[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.

Selection and validation of differentially expressed genes in head and neck cancer.

We applied a robust combinatorial (multi-test) approach to microarray data to identify genes consistently up- or down-regulated in head and neck squamous cell carcinoma (HNSCC). RNA was extracted from 22 paired samples of HNSCC and normal tissue from the same donors and hybridized to the Affymetrix U95A chip. Forty-two differentially expressed probe sets (representing 38 genes and one expressed sequence tag) satisfied all statistical tests of significance and were selected for further validation. Selected probe sets were validated by hierarchical clustering, multiple probe set concordance, and target-subunit agreement. In addition, real-time PCR analysis of 8 representative (randomly selected from 38) genes performed on both microarray-tested and independently obtained samples correlated well with the microarray data. The genes identified and validated by this method were in comparatively good agreement with other rigorous HNSCC microarray studies. From this study, we conclude that combinatorial analysis of microarray data is a promising technique for identifying differentially expressed genes with few false positives.

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.

[Establishment of an animal model of osteochondral defect by arthroscope in TMJ].

OBJECTIVE: To create an animal model of osteochondral defect in temporomandibular joint (TMJ) by arthroscope to minimize the surgical injury. METHODS: Subchondral drilling on the anterior slope of condyle and posterior slope of eminence were performed on 12 rhesus monkeys (24 joints) by arthroscope. RESULTS: The osteochondral defect models of TMJ were successfully made on 12 monkeys (24 joints). CONCLUSION: There are fewer injuries and bias in the animal models of TMJ osteochondral defect by arthroscope than by open surgery.

[Experimental study of the effect of TNP-470 on human salivary adenoid cystic carcinoma cell in vitro].

OBJECTIVE: To investigate the effects of TNP-470 on human salivary adenoid cystic carcinoma cell line ACC M in vitro. METHODS: Cell proliferation was assessed by MTT assays and dye exclusion counting. Morphological changes of apoptosis were observed with fluorescent microscope. DNA ladder, apoptosis rate and cell cycle were examined by DNA agarose gel electronphores and fluorescence flow cytometry (FCM), respectively. RESULTS: The 50% inhibitory concentrations (IC50) of TNP-470 on ACC-M cells proliferation by MTT assays and dye exclusion counting were 40.68microg/ml and 46.38microg/ml. Apoptosis were observed by fluorescent microscope. DNA electrophoresis for the cells treated with TNP-470 showed brighter DNA ladder; Sub-G1 peak and G2/M arrest were also determined by FCM (P<0.01). CONCLUSION: TNP-470 has the effect of inducing apoptosis in ACC-M cells in vitro, which may be one of its antitumor mechanisms.

[The MRI of the occult cervical metastasis with malignant tumor of the head and neck].

OBJECTIVE: To detect the occult cervical metastasis with MRI so as to find out its diagnostic accurate rate. METHODS: 41 lateral necks(negative by clinical palpation) with malignant tumor of head and neck were examined by MRI before operation and correlated with postoperative pathologic finding. RESULTS: With MRI evaluation occult cervical metastasis has higher accurate rate(75%), nine of 12 lateral metastatic positive necks were detected on MRI, other three false negative necks were not found, owing to no change of the shape of the metastatic nodes. CONCLUSION: At present, MRI is one of the effective methods evaluating occult cervical metastasis with malignant tumor of head and neck, but it has still a certain limitation.

Hydroxy-dibenzo crown ether stationary phase for capillary gas chromatography using sol-gel technology.

A new kind of crown ether, OH-dibenzo-14-crown-4 (OH-DB14C4), is prepared and coated onto the fused silica capillary by sol-gel process. Chromatographic characteristics including column efficiency (> 3,000 plates/m), thermal stability (to 330 degrees C) and ability of deactivation are studied. The selectivity of new stationary phase is superior to sol-gel OH-terminal silicone oil (OH-TSO) for positional isomers of some aromatic compounds such as xylene, dichlorobenzene, nitrotoluene, nitrochlorobenzene. The new stationary phase has high sample capacity for separation of small molecular mass compounds: low-molecular-mass alcohols, ethers and ketones, short-chain fatty acids and volatile amines.

[The Inhibitory Study of TNP 470 Combined CDDP on the Tumor Growth and Lung Metastasis of Adenoid Cystic Carcinoma ACC M in Nude Mice]

OBJECTIVE:To study the effect of TNP-470 combined CDDP on the tumor growth and lung metastasis of cell strain ACC-M in vivo. METHODS:High potential lung metastatic adenoid cystic carcinoma cell strains (ACC-M) 5x10(5) were injected simultaneously to 18 nude mice subcutaneously and enously. The animals were randomly divided into 3 groups. In group 1, TNP-470 was administered subcutaneously at the dose of 30mg/kg every other day for 2 weeks from the beginning of 3(rd) week to the end of 4(th) week. In group 2, 5mg/kg CDDP were injected into peritoneal cavity at the beginning of 3(rd) week and 4(th) week and TNP-470 in the same manner as group 1 additionally. In group 3, the same volume of 0.97% NaCl was injected in the manner of group 1. The mice were sacrificed by dislocating the neck at the end of 4 weeks. The tumor size and weights were recorded. The vascular density was measured by rabbit-anti-human factor VIII antibody stain. The results were analyzed by Student t and X(2) test. RESULTS:Group 1 and group 2 had fewer tumor weight and lung metastasis than the 3(rd) group. There was significant difference in the tumor weight and lung metastasis between group 1 and group 2. But the vascular density had no difference among three groups. CONCLUSION:TNP-470 combined CDDP has stronger inhibition on both the tumor growth and lung metastasis of human adenoid cystic carcinoma ACC-M than used alone.

[Anatomical and histologic study of the cervical vessels in goats]

OBJECTIVE:To investigate the normal anatomic relations and histologic features of the cervical arteries and veins of goat, with the aim of providing a basis for resection and reconstruction of the common carotid artery.MATERIALS AND METHODS: Surgical dissection was performed on 15 healthy adult goats under general anaesthesia. The external diameters of the common carotid artery (CCA) and external jugular vein(EJV) were measured at their midpoints. 1 cm of the CCA and EJV was subject to light microscopic examination. Direct carotid angiography was performed on 2 selected goats to observe the course and branches of the carotid artery and normal blood flow mapping of the CCA was recorded using Laser Doppler Flowmeter. RESULTS:The average external diameter of the EJV was 5.4 mm for the left side and 5.3 mm for the right side. The average external diameter of the CCA was 3.8 mm for the left side and 3.6 mm for the right side. Histologic examinations found that the media of the carotid artery had 10-15 layers of smooth muscles. The EJV had valvulae, its wall was thin, only 1-2 layers of smooth muscle were contained in its medium. CONCLUSION:The CCA and EJV of the goat had a longer course in the neck, and a larger diameter (3-5 mm). Their histologic structures were similar to that of the human being, which makes it advantageous to be more often used as an animal model in experimental surgery.

[The changes of chewing ability after orthognathic therapy: electromyographic analysis]

OBJECTIVE:The maxillo-facial skeletal deformity can only be corrected through orthognathics that consists of orthodontics and operation.There are various changes in aspect of the bite relationship between upper and lower dentition after orthognathic surgery.The change feature of the chewing efficiency of oral maxillary system can be detected through comparing studying of the contracti on force of chewing muscles before and after surgical operation.METHODS:All 6 patients in this research were diagnosed to be skeletal crossbite.Electromyogram was used to test the change of activity of superficial masseter,temporalis and digastrics.The examination was carried out 1 week before operation and 3 months after the operation. RESULTS:When mandibular is in its rest status,there is no significant difference in the change of muscular activities.when it is active,there is significant difference. CONCLUSION:The chewing ability of masticatory muscles is reduced after orthognathic surgery.The result indicated that there is a negative bite relationship between the upper and lower dentition,the occlusion relationship needs accurate adjustment for gaining stability of oral maxillary system.Therefore,orthodontics after operation is of vital importance.

[The in vitro comparison of platelet induced ACC-M cell adhesion with and without Aspirin]

ObJECTIVE:Observation the affection of aspirin to adhesion of highly metastatic salivary adenoid cystic carcinoma(ACC-M) cell induced by platelet.METHODS:Adhesive ratios of ACC-M cell induced by platelet with or without aspirin were measured.RESULTS:After the addition of platelet rich plasma(PRP),adhesive ratio of ACC-M cell increased significantly (P<0.01). The treatment with aspirin after addition of PRP led to a nonsignificant increase of adhesive ratio (P>0.05).The reduction of adhesive ratio by aspirin was found dosage independent within concentration range of 0.01-0.25g/L of aspirin. CONCLUSION:Adhesion of ACC-M cell was raised by added platelet.Addition of aspirin,platelet induced adhesion of ACC-M cell was inhibited significantly.

[Evaluation of cryosurgery for the management of oral malignant mucomembranous melanoma-A survey of 107 cases reports]

OBJECTIVE:There were 13 cases underwent operation.24 cases underwent cryosurgery only and 70 cases received comprehensive management,which as cryosurgery,operation,chemotherapy and immuno-therapy.RESULTS:The 3'and 5' year survival rate of three groups were 0.0%,0.0%,37.50%,31.25% and 57.14%,36.07%.There are significant differences between operation group and cryosurgery group and between operation group and comprehensive treatment group.Although the third group got the better result,but the difference between late two groups was not statistical significant.CONCLUSION:It is suggested that comprehensive treatment be the routine regime of melanoma in head and neck. Our experience with review of literature covered the classification, surgical principle and complication was presented.

[Observation in vivo histological response induced by imlplanted domestic poly-DL-lactic acid plates]

OBJECTIVE:To analyze the histological response and biocompatibility to implanted domestic PDLLA plates in vivo METHODS:Bilateral artificial fractures were created in mandibular bodies in dog and internal fixed with domestic PDLLA plate,TM plate respectively;meanwhile,a domestic PDLLA plate was imlplanted in femur.The interfacial soft tissue around the plates were collected and performed histological study RESULTS:All the skin wound healed well without abscess and fistula formation. From 2 to 4 weeks after the operation,the inflmmatory granulomatous response around the intenal fixation PDLLA plates was more serious than that of the control,in which more macrophages,plasmocytes and less lymphocytes,mononuclear cells infiltrated CONCLUSION:Domestic PDLLA plate is an inert internal fixation material with good biocompatibility, which induced a non-speciflc foreign reaction

[A comparison of the effects of 180kv X-ray radiation and cobalt-60 radiation on the jaws of the guinea pigs]

OBJECTIVE: Study of the effects of 180kv x-ray and cobalt-60 radiation on jaws and enhance the understanding of pathology of osteroradionecrosis of jaws(ORNJ).METHODS: 128 guinea pigs were grouped according to different irradiation sources and doses.Fractioned radiation from both sources was delivered in right mandible.The teeth extractions were conducted one week prior to radiation and 1,3,5 months after radiation respectively.Following radiation,the guinea pigs were examined by gross observation, x-ray film and histopathological examination at regular interval. RESULTS: Bone resorption occured within 1 month after irradiation as result of osteoblast inhibition and osteoclast activation.From 2 to 4 month afterwards,the number of osteocytes reduced and pyknosis, empty lacunae as well as obliteration of small vessels in periodontal membrane were commonly seen.The teeth extractions conducted at 3 months,5 months after radiation lead to ORNJ in 7 amimals (14.6%).CONCLUSION: 180kv x-ray radiation was far more damaging to jaws than cobalt-60 radiation.The dental extraction is an important factor inducint the development of ORNJ.

[The advanced studies on surgical treatment about the patients of TMJ ankylosis and OSAS]

OBJECTIVE: Through the treatment on the 10 patients suffered TMJ ankylosis and OSAS,by means of the TMJ reconstruction combining orthognathic surgery,it is demonstrated that the treatment on the patients must include relieve the TMJ anklosis,correct the maxillofacial deformitis and specially enlarge upper airway space.

Experimental study of radiation effect on the mandibular microvasculature of the guinea pig.

OBJECTIVE: This experimental study was performed to explore the intraosseous microvascular alterations in the irradiated mandible and to increase understanding of the pathogenesis of osteoradionecrosis. METHODS: One hundred twenty-eight guinea pigs were grouped according to different radiation sources and dosages. Fractioned radiation was delivered to the right mandibles. Dental extractions were conducted at 1, 3, and 5 months respectively, after radiation. One month later, the animals were examined by means of gross observation, histopathology, and microvascular corrosion castings. RESULTS: Histologic evaluation showed bone absorption within 2 months following radiation. Four months later, the number of osteocytes decreased and pyknosis and empty lacunae were commonly seen. The casting specimens revealed under scanning electron microscopy that capillary disconnection and obliteration with subsequent vein shrinkage aggravated over time. In the nonhealing dental extraction site, a large-scale vascular network defect presented with focal capillary proliferation around. CONCLUSIONS: The capillary is the part most vulnerable to the damage caused by radiation in the vascular system of the mandible. On the basis of "hypovascular, hypoxic, hypocellular" structure, local microcirculation failure induced by the trauma-repairing process leads to occurrence of osteoradionecrosis of jaws.