Association of gut microbiome and oral cavity cancer: A two sample mendelian randomization and case-control study.

INTRODUCTION: Considering the interconnectedness of the oral cavity and gut tract and the presence of abundant natural microbiota in both. We utilized Mendelian Randomization (MR) in a two-sample study to unveil the genetic causal impact of gut microbiota on the development of oral cavity cancer. MATERIALS & METHODS: The instrumental variables employed in this study consisted of single nucleotide polymorphisms (SNPs) that demonstrated a robust association with 211 distinct gut microbiota taxa, encompassing a sample size of 18,340 individuals. Our investigation sought to explore the potential causal relationship between these genetic variants and the incidence of oral cavity cancer. To accomplish this, we adopted a random effect inverse variance-weighted approach to analyze the causal effect. Additionally, sensitivity analyses were performed utilizing Cochran's Q tests, funnel plots, leave-one-out analyses, and MR-Egger intercept tests, to assess the robustness and validity of our findings. RESULTS: Five gut microbiota taxa (the family Prevotellaceae, the genus Alloprevotella, the genus Erysipelatoclostridium, the genus Parabacteroides, the genus Ruminococcus gauvreauii group) are predicted to play a causal role in promoting the initiation of the risk of oral cavity cancer. While the genus Christensenellaceae R 7 group, the genus Intestinimonas, the genus Ruminococcaceae, and the order Bacillales causally reduce the risk of oral cavity cancer. Furthermore, no significant evidence suggesting heterogeneity or pleiotropy was observed. DISCUSSION: The novel genetic causal effects of 211 gut microbiota taxa on oral cavity cancer are elucidated in this investigation, thus offering valuable insights for clinical interventions targeting oral cavity cancer.

Syndecan-1, an indicator of endothelial glycocalyx degradation, predicts outcome of patients admitted to an ICU with COVID-19.

BACKGROUND: We investigated the feasibility of two biomarkers of endothelial damage (Syndecan-1 and thrombomodulin) in coronavirus disease 2019 (COVID-19), and their association with inflammation, coagulopathy, and mortality. METHODS: The records of 49 COVID-19 patients who were admitted to an intensive care unit (ICU) in Wuhan, China between February and April 2020 were examined. Demographic, clinical, and laboratory data, and outcomes were compared between survivors and non-survivors COVID-19 patients, and between patients with high and low serum Syndecan-1 levels. The dynamics of serum Syndecan-1 levels were also analyzed. RESULTS: The levels of Syndecan-1 were significantly higher in non-survivor group compared with survivor group (median 1031.4 versus 504.0 ng/mL, P = 0.002), and the levels of thrombomodulin were not significantly different between these two groups (median 4534.0 versus 3780.0 ng/mL, P = 0.070). Kaplan-Meier survival analysis showed that the group with high Syndecan-1 levels had worse overall survival (log-rank test: P = 0.023). Patients with high Syndecan-1 levels also had significantly higher levels of thrombomodulin, interleukin-6, and tumor necrosis factor-α. Data on the dynamics of Syndecan-1 levels indicated much greater variations in non-survivors than survivors. CONCLUSIONS: COVID-19 patients with high levels of Syndecan-1 develop more serious endothelial damage and inflammatory reactions, and have increased mortality. Syndecan-1 has potential for use as a marker for progression or severity of COVID-19. Protecting the glycocalyx from destruction is a potential treatment for COVID-19.

Sex-dependent prolongation of sciatic nerve blockade in diabetes patients: a prospective cohort study.

INTRODUCTION: Diabetes may affect the duration of nerve block after regional anesthesia. This study aimed to compare the durations of sensory and motor block in diabetes versus non-diabetes patients after lower limb nerve block and delineate any sex-based differences in the duration of sensory and motor blocks of both diabetes and non-diabetes patients. METHODS: This prospective single-blinded cohort study recruited 86 patients who underwent unilateral lower extremity surgery; 52 patients were non-diabetic and 34 were diabetic. Each patient received an ultrasound-guided nerve stimulator-assisted subgluteal sciatic nerve block with 0.75% ropivacaine. Duration of sensory block was assessed with the Semmes-Weinstein monofilament test, and duration of motor block was assessed with dorsal and plantar flexion of the foot. RESULTS: The sensory and motor block durations of diabetes patients were significantly prolonged versus non-diabetes patients (19.8±6.0 hours vs 15.6±5.1 hours; p<0.05) and (19.5±8.1 hours vs 14.8±5.7 hours, p=0.005), respectively. The durations of sensory and motor block were comparable between male diabetes and non-diabetes patients, but they were significantly longer in female diabetes patients. Multiple regression analysis further revealed that, after adjustment for age and preoperative sensory threshold, diabetes, fasting plasma glucose and HbA1c levels were significantly associated with sensory and motor blocks. Sex analysis showed the association was only present in female diabetes patients, not male diabetes patients. CONCLUSION: The durations of sensory and motor block are significantly prolonged after subgluteal sciatic nerve block in diabetes patients. Furthermore, the prolonged nerve blockade is present only in diabetes women, not diabetes men. TRIAL REGISTRATION NUMBER: NCT02482831.

Comparative study of donor site complications between the medial sural artery perforator flap / 口腔疾病防治

Objective@#To demonstrate the advantages of performing medial sural artery perforator flap compared with forearm flap. @*Methods @# Between April 2010 and April 2011, 20 clinical cases were reconstructed using the medial sural artery perforator flap technique and compared with 20 forearm flap cases. Data on recent complications (in 2 weeks) and late complications (after 3 months) were collected. @*Results @#Of the 20 medial sural artery perforator flaps, Only 1 case needed a skin graft, while 19 cases were primarily closed, and 1 case occurred muscle necrosis. Only linear scar was found in the postoperative donor area, and the effect on appearance and function was slight. Of the 20 forearm flaps, all cases needed a skin graft. For the recent complications, 3 cases of effusion under the skin graft, 2 cases of partial necrosis and 2 cases of wound dehiscence were observed. For the late complications of the forearm, 16 cases of an abnormal sensation were observed in the forearm group and 5 cases of an abnormal sensation were observed in the medial sural artery perforator flap group, and these differences were statistically significant (P <0.05). Significant differences were not observed in the other subjective contrasts(P >0.05). Scarring and pigmentation were much more serious in the forearm cases than the medial sural artery cases (P <0.05), and significant differences in the functional objective examination results were not observed between the two groups (P >0.05). @*Conclusion @#The medial sural artery perforator flap represents a good alternative for oral and maxillofacial reconstructions of small- and medium-sized defects, and it presents advantages over the forearm flap since it has less donor-site morbidity.

[A preliminary study on free medial sural artery perforator flap for head and neck reconstruction following tumor ablation].

OBJECTIVE: To investigate the application of free medial sural artery perforator flap to reconstruct the defect following head and neck tumor ablation. METHODS: From April 2010 to January 2011, the defects after head and neck tumor resection were reconstructed with free medial sural artery perforator flaps in 16 patients. The clinical data were collected and analyzed, including site and histology of tumor, the skin paddle's size of the flap, the length of pedicle, the number of major perforators and donor-site morbidity. RESULTS: Medial gastrocnemius territories were evaluated before operation and free medial sural artery perforator flaps were used to reconstruct the defect after tumor ablation in 16 cases. One flap partially survived due to venous thrombosis. All of the other 15 flaps succeeded. The donor site was primarily closed in 15 cases and skin graft was applied in one case. All donor sites except one case healed in first intention. Long-term follow-up showed satisfying receipt-site reconstruction results with good functional and cosmetic outcome in the donor site. There was only minor sensory deficit in the donor site. CONCLUSIONS: The medial sural artery perforator flap is reliable for reconstruction of the small to medium-sized defect in head and neck region with less donor site morbidity.