Detecting recurrent disease and surgical outcomes in patients with locally advanced tongue cancer after multimodal treatment using ¹8F-FDG-PET/CT.

The purpose of this study was to evaluate the utility of ¹8F-fluorodeoxyglucose positron emission tomography/computed tomography (FPCT) parameters for detecting recurrent disease and the outcomes of salvage surgery in patients with locally advanced oral tongue squamous cell carcinoma (TSCC) after multimodal treatment. In total, 69 patients with locally advanced TSCC were treated with multimodal therapy. All patients underwent whole-body FPCT scans 4-10 months after the initial surgery. The analysis included FPCT parameters, such as maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Histological examination was used as the reference standard. Patients with recurrent TSCC underwent salvage surgery or surgery plus systemic treatment. This study included 69 patients: 36 in the recurrent TSCC group and 33 in the non-recurrent TSCC group. The SUVmax, MTV, and TLG in the recurrent TSCC group were 11.3 ± 3.6, 28.3 ± 15.6 cm3, and 113.2 ± 46.8 g, respectively; these values were 5.9 ± 3.6, 5.1 ± 2.2 cm3, and 13.4 ± 4.8 g, in the non-recurrent TSCC group respectively. The two groups had significant differences in terms of SUVmax, MTV, and TLG. In the recurrent TSCC group, 91.6 % of patients presented with local, locoregional, and regional disease and underwent salvage surgery plus systemic therapy, whereas 8.4 % had locoregional recurrence with distant metastases alone and underwent surgery plus systemic therapy. The patients were followed up for 12-60 months; 19 and 20 patients in the recurrent and non-recurrent TSCC groups showed no evidence of disease, whereas 11 and 8 were alive with the disease. Local recurrence or distant metastases led to the deaths of six patients in the recurrent TSCC group and five in the non-recurrent TSCC group. No significant differences in survival were observed between the two groups. FPCT parameters can detect the recurrence of locally advanced TSCC after multimodal treatment. Early salvage surgery can improve the treatment outcomes for recurrent TSCC.

MsYSL6, A Metal Transporter Gene of Alfalfa, Increases Iron Accumulation and Benefits Cadmium Resistance.

Iron (Fe) is necessary for plant growth and development. The mechanism of uptake and translocation in Cadmium (Cd) is similar to iron, which shares iron transporters. Yellow stripe-like transporter (YSL) plays a pivotal role in transporting iron and other metal ions in plants. In this study, MsYSL6 and its promoter were cloned from leguminous forage alfalfa. The transient expression of MsYSL6-GFP indicated that MsYSL6 was localized to the plasma membrane and cytoplasm. The expression of MsYSL6 was induced in alfalfa by iron deficiency and Cd stress, which was further proved by GUS activity driven by the MsYSL6 promoter. To further identify the function of MsYSL6, it was heterologously overexpressed in tobacco. MsYSL6-overexpressed tobacco showed better growth and less oxidative damage than WT under Cd stress. MsYSL6 overexpression elevated Fe and Cd contents and induced a relatively high Fe translocation rate in tobacco under Cd stress. The results suggest that MsYSL6 might have a dual function in the absorption of Fe and Cd, playing a role in the competitive absorption between Fe and Cd. MsYSL6 might be a regulatory factor in plants to counter Cd stress. This study provides a novel gene for application in heavy metal enrichment or phytoremediation and new insights into plant tolerance to toxic metals.

Various Types of Facial-Angular Artery-Based Flaps for Reconstructing Oral and Maxillofacial Defects Following Cancer Ablation.

BACKGROUND: The flap based on the facial-angular vessels (FAVs) has several names and cannot capture the hemodynamics. AIMS: This study was performed to assess the reliability of various types of flaps based on the FAVs for reconstructing oral and maxillofacial defects following cancer ablation. PATIENTS AND METHODS: Forty-three oral and maxillofacial defects were reconstructed with facial-angular artery island flaps (FAAIF, n =14), including V-Y advancement-type and rotation-type flaps based on FAVs and reverse-flow FAAIFs (R-FAAIF, n =29), including ipsilateral, contralateral rotation, full-thickness, and folded types, based on distal FAVs following cancer ablation. The patients (25 males and 18 females) ranged in age from 18 to 82 years. The lesions included basal cell carcinoma ( n =26), squamous cell carcinoma ( n =8), adenoid cystic carcinoma ( n =3), mucoepidermoid carcinoma ( n =3), verrucous carcinoma ( n =2), and nodular melanoma ( n =1). The tumors were classified as clinical stage I to III in 12, 25, and 6 cases, respectively. Lesions were observed in orbital ( n =4), infraorbital ( n =14), glabellar ( n =2), nasal ( n =4), cheek ( n =10), upper lip ( n =3), palate ( n =4), and lower gingival ( n =2) regions. The defects ranged in size from 2.0×2.5 to 5.0×12.0 cm. The skin paddle ranged in size from 1.5×3.0 to 4.0×12.0 cm. RESULTS: There was 1 flap failure, resulting in a flap success rate of 97.7%. Complications, including hematoma, infection, wound dehiscence, and fistula, occurred in 15 (34.9%) patients. Limitations of mouth opening and ectropion occurred in 12 (28.0%) patients. The esthetic outcomes were satisfactory in 36 (83.7%) patients but were not significantly different between the FAAIF and R-FAAIF groups. The patients were followed up for 6 to 60 months. At the time of the last follow-up, 27 (62.8%) patients were alive with no disease, 9 (20.9%) were alive with disease, and 7 (16.3%) had died due to their disease. There was no significant survival difference between the 2 groups. CONCLUSIONS: Various types of FAV-based flaps are valuable reconstructive options for the treatment of oral and maxillofacial defects following clinical stage I-III cancer ablation.

Maxillectomy and Flap Reconstruction of Maxillary Defects After Cancer Ablation Through the Lip-Split Parasymphyseal Mandibulotomy Approach in Patients With Advanced-Stage Maxillary Malignant Tumors.

BACKGROUND: The conventional approach for maxillectomy has some common and serious complications. AIMS: The present study evaluated the outcomes of maxillectomy and flap reconstruction after cancer ablation using the lip-split parasymphyseal mandibulotomy (LPM) approach. METHODS: Twenty-eight patients with malignant tumors, including squamous cell carcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma, underwent maxillectomy through the LPM approach. Brown classes II and III were reconstructed with the facial-submental artery submental island flap, an extensive segmental pectoralis major myocutaneous flap, and a free anterolateral thigh flap with the use of a titanium mesh, respectively. RESULTS: All proximal margin frozen section specimens showed negative surgical margins. Anterolateral thigh flap failure occurred in 1 patient, whereas ophthalmic and mandibulotomy complications developed in 4 and 7 patients, respectively. In all, 84.6% of the patients had satisfactory or excellent lip esthetic results. Of the patients, 57.1% were alive with no evidence of disease, whereas 28.6% were alive with disease and 14.3% died of local recurrence or distant metastasis. No significant survival difference was evident among the squamous cell carcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma groups. CONCLUSIONS: The LPM approach can provide good surgical access, facilitating maxillectomy in advanced-stage malignant tumors with minimal morbidity. Facial-submental artery submental island flap and anterolateral thigh flap or extensive segmental pectoralis major myocutaneous flap with a titanium mesh are ideal techniques for reconstructing Brown classes II and III defects, respectively.

Comprehensive Management of Infantile Hemangiomas Involving the Periorbital Region.

ABSTRACT: Periocular infantile hemangioma (pIH) is associated with a risk of vision loss and requires urgent medical intervention. We evaluated the outcomes of the comprehensive management of 44 pIH patients (aged 2-6 months) with superficial (n = 11), deep (n = 15), and mixed (n = 18) subtypes, treated with a standard propranolol dose (2 mg kg -1 d -1 ) without any obvious side effects. Obvious and slight improvements were observed in 70.5% and 29.5% of patients, respectively. Obvious improvement was found in 96.3% of patients 3 months or younger but only 29.4% of patients older than 3 months ( P = 0.036) after 4 weeks of treatment. Thirteen patients demonstrated slight improvement and were treated with an increased propranolol dose (3 mg kg -1 d -1 ) in combination with corticosteroid injections or plastic surgery, which led to good outcomes. The patients were followed up for 12 to 18 months, with no cases of amblyopia or ametropia. Oral propranolol was effective in the treatment of pIH. Earlier propranolol use was associated with better outcomes. An increased propranolol dose combined with corticosteroid injections or plastic surgery is appropriate for patients with propranolol resistance.

Anion directing self-assembly of 2D and 3D water-stable silver(i) cation metal organic frameworks and their applications in real-time discriminating cysteine and DNA detection.

Two water-stable silver(i) cation metal organic frameworks (MOFs), namely 2D MOF {[Ag(L)2]BF4}n (1) and 3D MOF {[Ag3(L)3]·(H2O)·(CF3SO3)3}n (2) (L = 1-(4-aminobenzyl)-1,2,4-triazole), have been prepared. 1 is the first example of a 2D MOF-based sensor for real-time discrimination of l- and d-cysteine from other amino acids through the quenching effect. Through deliberately tuning the nanoparticles of 2 under ultrasound conditions, these nanoparticles are, for the first time, successfully applied as an excellent DNA detecting platform.

Poly- and perfluorinated compounds activate human pregnane X receptor.

Poly- and perfluorinated compounds (PFCs), which have been detected worldwide in human blood, surface water and house dust, are suspected to induce potential endocrine-disrupting hormonal effects. In this study, cell-based reporter gene assays were used to determine the activity of a variety of PFCs against the human pregnane X receptor (hPXR) to identify the critical structural feature of PFCs related to their hPXR activity. Molecular docking studies combined with site-directed mutagenesis were employed to investigate the mechanism by which PFCs interact with and activate hPXR. We found that all tested PFCs can activate hPXR. The hPXR activity of the PFCs correlates with the carbon chain length and the functional group of the chemicals. Hydrogen bonding was characteristic of the interaction between PFCs and hPXR. We also identified the key residues within the hPXR ligand-binding pocket responsible for PFC-hPXR interaction. The outcome of the present study threw a light on the mechanism by which PFCs activate hPXR. PFCs may pose some potential endocrine-disrupting hormonal effects via activation of hPXR.

[Clinical value of acoustic radiation force impulse imaging for quantitative evaluation of degree of liver fibrosis in chronic hepatitis C patients].

OBJECTIVE: To investigate the diagnostic value of acoustic radiation force impulse (ARFI) imaging technology for the assessment of liver fibrosis in chronic hepatitis C (CHC) patients. METHODS: One-hundred-and-eight CHC patients were examined by real-time ultrasound elastography using the Acuson S2000 ARFI instrument (Siemens Healthcare) and underwent liver biopsy for pathohistological analysis. The correlation between liver fibrosis grades determined by the two approaches was analyzed. The cut-off values for diagnosis by ARFI (S more than 2, S more than 3 and S = 4) were determined by generating a receiver operating characteristic (ROC) curve. RESULTS: The spectrum of liver stiffness detected by ARFI sonoelastography included S1 at (1.26+/-0.27) m/s (n = 36), S2 at (1.45+/-0.51) m/s (n = 31), S3 at (2.01+/-0.54) m/s (n = 27), and S4 at (2.28+/-0.82) m/s (n = 14). The ARFI values were significantly different among the four different stages of liver fibrosis (P less than 0.001). The liver stiffness detected by ARFI sonoelastography was significantly correlated with the liver fibrosis stage determined by the gold standard pathohistological analysis (Spearman's rank coefficient: 0.61, P less than 0.001). Using the ARFI technology for assessment of liver fibrosis gave areas under the ROC curve of 0.779 for S more than 2 patients, of 0.863 for S more than 3 patients, and of 0.0880 for S = 4 patients. CONCLUSION: The real-time ultrasound elastography ARFI technology can show the elasticity modulus of liver, and its data values positively correlate with the patho-histology grade of liver fibrosis in CHC patients. ARFI technology is easy to operate, non-invasive, and quantitative, and has potential clinical value for assessing liver fibrosis in CHC.

[Tissue injury observation caused by thermal effects of microwave endometrial ablation].

OBJECTIVE: To investigate the thermal effects on tissue structures during microwave endometrial ablation (MEA) and seek a feasible method of endometrial thinning and a fitting mode of applicator radiating microwaves. METHODS: Operations were performed between the group of thorough uterine curettage and the group of early follicular phase in in vitro or in vivo uterus. The former was treated with MEA after thorough uterine curettage; while the latter was treated with MEA in the early follicular phase directly. The applicator radiating microwaves were moved in "Z" or "Z + W" shape inside uterine cavity. At the same time the serosal temperature was measured in the uterine fundus, tael cornua uteri, the posterior wall and the lower part of anterior wall. After operations the uterine specimens were stained by hematoxylin-eosin, and respiratory enzyme dehydronicotinamide adenine dinucleotide phosphate diaphorase (NADH-d) methods. The morphologic changes and the depth of tissue thermal damage were evaluated using an optical microscope and electron microscope. RESULTS: (1) Under the optical microscope the endometrial glands became distorted, the cell boundaries disappeared, the nucleoli turned condensed and were stained darker. A large number of acute inflammatory cells appeared in fibrous tissue. In the shallow muscle layer cells were arrayed thickly, nucleoli were solidified and condensed, and cellular plasm were concentrated. The endometrial and the superficial muscle layers were damaged and colorless with NADH-d staining. The scope of the tissue thermal damage was clearly seen. Under an electron microscope, some smooth muscle cells, chromatin, karyotheca and cellular membranes were destroyed. The mitochondria were swollen, membranes were ruptured, and the crista disappeared. Many organelles were destroyed. The chromatin was lightly wrecked in the transitional area between putrescence and the normal smooth muscle tissue. Karyotheca and cellular plasm still existed, the mitochondria were highly edematous and the crista were disappeared, and the granular endoplasmic reticula were slightly expanded and degranulated. (2) The serosal temperature in in vitro uterus was significantly higher than that in in vivo uterus (P < 0.01). However, the highest temperature in in vitro or in vivo uterus were all taken in the posterior wall, being 50.9 degrees C and 37.6 degrees C, respectively. (3) The injury depth in in vitro uterus was 4.0 - 8.8 mm in the uterine body, 1.6 - 3.8 mm in the cervix uteri-uterine body junction; while those of in vivo uterus were 4.1 - 6.6 mm, 0 - 2.8 mm, respectively. The highest injury depth of tissue was in the posterior wall, significantly different from the other parts (P < 0.01). The injury depth of the corresponding part in in vitro or in vivo uterus all had a significant difference (P < 0.05). The depth of thermal damage had no significant difference between the group of thorough uterine curettage and the group of early follicular phase (P > 0.05). The injury depth of the "Z + W" radiation group increased significantly than that of the "Z" radiation group (P < 0.05). CONCLUSIONS: (1) The depth of thermal damage is safe and controllable. (2) MEA with preoperative thorough uterine curettage or scheduling treatment at the follicular phase is efficient. (3) It is the ideal performing mode that the applicator radiating microwaves move in "Z + W" shape inside uterine cavity. (4) The thermal damage of MEA occurs more frequently in the portion with a shortage of blood supply.