Ischemia-reperfusion injury of free tissue flaps, airway management, and prognosis in oral cancer patients / 口腔疾病防治

@#Free tissue flap transplantation is the preferred option for repairing and reconstructing postoperative defects in oral and maxillofacial-head malignant tumors. However, challenges remain for oral and maxillofacial-head and neck oncology surgeons in terms of ischemia-reperfusion (I/R) injury, airway management, quality of life and prognosis. I/R injury is an inevitable complication of free-flap transplantation surgery. In addition to shortening the vascular anastomosis time as much as possible during the surgical process, many studies have attempted to further prevent and treat free-flap I/R injury using physical intervention therapy, antioxidant and reactive oxygen species (ROS) scavenger therapy, hyperbaric oxygen therapy, etc. However, there is a lack of large-scale clinical randomized controlled trial evidence to further support these methods. Postoperative tracheal management of patients receiving free tissue flap transplantation is very important. In recent years, delayed extubation has been proposed as an alternative to traditional tracheostomy. This method can facilitate wound care for patients, reduce infections, speed up patient recovery, and reduce the incidence of vascular crises. In the future, such management is expected to improve the practicality and safety of delayed extubation by formulating more appropriate patient selection criteria and intensive care plans. Preoperative selection of suitable free tissue flaps according to the defect for repair and reconstruction is beneficial for improving the quality of life and survival rate of patients. At the same time, for patients who require postoperative radiotherapy, reducing the complications of postoperative radiotherapy and improving the quality of life of patients can be achieved through intraoperative nerve anastomosis, preradiation oral hygiene maintenance, early speech training, and other methods.

Diagnosis and treatment of benign condylar hyperplasia / 口腔疾病防治

@#Benign condylar hyperplasia is one of the causes of mandibular lateral deformity, it is easily to be misdiagnosed clinically and leads to the treatment failure. This article will elaborate the etiology and clinical features of benign condylar hyperplasia, as well as the diagnostic points and treatment progress, based on the literature and the clinical experience of our research group, to provide evidence-based medical evidence for the standardized clinical treatment of benign condylar hyperplasia. The etiology of benign condylar hypertrophy includes neurotrophic disorders, local circulatory disorders, traumatic injuries (especially condylar injuries that occur in childhood), unilateral mastication, temporomandibular arthritis, endocrine disorders, condylar osteoma, and heredity. Benign condylar hypertrophy is insidious, and occurs most frequently in individuals 10-30 years old, and the course of disease can last for many years. Its clinical characteristics are slow progressive facial asymmetry. Radionuclide bone scans have become the basis for the diagnosis and differential diagnosis of and treatment planning for benign condylar hypertrophy. Different treatment plans for active and inactive periods need to be developed, including close observation, proportional condylar resection and orthognathic surgery.

Detection and significance of immune function in oral mucosa-associated diseases / 口腔疾病防治

@#The evaluation of immune function plays an important role in the diagnosis, treatment and prognosis of many diseases. To date, immune function detection includes cellular immunity, humoral immunity, and inflammatory markers. In this paper, the application of immune function detection in the diagnosis, differential diagnosis and treatment monitoring of various diseases was discussed; then, the application value of immune function detection in the diagnosis and treatment of three common oral mucosa-related diseases, including recurrent aphthous ulcer (RAU), oral lichen planus (OLP), and oral squamous cell carcinoma (OSCC), were reviewed combined with the literature and our research. Our research found that RAU patients present abnormal humoral immune function and obvious inflammatory reactions, whereas OLP and OSCC patients present mild inflammatory reactions and more serious abnormal cellular and humoral immune function, so the combined detection of immune function has a certain guiding value for the diagnosis and treatment of these diseases. Moreover, in the future, it is necessary to carry out a study on large sample, multicenter and multiindex joint detection to better clarify the role of immune dysfunction in the pathogenesis of various diseases and its mechanism, to establish the corresponding diagnostic model and prognostic prediction model, to find more effective treatment methods.

Epigenetic and oral squamous cell carcinoma / 口腔疾病防治

@#In recent decades, although great progress has been made on the diagnosis and treatment of oral squamous cell carcinoma (OSCC), its 5-year survival rate has not been significantly improved. The basic reason is the unclear pathogenesis, lack of effective molecular markers for assessing invasion, metastasis, and recurrence as well as therapeutic targets. The present view is that genetic and epigenetic abnormalities are related to the occurrence and development of OSCC. Epigenetic inheritance is a biological behavior that can be regulated and reversed, and it plays an important role in the occurrence and development of malignant tumors. First, this review will describe the role of epigenetic modifications in the development of OSCC in combination with our research and the latest research progress of epigenetics, including DNA methylation, RNA methylation, short noncoding RNAs (miRNAs, etc.), long noncoding RNAs, circular RNAs, histone modifications (acetylation and methylation), chromatin remodeling and genomic imprinting. Then, we will analyze the value of epigenetic studies in the prevention, diagnosis, and targeted therapy of OSCC.

Abnormal glucose and lipid metabolism and oral squamous cell carcinoma / 口腔疾病防治

@#Epidemiological studies have shown that abnormal glucose and lipid metabolism is associated with a variety of malignant tumors, including oral squamous cell carcinoma. In this paper, the role of abnormal glucose and lipid metabolism, especially diabetes mellitus and obesity, in the occurrence and development of oral squamous cell carcinoma and its pathogenesis are reviewed based on the research results of our group and the literature. Hyperglycemia and insulinemia in diabetes mellitus are the main mechanisms that increase the risk of cancer. Our research shows that hyperglycemia can promote the proliferation, invasion and metastasis of tongue squamous cell carcinoma through the glycolytic enzyme M2 pyruvate kinase (PKM2) and hexokinase 2 (HK2). Hyperinsulinemia can promote the proliferation, invasion and metastasis of tongue squamous cell carcinoma by activating the insulin-like growth factor signal transduction system. Obese patients are often accompanied by increased serum adipokine Chemerin (Chem). Our study shows that serum Chem concentrations in obese patients with tongue cancer are significantly higher compared with nonobese patients. Chem can regulate the proliferation, invasion and migration of tongue squamous cell carcinoma cells through the SOD2-H2O2 signaling pathway. These results provide a basis for the prevention of oral squamous cell carcinoma, provide a new iqdea for the precise treatment of oral squamous cell carcinoma, and suggest that the treatment of oral squamous cell carcinoma should also actively treat patients with diabetes and obesity.