Dental implant treatment in vascularized bone flaps after jaw reconstruction / 华西口腔医学杂志

Jaw defects caused by various reasons often seriously affect appearance and function. The goal of the treatment of oral and maxillofacial tumors should include the cure of the tumor and the restoration of premorbid function. The development of microsurgery and digital surgery technology has promoted the development of jaw reconstruction with vascularized free bone flap. Good appearance and improved predictability could be obtained with the help of preope-rative visual design. How to rehabilitate occlusal function on the reconstructed jaw and improve the quality of life of patients has become an important research direction. This article discusses the challenge of jaw reconstruction, the selection of vascularized bone flap, the choice of implant timing, the treatment of peri-implant soft tissue, and the influence of radiotherapy on implants after jaw reconstruction.

Study on the effect of early mobilization in oral cancer patients who have undergone free flap reconstruction / 中国实用护理杂志

Objective:To explore an early mobilization plan for oral cancer patients after free flap reconstruction and evaluate the application effect of the plan.Methods:This study was a prospective randomized controlled trial. A total of 173 patients undergoing free flap reconstruction surgery from December 2018 to December 2021 in the second ward of Peking University School and Hospital of Stomatology were selected. The patients were randomly divided into the control group (87 cases) and the intervention group (86 cases) by cluster randomized grouping. The control group received the routine nursing plan, that was, head immobilization for 4 days after surgery, and patients performed sat up and off-bed activity on the 5th day. The intervention group received the early mobilization plan, that was, patients sat up on the 2nd day after surgery and performed off-bed activity on the 3rd day. The incidence of vascular compromise, postoperative complications, sleep time in the first 5 days after surgery, catheter removal time, hospitalization duration and expenses were compared between the two groups.Results:The incidence of postoperative pulmonary infection, the daily sleep time in the first 5 days after surgery, the time for removing nasogastric tube, trachea cannula, and urinary catheter were 7.0%(6/86), (5.0 ± 1.0) h/d, (11.8 ± 7.3) d, (6.1 ± 3.2) d, (3.6 ± 0.6) d in the intervention group, and 13.8%(12/87), (4.4 ± 1.3) h/d, (14.2 ± 5.8) d, (7.3 ± 1.7) d, (4.0 ± 0.9) d in the control group, all differences were statistically significant ( χ2 = 3.89, t values were -3.57 - -2.44, all P<0.05). There was no significant difference in the incidence of rascular compromise, hospitalization duration and expenses between the two groups (all P>0.05). Conclusions:For patients undergoing free tissue flap reconstruction, it is safe to sit up on the 2nd day and get out of bed on the 3rd day, which can reduce the incidence of pulmonary infection, improve patient sleep, and shorten the indwelling time of nasogastric tube, trachea cannula and urinary catheter.

The change of mandibular morphology and its influencing factors in image-guided mandibular reconstruction surgery / 中华显微外科杂志

Objective:To study the change of mandibular morphology in image navigation guided mandibular reconstruction surgery and the influence of the methods for mandibular defect location and registration.Methods:Forty-one cases were included from August, 2011 to October, 2019. Specific anatomical landmarks were marked on the preoperative and postoperative 3D CT images, and the morphological changes of navigation-assisted mandibular reconstruction were recorded. Different groups were divided according to the reconstruction side and the non-reconstruction side of the mandible, whether the defect included the condyle and the registration method, then the 3D morphological changes of the mandible were compared, and the influencing factors were studied. Data was analyzed by independent t-test, and the difference was considered as statistically significant if P<0.05. Results:The mean value of 3D morphological changes of mandible ranged from 1.710 to 4.977 mm. When the condyle was involved in the mandibular defect, the change of 3D morphology [(1.671-5.587) mm] was greater than that when the condyle was not involved in a defect [(1.346-4.358) mm]. The difference of width of mandibular angle and medial distance and lateral distance of condyle was statistically significant ( P<0.05). In the navigation-assisted mandibular reconstruction, the accuracy of mandibular condyle and the length of mandible on non-reconstructed side in the group of bone-implanted fiducial marker registration was better than that in the surface registration ( P<0.05), and there was no significant statistical difference in other indexes. Conclusion:The image navigation guided mandibular reconstruction surgery can accurately restore the 3D configuration of mandible. When the mandibular defect involving condylar can significantly reduce the mandibular reconstruction accuracy, the fiducial maker registration is superior to the surface registration in the reconstruction of mandibular condyle.

Study on the reliability of NIRS to monitor fibular flaps on Rhesus monkeys / 中华显微外科杂志

Objective To confirm the sensitivity and validity of near-infrared spectroscopy (NIRS) technology to detect the dynamic changes of blood volume and regional tissue oxygen saturation (rSO2).Methods Six fibular flaps on Rhesus monkeys were raised simulating a clinical operation.Third generation of NIRS oxygen saturation oximeter (TSAH-100) was employed on Rhesus monkeys' fibular flaps when its dominant artery and vein were blocked respectively or simultaneously,and then their relative changes of blood volume and oxygen saturation were observed and recorded in June,2008 to October,2008.Results The statistic results showed that concentration of deoxygenated hemoglobin (cHb),concentration of oxyhe moglobin (cHbO2) and rSO2 had rapid,apparent and distinct changes respectively in the case of arterial occlusion,venous occlusion and total occlusion.The initial values of cHb and cHbO2 of 3 models were 0 μmol/L.Meanwhile,the initial values of rSO2 in artery embolism,vein embolism and arteriovenous embolism were 51.6％,54.3％ and 56.8％,respectively.The maximum variations of cHb,cHbO2 and rSO2 in 3 models indicated significant difference compared with initial values (P＜0.05),the values of rSO2 after 6 s,18 s and 8 s in 3 models had significant difference compared with initial values respectively(P＜0.05).Conclusion The TSAH-100 based on NIRS technology is an extraordinarily sensitive and reliable method to monitor the changes of oxygen saturation and blood perfusion in local tissue for buried flap within a depth of 2.0 cm.

Advance and application of CRISPR/ Cas9 mediated genome editing technique on pathogenic microorganism / 中国人兽共患病学报

Clustered regularly interspaced short palindromic repeats (CRISPR) is an acquired immune system existing in archaea and bacteria with the long-term process of evolutionary.CRISPR/Cas9 gene editing system is a new type of gene editing technology developed based on the system.CRISPR/Cas9 is a more efficient method for gene targeting than the previous methods.It has been successfully applied for gene-modified of eukaryotes since 2012,but the reports about pathogenic microorgaisms are rarely.Here,the research progress in the structure,mechanism of CRISPR/Cas9 system and its applications on pathogenic microorgaisms is reviewed.

Clinical observation of masseter-to-facial nerve anastomosis for treatment of facial paralysis / 中华显微外科杂志

Objective To evaluate the efficiency and functional improvement of masseter-to-facial nerve transfer for patients who acquired a proximal iniury to the facial nerve and preliminary determine the influence factors for recovery.Methods From January,2015 to May,2016,the clinical data of 6 patients with facial paralysis underwent nerve anastomosis were analyzed retrospectively.These patients were required to come back to the hospital for a check every 3 months,in order to evaluate their facial nerve function.House-Brackmnann(H-B)grading was used to evaluate the pre-oerative,post-operative and follow-up status.The masseter-to-facial nerve anastomosis was performed in all the 6 patients.Results All patients were followed-up.The mean time of follow-up was 16 months (ranged from 6 to 23 months).Among 6 cases,the facial nerve function was improved in 5 cases,unchanged in 1 case.The postoperative H-B grades were Ⅱ in 3 cases,Ⅲ in 2 cases.The improvement of facial paralysis was most significant for orbicularis muscles,followed by the orbicularis oculi muscles,and the worst was the improvement of frontal muscles.Conclusion Masseter-to-facial nerve transfer anatomosis is a useful treatment for facial paralysis and can improve the facial function.

Application of microvascular anastomotic device in head and neck reconstruction / 中华显微外科杂志

Objective To describe the clinical application of microvascular anastomotic device in head and neck reconstruction.Methods From July,2013 to November,2013,microvascular free flaps were transferred to reconstruct the defects simultaneously after tumor resection of head and neck region in 12 cases in Department of Oral and Maxillofacial Surgery,Peking University School of Stomatology.Microvascular anastomotic coupling devices (MACD) were used in vascular anastomosis.The clinical data were collected and analyzed,including the selection of free flap,diameter of donor and recipient vessels,type of MACD,time of anastomosis,instant patency of anastomosis.The flap was monitored closely after operation and the final survival rate was calculated.Results Twelve microvascular free flaps were done in this series,including 6 fibula flaps,4 forearm flaps and 2 anterolateral thigh flaps.Totally 17 MACD were used by end-to-end anastomosis in this series,including 5 arterial anastomosis and 12 venous anastomosis.The anastomose time using MACD was from 4 to 10 minutes,with a median time 6.8 minutes.The instant patency rate of anastomosis was 100％.There were some blood leakages near the anastomotic stoma in 1 arterial anastomosis using MACD.It was resolved successfully by changing a new MACD.Conclusion Our primary clinical experience showed that the MACD was well suited to the microvascular reconstruction of head and neck defect.The feasibility and reliability was confirmed by our clinical cases.It should be recommended as a safe,fast and reliable adjuvant anastomotic instrument for free tissue transfer.

Assembly and components of the type III secretion system of Salmonel l a / 中国人兽共患病学报

Salmonella is the main food-borne pathogen that causes food poisoning and gastroenteritis in human and ani-mals .The type III secretion system in Salmonella has played an important role in the invasion of host cell .In recent years ,the research of the composition ,assembly and related pathogenesis of Salmonella T3SS have made some progress .This article re-views the composition and assembly of Salmonella type III secretion system ,which could provide further study the pathogene-sis of Salmonella and also the new strategies and methods toward the treatment and prevention of Salmonella infections .