[Neck lymphatic metastasis, surgical methods and prognosis in early tongue squamous cell carcinoma].

Objective: To investigate the different pattern of neck lymph node metastasis, the choice of surgical methods and prognosis in early tongue squamous cell carcinoma. Methods: A total of 157 patients with early oral tongue squamous cell carcinoma were included in this study. Statistical analysis was performed to identify the pattern of lymph node metastasis, to determine the best surgical procedure and to analyze the prognosis. Results: The occurrence of cervical lymph node metastasis rate was 31%(48/157). Neck lymphatic metastasis was significantly related to tumor size (P=0.026) and histology differentiation type (P=0.022). The rate of metastasis was highest in level Ⅱ [33% (16/48)]. In level Ⅳ, the incidence of lymph node metastasis was 5%(7/157), and there was no skip metastases. The possibility of level Ⅳ metastasis was higher, when level Ⅱ (P=0.000) or Ⅲ (P=0.000) involved. The differentiation tumor recurrence, neck lymphatic metastasis and adjuvant radiotherapy were prognostic factors (P<0.05). Multivariate analyses revealed histology differentiation type, neck lymphatic metastases and adjuvant radiotherapy were the independent prognostic factors. Conclusions: Neck lymphatic metastasis rate is high in early tongue squamous cell carcinoma, simultaneous glossectomy and neck dissection should be performed. Level Ⅳ metastasis rate is extremely low, so supraomohyoid neck dissection is sufficient for most of the time. The histology differentiation type, neck lymphatic metastasis and adjuvant radiotherapy are independent prognostic factors.

Injectable bioactive glass in the restoration of oral bone defect.

OBJECTIVE: To explore the application value of injectable bioactive glass in the restoration of the oral bone defect. PATIENTS AND METHODS: This study included 58 consecutive patients with oral bone defect > 1 mm, these patients were randomly assigned to a control group (n=26, Hydroxyapatite bioceramics) and an observation group (n=32, Injectable bioactive glass). The purpose of this study was to assess the comparison of the healing of oral bone defect. RESULTS: X-ray examination was performed at 6-month and 12-month following treatment. The bone healing in the observation group was significantly better than the control group (p <0.05), the incidences of local rejection reactions were not significantly different (p >0.05). Cone-beam Computed Tomography (CBCT) was performed at 6-month and 12-month following treatment. The mean bone thickness in the observation group was significantly lower than the control group, p <0.05. Both the levels of bone morphogenetic protein 2 (BMP-2) and transforming growth factor ß (TGF-ß) in the observation group were significantly higher than the control group, p <0.05. CONCLUSIONS: The effect of injectable bioactive glass in the restoration of the oral bone defect was better than hydroxyapatite bioceramics. Thus, injectable bioactive glass has great application value.

Effects of predistention with normal saline containing adrenaline on blood-vessel injury during epidural catheter placement.

This study investigated the effects of predistention with normal saline containing adrenaline on vascular plexus injury during epidural catheter placement. Three hundred parturients undergoing caesarean sections were randomly divided into three groups. Group I (n = 102) received an epidural injection with 5 ml normal saline; group II (n = 93) received 5 ml normal saline containing adrenaline (5 µg/ml); group III (n = 100) received direct epidural catheter placement. Five women were excluded from the analysis for technical reasons. The incidence of bloody fluid in the epidural needle was significantly lower in groups I and II compared with group III (eight [7.8%] and seven [7.5%] versus 17 [17.0%], respectively). There were no significant differences in the incidence of bloody fluid in the epidural catheter or in the incidence of intravascular epidural catheter placement between the three groups. Predistention with 5 ml normal saline before catheter insertion reduced the incidence of blood-vessel injury during epidural catheter placement, but adrenaline provided no additional protective effects.