The metabolic reprogramming of γ-aminobutyrate in oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is the most common head and neck malignancy. The oncometabolites have been studied in OSCC, but the mechanism of metabolic reprogramming remains unclear. To identify the potential metabolic markers to distinguish malignant oral squamous cell carcinoma (OSCC) tissue from adjacent healthy tissue and study the mechanism of metabolic reprogramming in OSCC. We compared the metabolites between cancerous and paracancerous tissues of OSCC patients by 1HNMR analysis. We established OSCC derived cell lines and analyzed their difference of RNA expression by RNA sequencing. We investigated the metabolism of γ-aminobutyrate in OSCC derived cells by real time PCR and western blotting. Our data revealed that much more γ-aminobutyrate was produced in cancerous tissues of OSCC patients. The investigation based on OSCC derived cells showed that the increase of γ-aminobutyrate was promoted by the synthesis of glutamate beyond the mitochondria. In OSCC cancerous tissue derived cells, the glutamate was catalyzed to glutamine by glutamine synthetase (GLUL), and then the generated glutamine was metabolized to glutamate by glutaminase (GLS). Finally, the glutamate produced by glutamate-glutamine-glutamate cycle was converted to γ-aminobutyrate by glutamate decarboxylase 2 (GAD2). Our study is not only benefit for understanding the pathological mechanisms of OSCC, but also has application prospects for the diagnosis of OSCC.

[Treatment of infantile hemangiomas with long pulsed 1064nm laser and oral corticosteroids].

PURPOSE: To evaluate the clinical therapeutic efficacy on infantile hemangiomas using long pulsed 1064nm laser and oral corticosteroid. METHODS: One hundred and two infantile hemangiomas in the proliferating phase state were treated with long pulsed 1064nm laser, long pulsed 1064nm laser and oral corticosteroid .Color Doppler was used to detect the depth of tumor. Laser treatment was conducted for 1 to 3 sessions, and oral corticosteroid was one course for 12 weeks. The results were analyzed with SAS6.12 software package for Ridit test. RESULTS: Total response treated with long pulsed 1064nm laser, long pulsed 1064nm laser and oral corticosteroid were achieved in 12 cases(24.00%) and 14 cases(26.92%)respectively, good response were achieved in 18 cases(36.00%) and 27 cases(51.92%). There was significant difference between the two groups(P<0.05). Total response in patients with superficial lesions treated with long pulsed 1064nm laser, long pulsed 1064nm laser and oral corticosteroid were achieved in 8 cases(34.78%) and 7 cases(33.33%) respectively, while good response were achieved in 10 cases(43.48%) and 8 cases(38.10%).There was no significant difference between two groups(P>0.05).Total response in patients with deep lesions treated with long pulsed 1064nm laser, long pulsed 1064nm laser and oral corticosteroid were achieved in 4 cases(14.81%) and 7 cases(22.58%) respectively, good response were achieved in 8 cases(29.63%) and 19 cases(61.29%).There was significant difference between the two groups(P<0.05). CONCLUSION: Combined therapy with long pulsed 1064nm laser and oral corticosteroid is effective for infantile deep-seated hemangiomas in the proliferating stage.

[Clinical analysis of 193 patients with thickening and nodular port wine stains].

PURPOSE: The purpose of this study is to investigate the relation between age, gender and thickening and nodules in port wine stains(PWS) patients. METHODS: The gender and age of 193 cases with port wine stains were compared between those with flat, those with thickening, those with thickening and nodules, in 0-19, 20-year age group. SAS6012 software package was used for Fisher's exact test and Kruskal-Wallis test. RESULTS: There were 165 cases with flat (85.49%), 10 cases with thickening (5.18%), 18 cases with thickening and nodules (9.33%). Kruskal-Wallis test demonstrated significant difference between 2 age groups(P<0.01).There was an increase incidence of thickening, and thickening and nodule formation in 0-19, 20-year age group(P<0.01), but there was no gender difference between thickening and nodules.The data were analyzed by SAS6.12 Fisher's exact test and Kruskal-Wallis test. CONCLUSION: The incidence of thickening and nodule formation in PWS increase with age.

[Clinical analysis of neurofibromatosis in oral and maxillofacial regions treated with staged operations and laser therapy].

PURPOSE: To evaluate the clinical effect of neurofibromatosis in the oral and maxillofacial region treated with staged operations and laser therapy. METHODS: Eight cases with neurofibromatosis were treated with staged operations, laser therapy was used for hemostasis during operation, cafe-au-lait was treated with Q-switched laser. RESULTS: The average amount of bleeding was 100-400 ml, no hemorrhagic shock occurred intraoperatively. All patients were of good facial appearance, cafe-au-lait was improved during short-term follow-up. CONCLUSION: Staged operations and laser therapy is a valuable treatment for neurofibromatosis in the oral and maxillofacial region.

[Lip and cheek reconstruction with composite radial forearm-palmaris longus tendon flap].

PURPOSE: To investigate the value of functional reconstruction of the lip and cheek with composite radial forearm-palmaris longus tendon flap. METHODS: Composite radial forearm-palmaris longus tendon flap was used in 5 cases, the flap was folded for repair of oral mucosa and external skin, palmaris longus tendon and the remaining orbicularis muscles were sutured so that oral contour and function could be achieved. All the patients were followed up for at least 20 months. RESULTS: All 5 composite flaps survived well postoperatively. 6 months after reconstruction, the patients had good oral and facial contour; 10-12 months after surgery, the dynamic function of mouth opening and closing as well as mastication was recovered to normal. CONCLUSION: Composite radial forearm-palmaris longus tendon flap is reliable and thus recommended for functional reconstruction of the lip and cheek.

[Thyroid hormone level change in patients undergoing oral and maxillofacial surgery].

PURPOSE: To study the changes of thyroid hormone level in patients undergoing oral and maxillofacial surgery before and after operation, in order to provide some evidences for postoperative treatment and recovery. METHODS: 60 cases with oral and maxillofacial operations under general or local anesthesia were assayed by radioimmunoassay for hormone levels changes of T3 ,T4, r T3 and TSH in serum before operation and on the first, forth and seventh day after operation. SPSS10.0 software package was used for one way ANOVA. RESULTS: Compared to preoperative levels, T3, T4 and r T3 (P<0.01) as well as TSH (P<0.05) in patients receiving operations under general anesthesia on the first, forth and seventh day postoperatively decreased significantly, while the changes of thyroid hormone level in patients receiving operations under local anesthesia before and after operation were not significantly different. CONCLUSION: Thyroid hormone level change in patients who underwent oral and maxillofacial surgery may be related to the type of operation and anesthesia.

[Treatment of 113 oral and maxillofacial hemangiomas with long pulsed turnable 1064 nm Gentle YAG laser].

PURPOSE: To evaluate the clinical therapeutic efficacy on hemangioma of oral maxillofacial regions using pulsed Gentle YAG laser. METHODS: Since April 2005 to August 2005, 113 cases of oral and maxillofacial hemangiomas were treated using pulsed Gentle YAG laser 1064 nm wavelength in our department. Minimal coagulation laser dosage was defined and used to avoid side effects such as thermal skin damage. The laser dosage was 170-240 J/cm2, with 1.5 mm in diameter spot and pulse wide of 30-60 ms. Dynamic cooling device set was used 10-20 times and 10-15 times pre- and post-pulse respectively. 9 of 113 cases had two sessions of treatment, 104 underwent only one session. 96% cases were followed up for 4-6 months. RESULTS: Total response was achieved in 85 cases (75.22%), good response in 28 cases (24.78%), fair response and poor response was 0. Temporary side effects included hyper-pigmentation in 11 cases (9.73%), hypo-pigmentation in 2 cases (1.77%), and they disappeared after 4 to 6 months. 7 cases had scar formation accounting for 6.19%. CONCLUSION: The minimal coagulation dosage pulsed Gentle YAG laser is a good tool to treat hemangioma in oral and maxillofacial regions. It has the advantage of fast efficacy, short term sessions and fewer side effects. It is worthy of wide clinical application.

[Advances of in vivo confocal scanning laser microscopy].

In vivo confocal scanning laser microscopy is being widely established as a time-saving, non-invasive, investigative methods in the study of body surfaces. Skin can be observed in its native state in vivo without the fixing, sectioning and staining that is necessary for routine histology. It is a new technology that can provide detailed images of tissue architecture and cellular morphology of living tissue. This paper reviews the fundamentals of in vivo confocal imaging and its clinical applications.