Clinical research of extensive alveolar cleft treatment with computer assistant distraction osteogenesis / 中华口腔医学杂志

Objective@#To evaluate the feasibility and outcome of computer assisted distraction osteogenesis in the treatment of extensive alveolar cleft.@*Methods@#Four patients [1 male and 3 females, aged (15.5±3.7) years] received treatment in the Department of Oral-Maxillofacial Surgery and Plastic Surgery, School of Stomatology, China Medical University from June 2016 to April 2018 were involved in this study. All the patients with extensive alveolar cleft [cleft width (7.64±1.29) mm] were performed orthodontic treatment to expand the dental arch and interdental space between the first molar and premolars. Three-dimensional (3D) model of the maxilla and the osteotomy guider were printed according to the CT data. The fix wings of the distractor were pre-shaped according to the 3D model. The osteotomy was performed at the interdental space and horizontal plate of palate to dissociate the alveolar bone segment. The distractor was fixed on the predetermined position. Distraction (0.4-0.8 mm/day) was performed in 7 days later and stopped when the incision connected with the canine. The distractor was removed after six months.@*Results@#The distraction period was (10.8±2.5) d in four cases. The cleft was completely closed with interdental bone anchored distraction in four cases. The imaging examination in six months showed good new bone structure in the distraction zone and bone connection of the cleft.@*Conclusions@#Computer assisted distraction osteogenesis was effective and feasible to close the extensive alveolar cleft and provide sufficient new bone tissue.

Orthognathic surgical treatment of secondary maxillary deformities following the cleft lip and palate repair / 中华整形外科杂志

Objective@#The aim of this study is to summarize the experience of the orthognathic surgical treatment forsecondary maxillary deformities following the cleft lip and palate repair.@*Methods@#Twenty-two patients with secondary maxillary deformities following the cleft lip and palate repairment(orthognathic approach), were retrospectively analyzed.All the cases were treated in the Hospital of Stomatology, China Medical University from January 2007 to December 2016. There were 9 males and 13 females, ranging from 18 to 24 years in age. Only 3 of those cases were not undergone preoperative and postoperative orthodontic treatments. The anteroposterior maxilla and mandible discrepancy was 6-11 mm preoperatively. The modified surgical procedures are as follows: One-stage alveolar bone graftand maxillary osteotomy were performed for unilateral cleft patients; Internal fixation with micro-plate at the alveolar cleft region was performed to stabilize the maxillary dental arch intraoperatively; Intermolar wire ligation and palatal arch were used to control the width of maxilla intraoperatively and 1 month after operation; 2-3 mm overcorrection for the Le Fort Ⅰ advancement was produced to reduce relapse in sagittal direction. Mandibular set back was performed using bilateral sagittal split osteotomy at the same time. Rigid internal fixation with titanium palates and screws was applied for all the cases. All patients had been followed up for 1 to 2 years postoperatively.@*Results@#Most of the patients had satisfactory facial proportion, and good and stable occlusion relationship, with only one patient developed severely uncontrollable relapse to class Ⅲ malocclusion, and 3 patients experienced relapse resulted in edge to edge incisor relationship.@*Conclusions@#Le Fort Ⅰ osteotomy combined with bilateral sagittal split osteotomy was effective to correct the secondary maxillary deformities following the cleft lip and palate repair. The treatment plan should be individualized, depending on the patients′ occlusion relationship, skeletal deformity, and facial appearance as well. It is necessary to modify the surgical techniques of Le Fort Ⅰ osteotomy for the cleft patients.

Evaluation of intra-operative rectal washout in patients with rectal cancer during anterior resection / 中华普通外科杂志

Objective To evaluate the influence of rectal washout on the prognosis of rectal cancer after anterior resection.Methods Data of 144 patients with rectal cancer undergoing anterior resection at Chinese Academy of Medical Science Cancer Hospital between May 2006 and November 2007 were reviewed.69 patients received rectal washout and 75 patients did not.The incidences of recurrence and 5-year disease-free survival rates were compared.Data were analyzed by SPSS 13.0 software packet,using x2 and t inspection.Kaplan-Meier method was used to calculate postoperative survival rate.Results Washing sample was positive for malignant cells in 55 patients (79.7％).The incidences of recurrence were 4.6％ and 6.7％ in washout group and no-washout group respectively (x2 =0.368,P =0.721).The five-year disease-free survival rate was 79.7％ in washout group and 74.7％ in no-washout group(x2 =0.517,P =0.553).Conclusions Free malignant cells were ubiquitous in rectal lumen during anterior resection,and there was a high positive rate of cytological examine for washout sample.Rectal washout may reduce local recurrence and prolong patients' survival.

Comparison of the effects of dexmedetomidine and midazolam with fentanyl in patients with anticipated difficult intubation during awake blind nasal intubation / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To compare the effects of dexmedetomidine and midazolam with fentanyl with anticipated difficult intubation during awake blind nasal intubation on respiration and hemodynamics of patients.</p><p><b>METHODS</b>Forty patients (ASA class I to II) undergoing selective oral and maxillofacial surgeries with anticipated difficult intubation were enrolled in the study. The patients were randomly assigned into two equal groups. Experimental group received dexmedetomidine, control group received midazolam and fentanyl. The Ramsay sedation scores, mean artery pressure (MAP), heart rate (HR), respiratory rate (RR) and blood oxygen saturation of pulse (SpO2) were recorded at baseline (TI), beginning to intubate (T2), 10 min after beginning to intubate (T3), 20 min after beginning to intubate (T4), and after intubation (T5). The operative time for intubation, intubation times, success rate of intubation, the anesthetic effects and complications were recorded.</p><p><b>RESULTS</b>The success rate in the experimental group was significantly higher than that in the control group (P<0.05). Intubation times in the experimental group was less than that in the control group (P<0.05). The incidence of complications such as nausea, vomiting, cough and throat unwell in the control group was higher. Compared with the T1, RR decreased at T2 in the control group, but RR increased significantly at T4 and T5. RR and SpO2 had no significant change in the experimental group. Compared with T1, MAP and HR increased at T3, T4 and T5 in the control group (P<0.05). MAP and HR showed no significant variations in the experimental group (P>0.05). The Ramsay sedation scores in the control group were lower than those in the experimental group (P<0.05).</p><p><b>CONCLUSION</b>Appropriate application of dexmedetomidine can be safer and more effective than midazolam with fentanyl for awake blind intubation.</p>

Nonfunctional islet cell tumor: a report on 26 cases and review of the literature / 中华肝胆外科杂志

Objective To review our experience in the diagnosis and treatment of nonfunctional islet cell tumors(NICT).Method The clinicopathological data of 26 cases of NICT were retrospectively analysed and the medical literature was reviewed.Results In addition to the 26 cases seen in our center,there were 569 cases published in 37 articles in the medical literature.In China,NICT was more common in women.The male to female ratio was about 3 ∶ 7.The mean age of onset of the disease was 35 years old.Most NICT were solitary and malignant,surgery was effective in prolonging long-term survival.Conclusions NICT is rare and it had no specific clinical presentation.BUS and CT are useful for diagnosis and surgery is effective.

Change of calcium channel alpha-2-delta-1 subunit expression levels in trigeminal neuralgia rats / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To determine the expression levels of calcium channel alpha-2-delta-1 (Cavalpha2delta-1) subunit in trigeminal ganglia (TG) and trigeminal spinal subnucleus caudalis C1-C2 spinal cervical dorsal horn(Vc/C2) after infraorbital nerve (ION) ligation injury in relation to the development of neuropathic nociception.</p><p><b>METHODS</b>Twelve male SD rats were divided into two groups randomly, with 6 rats for each. In the ligation group, the ION was ligated by chromic gut loosely. In the sham operation group, the ION was exposed under same procedure but not ligated. The behavioral tests were conducted before 1 d and after 3, 6, 9, 12, 15 d with calibrated von Frey filaments. Cavalpha2delta-1 protein levels in TG and Vc/C2 were measured with Western blots 15 days after surgery.</p><p><b>RESULTS</b>Compared with the sham operation group, changes of allodynia to mechanical stimulation on the territory of ligated ION were found from the 9th to 15th day after operation in the ligation group (P<0.05). The expression levels of Cavalpha2delta-1 in TG and Vc/ C2 after ION ligation injury upregulated significantly (P<0.01).</p><p><b>CONCLUSION</b>The expression levels of Cavalpha2delta-1 in TG and Vc/C2 after ION ligation injury were upregulated and it may contribute to the pathogenesis of neuropathic nociception.</p>

Expression of annexin A1 and PCNA in pancreatic cancer and their correlation / 中华胰腺病杂志

Objective To investigate the expressions of the annexin A1 ( ANXA1 ) in pancreatic cancer and the correlations with proliferating cell nuclear antigen (PCNA). Methods Tissue microarray instrument was used to construct the chip. There were 39 samples of normal pancreas tissue, 42 samples of pancreatic cancer, 7 samples of islet cell tumor and 8 samples of ampullary carcinoma. The expressions of ANXA1 and PCNA protein were examined by immunohistochemistry and their correlation was analyzed. Results The off-chip rate of tissue chips after immunohistochemistry was 11.7% ～ 13.3%, which could satisfy the needs for experiment. Immunohistochemical results of pancreatic cancer tissue microarray showed that the positive rate of ANXA1 expression in pancreatic cancer was 71.4% (30/42), which was significantly higher when compared with that of normal pancreas tissue ( 18.4%, 7/38; P < 0. 01 ). The positive rate of PCNA expression in pancreatic cancer was 73.8% (31/42), which was significantly higher than that of normal pancreas tissue (22.2%, 8/36; P < 0.01 ). The expression of ANXA1 had a significant correlation with PCNA in pancreatic cancer ( P < 0.01 ). Conclusions The expression of ANXA1 protein was significantly increased in pancreatic cancer. The expression of ANXA1 was significantly correlated with the expression of PCNA.

Diagnosis and treatment of splenic harmatoma / 中国综合临床

Objective To discuss the diagnosis and treatment of splenic harmatoma(SH). Methods The clincial data of three cases of SH treated in our hospital from January 1997 to December 2007 were collected,and the other 17 cases which were published from January 1997 to December 2007 in the Chinese biological and medical lit-erature database were reviewed. The clinical manifestation,pathological findings,diagnosis and treatment of these 20 patients were analyzed. Results The main symptoms were abdominal pain or discomfort and abdominal mass in 13 cases(13/20). All 20 patients underwent surgical treatment with good recovery without severe complications and re-currence. Conclusions The definite diagnosis of SH depends on postoperative pathological findings. Complete surgi-cal resection is the best treatment for SH with favourable prognosis.

Comparative proteomic study of pancreatic cancer using antibody microarray / 中华胰腺病杂志

Objective By proteomic analysis of differentially expressed protein profiling in pancreatic cancer using antibody microarray, new tumor marker of pancreatic cancer was supposed to be discovered. Methods The antibody microarray containing 378 monoclonal antibodies was applied to detect the differentially expressed proteins of 7 sets of pancreatic ductal adenocareinoma pooled samples and their paired normal pancreas tissues pooled samples. Results 11 up-regulated proteins (UbcH6, GABA b R2, Plakophilin 2a, Inhibitor 2, Nestin, ShcC, PRK2, Neurogenin 3, STAT 3, NHE-3 and SRP54) and 9 down- regulated proteins (DCC, HPV-16 L1, RACKI, Gelsolin, Rabaptin-5, DBP2, IKKa/I, c-Cbl, FXR2) were found in pancreatic cancer. Conclusions Antibody microarray was an effective comparative proteomic technology. These dys-regulated proteins facilitated to elucidate the mechanisms of pancreatic cancer and to identify new diagnostic markers and therapeutic targets.

Degradation of gelsolin in pancreatic cancer cell lines by ubiquitin-proteasome pathway / 基础医学与临床

Objective To explore the role of ubiquitin-proteasome pathway for the gelsolin protein degradation in pancreatic cancer.Methods Pancreatic cancer cell lines BxPC-3 and PANC-1 were first treated with specific 26s proteasome inhibitor lactacystin.Immunoblots of cell lysates were probed for gelsolin expression.To determine whether gelsolin was conjugated to ubiquitin,proteins extracted from the cells with or without lactacystin were immunoprecipitated with anti-gelsolin antibody,followed by Western blot analysis.Results The expression of gelsolin protein increased obviously after treatment with lactacystin in BxPC-3 cells for 12 h.Using anti-gelsolin antibody to immunoprecipitate gelsolin protein and followed by Western blot using anti-ubiquitin monoclonal antibody,it was found that inhibition of proteasome pathway by lactacystin resulted in accumulation of ubiquitylated forms of gelsolin protein.In PANC-1 cell line,there was no significant changes of gelsolin after treatment with lactacystin.Conclusion Ubiquitin-proteasome dependent degradation may be an important regulatory mechanism for gelsolin down-regulation in pancreatic cancer cells.

The relation between apoptosis of acinar cells and nitric oxide during acute rejection of pancreas transplantation in rats.

Apoptosis is an important mechanism of immune-mediated graft damage. Nitric oxide (NO) generated by inducible NO synthase (iNOS) has been demonstrated to induce apoptosis. This study investigated whether apoptosis occurs during pancreas allograft rejection and examined the relationship of apoptosis of acinar cells and NO. The rats were divided into three groups: untreated isograft group, untreated allograft group and aminoguanidine (AG)-treated group. The pancreatic grafts were harvested on the post-transplantation day 3, 5 and 7 and were used to detect the histopathological rejection grade, the expression of iNOS and the apoptotic index (AI) of the graft. iNOS presented faint positive in the acinar cells of untreated isografts and did not change greatly after transplantation (P>0.05), the level of iNOS in the untreated allografts increased progressively (P<0.01) and at the same time point was significantly higher than that of untreated isograft group and AG-treated group (P<0.01). The transferase-mediated dUTP nick end labeling showed that the apoptotic cells were mainly acinar cells. A significant correlation between AI and iNOS was noted (P<0.01, r=0.611). Therefore, NO-mediated apoptosis of acinar cells plays an important role in acute rejection of pancreas transplantation, AG can mitigate the damage of pancreas allografts.