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1.
Front Psychol ; 13: 869997, 2022.
Article in English | MEDLINE | ID: mdl-35719512

ABSTRACT

The aim of this study was to investigate the applicability of the planned behavior theory model (TPB-5) and TPB-6 model of enhanced physical exercise in college students, and to explore the role of exercise commitment in the relationship between exercise intention and behavior, so as to provide theoretical and empirical support for college students to promotion exercise. The study participants were 581 college students (male = 243, female = 338, age = 19.27 ± 0.94) are investigated with Theory of Planned Behavior (TPB) Scale, Exercise Commitment Scale, and Physical Activity Rating Scale. Results showed that the explanatory power of the TPB to exercise intention and exercise behavior is 0.70 and 0.52, respectively, and exercise intention was the primary factor to predict exercise behavior of college students. The Model fit of TPB-6 model is acceptable, compared with TPB 5-factor model, the predictive power of TPB-6 (with the mediator: exercise commitment) on behavioral intention increases from 70.0 to 75.0%, and the predictive power towards behavior raises from 52.0 to 59.0%. Exercise commitment has a partial mediating effect between exercise intention and behavior, which accounts for 26.89% of the total effect, but it has no moderating effect. In conclusion, this research demonstrates the TPB-5 model has good applicability among the college students, with exercise commitment variables, exercise intention can better predict college students' exercise behavior, which can be used as the theoretical basis for the intervention on their exercise behavior.

2.
Macromol Rapid Commun ; 41(21): e2000155, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32627910

ABSTRACT

Pollen, the male microgametophyte of seed plants, is commonly used as a food and health supplement. Here, a facile method to transform sunflower pollen into pH-responsive microgels with tailored properties is presented. The structure and morphology of the pollen microgel are characterized by scanning electron microscopy, confocal laser scanning microscopy, and dynamic image particle analysis based on potassium hydroxide treatment with various incubation time and concentration. These pollen microgels exhibit significant volume change under different pH conditions and Ca+ /ethylenediaminetetraacetic acid treatment. The results describe the fundamental properties of pollen microgels and pave the way for its future applications, such as "smart" drug carriers.


Subject(s)
Microgels , Drug Carriers , Gels , Hydrogen-Ion Concentration , Pollen
3.
Nat Commun ; 11(1): 1449, 2020 03 19.
Article in English | MEDLINE | ID: mdl-32193375

ABSTRACT

Pollen's practically-indestructible shell structure has long inspired the biomimetic design of organic materials. However, there is limited understanding of how the mechanical, chemical, and adhesion properties of pollen are biologically controlled and whether strategies can be devised to manipulate pollen beyond natural performance limits. Here, we report a facile approach to transform pollen grains into soft microgel by remodeling pollen shells. Marked alterations to the pollen substructures led to environmental stimuli responsiveness, which reveal how the interplay of substructure-specific material properties dictates microgel swelling behavior. Our investigation of pollen grains from across the plant kingdom further showed that microgel formation occurs with tested pollen species from eudicot plants. Collectively, our experimental and computational results offer fundamental insights into how tuning pollen structure can cause dramatic alterations to material properties, and inspire future investigation into understanding how the material science of pollen might influence plant reproductive success.


Subject(s)
Materials Science , Microgels/chemistry , Pollen/chemistry , Biomimetics/methods , Computational Chemistry , Epitopes/chemistry , Epitopes/immunology , Esterification , Hardness , Hydrolysis , Hydroxides/chemistry , Microscopy, Fluorescence , Pectins/chemistry , Pectins/immunology , Pollen/immunology , Pollination/physiology , Potassium Compounds/chemistry , Spectroscopy, Fourier Transform Infrared
4.
ACS Appl Bio Mater ; 3(2): 920-934, 2020 Feb 17.
Article in English | MEDLINE | ID: mdl-35019294

ABSTRACT

Photopolymerization of protein-derived polymers functionalized with methacryloyl groups has been increasingly used to fabricate three-dimensional tissue constructs for biomedical applications because photocurable protein-based polymers (e.g., gelatin and collagen methacryloyl) feature spatial-temporal controllability of engineering complex constructs as well as inherent biological properties. Herein, we report photocurable albumin-based hydrogels. First, photocurable bovine serum albumin methacryloyl (BSA-MA) with different degrees of substitution (DM) was successfully synthesized in a precise manner, without substantially altering BSA native secondary structure. Resultant photocurable BSA-MA hydrogels exhibited tunable physio-biochemical properties over the swelling, degradation, and mechanical properties. Moreover, photo-cross-linked BSA-MA hydrogels provided a permissible environment to support cell viability and functionality both in two- and three-dimensional culture systems. Photocurable BSA-MA hydrogels may be used as a versatile platform for various bioapplications including tissue engineering and 3D bioprinting.

5.
J Oral Maxillofac Surg ; 78(2): 288-294, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31622571

ABSTRACT

PURPOSE: There are many methods to reconstruct the mandible, but they are often accompanied by trauma, which can lead to scarring of the maxillofacial skin. The purpose of this study was to show the utility of a minimally invasive method for reconstruction of the mandible with nonvascularized iliac bone grafts without a skin scar, as well as to evaluate the success rate and complications. PATIENTS AND METHODS: This was a retrospective case series. We retrospectively analyzed patients who underwent transoral resection of benign mandibular pathologies, followed by nonvascularized iliac bone graft reconstruction. The primary outcome variable was the success rate of the bone grafts. Secondary outcome variables were postoperative complications at the grafted bone recipient and donor sites, the long-term absorptivity of grafted bone, and the type of mandibular defect. We computed descriptive statistics or performed the χ2 test for each variable. RESULTS: Overall, 54 patients were included in the study, including 21 male and 33 female patients, with an age range of 10 to 65 years. The complete survival rate was 87.0% (47 of 54 patients), and the partial survival rate was 98.1% (53 of 54). The average bone absorption rate 3 years after surgery was 1.8 to 30.7%. We propose a new classification method for mandibular defects based on the extent of the tumor, location of the osteotomy, and degree of surgical difficulty. CONCLUSIONS: Intraoral nonvascularized iliac bone grafting is a highly successful minimally invasive method for mandibular reconstruction. It is also one of the best methods for mandibular reconstruction in patients with benign mandibular tumors without soft tissue involvement.


Subject(s)
Mandibular Neoplasms/surgery , Mandibular Reconstruction , Plastic Surgery Procedures , Adolescent , Adult , Aged , Bone Transplantation , Child , Cicatrix , Female , Humans , Ilium , Male , Mandible/surgery , Middle Aged , Retrospective Studies , Treatment Outcome , Young Adult
6.
Sci Rep ; 9(1): 9626, 2019 07 03.
Article in English | MEDLINE | ID: mdl-31270392

ABSTRACT

Sporoderms, the outer layers of plant spores and pollen grains, are some of the most robust biomaterials in nature. In order to evaluate the potential of sporoderms in biomedical applications, we studied the biodegradation in simulated gastrointestinal fluid of sporoderm microcapsules (SDMCs) derived from four different plant species: lycopodium (Lycopodium clavatum L.), camellia (Camellia sinensis L.), cattail (Typha angustifolia L.), and dandelion (Taraxacum officinale L.). Dynamic image particle analysis (DIPA) and field-emission scanning electron microscopy (FE-SEM) were used to investigate the morphological characteristics of the capsules, and Fourier-transform infrared (FTIR) spectroscopy was used to evaluate their chemical properties. We found that SDMCs undergo bulk degradation in a species-dependent manner, with camellia SDMCs undergoing the most extensive degradation, and dandelion and lycopodium SDMCs being the most robust.


Subject(s)
Biodegradation, Environmental , Biopolymers/chemistry , Capsules/chemistry , Carotenoids/chemistry , Biocompatible Materials , Pollen/chemistry , Spectrum Analysis , Spores/chemistry
7.
Sci Rep ; 9(1): 2944, 2019 02 27.
Article in English | MEDLINE | ID: mdl-30814619

ABSTRACT

Plant sporoderm are among the most robust biomaterials in nature. We investigate the erosion of Lycopodium sporoderm microcapsules (SDMCs) triggered by human blood plasma. Dynamic image particle analysis (DIPA), field emission scanning electron microscopy (FESEM) and Fourier transform infrared (FTIR) spectroscopy demonstrate the degradation events, suggesting bulk erosion as the dominant mechanism for SDMCs fragmentation in human blood. These results should prove valuable in discerning the behaviour of SDMCs in potential biological applications.


Subject(s)
Absorbable Implants , Biocompatible Materials/chemistry , Capsules/chemistry , Lycopodium/chemistry , Plasma/chemistry , Humans , Microscopy, Electron, Scanning , Spectroscopy, Fourier Transform Infrared
8.
RSC Adv ; 9(31): 17995-18007, 2019 Jun 04.
Article in English | MEDLINE | ID: mdl-35520590

ABSTRACT

As drug-induced hepatotoxicity represents one of the most common causes of drug failure, three-dimensional (3D) in vitro liver platforms represent a fantastic toolbox to predict drug toxicity and thus reduce in vivo animal studies and lessen drug attrition rates. The aim of this study is to establish a functional porcine hepatocyte culture using a biofunctionalized 3D inverted colloidal crystal (ICC) hydrogel platform. The performances of non-adhesive bare poly(ethylene glycol)diacrylate (PEGDA) ICCs and PEGDA ICCs coated with either collagen type I or fibronectin have been investigated. Porcine hepatocytes viability, morphology, hepatic-specific functions and patterns of gene expression have been evaluated over a period of two weeks in culture to test diclofenac, a well-known hepatotoxic drug. Interestingly, cells in the fibronectin-functionalized scaffold exhibit different aggregation patterns and maintain better liver-specific function than those in bare ICCs and in collagen functionalized scaffold. We concluded that the 3D cell culture environment and the presence of extracellular matrix (ECM) proteins, especially fibronectin, facilitate hepatocyte viability and maintenance of the liver-specific phenotype in vitro, and enable us to predict hepatotoxicity.

9.
Physiol Plant ; 167(2): 217-231, 2019 Oct.
Article in English | MEDLINE | ID: mdl-30467856

ABSTRACT

Ammonium (NH4 + ) represents a primary nitrogen source for many plants, its effective transport into and between tissues and further assimilation in cells determine greatly plant nitrogen use efficiency. However, biological components involved in NH4 + movement in woody plants are unclear. Here, we report kinetic evidence for cotton NH4 + uptake and molecular identification of certain NH4 + transporters (AMTs) from cotton (Gossypium hirustum). A substrate-influx assay using 15 N-isotope revealed that cotton possessed a high-affinity transport system with a Km of 58 µM for NH4 + . Sequence analysis showed that GhAMT1.1-1.3 encoded respectively a membrane protein containing 485, 509 or 499 amino acids. Heterologous functionality test demonstrated that GhAMT1.1-1.3 expression mediated NH4 + permeation across the plasma membrane (PM) of yeast and/or Arabidopsis qko-mutant cells, allowing a growth restoration of both mutants on NH4 + . Quantitative PCR measurement showed that GhAMT1.3 was expressed in roots and leaves and markedly up-regulated by N-starvation, repressed by NH4 + resupply and regulated diurnally and age-dependently, suggesting that GhAMT1.3 should be a N-responsive gene. Importantly, GhAMT1.3 expression in Arabidopsis improved plant growth on NH4 + and enhanced total nitrogen accumulation (∼50% more), conforming with the observation of 2-fold more NH4 + absorption by GhAMT1.3-transformed qko plant roots during a 1-h root influx period. Together with its targeting to the PM and saturated transport kinetics with a Km of 72 µM for NH4 + , GhAMT1.3 is suggested to be a high-affinity NH4 + permease that may play a significant role in cotton NH4 + acquisition and utilization, adding a new member in the plant AMT family.


Subject(s)
Ammonium Compounds/metabolism , Cation Transport Proteins/metabolism , Gossypium/genetics , Nitrogen/metabolism , Plant Proteins/metabolism , Arabidopsis/genetics , Arabidopsis/metabolism , Biological Transport , Cation Transport Proteins/genetics , Cell Membrane/metabolism , Gossypium/metabolism , Plant Leaves/genetics , Plant Leaves/metabolism , Plant Proteins/genetics , Plants, Genetically Modified , Saccharomyces cerevisiae/genetics , Saccharomyces cerevisiae/metabolism
10.
Front Plant Sci ; 9: 210, 2018.
Article in English | MEDLINE | ID: mdl-29563921

ABSTRACT

Although many members encoding different ammonium- and nitrate-transporters (AMTs, NRTs) were identified and functionally characterized from several plant species, little is known about molecular components for [Formula: see text]- and [Formula: see text] acquisition/transport in tobacco, which is often used as a plant model for biological studies besides its agricultural and industrial interest. We reported here the first molecular identification in tobacco (Nicotiana tabacum) of nine AMTs and four NRTs, which are respectively divided into four (AMT1/2/3/4) and two (NRT1/2) clusters and whose functionalities were preliminarily evidenced by heterologous functional-complementation in yeast or Arabidopsis. Tissue-specific transcriptional profiling by qPCR revealed that NtAMT1.1/NRT1.1 mRNA occurred widely in leaves, flower organs and roots; only NtAMT1.1/1.3/2.1NRT1.2/2.2 were strongly transcribed in the aged leaves, implying their dominant roles in N-remobilization from source/senescent tissues. N-dependent expression analysis showed a marked upregulation of NtAMT1.1 in the roots by N-starvation and resupply with N including [Formula: see text], suggesting a predominant action of NtAMT1.1 in [Formula: see text] uptake/transport whenever required. The obvious leaf-expression of other NtAMTs e.g., AMT1.2 responsive to N indicates a major place, where they may play transport roles associated with plant N-status and ([Formula: see text]-)N movement within aerial-parts. The preferentially root-specific transcription of NtNRT1.1/1.2/2.1 responsive to N argues their importance for root [Formula: see text] uptake and even sensing in root systems. Moreover, of all NtAMTs/NRTs, only NtAMT1.1/NRT1.1/1.2 showed their root-expression alteration in a typical diurnal-oscillation pattern, reflecting likely their significant roles in root N-acquisition regulated by internal N-demand influenced by diurnal-dependent assimilation and translocation of carbohydrates from shoots. This suggestion could be supported at least in part by sucrose- and MSX-affected transcriptional-regulation of NtNRT1.1/1.2. Thus, present data provide valuable molecular bases for the existence of AMTs/NRTs in tobacco, promoting a deeper understanding of their biological functions.

11.
Plant Sci ; 264: 102-111, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28969790

ABSTRACT

Although biological functions of ammonium (NH4+) transporters (AMTs) have been intensively studied in many plant species, little is known about molecular bases responsible for NH4+ movement in tobacco. Here, we reported the identification and functional characterization of a putative NH4+ transporter NtAMT1.3 from tobacco (Nicotiana tabacum). Analysis in silico showed that NtAMT1.3 encoded an integral membrane protein containing 464 amino acid residues and exhibiting 10 predicted transmembrane α-helices. Heterologous functionality study demonstrated that NtAMT1.3 expression facilitated NH4+ entry across plasma membrane of NH4+-uptake defective yeast and Arabidopsis qko mutant, allowing a restored growth of both yeast and Arabidopsis mutant on low NH4+. qPCR assay revealed that NtAMT1.3 was expressed in both roots and leaves and significantly up-regulated by nitrogen starvation and resupply of its putative substrate NH4+ and even nitrate, suggesting that NtAMT1.3 should represent a nitrogen-responsive gene. Critically, constitutive overexpression of NtAMT1.3 in tobacco per se improved obviously the growth of transgenic plants on NH4+ and enhanced leaf nitrogen (15% more) accumulation, consistent with observation of 35% more NH4+ uptake by the roots of transgenic lines in 20min root-influx test. Together with data showing its plasma membrane localization and saturated transport nature with Km of about 50µM for NH4+, we suggest that NtAMT1.3 acts an active NH4+ transporter that plays a significant role in NH4+ acquisition and utilization in tobacco.


Subject(s)
Ammonium Compounds/metabolism , Cation Transport Proteins/metabolism , Gene Expression Regulation, Plant , Nicotiana/genetics , Nitrogen/metabolism , Plant Proteins/metabolism , Amino Acid Sequence , Arabidopsis/cytology , Arabidopsis/genetics , Arabidopsis/metabolism , Biological Transport , Cation Transport Proteins/genetics , Cell Membrane/metabolism , Genetic Complementation Test , Mutation , Nitrates/metabolism , Phylogeny , Plant Proteins/genetics , Plants, Genetically Modified , Saccharomyces cerevisiae/genetics , Saccharomyces cerevisiae/metabolism , Sequence Alignment , Nicotiana/growth & development , Nicotiana/physiology , Up-Regulation
12.
Am J Transl Res ; 9(3): 1369-1380, 2017.
Article in English | MEDLINE | ID: mdl-28386362

ABSTRACT

B7 Homolog 3 (B7-H3), a newly identified member of the B7 family, is over-expressed in various human cancers and plays a vital role in tumor progression. To identify the expression pattern of B7-H3 in human salivary adenoid cystic carcinoma (AdCC) and its underlying mechanisms, we characterized B7-H3 expression in AdCC tissue microarrays using immunohistochemical staining, and analyzed potentially associated molecules. The results showed that B7-H3 was highly expressed in salivary AdCC, compared with normal salivary glands. Statistical analyses of immunohistochemical staining showed that B7-H3 was closely correlated with Slug and p-STAT3. Functional studies showed that knockdown of B7-H3 in AdCC cell lines using RNA interference did not influence cell growth and apoptosis, but decreased migration and invasion in vitro. Further mechanism studies suggested that B7-H3 influenced the migration and invasion of AdCC cells by regulating the epithelial-mesenchymal transition via JAK2/STAT3 pathway components. Collectively, these findings suggested that B7-H3 may be a potential therapeutic target for AdCC.

13.
J Cell Mol Med ; 21(9): 2199-2210, 2017 09.
Article in English | MEDLINE | ID: mdl-28401653

ABSTRACT

Immature myeloid cells including myeloid-derived suppressor cells (MDSCs) and tumour-associated macrophages (TAMs) promote tumour growth and metastasis by facilitating tumour transformation and angiogenesis, as well as by suppressing antitumour effector immune responses. Therefore, strategies designed to reduce MDSCs and TAMs accumulation and their activities are potentially valuable therapeutic goals. In this study, we show that negative immune checkpoint molecule B7-H3 is significantly overexpressed in human head and neck squamous cell carcinoma (HNSCC) specimen as compared with normal oral mucosa. Using immunocompetent transgenic HNSCC models, we observed that targeting inhibition of B7-H3 reduced tumour size. Flow cytometry analysis revealed that targeting inhibition of B7-H3 increases antitumour immune response by decreasing immunosuppressive cells and promoting cytotoxic T cell activation in both tumour microenvironment and macroenvironment. Our study provides direct in vivo evidence for a rationale for B7-H3 blockade as a future therapeutic strategy to treat patients with HNSCC.


Subject(s)
B7 Antigens/antagonists & inhibitors , Carcinoma, Squamous Cell/immunology , Carcinoma, Squamous Cell/pathology , Head and Neck Neoplasms/immunology , Head and Neck Neoplasms/pathology , Myeloid Cells/pathology , Animals , B7 Antigens/metabolism , Carcinogenesis/metabolism , Carcinogenesis/pathology , Disease Models, Animal , Humans , Macrophages/pathology , Mice, Knockout , Myeloid Cells/metabolism , Myeloid-Derived Suppressor Cells/pathology , Prognosis , Protein Serine-Threonine Kinases/metabolism , Receptor, Transforming Growth Factor-beta Type I , Receptors, Transforming Growth Factor beta/metabolism
14.
Oncotarget ; 7(37): 59691-59703, 2016 Sep 13.
Article in English | MEDLINE | ID: mdl-27474168

ABSTRACT

Chemotherapy is an effective weapon in the battle against cancer, but numerous cancer patients are either not sensitive to chemotherapy or develop drug resistance to current chemotherapy regimens. Therefore, an effective chemotherapy mechanism that enhances tumor sensitivity to chemotherapeutics is urgently needed. The aim of the present study was to determine the antitumor activity of dihydromyricetin (DHM) on head and neck squamous cell carcinoma (HNSCC) and its underlying mechanisms. We demonstrated that DHM can markedly induce apoptotic cell death and autophagy in HNSCC cells. Meanwhile, increased autophagy inhibited apoptosis. Pharmacological or genetic inhibition of autophagy further sensitized the HNSCC cells to DHM-induced apoptosis. Mechanistic analysis showed that the antitumor of DHM may be due to the activation phosphorylation of signal transducer and activator of transcription 3 (p-STAT3), which contributed to autophagy. Importantly, DHM triggered reactive oxygen species (ROS) generation in the HNSCC cells and the levels of ROS decreased with N-acetyl-cysteine (NAC), a ROS scavenger. Moreover, NAC abrogated the effects of DHM on STAT3-dependent autophagy. Overall, the following critical issues were observed: first, DHM increased the p-STAT3-dependent autophagy by generating ROS-signaling pathways in head and neck squamous cell carcinoma. Second, inhibiting autophagy could enhance DHM-induced apoptosis in head and neck squamous cell carcinoma.


Subject(s)
Apoptosis/drug effects , Autophagy/drug effects , Flavonols/pharmacology , Reactive Oxygen Species/metabolism , STAT3 Transcription Factor/metabolism , Blotting, Western , Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/pathology , Cell Line, Tumor , Head and Neck Neoplasms/metabolism , Head and Neck Neoplasms/pathology , Humans , Phosphorylation/drug effects , Signal Transduction/drug effects
15.
Oncoimmunology ; 5(5): e1130206, 2016 May.
Article in English | MEDLINE | ID: mdl-27467947

ABSTRACT

Cumulative evidence suggests that constitutively activated signal transducer and activator of transcription (STAT3) may contribute to sustaining immunosuppressive status, and that inhibiting STAT3 signaling represents a potential strategy to improve antitumor immunity. In the present study, we observed that high levels phosphorylated of STAT3 are significantly associated with the markers for both myeloid-derived suppressor cells (MDSCs) and tumor-associated macrophages (TAMs) in human head and neck squamous cell carcinoma (HNSCC). Additionally, we showed that targeting STAT3 signaling with a tolerable selective inhibitor S3I-201 significantly decreased immature myeloid cells such as MDSCs, TAMs and iDCs in genetically defined mice HNSCC model. These findings highlight that targeting STAT3 signaling may be effective to enhance antitumor immunity via myeloid suppressor cells in HNSCC.

16.
Oncotarget ; 6(41): 43581-93, 2015 Dec 22.
Article in English | MEDLINE | ID: mdl-26561201

ABSTRACT

Autophagy is considered as a double-edged sword. It can prolong the survival of cancer cells and enhance its resistance to apoptosis, and paradoxically, defective autophagy has been linked to increased tumorigenesis, but the mechanism behind this phenomenon is unclear. In this study, we demonstrated that decreased phosphorylation of signal transducer and activator of transcription 3 (p-STAT3) was correlated with increased autophagy through the Akt/mTOR and Erk signaling pathways in human head and neck squamous cell carcinoma (HNSCC). We also showed that blockage of STAT3 by NSC74859 could markedly induce apoptotic cell death and autophagy. Meanwhile, increased autophagy inhibited apoptosis. The pharmacological or genetic inhibition of autophagy and STAT3 further sensitized HNSCC cells to apoptosis. Furthermore, evidence from xenograft model proved that suppressed STAT3 activity combined with inhibition of autophagy promoted tumor regression better than either treatment alone. Taken together, this present study demonstrated that autophagy alleviates apoptotic cell death in HNSCC, and combination of inhibition of STAT3 by NSC74859 and autophagy might be a promising new therapeutic strategy for HNSCC.


Subject(s)
Autophagy/physiology , Carcinoma, Squamous Cell/pathology , Head and Neck Neoplasms/pathology , STAT3 Transcription Factor/antagonists & inhibitors , Signal Transduction/physiology , Aminosalicylic Acids/pharmacology , Animals , Autophagy/drug effects , Benzenesulfonates/pharmacology , Blotting, Western , Carcinoma, Squamous Cell/metabolism , Cell Line, Tumor , Cell Proliferation/drug effects , Cluster Analysis , Female , Head and Neck Neoplasms/metabolism , Humans , Immunohistochemistry , Mice , Mice, Inbred BALB C , Phosphorylation , Signal Transduction/drug effects , Squamous Cell Carcinoma of Head and Neck , Tissue Array Analysis , Xenograft Model Antitumor Assays
17.
Oral Oncol ; 51(11): 976-981, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26321080

ABSTRACT

The aim of this study was to compare the outcomes of elective neck dissection (END) with that of a more conservative approach comprising of observation plus therapeutic neck dissection for nodal relapse (OBS), by conducting a meta-analysis of randomized controlled trials (RCTs) that compare these two surgical approaches in patients. RCTs conducted prior to May 2015 were identified from electronic databases such as MEDLINE EMBASE and Cochrane Library. Reference lists within the retrieved articles were used as secondary reference sources. Disease-free survival (DFS) and overall survival (OS) were the primary outcome measures. Five RCTs with a combined subject population of 779 patients were included. Meta-analysis of these 5 RCTs showed that DFS in END group was higher than that in the OBS group with a significant inter-group difference (Risk Ratio [RR]:1.33; 95% Confidence Interval [CI] 1.06, 1.66); P=0.01; five trials, 779 participants]. However, there was a significant statistical heterogeneity among the studies (I-squared=56%, P=0.06). Four studies had reported on OS. Meta-analysis of these 4 RCTs revealed a higher OS in the END group as compared to that that in the OBS group with a significant inter-group difference (RR: 1.18; 95% CI 1.07, 1.29); P=0.0009; four trials, 708 participants]. The statistical heterogeneity of these 4 studies is small (I-squared=14%, P=0.32). The results of this meta-analysis suggest that END at the time of resection of the primary tumor confers a DFS and OS benefit in patients with clinically node-negative oral cancer.


Subject(s)
Carcinoma, Squamous Cell/surgery , Elective Surgical Procedures/methods , Mouth Neoplasms/surgery , Neck Dissection/methods , Neoplasm Recurrence, Local/prevention & control , Carcinoma, Squamous Cell/prevention & control , Female , Humans , Male , Middle Aged , Randomized Controlled Trials as Topic
18.
PLoS One ; 10(7): e0132476, 2015.
Article in English | MEDLINE | ID: mdl-26161897

ABSTRACT

OBJECTIVE: Neck dissection is the most definitive and effective treatment for head and neck cancer. This systematic review aims to compare the efficacy and surgical outcomes of neck dissection between the harmonic scalpel and conventional surgical techniques and conduct a quantitative meta-analysis of the randomized trials. METHODS: Randomized controlled trials (RCTs) were identified from the major electronic databases (MEDLINE, EMBASE and Cochrane Library) using the keywords ''harmonic scalpel'' and ''neck dissection,'' and a quantitative meta-analysis was conducted. The operative time and intraoperative bleeding were the primary outcome measures, and other parameters assessed included the drainage fluid volume and length of hospital stay. RESULTS: Seven trials that met the inclusion criteria included 406 neck dissection cases (201 in the harmonic scalpel group). Compared with conventional surgical techniques, the HS group had an operative time that was significantly reduced by 29.3 minutes [mean difference: -29.29; 95% CI = (-44.26, -14.32); P=0.0001], a reduction in intraoperative bleeding by 141.1 milliliters [mean difference: -141.13; 95% CI = (-314.99, 32.73); P=0.11], and a reduction in drainage fluid volume by 64.9 milliliters [mean difference: -64.86; 95% CI = (-110.40, -19.32); P=0.005] , but it is not significant after removal of studies driving heterogeneity. There was no significant difference in the length of the hospital stay [mean difference: -0.21; 95% CI = (-0.48, 0.07); P=0.14]. CONCLUSION: This systematic review showed that using the harmonic scalpel for neck dissection significantly reduces the operative time and drainage fluid volume and that it is not associated with an increased length of hospital stay or perioperative complications. Therefore, the harmonic scalpel method is safe and effective for neck dissection. However, the statistical heterogeneity was high. Further studies are required to substantiate our findings.


Subject(s)
Hemostasis, Surgical , Neck Dissection , Randomized Controlled Trials as Topic , Surgical Instruments , Blood Loss, Surgical , Drainage , Humans , Length of Stay , Operative Time , Publication Bias
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