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OBJECTIVE@#To investigate the clinical efficacy of a modified paramedian lower lip-submandibular approach for maxillary (subtotal) total resection.@*METHODS@#Eleven patients of maxillary tumors underwent maxillary (subtotal) total resection through the modified paramedian lower lip-submandibular approach. Clinical follow-up visits were conducted to evaluate appearance restoration, facial nerve functional status, parotid gland functional status, and orbital region complication.@*RESULTS@#During the follow-up period of 6-36 months, the appearance of all 11 patients recovered well. All cases presented hidden scars. No facial nerve and parotid duct injury, lower eyelid edema, lower eyelid ectropion, or epiphora in all cases was observed.@*CONCLUSIONS@#Applying modified paramedian lower lip-submandibular approach to maxillary (subtotal) total resection effectively reduces incidence of orbital region complications including lower eyelid edema, lower eyelid ectropion, and epiphora, which often occur to traditional approach. The modified approach produces more subtle scars than other methods and should be applied to treatment of maxillary (subtotal) total resection.
Subject(s)
Humans , Facial Nerve , Lip , Maxilla , Maxillary Neoplasms , Surgical FlapsABSTRACT
Objective:To evaluate the clinical applicability of CT angiography (CTA) for locating the perforator vessels of anterolateral thigh flap(ALTF) and the effects of individualized ALTF designed by CTA for the reconstruction of the soft tissue defects of tongue after the resection of tongue carcinoma.Methods:21 patients with tongue squamous cell carcinoma underwent CTA for locating the perforator vessels of ALTFs and for the design of individualized ALTFs before operation.The patients underwent soft tissue defect reconstruction with individualized ALTFs after tumor removal.Results:All the operations came off as preoperative designed,the intraoperative findings of the blood vessel alignment were consistent with the preoperative CTA results.The size of flaps was 6.0 cm × 5.0 cm-11.0 cm× 8.5 cm.20 ALTFs survived,2 ALTFs appeared vascular crisis,1 remained survival and the other was necrotic after surgical exploration.During 6 ～ 60 momhs of follow-up,the survival condition of flaps and the wound healing condition were both satisfactory.1 patient died because of distant metastasis 18 months after operation.20 patients reminded free of carcinoma and satisfied with the reconstructive effects of chewing,swallowing and linguistic function.Conclusion:CTA can accurately locate perforator vessels for the design of individualized AFLT.AFLT designed by CTA is an ideal choice for the reconstruction of postoperative soft tissue defects after resection tongue carcinoma.
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BACKGROUND:Bilateral ovariectomy is a most commonly used method to establish an animal model of postmenopausal osteoporosis.Up to now,little is reported on the C57 mouse model of osteoporosis with calvarial critical-size defects.OBJECTIVE:To establish the C57 mouse model of osteoporosis with calvarial critical-size defects.METHODS:Thirty-six C57 mice aged 8 weeks were randomly divided into two groups:the mice in model group received bilateral ovariectomy,and the same weight of fat tissues around the ovaries of the other mice were cut as control group.At 6 weeks after modeling,the mouse femur was removed for micro-CT scan and hematoxylin-eosin staining to testify whether there is a success or failure in animal modeling.Afterwards,six mice were respectively selected from each group,and two round calvarial defects with a diameter of 4 mm were symmetrically made on the parietal bone.The defect healing was evaluated by micro-CT scan at 8 weeks after modeling.RESULTS AND CONCLUSION:At 6 weeks after modeling,the bone volume fraction,bone surface to volume ratio,trabecular thickness,trabecular number,trabecular spacing and bone mineral density in the modeling group were significantly lower than those in the control group (P ＜ 0.05).In the model group,there were loosen or fractured trabeculae,and enlarged medullary cavity.At 8 weeks after bone defects,showed no significant micro-CT changes in the defect region in both two groups.These findings implicate a success in establishing the C57 mouse model of osteoporosis with calvarial critical-size defects.
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BACKGROUND:To obtain enough adipose-derived stem cells (ADSCs) is the premise of repairing osteoporotic bone defects by autograft transplantation;therefore,how to efficiently,simply and economically harvest primary autologous ADSCs is the key to the treatment of osteoporosis.OBJECTIVE:To isolate and culture ADSCs from mice with osteoporosis (OP-ADSCs) in vitro by tissue explant culture and collagenase digestion,and to compare the efficacies of these two methods.METHODS:Adipose tissues were isolated from the inguen of C57BL/6 mice,from which OP-ADSCs were obtained by tissue explant culture and collagenase digestion respectively.Then,the cells were subjected to primary culture and subculture.The surface specific antigens of passage 3 cells were observed using flow cytometry,while the yields and proliferation abilities of passage 3 were compared at 7 days of culture.The adipogenic and osteogenic differentiation of OP-ADSCs at passage 4 was detected.RESULTS AND CONCLUSION:(1) The expression levels of CD34,CD146,Sca-1 in passage 3 cells were (15.22±1.85)％,(75.55±3.36)％ and (83.48±4.22)％ for the tissue explant culture and (13.46±2.21)％,(76.62±2.47)％ and (84.84±3.56)％ for the collagenase digestion method,respectively.(2) The cell yield from each milligram of adipose tissue by tissue explant culture was significantly higher than that by collagenase digestion (P ＜ 0.05).(3) The proliferation rate of cells in the tissue explant culture group was higher than that in the collagenase digestion group after 24 hours of culture.(4) The OP-ADSCs cultured by the two methods could differentiate into adipocytes and osteoblasts,and the lipid accumulation and the mineralized nodules showed no significant difference between the two groups (both P＞ 0.05).These experimental findings indicate that the tissue explant culture is more suitable for obtaining OP-ADSCs in vitro as compared with collagenase digestion,which contributes to provide adequate cell sources for studies on ADSCs treatment of osteoporotic fractures and bone defects.
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<p><b>OBJECTIVE</b>To construct mouse enhanced green fluorecence protein (EGFP) -peroxisome proliferator-activated receptor (PPAR)gamma2, and to detect EGFP-PPARgamma2 expression in infected mouse bone marrow mesenchymal stem cells (BMSC).</p><p><b>METHODS</b>Cut the fragment of PPARgamma2 from the expression plasmid pcDNA flag PPARgamma2, then cloned the gene fragment into pEGFP-C1 and pEGFP-N1 vector. Subsequently, subclone the fragment EGFP-PPARgamma2 from pEGFP-C1-PPARgamma2 into the shuttle plasmid DC315. HEK293 cells were co-transfected with the constructed recombinant shuttle plasmid DC315-EGFP-PPARgamma2 and large adenovirus helper plasmid pBHGlox deltaE1, 3Cre in mediation of liposome. The obtained replication-defective recombinant adenovirus Ad-EGFP-PPARgamma2 was confirmed. Then it was propagated in HEK293 cells. After the BMSC were transfected for 72 h, adipogenic differentiation was demonstrated.</p><p><b>RESULTS</b>HEK293 cells were transfected with the pEGFP-C1-PPARgamma2 or pEGFP-N1-PPARgamma2 in mediation of liposome. The former green fluorescence protein was better than the latter by fluorescence microscope. The recombinant plasmids were digested and identified. Western blot analysis showed the expression of EGFP-PPARgamma2 in vitro. EGFP-PPARgamma2 protein was detectable in the nucleus of BMSC.</p><p><b>CONCLUSION</b>The recombinant adenovirus encoding EGFP-PPARgamma2 fusion protein was successfully constructed, which provided a basis for application of EGFP-PPARgamma2 gene to adenovirus-mediated gene therapy.</p>
Subject(s)
Animals , Humans , Mice , Adenoviridae , Bone Marrow Cells , Metabolism , Genetic Vectors , Green Fluorescent Proteins , Metabolism , HEK293 Cells , Mesenchymal Stem Cells , Metabolism , PPAR gamma , Metabolism , Recombinant Proteins , Metabolism , TransfectionABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical application effect of a three-dimensional craniomaxillofacial measurement instrument.</p><p><b>METHODS</b>A three-dimensional craniomaxillofacial measurement instrument was developed. Twelve patients of unilateral fracture of zygoma complex were treated with the help of the three-dimensional craniomaxillofacial measurement instrument.</p><p><b>RESULTS</b>The therapeutic effects of twelve patients were satisfactory with the three-dimensional craniomaxillofacial measurement instrument. No complication occurred, such as infection, injury of nerves and veins.</p><p><b>CONCLUSION</b>Three-dimensional craniomaxillofacial measurement instrument can exactly measure craniomaxillofacial hard tissue, and has adjuvant effect to restore and fix the fracture of unilateral zygoma complex.</p>
Subject(s)
Adult , Humans , Male , Imaging, Three-DimensionalABSTRACT
<p><b>OBJECTIVE</b>To study the characters of the diagnosis and treatment for midfacial fractures with orbital floor fractures.</p><p><b>METHODS</b>136 cases of midfacial fractures with orbital floor fractures were diagnosed and treated. All patients underwent CT scans and accepted surgical intervention. Orbital floor fracture was restituted in 49 cases. Orbital floor defects were reconstructed with autogenous bone, titanium mesh or porous polyethylene implant (Medpor) in 21 cases.</p><p><b>RESULTS</b>136 cases recovered well, their facial appearance and function were improved significantly. There were no severe complications happened postoperatively in all cases. 2 cases had postoperative wounds infection and 1 case had temporary ablepsia, but healed completely.</p><p><b>CONCLUSION</b>CT is the best method for diagnosing orbital floor fractures. The objective of treatment is restoration of normal orbital floor and orbital capacity, the reduction of orbital contents prolapsed and reconstruction of orbital floor fractures with repair materials.</p>