Autonomic reinnervation and functional regeneration in autologous transplanted submandibular glands in patients with severe keratoconjunctivitis sicca / 国际口腔科学杂志·英文版

Autologous submandibular gland (SMG) transplantation has been proved to ameliorate the discomforts in patients with severe keratoconjunctivitis sicca. The transplanted glands underwent a hypofunctional period and then restored secretion spontaneously. This study aims to investigate whether autonomic nerves reinnervate the grafts and contribute to the functional recovery, and further determine the origin of these nerves. Parts of the transplanted SMGs were collected from the epiphora patients, and a rabbit SMG transplantation model was established to fulfill the serial observation on the transplanted glands with time. The results showed that autonomic nerves distributed in the transplanted SMGs and parasympathetic ganglionic cells were observed in the stroma of the glands. Low-dense and unevenly distributed cholinergic axons, severe acinar atrophy and fibrosis were visible in the patients' glands 4-6 months post-transplantation, whereas the cholinergic axon density and acinar area were increased with time. The acinar area or the secretory flow rate of the transplanted glands was statistically correlated with the cholinergic axon density in the rabbit model, respectively. Meanwhile, large cholinergic nerve trunks were found to locate in the temporal fascia lower to the gland, and sympathetic plexus concomitant with the arteries was observed both in the adjacent fascia and in the stroma of the glands. In summary, the transplanted SMGs are reinnervated by autonomic nerves and the cholinergic nerves play a role in the morphological and functional restoration of the glands. Moreover, these autonomic nerves might originate from the auriculotemporal nerve and the sympathetic plexus around the supplying arteries.

Application of anaerobic bacteria detection in oral and maxillofacial infection / 北京大学学报(医学版)

Objective:To investigate the distribution and drug resistance of anaerobic bacteria in the patients with oral and maxillofacial infection.Methods:Aerobic and anaerobic bacteria cultures from 61 specimens of pus from the patients with oral and maxillofacial infection in the Department of Oral and Maxillofacial Surgery,Peking University School of Stomatology were identified.The culture type was evaluated by API 20A kit and drug resistance test was performed by Etest method.The clinical data and antibacterial agents for the treatment of the 61 cases were collected,and the final outcomes were recor-ded.Results:The bacteria cultures were isolated from all the specimens,with aerobic bacteria only in 6 cases (9 .8%),anaerobic bacteria only in 7 cases (1 1 .5%),and both aerobic and anaerobic bacteria in 48 cases (78.7%).There were 55 infected cases (90.2%)with anaerobic bacteria,and 81 anaero-bic bacteria stains were isolated.The highest bacteria isolation rate of Gram positive anaerobic bacteria could be found in Peptostreptococcus,Bifidobacterium and Pemphigus propionibacterium.No cefoxitin, amoxicillin/carat acid resistant strain was detected in the above three Gram positive anaerobic bacteria. The highest bacteria isolation rate of Gram negative anaerobic bacteria could be detected in Porphy-romonas and Prevotella.No metronidazole,cefoxitin,amoxicillin/carat acid resistant strain was found in the two Gram negative anaerobic bacteria.In the study,48 patients with oral and maxillofacial infection were treated according to the results of drug resistance testing,and the clinical cure rate was 81 .3%. Conclusion:Mixed aerobic and anaerobic bacteria cultures are very common in most oral and maxillofa-cial infection patients.Anaerobic bacteria culture and drug resistance testing play an important role in clinical treatment.