Reconstruction of mandible defect in osteoradionecrosis patients with free fibula osteomyocutaneous flap / 中华显微外科杂志

Objective To explore the clinical applicating and efficacy of free fibula osteomyocutane- ous flap in mandible defect reconstruction in osteoradionecrosis patients.Methods The mandible defects were reconstructed by free fibula flaps with or without muscle cuff.The soft tissue defects were repaired by skin paddles.Status of osteotomy in fibula and flap survival was recorded.The complication in recipient site and donor site,as well as mouth opening and occlusion were reviewed.Facial contour and chewing function after reconstruction were evaluated.Results Patients were followed up 3-16 months.4 free fibula flaps with muscle cuff and 5 without muscle cuff survived well.The size of mandible defects covered from 6cm to 17cm. And the harvested fibula flaps with length of 8.6-17cm were cut into 3 segments in 2 cases,and 2 segments in 5 cases.Fibula flap was divided into 2 segments and overlapped in 2 cases.No serious complication was oh- served in recipient site and donor site.Satisfying esthetic result and normal occlusiong of heath mandible were obtained in all cases.The degree of mouth opening was 2.5-3.3cm.Fair chewing function was revealed in re- constructive region after prosthesia repaired.Conclusion Free fibula osteomyocutaneous flap is relatively ideal reconstruction material of mandible defect in osteoradionecrosis patients for its high survival rate and well esthetic results.

Reconstruction of the tongue with rectus abdominis musculoperitoneal flap / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the outcome of surgical reconstruction of the tongue after hemiglossectomy with reinnervated rectus abdominis musculoperitoneal flaps in the treatment of tongue cancer.</p><p><b>METHODS</b>Five patients underwent immediate reconstruction of the tongue and oral floor defects with rectus abdominis musculoperitoneal flaps after resection of squamous cell carcinoma of tongue. The rectus abdominis musculoperitoneal flap consists of the rectus muscle, posterior rectus sheath, peritoneum, the 10 th, 11th, 12th intercostal nerves and the vascular pedicle that includes the deep inferior epigastric artery and veins. During the operation a reinnervated rectus abdominis musculoperitoneal free flap, in which the intercostal nerves were anastomosed to the descending branch of hypoglossal nerve, was grafted to remaining tongue stump.</p><p><b>RESULTS</b>All patients recovered uneventfully from surgery, with no immediate postoperative complications. All transplanted flaps survived. The peritoneum was replaced by squamous epithelium 8 weeks after surgery. The average follow-up period was 10 months. During the follow-up period the contour of the reconstructed tongues was satisfactory. The patients demonstrated good functional mobility of the reconstructed and remaining tongue. The swallowing and speech function was nearly at normal levels and the patients could ingest a solid or semisolid diet.</p><p><b>CONCLUSIONS</b>Reconstruction of the tongue with rectus abdominis musculoperitoneal flaps after hemiglossectomy is a suitable, cosmetically acceptable method. Long-term follow-up is needed for reaching some final conclusions.</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>

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>

Maxilla reconstruction with the free iliac osteomuscular flap and simultaneous osseointegrated implant embeding / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical outcome of reconstruction of maxillary defects with vascularized iliac crest flap and simultaneous osseointegrated implant embedding.</p><p><b>METHODS</b>During September to October 2003, two patients with maxillary defects from tumor resection underwent microsurgical reconstruction. The free iliac osteomuscular flap transferring and simultaneous osseointegrated implant embedding were performed to repair the defects. Three months after the reconstructive surgery, an abutment operation was preformed and denture was applied in both cases.</p><p><b>RESULTS</b>The flaps survived well. Postoperative follow-up for 8 to 9 months showed that the patients obtained good zygomaxillary appearance, normal occlusion, and satisfactory pronunciation, without oronasal fistula or other serious complications.</p><p><b>CONCLUSIONS</b>The free iliac crest osteomuscular flap with simultaneous osseointegrated implant embedding is an ideal, effective and cosmetically acceptable method for maxilla reconstruction.</p>