Clinical analysis of 40 newborns with head and neck occupying lesions / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the clinical features, diagnoses and treatments of head and neck occupying lesions in newborns. Methods: All newborns with head and neck occupying lesions admitted to Neonatel Intensive Care Unit of the First Affiliated Hospital of Zhengzhou University form January 2014 to November 2019 were included. There were 23 males and 17 females, admission age was from 2 d-28 d, and the clinical manifestations, examinations, treatments and outcomes were evaluated. Results: Among 40 newborns with head and neck occupying lesions, 22 cases were admitted with dyspnea, 15 cases with masses in oral cavity or head and neck, 2 cases with fever as the first symptom, and 1 case with hoarseness as the first symptom. There were 5 cases with local infection. All cases were examined with local ultrasound and CT or MRI. Nine cases with severe dyspnea were treated with invasive ventilationm, of them 6 cases underwent invasive ventilation for more than 48 hours, 4 cases received tracheal intubation and artificial nose. Diagnostic punctures were performed in 2 cases. Seven cases received conservative treatments. Surgeries were performed in 31 cases, and 25 cases obtained pathologic diagnoses, including 3 cases of soft palate mature teratomas, 1 case of hard palate teratoma, 1 case of granulosa cell tumor, 1 case of lobulated spindle cell tumor in tongue base, 1 case of polyp in right glottis, 1 case of polyp at esophageal entrance, 4 cases of lingual root cysts, 1 case of laryngeal cyst, 2 cases of thyroglossal duct cysts, 2 cases of lymphangiomas, 1 case of lymphangioma with hibernoma, 1 case of tracheal cyst, 1 case of esophageal cyst, 3 cases of left neck abscesses, 1 case of occipital hemangioma, and 1 case of left temporoparietal abscess. Conclusions: The head and neck occupying lesions in the newborn is prone to upper airway obstruction. Imaging examination can assist the diagnosis. Different treatments can be selected according to the natures of occupying lesions.

Diagnostic value of CA125, HE4 and Copenhagen Index in differentiating benign from malignant epithelial ovarian tumors / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze diagnostic value of Copenhagen Index based on pretreatment serum CA125, HE4 and age in differentiating benign and malignant epithelial ovarian tumors.</p><p><b>METHODS</b>The clinical data were analyzed for 208 consecutive patients with epithelial ovarian tumors (including 100 with malignant and 108 with benign tumors) treated in our department between September, 2014 and September, 2016. The receiver-operating characteristic curve was drawn based on the golden standard of pathological diagnosis for calculation of the diagnostic sensitivity and specificity of CA125, HE4 and the Copenhagen Index.</p><p><b>RESULTS</b>In the overall cases, early stage cases and advanced stage cases, the prediction probabilities of CA125, HE4 and Copenhagen Index were all significantly higher for malignant than in benign tumors (P<0.001). The sensitivities of CA125, HE4, Copenhagen Index for differentiating benign and malignant tumors were 81.0%, 86.0% and 91.0% in the overall cases, 64.0%, 68.0% and 72.0% in early stage cases, and 86.7%, 92.0% and 97.3% in advanced stage cases, and their diagnostic specificities were 88.0%, 93.5% and 96.3%, respectively. Copenhagen Index had the highest diagnostic sensitivity (but not in early stage cases) and specificity followed by HE4 and then by CA125 (P<0.001) (P>0.05).</p><p><b>CONCLUSION</b>Copenhagen Index combined with CA125, HE4 and age hase better diagnostic value than HE4 or CA125 alone for differentiation between benign and malignant epithelial ovarian tumors, and can be used clinically to improve the early diagnostic rate of epithelial ovarian cancer.</p>

Effects of docosahexaenoic acid on cell apoptosis, invasion and migration of cervical cancer cells in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of docosahexaenoic acid (DHA) on apoptosis, migration and invasion of cervical cancer cell lines.</p><p><b>METHODS</b>cervical cancer cell lines Hela and Siha in logarithmic phase were treated different concentrations of DHA. The morphological changes of the cells were observed microscopically and cell apoptosis was observed using Hoechst 33258 fluorescent staining. MTT assay was used to evaluate the effect of DHA in suppressing cell growth, and flow cytometry was employed to analyze the changes of cell apoptotic rate following DHA stimulations. Wound healing assay and Transwell migration assay were used to evaluate the migration of the cell lines. The expression levels of Bax, Bcl-2 cleaved caspase3, MMP-9 and VEGF proteins were detected by Western blotting.</p><p><b>RESULTS</b>DHA exposure of the cells caused obvious morphological changes and dose-dependently increased the number of apoptotic bodies in the cells. MTT assay showed that DHA inhibited the growth of the cancer cells in a time- and concentration-dependent manner. DHA also effectively suppressed migration and invasion of the cancer cells. The cells exposed to DHA showed significantly down-regulation of Bcl-2, MMP-9 and VEGF proteins and up-regulation of cleaved-caspase 3 and Bax.</p><p><b>CONCLUSION</b>DHA can promote cervical carcinoma cell apoptosis by down-regulating the anti-apoptotic proteins Bax, Bcl-2 and cleaved-caspase3 and suppress cell invasion by decreasing MMP-9 and VEGF expressions.</p>

The application of free tissue flap in simultaneous reconstruction of defects after tongue cancer / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the feasibility of using free tissue flap for simultaneous tongue reconstruction after tongue cancer resection.</p><p><b>METHOD</b>Radial forearm flaps and anterolateral thigh flaps were used for simultaneous reconstruction of different defects after tongue cancer resection in 47 cases. The functional evaluation was assessed during the follow-up period of 3 months to 9 years.</p><p><b>RESULTS</b>Only one flap failed,giving a success rate of 97.7%. The 36 patient available for postoperative follow-up were all able to communicate in basic languages and eat normally. Among them, normal speech was found in 34, while slurred speech was found in two. 31 patients could eat normal diet ,while eight could eat soft diet and two could eat liquid diet.</p><p><b>CONCLUSIONS</b>Simultaneous tongue reconstruction with free tissue flap is a reliable method with high successful rate. Flaps selection based on different tongue defects is the key point to achieve good functional and cosmetic results for the reconstruction tongue.</p>

Mutation and expression of tumor suppressor gene phosphatase and tensin homolog deleted in chromosome 10 in oral squamous cell carcinoma / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the role of mutation and mRNA expression of tumor suppressor gene phosphatase and tensin homolog deleted in chromosome 10 (PTEN) in tumorigenesis and progression of oral squamous cell carcinoma (OSCC).</p><p><b>METHODS</b>The mutation of exon 3, 5, 6 and exon 8 of PTEN gene in 42 oral squamous cell carcinoma tissue and paired normal tissue were detected by polymerase chain reaction (PCR) and DNA sequencing methods. The levels of PTEN mRNA expression in these tissues were assayed using semi-quantitative RT-PCR. Data was analyzed with SPSS 14.0 software package.</p><p><b>RESULTS</b>Mutated exon 5 of PTEN gene was found in 2 cases of advanced OSCC. The expression of PTEN mRNA was detected in all OSCC and paired normal tissue. The level of PTEN mRNA in OSCC tissue (0.36 +/- 0.12) was significantly lower than that of paired normal tissue (0.64 +/- 0.09, P < 0.01).</p><p><b>CONCLUSIONS</b>The decreased expression of PTEN mRNA contributes to tumorigenesis of OSCC.</p>

Reconstruction of large through-and-through palate defects with folded free forearm flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the reconstruction method of large through-and-through palate defects.</p><p><b>METHODS</b>From 2003 to 2006, 7 cases of large through-and-through palate defects were reconstructed with vascularized folded free forearm flap. 8 flaps were used, including 7 free forearm flaps and 1 pectoralis major myocutaneous flap.</p><p><b>RESULTS</b>All the tissue flaps survived well except one flap necrosis because of arterial thrombosis. The appearance of reconstructed palate was acceptable, and the functions of swallowing and speech were normal or almost normal.</p><p><b>CONCLUSIONS</b>It is feasible and effective to repair large through-and-through palate defects with folded free forearm flap.</p>

Diagnosis and treatment of Madelung's disease / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To review the characteristics of Madelung's disease which is rare and unfamiliar to clinicians and to find the method of diagnosis and treatment.</p><p><b>METHODS</b>Detailed clinical data of 7 patients with Madelung's disease were reviewed and analyzed. And related literatures were discussed together.</p><p><b>RESULTS</b>All of 7 patients have excessive subcutaneous fat deposit predominantly around neck. One patients had the complication of central and peripheral neuropathy, One patients had the complication of glucose intolerance, One patients had the complication of chronic hepatopathy and hyperuricaemia. These 3 patients were associated with sleep apnea syndrome simultaneously. Another one patient was accompanied by autonomic nervous system disease only. Total neck lipectomy and abstinence from alcohol were performed on 5 patients. No recurrence was seen during a follow-up of 6 months to 5 years. One patient received partial lipectomy twice and relapsed again. All pathological results were nonencapsulated fat. One patient refused treatment. Six men patients were alcohol abusers.</p><p><b>CONCLUSIONS</b>Madelung's disease is characterized by massive accumulation of nonencapsulated subcutaneous fat mainly located symmetrically in the neck. Chronic alcoholism may be a major risk factor. It may be associated with some internal diseases. Total neck lipectomy to improve figuration and relieve pressure and abstinence from alcohol may be the main effective therapy.</p>

Application of CTA and CAD\CAM techniques in mandible reconstruction with free fibula flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the application of computed tomographic angiography (CTA) and computer aided design\manufacture (CAD\CAM) techniques in mandible reconstruction with free fibula flap.</p><p><b>METHODS</b>7 cases of complex mandible defect were reconstructed with free fibula flap. Patients' lower extremity vasculature was evaluated by preoperative CTA examination; mandible tumor resection and reconstruction were simulated by CAD technique, the surgical template was manufactured with CAM technique preoperatively; and fibula flap was shaped according to surgical template during mandible reconstruction operation.</p><p><b>RESULTS</b>Preoperative CTA examination performed without complication, the desired anatomy was adequately demonstrated in all patients. All of flaps survived, patients' facial contour are symmetry approximately.</p><p><b>CONCLUSIONS</b>CTA and CAD\CAM techniques have important value for complex mandible reconstruction in selection of donor site, planning of operation and shaping of fibula flap.</p>

One-stage reconstruction of oral and maxillofacial soft tissue defect by using forearm free flap / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study technique of one-stage reconstruction of oral and maxillofacial soft tissue defect by using forearm free flap.</p><p><b>METHODS</b>The microsurgery procedure was used in the treatment of 4 oral cancer patients with oral and maxillofacial soft tissue defect after surgery.</p><p><b>RESULTS</b>The forearm free flap was survived, for 4-18 months the oral function was well, and the appearance was satisfactory.</p><p><b>CONCLUSION</b>This is a good approach to the reconstruction of oral and maxillofacial soft tissue defect by using forearm free flap technique.</p>