Clinical study of submental artery island myocutaneous flap for reconstruction of oral and maxillofacial defects following operation / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the outcome and indication of the reconstruction of oral and maxillofacial postoperative defects by submental artery island myocutaneous flaps.</p><p><b>METHODS</b>Sixty eight cases with the reconstruction of oral and maxillofacial defects by submental artery island myocutaneous flaps from January 2006 to May 2010 were analysed retrospectively. Primary lesions included carcinomas originating from tongue (28 cases), palate (13 cases), mouth floor (9 cases), gingiva (4 cases), buccal mucosa (6 cases), lip (3 cases), and other malignant or benign tumors (5 cases). The ages ranged from 25 to 84 years (mean 58 years); 47 males and 21 females. The sizes of skin paddle varied from a minimum of 4 cm × 4 cm to a maximum of 15 cm × 10 cm.</p><p><b>RESULTS</b>Of the 68 flaps, 62 were survival, 4 had partial necrosis but healed with treatments, and 2 failed due to complete necrosis. Appearance and functions of recipient sites were satisfactory. The followed-up time was 3 - 24 months, local recurrence occurred in 5 cases and cervical lymph node metastases were found in 15 patients.</p><p><b>CONCLUSION</b>Submental island flap is reliable for the reconstruction of postoperative defects in early oral cancer without regional lymph node metastasis or in benign tumor.</p>

Application of multislice spiral CT and 3D reconstruction in diagnosis and treatment of vascular malformations in head and neck / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the application of MS-CT and 3D reconstruction in diagnosis and treatment of vascular malformations in head and neck.</p><p><b>METHODS</b>20 cases with vascular malformations in head and neck underwent MS-CT and 3-D reconstruction. Then the treatment was determined based on the results of MSCT scanning. The postoperative results were evaluated.</p><p><b>RESULTS</b>The images of MS-CT showed the edge of vascular malformations partially or completely in 16 cases of venous malformations. The lesion's anatomic site and 3-D position was obtained. The 3-D images also showed the overexpanded supply arteries in 4 case of arteriovenous malformations. 2 case of venous malformations in lip underwent resection and healed completely. 12 cases of venous malformations in buccal and floor of mouth were treated with compartmentalized sclerotherapy with partial lesion involution. 2 case of venous malformations in mouth floor were treated with operation followed by sclerotherpy with partial lesion involution. 4 cases of arteriovenous malformations were treated with Superselective Artery Embolization with partial lesion involution.</p><p><b>CONCLUSION</b>MS-CT and 3D reconstruction can play an important role in diagnosis and treatment of vascular malformations in head and neck.</p>

Effects of Ezrin gene on the proliferation and invasion activity of human salivary gland adenoid cystic carcinoma / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To examine the expression of Ezrin in human salivary gland adenoid cystic carcinoma and investigate the effects of Ezrin gene silence on cell proliferation, apoptosis and invasion of adenoid cystic carcinoma (ACC)-M.</p><p><b>METHODS</b>The expression of Ezrin was detected by immunohistochemistry in normal salivary gland tissue (n=15), pleomorphic adenoma (n=40) and salivary gland adenoid cystic carcinoma (n=43). The Ezrin Stealth RNAi Duplex, containing Stealth RNAi Negative Control Duplex were constructed and transfected into ACC-M cells by Lipofectamine 2000. The expression levels of Ezrin were detected by RT-PCR and immunohistochemistry. The cell cycle and apoptosis rate were analyzed by flow cytometry (FCM). The cell proliferation was detected by methyl thiazolyl tetrazolium (MTT) and cell invasion by Transwell test.</p><p><b>RESULTS</b>The positive rate of Ezrin expression in ACC was significantly higher than that in normal salivary gland tissue and pleomorphic adenoma (P<0.05). After transfection of Ezrin Stealth RNAi Duplex, the mRNA and protein expression of Ezrin were down-regulated, the cell proliferation activity was inhibited, the G0-G1 Phase cells were increased, and the apoptosis rate of Ezrin Stealth RNAi Duplex group was higher than that in control groups and cell invasion ability was decreased.</p><p><b>CONCLUSIONS</b>Over expression of Ezrin in human salivary gland adenoid cystic carcinoma may promote genesis, development and metastasis of tumors. Ezrin Stealth RNAi Duplex could efficiently down-regulate the expression of Ezrin gene, and partly inhibited proliferation of ACC-M cells, induce apoptosis and decrease invasion ability of these cells in vitro.</p>

Evaluation of the articulator function in the hemi-tongue defect patients after radical tongue cancer resection and simultaneous reconstruction with forearm flap or primary close / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the effect of the patients' articulator function after reconstruction of hemi-tongue defect with forearm flap (FAP) or prime close (PC).</p><p><b>METHODS</b>36 patients who underwent hemiglossectomy were investigated after radical surgery for TSCC. 20 cases were reconstructed with FAP flaps and 16 with primary closure. The patients' articulator functions were evaluated by articulation tests. VS-9700 was used to analyze the speech character when they pronounce /ji/.</p><p><b>RESULTS</b>1) The speech articulation of patients who underwent hemi-tongue reconstruction with FAF was better than that of patients with PC, and there was significant difference between them (P < 0.05). 2) The first formant (F1) of /i/ of the PC group was lower than that of the control group (P < 0.05). But the second formant (F2) of the PC group was higher than that of the control group (P < 0.05). The first formant (F1) of /i/ of the FAF group was lower than that of the control group (P < 0.05), but there were no significant differences between FAF group and control group in F2 of /i/ (P > 0.05).</p><p><b>CONCLUSIONS</b>Articulator function can be well achieved by forearm flaps reconstruction to hemi-tongue defect patients.</p>

Silencing of survivin gene enhances chemosensitivity of human tongue cancer cell line Tca8113 to cisplatin / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of survivin short hairpin RNA (shRNA) on survivin expression, cell apoptosis, and chemosensitivity of human tongue cancer cell Tca8113 to cisplatin.</p><p><b>METHODS</b>Survivin-directed shRNA plasmid vector was delivered into Tca8113 cells with lipofectamine(TM) 2000 reagent. Survivin expression was detected with the reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting. Flow cytometry was used to examine cell apoptosis, and the sensitivity to anticancer agents was evaluated by methyl thiazolyl tetrazolium (MTT) assay.</p><p><b>RESULTS</b>After survivin shRNA vector transfection in Tca8113 cells, the expression of mRNA/protein declined significantly, and the apoptotic rate increased in time-dependent manner up to 37.9% at 48 hours. RNAi-mediated survivin reduction selectively inhibited growth and enhanced chemosensitivity of cisplatin but not of 5-fluorouracil.</p><p><b>CONCLUSIONS</b>Survivin shRNA could inhibit the expression of survivin mRNA and it's protein and enhance the chemosensitivity of cisplatin.</p>

Role of survivin gene on the apoptosis of Tca8113 cells induced by cisplatin / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To observe the induction of apoptosis of cisplatin (DDP) to oral squamous cell carcinoma cell line (Tca8113) in vitro and study the role of Survivin on the apoptosis of Tca8113 cells induced by cisplatin.</p><p><b>METHODS</b>The inhibitory effects of different doses of DDP on Tca8113 cells were assayed with MTT test. Apoptosis was determined by flow cytometry. The expression of Survivin was detected by RT-PCR and immunocytochemistry.</p><p><b>RESULTS</b>Cisplatin obviously inhibited Tca8113 cells growth in a dose and time dependent manner. The apoptotic index showed the similar trend. Survivin gene expression was decreased with increasing of time and reached the lowest level at 24 hours after DDP treatment, then increased after that time.</p><p><b>CONCLUSION</b>Cisplatin gene can effectively induce apoptosis in Tca8113 cells and the inhibition of Survivin gene expression may play a critical role on Tca8113 cell apoptosis induced by cisplatin.</p>

Combined repair of large defect caused by radical surgery of advanced tongue cancer with rib-major pectoralis myocutaneous flap carrying costal parietal pleura / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the clinical value and safety of using rib-major pectoralis myocutaneous flap carrying costal parietal pleura in combined repair of large soft and hard tissue defect caused by radical surgery of advanced tongue cancer.</p><p><b>METHODS</b>Six patients with advanced tongue carcinoma involving the floor of mouth and mandible were performed combined radical neck dissection with glossectomy and mandibulectomy, which caused large soft and hard tissue defect. Six rib-major pectoralis myocutaneous flaps carrying costal parietal pleura were transferred for immediate repair of the large defects. The rib flaps were applied for the repair of mandible, and the major pectoralis myocutaneous flaps were applied for the reconstruction of tongue and floor of mouth.</p><p><b>RESULTS</b>Six patients recovered well after operation. Six rib-major pectoralis myocutaneous flaps carrying costal parietal pleura survived well; the wounds of surgical incision of the oral cavity, neck, and chest healed up. The reconstructed tongue and the lower face appearance were satisfactory, the occlusion relationships were normal; the speaking as well as swallowing functions recovered.</p><p><b>CONCLUSIONS</b>It's safe and reliable to use rib-major pectoralis myocutaneous flap carrying costal parietal pleura to repair large soft and hard tissue defect in oral and maxillofacial region. Opening pleural cavity and harvest costal parietal pleura would not influence patients' thoracic movement and breath function and would not cause other complications. It's simple and safe for harvesting the composite flap. Carrying costal parietal pleura assures the sufficient blood supply of rib in the composite flap.</p>

Construction and selection of siRNA expression cassettes targeting human telomerase reverse transcriptase gene in vitro / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To determine whether the human telomerase reverse transcriptase (hTERT) gene silencing could be effectively induced by PCR-derived siRNA expression cassettes (SEC) transfected by the fifth generation polyamidoamine dendrimer (G5 PAMAM-D) in Tca8113 cells.</p><p><b>METHODS</b>Four SEC were rationally designed and constructed based on a two-step PCR reaction. The SEC were then transferred into Tca8113 cells using G5 PAMAM-D, and hTERT expression was investigated by real-time fluorescence-quantitative reverse transcriptase-PCR and western blot analysis.</p><p><b>RESULTS</b>The RNA interference effects of the SEC targeted for varying hTERT mRNA positions showed a significant disparity. Among them, SEC-A revealed the most potent inhibitory effects (above 95% of reduction), followed by SEC-D and SEC-C, and SEC-B had no effect on hTERT expression (P > 0.05). That the endogenous hTERT gene silencing induced by G5 PAMAM dendrimer-mediated SEC-A was highly sequence-specific, and multiple transfection as well as properties of the vectors were routinely attributable to the specific suppression.</p><p><b>CONCLUSIONS</b>Specific inhibition of endogenous hTERT expression by use of a PCR-based short hairpin siRNA technique and dendrimer transfer system may serve as a novel strategy for treatment of tongue cancers expressing hTERT in vitro.</p>

An island pectoralis major myocutaneous flap for the reconstruction of tongue and floor of mouth / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate an island pectoralis major myocutaneous flap for immediate reconstruction of the total tongue body and the floor of the mouth after radical resection of bilateral tongue carcinoma involved.</p><p><b>METHODS</b>Form October 2000 to December 2002, seven patients with bilateral tongue carcinoma were selected to treat with salvage surgery, and an island pectoralis major myocutaneous flap were applied for immediate reconstruction of total body of tongue and floor of mouth.</p><p><b>RESULTS</b>Six flaps survived well. Only one flap showed a partial necrosis, with no submandibular fistula, infection, and other complications. The reconstructed tongue and floor of mouth worked well. The speaking and swallowing functions were satisfactory after 2 approximately 16 months' follow-ups. Only one patient died of lung metastasis carcinoma in 9 months after the operation.</p><p><b>CONCLUSIONS</b>The island pectoralis major myocutaneous flap could be an ideal selection for the immediate reconstruction of the total tongue body and the floor of mouth.</p>

Effect of salvage surgery for patients with recurrent oral squamous cell carcinoma / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To examine the benefit of restaging recurrent oral squamous cell carcinoma (R-OSCC) and the effect on salvage surgery.</p><p><b>METHODS</b>An analysis was performed on 30 patients with local only first failure (n = 13) or loca-regional only first failure (n = 9) or first recurrence in the neck (n = 8) after surgery and/or radiation treatment given for oral squamous cell carcinoma. All the 30 patients were restaged and treated with salvage surgery.</p><p><b>RESULTS</b>The overall survival time and disease-free survival time of patients with early staged R-OSCC was longer than that of patients with advanced staged R-OSCC. The 1-year survival and 1-year disease-free survival rates for early staged R-OSCC is also higher than that of advanced staged R-OSCC.</p><p><b>CONCLUSIONS</b>The re-stage of the recurrent tumor is significantly correlated with survival. The salvage surgery is an effective measure in patients with recurrent oral squamous cell carcinoma, especially in early staged patients of R-OSCC.</p>

Transfection of human endostatin gene with lipofectamin and the expression of hES protein in Tca8113 cell / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The purpose of this study was to establish transfergeneic Tca8113 cell and evaluate the expression of human endostatin (hES) gene in the cell colone in vitro.</p><p><b>METHODS</b>To transfect hES gene into Tca8113 cells, lipofectamin was complexed with plasmid encoding hES gene, and blasticidin S antibiotic was adopted to select Tca8113--hES cell clone. Immunohistochemistry S-P method was adopted to detect the expression of hES in the transfergenic Tca8113 cell in vitro.</p><p><b>RESULTS</b>Transfected by hES, the transfergenic Tca8113 cells could grow and proliferate in RPMI--1640 culture medium containing blasticidin S antibiotic. The expression rate of hES reached 100%.</p><p><b>CONCLUSION</b>hES gene can express in hES-transfected Tca8113 cell in vitro.</p>

Effect of fas gene transfection on tumourigenicity and proliferation of transplanted tumor of oral squamous cell carcinoma cell line Tca8113 / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of fas gene transfection and monoclonal anti-fas antibody on tumorigenicity and proliferation of transplanted tumor of Tca8113 cell.</p><p><b>METHODS</b>Plasmid including fas gene was transfected into Tca8113 cell by lipofectamine kit. Some transfected cells were treated by monoclonal anti-fas antibody after 48 hours since transfection. Untransfected cell (control), fas-tansfected cell and fas-transfected cell treated with antibody were transplanted to nude mice subcutaneously. Growth of transplanted tumor was observed and recorded regularly. Animals were sacrificed and tumor samples were harvested at the end of experiment. Fas expression in each neoplasm was assessed by RT-PCR. Apoptosis, proliferation and expression of fas protein in tumor tissue were measured by flow cytometry (FCM).</p><p><b>RESULTS</b>Tumor occurred much later in fas-transfected group and fas-transfected plus antibody treated group. Growth arrest was found in them. RT-PCR and FCM suggested that fas-transfection up-regulated the expression of fas mRNA and protein, increased apoptosis index (AI). But no effect on proliferation index (PI) was observed. Monoclonal anti-fas antibody did not effect the expression of fas mRNA and protein, but increased AI and decreased PI.</p><p><b>CONCLUSION</b>Fas-transfection suppressing tumorigenesis of Tca8113 cell transplanted in nude mice might be caused by up-regulation of expression of fas gene and enhancement of apoptosis. However, anti-fas antibody suppressing tumorigenesis might be associated with activation of apoptosis and repression of proliferation.</p>

The inhibitory effect of human endostatin gene on tumor growth of tongue squamous cell carcinoma / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the expression of transfected human endostatin (hES) gene in tongue squamous cell carcinoma (TSCC) and its inhibitory effects on the growth of tumor cells in vivo.</p><p><b>METHODS</b>Lipofectamine-mediated hES gene was transferred into Tca8113 cells, selected with Blasticidin S; The stable transfected cells were inoculated in BALB/c mice, and then the growth of xenografts was observed. The hES and vascular endothelial growth factor (VEGF) protein expression of xenografts was detected by S-P immuno-histochemical assay. We also detected the microvessel density (MVD) of xenografts with Weidern's method and apoptotic index of the tumor cells by flow cytometry (FCM).</p><p><b>RESULTS</b>The hES protein expression of xenografts in experimental group was significantly higher than that in control group (P < 0.01), while the expression of VEGF protein was on the other way round (P < 0.01). MVD counting of xenografts in experimental group was lower than that in control group (P < 0.01). The mean apoptotic level of the tumor cells in control group was also lower than in experimental group (P < 0.01). In addition, the inhibitory rate to growth of xenografts induced by hES transfection was 78.9%.</p><p><b>CONCLUSIONS</b>hES gene can be transferred into TSCC cells and then induce corresponding protein expression efficiently in xenograft model, resulting in significantly inhibitory effects on the xenografts in vivo.</p>

Study on the relationship between Fas expression and apoptosis in oral squamous cell carcinoma / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the relationship of Fas mRNA and protein expression and apoptosis in human oral squamous cell carcinoma.</p><p><b>METHODS</b>Northern blot and flow cytometry (TUNEL method) were used to detect the expression of Fas mRNA and Fas protein, cell cycle and apoptotic level in oral squamous cell carcinoma. The relationship between Fas gene expression and OSCC apoptosis was analyzed statistically.</p><p><b>RESULTS</b>Fas mRNA and protein could be detected in all five normal oral mucosa specimens. There was positive correlation between expression of Fas mRNA/protein and cell differentiation as well as apoptosis in OSCC (P < 0.005).</p><p><b>CONCLUSION</b>The expression of Fas gene was highly correlated with the differentiation and apoptosis in OSCC.</p>

One-stage reconstruction of bilateral mandibular with free fibula flap / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the method of clinical application and the efficacy of free fibula osteomyocutaneous flap in one-stage reconstruction of transmidline bilateral mandibular defect caused by giant neoplasms.</p><p><b>METHODS</b>From july 2000 to october 2002, transmidline bilateral mandibular defects caused by ameloblastoma (4 cases) and gingival carcinoma (2 cases), according to the character of defects, were reconstructed with free fibula osteomyocutaneous flaps. Peroneal artery and vein were used as vascular pedicle, the fibula was reshaped, and micro-titanium plates were used in rigid fixation between fibula and residue of bilateral mandible. Microvascular anastomoses were carried out between peroneal artery/vein and small artery/vein in neck.</p><p><b>RESULTS</b>Six free fibular osteomyocutaneous flaps survived well. Follow up duration ranged from 6 months to 2 years, the lower face appearance recovered well, occlusion relationship were normal, all patients were satisfactory with appearance and chewing function after repair of removable denture.</p><p><b>CONCLUSION</b>Free fibular osteomyocutaneous flap is a favorable material in the reconstruction of transmidline bilateral mandibular giant defect. The blood supplement of fibula is offered both by segmentral periosteum and nutrient artery from bone marrow, It is greatly benefit to reshaping as arched mandible.</p>