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20 July 2021, Volume 19 Issue 4 Previous Issue    Next Issue

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The role of xanthine oxidoreductase in nitrate-nitric oxide transformation in vascular endothelial cells of hypoxia injury YANG Yang, NIU Qi-fang, LI Delong, ZHANG Shu, QIN Li-zheng, HAN Zheng-xue 2021, 19 (4):  289-294.  doi: 10.19438/j.cjoms.2021.04.001 Abstract ( 366 )   PDF (853KB) ( 278 )   PURPOSE: To investigate the mechanism of nitrate-nitric oxide (NO) transformation in vascular endothelial cells under hypoxia injury and the role of xanthine oxidoreductase(XOR). METHODS: Model of hypoxia reoxygenation injury of human vascular endothelial cells was established. The level of nitric oxide and the content of sodium nitrate were detected in cells cultured in medium with different concentrations of sodium nitrate and sodium nitrite. The expression of endothelial nitric oxide synthase(eNOS) and XOR were detected by real-time quantitative PCR and Western blot. After eNOS inhibitor L-NMMA and XOR inhibitor allopurinol were used respectively, the levels of NO in cells cultured in medium with sodium nitrate were detected again. The data were analyzed with GraphPad Prism 8.0 software package. RESULTS: Higher concentration of extracellular nitrate increased intracellular nitrate content in both normoxia and hypoxia conditions. Nitrite and nitrate extracellular only increased levels of intracellular NO in hypoxia condition, and with allopurinol, XOR inhibitor, extracellular nitrate did not increase intracellular NO level. CONCLUSIONS: Nitrate-NO transformation in human vascular endothelial cells occurs in condition of hypoxia, which is mainly dependent on XOR. References | Related Articles | Metrics

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Effect of SREBP2 on proliferation and migration of oral squamous cell carcinoma and its regulatory mechanism GUO Ming, CHEN Yu-ling, WU Li, ZHANG Bi-ru, SHEN Yue-hong, YANG Hong-yu 2021, 19 (4):  295-301.  doi: 10.19438/j.cjoms.2021.04.002 Abstract ( 391 )   PDF (1479KB) ( 336 )   PURPOSE: To investigate the effect of sterol regulatory element-binding protein 2 (SREBP2) on the malignant biological behaviors of oral squamous cell carcinoma (OSCC) cell lines. METHODS: The expression of SREBP2 in OSCC was detected by qRT-PCR. SiRNA and overexpression plasmids were constructed and transferred into CAL27. The ability of cell proliferation was detected by cell counting kit-8(CCK-8) assay and EdU cell-proliferation assay; the level of apoptosis was detected by flow cytometry; the ability of migration and invasion was detected by wound-healing assay and Transwell migration and invasion assays. Western blotting was used to detect the expression of SREBP2-related proteins. The data were plotted by Graphpad 5.0; Student's t tests were used to evaluate difference among groups. RESULTS: The expression of SREBP2 in 50 pairs of OSCC tissues and OSCC cell lines was significantly lower than that in normal controls. Knock-down and overexpression experiments showed that the change of SREBP2 expression affected the malignant biological behavior of OSCC cells and affected the development of OSCC through MVA signal pathway. CONCLUSIONS: SREBP2 inhibits proliferation, migration, invasion and promotes apoptosis of cancer cells in OSCC. References | Related Articles | Metrics

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Effect of POLD1 on proliferation and invasion of oral squamous cell carcinoma and its regulatory mechanism ZHANG Ying, WU Li, CHEN Yu-ling, LIN Yun-tao, SHEN Yue-hong, YANG Hong-yu 2021, 19 (4):  302-308.  doi: 10.19438/j.cjoms.2021.04.003 Abstract ( 349 )   PDF (2043KB) ( 317 )   PURPOSE: To investigate the effect of POLD1 expression on cell proliferation, migration, invasion and cell cycle of oral squamous cell carcinoma (OSCC) cell lines and the relevant mechanism. METHODS: Online data were used to analyze POLD1 expression in head and neck squamous cell carcinoma (HNSCC) samples and normal tissues. POLD1 expression was evaluated in OSCC and normal tissues using immunohistochemistry. OSCC cell lines（SCC9 and CAL27) were infected with lentivirus, and the expression of POLD1 in stable cell lines was detected by Western blot. CCK-8 assay and EdU assay were used to detect cell proliferation; wound healing assay and Transwell migration and invasion assay were used to detect cell migration and invasion. The effect of POLD1 on cell cycle was detected by flow cytometry and the related pathway was studied via Western blot. SPSS 21.0 software package and GraphPad Prism were used for data analysis and plotting. RESULTS: POLD1 was abnormally upregulated in head and neck squamous cell carcinoma and OSCC tissues (P<0.001). Depletion of POLD1 in OSCC cells not only inhibited proliferation, migration, and invasion of cancer cells but also resulted in G2 arrest. The expression of P-Cdc2(Tyr15) and P-Rb(Ser807) in the experiment group were significantly increased. CONCLUSIONS: Down-regulation of POLD1 inhibits proliferation, migration and invasion of OSCC cells. References | Related Articles | Metrics

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Fgf9 regulated murine mandibular development by promoting endochondral and intramembranous ossification LI Ruo-mei, WENG Meng-jia, SUN Yi-dan, CHEN Zhen-qi 2021, 19 (4):  309-314.  doi: 10.19438/j.cjoms.2021.04.004 Abstract ( 315 )   PDF (2009KB) ( 275 )   PURPOSE: To investigate the role of fibroblast growth factor 9 (Fgf9) in endochondral and intramembranous ossification during mandibular development by analyzing the mandibular phenotype of Fgf9 knockout mice. METHODS: A Fgf9 gene-knock-out mice model was established for understanding the role of Fgf9 during mandibular development. Micro-CT was applied for analyzing the bone morphology and parameters. In situ hybridization was used for detecting the expression pattern of Fgf9 in mandible. H-E and Safranin O-fast green staining were used for histologic analysis of condyle, Meckel's cartilage, and the region generated by intramembranous ossification. SPSS 25.0 software was performed for statistical analysis. RESULTS: Micro-CT showed defective condyle, coracoid process, and mandibular angle in Fgf9-/-mice with Tb. N and BMD decreased, and Tb. Sp increased. In situ hybridization indicated that Fgf9 was widely expressed in perichondrium, chondrocyte, osteoblast, endothelial cells, and mesenchyme around the cartilage and trabecular bone. H-E and Safranin O-fast green staining exhibited a malformed condyle cartilage with an inadequate secretion of cartilage matrix, decreased proportion of hypertrophic chondrocyte, and defective and dispersive trabecular bone. Moreover, the trabecular bone in the regions of the anterior part of the Meckel's cartilage and the intramembranous ossification was defective, dispersive, and hypo-mineralized. CONCLUSIONS: During mandibular development, Fgf9 participates in the endochondral ossification of the condyle by promoting maturation and secretion of the chondrocyte. Meanwhile, it is able to facilitate the secretion of osteoblast for pursuit of well-morphed trabecular bone. Furthermore, Fgf9 is involved in intramembranous ossification by regulating the osteoblast during the formation and mineralization of the trabecular bone. References | Related Articles | Metrics

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Study on the osteogenic potential of macrophages in alveolar cleft repaired with β-TCP scaffold SHAN Yu-hua, YING Xi-yu, ZHANG Xiao-yu, CHEN Zhen-qi 2021, 19 (4):  315-319.  doi: 10.19438/j.cjoms.2021.04.005 Abstract ( 271 )   PDF (1269KB) ( 275 )   PRUPOSE: To study the osteogenic potential of 3D printed β-TCP scaffold combined with bone marrow stem cells（BMSCs） repairing alveolar cleft and the role of macrophages in osteogenesis. METHODS: Bilateral maxillary first molars were extracted in the first eight rats to form a box shaped bone defect in the size of 4 mm × 4 mm × 3 mm. 3D printed β-TCP scaffold with BMSCs was implanted on one side and control scaffold was implanted on the other side eight weeks later. In the second group, 3D printed β-TCP scaffold with BMSC was placed on both sides at the same time, and macrophages were removed on one side. Eight weeks after operation, Micro-CT scanning and histological analysis were performed to detect bone formation. SAS 8.0 software was performed for statistical analysis. RESULTS: BV/TV ratio was (41.38±3.334)% in β-TCP group and (30.42±2.964)% in the control group (P<0.05). BV/TV ratio was (18.71±2.193)% in macrophage-depletion group and (39.81%±2.678)% in the control group. There was no significant difference between the two groups with the same β-TCP side. CONCLUSIONS: BMSCs combined with 3D printed β-TCP scaffold has satisfying osteogenic ability, and macrophages play an important role in β-TCP mediated osteogenesis. The depletion of macrophages hinders new bone formation. References | Related Articles | Metrics

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Effects of thyroid hormone on axon regeneration and electrophysiological function of facial nerve injury in mice CHEN Xing-yu, DONG Fei-fei, LI Kai 2021, 19 (4):  320-324.  doi: 10.19438/j.cjoms.2021.04.006 Abstract ( 294 )   PDF (1037KB) ( 222 )   PURPOSE: To investigate the effect of thyroid hormone on axon regeneration and neurophysiological function of facial nerve injury in mice. METHODS: Sixty-four mice were randomly divided into 4 groups: sham operation group, model group, thyroxine group, and thyroxine + LY group, each with 16 mice. Except for the sham operation group, facial nerve injury models were established in the remaining groups. Intervention was started after recovery: the thyroxine group was injected subcutaneously with 50 μg/kg neutral thyroxine solution, the thyroxine + LY group was intraperitoneally injected with 600 μg/kg PI3K/AKT pathway inhibitor LY294002 on the basis of the thyroxine group. The sham operation group and model group were injected with normal saline once a day for 2 weeks. After intervention, neuroelectrophysiological test was performed, the number of regenerated axons were counted by osmium acid staining, and the expression of p-AKT, NGF and BDNF protein in facial nerve tissue was detected by Western blot. SPSS 21.0 software package was used for data analysis. RESULTS: In the sham operation group, no new axons were found outside the myelin sheath of normal nerves. Compared with the model group, the number of regenerated axons in the thyroxine group and the thyroxine + LY group both increased, and the thyroxine group was significantly higher than the thyroxine + LY group(P<0.05). Compared with the sham operation group, the motor nerve conduction velocity (MNCV) and amplitude of the model group were reduced, and the incubation period was prolonged(P<0.05). Compared with the model group, the MNCV and amplitude of the thyroxine group and the thyroxine + LY group were increased, and the thyroxine group was significantly higher than that of the thyroxine + LY group(P<0.05). Compared with the model group, the latency of the thyroxine group and the thyroxine + LY group were shortened, and the thyroxine group was significantly shorter than the thyroxine + LY group (P<0.05). Compared with the sham operation group, the relative expression of p-AKT, NGF and BDNF protein in the model group significantly increased(P<0.05). Compared with the model group, the relative expression of p-AKT protein in the thyroxine group increased, while that in the thyroxine+LY group significantly decreased(P<0.05). Compared with the model group, the relative expression of NGF and BDNF protein in the thyroxine group and the thyroxine + LY group increased, and the thyroxine group was significantly higher than thyroxine + LY group (P<0.05). CONCLUSIONS: Thyroid hormone can effectively promote the regeneration of facial nerve axons in mice and improve the electrophysiological function of the nerve. Its mechanism may be through promoting the activation of AKT phosphorylation and play a regulatory role. References | Related Articles | Metrics

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Preoperative finite element analysis of fibula myocutaneous flap for segmental mandibular reconstruction WANG Yi-zhou, CAI Man, SUN Li-fan, ZHU Qing-hai, HOU Chen-xing, HAN Wei, TANG Yu-ting, SUN Nan-nan, WANG Chen-xing, LI Huai-qi, YE Jin-hai 2021, 19 (4):  325-331.  doi: 10.19438/j.cjoms.2021.04.007 Abstract ( 425 )   PDF (1665KB) ( 417 )   PURPOSE: To explore the biomechanical reasons of mandible deviation after vascularized fibular myocutaneous flap repair and reconstruction of large-area segmental defect of mandible by using finite element static analysis method, and to verify the effectiveness of the analysis through postoperative follow-up, so as to obtain a research method that can provide reference for the design of operation plan before operation. METHODS: Ten cases of traditional surgery and 10 cases of digital technology for mandibular segmental resection and vascularized fibula reconstruction were included in this study. Based on a case of digital preoperative three-dimensional surgery, the three-dimensional finite element analysis model of mandible reconstruction was established to analyze the strain trend. Then cone-beam CT (CBCT) data of postoperative follow-up and preoperative CBCT data were compared. GraphPad Prism 8 software package was used for statistical analysis. RESULTS: There was no significant difference between the two groups before and after operation; but compared with the traditional group, the change of joint space of the affected side in the digital group was significantly reduced(P<0.05). Based on the preoperative operation plan of a case using digital technology, the finite element analysis model was successfully established, and the results showed that the condyle of the affected side (right side) rotated clockwise in the transverse position; the epicondyle rotated inward in the coronal position; the coronal process shifted outward and downward in the sagittal position. The CBCT images before and 6 months after operation were compared, and the jaw displacement trend was consistent with the findings of finite element analysis. CONCLUSIONS: Finite element analysis can qualitatively analyze the deviation of mandible after reconstruction of mandible defect with vascularized fibula flap using improved digital guide plate technology, and provide reference for the design of operation plan before operation. References | Related Articles | Metrics

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Application of atelo-collagen for distal bone defect restoration of the second molar after mandibular third molar extraction: a split-mouth clinical trial GUO Ya-rong, LU Xu-guang, WANG Xing, CHENG Yong-feng, HE Dong-ning 2021, 19 (4):  332-336.  doi: 10.19438/j.cjoms.2021.04.008 Abstract ( 448 )   PDF (1023KB) ( 337 )   PURPOSE: To evaluate the clinical effect of atelo-collagen grafting on reconstruction of intrabony defects of the second molar after mandibular third molar extraction. METHODS: Thirty-two patients who had their mandibular third molars extracted at Shanxi Medical University Hospital of Stomatology from January 2019 to July 2019 were included in this study. Bilateral mandibular third molars were in horizontal position in all patients. After extraction, the same person's tooth sockets were divided into two groups: the control group and the atelo-collagen group. The tooth sockets in the control group received colloidal silver gelatin sponge, while in the atelo-collagen group atelo-collagen was used to fill the sockets. The patients were followed up for 3, 6 months. Assessments of distal buccal probing depth of the second molar and X-ray examination were performed 3, 6 months postoperatively. The data were analyzed with SPSS 24.0 software package. RESULTS: Probing depths were improved after operation in both groups. There was no significant difference between the two groups. The height and bone density of the new bone in the atelo-collagen group were significantly higher than those in the control group(P<0.001). Three months after operation, the volume of new bone in the atelo-collagen group was significantly larger than the control group. CONCLUSIONS: Atelo-collagen can promote bone regeneration and reconstruction in the intrabony defect of second molar caused by extraction of mandibular third molar. References | Related Articles | Metrics

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Evaluation of two methods for fixation of oral tracheal intubation during intraoral surgery SUN Yun-feng, FENG Da-jun 2021, 19 (4):  337-339.  doi: 10.19438/j.cjoms.2021.04.009 Abstract ( 364 )   PDF (553KB) ( 265 )   PURPOSE: To design a method for fixation of oral tracheal intubation, to prevent anesthetic intubation fall-off during operations, then improving surgical safety and surgical efficiency. METHODS: Eighty patients undergoing intraoral surgery were chosen, who had rhinostenosis and required oral intubation. The patients were randomly divided into experimental and control groups. In the experimental group, anesthetic cannulas were placed at the corner of mouth, several teeth were fixed by 4-0 silk thread according to the surgical site, then knotted around the cannulas. In the control group, anesthetic cannulas were placed at the corner of mouth, the soft tissue of mouth were fixed by 4-0 silk thread, then knotted around the cannulas. SPSS 19.0 software package was used for statistical analysis. RESULTS: There were 18 patients with mild displacement, two patients with moderate displacement in the control group, while there were two patients with mild displacement in the experimental group, and the difference between the two groups was statistically significant(P<0.001）. There were 11 patients with mild oral commissure injury in the control group, while there was no oral commissure injury in the experimental group, and the difference between the two groups was statistically significant(P<0.001). There was no gingival injury in the control group, and there was only one patients with gingival injury in the experimental group, the difference between the two groups was not statistically significant(P=0.314). There was no change of tooth stability in the control group and the experimental group. CONCLUSIONS: The method for fixation of oral tracheal intubation can be used as a routine method during intraoral surgery. References | Related Articles | Metrics

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The effect of quality control circle on improving the compliance of postoperative functional exercise in patients with temporomandibular joint disease SUN Ming-yuan, YU Lei-lei, GU Ya-jie, XIA Di 2021, 19 (4):  340-344.  doi: 10.19438/j.cjoms.2021.04.010 Abstract ( 331 )   PDF (726KB) ( 316 )   PURPOSE: To explore the practical effect of quality control circle (QCC) movement on improving the compliance of postoperative functional exercise in patients undergoing temporomandibular joint(TMJ) anchorage surgery. METHODS: A convenience sampling method was used to select 50 cases with temporomandibular joint diseases (TMD) diagnosed in the Department of Oral Surgery as the control group from July 2019 to August 2019, and 50 cases were selected as the experimental group using the same method from December 2019 to January 2020. Patients in the control group were given routing nursing care. QCC program with the theme of "Improving postoperative functional exercise compliance of patients with temporomandibular disorder" was conducted in the experimental group, in which common quality control tools were used to analyze the causes and made strategies for those with low functional exercise compliance. The functional exercise compliance, pain score and maximum mouth opening were compared between the two groups. SPSS 20.0 software package was used for statistical analysis. RESULTS: The functional exercise compliance of TMD patients increased from 57.90% to 87.78%, maximum mouth opening at postoperative 1 month increased from (26.54±5.33)mm to (28.32±4.67)mm(P<0.05), while VAS score of pain decreased from 2.48±1.084 to 1.40±0.957(P<0.05). CONCLUSIONS: Implementation of QCC program has positive effect on improving the postoperative functional exercise compliance and the joint function recovery of TMD patients, promoting the comprehensive ability of nurses and assuring the nursing quality. References | Related Articles | Metrics

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The effect of nasal tube stabilization on pressure between tube and nose HU Wen-yue, LYU Xiang, SUN Yu 2021, 19 (4):  345-349.  doi: 10.19438/j.cjoms.2021.04.011 Abstract ( 355 )   PDF (733KB) ( 377 )   PURPOSE: This clinical trial was performed to evaluate the effect of nasal tube stabilization (NTS) on pressure between tube and nose(PTN) in both supine and neck extension position. METHODS: Twenty-four ASAⅠorⅡ adult patients scheduled for oral and maxillofacial surgeries requiring naso tracheal intubation(NTI) were randomly assigned to intubate with either wire-reinforced or Ring-Adair-Elwyn tube. Thin film pressure sensor was used to measure PTN before and after NTS in both supine and neck extension position. Statistical analysis was performed with Graphpad Prism 9.0 software package. RESULTS: The PTN of wire-reinforced tubes were 51 mmHg higher than that of RAE tubes in supine position before NTS (P=0.005), and 68 mmHg higher than that in extension position before NTS (P=0.0007). In wire-reinforced tube group before NTS, the PTN of neck extension position increased by 24 mmHg compared with supine position (P=0.0005). After NTS, the PTN in supine and neck extension position was comparable (P=0.1514). NTS significantly reduced PTN in both supine (P=0.0005) and neck extension position (P=0.0005); while in RAE tube group before NTS, the PTN in supine and neck extension position was comparable (P=0.3394). After NTS, the pressure in supine and neck extension position was comparable(P=0.7910). NTS also significantly reduced PTN in both supine (P=0.0005) and neck extension position (P=0.0005). CONCLUSIONS: NTS effectively reduced PTN of both wire-reinforced and RAE tubes regardless of supine or neck extension position. RAE tube also significantly reduced PTN compared with wire-reinforced tube. References | Related Articles | Metrics

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Comparative study of four trauma scoring systems to evaluate maxillofacial fractures CHEN Chen, SUN Ning-ning, HE Yang, AN Jin-gang, GONG Xi, ZHANG Yi 2021, 19 (4):  350-353.  doi: 10.19438/j.cjoms.2021.04.012 Abstract ( 928 )   PDF (433KB) ( 275 )   PURPOSE: To select a scoring system suitable for scoring of maxillofacial trauma by comparing the effects of four commonly used trauma scoring systems. METHODS: This study cohort comprised 1 009 patients with maxillofacial trauma from January 2008 to December 2013 at Peking University School and Hospital of Stomatology. There were 46 cases with simple maxillary fractures, 536 cases with simple mandibular fractures, 233 cases with simple zygomatic arch fractures, and 194 cases with compound fractures. New Injury Severity score (NISS), Facial Injury Severity Score (FISS), Maxillofacial Injury Severity Score (MFISS), and Maxillofacial Injury Severity Score (MISS) were used to grade the injury severity of the patients before surgery. The data were imported into SPSS 21.0 software package. Correlation coefficients between the results of the four scoring systems and clinical effective indexes were calculated by non-parametric correlation analysis. Multivariate linear regression analysis was carried out with length of stay and hospitalization expenses as dependent variables. RESULTS: There was no significant difference between the score of mandibular fracture and zygomatic fracture by NISS. When FISS, MFISS, and MISS were applied, there was no significant difference between maxillary fracture scores and mandibular fracture scores(P>0.05). NISS, FISS, MFISS and MISS were positively correlated with operation time, cost of anesthesia, length of hospitalization stay, and correlation coefficients of MFISS were the highest(0.475,0.485, 0.434). The difference was statistically significant(P<0.05). Trauma score and concomitant injury were positively significant influencing factors of length of hospital stay and hospitalization expenses(P<0.05). CONCLUSIONS: MFISS showed the highest correlation with clinical effective indexes, and affected the length of hospital stay and hospitalization expenses significantly. MFISS reflected the injury severity of maxillofacial trauma better. References | Related Articles | Metrics

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Long term survival of mature autotransplanted teeth in 41 consecutive cases LU Li-rong, DING Xu, LIU Yu-chan 2021, 19 (4):  354-357.  doi: 10.19438/j.cjoms.2021.04.013 Abstract ( 1733 )   PDF (658KB) ( 419 )   PURPOSE: To investigate the long term survival of mature autotransplanted teeth, so as to provide reference for clinical application. METHODS: The clinical data of 41 patients (46 teeth) who underwent mature autotransplanted teeth were retrospectively analyzed. All patients were followed up regularly for clinical examination and X-ray examination. The 5-year cumulative survival rate and cumulative success rate of all implantations were analyzed. Digital X-ray film was used to detect the lesions, then the effects of gender, age and root canal therapy on the cumulative survival rate and success rate of implantations were analyzed with SPSS 19.0 software package. RESULTS: During the 5-year follow-up period, the cumulative survival rate was 84.78% (39/46), and the cumulative success rate was 71.74% (33/39). The lesions were detected in 10 of the 46 mature autotransplanted teeth, with a detection rate of 21.74%. The effect of root canal treatment showed significant impact on the cumulative success rate of mature autotransplanted teeth(P<0.05). CONCLUSIONS: The 5-year cumulative survival rate and cumulative success rate of mature autotransplanted teeth are relatively high, so it can be used in restoration of dentition defect; moreover, root canal therapy after implantation can effectively improve the success rate. References | Related Articles | Metrics

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Comparison of the effects of closed negative pressure drainage and traditional open drainage in maxillofacial space infection JIN Ze-gao, CHENG Jie, LI Yan-fang, WANG Mi-la 2021, 19 (4):  358-361.  doi: 10.19438/j.cjoms.2021.04.014 Abstract ( 337 )   PDF (498KB) ( 297 )   PURPOSE: To investigate the difference between closed negative pressure drainage and traditional open drainage in the treatment of maxillofacial space infection. METHODS: A total of 139 patients with maxillofacial space infection treated from February 2017 to August 2019 were selected and randomly divided into negative pressure group (closed negative pressure drainage, n=69) and traditional group (traditional incision drainage, n=70). Differences in visual analog scale (VAS) score, changes in serum procalcitonin (PCT), C-reactive protein (CRP), treatment effect, number of dressing changes, antibiotic use time, and granulation tissue growth time were compared between the two groups using SPSS 21.0 software package. RESULTS: Before treatment, there was no significant difference in VAS scores between the two groups (P>0.05). After 3 and 7 days of treatment, the VAS scores of the negative pressure group were significantly lower than the traditional group(P<0.05). Before treatment, there was no significant difference in serum CRP and PCT levels between the two groups(P>0.05). After 3 days and 7 days of treatment, the serum CRP and PCT levels of the negative pressure group were significantly lower than those of the traditional group (P<0.05); the number of dressing changes, antibiotic use time, and granulation tissue growth time of the negative pressure group were significantly lower than those of the traditional group (P<0.05); the curative rate and effective rate were 60.87%, 37.68% in the negative pressure group, and 44.29%, 51.43% in the traditional group. CONCLUSIONS: Closed negative pressure drainage is more effective than traditional incision drainage in treating maxillofacial space infection. References | Related Articles | Metrics

Clinical Reports

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Re-reconstructions for cases with persistent post-reconstructive orocutaneous or oropharyngocutaneous fistulas after extensive reconstructive operations in head and neck region MA Chun-yue, ZHU Yun, GUO Bing, WANG Liang, SHEN Yi 2021, 19 (4):  362-367.  doi: 10.19438/j.cjoms.2021.04.015 Abstract ( 466 )   PDF (1166KB) ( 426 )   PURPOSE: Orocutaneous or oropharyngeal fistulas may develop after extensive surgery in the head and neck region. This paper described our experiences in applying salvage secondary or tertiary reconstructions in these situations. METHODS: A retrospective study was performed based on the 10-year experiences of secondary or tertiary reconstructions for correction of persistent post-reconstructive orocutaneous or oropharyngocutaneous fistulas in our institution. Thirty-one cases were considered as eligible. The possible causes for these fistulas were recorded. The salvage reconstructive approaches were summarized, while related complications and follow-up outcomes were reported as well. Multivariate statistical analyses for the survival-related factors were performed using SPSS 25 software package. RESULTS: Among all these cases, 19 cases(61.3%) were with post-reconstructive orocutanenous fistulas, while 12(38.7%) were with oropharyngocutaneous fistulas. Anterolateral thigh flaps(n=15, 48.4%) were the most used flaps in the failed prior operations. Most of the cases(n=19, 61.3%) were with histories of prior irradiation. As for the specific salvage reconstructive approaches, 8 cases (25.8%) were re-reconstructed with anterolateral thigh free flaps, while 18(58.1%) were with pectoralis major myocutaneous flaps and 3(9.7%) with fibular flaps, respectively. All re-reconstructive flaps survived postoperatively. Complication rate reached 38.7%(12/31),with pulmonary infections and minor wound dehiscence representing the most likely ones. The overall survival rate reached 58.1%(18/31) calculated at recent follow-ups. CONCLUSIONS: Secondary or tertiary reconstructions for these cases are challenging. Careful planning and considerable expertise in re-reconstructive surgery are both required for successful management of these serious complications. References | Related Articles | Metrics

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Clinical application of three-dimensional preformed titanium mesh assisted by individualized 3D printing skull model in the treatment of 6 patients with complex maxillary fractures DU Fu-jiang, HE Shui-ming, ZHU Peng-na 2021, 19 (4):  368-371.  doi: 10.19438/j.cjoms.2021.04.016 Abstract ( 355 )   PDF (949KB) ( 298 )   PURPOSE: To evaluate the clinical value of 3D printing model and three-dimensional preformed titanium mesh in the treatment of complex maxillary fractures. METHODS: From January 2017 to October 2018, six patients with complex maxillary fractures treated in the Department of Oral and Maxillofacial Surgery of Shaoxing Central Hospital were analyzed retrospectively. The skull data were imported into computer-aided design mimics l0.01 software and Geomagic Studio 2013 software through 16 slices of CT scans, to accurately segment fracture sites and reconstruct three-dimensional models. Fracture reduction was simulated in the software. The fracture model of l∶l ratio was printed by 3D printing technique both before and after fracture reduction. According to the entity model, pre-bending of titanium mesh was completed before operation,and the surgical effect was evaluated after operation. RESULTS: All the 6 cases completed the operation successfully and followed up for an average of 12 months. The restoration of facial outline and occlusion relation was satisfactory in 5 cases and relatively satisfactory in 1 case. CONCLUSIONS: For patients with complex maxillary fracture, application of 3D print model and three-dimensional preformed titanium mesh is helpful to shorten the operation time, reduce the incidence of postoperative adverse events, improve the effect of fracture reduction and facial symmetry. References | Related Articles | Metrics

Academic Controversy

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Discussion on naming of obstructive sleep apnea syndrome WANG Shi-quan, GUAN Qun-li, LIN Xi-jiang, WANG Xin-xin, MENG Li-qun, WANG Yao-zhong 2021, 19 (4):  372-375.  doi: 10.19438/j.cjoms.2021.04.017 Abstract ( 444 )   PDF (500KB) ( 395 )   From early clinical stage to present, textbooks, reference books and even various related literatures and magazines all use the medical term "obstructive sleep apnea syndrome", also known as "obstructive sleep apnea hypopnea syndrome", its English abbreviation is OSAHS. Since the nomenclature of OSAHS does not reflect the pathophysiological characteristics of the disease and its causal relationship, the authors here proposed the nomenclature of " sleep induced upper respiratory failure or obstructive apnea syndrome" (SURFOAS). Through all-round comparison with the former terms, it is believed that SURFOAS can better reveal the main pathophysiological characteristics of the disease, especially from the nomenclature, the location of the obstructed ventilation and obstruction can be clearly identified. Moreover, this article listed many abnormal structural changes (arguments) from the anatomy of the upper respiratory tract of patients with SURFOAS, and further demonstrated the causal relationship between sleep and upper respiratory tract ventilation obstruction or even apnea. Therefore, the proposal and naming of SURFOAS are reasonable and logical in comparison with OSAHS, regardless of horizontal comparison or vertical comparison, and conform to the naming principle of clinical medical diseases, which is relatively more practical for guiding clinical work with basic medical theories. References | Related Articles | Metrics

Review Articles

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Research progress of inflammatory microenvironment in NF1 related neurofibroma YOU Yuan-he, WANG Yan-an 2021, 19 (4):  376-379.  doi: 10.19438/j.cjoms.2021.04.018 Abstract ( 339 )   PDF (441KB) ( 408 )   Neurofibroma is one of the characteristic lesions of neurofibromatosis type 1. However, the pathogenesis of neurofibromas is still not completely known. The highly active RAS-GTP signal transduction of Schwann cells with biallelic inactivation can produce a large number of cytokines, which provides a cytokine-rich microenvironment for immune cell recruitment. In normal peripheral nerves, the proportion of immune inflammatory cells is not high. In NF1-related neurofibromas, 30% of the cells are monocytes/macrophages. Mast cells, T cells and dendritic cells (DC) also present. Increased evidences indicate that there is a correlation between inflammation and tumorigenesis. This review summarized the research progress of inflammatory cells in the microenvironment of NF1-related neurofibroma. References | Related Articles | Metrics

Case Reports

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Primary facial CD30 positive anaplastic large cell lymphoma：report of one case and review of the literature YANG Cai-xiu, BU Ling-xue, CHEN Li-qiang, FAN Cun-hui, WANG Shuang-yi 2021, 19 (4):  380-384.  doi: 10.19438/j.cjoms.2021.04.019 Abstract ( 470 )   PDF (1724KB) ( 304 )   Primary CD30 positive anaplastic large cell lymphoma is a rare non-Hodgkin's lymphoma. The disease mainly occurs around 60 years old, often in the limbs and trunk. Clinical examination often found tough, well demarcated nodular mass. Histopathological examination showed that a large number of lymphocytes are in the subcutaneous tissue. Morphology combined with immunohistochemical is more effective for diagnosis of this disease. Primary cutaneous ALCL is relatively rare, and primary anaplastic cell lymphoma occuring in the maxillofacial skin is much rare in clinic. In order to improve the diagnosis and treatment of the disease by oral and maxillofacial surgeons, this paper reported a case of ALCL in the maxillofacial skin and review the relevant literatures. References | Related Articles | Metrics