[The prognosis of neck dissection with sternocleidomastoid muscle preservation and resection in advanced oral squamous cell carcinoma: a retrospective cohort analysis].

PURPOSE: To investigate the prognosis of advanced oral squamous cell carcinoma (AOSCC) patients undergoing neck dissection with sternocleidomastoid muscle (SCM) preservation and resection. METHODS: From January 2013 to June 2017, a total of 235 AOSCC patients(stage Ⅲ and stage Ⅳ) who were diagnosed and underwent neck dissection at the Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, were collected and followed-up. The differences in overall survival（OS）, local recurrence-free survival (LRFS) and regional recurrence-free survival (RRFS) were compared between different surgical procedures. SPSS 25.0 software package was used for statistical analysis. RESULTS: Among 235 patients with postoperative follow-up, 101 patients retained the SCM during operation, and 134 patients had SCM removed. There was no significant difference in 5-year survival rate and 5-year regional recurrence rate between the SCM preservation group and the SCM resection group. Kaplan-Meier method of univariate analysis showed that SCM preservation or resection had no significant difference in OS, LRFS and RRFS. Cox multivariate regression analysis results showed that there was no significant difference between different surgical procedures in OS, LRFS and RRFS, while N stage and postoperative chemoradiotherapy were independent influencing factors for OS, LRFS and RRFS in AOSCC patients. CONCLUSIONS: Neck dissection with SCM preservation in AOSCC patients has no effect on survival and recurrence (including local recurrence and regional recurrence). It is feasible for AOSCC patients to undergo SCM-preserving neck dissection when metastatic cervical lymph nodes do not invade SCM. N stage and postoperative chemoradiotherapy affect the prognosis of AOSCC patients.

[Maintenance of the stemness in CD133+primary oral squamous cell carcinoma cells under different culture conditions].

PURPOSE: CD133+/-cells were isolated and purified from primary oral squamous cell carcinoma(OSCC) to explore the effects of different culture conditions on the maintenance and biological characteristics of CD133+ primary OSCC. METHODS: CCK-8 was used to detect the ability of proliferation and cisplatin resistance between CD133+/-cell subsets. Transwell assay was used to compare the invasive ability of two cell subsets under the action of cisplatin. Flow cytometry was used to detect the proportion of CD133+ cells cultured by serum free medium(SFM) (with or without leukemia inhibitory factor, LIF) or serum supplied medium (SSM). Subcutaneous tumor model in nude mice was used to verify the difference in tumorigenicity of CD133+/- cell subsets. The transplanted tumor was removed for H-E staining and immunohistochemistry (IHC). SPSS 25.0 software package was used for statistical analysis. RESULTS: Compared with CD133- cell subsets, CD133+ cell subsets had stronger ability of proliferation in vitro(P<0.05) and cisplatin tolerance(P<0.001). Cisplatin had a stronger effect on the invasive ability of CD133- cell subsets than CD133+ cell subsets (P<0.01). No significant difference in the proportion of CD133+ cell between LIF-SFM and no-LIF-SFM was found (P>0.05); but compared with SSM culture method, SFM culture method could maintain the proportion of CD133+ cell better(P<0.05). CD133+ cell subsets showed stronger tumorigenic ability with fewer cells than CD133- cell subsets in nude mice(P<0.05). CONCLUSIONS: Serum free culture method can better maintain the characteristics of primary OSCC stem cells, but the addition of LIF has no significant effect on the maintenance of stemness of primary OSCC cells.

[Efficacy and safety of segmental pulmonary vein isolation and circumferential pulmonary vein isolation in patients with atrial fibrillation: a comparative study].

OBJECTIVE: To compare the efficacy and safety of segmental pulmonary vein isolation (SPVI) and circumferential pulmonary vein isolation (CPVI) guided by EnSite NavX system in patients with atrial fibrillation (AF). METHODS: Eighty-five patients with paroxysmal AF and persistent AF were enrolled in this study. Forty patients (30 with paroxysmal AF and 10 with persistent AF) underwent SPVI procedure, and 45 (31 with paroxysmal AF and 14 with persistent AF) underwent CPVA guided by EnSite NavX three-dimensional electrophysiological mapping system. All the patients were followed up for over six months. RESULTS: The success rate was 65% in the SPVI group and 84.4% in the CPVI group (P=0.0332), with incidence of major complications of 17.5% and 6.7%, respectively (P=0.0845). In the SPVI group, 12.5% patients had pulmonary vein stenosis after the operation, which occurred in none of the patients in the CPVI group (P=0.0312). The total procedure time was 200.4+/-37.0 min in the SPVI group, significantly shorter than that in the CPVI group (226.5+/-26.1 min, P=0.002). The fluoroscopy time in the SPVI group was obviously longer than that in the CPVI group (54.7+/-9.7 vs 27.1+/-3.1 min, P<0.001). CONCLUSIONS: CPVI guided by EnSite NavX system is more effective than SPVI for treatment of atrial fibrillation with significantly shortened fluoroscopy time but prolonged procedure time. The two procedures results in comparable incidences of major complications, but CPVI is associated with reduced rate of pulmonary vein stenosis in comparison with SPVI.

[Circumferential pulmonary vein ostial isolation for atrial fibrillation guided by EnSite NavX three-dimensional electrophysiological mapping].

OBJECTIVE: To investigate the efficacy and safety of circumferential pulmonary vein ostial isolation guided by EnSite NavX three-dimensional electrophysiological mapping in patients with atrial fibrillation (AF). METHODS: Thirty-eight patients with drug refractory paroxysmal or persistent AF underwent circumferential pulmonary vein ostial isolation and were followed up to investigate the efficacy and safety of the treatment. RESULTS: All cases reached the endpoint of the ablation, and both sides of the pulmonary vein were completely isolated, with an average procedure time of 200.4-/+37.0 min, X-ray exposure time of 54.7-/+9.7 min, and three-dimensional left atrial geometry reconstruction time of 27.5-/+7.5 min. During the follow-up for 9-/+3 months, the success rate of initial ablation was 89.5%, and the incidence of procedure-related complications were 7.9%. CONCLUSIONS: Circumferential pulmonary vein ostial isolation guided by EnSite NavX three-dimensional electrophysiological mapping can be effective and safe for AF treatment.