Comparison of outcomes between single- and multiple-perforator-based free perforator flaps: A systematic review and meta-analysis.

BACKGROUND: Perforator-based free perforator flaps have become an important tool for the reconstruction of tissue defects. The effect of the number of perforators on the outcomes of perforator flaps has been widely debated. This study aimed to compare the outcomes of single- and multiple-perforator-based free perforator flaps in free-flap reconstruction. METHODS: We searched PubMed, Web of Science, EMBASE, Chinese BioMedical Literature Database (CBM), Cochrane Library, and clinicaltrials.gov between January 2000 and June 2021 to identify studies that reported data on the outcomes of free perforator flaps. Two authors individually extracted data and performed quality assessment. Outcomes, including partial flap loss, total loss, fat necrosis, arterial insufficiency, venous insufficiency, hemorrhage and hematoma, wound dehiscence at recipient sites and donor site complications, were evaluated. RESULTS: Thirty-two studies with 2498 flaps were included in our analysis. No significant difference was found in the rates of partial loss and arterial insufficiency of flaps, hemorrhage and hematoma, wound dehiscence at recipient sites and donor site complications. However, the multiple-perforator group showed significantly lower rates of total loss (relative risk [RR] = 1.08, 95% confidence interval [CI]: 0.78-1.79, p = .754), fat necrosis (RR = 1.79, 95% [CI]: 1.36-2.36, p = .000) and venous insufficiency (RR = 1.72, 95% CI: 1.07-2.79, p = .026) than the single-perforator group. CONCLUSION: The rates of total loss, fat necrosis and venous insufficiency in the multiple-perforator group were lower than those in the single-perforator group. Hence, we recommend that multiple perforators be included in the free perforator flap when appropriate, to yield better clinical outcomes in reconstruction.

Risk Factors for Free Flap Outcomes: A Retrospective Study of 318 Free Flaps for Head and Neck Defect Reconstruction.

OBJECTIVES: This study was conducted to identify the risk factors for free flap outcomes in head and neck reconstruction. METHODS: A retrospective review of 318 free flaps were used for head and neck reconstructions in 317 patients over seven years. The patient characteristics, surgical data, and flap outcomes were recorded. The impact of risk factors related on the outcomes of free flaps were analyzed using single and multivariate analysis. RESULTS: For single factor analysis, 295 free flaps for the first reconstruction were included. Hypertension and the type of recipient vein are associated with venous thrombosis (P = .018, P = .047). Hypertension, type of free flap, recipient artery, and recipient vein were associated with the incidence of re-exploration (P = .009, P = .011, P = .017, P = .021). Hypertension had an obvious effect on the flap survival (P = .005). For multivariate analysis, hypertension (odds ratio = .166, 95% confidence interval: .043 - .636; P = .009) was a statistically significant risk factor for flap survival. For types of recipient artery and vein, selecting two venous anastomosis (one of IJVS and one of EJVS) had the minimum incidence of venous thrombosis (2.2%), and selecting facial artery, single vein (one of IJVS), and two veins (one of IJVS and one of EJVS) for anastomosis had lower incidence of re-exploration, which were 4.4%, 2.9%, and 6.0%, respectively (P < .05). CONCLUSIONS: Risk factors as hypertension, type of free flap, recipient artery and vein should be paid more attention in the free flaps for head and neck reconstructions. We believe proper measures will lead to better results in head and neck reconstruction.

Comparing donor site morbidity between radial and ulnar forearm free flaps: a meta-analysis.

The vascularised forearm free flap is a workhorse flap for the reconstruction of many types of soft tissue defects. However, the difference in donor-site morbidity between the radial forearm free flap (RFFF) and ulnar forearm free flap (UFFF) remains controversial. This study aimed to compare the donor-site outcomes of RFFF and UFFF. We searched PubMed, EMBASE, Web of Science, clinicaltrials.gov, Cochrane Library, and Chinese Biomedical Literature Database up to August 10, 2021, to identify studies on donor-site outcomes of RFFF versus UFFF in patients undergoing reconstructive surgery. Two authors individually extracted data and performed quality assessments of the selected articles. The overall morbidity and overall effect of individual complications of the donor site were analysed. In total, 288 cases from five studies were included in our analysis. The UFFF group was significantly superior to the RFFF group regarding overall morbidity and overall effect of individual complications of the donor site. The morbidity of UFFF donor sites was significantly lower than that of RFFF, and UFFF may be an ideal substitute for RFFF in reconstructive surgery. However, additional large-scale studies are necessary to confirm this finding.

The effectiveness and harms of bortezomib in combination with chemotherapy for mantle cell lymphoma: A protocol for systematic review and meta-analysis.

BACKGROUND: Chemotherapy with or without consolidation followed by autologous hematopoietic stem cell transplantation is the first-line treatment for mantle cell lymphoma. However, the effectiveness and safety of bortezomib-based chemotherapy for patients with mantle cell lymphoma is still uncertain. METHODS: In this systematic review, the electronic databases of Cochrane Central Register of Controlled Trials, EMBASE, and PUBMED will be searched from inception to May 1, 2020. Randomized controlled trials that assessed the effectiveness and safety of bortezomib in combination with chemotherapy for patients with mantle cell lymphoma will be included. The patient's important outcomes include overall survival, progression-free survival, overall response rate, quality of life, and serious adverse events (eg, grade III-IV peripheral neuropathy, neutropenia, and infection). All process of the study selection, data extraction, and methodology evaluation will be carried out by 2 authors independently. RevMan 5.3 software will be utilized for statistical analysis. RESULTS: This study will provide a detailed summary of latest evidence related to the effectiveness and safety of bortezomib in combination with chemotherapy in overall survival, progression-free survival, overall response rate, quality of life, and serious adverse events for patients with mantle cell lymphoma CONCLUSION:: The findings of this study may provide possible guidance for bortezomib in combination with chemotherapy for patients with mantle cell lymphoma. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD 42020154938.

MicroRNA­21 serves an important role during PAOO­facilitated orthodontic tooth movement.

Periodontal accelerate osteogenesis orthodontics (PAOO) is an extension of described techniques that surgically alter the alveolar bone; however, the specific mechanism underlying the technique is not completely understood. The aim of the present study was to evaluate the roles of microRNA (miR)­21 during PAOO. Sprague­Dawley rats were divided into the following four groups: i) Group tooth movement (TM), underwent TM and were administered normal saline (NS); ii) Group PAOO, underwent PAOO + TM and were administered NS; iii) Group agomiR­21, underwent PAOO + TM and were administered agomiR­21; and iv) Group antagomiR­21, underwent PAOO + TM and were administered antagomiR­21. To validate the rat model of PAOO, morphological analyses were performed and measurements were collected. Reverse transcription­quantitative PCR, western blotting and immunohistochemical staining were performed to examine the expression levels of programmed cell death 4 (PDCD4), activin A receptor type 2B (ACVR2b), receptor activator of NF­κΒ ligand (RANKL) and C­Fos. Dual­luciferase reporter assays were performed to validate PDCD4 as a target of miR­21 in vitro. Following 7 days of treatment, the TM distance of group PAOO was longer compared with groups TM and antagomiR­21 (P<0.05), but shorter compared with group agomiR­21 (P<0.05). Tartrate­resistant acid phosphatase staining indicated that following treatment with agomiR­21, osteoclast activity was notably increased, whereas the mRNA and protein expression levels of PDCD4 were notably decreased compared with group PAOO. The mRNA and protein expression levels of RANKL and C­Fos in group agomiR­21 were notably increased compared with group PAOO, whereas group antagomiR­21 displayed the opposite pattern (P<0.05). With regard to ACVR2b, no significant differences were observed among the group agomiR­21 and antagomiR­21 compared with group PAOO. Bioinformatics analysis predicted that PDCD4 was a potential target gene of miR­21, and dual­luciferase reporter assays demonstrated that miR­21 directly targeted PDCD4. In conclusion, the present study demonstrated that miR­21 serves an important role during PAOO­mediated orthodontic TM.

MicroRNA-532-3p Suppresses Malignant Behaviors of Tongue Squamous Cell Carcinoma via Regulating CCR7.

To provide better therapeutic avenues for treating tongue squamous cell carcinoma (TSCC), a series of experiments about the effects of microRNA (miR)-532-3p on TSCC malignant behaviors were carried out. The result showed that miR-532-3p was down-regulated and C-C chemokine receptor 7 (CCR7) was up-regulated in the tumor tissues compared with those in the paired paratumor tissues. Further, expression of miR-532-3p was detected in four TSCC cell lines, TSCCA, TCA8113, CAL-27, and SCC-25. The miR-532-3p mimics and inhibitor were transfected into the CAL-27 and TCA8113 cell lines which were the relatively lowest and highest miR-532-3p expressions, respectively. It was found that the overexpression of miR-532-3p suppressed TSCC cell proliferation, migration, invasion, and promoted apoptosis in vitro, whilst the knockdown of miR-532-3p reversed these behaviors. The bioinformatics predicted that CCR7 was a downstream gene of miR-532-3p, which was confirmed via luciferase assay. Following, the decline of CCR7 in the miR-532-3p mimics group and the rise of CCR7 in the miR-532-3p inhibitor group were also verified. In addition, enhanced cell proliferation, migration and invasion induced by CCR7 were partly restrained by miR-532-3p in TSCC cell. Meanwhile, miR-532-3p attenuated tumourigenesis in vivo due to the reduction of tumor volume and Ki-67 positive rate and the increase of apoptotic cells. Taken together, these findings reveal a pivotal role for the miR-532-3p/CCR7 axis in regulating TSCC, and this novel axis could be suitable for therapeutic intervention in TSCC disease.

Association between polymorphism of TGFA Taq I and cleft lip and/or palate: a meta-analysis.

BACKGROUND: Cleft lip and palate (CL/P) is one of the most common malformations in humans. Transforming growth factor alpha (TGFA) is a well characterized mammalian growth factor which might contribute to the development of CL/P. This meta-analysis aimed to summarize the association between the TGFA Taq I polymorphisms and CL/P. METHODS: We retrieved the relevant articles from PubMed, EMBASE, ISI Web of Science and SCOPUS databases. Studies were selected using specific inclusion and exclusion criteria. The odds ratios (ORs) and their 95% confidence intervals (95% CIs) were calculated to assess the association between TGFA Taq I polymorphism and CL/P risk. Meta-analyses were performed on the total data set and separately for the major ethnic groups, disease type and source of control. All analyses were performed using the Stata software. RESULTS: Twenty articles were included in the present analysis. There is a significant association between the TGFA Taq I polymorphism and CL/P (C1C2 vs C1C1: OR = 1.67, 95% CI = 1.23-2.25, C2C2 + C1C2 vs C1C1C1: OR = 1.52, 95% CI = 1.15-2.01; C2 vs C1:OR = 1.41, 95% CI = 1.12-1.78). Stratified analyses suggested that the TGFA Taq I polymorphism was significantly associated with CL/P in Caucasians (C1C2 vs C1C1: OR = 1.95, 95% CI = 1.34-2.86; C2C2 + C1C2 vs C1C1: OR = 1.68, 95% CI = 1.18-2.38; C2 vs V1: OR = 1.52, 95% CI = 1.14 -2.02). CONCLUSION: TGFA Taq I polymorphism may be associated with the risk of CL/P.

C392T polymorphism of the Wnt10a gene in non-syndromic oral cleft in a northeastern Chinese population.

Non-syndromic oral cleft is one of the most common congenital malformations, and more than 40 genes may be involved in its aetiology. Recent studies have shown that the Wnt10a gene may also contribute. We recruited 198 patients with non-syndromic oral clefts, comprising 96 elementary families (restricted to the patients and their parents) and 187 controls, to investigate their associations with the risk of such clefts and their subgroups in a Chinese Han population. The variant evaluated in this study was a single nucleotide polymorphism - specifically, a missense mutation C392T of Wnt10a. Polymerase chain reaction (PCR) restriction fragment length polymorphism (RFLP) was used to genotype the marker, and case-control and family-based associations were analysed. Although in the case-control study there were no significant differences in frequency distributions of genotypes or alleles between cases and controls in the groups with cleft palate and cleft lip and palate, the genotypic and allelic frequencies of C392T in the total groups and the group with cleft lip alone differed significantly from those in the controls (p=0.04, and 0.01, respectively). A transmission disequilibrium test showed a transmitted disequilibrium in C392T. In conclusion, we found an association between the C392T variant and non-syndromic oral clefts.

Accelerated OH(-) transport in activated carbon air cathode by modification of quaternary ammonium for microbial fuel cells.

Activated carbon (AC) is a promising catalyst for the air cathode of microbial fuel cells (MFCs) because of its high performance and low cost. To increase the performance of AC air cathodes, the acceleration of OH(-) transport is one of the most important methods, but it has not been widely investigated. Here we added quaternary ammonium to ACs by in situ anchoring of a quaternary ammonium/epoxide-reacting compound (QAE) or ex situ mixing with anion exchange resins in order to modify ACs from not only the external surface but also inside the pores. In 50 mM phosphate buffer solution (PBS), the in situ anchoring of QAE was a more effective way to increase the power. The highest power density of 2781 ± 36 mW/m(2), which is 10% higher than that of the control, was obtained using QAE-anchored AC cathodes. When the medium was switched to an unbuffered NaCl solution, the increase in maximum power density (885 ± 25 mW/m(2)) was in accordance with the anion exchange capacity (0.219 mmol/g). The highest power density of the anion exchange resin-mixed air cathode was 51% higher than that of the control, indicating that anion exchange is urgently needed in real wastewaters. Excess anchoring of QAE blocked both the mesopores and micropores, causing the power output to be inhibited.

Down-regulation of Wnt10a by RNA interference inhibits proliferation and promotes apoptosis in mouse embryonic palatal mesenchymal cells through Wnt/Beta-catenin signaling pathway

Cleft palate is one of the most common birth defects. Both environmental and genetic factors are involved in this disorder. Here, we investigated the function of Wnt10a in proliferation and apoptosis of mouse embryonic palatal mesenchymal (MEPM) cells. Expression of Wnt10a was down-regulated at both the mRNA and protein levels in transfected MEPM cells containing Wnt10a-specific small hairpin RNA (shRNA) plasmid. Down-regulation of Wnt10a inhibited cell proliferation and induced cell cycle arrest in the S phase in MEPM cells. Moreover, apoptosis was significantly increased in MEPM cells of Wnt10a gene silencing. Finally, the expression of β-catenin was markedly reduced in MEPM cells transfected with shRNA plasmid, indicating that the canonical Wnt/β-catenin signaling pathway was involved in the alterations of cell proliferation and apoptosis induced by Wnt10a knockdown. Thus, our findings reveal that Wnt10a regulates proliferation and apoptosis of MEPM cells at least partially through the canonical Wnt/β-catenin signaling pathway

Down-regulation of Wnt10a by RNA interference inhibits proliferation and promotes apoptosis in mouse embryonic palatal mesenchymal cells through Wnt/ß-catenin signaling pathway.

Cleft palate is one of the most common birth defects. Both environmental and genetic factors are involved in this disorder. Here, we investigated the function of Wnt10a in proliferation and apoptosis of mouse embryonic palatal mesenchymal (MEPM) cells. Expression of Wnt10a was down-regulated at both the mRNA and protein levels in transfected MEPM cells containing Wnt10a-specific small hairpin RNA (shRNA) plasmid. Down-regulation of Wnt10a inhibited cell proliferation and induced cell cycle arrest in the S phase in MEPM cells. Moreover, apoptosis was significantly increased in MEPM cells of Wnt10a gene silencing. Finally, the expression of ß-catenin was markedly reduced in MEPM cells transfected with shRNA plasmid, indicating that the canonical Wnt/ß-catenin signaling pathway was involved in the alterations of cell proliferation and apoptosis induced by Wnt10a knockdown. Thus, our findings reveal that Wnt10a regulates proliferation and apoptosis of MEPM cells at least partially through the canonical Wnt/ß-catenin signaling pathway.

Rapid analysis of piperazine ferulate tablets by optic-fiber sensing technology and the similarity of ultraviolet spectra.

A rapid analysis method of piperazine ferulate tablets by optic-fiber sensing technology with UV-vis absorption spectrum was established. Qualitative and quantitative data were obtained and compared by maximum and minimum wavelength, absorbance and contrast spectra. Similarity method was used to identify authenticity of drugs. The difference of contents measured by this method and UV determination method in China Pharmacopoeia showed no statistical significance (P>0.05), while the similarity can be used as a parameter to identify the authenticity of drugs.

[A three-dimensional finite element analysis for the biomechanical characteristics of orthodontic anchorage micro-implant].

PURPOSE: To establish a three-dimensional finite element model for orthodontic anchorage micro-implant,and to analyze the influence of different titled angles on the biomechanical characteristics of orthodontic anchorage implant-bone interface. METHODS: ANSYS(Analysis System)finite element analysis software was used to perform the finite element modeling of the micro-implant with 7 different tilted angles, including 30 degrees, 40 degrees, 50 degrees, 60 degrees, 70 degrees, 80 degrees and 90 degrees. A simulated orthodontic force, which was 200 grams, was loaded mesiodistally to the mathematical models. The stress and displacement distribution on the implant-bone interface were analyzed. RESULTS: As the titled angle increased, the Von-Mises stress at the cervix of the implants were 1.0792, 1.0104, 0.8848, 0.8181, 0.7583, 0.6339 and 0.5608MPa, while the displacement were 5.5513, 4.9900, 3.7419, 3.1264, 2.5874, 1.3624 and 0.8027microm CONCLUSION: The micro-implant can be safely loaded with 200 grams of mesiodistal orthodontic force. The increase of the titled angle can efficaciously enhance the ability,implicating that the implant can bear a mesiodistal orthodontic force, vertical angle should be chosen when the micro-implant is embedded. Supported by Natural Science Foundation of Liaoning Province (20042076).

[Effect of fluorided etching fluid on the shear bond strength and the deposition on the surface of enamel.].

PURPOSE: The aim of this study was to find the best concentration of fluorided etching acid in the dental clinic which had both the best shear bond strength and the maximal anti-caries effect. METHODS: 84 extracted human premolars were divided into four groups of 21 teeth each. The enamel of each group was conditioned with 35% phosphoric acid containing 0%, 1.23%, 2%, 3% NaF. The shear bond strength was tested by bond strength machine and the enamel morphology was observed by scanning electron microscopy at once, 1 week, 4 weeks, 12 weeks, 24 weeks after etching. The shear bond strength was statistically analyzed by SPSS10.0 software. RESULTS: The shear bond strength of the group whose acid containing 3% NaF was less than the others significantly (P<0.05); and there was no significant difference among the other groups (P>0.05). The amount of the deposition on the surface of enamel after etching was increased with the time after etching and the concentration of NaF increasing. CONCLUSIONS: 2% NaF added to 35% phosphoric acid has both the best bond strength and the best effect of preventing enamel from caries.