Polyethylene glycol crosslinked decellularized single liver lobe scaffolds with vascular endothelial growth factor promotes angiogenesis in vivo.

BACKGROUND: Improving the mechanical properties and angiogenesis of acellular scaffolds before transplantation is an important challenge facing the development of acellular liver grafts. The present study aimed to evaluate the cytotoxicity and angiogenesis of polyethylene glycol (PEG) crosslinked decellularized single liver lobe scaffolds (DLSs), and establish its suitability as a graft for long-term liver tissue engineering. METHODS: Using mercaptoacrylate produced by the Michael addition reaction, DLSs were first modified using N-succinimidyl S-acetylthioacetate (SATA), followed by cross-linking with PEG as well as vascular endothelial growth factor (VEGF). The optimal concentration of agents and time of the individual steps were identified in this procedure through biomechanical testing and morphological analysis. Subsequently, human umbilical vein endothelial cells (HUVECs) were seeded on the PEG crosslinked scaffolds to detect the proliferation and viability of cells. The scaffolds were then transplanted into the subcutaneous tissue of Sprague-Dawley rats to evaluate angiogenesis. In addition, the average number of blood vessels was evaluated in the grafts with or without PEG at days 7, 14, and 21 after implantation. RESULTS: The PEG crosslinked DLS maintained their three-dimensional structure and were more translucent after decellularization than native DLS, which presented a denser and more porous network structure. The results for Young's modulus proved that the mechanical properties of 0.5 PEG crosslinked DLS were the best and close to that of native livers. The PEG-VEGF-DLS could better promote cell proliferation and differentiation of HUVECs compared with the groups without PEG cross-linking. Importantly, the average density of blood vessels was higher in the PEG-VEGF-DLS than that in other groups at days 7, 14, and 21 after implantation in vivo. CONCLUSIONS: The PEG crosslinked DLS with VEGF could improve the biomechanical properties of native DLS, and most importantly, their lack of cytotoxicity provides a new route to promote the proliferation of cells in vitro and angiogenesis in vivo in liver tissue engineering.

Dexmedetomidine promotes inflammation resolving through TGF-ß1 secreted by F4/80+Ly6G+ macrophage.

Dexmedetomidine (DEX) is a highly selective α2-adrenoceptor agonist, which can regulate inflammatory responses. However, whether DEX interferes with the inflammation resolving remains unclear. Here, we reported the effects of DEX on zymosan-induced generalized inflammation in mice during resolution. Mice were administered intraperitoneally with DEX after the initiation of sepsis. The resolution interval (Ri), a vital resolution indice, decreased from twelve hours to eight hours after the administration of DEX. The induction of peritoneal pro-inflammatory interleukin [IL] - 1ß and tumour necrosis factor-α (TNF-α) appeared to be inhibited. Of interest, the anti-inflammatory transforming growth factor-ß1 (TGF-ß1) but not IL-10 levels were up-regulated at twenty-four hours in the DEX group along with 1.0 mg/mice zymosan A (ZyA) treatment. The expression levels of multiple genes related to protective immune processes and clearance functions were detected and revealed the same trends. DEX markedly increased the F4/80+Ly6G+ macrophage population. Additionally, the adequate apoptotic neutrophil clearance from injury after DEX installation could be reverse by opsonization or co-instillation of TGF-ß1 neutralizing antibody in vivo, promoting the inflammation-resolution programs. In conclusion, DEX post-treatment, via the increase of F4/80+Ly6G+ macrophages, provokes further secretion of TGF-ß1, leading to the attenuated cytokine storm and accelerated inflammation resolving.

Value of a smartphone-compatible thermal imaging camera in the detection of peroneal artery perforators: Comparative study with computed tomography angiography.

BACKGROUND: The aim of this study was to investigate the value of a smartphone-compatible thermal imaging camera in the mapping of the peroneal artery perforators. METHODS: Twelve consecutive patients scheduled for fibular flap reconstruction were enrolled. The lower limbs were first studied using smartphone-based dynamic infrared thermography (DIRT). During the rewarming, the hotspots were marked, small rubber markers were taped to the registered sites, and then the patients were sent for a CT scan. The diagnostic performance of smartphone-based DIRT was evaluated by comparing the DIRT findings with CT angiography and intraoperative findings. RESULTS: DIRT detected 42 of the 57 dominant perforators in 24 limbs and resulted in a sensitivity of 73.7% and a positive predictive value of 65.6%. CONCLUSIONS: The sensitivity and positive predictive value of the smartphone-based DIRT are low. Currently, it should be used as an adjunctive tool together with the established imaging techniques.

Electrospinning of PELA/PPY Fibrous Conduits: Promoting Peripheral Nerve Regeneration in Rats by Self-Originated Electrical Stimulation.

Peripheral nerve injuries represent a great challenge for surgeons. The conductive neural scaffold has experienced increasing interest because of its good biocompatibility and similar electrical properties as compared to those of a normal nerve. Herein, nerve conduits made from poly(d,l-lactide)-co-poly(ethylene glycol) and polypyrrole (20%, 30%, and 50%) (PELA-PPY) were prepared by electrospinning, and used in regeneration of peripheral nerve defects. The results of an in vitro experiment indicated a high biocompatibility for the as-prepared materials, supporting the attachment and proliferation of a rat pheochromocytoma PC-12 cell. Furthermore, the PELA-PPY nerve conduit implanted in the sciatic nerve defects (10 mm) of the Spraguee-Dawley rats for 12 weeks showed similar results with the autograft, while it demonstrated a better outcome than the PELA nerve conduit in electrophysiological examination, sciatic function index, total amount of regenerated myelinated nerve fibers, axon diameter, myelin thickness, and several immunohistochemistry indices (S-100, laminin, neurofilament, bromodeoxyuridine, and glial fibrillary acidic portein). We supposed that the bioactivity is mainly generated by the PPY in composite nanofibers which could transmit self-originated electrical stimulation between cells. Due to the facile preparation and excellent in vivo performance, the PPY-PELA nerve conduit is promising for use as a bioengineered biomaterial for peripheral nerve regeneration.

HSV-2 vaccine: current status and insight into factors for developing an efficient vaccine.

Herpes simplex virus type 2 (HSV-2), a globally sexually transmitted virus, and also one of the main causes of genital ulcer diseases, increases susceptibility to HIV-1. Effective vaccines to prevent HSV-2 infection are not yet available, but are currently being developed. To facilitate this process, the latest progress in development of these vaccines is reviewed in this paper. A summary of the most promising HSV-2 vaccines tested in animals in the last five years is presented, including the main factors, and new ideas for developing an effective vaccine from animal experiments and human clinical trials. Experimental results indicate that future HSV-2 vaccines may depend on a strategy that targets mucosal immunity. Furthermore, estradiol, which increases the effectiveness of vaccines, may be considered as an adjuvant. Therefore, this review is expected to provide possible strategies for development of future HSV-2 vaccines.

Reverse facial artery flap to reconstruct the medium-sized defects in the middle facial region following cancer ablation.

This retrospective clinical study assessed the reliability of the reverse facial artery flap to reconstruct the medium-sized defects in the middle facial region following cancer ablation.Fifteen medium-sized defects were repaired with reversed facial artery flap following cancer surgery. The ages of the patients ranged from 2 to 69 years; 9 were male and 6 were female. The primary lesions included palate (5 cases), maxillary gingival (6 cases), cheek or buccal mucosa (3 case), and upper lip (1 case). The size of the skin paddle varied from 4.0 cm × 6.0 cm to 5.0 cm × 10.0 cm. Direct closure was achieved at all donor sites. Fourteen of the 15 flaps survived. No donor-site problems occurred. Two patients appeared to have temporary injury of facial nerve after operation. The follow-up period ranged from 8 to 36 months; 1 patient died as a result of local recurrence and 1 patient developed cervical recurrence.Consequently, it has been demonstrated that the reversed facial artery flap had reliable blood supply and can reliably and conveniently be used for reconstruction of the medium-sized defects, especially in the middle third of oral and maxillofacial region.

Telangiectatic osteosarcoma: a review of literature.

Telangiectatic osteosarcoma is a rare variant of osteosarcoma and hence its occurrence, presentation, and prognosis are poorly understood. With advancements in technology and available treatment options, the scenario of its diagnosis, management, and outcome has changed. Chemotherapy with surgery was challenged previously, but has now been proved to be beneficial. We reviewed the available literature and compared results to define the characteristics of the disease, its presentation, radiographic and pathologic features, optimal treatment, and prognosis.

[Case-control study on minimally invasive percutaneous new plate osteosynthesis applied in proximal humerus fractures in elder patients].

OBJECTIVE: To evaluate the clinical significance of minimally invasive percutaneous new plate osteosynthesis (MIPPO) applied in three and four-part fractures of proximal humerus in elder patients. METHODS: From June 2008 to December 2010, 98 old patients with three and four-part fractures of proximal humerus were treated with locking plate osteosynthesis. There were 43 males and 55 females with an average age of (71.3 +/- 6.2) years ranging from 65 to 84. Among them,47 cases were treated with minimally invasive percutaneous new plate osteosynthesis (MIPPO) through antrolateral transdeoltoid approach, and meanwhile 51 cases were treated with open reduction and internal fixation (ORIF) through a traditional deltopectoral approach. The operation time,blood loss,wound complications and hospital stay were recorded. The functional outcomes of the shoulder were assessed according to Constant score. RESULTS: Ninety-six patients were followed up for 13 to 42 months (averaged 18.1 months),and 2 patients died during the follow-up period. The mean blood loss of the MIPPO group was lower than that of the ORIF group by 125 ml (P < 0.05). There was no difference in the operation time between two groups. But the MIPPO group had a slightly shorter hospital stay than the ORIF group (P < 0.05). All the fractures united clinically and radiologically. The difference of the mean healing time between two groups was not significant. The mean Constant score at final follow-up of two groups had no statistic difference. But the rate of complication of the MIPPO group was lower than that of the ORIF group (P < 0.05). Only 1 case of the MIPPO group had axillary nerve paralysis post-operatively, but 4 cases had slack internal fixation and 2 cases had avascular necrosis of the humeral head in the ORIF group. CONCLUSION: The technique of percutaneous insertion combined new locking plate internal fixation has the advantages of less blood loss, rapid recovery, less vascular damage, lower risk of complications and so on. It can effectively treat the proximal humerus three-and four-part fractures, especially to elder patients with osteoporosis.

Changes of lymph metabolites in a rat model of sepsis induced by cecal ligation and puncture.

BACKGROUND: Sepsis is a clinical syndrome defined by a systemic response to infection and remains a prevalent clinical challenge. The underlying pathophysiology of sepsis is poorly understood. Using a metabolomic method, the present study observed changes in lymph composition during sepsis in a septic model in an attempt to find out new biomarkers for the early diagnosis and treatment of sepsis. METHODS: Adult male Sprague-Dawley rats underwent cecal ligation and puncture. Blood samples were obtained via the lateral caudal vein, and lymph was obtained from the thoracic duct. Cytokines were measured in plasma and lymph samples by enzyme-linked immunosorbent assay at different time points after cecal ligation and puncture. Rat lymph samples were analyzed by high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry. Multivariate analysis was used to profile potential biomarkers in rat septic lymph samples. RESULTS: Plasma and lymph tumor necrosis factor α, interleukin 1ß, and interleukin 6 levels were elevated in septic group as compared with the control. Of the 10 characteristic metabolites identified in the septic model, six (palmitoyl-L-carnitine, creatinine, phenylalanine, isonicotinic acid, choline, and 5-azacytidine) were high, and four (1-O-Hexadecyl-2-lyso-glycero-3-phosphorylcholine, alanine, 4-amino-5-hydroxymethyl-2-methylpyrimidine, and asymmetric dimethylarginine) were low. CONCLUSION: These biomarkers were mainly involved in energy metabolism and vascular tone and may prove beneficial to distinguish sepsis from other inflammatory conditions or predict outcomes.

[Clinical study of submental artery island myocutaneous flap for reconstruction of oral and maxillofacial defects following operation].

OBJECTIVE: To evaluate the outcome and indication of the reconstruction of oral and maxillofacial postoperative defects by submental artery island myocutaneous flaps. METHODS: Sixty eight cases with the reconstruction of oral and maxillofacial defects by submental artery island myocutaneous flaps from January 2006 to May 2010 were analysed retrospectively. Primary lesions included carcinomas originating from tongue (28 cases), palate (13 cases), mouth floor (9 cases), gingiva (4 cases), buccal mucosa (6 cases), lip (3 cases), and other malignant or benign tumors (5 cases). The ages ranged from 25 to 84 years (mean 58 years); 47 males and 21 females. The sizes of skin paddle varied from a minimum of 4 cm × 4 cm to a maximum of 15 cm × 10 cm. RESULTS: Of the 68 flaps, 62 were survival, 4 had partial necrosis but healed with treatments, and 2 failed due to complete necrosis. Appearance and functions of recipient sites were satisfactory. The followed-up time was 3 - 24 months, local recurrence occurred in 5 cases and cervical lymph node metastases were found in 15 patients. CONCLUSION: Submental island flap is reliable for the reconstruction of postoperative defects in early oral cancer without regional lymph node metastasis or in benign tumor.

Application of CAD/CAM-assisted technique with surgical treatment in reconstruction of the mandible.

OBJECTIVE: The purpose of this clinical study was to explore the optimal method of reconstruct mandible defects individually and immediately. STUDY DESIGN: Three-dimensional model simulation technique and vascularized fibular osteomyocutaneous flap were used to repair 15 cases of mandible defects, which were caused by ameloblastoma. A three-dimensional computed tomography (CT) images were converted to a virtual model using CAD software and the 3-dimensional (3D) simulated resin models of skeleton and fibula were used to design the osteotomies, bone segment replacement and titanium mesh shaping preoperatively. RESULTS: Fibula flaps were alive and no complication occurred. The patients were satisfied with the results both esthetically and functionally. CONCLUSIONS: This preliminarily clinical study and case demonstrated that CAD/CAM-assisted technique with surgical treatment offers an individual anatomical reconstruction of the mandible in ameloblastoma patients. The procedures guarantee intraoperatively an exact placement of the preformed mesh even for precise reconstruction of extensive mandible defects.

[Responses of pancreatic cancer cells to stimulations by nerve growth factor and the role of Trk-A expression].

OBJECTIVE: To study the responses of different pancreatic cancer cells to stimulations by nerve growth factor (NGF) and explore the role of Trk-A in such responses. METHODS: Five pancreatic cancer cell lines (MIA-PaCa-2, PANC-1, SW-1990, AsPC-1, and BxPC-3) were exposed to different concentrations of NGF (0, 4, 20, 100, and 500 ng/ml). MTT and Matrigel invasion method were used to observe the changes in the cell proliferation and invasion ability. Trk-A expression in these cells was detected by PCR and Western blotting, and the relations of Trk-A expression to the cell proliferative and invasive abilities following NGF treatment were analyzed. RESULTS: NGF at 100 ng/ml most obviously stimulated the cell proliferation, and PANC-1 cells showed the highest while AsPC-1 cells showed the least sensitivity to 100 ng/ml NGF stimulation. Matrigel invasion test showed that NGF enhanced the invasiveness of PANC-1 and MIA-PaCa-2 cells but produced only limited effect on AsPC-1 cells; the effect of NGF was completely inhibited by the Trk-A inhibitor CEP701. The expression levels of Trk-A mRNA and protein were the highest in PANC-1 cells and the lowest in AsPC-1 cells. CONCLUSION: NGF can enhance the proliferation and invasiveness of pancreatic cancer cells, and this effect is possibly mediated by Trk-A protein.

Disorders in angiogenesis and redox pathways are main factors contributing to the progression of rheumatoid arthritis: a comparative proteomics study.

OBJECTIVE: To clarify the pathogenesis of rheumatoid arthritis (RA) by comparing protein expression in fibroblast-like synoviocytes (FLS) from patients with RA with that in FLS from normal subjects, using proteomics analysis. METHODS: Proteins extracted from primary cultures of FLS obtained from 50 patients with RA and 10 normal subjects were analyzed by automated 2-dimensional nano-electrospray ionization liquid chromatography tandem mass spectometry. Differentially expressed proteins were screened by 2-sample t-test (P < 0.05) and fold change (>1.5), based on the bioinformatics analysis. The expression of vasculature development-related proteins (Thy-1, connective tissue growth factor [CTGF], and thrombospondin 1 [TSP-1]) and redox-related proteins (superoxide dismutase 2 [SOD2]) in synovial tissue was confirmed by real-time polymerase chain reaction and Western blotting. The effect of Thy-1 and CTGF knockdown on Thy-1, CTGF, TSP-1, and vascular endothelial growth factor (VEGF) was analyzed by RNA interference experiments. RESULTS: According to the criteria of having >1 unique peptide per protein present and a false discovery rate of ≤5%, 1,060 proteins were identified from patients with RA, and 1,292 proteins were identified from normal subjects, from which 100 differentially expressed proteins were screened out from the RA proteins. Of these, 46 proteins were up-regulated, and the remaining 54 proteins were down-regulated. Gene ontology and pathway analyses showed that 6 vasculature development-related proteins were up-regulated, including Thy-1, CTGF, and TSP-1, while 11 redox-related proteins were down-regulated, including SOD2. The results were consistent with those obtained using mass spectrometry. Thy-1, VEGF, CTGF, and TSP-1 were down-regulated after Thy-1 knockdown, and VEGF and CTGF were down-regulated after CTGF knockdown. Recombinant human CTGF could enhance proliferation and Transwell migration of human umbilical vein endothelial cells. CONCLUSION: Up-regulation of vasculature development-related proteins and down-regulation of redox-related proteins in FLS are predominant factors that may contribute to the pathogenesis of RA.

Connective tissue growth factor, a regulator related with 10-hydroxy-2-decenoic acid down-regulate MMPs in rheumatoid arthritis.

10-hydroxy-2-decenoic acid (10H2DA) is suggested to be a potential medication for rheumatoid arthritis (RA) by activation of matrix metalloproteinases (MMPs) via mitogen-activated protein kinase signaling pathways. The aim of the present work was to seek differentially expressed proteins in rheumatoid arthritis synovial fibroblasts (RASFs) treated with 10H2DA by comparative proteomics analysis. Two-dimensional electrophoresis (2-DE) and LC-MS/MS were performed to identify changes in protein expression after 24-h 10H2DA treatment. Differentially expressed proteins were identified by real-time PCR and Western blot analysis. Influence of down-regulation of connective tissue growth factor (CTGF) expression on MMPs was studied by RNAi. Ten proteins were up-regulated and 9 proteins were down-regulated after 24-h 10H2DA treatment. A total of 19 differentially expressed proteins were identified and found to be associated with glycolysis, lipid metabolism, cell adhesion, ATP synthesis, oxidation reduction, and anti-apoptosis. CTGF, a member of the C-terminal cystein-rich proteins (CCN) family, was down-regulated after 24-h 10H2DA treatment. MMPs were down-regulated after RNAi (CTGFi). These results suggest that CTGF is a regulator factor in the expression of MMPs, and 10H2DA down-regulate the concentration of MMPs probably by down-regulating the expression of CTGF.

Efficacy survey of swallowing function and quality of life in response to therapeutic intervention following rehabilitation treatment in dysphagic tongue cancer patients.

PURPOSE: This quasi-experimental parallel cluster study was carried out to investigate the utility of interdisciplinary swallowing therapy exercises in improving swallowing function and quality of life (QOL) in dysphagic cancer patients following tongue resection and subsequent rehabilitation treatment. METHODS: All subjects in the experimental group underwent a structured swallowing training program. The subjects in the experimental group (n = 23) received 30 min of swallowing training each day, 6 days per week for 2 weeks. The control group (n = 23) received no training. Analysis of variance was used, and the M.D. Anderson Dysphagia Inventory (MDADI) discriminated between groups of subjects. RESULTS: Patients who underwent structured swallowing training (n = 23) showed improvement in the overall MDADI score (P < 0.01) compared with the control population. Furthermore, a separate analysis of individual domains of the MDADI (global, emotional, functional, and physical) demonstrated improved QOL. Although the mean score for tongue rehabilitation indicated that ≥50% subjects in the functional subscale were improved compared with the control population, the difference was not statistically significant (P > 0.05). CONCLUSIONS: This study used objectively timed swallowing tests, an interdisciplinary swallowing therapy protocol, and a swallowing questionnaire to evaluate the effects of swallowing training. We found that implementation of swallowing education and exercises improved dysphagia and QOL in cancer patients following tongue resection and rehabilitation. Furthermore, this study indicated that swallowing safety and dysphagia training for nursing professionals is effective.

Expression of the membrane-cytoskeletal linker Ezrin in salivary gland adenoid cystic carcinoma.

OBJECTIVE: The aim of this study was to investigate the relationship between membrane cytoskeleton linker protein Ezrin and CD44v6, iNOS, Ki-67, and clinicopathologic characteristics, and the prognostic significance of Ezrin expression in salivary gland adenoid cystic carcinoma (SACC). STUDY DESIGN: Immunohistochemistry and reverse-transcription polymerase chain reaction were used to quantify the expression of Ezrin, CD44v6, inducible nitric oxide synthase (iNOS), and Ki-67 in 75 primary SACCs, 25 tumor-free salivary tissues, and 2 SACC cell lines (ACC-M and ACC-2). Survival analysis was performed to find the prognostic significance of Ezrin expression. RESULTS: Expressions of Ezrin, CD44v6, iNOS, and Ki-67 in SACC tissues, especially with distant metastasis, were significantly higher than in tumor-free tissues. Ezrin mRNA and protein levels in ACC-M cells were significantly higher than in ACC-2 cells. Ezrin, CD44v6, iNOS, and Ki-67 expressions were significantly higher in solid pattern than in cribriform and tubular patterns. Ezrin and its partners, CD44v6, iNOS, and Ki-67, were significantly related to tumor size, clinical stage, perineural and vascular invasion, and recurrence. Furthermore, Ezrin had an independent prognostic effect on overall survival. CONCLUSIONS: The increased expression of Ezrin and its partners, CD44v6, iNOS, and Ki-67, in SACC correlated with histologic patterns, may play a role in distant metastasis, and might indicate poor clinical outcome.

Reverse facial artery-submental artery deepithelialised submental island flap to reconstruct maxillary defects following cancer ablation.

OBJECTIVE: The present study assessed the reliability of the reverse facial artery-submental artery deepithelialised submental island technique to reconstruct maxillary defects. METHODS: The study included 13 patients (9 men and 4 women; 43-62 years) with maxillary defects resulting from cancer ablation. Ten patients presented with maxillary gingival squamous cell carcinoma and the remaining 3 cases were hard palate squamous cell carcinomas. The maxilla was resected and the remaining defects were classified as Class 2a. Reverse facial artery-submental artery deepithelialised submental island flaps measuring 8-10 cm in length and 4-5 cm in width were used to reconstruct the defects. RESULTS: Twelve of the 13 flaps survived. No donor-site problems or palsy of the marginal mandibular branch of the facial nerve occurred. The follow-up period ranged from 8 to 24 months, 1 patient died as a result of local tumour recurrence and 2 patients developed cervical recurrence. CONCLUSION: The reverse facial artery-submental artery deepithelialised submental island flap is safe, quick and simple to use or elevate. The flap is a reliable technique for reconstructing maxillary defects following cancer ablation.

Peripheral nerve regeneration using composite poly(lactic acid-caprolactone)/nerve growth factor conduits prepared by coaxial electrospinning.

Many neurotrophic factors have been shown to promote neurite outgrowth by improving the microenvironment that is required for nerve regeneration. However, the delivery of these bioactive agents to the nerve injury site, as well as effective and local release, remains a challenging problem. We have developed a novel composite nerve conduit comprised of poly(lactic acid-caprolactone) (P(LLA-CL)) and nerve growth factor (NGF). This was developed from core-shell structured biodegradable nanofibers, which were fabricated by coaxial electrospinning of P(LLA-CL) for the shell and bovine serum albumin (BSA) or BSA/NGF for the core. In rats, gaps of 10-mm long sciatic nerves were bridged using an autograft, an empty P(LLA-CL) conduit, a NGF injection P(LLA-CL) conduit, a P(LLA-CL)/NGF composite conduit, respectively. Regenerated nerve fibers were harvested and morphological and functional evaluation of nerve regeneration was performed at 12 weeks postsurgery. Although partial biodegradation and small cracks in the conduits were observed, the conduit outlines remained intact for 12 weeks after surgery. Based on functional and histological observations, the number and arrangement of regenerated nerve fibers, myelination, and nerve function reconstruction was similar in the P(LLA-CL)/NGF conduit group to that of the nerve autograft group (p > 0.05), but was significantly greater to the empty P(LLA-CL) and injection NGF P(LLA-CL) conduit groups (both p < 0.05). Therefore, the composite P(LLA-CL)/NGF conduit, which exhibited favorable mechanical properties and biocompatibility, could effectively promote sciatic nerve regeneration in rats.

Aesthetic and functional radical surgery in young patients with stage one or two tongue cancer: a preliminary report.

INTRODUCTION: The effect of an initial radical cure and the post-operative quality of life in young patients with stage one or two tongue cancer seems to be more important than in old patients. The aim of this study was to achieve both optimal surgical effectiveness and improved post-operative quality of life for young patients with stage one or two tongue cancer. MATERIALS AND METHODS: 7 patients under 40 years of age with T(1)-T(2)N(0)M(0) squamous cell carcinoma of tongue underwent aesthetic and functional radical surgery in which reconstruction of the defect in the oral cavity and conservation of the main functional organs in neck with good scar aesthetics in the face and neck were performed. The outcomes were assessed clinically. RESULTS: No tumour recurrence was found in the tongue, floor of mouth or neck at the end of follow-up (at least 37 months). The appearance of the tongue and oral function was retained; function in face, neck and shoulder was maintained; a satisfactory cosmetic appearance of the face and neck was achieved. CONCLUSIONS: Aesthetic and functional radical surgery could ensure radical cure and unchanged, or improved post-operative, quality of life in young patients with stage one or two tongue cancer.