Parotid duct anastomosis with an epidural catheter as a stent and evaluation of postoperative gland function / 口腔疾病防治

Objective @#To investigate the feasibility of epidural catheters in parotid gland duct anastomosis and the function of the affected side gland after parotid gland duct anastomosis. @* Methods@# Thirteen patients who were treated in the Department of Oral and Maxillofacial Surgery of Xuzhou Central Hospital using an epidural catheter as the scaffold for parotid gland catheter anastomosis were enrolled from Jan. 2019 to June 2021. The swelling, salivary fistula and catheter patency in the parotid gland area were evaluated two weeks after the operation. 99mTcO4- single photon emission computed tomography (SPECT) was used for quantitative detection of salivary gland secretion function@*Results@# Thirteen patients had no swelling or salivary fistula in the parotid gland area of the affected side two weeks after the operation, and the catheter secretion was unobstructed. There was no significant difference in the uptake rate between the parotid gland on the affected side and the parotid gland on the healthy side (t = -0.859, P = 0.399), and there was no significant difference in the excretion rate between the parotid gland on the affected side and the parotid gland on the healthy side (t = 0.693, P = 0.495). The parotid gland excretion function of the affected side was excellent three months after the operation.@*Conclusion @#Parotid duct anastomosis with an epidural catheter as the stent has good feasibility, and parotid gland secretion function recovers well after the operation, which is worthy of clinical application.

Refractory pneumoparotid in children: a case report and literature review / 口腔疾病防治

Objective @#To discuss the treatment of pneumoparotid and to provide a reference for clinical practice. @*Methods@# A case of refractory pneumoparotid was reported, and the diagnosis and treatment of parotid emphysema were reviewed and analyzed in combination with the literature.@*Results @#This child had parotid gland enlargement without any obvious cause for more than 1 month. Conservative treatment, such as anti-inflammatory agents, psychological interventions and physical compression were ineffective. The patient had a history of cerebral palsy with epilepsy and involuntary cheek bulging behavior. Therefore, we considered it a refractory case. It was cured after parotid duct ligation and partial parotidectomy of the superficial lobe. A literature review showed that a pneumoparotid is a rare parotid enlargement. Most of the clinical cases were considered to be caused by the return of air into the parotid gland through the parotid duct due to an increase in oral pressure. The diagnosis of pneumoparotid mainly depends on intermittent parotid gland swelling and other clinical manifestations and imaging examination methods, such as ultrasound, CT, MRI and angiography. Its treatment mainly includes conservative anti-inflammatory treatment, physical therapy and psychological intervention. Surgical treatment is indicated for refractory parotid emphysema.@*Conclusion@# Pneumoparotid cases may further develop into parotid inflammation, which is generally treated conservatively. For some severe, recurrent and poor compliance cases, surgical treatment is sometimes needed.

Research progress and application of rodents model construction of peri-implantitis / 口腔医学

@#With the increasing popularity of dental implants, prevalence of peri-implantitishas also been increasing in recent years. However, a deeper understanding of the pathogenesis of peri-implantitis is still lacking. Animal models are a good bridge for studying the pathogenesis of clinical diseases. Animals such as mini-pigs, canines, non-human primates and rodents are used to construct animal models of peri-implantitis. Among them, rodents are easy to obtain and feed, and have a wide range of applications for research. In this review, we summarize the construction of rodent modelswithperi-implantitis as well as the research progress and applications.

Application of improved 3D digital guide plate-assisted guided puncture in microballoon compression for primary trigeminal neuralgia / 口腔疾病防治

Objective @#To investigate the clinical efficacy and application value of an improved 3D-printed guide plate for the treatment of primary trigeminal neuralgia (PTN) by percutaneous microballoon compression (PMC). @*Methods @# This prospective study included 42 patients with primary trigeminal neuralgia treated at the Department of Stomatology, Xuzhou Central Hospital, from September 2019 to January 2022. The group was divided by the random number table method into the experimental group (adopting 3D printing technology to make guide plates to guide the puncture, 22 cases) and the control group (adopting the traditional Hartel anterior approach to position the puncture, 20 cases). The intraoperative success rate of the first puncture, puncture time, operative time, radiation exposure of patients and postoperative complications were compared between the two groups. Postoperative Barrow Neurological Institute Scale (BNI) scores, facial numbness, diminished corneal reflexes and chewing weakness were recorded. The t-test, rank-sum test and chi-square test were used for statistical analysis, with P<0.05 indicating a statistically significant difference. @*Results @#The experimental group was significantly better than the control group in terms of the success rate of the first puncture (χ2 = 21.51, P<0.001), puncture time (Z = -5.51, P<0.001), operative time (t = 9.37, P<0.001), and the number of C-arm scans (Z = -4.59, P<0.001). Postoperative BNI scores of the experimental group included 21 cases of grade Ⅰ (91.5%) and 1 case of grade Ⅱ, while the control group included 17 cases of grade Ⅰ (85.0%), 2 cases of grade Ⅱ (10.0%) and 1 case of grade Ⅲ (5.0%), with no statistical significance (P>0.05). In the experimental group, 16 patients had postoperative masseter weakness, 1 had keratitis and 10 had perilabial herpes, while in the control group, 18 patients had postoperative masseter weakness, 2 had keratitis, 11 had perilabial herpes and 1 had monocular blindness. There was no significant difference in postoperative complications between the two groups (P>0.05). At 12 months of follow-up, there was no recurrence in either the experimental or control group. @* Conclusions @#3D digital guide plate-guided percutaneous microballoon compression for primary trigeminal neuralgia can improve the accuracy and safety of puncture to a certain extent, obviously shorten the operation time, reduce radiation exposure of the patients, improve the success rate of the operation, meaning it has a high clinical application value.

Effect of tension on recovery of the donor site of a modified forearm flap / 口腔疾病防治

Objective @#To investigate the effect of tension on donor site recovery of modified forearm flaps (closed forearm donor site skin flaps).@*Methods @# From October 2018 to April 2021, 12 patients with oral cancer underwent forearm flap repair at Xuzhou Central Hospital. Handgrip strength and wrist motion were recorded before surgery. During the surgical incision at the donor site of the forearm, the triangular full-thickness skin of the donor site was used to close part of the surgical incision, and the other part of the surgical incision was directly closed and sutured. Tension was measured with a tension meter during the surgical incision at the donor site. Patients were followed up after surgery to observe whether there were postoperative complications such as necrosis and poor healing of donor site wounds, as well as forearm grip strength, wrist range of motion and appearance satisfaction.@* Results@#Among the 12 patients, there was only one elderly patient with postoperative necrosis near the wrist in the donor site skin, and the average tension of the patient was 0.65 kg; the lesion healed after dressing changes. All of the other patients recovered well without postoperative complications. The mean tension of 12 patients was (0.51 ± 0.05) kg. The preoperative and postoperative grip strength of 12 patients was (23.7 ± 10.3) kg and (22.3 ± 10.7) kg, respectively, and the difference was not statistically significant (t=5.872, P<0.001). The mean range of motion of the wrist was (47.6 ± 8.3)°, (45.8 ± 5.8)°; dorsiflexion (54.6 ± 3.2)°, (53.9 ± 2.3)°; radial deviation (37.0 ± 2.3)°, (36.1 ± 2.2)°; ruler deviation (27.1 ± 1.9)°, (26.4 ± 1.3)°, respectively. The t values were 1.64, 1.636, 2.116 and 1.412, and the P values were 0.129, 0.130, 0.058 and 0.186, respectively. All 12 patients were satisfied with the appearance of the donor site of the forearm.@*Conclusion@#When the average tension during suturing is less than 0.5 kg, there is a lower risk of complications at the donor site of the forearm one month after surgery, a lower risk of impaired donor site function, and a greater possibility of patient satisfaction with the appearance of the donor site.

The fourth branchial cleft deformity on the left anterior chest wall: a case report and literature review / 口腔疾病防治

Objective @#To explore the main points of clinical treatment of fourth branchial cleft deformity in special positions and to provide a reference for clinical practice. @*Methods@#The clinical data of one case of a fourth branchial cleft deformity that occurred in the left anterior chest wall with a fistula below the clavicle are summarized and combined with a literature review.@*Results@# The patient complained of repeated swelling and pain under the left anterior chest wall for 2 months. A 10 mm×10 mm fistula with yellow clear liquid exudate from the fistula was observed on the left side below the clavicle. A 20 mm×20 mm×10 mm swelling was immediately adjacent at the superficial cervicothoracic junction of the upper sternoclavicular joint, with no fluctuation and poor activity; this swelling produced slight pain upon pressing. Imaging examinations pointed to cystic lesions. The primary diagnosis was a fourth branchial deformity. A small amount of methylene blue was injected into the patient's subclavian fistula, and a supraclavicular T-shaped incision was made where the cyst contacted the fistula. By turning the flap, all the methylene blue-stained areas and adjacent submucosal tissues were exposed. During the operation, a mass was found on the sternum. The platysma was found deep in the notch, which was incised before excising the surrounding area. The pathological result is the fourth branchial cleft deformity. After 1 week and 3 months of follow-up, the patients had no discomfort and no recurrence. A review of the relevant literature shows that the fourth branchial cleft deformity is a congenital developmental abnormality that occurs in 1% of all branchial cleft deformity. It often presents as a fistula, cyst, or sinus tract and is anatomically located at the neck root and supravicular region. The fistula is close to the medial lower boundary of the sternocleidomastoid muscle. The diagnosis is often made based on its anatomical location, imaging examinations and, ultimately, pathology. The differential diagnoses include other cervical swellings, such as hemangioma and a thyroglossal duct cyst. Surgical resection is a commonly used treatment method. In recent years, endoscopic positioning and internal fistula burning have had good curative effects for recurrent fourth branchial cleft deformity, with a small chance of recurrence or cancer.@* Conclusion @#Given its unique position, clinicians should make full use of imaging methods to determine the size, anatomical location and course of the lesion when treating the fourth branchial cleft deformity to ensure the complete and safe surgical resection of the lesion and prevent recurrence.

Effect of Different Hot Air Drying Methods on Chemical Constituents of Trichosanthis Fructus / 中国实验方剂学杂志

Objective:To compare the effects of different drying methods on the chemical constituents of Trichosanthis Fructus. Method:Trichosanthis Fructus was dried by means of air drying， sun drying， hot air drying （40， 60， 80 ℃） and variable temperature drying （50-80， 80-50 ℃）. The contents of nucleosides and flavonoids in Trichosanthis Fructus peels and seeds treated by different methods were compared by high performance liquid chromatography （HPLC）， mobile phase was acetonitrile-0.2% acetic acid aqueous solution （3∶7） （A）-acetonitrile （B） for gradient elution （0-15 min， 97-95%B； 15-30 min， 95%-90%B； 30-35 min， 90%-87%B； 35-40 min， 87%-86.5%B； 40-48 min， 86.5%-97%B； 48-50 min， 97%B）， the detection wavelength was 260 nm， and the flow rate was 0.4 mL·min^-1. Gas chromatography-ion mobility spectrometry （GC-IMS） was used to compare the changes of volatile components in the samples treated by different treatments. The volatile components were incubated on a SE-54 capillary column （0.32 mm×30 m， 0.25 μm） at 80 ℃ and 500 r·min^-1 for 15 min， the injection temperature was 85 ℃， the injection volume was 400 μL， the analysis time was 35 min， carrier gas was high purity nitrogen， the flow rate of carrier gas was 2.0 mL·min^-1， the flow rate of drift gas was 150 mL·min^-1， and the temperature of IMS detector was 45 ℃. Result:The contents of uridine， adenosine and adenine were higher after hot air drying at >50 ℃. Low temperature drying was conducive to maintaining the stability of cytidine， cytosine， rutin， luteolin and 2ʹ-deoxyadenosine. GC-IMS technology could realize the analysis and identification of Trichosanthis Fructus samples after different treatments. There were more volatile components after hot air drying at 80 ℃ and variable temperature drying. Conclusion:Hot air drying at 40 ℃ and 60 ℃ can retain nucleosides and flavonoids， and the volatile components are similar to those in traditional drying methods， which has the advantages of high efficient， controllable and suitable for industrial production.

Polydocanol percutaneous sclerotherapy for the treatment of giant venular malformation of the lips and cheeks in adults / 口腔疾病防治

Objective @#To investigate the clinical effect of polidocanol sclerotherapy in the treatment of giant venular malformations of the lips and cheeks in adults.@*Methods@# From September 2019 to September 2020, 5 patients with huge venular malformations of the lips and cheeks (4 males, 1 female) admitted to Xuzhou Central Hospital were included in the study. All the patients were treated with local injection of polidocanol foam scleroagent, and all patients were followed up with a 3-week treatment course. If the clinical symptoms were not alleviated and the MRI examination showed that > 25% of the lesion remained, or it relapsed again after symptoms are stable, the patient needed to be treated again. The endpoints of treatment were: ①subsidence of clinical symptoms and MRI showing residual lesions < 25% in size; ②continuous treatment for 4 times without relief or aggravation of symptoms; ③a discontinuation of treatment. @* Results@#All 5 patients successfully completed the treatment and were injected 2 to 4 times during treatment. The curative effect was evaluated according to the Achauer standard, including grade Ⅰcurative effects in 1 patient, grade Ⅱ in 2 patients, grade Ⅲ in 2 patients. Among them, one patient suffered from erosion and bleeding in the lesion before the operation, and the symptoms were significantly improved postoperatively. No serious side effects were found except skin pigmentation in 1 case. @*Conclusion@#Local injection of polidocanol foam scleroagent is a safe and effective treatment method for adult giant venular malformations of the lips and cheeks, and it has a hemostatic effect on spontaneous bleeding invenular malformations.

Application progress of recombinant human endostatin in the treatment of head and neck cancer / 口腔疾病防治

@#The main treatment of head and neck cancer is comprehensive sequential treatment, but the 5-year overall survival rate is less than 50%. Strategies to further improve the curative effect of head and neck cancer are urgently needed in the clinic. Recombinant human vascular endostatin is an antiangiogenesis drug targeting vascular endothelial cells, which has a certain inhibitory effect on tumors. The treatment of malignant tumors by drugs alone is not significantly better than chemoradiation, but combined with radiotherapy and chemotherapy, it can increase the effect of radiotherapy and chemotherapy without drug resistance by changing the distribution of blood vessels, reducing oxygen and normalizing blood vessels. Head and neck tumor treatment has certain advantages. New tumor treatments are expected. The results of a literature review showed that the mechanism of action of recombinant human endostatin mainly includes regulating the matrix protein inside and outside the endothelial cells to influence neovascularization, acting on receptors related to the surface of endothelial cells, reversing abnormal neovascularization to achieve vascular normalization, inhibiting hypoxia inducible factor to improve the hypoxic status of the tumor area, and regulating the cell cycle to ensure the tumor cells are sensitive to radiation in the sensitive period, and vascular normalization can increase the effect of radiotherapy. This treatment has a good synergistic effect with radiotherapy and chemotherapy of head and neck tumors and has a good effect on advanced head and neck tumors.

Effects of Ultrashort Wave on Inflammatory of Acute Lung Injury and Related Signaling Pathway in Rats / 中国康复理论与实践

Objective:To observe the effects of ultrashort wave (USW) on lipopolysaccharide (LPS) induced acute lung injury (ALI) and nucleotide-binding oligomerization domain like receptor protein 3 (NLRP3) signaling pathway in rats. Methods:Twenty-four three-month-old male Sprague-Dawley rats were randomly divided into control group (n = 8), ALI group (n = 8) and USW group (n = 8). The ALI and USW groups were instilled with LPS to induce ALI, and the USW group was treated with ultrashort wave 0, four and eight hours after instillation, 15 minutes a time. Twenty-four hours after instillation, the lung tissue of the rats was measured the wet/dry mass ratio (W/D), and observed under HE staining. Serum levels of interleukin (IL)-1β and IL-18 were detected with ELISA. The mRNA and protein expression of NLRP3, caspase-1 and IL-1β in the lung tissue were detected with reverse transcription polymerase chain reaction and Western blotting, respectively. Results:W/D increased in ALI group compared with that of the control group (P < 0.05), and it decreased in USW group without significance compared with that of ALI group (P > 0.05). Lung injury score increased in ALI group compared with that of the control group (P < 0.05), and it decreased in USW group compared with that of ALI group (P < 0.05); as well as the serum IL-1β and IL-18, and mRNA and protein expression of NLRP3, caspase-1 and IL-1β. Conclusion:USW can alleviate the inflammatory of acute lung injury, which may associate with inhibiting of NLRP3 signaling pathway.

Involvement of HSP90 in ischemic postconditioning-induced cardioprotection by inhibition of the complement system, JNK and inflammation

Abstract Purpose To investigate whether heat shock protein 90 (HSP90) is involved in complement regulation in ischemic postconditioning (IPC). Methods The left coronary artery of rats underwent 30 min of occlusion, followed by 120 min of reperfusion and treatment with IPC via 3 cycles of 30s reperfusion and 30s occlusion. The rats were injected intraperitoneally with 1 mg/kg HSP90 inhibitor geldanamycin (GA) after anesthesia. Eighty rats were randomly divided into four groups: sham, ischemia-reperfusion (I/R), IPC and IPC + GA. Myocardial infarct size, apoptosis index and the expression of HSP90, C3, C5a, tumor necrosis factor (TNF)-alpha, interleukin (IL)-1β and c-Jun N-terminal kinase (JNK) were assessed. Results Compared with the I/R injury, the IPC treatment significantly reduced infarct size, release of troponin T, creatine kinase-MB, and lactate dehydrogenase, and cardiomyocyte apoptosis. These beneficial effects were accompanied by a decrease in TNF-α, IL-1β, C3, C5a and JNK expression levels. However, all these effects were abrogated by administration of the HSP90 inhibitor GA. Conclusion HSP90 exerts a profound effect on IPC cardioprotection, and may be linked to the inhibition of the complement system and JNK, ultimately attenuating I/R-induced myocardial injury and apoptosis.

Nimotuzumab plus chemotherapy with docetaxel, cisplatin, 5-fluorouracil for locally advanced head and neck squamous cell carcinoma: A clinical study

Background: A clinical study was conducted to determine the efficacy of nimotuzumab combined with docetaxel, cisplatin, and 5-fluorouracil (TPF) for patients with locally advanced head and neck squamous cell carcinoma (HNSCC) after surgery and conformal radiotherapy. Methods: Thirty-one HNSCC patients received three courses of chemotherapy every 21 days, at a dose of 75 mg/m2 of docetaxel and cisplatin on day 1 and 750 mg/m2 of 5-fluorouracil on days 1–5 followed by 200 mg/m2/week of nimotuzumab on week 1–2 (day 6–21). Results: After sequential therapy, complete and partial responses were observed in 10 (32.3%) and 17 (54.8%) patients, respectively. The overall response rate was 87.1%. A progression-free survival of 71.2% (95% confidence interval [CI] 51.6%–93.7%) and an overall survival of 78.3% (95% CI 58.9%–89.5%) were achieved at 2nd year. The most common Grade 3–4 toxicities during the complete treatment were lymphopenia (25.8%), neutropenia (22.6%), anemia (12.9%), and diarrhea (16%). In addition, no rash and treatment-related death occurred during this study. Conclusions: Nimotuzumab in combination with TPF has been well tolerated as a treatment program for locally advanced HNSCC

IgG4-related Mikulicz disease: a case report and literature review / 口腔疾病防治

Objective@#To explore the etiology, clinical manifestations, diagnosis and treatment of IgG4-related Mikulicz disease and to provide a reference for clinical diagnosis and treatment. @*Methods @#Case data from a patient with IgG4-related Mikulicz disease occurring in the submandibular gland and the literature were retrospectively analyzed.@*Results @# IgG4-related Mikulicz disease is a rare autoimmune disease. Its typical features include lacrimal gland and salivary gland swelling, a significant increase in the serum IgG4 level (> 1.35 g/L), and IgG4-positive plasma cell infiltration into a large number of pathological tissues. The disease can easily recur. Treatment is mainly symptomatic, including surgical resection and administration of glucocorticoid and other drug treatment. Long-term follow-up is required after the operation. @*Conclusion@#IgG4-related Mikulicz disease has no specific clinical features. The diagnosis relies mainly on pathological examination and serum IgG4 examination. The main treatment methods are surgery and the use of glucocorticoids, which require long-term follow-up.

Effect of Trigonella foenum-graecum 4-hydroxyisoleucine on high-glucose induced insulin resistance in 3T3-L1 adipocytes of mice / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the effect of 4-hydroxyisoleucine (4-HIL), an active component of Trigonella Foenum-graecum L. on high glucose induced insulin resistance (IR) in 3T3-L1 adipocytes, and to explore underlying molecular mechanisms.</p><p><b>METHODS</b>3T3-L1 adipocytes were treated with 25 mmol/L glucose and 0.6 nmol/L insulin to induce IR. They were intervened by different concentrations of 4-HIL (at 5, 10, and 20 micromol/L). [3H]-Deoxy-D-glucose up-taking method was used to detect the glucose uptake. The mRNA expression of cellular tumor necrosis factor-alpha (TNF-alpha) was detected by polymerase chain reaction (PCR). The content of TNF-alpha in the culture supernatant was detected by enzyme-linked immunosorbent assay (ELISA). Palmitic acid (PA) acted as the control.</p><p><b>RESULTS</b>After intervened by 25 mmol/L glucose and 0.6 nmol/L insulin for 18 h, the insulin-stimulated glucose transportation in 3T3-L1 adipocytes was inhibited by 63%. The mRNA expression of cellular TNF-alpha in adipocytes significantly increased, when compared with that in normal adipocytes (P < 0.05). The level of TNF-alpha secreted in the culture supernatant was increased by 70 pg/mL (P < 0.05). Similar changes occurred in the PA group. After exposure to 4-HIL (5, 10, or 20 micromol/L) for 24 h, the glucose transportation was increased by 35%, 50%, and 60%, respectively. PCR results showed that along with increasing 4-HIL concentrations, the mRNA expression of cellular TNF-alpha showed a decreasing trend, showing statistical difference when compared with the model group and the PA group (P < 0.05). Compared with the model group, the TNF-alpha level in the supernatant was respectively reduced by 10 pg/mL, 18 pg/mL, and 39 pg/mL after intervention (P < 0.05).</p><p><b>CONCLUSION</b>4-HIL could remarkably improve high glucose-induced IR in 3T3-L1 adipocytes. Meanwhile, 4-HIL could inhibit the secretion of TNF-alpha.</p>