[Risk factor and nomogram for predicting the probability of a permanent stoma after laparoscopic intersphincteric resection for ultralow rectal cancer].

Objective: A permanent stoma can seriously affect patients' quality of life. Clinicians need to consider the risk of a permanent stoma when making clinical decisions. This study analyzed preoperative predictors of a permanent stoma after laparoscopic intersphincteric resection for low rectal cancer (LISR), and a prediction model was constructed validated. Methods: This was a retrospective study that analyzed clinical data of 331 ultralow rectal cancer patients who were diagnosed with primary rectal adenocarcinoma by endoscopy and pathology, including 218 males and 113 female, (58.8±11.2) years and (23.7±3.1) kg/m2. The patients underwent LISR with a preventive stoma from January 2012 to December 2020. Patients with multiple primary colorectal cancers, who underwent emergency surgery for intestinal obstruction or bleeding or perforation, and did not complete 18 months follow up were exclucled. R software was used to randomly select 234 patients as the modeling group with a ratio of approximately 7:3, and the remaining 97 patients comprised the validation group. The stoma site was determined by the surgeon before the operation, and the ileum 30 cm from the ileocecal valve was selected. The rates of a permanent stoma for the entire group and the preoperative clinical factors that may affect the permanency of a stoma in the modeling group were determined. A permanent stoma was defined as failure to close the stoma at 18 months after surgery. Multivariate logistic regression analysis was used to analyze the preoperative independent risk factors for a permanent stoma after LISR. R software was used to create the nomogram model, and the predictive ability of the nomogram model was evaluated by receiver operating characteristic (ROC) curve analysis. Results: Among the 331 patients who underwent LISR, 37 (26 cases in the modeling group and 11 cases in the validation group, 11.2%) developed a permanent stoma for the following reasons: anastomotic stenosis due to leakage (16 cases, 43.2%), distant metastasis (16 cases, 43.2%), intolerant to stoma closure surgery (3 cases, 8.1%), stenosis due to postoperative radiation (1 case, 2.7%), and poor recovery of anorectal function (1 case, 2.7%). Univariate analysis showed that preoperative neoadjuvant chemoradiotherapy, poorly differentiated tumor, cT3 stage, and distant metastasis were associated with a permanent stoma. Multivariate logistic regression analysis showed that neoadjuvant chemoradiotherapy [OR=3.078, 95% confidence interval (CI): 1.326-7.147; P=0.009], cT3 stage (OR=2.257, 95%CI: 1.001-5.091; P=0.049), and stage IV cancer (OR=16.180, 95%CI: 2.753-95.102; P=0.002) were independent risk factors for permanent stoma after LISR. Based on the selected risk factors, a nomogram model for predicting permanent stoma was constructed. The area under the ROC curve of the modeling group was 0.793, the optimal cut-off value was 0.890, the sensitivity was 0.577, and the specificity was 0.885. The area under the ROC curve of the validation group was 0.953. The corrected curves of the modeling group and the validation group showed a good degree of fit. Conclusion: Neoadjuvant chemoradiotherapy, cT3 stage, and distant metastasis are independent predictors of a permanent stoma after LISR, and the nomogram model is helpful to predict the probability of a permanent stoma. Patients with high-risk factors should be adequately informed of the risk of a permanent stoma before colorectal surgery.

Long non-coding RNAs associated with oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is one of the most common and fatal diseases in the head and neck region worldwide. To better understand the carcinogenesis and to find efficient biomarkers and therapeutic targets are still in urgent need. The studies of expression profile and mechanisms of long non-coding RNAs (lncRNAs) develop fast in recent years. This molecule form is aberrantly expressing and influencing many cellular processes in different cancer types. But its expression pattern and association with oral squamous cell carcinoma are yet to be elucidated. Here we reviewed recently reported OSCC-related lncRNAs and their relationship with the clinical status of patients. Functional mechanisms were also discussed. With the emerging knowledge and techniques in this area, more efficient biomarkers and therapeutic targets are promising in the future.

Cephalometric studies on the upper airway space in normal Chinese.

A detailed cephalometric analysis of the soft and hard tissues of the upper airway was conducted with lateral cephalographs from 116 normal Chinese, aged between 18 and 25 years. Normal values and deviation range were preliminarily established for the size of the tongue, soft palate, nasopharynx, oropharynx, and hypopharynx, and for the relative position of the hyoid bone and vallecula in both sexes. Statistical findings showed that there were significant differences between the sexes. Significant relationships (P < 0.001) were observed 1) between the hypopharyngeal depth and the position of the hyoid bone and the vallecula, in which the horizontal position of vallecula appears to be the best predictor of the hypopharyngeal depth, as confirmed by the multiple regression equation; 2) between the upper airway depths at four different levels; and 3) between the naso-oropharyngeal area and tongue, soft palate, and oral area. The present data can be used to investigate further the upper airway in abnormal states.

Selection of adenoid cystic carcinoma cell clone highly metastatic to the lung: an experimental study.

Lung metastasis is very common in patients with adenoid cystic carcinoma (ACC). The purpose of the present study is to establish a model for an experimental study of ACC metastatic mechanisms and antimetastatic procedures. After five repeated selection in vivo, combined with an in vitro cloning technique and analysis of platelet aggregation activity, a clone (Acc-M) highly metastatic to the lung was selected from an ACC cell line (Acc-2). The metastatic rate was 96% vs 18% for Acc-M and the Acc-2 cell line. The metastatic rate and the weight of the lung with metastases correlated positively with platelet aggregation activity. The present study might be important for research into mechanisms of ACC metastases.

Treatment of cleft lip and cleft palate.

The first case of cheiloplasty recorded was in China at about 200 BC. The technique of course has been vastly improved over the centuries. Cleft lip and/or cleft palate are among the most common congenital anomalies in China and the world. There is controversy over some of the surgical techniques used and age for operation, especially in cleft palate, but the condition requires surgery. Unilateral cleft lip is operated on at 3-6 month of age and bilateral cleft lip at 6-12 month of age. Views on palatoplasty are: 1. Cleft palate should be repaired at an early age; 2. Supplementary orthodontic treatment to expand the upper arch postoperatively is necessary, and orthognathic surgery is performed if needed when the patient has matured. This is the best choice at present.

Osteoid osteoma of the eminence of the temporomandibular joint.

We describe an osteoid osteoma in the articular eminence of the left temporomandibular joint of a 24-year-old woman. This is an uncommon tumour of the jaws, and has not previously been reported in this location. The mass was removed, she made a good recovery, and there are not signs of recurrence four years later.

[Kinetics of the thermotolerance of human tongue squamous cell carcinoma cells (Tca 8113) in vitro].

This paper reports an observation on kinetics of induction and resolution of the thermotolerance expressed by Tca8113 in vitro in form of colony-forming rate, synchronization and laser flow cytometry after the cells being exposed to continuous and fractionized heat treatment of 41.5-45.5 degrees C for 4 hours. The process of thermotolerance kinetics could be divided into three phases: triggering, development and decay. The triggering phase lasted about 8 hours. The duration of development and decay phases was related to the temperature of initial heating. The higher the temperature, the shorter the duration. Generally, thermotolerance gradually disappeared 96 hours after the initial heating treatment. The thermotolerance of the synchronized cells in various phases was G1 greater than G2 greater than M greater than S. Hyperthermia simultaneously combined with pingyangmycin both produces a greater synergetic cytotoxic effect and reduces the degree of thermotolerance.

[A preliminary experience of chemotherapy using cisplatin (CDDP) in oral and maxillofacial carcinoma].

During 1984-1986, fifty-one patients, including 42 squamous cell carcinomas, 8 carcinomas of salivary gland origin and 1 malignant histiocytoma, were treated in our hospital using the PVP (CDDP, VCR and PINGYANGMYCIN) regimen or single CDDP. The response rate was 71.4% (30/42) for squamous cell carcinoma (CR 4 cases, PR 26 cases, NR 12 cases) with PVP, and 3/8 (all PR cases) for carcinoma of salivary gland origin (all adenoid cystic carcinomas) with CDDP. The authors indicate that besides the MTX and PINGYANGMYCIN, CDDP is another effective and useful drug for squamous cell carcinoma. When single dose (80-120 mg) is given by infusion with fluid and diuretics, it is very safe and (no need) worry about impairment of kidney function.

[Clinical management of tumours in the infratemporal fossa and parapharyngeal space:A report of 44 cases]

From June 1971 to June 1993,44 cases suffered from tumors of the infratemporal fossa and parapharyngeal space were summarized on their materials showing thirty-one of them were benign tumors which first arised in the true deep lobe of the parotid gland and next in the neruolemma.Thirteen cases were malignant tumors arising in several tissues.The chief clinical sign in these patients was a lateral pharyngeal wall bulge and deformity without pain.A few patients occured change in voice characteristics or diffculty in swallowing.All these patients were performed surgery.93%(41/44)of patients were followed up.The longest follow-up has lasted 20 years.In this paper,the specific clinical appearance,diagnosis and surgical technique for tumors of the infratemporal fossa and parapharyngeal space are further discussed by us.

Treatment of habitual dislocation of the temporomandibular joint with subsynovial injection of sclerosant through arthroscope.

Five patients with habitual dislocation of the temporomandibular joint (TMJ), failing in conservative therapy, were treated with subsynovial injections of sclerosant through an arthroscope, and this treatment was proved to be effective over the short-term. Compared with operation, this method is easily performed and produces less damage and no significant sequelae, but the long-term effects have yet to be observed.

[Differential diagnosis between infection and neoplasm of the infratemporal fossa].

Because there are many similarities in infection and neoplasm of the infratemporal fossa (ITF), it is difficult to differentiate between these two diseases. By analysing 28 cases of the ITF lesions (8 cases of infection, 20 cases of neoplasm) the authors find the following points are important to differentiate between infection and neoplasm of the ITF. 1. The patients suffering from ITF infection almost all have odynophagia, while the patients suffering from the ITF neoplasm have no such symptom. The latter presents numbness in branches of the fifth nerve, while the former scarcely exhibits this symptom. 2. In the ITF neoplasm the mass could be found by CT or MRI, while in the ITF cellulitis no mass could be found. Although CT or MRI could find the mass in the ITF abscess, at the same time CT definitely could find some imaging signs which signify infection such as abscess formation (lucency) and gas bubbles. CT could find adjacent bone destruction in most ITF neoplasms, while this is rare in (ITF) infection. MRI is very helpful in differentiating between these two.

[Verapamil enhancement of antitumor effect of mitoxantrone on ACC-2 cell line in vitro and in vivo].

In this study, we investigated the effects of combination of Ca++ antagonist verapamil (VP) with a new anticancer agent, mitoxantrone (DHAD) on the growth of human adenoid cystic carcinoma cell (ACC-2) in vitro and in vivo. Non-toxic VP enhanced the cytotoxicity of DHAD in ACC-2 cells and significantly inhibited the cell proliferation. VP potentiated DHAD's inhibitory effect on incorporation of 3H-TdR into ACC-2 cells. When combined use of VP with DHAD, IC50 of DHAD on DNA synthesis decreased by 3.32 fold. FCM analysis showed that VP enhanced the block effect of DHAD on ACC-2 cell cycle traverse, causing cell accumulation in the G2M phase. In vivo study also proved that VP enhanced the tumoricidal effect of DHAD on ACC-2 implanted to nude mice. The inhibitory rate of tumor growth was increased from 57.9% to 88.4% when DHAD was administered with VP.

[Comparison of antitumor activity of tumor draining lymph node lymphocytes and peripheral blood lymphocytes in human oral cancer].

The in vitro and in vivo antitumor activity between DNL and autologous LAK cells was compared. The results showed that DNL cells activated in vitro by rIL-2 exhibited higher cytotoxicity to Tca 8113 cells than the same patient's LAK cells (75% and 36%, respectively). According to Winn's method, the inhibition rates of subcutaneously transplanted Tca cells in mice were 74% and 42% respectively. There was significantly difference in the antitumor activity in vitro and in vivo between two groups (P < 0.05), indicating that DNL cells which are more available are more practicable for adoptive immunotherapy.

[Lingualoplasty with modified forearm flap: A preliminary report with 6 cases]

A modified technic with forearm flap for lingualoplasty after ablative surgery for tongue cancer is reported.The tongure flap is pedicaled with the root of tongue by the residual excixion margin,and an oblique incision is made on the side of the placed forearm flap.Finally,the tongue flap is inlaid into the forearm flap in order to increasing the moving activity and function of the flap.This method has been applied to treat 6 patients of the tongue cancer.For them,the objective comments for function of the tongue after operation was given.

[Clinical assessment of rehabilitation after radical surgery of tongue cancer.].

It is same important to consider both patient's own evaluation and the clinical examination.It is helpful to judge the state of the functional rehabilitation. We have followed up 128 cases of tongue cancer postoperatively,recieved 104 letters and checked up 87 patients in the clinic.It has been discovered:1.the female patients paid more attention to the speech and apperance,while the male to the eating;2.on the donor site of flaps,some patients complained of the numbness in the fingers and the obvious scars in the forearm flap,while the fracilis myocutaneous flap is a relatively good method;3.in the cases of 1/2 anterior glossal defect,the forearm flap is available;to that more than 2/3 defect of the tongue,we used the myocutaneous flaps which have great volume of tissue;4.it is necessary to concern the mobility of the essential factors effecting the functional rehabilitation.

[The management of the treatment and diagnosis for the calcifying odontogenic cyst]

18 Patients with calcifying odontogenic cyst underwent surgery in our Department from 1977 to 1993 were reported.8 male and 10 female aged from 11 to 52 with medium or 33 years were included.16 cases were pathologically confirmed as primary intraosseous cyst(central),and 2 as extraosseous cyst(peripheral).There was no recurrence after the local excision for preripheral calcifying odontogenic cyst and local curettage for central one.There were 3 in 6 cases of tumor typed cyst who had recurred postoperatively,two of them had recurred repeatedly and cured by means of local radiotherapy.The authors recommend that the tumor type of intraosseous calcifying odontogenic cyst be classified as a border-line tumor and treated as well as the principles of low malignant tumor.Post-operative radiotherapy could be used for recurrent cases.

[Observation of clinical and pathological responses in short-term following immunochemotherapy for oral squamous cell carcinoma]

24 patients with oral SCC in Stage T3 or T4 were randomly divided into two groups,and treated with two inductive therapies,13 cases of whom received an immumochemotherapy regimen(Sapylin 15 KE+CDDP 70mg/m(2)+VCR 1.4mg/m(2)+PYM 80mg,S-PVP) and 11 cases,a chemotherapy regimen(CDDP 90mg/m(2)+VCR 1.4mg/m(2)+PYM 80mg,PVP) as control.The clinical response and pathological effect after immunochemotherapy or chemotherapy were evaluated through the clinical measurement of tumor size and pathological examination of the specimen.The results showed that the rate of clinical and pathological responses in S-PVP group were 92.3% and 84.6%,respectively;and in PVP group,72.7% and 45.5%.There was a significant difference between two groups in pathological effect(P<0.05),which indicated that the S-PVP regimen in short-term was better than of inductive chemotherapy.It may be relatively objective and accurate in comparison with clinical investigation which could act as an important supplement to the evaluation of clinical response.