Clinical application of V-shaped folded submental flap in the repair of oral defect. / Våž‹æŠ˜å é¢ä¸‹çš®ç“£ä¿®å¤å£è ”ç¼ºæŸçš„ä¸´åºŠåº”ç”¨.

OBJECTIVES: The repair of small and medium-sized defects in the oral has always been a challenge, free skin flap and distal pedicled tissue flaps are difficult to meet clinical needs, and the traditional under-chin flap has the risk of donor-area injury. This study aims to investigate the efficacy of V-shaped folded submental flap in the repair of small-sized and medium-sized oral defects. METHODS: The clinical data of 28 patients with oral defect lesions, who were hospitalized in the Department of Stomatology, Third Xiangya Hospital of Central South University from March 2019 to December 2022, were retrospectively analyzed. Patients were divided into a V-shaped folded group (17 cases) and a conventional group (11 cases) according to different surgical methods. The V-shaped folded group was treated with a V-shaped folded submental flap for postoperative soft tissue repair, while the conventional group was treated with a conventional submental flap for repair. The postoperative follow-up time was 6-48 months. The survival status, repair time, and repair effect of the 2 groups were compared. RESULTS: There was no significant difference in flap survival rate, flap size, flap preparation time, repair surgery time, and postoperative hospital stay between the 2 groups (all P>0.05). At 6 months after the surgery, the V-shaped folded group had no difficulty in raising the head or everting the lower lip, no "cat ear" deformity in the submental skin. Scars in the V-shaped folding group were hidden at the lower edge of the mandible. The wound aesthetics and functional scores in the V-shaped folded group were significantly higher than those in the conventional group (both P<0.05). CONCLUSIONS: The V-shaped foldable submental flap has the advantages of flexible design, simple preparation, reliable blood supply, and protection of the donor area, which can effectively protect the appearance of the chin and avoid functional disorders.

V-shaped Folded Nasolabial Flap in the Repair of the Anterior Buccal Mucosal Defect.

OBJECTIVE: To investigate the efficacy of V-shaped folded nasolabial flap in the repair of small-sized and medium-sized defects of the anterior buccal mucosa. METHODS: From March 2019 to December 2021, 9 cases of male patients with anterior buccal mucosal lesions were enrolled in this study. After the lesions were completely excised, the mucosa and part of the buccal mucosal defect were left. A transverse V-shaped folded nasolabial flap was created with the pedicle located at the corner of the mouth and the long axis along the nasolabial fold. The lower part was lifted from the end to the pedicle. Next, from the level of the superficial musculo-aponeurotic system, the upper and lower parts were lifted from the end to the pedicle, and the V-shaped flap was folded and turned over through the buccal tunnel to repair the mucosal defect. The extraoral donor site was directly pulled and sutured. RESULTS: The nasolabial flap survived in 9 patients, and the wounds inside and outside the mouth healed at stage I. The postoperative follow-up time was 4 to 32 months, and the patients had no recurrence, with symmetrical buccal shape, and no traction and deformation in the affected buccal organs. In addition, the linear scar had no obvious hyperplasia and was hidden in the affected nasolabial folds, without symptoms of buccal nerve injury, and the shape of the corner of the mouth was normal. The width and opening degree of oral fissure were not significantly reduced compared with those before operation. Meanwhile, the intraoral flap was thin and flat, and healed well with the surrounding mucosa, without obvious flap contracture, buccal bite, or incomplete closure. CONCLUSION: Overall, V-shaped folded nasolabial flap has the advantages of flexible design, simple preparation, reliable blood supply, and protection of the donor site, which may be one of the effective methods for repairing small-sized and medium-sized defects in the anterior buccal mucosa.

Fabrication of MgAl LDH@graphene oxide nanohybrids and their effect on the thermal stability and crystallization behavior of polypropylene.

The co-precipitation method is used to fabricate layered double hydroxide (LDH) nanohybrids with surface engineering of graphene oxide (GO) by radially grafting borate-LDH (BLDH) to BLDH@GO nanosheets, aiming at improving the surface characteristics and compatibility of LDH with the polymer matrix. The results prove the successful fabrication of BLDH@GO and LDH@GO nanosheets. The nanosheets are mixed into polypropylene (PP) by melt blending to study the structure and properties of the composites. The PP composites with BLDH@GO and BLDH have both exfoliation structures and aggregation structures, and the two nanosheets show enhanced interfacial interactions with the PP matrix compared with LDH and LDH@GO. The initial decomposition temperatures of the PP composites are lower than those of the neat PP, but the thermal degradation temperatures of the PP composites are higher. Compared with the other samples, BLDH@GO provides a higher nucleation density, reflected in a smaller spherulite size and a higher crystallization temperature confirmed by the differential scanning calorimetry (DSC) results. BLDH@GO shifts the crystallization temperature of PP to higher values (compared to the neat PP) due to the nucleation effect, which is in line with the increase in the nucleation density detected by polarized optical microscopy (POM).

Modified V-Y Myocutaneous Flap With Vascular Pedicle for the Repair of Maxillofacial Skin Defects.

OBJECTIVE: It is challenging to repair postoperative defect caused by skin tumor resection on the maxillofacial, which not only affects appearance but also impairs functions. To better repair skin defect on the maxillofacial, the application value of V-Y vascular myocutaneous flap was introduced in our study. METHODS: Between June 2011 and December 2018, 16 patients with maxillofacial skin tumors who received extensive resection were enrolled in our study. The defect on the maxillofacial was repaired by V-Y vascular myocutaneous flap. The follow-up period lasted for 12 to 24 months. RESULTS: All 16 cases of myocutaneous flaps survived with 1 case of partial venous congestion and 1 case of partial distal necrosis. No recurrence occurred during follow-up. The color and texture of myocutaneous flaps like those of the surrounding skin. CONCLUSION: Featured with better freeness, larger repair range and aesthetic effect of "kite" flaps, V-Y vascular myocutaneous flap can repair the superior border of zygomatic arch pedicled with facial artery and repair 1.5 cm above the superior border of zygomatic arch pedicled with transverse facial artery for elderly patients in Asia.

The Efficacy and Safety of Submandibular Transcatheter Perfusion Anesthesia in Submandibular Gland Surgery.

The present study aims to evaluate the feasibility, safety, and effects of the combined use of submandibular transcatheter perfusion with lingual nerve block and subcutaneous infiltration for anesthetic purposes during submandibular gland surgery. A total of 38 patients with benign tumors, who had undergone resection by submandibular gland surgery were randomly divided into 2 groups. Patients in group A were administered with submandibular anesthesia through catheter perfusion, lingual nerve block, and subcutaneous infiltration anesthesia. Patients in the group B were only treated with lingual nerve block and subcutaneous infiltration anesthesia. The submandibular gland surgery was performed within 5 minutes following anesthesia administration, after which the numerical rating scale (NRS) was evaluated before surgery, during skin incision (T1), during the pulling process of the submandibular gland (T2), during the removal of the submandibular gland (T3), and at 2, 6, 12, and 24 hours post-surgery. The dosage of analgesic drugs was also measured after surgery. The findings revealed no significant difference in NRS before surgery, at T1, 6, 12, and 24 hours after surgery (P > 0.01) while NRS was much lower in group A patients as observed at T2, T3, and 2 hours after surgery when compared with group B (P < 0.01). The combined application of submandibular transcatheter perfusion with lingual nerve block and subcutaneous infiltration can be used as an effective anesthetic method during submandibular gland surgery.

The anterolateral thigh flap for soft tissue reconstruction in patients with tongue squamous cell carcinoma.

BACKGROUND: Surgery remains the first choice of treatment for tongue cancer. Immediate reconstruction should be performed after wide resection of tumour. The aim of this study was to evaluate the anterolateral thigh flap for reconstruction of lingual defects. METHODS: We report 39 consecutive oral tongue squamous cell carcinoma patients who underwent lingual reconstruction with the anterolateral thigh flap between 2009 and 2010. RESULTS: The width of the skin island was 4 to 5 cm and the length of the skin island was 6 to 8 cm in 31 patients with T2 tumour, while the width of the skin island was 5.5 to 6 cm and the length of the skin island was 9 to 12 cm in 8 patients with T3/4 tumours. The all flap survival rate was 97.5 % in our series. CONCLUSIONS: We could obtain sufficient flap volume using the anterolateral thigh flap for tongue reconstruction. The single perforator-based anterolateral thigh flap is a good option for soft tissue reconstruction in patients with oral tongue squamous cell carcinoma.

[Cephalometric analysis of the soft tissue profile in Hunan Han adults with normal occlusion].

OBJECTIVE: To analyze the characteristics soft tissue profile in Hunan Han adults with normal occlusion and to explore the differences of the soft tissue profile in gender, region and race. METHODS: Lateral cephalometric radiographs were performed for 323 volunteers (164 females and 159 males) from Hunan Province. The digital cephalometric radiographs were imported into the WinCeph8.0 measurement and analysis system in a same computer. According to the Holdaway analysis method, the mean and standard deviation were calculated. Then the results were compared to the data from Liaoning, Nepalese, Japanese, North American Caucasians. RESULTS: The normal value of cephalometric facial soft tissue profile in Han population adults with normal occlusion in Hunan Province were obtained. There were significant differences in subnasale to H line (Sn-H), upper lip tension, lower lip sulcus depth (Si-PgsLs), and soft tissue chin thickness (Pg-Pgs) between males and females (all P<0.05). Compared with Liaoning Province, significant regional differences in soft tissue facial angle (FH-NsPgs), upper lip sulcus depth (Ss-Ls), Sn-H, lower lip thickness, upper lip thickness, H angle, lower lip to H line (Li-PgsLs), Si-PgsLs, and Pg-Pgs were found in Hunan Province (all P<0.05). Compared with the Japan, significant regional differences in FH-NsPgs, nose prominence (Sn-Pn), lower lip thickness, upper lip tensity, H angle, Li-PgsLs, Si-PgsLs, and Pg-Pgs were found in Hunan Province (all P<0.05). Compared with the Nepalese, significant regional differences in Sn-Pn, Ss-Ls, Sn-H, skeletal profile convexity (A-NPs), basic upper lip thickness, upper lip tensity, H angle, Li-PgsLs and Pg-Pgs were found in Hunan Province (all P<0.05). Compared with the North America, significant regional differences in Sn-Pn, Ss-Ls, Sn-H, A-NPs, basic upper lip thickness, upper lip tensity, H angle, Li-PgsLs, Si-PgsLs and Pg-Pgs were found in Hunan Province (all P<0.05). CONCLUSION: There are both similarities and differences in facial soft tissue profile between males and females with normal occlusion in Hunan Province. The characteristics of facial soft tissue profile in Hunan Province are different from that in Liaoning area, Nepal, Japan and North America.

The impact of clinical prognostic factors on the survival of patients with oral squamous cell carcinoma.

PURPOSE: This study investigated prognostic factors and useful predictors for survival in patients with oral squamous cell carcinoma. PATIENTS AND METHODS: The medical records of all patients with oral squamous cell carcinoma who underwent curative surgery with or without adjuvant radiation from 2009 through 2011 were retrospectively reviewed. RESULTS: Seventy-seven patients (63 men and 14 women) were enrolled. The 2-year disease-free and overall survival rates were 67.5% and 74%, respectively. Multivariate analyses showed that a diagnostic delay longer than 2 months (hazard ratio [HR]=4.43; 95% confidence interval [CI], 1.26-15.51; P=.02), T3 or T4 tumor (HR=4.40; 95% CI, 1.91-10.12; P=.001), neck metastasis (HR=1.96; 95% CI, 1.21-4.37; P=.01), and stage III or IV disease (HR=3.94; 95% CI, 1.64-9.47; P=.002) were independent adverse factors for survival rate. CONCLUSION: Oral squamous cell carcinoma is an important health issue associated with poor survival. A diagnostic delay longer than 2 months, T3 or T4 tumor, neck metastasis, and stage III or IV disease were independent adverse factors for subsequent survival rate and locoregional recurrence in patients with oral squamous cell carcinoma.

Temperature and pressure sensitive ionic conductive triple-network hydrogel for high-durability dual signal sensors.

In this work, the fabrication of strengthened triple network hydrogels was successfully achieved based on in-situ polymerization of polyacrylamide by combining both chemical and physical cross-linking methods. The ion conductive phase of lithium chloride (LiCl) and solvent in the hydrogel were regulated through soaking solution. The pressure and temperature sensing behavior and durability of the hydrogel were investigated. The hydrogel containing 1 mol/L LiCl and 30 %v/v glycerol displayed a pressure sensitivity of 4.16 kPa-1 and a temperature sensitivity of 2.04 %/oC ranging from 20 to 50 °C. The durability results reveal that the hydrogel could maintain water retention rate of 69 % after 20 days of ageing. The presence of LiCl disrupted the interactions among water molecules and made it possible for the hydrogel to respond to changes in environment humidity. The dual signal testing revealed that the delay of temperature response over time (about 100 s) is much different from the rapidity of pressure response (in 0.5 s). This leads to the obvious separation of the temperature-pressure dual signal output. The assembled hydrogel sensor was further applied to monitor human motion and skin temperature. The signals can be distinguished by different resistance variation values and curve shapes in the typical temperature-pressure dual signal performance of human breathing. This demonstrates that this ion conductive hydrogel has the potential for application in flexible sensors and human-machine interfaces.

Modified separators boost polysulfides adsorption-catalysis in lithium-sulfur batteries from Ni@Co hetero-nanocrystals into CNT-porous carbon dual frameworks.

In this manuscript, nickel/cobalt bimetallic nanocrystals confining into three-dimensional interpenetrating dual-carbon conductive structure (NiCo@C/CNTs) were successfully manufactured by annealing its core-shell structure (Ni-ZIF-67@ZIF-8) precursor under the high temperature. The results presented that the bimetallic nickel and cobalt nanocrystals with superior catalytic activity could quickly convert solid Li2S/Li2S2into soluble LiPSs and effectively decrease the energy barrier. While the hierarchical CNT-porous carbon dual frameworks can provide quick electron/ion transport because of their large specific surface area and the exposure of enough active sites. When used as the separator modifier for lithium sulfur batteries, the battery properties were significantly improved with high specific capacity, outstanding rate capability, and long-term cycle stability. Specifically, its initial specific capacity can achieve to 1038.51 mAh g-1 at 0.5C. At the high rate of 3C, it still delivers satisfactory discharge capacity of 555 mAhg-1 and the capacity decay rate is only 0.065% per cycle after 1000 cycles at 1C. Furthermore, even exposed to heavy sulfur loading (3.61 mg/cm2), they still maintain promising cycle stability. Therefore, such kinds of MOFs derivative with powerful chemical immobilization and catalytic conversion for polysulfides provides a novel guidance for the modification separator and the potential application in the field of high-performance Li-S batteries.

Computer-assisted intraoral approach in the management of infected comminuted mandibular fractures: Technical notes.

In the extraoral approach for mandibular fractures, facial scars and facial nerve injury are common complications. Herein, we introduce an improved surgical technique to reduce fragments of infected comminuted mandibular fractures with the assistance of computer software. Firstly, the model was reset by 3-dimensional (3D) printing, and then the titanium plate was reconstructed on the model. Finally, open reduction and internal fixation through intraoral approach. This method can effectively control infection, reduce facial scars and avoid the risk of facial nerve injury.

Preliminary application and evaluation of autograft reconstruction of parotid duct defect with submandibular gland duct for buccal cancer.

Background: We aimed to preserve parotid function in patients with buccal carcinoma by applying a new surgical protocol based on reconstruction of parotid ductal defect with submandibular gland ductal.Aims/Objectives: The aim of this study is to introduce the method of autologous submandibular gland duct reconstruction for the treatment of parotid duct defect in buccal carcinoma, and to evaluate its clinical application in follow-up.Material and methods: A total of 28 patients with buccal carcinoma who underwent buccal and neck combined with radical surgery and vascularized flap transplantation were enrolled. Function of the reconstructed duct was reviewed in 6 months after surgery.Results: Both groups achieved good short-term results within 1 month after surgery. The 6-month postoperative angiography examination of the submandibular gland duct showed that 6% of patients in the submandibular gland duct graft group had a blockage or was not smooth. At the same time, 45% of the patients in the vein graft group had failure or obstruction, and the VAS score of pain was higher than that of the submandibular gland ductal graft group (p < .05).Conclusion and significance: Compared with vein grafting, the reconstruction of parotid ductal defect with submandibular gland ductal graft has better long-term effects.

Impact of right coronary dominance on triple-vessel coronary artery disease: A cross-sectional study.

This study was conducted to investigate the relationship between right coronary dominance and coronary angiographic characteristics in patients with or without significant coronary artery disease (CAD).A total of 2225 patients undergoing coronary angiography (CAG) between January 2011 and November 2014 were recruited in our study. Based on the CAG results, patients were divided into the left dominance (LD) group, right dominance (RD) group, and co-dominance (CD) group. Multinomial logistic regression was applied to analyze the relationships between coronary dominance and triple-vessel CAD.We found that patients with RD had a higher prevalence of triple-vessel CAD (36.6% vs 27.3%, P = .008) and significant stenosis in the right coronary artery (40.5% vs 29.2%, P = .001). In addition, results of multinomial logistic regression analysis showed that RD was significantly associated with the triple-vessel disease (odds ratio 1.768, 95% confidence interval 1.057-2.956, P = .030).In conclusion, RD positively correlated with triple-vessel CAD rather than LD or CD in patients. This result suggested that RD may serve as a risk factor for triple-vessel CAD and more effective measures should be taken in RD patients to prevent fatal cardiovascular events.

[Effect of cyclosporin A and tumor necrosis factor-α on cell proliferation of cultured human gingival fibroblasts].

OBJECTIVE: To investigate the effect of cyclosporin A (CsA) and tumor necrosis factor-α (TNF-α) on cell proliferation of cultured human gingival fibroblasts (GF), and the relationship between gingival inflammation and drug-induced gingival overgrowth. METHODS: Human GF were cultured in vitro using tissue culture method. then cells from the 4 - 8 th passage were used in the experiment. The cells were cultured and incubated with various concentrations of CsA and TNF-α (A: blank group, B1: 10 µg/L CsA, B2: 50 µg/L CsA, B3: 250 µg/L CsA, B4: 1250 µg/L CsA, C: 5 µg/L TNF-α, D1: 10 µg/L CsA + 5 µg/L TNF-α, D2: 50 µg/L CsA + 5 µg/L TNF-α, D3: 250 µg/L CsA + 5 µg/L TNF-α, D4: 1250 µg/L CsA + 5 µg/L TNF-α) solution for 3, 5 and 7 days. Methyl thiazolyl tetrazolium assay was used to evaluate the cell proliferation in the culture meidiun. RESULTS: The proliferation of fibroblasts was inhibited when exposed to different concentration of CsA and A value decreased. There was no significant difference between group B1, B2, B3 and the control group, while the A value of group B4 was significantly higher than that of control group (P < 0.01). Fibroblast proliferation was significantly increased while cultured with 5 µg/L TNF-α. A value increased (P < 0.01). When exposed to CsA + TNF-α, A value of group D1, D2, D3 was much higher than that of group A, but was lower than that of group C (P < 0.05). Cell proliferation in group D4 was significantly increased, and significantly different with that in group C (P < 0.01). CONCLUSIONS: CsA did not stimulate the cell proliferation, and high concentration of CsA inhibited cell proliferation. TNF-α can stimulate the cell proliferation. High-concentration CsA + TNF-α can enhance the fibroblast proliferation, which suggests that CsA in certain concentration have amplification effect on TNF-α to stimulate fibroblast proliferation.

[Expression of survivin and its correlation to angiogenesis in oral squamous cell carcinoma].

BACKGROUND & OBJECTIVE: Survivin can block the cell apoptosis through inhibiting the functions of Caspase-3 and Caspase-7, and selectively overexpresses in common human cancers. This study was designed to investigate the effects of Survivin on tumorigenesis and development of oral cancer and its correlation to angiogenesis. METHODS: The expression of Survivin in 8 specimens of normal oral mucosa, 14 specimens of dysplastic leukoplakia and 47 specimens of oral squamous cell carcinoma (OSCC), and the expression of CD34 in the 47 specimens of OSCC was detected by SP immunohistochemistry. Microvessel density (MVD) was also assessed. The correlations of Survivin expression to MVD and clinicopathologic features of the OSCC patients were analyzed. RESULT: The positive rates of Survivin were 0% in normal oral mucosa, 14.24% in dysplastic leukoplakia, and 55.32% in OSCC. Survivin expression was significantly stronger in OSCC than in normal oral mucosa and dysplastic leukoplakia (P < 0.05), while there was no difference between the last 2 groups (P > 0.05). Survivin expression was significantly stronger in moderately and poorly differentiated OSCC than in well differentiated OSCC (P < 0.05); the positive rate of Survivin was significantly higher in OSCC with lymph node metastasis than in OSCC without lymph node metastasis(71.43% vs. 38.89%, P < 0.05). In OSCC, MVD was increased (25.87 +/- 12.10, 28.70 +/- 7.69, 35.42 +/- 10.09, 41.13 +/- 9.62, respectively) along with the strengthened Survivin expression (-, +, 2+, 3+) (P < 0.05). CONCLUSION: Survivin expression is up-regulated in OSCC, and closely related with tumor cell differentiation, lymph node metastasis, and MVD; it may play an important role in tumorigenesis and development of OSCC.

[Physiotherapy with drugs for acute lymphadenitis of face and neck].

OBJECTIVE: To observe the clinical efficacy of acute lymphadenitis of face and neck treated by physiotherapy with drugs. METHODS: Ninety-six children with acute lymphodenitis of face and neck were randomly divided into 2 groups. Of the 96 patients, 48 were treated by drugs as the control group, and the other 48 were treated by physiotherapy with drugs as the treatment group. Improvement of clinical symptoms and signs was compared after 3 days, and the treatment period was observed. RESULTS: Clinical symptom and sign of the treatment group were improved more than those of the controls (P < 0.01); the treatment period of the treatment group was shorter than that of the controls (P < 0.01). CONCLUSION: It is more effictive and costs less time to treat acute lymphadenitis of face and neck with physiotherapy with drugs.

Accelerating catalytic conversion and chemisorption of polysulfides for advanced Li-S batteries from incorporating Fe0.64Ni0.36@Co5.47N hetero-nanocrystals into boron carbonitride nanotubes.

With the rapid development of large-scale clean energy, lithium-sulfur (Li-S) batteries are considered to be one of the most promising energy storage devices. In this manuscript, the polymetallic hetero-nanocrystal of iron nickel@cobalt nitride encapsulating into boron carbonitride nanotubes (Fe0.64Ni0.36@Co5.47N@BCN) was designed and optimized for use as a modified material for commercial polypropylene (PP) separators. The prepared Fe0.64Ni0.36@Co5.47N@BCN-12 hybrid material presents strong chemisorption and catalytic conversion capabilities, which endows the Fe0.64Ni0.36@Co5.47N@BCN-12//PP separator with enhanced polysulfide shuttling inhibition. The assembled Li-S cells with Fe0.64Ni0.36@Co5.47N@BCN-12//PP separators have minimized charge transfer resistance and faster redox kinetics. Additionally, cells with Fe0.64Ni0.36@Co5.47N@BCN-12//PP separator provide high reversible capacity of 674 mAh/g for 400 cycles at 0.5C and excellent cyclability for 1000 cycles at 2C with a low decay rate of 0.05 % per cycle. Therefore, this study provides a feasible functionalization route for improving the electrochemical performance of Li-S batteries through separator modification.