Application of individualized free anterolateral thigh combined flap for tongue and mouth floor defects resulted from tongue carcinoma / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the application of individualized free anterolateral thigh combined flap (ALTCF) for tongue and mouth floor defect resulted from tongue carcinoma.</p><p><b>METHODS</b>From 2006 to 2008, individualized ALTCFs were used in 31 cases of tongue and mouth floor defects resulted from tongue carcinoma. The nutritional perforator vessel was musculocutaneous pattern in 22 cases and septocutaneous pattern in 9 cases. The size of the flaps and the included muscle was (4-8) cm x (5-10) cm and (2-5) cm x (3-6) cm, respectively. The length of blood vessel pedicle was (6.81 +/- 3.23) cm.</p><p><b>RESULTS</b>All the 31 free flaps survived with primary healing and no complication. The appearance and function were both satisfactory. During the follow-up period of 1-3 years, 28 cases survived, 2 cases were reoperated due to the neck lymphatic metastasis on the contralateral side. 1 case died of distant metastasis.</p><p><b>CONCLUSIONS</b>Individualized ALTCF is a reliable flap for the tongue and month floor defects resulted from tongue carcinoma. Both the cosmetic and functional results are satisfactory with less morbidity in donor site and less complication.</p>

Clinical and pathological analysis of central compartment dissection in patients with papillary thyroid cancer with negative clinical lymph node metastasis / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the significance of central compartment dissection in papillary thyroid cancer with negative clinical lymph node metastasis.</p><p><b>METHODS</b>Clinical and pathological data of 641 papillary thyroid cancer patients with negative clinical lymph node metastasis who were treated from January 1998 to April 2006 were collected. The positive rate of the lymph nodes metastasis was analyzed. The relations between the central compartment lymph nodes and the patients' gender, age, tumor size and number were concerned. Among the 641 cases, 114 case who received operation more than five years were followed up for the relations between the pathological status of central compartment lymph nodes and ipsilateral neck metastasis or contra thyroid lobe recurrence.</p><p><b>RESULTS</b>The median number of the central compartment lymph nodes was 4 each case and 53.0% (340/641) cases of papillary thyroid cancer patients with negative clinical lymph node metastasis had positive central compartment lymph nodes metastasis. Large tumor size and multiple origins were related to central compartment lymph nodes involvement, but the patients' gender or age was not. In the 114 follow-up cases, ipsilateral neck metastasis occurred in 12 cases, among which 11 cases had high positive central compartment lymph nodes metastasis. Contra thyroid lobe recurrence occurred in 5 cases, whose statuses of central compartment lymph nodes were different.</p><p><b>CONCLUSIONS</b>Papillary thyroid cancer patients with negative clinical lymph node metastasis deserve formal central compartment dissection. The pathological status of central compartment lymph nodes relates to the tumor size and number. High positive rate of central compartment lymph nodes may lead to possible ipsilateral neck metastasis.</p>

Anti-tumor mechanism of norcantharidin for the implanted tumors of human gallbladder carcinoma in nude mice in vivo / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the anti-tumor mechanism of norcantharidin (NCTD) for the implanted tumors of human gallbladder carcinoma in nude mice in vivo.</p><p><b>METHODS</b>Animal model of implanted tumors of human gallbladder carcinoma in nude mice was established. Mice were randomly divided into control, 5-FU, NCTD and NCTD + 5-FU groups and were taken different treatment. The expressions of PCNA, Ki-67, cyclin D1, p27, Bcl-2, Bax, Survivin, nm23/nm23-H1, MMP2 and TIMP2 proteins or genes in each tissue section of every group were determined by immunohistochemistry and RT-PCR.</p><p><b>RESULTS</b>(1) On proliferation-related gene proteins, the expression of PCNA, Ki-67, cyclin D1 was significantly decreased, with significantly increased expression of p27 protein, in paraffin sections of NCTD group when compared with control group (P < 0.05); The expression of PCNA mRNA, cyclin D1 mRNA was decreased, with significantly increased expression of p27 mRNA in NCTD group. (2) On apoptosis-related gene proteins, the expression of Bcl-2 was significantly decreased in paraffin sections of NCTD group when compared with control group (P < 0.05); The expression of Bcl-2 mRNA, Survivin mRNA was significantly decreased, with significantly increased expression of Bax mRNA in NCTD group. (3) There was significant difference on invasion around tumor and lung metastasis in NCTD group when compared with control group (P < 0.01). On metastasis-related gene proteins, the expression of nm23 and TIMP2 was significantly increased, with significantly decreased expression of MMP2 in paraffin sections of NCTD group when compared with control group (P < 0.05); The expression of nm23-H1 mRNA, TIMP2 mRNA was significantly increased, with significantly decreased expression of MMP2 mRNA in NCTD group.</p><p><b>CONCLUSIONS</b>The anti-tumor mechanism of NCTD for human gallbladder carcinoma in nude mice might correlated with inhibition of cell proliferation, blockage of cell cycle, induction of cell apoptosis, reducing of cell motility and invasive capability, alteration of the expression of proliferation-, apoptosis- and metastasis-related gene proteins such as PCNA, Ki-67, cyclin D1, p27, Bcl-2, Bax, Survivin, nm23, MMP2 and TIMP2.</p>

The in vitro effect of norcantharidin on proliferation and invasion of human gallbladder carcinoma GBC-SD cells and its mechanism / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the effect and mechanism of action of norcantharidin on proliferation and invasion of GBC-SD cells.</p><p><b>METHODS</b>GBC-SD cells of human gallbladder carcinoma were cultured by cell culture technique. The tetrazolium-based colorimetric assay was used to evaluate cell growth. The Matrigel experiment and the crossing-river test were used to examine the invasiveness of GBC-SD cells. Expression of MMP(2), TIMP(2), PCNA and Ki-67 proteins of GBC-SD cells was determined by streptavidin-biotin complex method.</p><p><b>RESULTS</b>Norcantharidin inhibited the growth and proliferation of GBC-SD cells in a dose and time dependent manner, with an IC(50) value of 56.18 micro g/ml at 48 h. The Matrigel experiment showed that norcantharidin began to inhibit the in vitro invasion of GBC-SD cells at the concentration of 5 micro g/ml. At 40 micro g/ml, the invasive action of GBC-SD cells was inhibited completely and their crossing-river time was prolonged significantly. After treatment with norcantharidin, the expression of PCNA, Ki-67, MMP(2) was significantly decreased. With the increase in TIMP(2) expression, the MMP(2) to TIMP(2) ratio was decreased significantly (P < 0.05).</p><p><b>CONCLUSION</b>Norcantharidin inhibits the in vitro proliferation and growth of human gallbladder carcinoma cells at relatively low concentrations by inhibiting PCNA and Ki-67 expression. Its anti-invasive activity may be the results of decrease in MMP(2) to TIMP(2) ratio and reduced cell motility.</p>