Clinical application of thoracodorsal artery perforator flaps in the repair of head and neck defects / 中华耳鼻咽喉头颈外科杂志

Objective: To analyse the clinical application of thoracodorsal artery perforator flaps (TDAPF) in the repair of head and neck defects. Methods: A retrospective review was conducted on 38 patients with oral and maxillofacial head and neck malignant tumors who underwent radical resection of oral and oropharyngeal carcinoma and TDAPF repair in the Department of Oral and Maxillofacial Head and Neck Oncology of the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from June 2017 to November 2018. Among them, 32 were males and 6 were females, aged 30-74 years. Flap size, vessel pedicle length, diameter and number of perforators, and flap fat thickness were recorded and counted. Elasti Meter and Skin Fibro Meter were applied to measure the skin elasticity and hardness in the donor areas of 4 kinds of skin flaps before the flap preparation. SPSS 19.0 statistical software was used for statistical analysis of the data. Results: All the flaps survived (100%). The mean elasticity of TDAPF [(41.2±12.9) N/m] was significantly lower than that of anterolateral thigh [(77.6±23.3) N/m, χ²=88.89, P<0.05], anterolateral thigh [(62.6±17.7) N/m, χ²=59.99, P<0.05] and or forearm flap [(51.7±8.6) N/m, χ²=37.82, P<0.05]. The hardness of TDAPF [(0.037±0.016) N] was also significantly lower than that of anterolateral femoral [(0.088±0.019) N, F=93.27, P<0.05], anteromedial femoral [(0.059±0.020) N, F=25.71, P<0.05] or forearm flap [(0.062±0.016) N, F=29.11, P<0.05]. Follow-up period ranged from 2 to 14 months. The 38 patients treated with TDAPF had a good recovery of the functions in the recipient areas, and the scars of the donor areas were not obvious after surgery, without serious complications. Conclusion: TDAPF is suitable for reconstruction of head and neck defect, with ductile texture and good recovery of the morphology and function of head and neck.

Multidisciplinary team model for patients with oral cancer and systemic diseases: an expert consensus / 华西口腔医学杂志

Large general hospitals currently play an increasingly important role in the diagnosis and treatment for acute critical patients and difficult diseases because of the development of dual referral system and hierarchical diagnosis, as well as the formation of medical treatment alliance. Patients with oral cancers are often associated with systemic diseases, which increases the complexity of the condition. Thus, meeting the demand through the traditional single medical model is difficult. As such, a multidisciplinary team (MDT) model has been proposed and has achieved a good clinical effect. To standardize the application of this model, we organized an event in which relevant experts discussed and formulated a consensus to provide standardized suggestions on the MDT process and the diagnosis and treatment of common systemic diseases as reference for clinical practice.

Biomechanical evaluation on prosthetic retention program for hemi-maxillary defects / 医用生物力学

Objective To make biomechanical evaluation on three prosthesis retention schemes for unilateral maxillary defects-clasp retention, one or two zygomatic implants and zygomatic implant and clasp united retention. Methods A three-dimensional (3D) finite element model of normal human skull was constructed based on CT scan data. The maxillary complex stress distributions on three reconstructed models were calculated and analyzed by 3D finite element method to make comprehensive comparison on stress level of the prosthesis, abutment, clasp, implants and zygoma. Results For single clasp retention, peak stress of the abutment was 130.7 MPa, and displacement of the prosthesis was 4.439 mm, while peak stress of the clap was 452.4 MPa, and stress of the contralateral orbital rim was 23.32 MPa. After one zygoma was implanted, the stress of the clap was reduced to 118.1 MPa, while peak stress of the abutment was 31.12 MPa, and stress of the contralateral orbital rim was only 5.387 MPa. For two zygomatic implant retention, zygomatic stress was decreased from 66.11 MPa to 48.12 MPa, and the maximum stress on the zygomatic implants was reduced from 500.2 MPa to 313.8 MPa. Conclusions For zygomatic implant and clasp united retention, the maxillofacial skeleton stress distributions were more consistent with the rules of bite force transduction. The research findings will provide important references for design and optimization of human unilateral maxillary defect reconstruction program.

Study on neck management for tongue squamous cell carcinoma of cN0 stage / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This retrospective study is to analyze the outcomes of cN0 stage tongue squamous cell carcinoma and to discuss a reasonable neck management for these cases.</p><p><b>METHODS</b>Totally 132 cases of cN0 stage tongue squamous cell carcinomas were included. Seventy-one cases were performed neck dissection(group ND), 61 cases were under wait-and-see (group WS). The clinical, pathological and follow up data of two groups were analyzed.</p><p><b>RESULTS</b>The cumulative three-year-survival between group ND and group WS were 87.3% and 83.4% respectively. In group ND, the survival of T1 and T2 cases were 89.3% and 83.3% respectively, while 89.6% and 58.3% in WS. For T2b cases which the size was larger than 3.0 cm, the survival of group WS was greatly lower than that of group ND. Both in ND and WS groups. The pathologically poor differentiation cases got poor survival than middle and well cases.</p><p><b>CONCLUSION</b>The wait-and-see policy is recommanded for T1 stage cN0 tongue squamous cell carcinoma. For T2 cases that the tumor size is smaller than 3.0 cm, the wait-and-see is also reasonable, while the neck dissection should be considered in cases of poor differentiation. For large T2 cases, the selective neck dissection should be performed.</p>

Investigation of mRNA expression of collagen genes in oral squamous cell carcinoma and paired normal tissue / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the mRNA expression of collagen genes in oral squamous cell carcinoma (OSCC) and paired normal oral mucosal tissue.</p><p><b>METHODS</b>The differential mRNA expressions of collagen genes between 30 OSCC tissues and the paired normal oral mucosal tissues were detected by RT-PCR.</p><p><b>RESULT</b>The relative expression level of COL1A1 mRNA in the 30 cancerous tissues was up-regulated by 2.78 folds as compared with its expression in the paired normal samples, suggesting its significant overexpression in OSCC (P<0.001). The expression levels of COL1A2, COL4A1, COL4A2, and COL5A2 mRNA in the cancerous tissues were up-regulated by 1.07, 1.15, 1.27, and 1.16 folds compared to those in paired normal samples (P>0.05).</p><p><b>CONCLUSION</b>COL1A1 mRNA overexpression may play an important role in the carcinogenesis of OSCC and can be a potential molecular marker of OSCC.</p>

Establishment of an animal model of widening distraction of tubular bone with dental implant distractor / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To establish an animal model of widening distraction of tubular bone with dental implant distractor (DID) and investigate radiographical and histomorphological changes of long tubular bone following widening distraction with dental implant.</p><p><b>METHODS</b>Twelve Chinese mountain goats were used. Two sets of DID were installed in each goat's tibiae. After an 8-day latency period, nine tibiae were distracted at a rate of 0.35 mm each time and 2 times per day using DID devices. Radiography and histomorphology were used to evaluate the new generated bone in different period after distraction. The other three animals served as sham control.</p><p><b>RESULTS</b>After 10 - 14 days' distraction, the average width of the tibiae increased by 7.83 mm. Digital subtraction angiography (DSA) showed that there was a similarity between goat's tibiae and human's fibula in the blood supply. From the end of distraction to 3-month after the consolidation period, radiography demonstrated that the distraction gaps gradually became vague and filled with newly formed bone. The histomorphological study showed different results of bone formation in both distracted gaps. The osseointegration between bone and implant only occurred at screw-shaped part, while the moving part in tibiae was encapsulated by fibrous tissue.</p><p><b>CONCLUSIONS</b>There are lots of similarities between goat's tibiae and human's fibula in anatomy and blood supply. The model of widening distraction osteogenesis of the goat's tibiae is ideal for studying human's fibula.</p>

Three-dimensional finite element analysis of the mandible reconstruction with fibula / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To construct a three-dimensional finite element model of reconstructed mandible and analyze the stress distributions of the model.</p><p><b>METHODS</b>CT scan and CAD/CAM software was used to develop the three-dimensional finite element model of reconstructed mandible and stress analysis was performend with ANASYS 7.0 software.</p><p><b>RESULTS</b>The three-dimensional finite element models of normal mandible and reconstructed mandible were constructed. The stress analysis discovered an unbalanced stress distribution in the mandible.</p><p><b>CONCLUSION</b>Reconstructing mandible with fibular flap not only damages its structure, but also induced the badness of its biomechanical environment, in which condyle was the most sensitive region during the stresses in the mandible were changed.</p>

Application of individualized free anterolateral thigh combined flap for tongue and mouth floor defects resulted from tongue carcinoma / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the application of individualized free anterolateral thigh combined flap (ALTCF) for tongue and mouth floor defect resulted from tongue carcinoma.</p><p><b>METHODS</b>From 2006 to 2008, individualized ALTCFs were used in 31 cases of tongue and mouth floor defects resulted from tongue carcinoma. The nutritional perforator vessel was musculocutaneous pattern in 22 cases and septocutaneous pattern in 9 cases. The size of the flaps and the included muscle was (4-8) cm x (5-10) cm and (2-5) cm x (3-6) cm, respectively. The length of blood vessel pedicle was (6.81 +/- 3.23) cm.</p><p><b>RESULTS</b>All the 31 free flaps survived with primary healing and no complication. The appearance and function were both satisfactory. During the follow-up period of 1-3 years, 28 cases survived, 2 cases were reoperated due to the neck lymphatic metastasis on the contralateral side. 1 case died of distant metastasis.</p><p><b>CONCLUSIONS</b>Individualized ALTCF is a reliable flap for the tongue and month floor defects resulted from tongue carcinoma. Both the cosmetic and functional results are satisfactory with less morbidity in donor site and less complication.</p>

Experimental study of tissue-engineered biological small intestinal submucosa, membrane employed in dental implant traction / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To construct the tissue-engineered biological small intestinal submucosa(SIS) membrane and evaluate the feasibility of its use as a surrogate of periosteum and its possible role in dental implant distraction (DID).</p><p><b>METHODS</b>The tissue-engineered biological SIS membrane was constructed through the co-culturing of boat bone marrow stromal cells (BMSC) and small intestinal submucosa. The cellular compatibility was evaluated with the phase contrast microscope, SEM, alkaline phosphatase(ALP) activity and histology, and its effect of osteogenesis promotion was detected by Micro-CT and histology after implanted in the exposed side of DID operation.</p><p><b>RESULTS</b>The phase contrast microscope, SEM, ALP activity and histology confirmed that the BMSC could adhere to SIS and proliferate on it normally, the cellular activity and function were not affected by SIS. Three months after the tissue-engineered biological SIS membrane was implanted into the exposed side, some discontinuous new bone in the "biological SIS membrane" group was detected by the Micro-CT under a higher window level. The histology revealed that there was a quantity of new bone in the distracted region and the majority was woven bone. The quantity and quality of the new bone in the "biological SIS membrane" implanted group were similar to the unexposed side, but the bone nonunion was detected in the un-implanted group and the interspace was fixed by fibrous connective tissue.</p><p><b>CONCLUSIONS</b>The tissue-engineered biological SIS membrane can provide both daughter cells, guide bone regeneration in DID and promote the osteogenesis. But the outcome of the biological SIS membrane, especially the function of the osteoblast cultured in the SIS in new bone formation, still needs further study.</p>

Expression of MMP1 mRNA in oral squamous cell carcinoma and paired normal tissues / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the mRNA expression of matrix metalloproteinase 1 (MMP1) gene in oral squamous cell carcinoma (OSCC) and the paired normal tissues.</p><p><b>METHODS</b>The differential expression of MMP1 mRNA between 30 OSCC and paired normal tissues were detected with reverse transcription-PCR (RT-PCR).</p><p><b>RESULTS</b>The relative expression level of MMP1 mRNA in the OSCC tissues showed a 3.26-fold increase in comparison with that in the paired normal tissues (4.06-/+0.52 vs 1.24-/+0.17, P<0.0001). In the 30 OSCC tissues, the relative expression level of MMP1 mRNA was higher in histological grade II/III tissues (4.31-/+0.68) than in grade I (3.87-/+0.57) tissues, higher in OSCC in advanced stages (III/IV) than in tumors in early stages (I/II) (4.18-/+0.67 vs 3.65-/+0.53), and also higher in OSCC with cervical lymph node invasion than in those without cervical lymph node invasion (4.32-/+0.71 vs 3.91-/+0.51), but these differences were not statistically significant (P>0.05).</p><p><b>CONCLUSION</b>MMP1 gene may play a role in local invasion of OSCC, and can serve as a potential biomarker molecule for diagnosis, treatment and prognostic evaluation of OSCC, with also clinical value for OSCC classification.</p>

Expression of osteopontin mRNA in oral squamous cell carcinoma and normal oral mucosa / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate osteopontin (OPN) mRNA expression in oral squamous cell carcinoma (OSCC) and normal oral mucosa tissues.</p><p><b>METHODS</b>Differential OPN gene expression were detected in 30 cancerous tissues and their paired normal tissues using real-time reverse transcription-PCR (real-time RT-PCR), and the data were analyzed statistically.</p><p><b>RESULTS</b>Real-time RT-PCR results demonstrated that the relative expression level of OPN mRNA in the cancerous tissues were significantly higher than that in paired normal samples (4.17-/+0.51 vs 0.97-/+0.12, P<0.001), showing a 4.3-fold up-regulation. In the 30 OSCC specimens, OPN mRNA expression in the OSCC of histological grades I showed a 3.1-fold down-regulation, significantly lower than the expression in grade II/III tumors (2.16-/+0.17 vs 6.80-/+0.72, P<0.05); its expression was significantly lower in early stage than in advanced stage OSCCs (2.34-/+0.17 vs 4.73-/+0.35, P<0.05). In cases of cervical lymph node metastasis, the expression was significantly higher than that in cases without lymphatic metastasis (6.38-/+0.56 vs 2.89-/+0.32, P<0.05).</p><p><b>CONCLUSION</b>OPN mRNA overexpression may play an important role in OSCC carcinogenesis and can be a potential target for OSCC therapy.</p>

Clinical outcome of dental implants placed in fibula-free flaps for orofacial reconstruction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Functional reconstruction of the jaw defect due to tumor resection poses a challenging problem in maxillofacial surgery. The osteocutaneous fibula free flap in combination with simultaneous or second stage insertion of dental implants has exhibited growing popularity for such reconstructions. This study was aimed at evaluating the clinical status and the success rates of dental implants inserted in fibula-free flaps for orofacial reconstruction following ablation of tumors.</p><p><b>METHODS</b>We conducted a clinical follow-up study based on 29 patients after oral tumor surgery, who received vascularized fibula bone grafts and endosseous implants for functional jaw reconstruction during a 5-year period. The follow-up protocol included clinical examination and radiological evaluation. The clinical records of the patients were reviewed retrospectively. Information on treatment modalities, dentition, implant parameters, and prostheses was collected and analyzed.</p><p><b>RESULTS</b>In general, a high primary stability for implants placed into the free fibula grafts was achieved. The 1-year and 5-year cumulative survival rates of the implants were 96% and 91%, respectively, using the Kaplan-Meier method. The 1-year and 5-year cumulative success rates of implants placed into the fibula bone grafts were 95% and 87%, respectively. The main reasons for failure of the dental implants were infection, tumor recurrence and soft tissue proliferation. The fibula flap presents many advantages for implant placement, but its limited height sometimes makes implant-supported prosthetic rehabilitation difficult.</p><p><b>CONCLUSIONS</b>Vascularized fibula bone grafts provide a firm basis for the placement of dental implants in jaw reconstruction. Implants placed in fibula bone grafts were shown to integrate normally. The double-barrel technique, or increasing the height of the fibula flap by vertical distraction osteogenesis before implant placement in the mandible, is desirable from a functional and esthetic point of view.</p>

Vascularized iliac crest graft with internal oblique muscle for immediate reconstruction of composite mandibular defect / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the vascularized (deep circumflex iliac vessels) iliac crest graft with internal oblique muscle as a method for reconstruction of composite mandibular defect.</p><p><b>METHODS</b>Vascularized iliac crest graft with internal oblique muscle was used to reconstruct the composite mandibular defects in 10 patients. All clinical data were analyzed retrospectively. A detailed inspection of the case-notes was undertaken to ascertain the presenting diagnosis, the surgery, the complications and the outcome. The type of mandibular defect was recorded.</p><p><b>RESULTS</b>Of the 10 patients with composite mandibular defects including mandibular body, mandibular angle, mandibular ramus and the soft tissue around them, 7 patients were recorded with the defects of mandibular condyles. During the follow-up period from 3 months to 24 months, primary wound healing was observed in all patients, except one patient with minor muscular necrosis. All patients were satisfied with their facial contour and mandibular shape, without tumor recurrence. Donor site problems important enough to be recorded in the notes were minimal.</p><p><b>CONCLUSIONS</b>The vascularized iliac crest graft with internal oblique muscle offers a useful solution for reconstruction of composite mandibular defect. There is sufficient height and depth of bone to maintain a facial contour and mandibular shape. It can be used as a routine surgical technique to reconstruct composite mandibular defect.</p>

The histomorphological changes of tubular bone following widening distraction osteogenesis / 中华整形外科杂志

<p><b>OBJECTIVE</b>The purpose of this experimental study was to investigate the histomorphological changes of tubular bone following widening distraction osteogenesis.</p><p><b>METHODS</b>Twelve Chinese mountain goats were subjected to the study. After the procedure of vertical and horizontal osteotomy, two widening distraction osteogenesis devices were put in each goat's left tibiae. After an 8-day latency period, nine tibiae were widening distracted; another three tibiae served as sham control group. Every three animals from the experimental group were sacrificed in different consolidated periods including 1-month, 2-month, and 3-month. Radiography, tetracycline double labeling, histomorphology, as well as biomechanics were used to evaluate the quality and quantity of new generated bone in different consolidated period after distraction osteogenesis.</p><p><b>RESULTS</b>After a distraction period, the average width of the tibiae is increased 7.83mm. From the end of distraction to 3-month after the consolidation period, radiography demonstrated that the distraction gaps gradually became vague. Tetracycline double labeling showed that the double labeling brands were rarely seen in normal cortex bone, but strongly increased in the distracted callus. Mineralization rates (MR) has a significant difference (P < 0.05) within distracted callus region compared with control cortex bone. Histomorphological study shows that there was a different result in two sides of vertical distracted gaps. The non-exposure side had a good bone formation, while a non-union of bone occurred at the exposure side. Three months after consolidation period, part of the gap in exposure side was filled with dense connection tissue, whereas the distracted callus had been remodeled and become lamellar bone in non-exposure side. The control group showed normal fracture healing procedure.</p><p><b>CONCLUSIONS</b>There was a different outcome in two sides distraction gaps of tubular bone following widening distraction osteogenesis. A viable and well-perfused soft-tissue envelope in the area of distraction osteogenesis is important for creation of sufficient amount of new bone during distraction osteogenesis.</p>

A retrospective study of 541 cases with segmental resection of mandible / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the epidemiology and treatment of segmental defect of mandible.</p><p><b>METHODS</b>A total of 541 patients were evaluated retrospectively. The character of the mandibular defect and method of reconstruction were analyzed.</p><p><b>RESULTS</b>The majority of segmental defect of mandible were found in 40 - 70 years old males and the leading cause was tumor. The reconstruction methods included soft flap, reconstruction plate and bone grafts. The main complications were infection and fistula.</p><p><b>CONCLUSIONS</b>Tumor was the main cause of segmental resection of mandible, which occurs mainly in adult males. The body of the mandible was often involved. Vascularized bone grafts were the main methods in reconstruction of mandible.</p>

Surgery of the carotid artery: a retrospective study of 35 consecutive cases / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To retrospectively analyze a single institution's experience with surgery of the carotid artery performed as part of an oncological procedure and emergency hemostasis, with the aim to determine the preoperative methods for evaluation of cerebral circulation, selection of surgical procedures and perioperative complications.</p><p><b>METHODS</b>From January 1999 to December 2004, a total of 35 patients underwent carotid artery surgery including repair of carotid artery in 7 cases, ligation or resection of carotid artery in 17 cases, and reconstruction of carotid artery in 11 cases. All the patients were evaluated for blood flow in the circle of Willis with DSA, DSA plus TBO plus SPECT, and TCD and followed up from 4 months to 4 years. The perioperative complications and surgical outcomes were recorded and analyzed.</p><p><b>RESULTS</b>There were 16 carotid body tumors, 1 malignant carotid body tumor, 17 malignant tumors involving the carotid artery and 1 traumatic arterio-venous fistula. Twenty-seven patients underwent carotid occlusion test, 10 were positive and 17 were negative (tolerable). Of 7 cases with repair of the carotid artery, 1 patient died of uncontrolled bleeding due to rupture of the anastomosis, and the remaining was uneventful. Of 17 cases with ligation or resection of the carotid artery, 4 developed neurologic deficit 2 weeks postoperatively. Three patients with malignant tumors died 1 month, 4 months, and 4 months postoperatively, respectively. One patient with carotid artery body tumor complained of inarticulate speech 4 months after operation; another patient complained of incapability and limited movement of the ipsilateral upper limbs; 5 patients complained of dizziness 4, 6, 12, 24 and 48 months postoperatively. Of 11 patients who underwent carotid reconstruction, no major cerebral complications were noted after operation. One patient died of recurrence, 1 patient with carotid body tumor complained inarticulate speech and incapability of the contralateral limbs, the remaining was uneventful. Color Doppler showed patent vascular graft 1 year postoperatively.</p><p><b>CONCLUSIONS</b>TBO plus SPECT is a reliable method for evaluation of the circle of Willis currently. The short term and long term complications of ligation of carotid artery are high, therefore, resection and revascularization of the carotid artery is advocated for carotid artery tumors when possible.</p>

The installation of zygomatic implants and drilling guide / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To discuss the technique of installation of zygomatic implants in severely resorbed edentulous maxillae, and maxillary defect.</p><p><b>METHODS</b>Five patients received 8 zygoma implants and 11 dental implants. On the basis of an axial spiral CT data, anatomical models of natural size were manufactured using CAD/CAM system and before operation preoperative measurements of relevant parameters (length, areas, and volumes) carried out. Theses maxillary and zygomatic measurements obtained were referred for installing zygomatic implants.</p><p><b>RESULTS</b>The ideal direction and position of installation of the 8 zygomatic fixtures were obtained in 5 patients. The anatomical model and surgical plate were used for preoperative planning and intraoperative control of the insertion of zygomatic fixtures. The implants could be positioned precisely as preoperatively planned. The length of the zygomatic implants was between 40 mm and 50 mm.</p><p><b>CONCLUSIONS</b>The use of surgical drilling guides should be encouraged for zygomatic implant placement. 3-D image data and anatomical models improves preoperative planning and facilitates clinical procedure.</p>

Diagnosis and treatment of high-flow vascular malformation of the jaws / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To report our experience on diagnosis and treatment of the high-flow vascular malformation of the jaws.</p><p><b>METHODS</b>Thirty-seven cases of high-flow vascular malformation of the jaws (6 cases in maxilla and 31 in mandible) were comprised this study. Twenty-one patients were embolized with coils and N-buty1-2-cyanoacrylate, and 16 cases underwent surgery. The embolization was carried out with both arterial and venous route.</p><p><b>RESULTS</b>Different signs of the lesions were demonstrated on X-ray plain film, such as locular, rough of bone trabecula and soap bubble-like changes, frequently accompanied by dilatation of the mandibular nerve canal. CT scan showed unilocular and multilocular radiolucency. T(1)WI and T(2)WI on MRI exhibited low signal, and varix was found on DSA. The high-flow vascular malformation of the jaws classified into two groups: arterial malformation and arteriovenous malformation according to CT and DSA. The acute bleeding of 16 cases was effectively controlled by embolization. The chronic bleeding in the other 5 cases stopped after the 4 - 59 months and new bone formation was found in the follow-up radiography.</p><p><b>CONCLUSIONS</b>The characteristic signs were not unique on X-ray plain film, and MRI and DSA had diagnostic value. Arteriovenous malformation of the jaws should be embolized by direct puncture in conjunction with endovascular therapy, and arterial malformation be superselectively embolized with NBCA.</p>

Clinical study on laser therapy of the venous malformations and hemangioma in oral and maxillofacial regions / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To try to find the best method of laser therapy for the management of venous malformation and hemangioma in oral and maxillofacial regions.</p><p><b>METHODS</b>From June, 1999 to July, 2002, 2 481 cases of venous malformations and hemangiomas were treated by several kinds lasers in our department. The lesions included port-wine stains, venous malformations, telangiectasia and hemangioma. The lasers used were continuous wave CO(2), Nd:YAG and Krypton lasers, pulsed dye laser and ultra-pulsed CO(2) lasers. The treatment modalities were direct irradiation, irradiation after surgical flap raising and photodynamic therapy.</p><p><b>RESULTS</b>Follow up between 2 - 5 years revealed the treatment results as follows: excellent is 79.24%, good is 14.31% and poor is 6.45%.</p><p><b>CONCLUSIONS</b>Laser therapy is one of the best method to treat venous malformations and hemangiomas. The key point is to apply different lasers properly.</p>

Development of salivary gland tumors in pleomorphic adenoma gene 1 transgenic mice / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>Activation and overexpression of pleomorphic adenoma (PLAG1) gene due to t(3;8)(p21;q12) translocation are associated with the development of human pleomorphic adenomas of the salivary glands. This study was conducted to generate ubiquitously-expressed or tissue-specific expressed PLAG1 transgenic mice and to elucidate the role of PLAG1 gene in tumorigenesis in vivo.</p><p><b>METHODS</b>Human PLAG1 cDNA was cloned from salivary gland tumor or placenta tissues by RT-PCR. Ubiquitous expression vector pCMV-EGFP/PLAG1 driven by CMV promoter and tissue-specific expression vector pMMTV-PLAG1 driven by MMTV LTR were constructed. NIH3T3 cells transiently transfected with pCMV-EGFP/PLAG1 showed high expression of PLAG1 in nucleus. Transgenes were microinjected into pronucleus of zygotes to generate transgenic mice.</p><p><b>RESULTS</b>It was found that the human PLAG1 cDNA cloned from several salivary gland tumor and normal placenta tissues consistently showed a variation of a single nucleotide at the same position when compared with the human PLAG1 cDNA sequence in Genbank (Accession No. U65002), which led to T458P at protein level. It might be a single nucleotide polymorphism (SNP)locus. Fused EGFP/PLAG1 protein was found to be localized in the nucleus of NIH3T3 cells transiently transfected with pCMV-EGFP/ PLAG1. Several pCMV-EGFP/PLAG1 and pMMTV-PLAG1 transgenic mouse lines were obtained respectively. As might be expected, pMMTV-PLAG1 transgenic mice spontaneously developed salivary gland tumors in three independent lines, among which, line 42 showed tumorigenic phenotype in 100% of transgenic mice within three months after birth.</p><p><b>CONCLUSION</b>Overexpression of PLAG1 gene plays a crucial role in tumorigenesis of salivary gland tumors.</p>