[Effects of dynamic nutrition support on energy metabolism, immune function and stress response after oral and maxillofacial tumor surgery].

PURPOSE: To observe the effect of dynamic nutrition support on postoperative energy metabolism, immune function and stress response in patients with oral and maxillofacial tumors. METHODS: Fifty-six patients with oral and maxillofacial tumor surgery were randomly divided into experimental group and control group (28 in each group). Patients in the experimental group received dynamic enteral and parenteral nutrition support according to the stress period after surgery, ω-3 fish oil fat milk injection and glutamine were added in the nutrition support program. Patients in the control group were given routine postoperative enteral and parenteral camp support. Energy metabolism, immune function and stress indexes were detected 1 day before surgery, 2 days after surgery and 7 days after surgery, respectively. SPSS 19.0 software package was used to analyze the data. RESULTS: Energy metabolism indexes in the experimental group were higher than the control group on day 2 after PA surgery and day 7 after ALB and PA surgery, while energy metabolism indexes in the experimental group were lower than the control group on day 2 and day 7 after FPG and TG surgery with significant difference(P<0.05). The levels of IgA, IgG, IgM, CD3+, CD4+ and CD4+/CD8+ in the experimental group were higher than those in the control group 7 days after surgery, with significant differences (P<0.05). The levels of CRP, TNF- and IL-6 in the experimental group were lower than those in the control group 7 days after surgery, and the difference was significant(P<0.05). There was no significant difference in postoperative complications between the two groups. CONCLUSIONS: Dynamic nutrition support can improve postoperative energy metabolism of patients with oral and maxillofacial tumors, improve immune function, and alleviate stress response.

A preliminary study on the application of bone marrow stromal cell sheet on the formation of functional tissue-engineered bone in dogs.

PURPOSE: The aim of this study was to construct functional tissue-engineered bone in dogs using cell sheet engineering, a new technique to gain and transfer seed cells. MATERIALS AND METHODS: Demineralized bone matrixes, prepared from homologous bone, were coated with recombinant human bone morphogenetic protein-2. Bone marrow stromal cells (BMSCs) were isolated and subcultured. Osteogenic-induced BMSCs were incubated in a temperature-responsive culture dish to form the BMSC sheet. The complex of demineralized bone matrix, recombinant human bone morphogenetic protein-2, and BMSCs wrapped with BMSC sheets was implanted around the blood vessels of the latissimus dorsi muscle in the experimental side, and the same complex without BMSC sheets was implanted around the blood vessels of the latissimus dorsi muscle on the other side as a control. At 4, 8, 12, and 16 weeks after implantation, the implants were removed for radiographic evaluation, descriptive histologic observation, and histologic quantitative analysis. RESULTS: Radiographic analysis showed that the optical density of the tissue-engineered bone on the 2 sides increased with time. However, the optical density of the experimental side was significantly greater than that of the control side at the same points. Sixteen weeks after implantation, mature lamellar bone was formed in the experimental side, with red bone marrow in the bone marrow cavity. In contrast, the control side exhibited significantly less lamellar bone. Histologic quantitative analysis showed that the experimental side exhibited significantly more bone per area compared with the control side. CONCLUSION: BMSC sheet engineering may be useful to construct functional tissue-engineered bone.

Single nucleotide polymorphisms in the u-PA gene are related to susceptibility to oral tongue squamous cell carcinoma in the Northern Chinese Han population.

AIM: The purpose of this study was to determine whether susceptibility to oral tongue squamous cell carcinoma (OSCC) is related to polymorphisms in the u-PA gene. METHODS: We examined the rs2227564 C/T and rs2227562 G/A single nucleotide polymorphisms (SNPs) in 196 OSCC patients and 201 age- and gender- matched controls via direct sequencing and PCR-RFLP methods. RESULTS: Significant differences were found in allelic and genotypic distributions of the rs2227564 and rs2227562 loci when comparing cases and controls. In addition, logistic analyses indicated that the rs2227564 C/T genotype was related to a 1.52-fold increased risk of developing OSCC (adjusted OR=1.521, 95%CI: 1.144~2.022, P=0.004). Linkage disequilibrium analysis was conducted and no association between the two loci was found (D'=0.031, r2=0.000). CONCLUSIONS: Our findings provide evidence that the rs2227564 C/T SNP in the u-PA gene is associated with the development of OSCC.

A dominant CD4(+) T-cell response to Helicobacter pylori reduces risk for gastric disease in humans.

BACKGROUND & AIMS: Immunodominance is an important feature of antiviral, antitumor, and antibacterial cellular immune responses, but it is not well demonstrated in the immune responses against Helicobacter pylori. Antigen-specific CD4(+) T cells protect mice against infection with H pylori. We investigated the immunodominant CD4(+) T-cell response to neuraminyllactose-binding hemagglutinin (HpaA), which is a conserved, H pylori-specific colonization factor that is being investigated as an antigen for vaccination strategies. METHODS: HpaA-specific CD4(+) T cells were expanded with autologous peripheral blood mononuclear cells that had been incubated with recombinant HpaA and characterized using overlapping synthetic peptides. We compared the percentage of CD4(+) T cells with specificity for HpaA(88-100), restricted to HLA-DRB1*1501, among 59 H pylori-infected subjects with different gastric diseases. RESULTS: We identified and characterized several immunodominant CD4(+) T-cell epitopes derived from HpaA. The immunodominant CD4(+) T-cell responses specific to HpaA(88-100) were observed in most H pylori-infected individuals who expressed HLA-DRB1*1501 and were significantly more abundant in patients with less severe diseases (P < .05). CONCLUSIONS: The HLA-DRB1*1501-restricted immunodominant CD4(+) T-cell response to HpaA(88-100) is associated with reduced risk of severe gastric diseases. Further study of these and other immunodominant CD4(+) T-cell responses to H pylori will provide insight into mechanisms of protective immunity and aid in vaccine design.

[An experimental study of endothelial progenitor cells on bone formation in tissue-engineered bone in dogs].

PURPOSE: To observe the effects of endothelial progenitor cells (EPCs) on bone formation of tissue engineered bone in dogs. METHODS: Bone marrow stromal cells (BMSCs) and EPCs were derived from dog bone marrow and cultured in different medium in vitro. They were seeded on demineralized bone matrix (DBM) to build tissue engineered bone, then the construct was implanted into the fasciae of latissimus dorsi muscle, the degree of bone formation was analyzed with imaging and histological methods at different time points. SPSS13.0 software package was used for statistical analysis. RESULTS: 4, 8, 12 weeks after operation, X-ray film showed bone mineral density (BMD) in the EPCs group was significantly higher than the control group, and there was significant difference between the two groups(P<0.05); Histological examination revealed that the degree of bone formation in the EPCs group was higher than the control group, the new bone area and blood vessel area between the two groups were significantly different(P<0.05). CONCLUSION: EPCs can promote bone formation and accelerate new bone formation in tissue-engineering bone.

[Construction of tissue engineering bone with bone marrow stromal cell sheets].

OBJECTIVE: To construct tissue engineering bone with bone marrow stromal cell (BMSC) sheets of dogs. METHODS: BMSC were derived from dog bone marrow and cell sheets were prepared with temperature-responsive dishes after the cells were induced by osteogenesis. Allogeneic dogs decalcification bone matrixes (DBM) were prepared. Sixteen dogs were divided into 4 groups. The MSC cell sheets-rhBMP-2-BMSC-DBM were implanted under the left latissimus dorsi myofascial as the experimental side; while the rhBMP-2-BMSC-DBM were implanted in the right side as the control. Ectopic bone formation in vivo was evaluated by histological examination 4, 8, 12, 16 weeks after operation. RESULTS: The osteogenesis in the experimental group was better than that in the control group. New bone area in the experimental side was larger than that in the control group, and the difference was significant (P < 0.05). After 16 weeks, lamellar bone was connected into a film in the experimental group. Haversian system and red bone marrow could be seen. CONCLUSIONS: BMSC cell sheets could promote the bone formation of functional tissue-engineered bone.

Progress of oral sequelae during head-neck radiotherapy.

OBJECTIVE: To evaluate xerostomia, mucositis and dental caries during head and neck radiotherapy. METHODS: Twenty patients with nasopharyngeal carcinoma were included. Oral examinations were conducted before radiotherapy, after dosage of 2000 cGy irradiation, immediately after the termination of radiotherapy, and 1 month and 6 months after termination of the radiotherapy. Oral hygiene instruction, effective oral care and dental intervention were performed during the treatment. Salivary flow rate was evaluated by modified Schirmer's test. Xerostomia, mucositis and dental caries status were evaluated based on oral examinations. RESULTS: Salivary flow rate decreased significantly after the first dosage of 2000 cGy, and was aggravated with the increase in irradiation dosage until the termination of radiotherapy. Xerostomia and mucositis were observed in parallel with the reduction of saliva flow rate, and were aggravated with the increase in irradiation dosage. Mucositis began to recover within 1 month after the termination of radiotherapy and fully recovered within 6 months after the termination of the radiotherapy. Six months after the termination of irradiation, new carious lesions were detected in two patients. CONCLUSION: Oral sequelae developed during radiotherapy of the head and neck. Oral health instructions and effective intervention were essential before, during and after the radiotherapy.

[Study of bone marrow stroma stem cells cell-sheet and endothelial progenitor cells cultured in vitro on allogenic demineralized bone matrix in mongrel].

PURPOSE: To investigate the growth situation of bone marrow stroma stem cells(BMSCs) cell-sheet and endothelial progenitor cells (EPCs) on demineralized bone matrix (DBM) and explore the effect of DBM/BMSCs cell-sheet and DBM/EPCs complex on the construction of functional and vascularized tissue-engineered bone in mongrel. METHODS: BMSC cell-sheet was prepared with cell-sheet engineering approach, EPCs were isolated from canine bone marrow and DBM was prepared from homologous bone. BMSCs cell-sheet and EPCs were inoculated on DBM respectively and observed by inverted phase contrast microscope and scanning electron microscope. The porosity of DBM was measured. RESULTS: The DBM/BMSCs cell-sheet and DBM/EPCs complex were successfully constructed. The BMSCs cell-sheet and EPCs adhered to DBM well and grew rapidly. CONCLUSIONS: The BMSCs cell-sheet and EPCs have good biocompatibility with DBM. The complex of DBM/ BMSCs cell-sheet, DBM/EPCs could provide good conditions to acquire functional and vascularized tissue-engineered bone. Supported by National Natural Science Foundation of China (Grant No.30872896) and Natural Science Foundation of Shandong Province (Grant No.Y2008C77).

Effect of platelet-rich plasma and latissimus dorsi muscle flap on osteogenesis and vascularization of tissue-engineered bone in dogs.

PURPOSE: The present study evaluated the effects of platelet-rich plasma (PRP) and the latissimus dorsi muscle flap on osteogenesis and vascularization of tissue-engineered bone. MATERIALS AND METHODS: Bone marrow stromal cells (BMSCs) were subcultured, and PRP was obtained from the same dogs. Demineralized bone matrix (DBM) was prepared from homologous bone. The complexes of DBM/BMSCs/PRP were implanted into areas A and B on the left side of the dogs' backs; complexes of DBM/BMSCs without PRP were implanted in areas C and D on the right side of the same dog. The implants in areas A and C were wrapped with a latissimus dorsi muscle flap, and the implants in areas B and D were wrapped with inferior fascia. At 4, 8, and 12 weeks later, the implants were removed for evaluation. RESULTS: The radiographic evaluation, descriptive histologic analysis, and histologic quantitative analysis showed that the PRP/BMSCs/DBM complex was better than the BMSCs/DBM complex in both vascularization and osteogenesis of the ectopic tissue-engineered bones, and the complex wrapped with the latissimus dorsi muscle flap was better than that packed with superficial fascia without blood vessels. CONCLUSIONS: The PRP and blood vessels in the latissimus dorsi muscle could cooperatively promote osteogenesis and vascularization in tissue-engineered bone.

[A comparison between CT and SPECT in detecting mandibular invasion by lower gingival squamous cell carcinoma].

PURPOSE: The purpose of this study is to compare the value of CT and SPECT in diagnosis of lower gingival carcinoma invading the mandible. METHODS: From February 2002 to October 2006, twenty-one patients with lower gingival squamous cell carcinoma were enrolled.The data of CT and SPECT were studied,and compared with histopathological findings. RESULTS: Among the 21 patients,the sensitivity, accuracy, negative predictive value and Youden's index of SPECT were 100.00%, 95.24%, 100.00% and 1.00,respectively. While the sensitivity, accuracy, negative predictive value and Youden's index of CT were 80.00%, 80.95%, 20.00% and 0.80, respectively. There were four false negatives assessments of bone invasion(80.00%) by CT scan, while no false negatives by SPECT. CONCLUSIONS: SPECT is superior to CT, and can be used as a routine screening method to assess lower gingival carcinoma invading the mandible.

[A preliminary study on alveolar bone and teeth defect by immediate autologous bone graft and secondary dental implantation].

PURPOSE: The purpose of this study is to evaluate immediate autologous bone graft combined with secondary dental implant to repair traumatogenic defect and lost teeth. METHODS: 16 patients with labial anterior maxillary alveolar bone defect, caused by trauma for various reasons were selected as the experimental group. The suitable size autologous skull plates or chin bone plates were harvested and transplanted to the bone defect site and fixed with titanium screw immediately after the wound was completely cleaned, and then the gingiva and mucosa were sutured adequately. 42 ITI SLA implants were implanted 12 weeks after bone graft surgery. Porcelain fused metal crowns were made 12 weeks after implantation. Meanwhile, a total of 22 patients with 50 ITI SLA implants which were routinely implanted in anterior maxillary alveolar bone without bone graft surgery were selected as the control group. Resonance frequency analysis(RFA) was taken at 0,4,12,52 weeks after implant surgery in both groups to get implant stability quotient(ISQ) values. Student's t test was used to calculate P values for ISQ with SPSS13.0 software package. RESULTS: The soft tissue wound of 16 patients healed 7-9 days after trauma. The alveolar arch returned normal, the alveolar ridge was with adequate height and width. The contour and function of dentures restored 12 weeks after implantation. No significant difference in ISQ values was found between the two groups at 0,4,12,52 weeks after implant surgery(P>0.05). CONCLUSIONS: The course of treatment is shortened, the times of surgery are reduced, and the repair effect is satisfied by immediate autologous bone graft and secondary dental implantation for upper anterior labial alveolar bone defect and teeth loss caused by trauma.

[Early laser intervention of hemangioma in facial and neck regions of infant].

OBJECTIVE: The study was to evaluate the method of early laser intervention of hemangioma in facial and neck regions of infant. METHODS: Between January 1999 and December 2006, twelve patients, aged 6 days to 3 months, with cutaneous hemangioma in facial and neck regions, were treated with laser, eight cases with Nd:YAG laser therapy and four cases with Venus laser therapy. Four cases with hemangioma in facial and neck regions of infant treated with oral corticosteroid were as control. The outcome was recorded with 1 to 6 years of follow-up. RESULTS: Total resolution was obtained in twelve patients with laser intervention. Atrophic scars occurred in eight patients with Nd:YAG laser therapy, without other complications, such as ulceration, life-threatening hemorrhage and et al. No scar occurred in four patients with Venus laser therapy. Recurrence was not seen in twelve cases with laser therapy with follow-up. Hemangiomas enlarged continuously in four cases with oral corticosteroid therapy. CONCLUSION: Early laser intervention is an excellent management of cutaneous hemangioma in facial and neck regions of infant.

Madelung disease: manifestations of CT and MR imaging.

OBJECTIVE: The purpose of the present study was to assess the head and neck imaging features of Madelung disease on computerized tomography (CT) and magnetic resonance imaging (MRI), delineate the effects of the fatty deposits on underlying structures, and tabulate the anatomic sites where the neck fat was deposited. STUDY DESIGN: Sixteen Chinese patients with Madelung disease in our hospital were reviewed. The CT manifestations of the 16 cases and the MRI manifestations of 1 case were analyzed retrospectively. The imaging features of the fatty distribution in the head and neck area were studied. RESULTS: Cross-sectional CT showed that the excess fat was symmetric and unencapsulated, mainly deposited at the anterior or posterior subcutaneous tissue of the neck, was deep under the sternocleidomastoid and trapezius muscles, was situated in the posterior cervical triangle, and was around the salivary glands. It was also found to be situated in supraclavicular fossa, around the paraspinal muscles and larynx, and so on. The accumulated fat at superficial sites was situated at the napex and/or at the anterior neck, forming small or large fatty masses to protrude backwards locally or sometimes at submentum; the markedly thickened neck might appear tubby or oval in anteroposterior diameter. The accumulated fat at deep sites compressed adjacent muscles, salivary glands, and great vessels and caused them to shift and deform. The distinctive appearance was that marked thickening of fat caused sternocleidomastoid muscles and submaxillary glands to shift forward obviously, like a bird spreading its wings. The density of the abnormally proliferated fat was equal to that of normal fat. In MRI, the distribution of the excess fat was equal to that seen with CT. The signal intensity of the excess fat was equal to that of normal fat. Besides the accumulation of the neck fat tissue, CT and MRI did not show other abnormal soft tissue masses. CONCLUSIONS: The use of CT and MRI can accurately show the excess fat based on density of CT and signal intensity of MRI. The density and signal intensity of the excess fat are equal to those of normal fat. The excess fat, mainly deposited at the anterior or posterior subcutaneous tissue of the neck, was deep under the sternocleidomastoid and trapezius muscles, was situated in the posterior cervical triangle, and was around the salivary gland, and so on. CT and MRI can also show compression, shift, and deformation of surrounding salivary glands, great vessels, and muscles caused by the excess fat. The CT and MRI can accurately diagnose the disease and exclude other soft tissue tumors.

[Establishment and identification of biological characteristics of rat monoclone cell line Rca-B].

OBJECTIVE: To establish a monoclone cell line of squamous cell carcinoma (SCC) in rat buccal mucosa and to study its biological characteristics. METHODS: SCC in rat oral mucosa was induced by adding 4-nitroquinoline-1-oxide (4NQO) into the SD rats' drinking water, and the cancer cells were then cultured to obtain mixed cells in vitro. The mixed tumor cells were purified by mono cell cloning method. The biological characteristics of the cells were studied by microscope and electronic microscope observation, chromosome analysis, Methyl thiazolyl tetrazolium (MTT) test, flow cytometry assay and immunohistochemistry staining. Hypodermic inoculations of the cells in nude mice and injection of the cells by nude mice tail veins were performed to observe the tumor formation and long distance metastasis. RESULTS: The morphology proved that the cell line was squamous cell carcinoma cells, which were cultured from one cell. The population doubling time for passage 65 cells was 25.44 hours. The cells in S-phase accounted for 20.13% of the cell cycle. The chromosome modal number was 84. All the cells expressed the proteins of cytokeratin and vimentin. The xenograft rate and the tumor metastatic rate to the lung were 100% in nu/nu BALB/C mice, but the homograft rate was zero in SD Rats. CONCLUSIONS: Rca-B was a typical oral squamous cell carcinoma cell line derived from Sprague-Dawley rat buccal mucosa carcinoma, and the cell line has high metastatic potential and its biological characteristics were well ascertained.

[Effect of platelet rich plasma on vascularization of tissue-engineered bone].

OBJECTIVE: To study the effects of platelet rich plasma (PRP) on vascularization of tissue-engineered bone. METHODS: Bone marrow stromal cell (BMSC) were isolated from iliac bone of dogs. PRP was obtained from the same dog and demineralized bone matrix (DBM) was prepared from homologous bone. Twelve dogs were divided into three groups and the back of each dog was divided into four areas. The DBM- BMSC- PRP was implanted in the area A and B; the DBM-BMSC without PRP was implanted in the area C and D. The implants in the areas A and C were wrapped using myo-fascia with blood vessel of latissimus dorsi. The implants in the area B and D were wrapped using superficial fascia of the back without blood vessel. The implants were taken out 4, 8 and 12 weeks later for examination. RESULTS: The degree of calcification and blood vessel formation of the implants was A > B > C > D. CONCLUSIONS: Both PRP and vessels of latissimus dorsi muscle could promote calcification and vascularization in tissue-engineered bone, when used separately or in combination.

Submandibular area metastasis from prostate small cell carcinoma with neuroendocrine differentiation.

Neuroendocrine differentiation in prostatic carcinomas generally confers a more aggressive clinical behavior and less favorable prognosis than usual prostatic carcinomas. In this article, we report a case of a 65-year-old man with prostatic carcinoma who had a metastasis of the submandibular area. His serum prostate-specific antigen level was reduced to below the normal range and carcinoembryonic antigen was increased. Pathologic specimens demonstrated a small cell carcinoma with neuroendocrine differentiation by immunohistochemical studies.

[Effect of platelet-rich plasma and latissimus dorsi myofascia with blood vessel on vascularization of tissue engineered bone in dogs].

OBJECTIVE: To study the effect of platelet-rich plasma (PRP) and latissimus dorsi myofascia with blood vessel on vascularization of tissue engineered bone in dogs. METHODS: Bone marrow stromal cells (BMSCs) were isolated from iliac bone of dogs. PRP was obtained from the same dog. And demineralized bone matrix (DBM) were prepared from homologuous bone. ABCD 4 areas were divided on the back of dog. PRP/BMSCs/DBM was implanted around the vessels of lattisimus dorsi muscle in the A. PRP/BMSCs/DBM wrapped by superficial fascia in the B. BMSCs/DBM was implanted around vessels of lattisimus dorsi muscle in the C. BMSCs/DBM wrapped by superficial fascia in the D area of the same dog. 4, 8, 12 weeks after implantation, gross specimen and histology examination were made. RESULTS: Osteogenesis and blood vessel formation results were A>B>C>D area. CONCLUSION: The results suggested that the PRP and latissimus dorsi myofascia with blood vessels could promote calcification and vascularization in tissue-engineered bone.

[Study of MSCs in vitro cultured on demineralized bone matrix of mongrel].

PURPOSE: To manufacture demineralized bone matrix(DBM) of mongrel and to explore the feasibility of DBM as scaffold of bone tissue engineering. METHODS: Thigh bones of mongrel were degreased, demineralized, deproteined, freezed, dried and sterilized to form DBM. Mesenchymal stem cells(MSCs) were seeded onto the scaffold and their growth were examined by inverted phase contrast microscope and scanning electron microscope. RESULTS: DBM had a three-dimensional mesh structure.The mean pore diameter of DBM was (254.39+/-88.71)microm and the pore rate was about 70%.MSCs could adhere to the surface and inner walls of DBM, proliferated well and secreted a large amount of extracellular matrix. CONCLUSION: DBM has satisfactory biocompatibility.

[Madelung disease: CT and MRI findings].

OBJECTIVE: To investigate the CT and MRI manifestations of Madelung disease. METHODS: The CT and MRI manifestations of 12 cases of Madelung disease were analyzed retrospectively. RESULTS: The CT and MRI manifestations: cross-sectional CT showed that abnormally proliferated fat mainly deposited in anterior or posterior subcutaneous tissues of the neck, deep into the sternomastoid and trapezius muscles, situated in posterior cervical triangle, around the salivary glands, and excess fat was also found to be situated in supraclavicular fossa, around the paraspinal muscles and larynx, and so on. The abnormally proliferated fat can compress surrounding organs and tissues. The density of the abnormally proliferated fat was equal to that of normal fat. The MRI manifestations: the distribution of the thickened fat was equal to that seen with CT. The signal intensity of the thickened fat was equal to that of normal fat. CONCLUSIONS: CT and MRI can accurately show distribution of the thickened fat, compression of surrounding organs and tissues and exclude soft tissue tumors. MRI seemed to be superior to CT.

[Study of three dimensional reconstruction and visualization of human mandible].

PURPOSE: This study is designed to reconstruct 3-D digital visible mandibular model using digital human database. METHODS: An appropriate cadaver was fixed, and fused through arterial infusion, then embedded and sliced. The 2-D imaging data of mandible were obtained from this virtual human, and the virtual mandible was reconstructed using Amira software. RESULTS: Complete and accurate data of the mandible sections were collected, with which the virtual mandible was reconstructed three dimensionally. This virtual mandible displayed accurately the anatomical structure of the actual mandible, including the location and direction of the mandibular teeth and the mandibular canal. CONCLUSION: The 3-D mandible was constructed through the database of the digital human. The visible mandibular model will be an important learning tool in oral and maxillofacial anatomy and surgery, diagnosis and operation of mandibular diseases, and mandibular dental implantation.