的现状,生物材料,和组织工程策略在创造功能的背景下,可植入唾液腺结构。主要考虑因素包括实现血管化,以获得适当的营养供应,在打印过程中保持细胞活力和功能,促进组织成熟和与周围组织的整合。尽管存在挑战,最近的进展为开发个性化治疗选择以治疗唾液腺疾病提供了巨大的潜力.该领域的持续研究和创新具有彻底改变唾液腺状况管理的潜力,改善患者预后和生活质量。这项系统审查涵盖了2018年至2024年4月的出版物,并在四个数据库上进行:谷歌学者,PubMed,EBSCOhost,和WebofScience。成功创作所需的关键特征,解决了生物打印唾液腺的植入和功能。
    Salivary gland biofabrication represents a promising avenue in regenerative medicine, aiming to address the challenges of salivary gland dysfunction caused by various factors such as autoimmune diseases and radiotherapy. This review examines the current state of bioprinting technology, biomaterials, and tissue engineering strategies in the context of creating functional, implantable salivary gland constructs. Key considerations include achieving vascularization for proper nutrient supply, maintaining cell viability and functionality during printing, and promoting tissue maturation and integration with surrounding tissues. Despite the existing challenges, recent advancements offer significant potential for the development of personalized therapeutic options to treat salivary gland disorders. Continued research and innovation in this field hold the potential to revolutionize the management of salivary gland conditions, improving patient outcomes and quality of life. This systematic review covers publications from 2018 to April 2024 and was conducted on four databases: Google Scholar, PubMed, EBSCOhost, and Web of Science. The key features necessary for the successful creation, implantation and functioning of bioprinted salivary glands are addressed.
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  • 文章类型: Journal Article
    COVID-19,一种呼吸道疾病,对全球数百万人产生影响,最近与影响各种身体系统的表现有关,包括口腔。研究强调口头问题,比如溃疡,水泡,和白色斑块,除了嗅觉和味觉功能障碍,影响个人的生活质量。在这种情况下,我们的研究旨在评估口腔病变的频率,嗅觉和味觉紊乱,和COVID-19引起的口干症。对414例患者进行了一项观察性研究,以评估COVID-19引起的口腔症状的频率。患者被诊断为轻度症状,并通过口腔临床检查和评估功能改变的问卷进行评估。结果显示,414例患者中有139例出现临床表现,口腔病变最普遍(19.1%),其次是味觉障碍(18.1%),口干症(14.2%),嗅觉功能障碍(14%)。最常见的口腔病变是溃疡(n=51),念珠菌病(n=8),和红斑或红色斑块(n=7)。不幸的是,50例(12.1%)患者在本研究中死亡。因此,口腔病变,嗅觉和味觉功能障碍,口干症是与COVID-19相关的常见症状。
    COVID-19, a respiratory illness with a global impact on millions, has recently been linked to manifestations affecting various bodily systems, including the oral cavity. Studies highlight oral issues, like ulcers, blisters, and white patches, alongside olfactory and gustatory dysfunction, influencing an individual\'s quality of life. In this context, our study aimed to assess the frequency of oral lesions, olfactory and gustatory disorders, and xerostomia resulting from COVID-19. An observational study was conducted with 414 patients to evaluate the frequency of oral symptoms resulting from COVID-19. Patients were diagnosed with mild symptoms and evaluated through clinical examination of the oral cavity and a questionnaire to assess functional alterations. The findings showed that 139 out of 414 patients presented clinical manifestations, with oral lesions being the most prevalent (19.1%), followed by gustatory disorders (18.1%), xerostomia (14.2%), and olfactory dysfunction (14%). The most prevalent oral lesions were ulcerations (n = 51), candidiasis (n = 8), and erythema or red plaques (n = 7). Unfortunately, 50 (12.1%) patients died during this study. Therefore, oral lesions, olfactory and gustatory dysfunctions, and xerostomia are common symptoms associated with COVID-19.
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  • 文章类型: Journal Article
    Xerostomia emerges as a consequence of salivary gland hypofunction, and seriously compromises the integrity of hard and soft oral tissues, whileperiodontitis is an infectious disease characterized by biofilm accumulation, inflammation and alveolar bone resorption.
    OBJECTIVE: The aim this study was to compare the deleterious effects caused by experimental hyposalivation, periodontitis, and the combination of both on periodontal tissues and mandibular biomechanics in rats.
    METHODS: Hyposalivation (group H) was induced through bilateral submandibulectomy. Periodontitis (group EP) was induced by injecting LPS (1 mg/ml) into the gingiva of the first lower molars. A third group was subjected to both conditions (group H+EP). Alveolar bone loss was evaluated by micro-computed tomography and histomorphometric analysis, and gingival inflammatory mediators were assessed by specific techniques. Biomechanical properties were evaluated in mandible.
    RESULTS: Alveolar bone loss increased similarly in groups H, EP and H+EP compared to control. Metalloproteinase (MMP2 and MMP9) activity was similar in H and control, but higher in groups EP and H+EP (MMP2: C 9644+2214, EP 34441+3336, H 5818+1532, H+EP 42673+3184; MMP9: C 5792+961, EP 14807+861, H 9295+520, H+EP 4838+1531). The rest of the inflammatory mediators evaluated increased in groups H, EP and H+EP to a greater or lesser extent with respect to the control, although in most cases, they were higher in groups EP and H+EP than in group H. The biomechanical properties of the mandible increased in group H compared to the other three groups.
    CONCLUSIONS: Both hyposalivation and periodontitis cause periodontal damage, but hyposalivation also produces biomechanical alterations, causing more extensive deleterious effects than periodontitis.
    La xerostomía surge como consecuencia de la hipofunción de las glándulas salivales y compromete seriamente la integridad de los tejidos orales duros y blandos, mientras que la periodontitis es una enfermedad infecciosa caracterizada por la acumulación de biofilm, inflamación y reabsorción ósea alveolar.
    OBJECTIVE: El objetivo del presente estudio fue comparar los efectos deletéreos causados por la hiposalivación y la periodontitis experimental, y la combinación de ambas sobre los tejidos periodontales y la biomecánica mandibular en ratas.
    UNASSIGNED: La hiposalivación (H) se indujo mediante una submandibulectomía bilateral. Por otra parte, la periodontitis (PE) se indujo mediante la inyección de LPS (1 mg/ml) en la encía de los primeros molares inferiores. Otro grupo se sometió a ambas condiciones (H+PE). La pérdida ósea alveolar se evaluó mediante tomografia microcomputarizada y análisis histomorfométrico, mientras que los mediadores inflamatorios gingivales fueron determinados mediante técnicas específicas. Se evaluaron las propiedades biomecánicas en la mandíbula.
    RESULTS: La hiposalivación aumentó la pérdida ósea alveolar en comparación con el control de forma similar a la PE y H+PE. La actividad de las metaloproteinasas (MMP2 y MMP9) fue similar en los grupos H y control, pero resultó mayor en los grupos PE y H+PE (MMP2: C 9644+2214, PE 34441+3336, H 5818+1532, H+PE 42673+3184; MMP9: C 5792+961, PE 14807+861, H 9295+520, H+PE 24838+1531). El resto de los mediadores inflamatorios evaluados aumentaron en mayor o menor medida en los grupos H, PE y H+PE respecto al control, aunque en la mayoría de los casos fueron superiores en los grupos PE y H+PE respecto al grupo H. Sin embargo, las propiedades biomecánicas de la mandíbula aumentaron en el grupo H con respecto a los otros grupos.
    CONCLUSIONS: Tanto la hiposalivación como la periodontitis causan daño periodontal, pero la hiposalivación también produce alteraciones biomecánicas, provocando efectos deletéreos más extensos que la periodontitis.
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  • 文章类型: Journal Article
    目的:评价激光辅助原位角膜磨镶术(LASIK)患者干眼症(DED)的患病率。
    方法:对连续接受完整眼表检查的LASIK候选人进行了图表回顾,包括眼表疾病指数(OSDI),非侵入性测试(非侵入性泪液破裂时间[ni-TBUT],撕裂半月板高度,脂质层厚度,和介体图),和侵入性测试(Schirmer测试I,荧光素TBUT,角膜染色,和睑板腺[MG]表达能力)。DED的患病率是根据干眼研讨会II(DEWSII)计算的,以及日本和亚洲干眼协会(JDES/ADES)标准。
    结果:总计,评估了135例患者(270只眼)。平均年龄为32.6±8.3岁,62.9%为女性(n=85);19例(15.4%)戴隐形眼镜,31例患者(23.8%)使用人工泪液。平均OSDI为18.2±16.9,异常率为54.1%(n=62)。下眼睑MG脱落是异常结果百分比最高的迹象(61.5%;n=83)。除ni-TBUT外,男性和女性在任何测试中都没有差异(分别为6.3±0.3和7.2±0.2;P=0.002)。干眼症患病率分别为25.9%和53.3%,根据JDES/ADES和DEWSII标准,分别。DED的唯一重要危险因素是DEWSII(比值比[OR]=3.5,置信区间[1.35-9.39])和JDES/ADES(OR=2.58,CI[1.03-6.48])的人工泪液使用。
    结论:本研究发现LASIK候选患者中DED和异常的患病率很高,并强调了光折变手术前眼表评估的重要性。
    OBJECTIVE: To evaluate the prevalence of dry eye disease (DED) in laser-assisted in situ keratomileusis (LASIK) candidates.
    METHODS: A chart review of consecutive LASIK candidates who underwent full ocular surface work-up was performed, including ocular surface disease index (OSDI), noninvasive tests (noninvasive tear breakup time [ni-TBUT], tear meniscus height, lipid layer thickness, and meibography), and invasive tests (Schirmer test I, fluorescein TBUT, corneal staining, and meibomian gland [MG] expressibility). The prevalence of DED was calculated according to the Dry Eye Workshop II (DEWS II), and Japanese and Asia Dry Eye Society (JDES/ADES) criteria.
    RESULTS: In total, 135 patients (270 eyes) were evaluated. The mean age was 32.6±8.3 years, and 62.9% were women (n=85); 19 patients (15.4%) wore contact lenses, and 31 patients (23.8%) used artificial tears. The mean OSDI was 18.2±16.9, which was abnormal in 54.1% (n=62). Inferior lid MG dropout was the sign with the highest percentage of abnormal results (61.5%; n=83). There were no differences between men and women in any test except for ni-TBUT (6.3±0.3 and 7.2±0.2, respectively; P=0.002). Dry eye disease prevalence was 25.9% and 53.3%, according to JDES/ADES and DEWS II criteria, respectively. The only significant risk factor for DED was artificial tear use for both DEWS II (odds ratio [OR]=3.5, confidence interval [CI] [1.35-9.39]) and JDES/ADES (OR=2.58, CI [1.03-6.48]).
    CONCLUSIONS: This study found a high prevalence of DED and abnormalities in LASIK candidates and highlights the importance of ocular surface evaluation before photorefractive surgery.
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  • 文章类型: Journal Article
    目的:探讨原发性获得性鼻泪管阻塞(PANDO)患者干眼(DE)的患病率和泪膜稳定性的变化。
    方法:在此横截面中,观察性研究,对223例PANDO患者的370只眼进行了评估。眼表疾病指数(OSDI)用于评估眼表症状,并使用角膜摄影5M无创眼表分析仪评估眼表参数。根据TFOSDEWSII标准,OSDI≥13且NIKBUT<10s的患者被诊断为DE。
    结果:在223名PANDO患者中,65(29.1%)符合DE的诊断标准。与没有DE的患者相比,患有DE的PANDO患者明显年龄较大(p<0.001),有一个较长的持续时间的溢泪(p=0.023),并且更可能对泪囊压力(ROPLAS)信号(p=0.003)有正反流。多因素分析表明,年龄较大,ROPLAS阳性和高血压是DE的显著独立预测因子(p<0.05)。在147例无DE的单侧PANDO患者中,TMH,NIKBUT-First,PANDO两侧的NIKBUT平均和球红斑评分明显较高。
    结论:这项研究表明,在PANDO患者中,DE的患病率为29.1%,并且在年龄较大的患者中更容易发生,有高血压,ROPLAS阳性。此外,单侧鼻泪管阻塞的患者,在健康眼睛中观察到泪膜稳定性降低。
    OBJECTIVE: Exploring the prevalence of dry eye (DE) and the changes of tear film stability in patients with primary acquired obstruction of the nasolacrimal duct (PANDO).
    METHODS: In this cross-sectional, observational study, 370 eyes in 223 patients with PANDO were assessed. The ocular surface disease index (OSDI) was used to evaluate ocular surface symptoms, and the Keratograph 5M non-invasive ocular surface analyser was used to assess ocular surface parameters. According to the TFOS DEWS II criteria, patients with OSDI ≥ 13 and NIKBUT < 10 s were diagnosed with DE.
    RESULTS: Of the 223 PANDO patients, 65 (29.1%) met the diagnostic criteria for DE. Compared with patients without DE, PANDO patients with DE were significantly older (p < 0.001), had a longer duration of epiphora (p = 0.023), and more likely to have a positive regurgitation on pressure over the lacrimal sac (ROPLAS) sign (p = 0.003). Multifactorial analysis showed that older age, positive ROPLAS and hypertension were significant independent predictors of DE (p < 0.05). Among the 147 unilateral PANDO patients without DE, the TMH, NIKBUT-first, NIKBUT-average and bulbar erythema scores were significantly higher in the PANDO sides.
    CONCLUSIONS: This study illustrated the prevalence of DE in PANDO patients was 29.1% and DE is more likely to occur in those who are older, have hypertension and are positive for ROPLAS. In addition, in patients with unilateral nasolacrimal duct obstruction, a decrease in tear film stability was observed in the healthy eye.
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  • 文章类型: Journal Article
    接受姑息治疗的患者通常会出现使人衰弱的口腔疾病,包括口干症.这些情况可能会显著影响患者的生活质量。尽管口干症的患病率很高,影响也很不利,有效的管理策略尚不清楚。进行这项范围审查是为了阐明接受姑息治疗和临终关怀的患者口干症的有效干预措施。采用全面的搜索策略来确定截至2023年8月的相关研究。该综述包括了有关接受姑息治疗的患者口干症的全文主要文章。选择了11篇文章进行分析,数据由六名审查人员提取。本审查遵循了系统审查和荟萃分析指南的首选报告项目。在11项研究中,干预措施从口腔护理到唾液替代品和刺激唾液分泌的方法。评估口干症的主要方法是使用视觉模拟量表得分或数字评定量表得分进行主观评估。各种干预措施,包括口腔护理方案,局部治疗,报告了混合疗效结局。值得注意的是,只有一项研究直接测量了唾液体积,在大多数研究中强调对主观终点的依赖。尽管无法得出关于最有效干预措施的明确结论,对于接受姑息治疗的患者,口腔护理是治疗口干症的首选方案.此外,辅助治疗,如冰块,盐水,保湿霜显示出希望,但需要进一步调查。客观措施应纳入未来的干预试验,以补充主观评估,并对该患者人群的口干症管理策略进行全面评估。
    Patients undergoing palliative care often develop debilitating oral conditions, including xerostomia. These conditions may significantly impact patients\' quality of life. Despite the high prevalence and adverse impact of xerostomia, effective management strategies remain unclear. This scoping review was performed to elucidate effective interventions for xerostomia in patients undergoing palliative and end-of-life care. A comprehensive search strategy was employed to identify relevant studies up to August 2023. Full-text primary articles focusing on xerostomia in patients receiving palliative care were included in the review. Eleven articles were selected for analysis, and data were extracted by six reviewers. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Among the 11 studies, interventions ranged from oral care to saliva substitutes and methods to stimulate saliva secretion. The primary method of assessing xerostomia was the performance of subjective evaluations using visual analog scale scores or numerical rating scale scores. Various interventions including oral care regimens, topical treatments, and mixed efficacy outcomes were reported. Notably, only one study directly measured the saliva volume, highlighting a reliance on subjective endpoints in most studies. Although no definitive conclusions can be drawn regarding the most effective intervention, oral care was a preferred option for managing xerostomia in patients undergoing palliative care. Additionally, adjunctive treatments such as ice cubes, saline, and moisturizers showed promise but require further investigation. Objective measures should be incorporated into future intervention trials to complement subjective assessments and provide a comprehensive evaluation of xerostomia management strategies in this patient population.
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