Stevens-Johnson syndrome secondary to massive inflammatory hyperplasia of bilateral lingual margins: a case report and literature review / 华西口腔医学杂志

Stevens-Johnson syndrome (SJS), also known as the multifactorial erythematous drug eruption, is a class of adverse reactions of the skin and mucous membranes primarily caused by drug allergy often involving the oral cavity, eyes, and external genital mucosa, generally accompanied by fever, and can be life-threatening in severe cases. In February 2022, the Department of Stomatology, the First Affiliated Hospital of Zhengzhou University admitted a patient with huge inflammatory hyperplasia of bilateral lingual margins secondary to SJS. Upon admission, no other obvious symptoms were observed except for tongue hyperplasia. The patient suffered from a severe adverse drug reaction caused by acetaminophen 2 months ago and was complicated by liver dysfunction and pulmonary infection. After 1 month of treatment and rehabilitation, he developed a secondary tongue mass and was subsequently admitted to Dept. of Oral and Maxillofacial Surgery Ward 2, the First Affiliated Hospital of Zhengzhou University. After completing the examination, the tongue mass was surgically removed. After a follow-up of 11 months, the patient's condition was satisfactory and no temporary discomfort was observed. The case of tongue mass secondary to SJS is extremely rare. If a stomatologist encounters a similar case, we should carefully inquire about the drug allergy history and recent medication history, and be alert to whether or not they had adverse drug reactions recently.

Effect of digital and 3D printing technology combined with non-vascularized ilium in repairing post-traumatic bone defect in maxillary anterior teeth area / 中华创伤杂志

Objective:To explore the effect of digital technology and 3D printing technology combined with non-vascularized ilium bone in repairing post-traumatic bone defect in maxillary anterior area.Methods:A retrospective case series study was performed to analyze clinical data of 8 patients with severe bone defect in maxillary anterior area after trauma admitted to First Affiliated Hospital of Zhengzhou University from June 2013 to January 2018. There were 6 males and 2 females, with the age of 18-43 years [(31.9±9.0)years]. The maxillary bone was reconstructed before surgery by employing digital technology. The intercept range of ilium was determined according to the best form of defect to be recovered. Then the model and guide plate was printed out by employing 3D print technology. The titanium mesh was prebended on the model. The bone was extracted and Onlay bone grafting was performed according to the guide plate. The implant restoration was performed 6 to 9 months after operation, and porcelain crown restoration was performed 4 to 6 months later. The iliac bone survival and postoperative complications were detected 6 months after bone grafting. The near-middle-far and vertical bone elevation of the alveolar ridge as well as bone elevation of lip palatal were measured before implantation. The condition around the implants was observed 6 months after porcelain crown restoration. The visual analogue score (VAS) was used to evaluate the pain after iliac bone transplantation and implantation. The implant stability coefficient (ISQ) was applied to assess the stability of the implants on the day and 4 months after operation.Results:All the patients were followed up for 24-48 months [(33.3±9.7)months]. Eight patients with non-vascularized iliums were all survived. There was one patient with mild infection after bone grafting and one patient with gingival inflammatory hyperplasia after implantation, both of whom were healed after treatment. There was no obvious peri-implant inflammation or absorption of the grafted bone. The increase in height of the alveolar on the mesial and distal bone, vertical bone and labial-palatal bone was 30.28-39.67 mm, 9.58-11.32 mm and 2.06-7.41 mm, respectively. All the implants showed good osseointegration. The VAS after implantation was (3.4±0.7)points, significantly alleviated compared with the preoperational level [(7.3±2.0)points] ( P<0.05). The ISQ was 84.4±1.9 at postoperative 4 months, showing no significant difference from that on the day after operation (72.9±1.4) ( P>0.05). Conclusions:In repair of severe bone defect in maxillary anterior area after trauma, the digital and 3D printing technology combined with non-vascularized ilium can improve the survival rate of bone grafts. The implant restoration after operation can reduce pain, restore the patients' facial appearance and achieve satisfactory oral physiological function.

Retrospective study on incomplete intestinal obstruction treated with the adjuvant therapy of acupuncture and moxibustion / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the clinical effects on incomplete intestinal obstruction treated with the adjuvant therapy of acupuncture and moxibustion.</p><p><b>METHODS</b>Using the retrospective analysis, 80 patients of incomplete intestinal obstruction were divided into an observation group and a control group, 40 cases in each one. In the control group, the routine treatment was given, such as fasting, gastrointestinal decompression, parenteral nutrition, infection prevention with antibiotics and enema laxative. In the observation group, on the basis of the treatment as the control group, acupuncture was applied at bilateral Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39); moxibustion was used at left Yangchi (TE 4), Zhongwan (CV 12), Qihai (CV 6) and Guanyuan (CV 4). The treatment was given once a day, 30 min each time. The average days of treatment, the surgical transfer rate, the time to first flatus, the recovery time of defecation and the time of solid food intake were observed in the patients of the two groups.</p><p><b>RESULTS</b>The average days of treatment in the observation group was obviously less than that in the control group (<0.05). The surgical transfer rate in the observation group was obviously lower than that in the control group (<0.05). The time to first flatus, the recovery time of defecation and the time of solid food intake were all obviously earlier than those in the control group (all <0.05).</p><p><b>CONCLUSION</b>The adjuvant therapy of acupuncture and moxibustion achieves the significant therapeutic effects on incomplete intestinal obstruction, shortens the treatment duration and reduces the surgical transfer rate and the patient's economic burden.</p>

[Application of carbon nanoparticles as lymph node tracers in patients with cN0 lingual squamous cell carcinoma un-dergoing neck dissection].

OBJECTIVE: This study aimed to investigate the value of carbon nanoparticles as lymph node tracers in neck dissection for cN0 lingual squamous cell carcinoma patients. METHODS: Ninety-six patients with cN0 lingual squamous cell carcinoma were recruited to undergo surgical treatment were randomly divided into two groups, namely, the carbon nanoparticle-labeled group (the experimental group, 50 cases) and the control group (46 cases). Carbon nanoparticle suspension was injected into the submucosal layer around the site of the primary tumor at three or four points (0.1 mL for each point) 12 h before surgery. Supraomohyoid neck dissection (SOHND, Levels Ⅰ to Ⅲ) or comprehensive neck dissection (CND, Levels Ⅰto Ⅴ) were performed based on the size and location of the primary tumor. All the lymph nodes were dissected and separated from the ex vivo surgical specimens for histopathological evaluation. The number, size, location, and pathological result of all the lymph nodes were compared between the two groups. Statistical analyses were conducted by SPSS 19.0 software. RESULTS: A total of 1 137 lymph nodes were detected in 31 SOHND patients. The average number of lymph nodes detected in the experimental group was (43.79±19.23) /case, which was significantly higher than that in the control group [(30.82±8.77) /case] (P=0.019). Level Ⅲ covered the largest number of lymph nodes in the two groups. However, the number and proportion of lymph nodes found in Level Ⅱ of the experimental group were significantly higher than those of the control group (P=0.000). A total of 3 938 lymph nodes were detected in 65 CND patients. The average number of lymph nodes detected in the experimental group [(66.67±20.02) /case] was larger than that in the control group [(53.03±20.98) /case] (P=0.026). The difference in the lymph node location between the two groups was not statistically significant (P=0.354). In the two neck dissection methods, both the proportion of minute lymph nodes and the accuracy of the detected lymph nodes in the experimental group were significantly larger than those in the control groups (P=0.000). Compared with the control group, more metastases were proven by the carbon nanoparticle-labeled lymph nodes (P=0.000) in the experimental group. CONCLUSIONS: Carbon nanoparticles as lymph node tracers in patients with cN0 lingual squamous cell carcinoma undergoing neck dissection can increase the number of detected lymph nodes, especially the minute nodes. Such nanoparticles can further ensure the thoroughness of neck dissection and the accuracy of clinicopathological stage.