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20 March 2023, Volume 21 Issue 2 Previous Issue    Next Issue

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Effect of docetaxel on cell pyroptosis of head and neck squamous cell carcinoma and its mechanism GAO Jia-min, YAO Yan-li, WANG Yu-jue, ZHANG Zhi-yuan, SUN Shu-yang 2023, 21 (2):  105-111.  doi: 10.19438/j.cjoms.2023.02.001 Abstract ( 284 )   PDF (1436KB) ( 166 )   PURPOSE: To explore the effect of docetaxel on pyroptosis of head and neck squamous carcinoma and the underlying molecular mechanism. METHODS: Head and neck squamous carcinoma cell lines (CAL33 and SCC154) were treated with control group(0 μmol/L) and different concentrations of docetaxel (0.625, 1.25, 2.5, 5 and 10 μmol/L). The morphological change of cell proptosis was observed by living cell workstation. Western blot was used to assess the protein expression of GSDME, GSDME-N terminal, caspase-3 and cleaved caspase-3. The expression of caspase-3 in living cells was monitored by Caspase-3 Activity and Apoptosis Detection Kit for Live Cell. The level of reactive oxygen species(ROS) was quantified by Reactive Oxygen Species Assay Kit. To determine whether the inhibition of ROS had an effect on pyroptosis induced by docetaxel, acetylcysteine (NAC) was used to inhibit the ROS accumulation and the protein expression of GSDME and GSDME-N terminal of control group(0 μmol/L) was tested, group of docetaxel (2.5 μmol/L) without NAC(5 mmol/L), group of docetaxel with NAC and group of NAC without docetaxel by Western blot. SAS 9.4 software package was used for data analysis. RESULTS: Compared with the control group, docetaxel induced cell pyroptosis of CAL33 and SCC154, which was characterized by membrane rupture and surface protrusions. Docetaxel also promoted caspase-3 activity in the living cells, while the GSDME-N terminal and Cleaved-caspase-3 were upregulated(P<0.05). The level of ROS was increased by docetaxel, and high expression of GSDME-N terminal was significantly reversed by acetylcysteine(P<0.05). CONCLUSIONS: Docetaxel may induce pyroptosis of head and neck squamous carcinoma cells by activating ROS/Caspase-3/GSDME pathway. References | Related Articles | Metrics

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Micro-nano titanium phosphate coating promoted osseointegration of titanium material SUN Yi-xin, ZHU Song-song, JIANG Nan 2023, 21 (2):  112-118.  doi: 10.19438/j.cjoms.2023.02.002 Abstract ( 228 )   PDF (1917KB) ( 114 )   PURPOSE: To fabricate micro-nano titanium phosphate coating on the surface of titanium (Ti) material to promote osseointegration. METHODS: Through the hydrothermal reaction of phosphoric acid under specific conditions, a Ti sheet/cylinder with a coating of micro-nano titanium phosphate, namely micro/nanorod Ti (P-R-Ti), was prepared. The control group was untreated smooth pure Ti (cp-Ti). The materials were characterized and analyzed in terms of composition, morphology, hydrophilicity, etc., and the cell proliferation activity was tested in vitro. The changes in protein and gene expression related to cell adhesion and differentiation were analyzed to explore the effect of P-R-Ti on the biological behavior of rat bone marrow mesenchymal stem cells (BMSCs). At the same time, the effects of P-R-Ti on bone union were evaluated 12 weeks after implantation into rat tibia, and its biomechanical strength was tested.SPSS 21.0 software package was used for data analysis. RESULTS: The material characterization showed that the surface of P-R-Ti had a dense micro nano rod structure. In vitro experiments showed that the expression of adhesion related proteins and mRNA in P-R-Ti group was up-regulated, and the cell viability was significantly enhanced. The expression levels of ALP activity, Runx-2, Col-1, OPN, OCN mRNA in P-R-Ti group were significantly higher than those in cp Ti group. In vivo experiments showed that the bone area ratio and the contact between bone and implant in P-R-Ti group were significantly higher than those in cp-Ti group. The maximum pushing force was(179.3±11.3)N, and the ultimate shear strength was (19.25±1.85)N/mm2. CONCLUSIONS: P-R-Ti can effectively promote the osseointegration of titanium material. It is expected to be used as an excellent method of titanium surface modification for clinical application. References | Related Articles | Metrics

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The regulation and mechanism of cancer-associated fibroblasts on tumor-infiltrating immune cells in head and neck squamous cell carcinoma HAN Lin-zi, ZHOU Jian-hua, ZHAO Qian, DONG Lei, CHEN Zheng-gang, QIU Jian-zhong, YUAN Rong-tao 2023, 21 (2):  119-124.  doi: 10.19438/j.cjoms.2023.02.003 Abstract ( 269 )   PDF (1002KB) ( 173 )   PURPOSE: To explore the mechanism of cancer-associated fibroblasts (CAFs) regulating the expression of tumor-infiltrating immune cells in head and neck squamous cell carcinoma (HNSCC). METHODS: The expression profile and clinical data analysis of lncRNA MIR99AHG related to HNSCC were obtained through the TCGA database, and clinical tumor samples. Primary cell culture and identification of CAFs and normal fibroblasts(NFs) were taken. The expression of lncRNA MIR99AHG in tongue cancer cells co-cultured with CAFs or NFs were detected by qRT-PCR. Correlation of lncRNA MIR99AHG in HNSCC and tumor-infiltrating immune cells was analyzed with Graph Pad 8.0.2 software. RESULTS: LncRNA MIR99AHG was a low expression gene in HNSCC and high expression of lncRNA MIR99AHG was positively correlated with prognosis. Western blot analysis showed that α-SMA was highly expressed in CAFs. qRT-PCR showed that the expression of lncRNA MIR99AHG in tongue cancer cells co-cultured with CAFs was significantly downregulated compared with the negative control group. LncRNA MIR99AHG was positively correlated with T cells, CD8+ T cells, B cells, NK cells, but negatively correlated with Th1, Th2, neutrophils, Tgd. CONCLUSIONS: CAFs may inhibit the expression of lncRNA MIR99AHG to regulate the expression of tumor-infiltrating immune cells in HNSCC. References | Related Articles | Metrics

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A new clinical classification of severe oromaxillofacial head and neck multi-space infections QIU Yin-xiu, DAI Tian-guo, XU Bo, CHENG Jin-qiang, LIU Zhong-long 2023, 21 (2):  125-130.  doi: 10.19438/j.cjoms.2023.02.004 Abstract ( 284 )   PDF (1483KB) ( 168 )   PURPOSE: To explore a new clinical classification method for oromaxillofacial head and neck multi-space infections. METHODS: The clinical and radiographic data of patients with severe oromaxillofacial head and neck multiple-space infections treated under general anesthesia in Panzhihua Central Hospital from July 2015 to March 2022 were retrospectively analyzed, and a new classification method was proposed. SPSS 17.0 software package was used for data analysis. RESULTS: Severe oromaxillofacial head and neck multi-space infections can be divided into five types. Type Ⅰ(n=82, 68.33%), the infection was concentrated between the hyoid plane and the zygomatic arch plane, and the infection in each space could be fully drained through the submaxillary incision. Type Ⅱ(n=13, 10.83%), the infection spread upward to the deep temporal space, and two submandibular and temporal incisions were needed for full drainage. Type Ⅲ(n=14, 11.67%), the infection spread down to the lower cervical space above the clavicle, and full drainage through submaxillary and supraclavicular incision was needed. Type Ⅳ(n=5, 4.17%), the infection spread from the temporal to the supraclavicle area, and multiple submaxillary, temporal and supraclavicle incisions were needed for drainage. In 6 cases (5%) of type Ⅴ, the infection broke through the clavicular plane and spread to the mediastinum and thorax. Mediastinum and thorax drainage must be combined with cardiothoracic surgery at the same time. From typeⅠto typeⅤ, the general condition gradually worsened, the treatment difficulty and risk gradually increased, and the consumption of medical resources such as average ICU monitoring time, hospitalization time, hospitalization cost and antibacterial drug cost also gradually increased (P<0.0001). CONCLUSIONS: Severe oromaxillofacial head and neck multi-space infections are life-threatening, and multidisciplinary therapy is the premise of treatment. Reasonable classification of the disease is the basis of accurate and standardized treatment. Extensive incision and drainage combined with effective auxiliary irrigation technology is the key to treatment. References | Related Articles | Metrics

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Risk factors and clinical value of neutrophil-to-lymphocyte ratio in prediction of delirium after free flap surgery for head and neck cancer SHEN Meng-yuan, ZHANG Xue-ying, ZHAO Shan, XU Xin-chen, LI Xiao-dong, MENG Jian 2023, 21 (2):  131-136.  doi: 10.19438/j.cjoms.2023.02.005 Abstract ( 223 )   PDF (708KB) ( 134 )   PURPOSE: To investigate the incidence and risk factors of postoperative delirium (POD) after free flap reconstruction in patients with head and neck cancer, and then establish the risk prediction model and investigate whether neutrophil-to-lymphocyte ratio (NLR) has potential to be a biomarker for prediction of delirium. METHODS: A retrospective analysis of 128 patients who underwent free flap surgery for head and neck cancer in Xuzhou Central Hospital between January 2016 to March 2022 were performed. The patients were evaluated daily after surgery until discharge for delirium with Confusion Assessment Method (CAM), and they were divided into delirium group and non-delirium group. The related risk factors of delirium were analyzed using SPSS 26.0 software package. Logistic regression was used to screen clinical indicators and develop a risk prediction model. The predictive power of the model was verified by the area under the receiver operating characteristic curve(AUC) of the prediction model and the sensitivity and specificity under the optimal threshold. RESULTS: A total of 17(13.3%) patients had POD. Single factor analysis results indicated that POD was associated with age≥65, preoperative NLR, preoperative total protein, time of operation, intraoperative blood transfusion, postoperative ICU observation time, postoperative sleep disorder and postoperative pain. Multiple logistic regression analysis showed that the independent risk factors of POD included age≥65(OR=5.253; 95%CI: 1.146-24.074), preoperative NLR(OR=1.891; 95%CI: 1.050-3.405), intraoperative blood transfusion(OR=6.108; 95%CI: 1.109-33.644), postoperative sleep disorder (OR=9.292; 95%CI: 1.441-59.914) and postoperative pain(OR=1.807; 95%CI: 1.018-3.206). The receiver operating characteristic curve of the NLR-predictive model constructed using these risk factors was AUC=0.913, the Youden's index was 0.522, the best cutoff for NLR was 2.540, the sensitivity was 0.765 and the specificity was 0.757. CONCLUSIONS: NLR predictive model has good predictive value for POD in patients with head and neck cancer after free flap reconstruction. NLR has the potential as a biomarker, which can be used to guide early intervention and treatment in clinical practice. References | Related Articles | Metrics

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Clinical application of a new protective device for patients undergoing tracheotomy in oral oncology ward during COVID 19 WANG Yue-ping, XU Zhu-feng, SHI Jia-min, YUAN Wei-jun, HOU Li-li 2023, 21 (2):  137-141.  doi: 10.19438/j.cjoms.2023.02.006 Abstract ( 259 )   PDF (725KB) ( 143 )   PURPOSE: To evaluate the application effect of a new type of gas cutting catheter protection device in the rehabilitation period of patients with tracheotomy after oral tumor surgery. METHODS: A total of 150 patients with oral tumor undergoing tracheotomy were selected. According to random number table, they were divided into experimental group(n=76) and control group(n=74). The experimental group used a new device to cover the tracheotomy, while the control group used traditional method. Patients in both two groups were observed for the frequency of changing covering and neck wound care, the degree of environment pollution, the incidence of complications and satisfaction. RESULTS: The experimental group was better than the control group in reducing medical consumables and clinical workload of nurses; the incidence of lower respiratory tract infection in the experimental group was lower than that in the control group; the anti-splash effect and satisfaction of the experimental group were higher than those of the control group(P<0.05). CONCLUSIONS: The new protective device for tracheotomy tube can prevent sputum splashing, prevent virus and bacteria in the air. It reduces the risk of occupational exposure to medical staff. It also reduces the incidence of pulmonary infection, decreases the expenditure of medical consumables, and helps patients better return to their families and society. References | Related Articles | Metrics

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Clinical study of angle between base of tongue and thyroid cartilage measured by ultrasound to predict difficult laryngoscopy WANG Jun-an, GU Hai-lin, SHI Wen-tao, SUN Yu 2023, 21 (2):  142-145.  doi: 10.19438/j.cjoms.2023.02.007 Abstract ( 193 )   PDF (946KB) ( 70 )   PURPOSE: To evaluate the risk factors of difficult laryngoscopy through structure of airway measured by ultrasound. METHODS: A total of 300 patients supposed to receive elective surgery under general anesthesia with endotracheal intubation were included. Before anesthesia induction, indicators such as tongue width, tongue thickness, mentohyoid distance, thyrohyoid distance and angle between base of tongue and thyroid cartilage were measured and recorded by ultrasound. After anesthesia induction, Cormack-Lehane (C-L) grade under laryngoscopy was conducted. One and 2 grades were defined as non-difficult laryngoscopy group and 3 and 4 grades were defined as difficult laryngoscopy group. The correlation between each evaluation index and C-L classification was analyzed by SPSS 22.0 software package. RESULTS: Angle between base of tongue and thyroid cartilage was thought as independent risk factor for predicting laryngoscopy, the cut-off point was 43°, sensibility was 96.2%, specificity was 83.6%, area under curve(AUC) was 0.866 [95%CI: 0.769-0.962]. CONCLUSIONS: Measuring angle between base of tongue and thyroid cartilage by ultrasound can be applied to predict difficult airway. References | Related Articles | Metrics

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Effect of columnar collagen sponge on the extraction of impacted teeth and the risk of complications WANG Chen-xin, PENG Jing, HUANG Xin, SHI Le, DAI Xiao-feng 2023, 21 (2):  146-151.  doi: 10.19438/j.cjoms.2023.02.008 Abstract ( 544 )   PDF (963KB) ( 258 )   PURPOSE: To investigate the effect of collagen sponge in the extraction of impacted teeth and the risk of complications. METHODS: A total of 160 patients with impacted teeth extraction were selected from June 2021 to December 2021 in Shanghai Jing'an Dental Clinic. The patients were randomly divided into experimental group and control group, 80 cases in each group. Both groups underwent conventional extraction of impacted teeth, and the control group was rinsed with 20 mL sodium chloride solution after extraction. In the experimental group, on the basis of the control group, columnar collagen sponge was inserted into the extraction wound. Bleeding, postoperative pain score, postoperative swelling degree 7 days after surgery, levels of inflammatory factors[prostaglandin E2(PGE2), myeloperoxidase(MPO), calcitonin gene-related peptide(CGRP)] in gingival crevicular fluid before and after treatment and postoperative complications (restricted opening, inflammatory induration or bruising of maxillofacial region, infection, dry socket) were compared between the two groups. SPSS 22.0 software package was used for data analysis. RESULTS: The postoperative bleeding time of the experimental group was significantly lower than that of the control group(P<0.05). The VAS scores of spontaneous pain and dysphagia in the experimental group were significantly lower than those of the control group(P<0.05). The swelling degree of experimental group was significantly lower than that of control group 7 days after tooth extraction(P<0.05). There was no difference in PGE2, MPO and CGRP between the two groups before treatment(P>0.05). After treatment, PGE2, MPO and CGRP in the two groups were significantly increased(P<0.05), PGE2, MPO and CGRP of the experimental group after treatment were significantly lower than those of the control group after treatment(P<0.05). The incidence of postoperative complications in the experimental group was significantly lower than that in the control group (P<0.05). CONCLUSIONS: Columnar collagen sponge has a good effect in extraction of impacted teeth, and can effectively avoid postoperative complications, and has little influence on inflammatory factors in gingival crevicular fluid, which is worthy of wide application. References | Related Articles | Metrics

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Clinical application of ultrasonic scalpel in the preparation of fibular osteomyocutaneous free flap HU Xiao-dan, XU Hao-yue, LI Xiao, BU Ling-xue, JIA Mu-yun, YUAN Rong-tao, PANG Bao-xing 2023, 21 (2):  152-157.  doi: 10.19438/j.cjoms.2023.02.009 Abstract ( 226 )   PDF (867KB) ( 131 )   PURPOSE: To explore the feasibility and practicability of ultrasonic scalpel in the preparation of fibular osteomyocutaneous free flap. METHODS: From September 2019 to March 2022, 62 patients who needed fibular osteomyocutaneous free flap to repair head and neck defects in the Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Qingdao University were collected. In the experimental group, fibular osteomyocutaneous free flaps were prepared by ultrasonic scalpel(n=30); while in the control group, fibular osteomyocutaneous free flaps were prepared by traditional monopolar electrotome(n=32). The preparation time of fibular osteomyocutaneous free flap, total intraoperative blood loss, blood loss of fibular donor site, drainage volume of fibular donor site, drainage days of fibular donor site and other surgery-related indexes were compared. The levels of tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) in the postoperative drainage fluid were also compared. At the same time, postoperative complications (bleeding, edema, flap necrosis) and postoperative fibula donor site pain score were compared. SPSS 25.0 software package was used for statistical analysis. RESULTS: In the experimental group, the blood loss from fibular donor site was significantly decreased(P<0.01), and the preparation time of fibular osteomyocutaneous free flap, the total intraoperative blood loss, the drainage volume of fibular donor site, and the drainage days of fibular donor site were significantly decreased(P<0.05). The levels of TNF-α and IL-6 in the drainage fluid of the experimental group were significantly decreased(P<0.01). There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05). In addition, there was no significant difference in the pain score of the fibular donor site on the first day after operation between the two groups(P> 0.05), but the pain score of the fibular donor site in the experimental group was significantly decreased from the second day to the fifth day after operation(P<0.05). CONCLUSIONS: The preparation of fibular osteomyocutaneous free flap assisted by ultrasonic scalpel has less damage and better postoperative recovery for patients than traditional monopolar electrotome. Hemostasis with ultrasonic scalpel during operation has a good clinical application prospect in oral reconstructive surgery. References | Related Articles | Metrics

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Using computerized tomography sialography in the diagnosis of parotid diseases GAO An-tian, LIANG Yi, LIN Zi-tong 2023, 21 (2):  158-162.  doi: 10.19438/j.cjoms.2023.02.010 Abstract ( 448 )   PDF (1400KB) ( 127 )   PURPOSE: To investigate the key points of technique of computerized tomography sialography (CT-sialography) and its diagnostic value in parotid gland diseases. METHODS: A total of 34 patients with chronic parotitis, Sjogren's syndrome, parotid fistula and parotid tumors and tumor-like lesions were collected. All patients were scanned with spiral CT immediately after iodine contrast injection into the primary parotid duct, followed by image post-processing and disease diagnosis. The diagnostic accuracy was calculated according to the follow-up results and postoperative pathological results. The imaging characteristics of parotid gland diseases were summarized and analyzed. RESULTS: The overall diagnostic accuracy rate was 82.35%. The diagnostic accuracy rate of benign and malignant parotid tumors and tumor-like lesions was 88.24%. CONCLUSIONS: CT-sialography is an effective method for diagnosis of obstructive parotitis, parotid fistula, Sjogren's syndrome and tumor and tumor-like lesions in parotid gland. References | Related Articles | Metrics

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Modified paranasal bone grafting reduced vertical maxillary recurrence after Le Fort Ⅰ osteotomy GE Wei-wen, QI Lei, WANG Yun, ZHANG Lei 2023, 21 (2):  163-167.  doi: 10.19438/j.cjoms.2023.02.011 Abstract ( 236 )   PDF (1049KB) ( 127 )   PURPOSE: To evaluate if the modified paranasal bone grafting can reduce the recurrence of Le Fort I osteotomy for maxillary downward. METHODS: A total of 30 patients with a large maxillary downward movement (>3 mm) during orthognathic surgery were included in the study. Patients were divided into modified paranasal bone grafting group and non-modified paranasal bone grafting group. Three-dimensional measurements of the maxillary position were taken using maxillofacial CT data at preoperative(T0), 3 days postoperatively(T1), and 6 months postoperatively (T2). Meanwhile, CT scans of T1 and T2 were used to calculate the changes in bone thickness. SPSS 22.0 software package was used for data analysis. RESULTS: At 6 months after operation, in the vertical direction, the recurrence amount of U1 in the modified paranasal bone grafting group was (0.54±0.35)mm, and the recurrence amount of U1 in the non-modified paranasal bone grafting group was (1.18±0.76)mm(P=0.3997). There was no significant difference in recurrence between the two groups in the anteroposterior and horizontal directions. In the modified group, the bone graft thickness was reduced by (11.75±6.25)%, and that of the non-modified group was (33.77±11.56)%(P<0.0001). CONCLUSIONS: Modified nasal bone graft can effectively reduce the absorption of bone graft and decrease the vertical recurrence of maxilla. References | Related Articles | Metrics

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Diagnostic value of contrast-enhanced ultrasound in cervical lymph node metastasis from oral and maxillofacial squamous cell carcinoma LIU Jiang-long, JIA Fang, WANG Xiao-rong, REYILAI Abudukeremu, WUERGULI Alifu, MAIMAITITUXUN Tuerdi 2023, 21 (2):  168-174.  doi: 10.19438/j.cjoms.2023.02.012 Abstract ( 244 )   PDF (1428KB) ( 98 )   PURPOSE: To investigate the diagnostic value of contrast-enhanced ultrasound（CEUS） for cervical lymph node metastasis from oral and maxillofacial squamous cell carcinoma. METHODS: Forty-one patients with oral and maxillofacial squamous cell carcinoma who underwent surgery and neck dissection were selected, and all patients were examined preoperatively with both conventional ultrasound and CEUS. The postoperative pathological diagnosis was used to divide the metastatic and non-metastatic group, the differences in conventional ultrasound and CEUS imaging characteristics of lymph nodes between the two groups were evaluated and multifactorial logistic regression models were used to analyze the risk factors associated with metastatic lymph nodes. The receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of the two tests for cervical lymph node metastasis from oral and maxillofacial squamous cell carcinoma. SPSS 25.0 software package was used for data analysis. RESULTS: Pathological diagnosis was made in 17 patients with a total of 29 metastatic lymph nodes and in 24 patients with a total of 28 non-metastatic lymph nodes. Conventional ultrasound in the metastatic group showed L/S≤2, irregular morphology, abnormal lymphatic hilum, inhomogeneous echo inside, and peripheral or mixed blood flow, which were significantly different from the non-metastatic group (P<0.05). The difference in perfusion pattern and perfusion type between the metastatic and non-metastatic groups was statistically significant(P<0.05). Conventional ultrasound showed irregular morphology, abnormal lymphatic hilum, inhomogeneous echo inside, peripheral type or mixed blood flow. CEUS showed centripetal or mixed type, inhomogeneous enhancement with irregular perfusion defect type or faint enhancement type were associated risk factors for metastatic lymph nodes(P<0.05). The sensitivity of conventional ultrasound and CEUS for the diagnosis of cervical lymph node metastasis from oral and maxillofacial squamous cell carcinoma was 65.5% and 79.3%, respectively; the specificity was 71.4% and 82.1%, respectively; the positive predictive value was 70.4% and 82.1%, respectively; the negative predictive value was 66.7% and 79.3%, respectively; and the area under the ROC curve was 0.685 and 0.807, respectively. CONCLUSIONS: CEUS has higher clinical value than conventional ultrasound in the diagnosis of cervical lymph node metastasis from oral and maxillofacial squamous cell carcinoma. References | Related Articles | Metrics

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Risk factors of postoperative pain after pediatric obstructive sleep apnea syndrome surgery in postanesthesia care unit FENG Wan-qing, LI Jing-jie, LIU Jin-xing, LAO Wei 2023, 21 (2):  175-179.  doi: 10.19438/j.cjoms.2023.02.013 Abstract ( 341 )   PDF (539KB) ( 130 )   PURPOSE: To investigate the risk factors of postoperative pain in children after obstructive sleep apnea syndrome(OSAS) surgery. METHODS: A total of 531 children aged 3-12 years who underwent OSAS surgery were included. Children's preoperative anxiety state, parents' anxiety state, information related to anesthesia and surgery, postoperative agitation, postoperative pain during postanethesia care unit (PACU) were recorded. Multivariate logistic regression analysis was used to assess the risk factors of postoperative pain intensity. SAS 9.4 software was used for data analysis. RESULTS: The incidence of moderate to severe pain was 16.6% in PACU. Age(OR=0.85, 95%CI: 0.76-0.95), tonsillectomy with or without adenoidectomy (OR=1.5, 95%CI: 1.12-1.99), preoperative anxiety(OR=1.01, 95%CI: 1.00-1.02), emergence agitation (OR=1.22, 95%CI: 1.17-1.26) and ketamine use were independently associated with higher pain in PACU. CONCLUSIONS: Age,tonsillectomy with or without adenoidectomy, preoperative anxiety, emergence agitation and ketamine use are independent risk factors for postoperative pain in PACU. References | Related Articles | Metrics

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Influencing factors of extubation time after general anesthesia in children with obstructive sleep apnea syndrome SHI Jin-ya, LI Jing-jie, LIU Jin-xing, QIU Lin 2023, 21 (2):  180-185.  doi: 10.19438/j.cjoms.2023.02.014 Abstract ( 235 )   PDF (716KB) ( 146 )   PURPOSE: To investigate the influencing factors of tracheal extubation time after general anesthesia in children with obstructive sleep apnea syndrome(OSAS) who underwent palatopharyngoplasty, tonsillectomy and/or adenoidectomy (ablation). METHODS: A total of 529 children (ASA gradeⅠ-Ⅱ, aged 3-12 years) with OSAS who underwent palatopharyngoplasty/tonsillectomy and/or adenoidectomy(ablation) under general anesthesia were retrospectively analyzed. In the data collected, the first 75% of the quartile was defined as "fast extubation" and the remaining 25% was defined as "slow extubation" in order of extubation time from fast to slow. There were 137 cases with slow extubation after anesthesia, and 392 cases with rapid extubation after anesthesia. The data of the two groups were compared, and the influencing factors of extubation time were analyzed by stepwise regression with SPSS 21.0 software package. RESULTS: There were significant differences between the two groups in emergence agitation, anesthesia method (inhalation anesthesia vs intravenous anesthesia), total amount of fentanyl, use of dexmedetomidine and neostigmine, and use of analgesic pump (P<0.05). CONCLUSIONS: Emergence agitation, anesthesia method, total amount of fentanyl, use of dexmedetomidine and neostigmine, and use of analgesic pump were the influencing factors of tracheal extubation time. References | Related Articles | Metrics

Review Articles

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Research progress in the role and mechanism of Porphyromonas gingivalis in promoting oral squamous cell carcinoma REZIWANGULI·Yasen, MAIREPATI·Maiming, LI Chen-xi, GONG Zhong-cheng 2023, 21 (2):  186-190.  doi: 10.19438/j.cjoms.2023.02.015 Abstract ( 333 )   PDF (550KB) ( 185 )   A large number of studies have shown that P.gingivalis is one of the bacterial species, as an important risk factor, of oral squamous cell carcinoma (OSCC). P.gingivalis is closely associated with the pathogenicity, development, invasion, metastasis and prognosis of OSCC. For its potential mechanisms, it may accelerate OSCC occurrence and progress probably through multiple ways as follows: resisting and destroying the innate immune system of the host, promoting epithelial-mesenchymal transition, promoting cancerous invasion and metastasis, inhibiting cell apoptosis, activating cell proliferation. This review summarized the research progress in the role and mechanism of P.gingivalis in promoting OSCC. References | Related Articles | Metrics

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Application and advancement of minimally invasive instruments and micro-power devices in tooth extraction LI Yan-xiang, YAN Li-jun, LING Xiao-wan, ZHOU Wen-jie, WANG Yue-ping 2023, 21 (2):  191-196.  doi: 10.19438/j.cjoms.2023.02.016 Abstract ( 672 )   PDF (914KB) ( 416 )   Tooth extraction is to remove the affected teeth that can no longer provide oral function, and it is also one of the most basic and common procedures in alveolar surgery. Conventional tooth extraction applies elevators, forceps, chisels and other instruments, which may cause severe physical and psychological trauma to the patient. In recent years, the concepts of minimally invasive tooth extraction has been accepted in the clinic, and the development of materials has led to more refined extraction instruments. Meanwhile the use of micro-power devices has greatly improved the efficiency of tooth extraction. Advancements in tooth extraction techniques and equipments are aimed to maximumly preserve the integrity of the alveolar bone, reduce the complications, and relieve the pain. This paper described the development of minimally invasive tooth extraction techniques through the evolution of instruments and the application of micro-power devices, so as to provide reference for more dentists to understand and apply minimally invasive equipments in daily practice. References | Related Articles | Metrics

Case Reports

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Analysis of a case with immediate implant and autocrown restoration of left upper root incisor without flap assisted by digital guide plate SUN Shou-fu, ZHANG Ying, ZHAO Hao-ming, WANG Wen-chao, WEI Wen-jia, GUO Ke 2023, 21 (2):  197-202.  doi: 10.19438/j.cjoms.2023.02.017 Abstract ( 231 )   PDF (1216KB) ( 167 )   This case report was aimed to evaluate the clinical aesthetic effect of immediate implant without flap and autocrown restoration for traumatic teeth in the aesthetic area of anterior teeth assisted by digital guide plate, and explore the clinical factors affecting implant restoration in the aesthetic area. After minimally invasive extraction of the affected tooth due to traumatic root fracture of the patient's left upper central incisor, immediate implantation without flap was performed under the assistance of digital guide plate, and immediate temporary restoration was performed with autogenous crown at the same time. Six months later, personalized mold extraction column was prepared for precise mold extraction, and personalized all-porcelain abutment-zirconia all-porcelain crown restoration was finally completed. During the 18-month follow-up period, the patient achieved a good red-white aesthetic effect, and imaging examination also showed good peri-implant bone bonding and no absorption at the edge bone level. This case showed that with the assistance of digital guide plate, immediate implantation of traumatic teeth in aesthetic area without flap and immediate autologous crown restoration can achieve good red-white aesthetic effect. References | Related Articles | Metrics

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Peri-implant squamous cell carcinoma appeared after implant-restoration in the left mandible: a case report LAN Rong, RUAN Min, HAN Nan-nan, WANG Feng 2023, 21 (2):  203-205.  doi: 10.19438/j.cjoms.2023.02.018 Abstract ( 212 )   PDF (1257KB) ( 134 )   Recently, there have been several case reports of peri-implant squamous cell carcinoma, but whether implant-restoration has direct or indirect relation to tumorigenesis is not clear. In addition, peri-implant carcinoma is likely to be misdiagnosed as peri-implantitis. This paper reported a case with gingival squamous cell carcinoma after five years of implant-restoration. We retrieved the relevant literatures to summarize the features of peri-implant carcinoma, in order to improve the understanding of this disease, regular visits after implant restoration is also highlighted. References | Related Articles | Metrics

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Adenoid cystic carcinoma with high grade transformation and sialolithiasis of the right submandibular gland: a rare case report HU Yong, WANG Qiong, ZHAO Da-yong, YE Jin-hai 2023, 21 (2):  206-208.  doi: 10.19438/j.cjoms.2023.02.019 Abstract ( 222 )   PDF (1410KB) ( 158 )   Adenoid cystic carcinoma(ACC) with high grade transformation(HGT) is rare, with the coexistence of a sialolith to be considered an extremely infrequent case. This article presented a case of ACC-HGT with sialolithiasis in the right submandibular gland, the poorly differentiated adenocarcinoma component of the tumor invaded the lung, spinal and brain after tumor resection, selective neck dissection and adjuvant radiotherapy and chemotherapy. The patient died twenty months after surgery due to metastases. References | Related Articles | Metrics