Double anterior (anterolateral and anteromedial) thigh flap for oral perforated defect reconstruction

OBJECTIVE

The purpose of this study was to assess the therapeutic efficacy of oral perforated defect reconstruction with a double anterior (anterolateral and anteromedial) thigh flap through the modified lateral lip-submandibular approach.

MATERIALS AND METHODS

From July 2010 to August 2013, eight patients with oral perforated defects secondary to oral cancer ablation involving the superior partial mandible or the posterior partial maxilla, with immediate reconstruction by double anterior (anterolateral and anteromedial) thigh flaps, were retrospectively enrolled into this study.

RESULTS

All double anterior flaps were musculocutaneous flaps. Seven double flaps resulted in good functional and aesthetic outcomes with complete flap survival. One patient required operative exploration in the postoperative period due to thrombosis in the external jugular vein. After the salvage, one of the double flaps in the intraoral region resulted in partial failure of the superficial skin of the flap. No functional impairment at the donor sites occurred in any of the cases.

CONCLUSION

The double anterior (anterolateral and anteromedial) thigh flap is a feasible and acceptable technique for reconstruction of an oral perforated defect involving the mandible or the maxilla through the modified lateral lip-submandibular approach. It presents a very acceptable aesthetic and functional result with the additional advantage of low morbidity at the donor site.

Polarization-independent etching of fused silica based on electrons dynamics control by shaped femtosecond pulse trains for microchannel fabrication

We propose an approach to realize polarization-independent etching of fused silica by using temporally shaped femtosecond pulse trains to control the localized transient electrons dynamics. Instead of nanograting formation using traditional unshaped pulses, for the pulse delay of pulse trains larger than 1 ps, coherent field-vector-related coupling is not possible and field orientation is lost. The exponential growth of the periodic structures is interrupted. In this case, disordered and interconnected nanostructures are formed, which is probably the main reason of etching independence on the laser polarization. As an application example, square-wave-shaped and arc-shaped microchannels are fabricated by using pulse trains to demonstrate the advantage of the proposed method in fabricating high-aspect-ratio and three-dimensional microchannels.

Computer-assisted virtual technology in intracapsular condylar fracture with two resorbable long-screws

Our aim was to fix intracapsular condylar fractures (ICF) with two resorbable long screws using preoperative computer-assisted virtual technology. From February 2008 to July 2011, 19 patients with ICF were treated with two resorbable long screws. Preoperatively we took panoramic radiographs and spiral computed tomography (CT). Depending on their digital imaging and communications in medicine (DICOM) data, the dislocated condylar segments were restored using the SimPlant Pro™ software, version 11.04. The mean (SD) widths of the condylar head and neck from lateral to medial were 19.01 (1.28)mm and 13.84 (1.13)mm, respectively. In all patients, the mandibles and the ICF seen intraoperatively corresponded with the preoperative three-dimensional and virtual reposition. All patients were followed up for 6-46 months (mean 21). Occlusion and mouth opening had been restored completely in all but one patient, and absolute anatomical reduction was also achieved in most cases. Computer-assisted virtual technology plays an important part in the diagnosis of ICF, as well as in its preoperative design. Fixation with only two resorbable long screws is an effective and reliable method for fixing ICF.

Large exchange bias after zero-field cooling from an unmagnetized state

Exchange bias (EB) is usually observed in systems with an interface between different magnetic phases after field cooling. Here we report an unusual phenomenon in which a large EB can be observed in Ni-Mn-In bulk alloys after zero-field cooling from an unmagnetized state. We propose that this is related to the newly formed interface between different magnetic phases during the initial magnetization process. The magnetic unidirectional anisotropy, which is the origin of the EB effect, can be created isothermally below the blocking temperature.

Coeliac disease in China, a field waiting for exploration

BACKGROUND

no systematic studies on the prevalence of coeliac disease (CD) have been reported from China. In western populations CD is more common in patients with insulin dependent diabetes mellitus (IDDM) and in diarrhoea-predominant irritable bowel syndrome (D-IBS). We have screened patients with these conditions presenting to the outpatient department of a large hospital of "Traditional Chinese Medicine" (TCM) in Nanjing, Jiangsu province, P.R. China.

METHODS

we tested sera of 78 unrelated Han Chinese patients (5 IDDM and 73 D-IBS), using ELISA serological tests for IgG anti-gliadin antibodies (IgG-AGA) and IgA anti-tissue transglutaminase antibodies (IgA-tTG).

RESULTS

six out of 78 patients (7.7%) were positive for IgG-AGA (two men and four women) and two (2.6%) were positive for IgA-tTGs. One of the latter patients was negative for IgG-AGA. Besides, one patient had a dubious IgA-tTG antibody and a positive IgG-AGA. None of the six patients agreed to undergo duodenal biopsy. Two out of these six patients followed a gluten-free diet for one year. In one patient the diarrhoea ceased and his body weight increased. Another stopped losing weight.

CONCLUSIONS

this study previously published as a letter in GUT (Wu J, Xia B, von Blomberg BME, Zhao C, Yang XW, Crusius JBA, Peña AS. Coeliac disease: emerging in China? Gut 2010; 59(3): 418-9) demonstrated that CD may exist in the Jiangsu province of P.R. China. The present article draws attention to the difficulties of following a standard protocol in China such as established in western countries and highlights important factors less well known in the west in relation to the development of CD in China. Wheat production became significant in China between 1600 and 1300 B.C. After the Han dynasty (500-200 B.C.), wheat was one of the main cereals in China. One the major wheat fields in China is located in the Jiangsu province where the research for this article was performed. A review of Chinese literature shows that the predominant HLA-DQ CD risk alleles and haplotypes are present in the Jiangsu province. Genetic background, food consumption, and the results of our study suggest that CD should actively be investigated in P.R. China.

Involved-field radiotherapy for patients with limited small cell lung cancer: Patterns of local-regional failure and feasibility

7554

Background: To investigate the feasibility of the involved-field radiotherapy in patients with limited-stage small cell lung cancer (LSCLC) according to the patterns of local failure, focused on the first local-regional failure. Methods: Two clinical phase II studies for patients with LSCLC treated at our institute between 1997 and 2007 were reviewed. All patients received combined chemotherapy (CHT) with cisplatin and etoposide, and thoracic RT (TRT) was generally delivered sequentially following one to three cycles of CHT and consisted of either 56 Gy in 40 fractions for 4 weeks or 55 Gy in 22 fractions for 4–5 weeks. TRT fields encompassed primary tumor volume (post-CHT) and the involved nodal areas (pre- and post-CHT) without elective node irradiation. The local-regional failure was defined as failure within thoracic cavity and supraclavicular fossa except for pleural effusion, which was then divided into two subtypes: in-field and out-field failure according to the first occurred site in the planning target volume or not. Results: There were 89 patients completed the planed regimen and eligible for evaluating patterns of failure, 54 patients (57%) in 56 Gy cohort and 35 patients(43%) in 55 Gy cohort. The media cycles of CHT were 6 (4–8). The overall survival and local progression-free survival rates for 89 patients at 2 years were 56% and 71%, respectively, with a median survival of 25.6 months. 56 patients (63%) developed distant metastases and 21 patients (24%) developed local-regional failures: 12 in-field and 9 out-field. 8 out of 9 out-field failures occurred in the ipsilateral supraclavicular fossa, and the media duration to the end of TRT was 6 mouths (5–14). Comparing the 56 Gy and 55 Gy cohorts, the rates of any thoracic, in-field and out-field failures were no difference significantly. Conclusions: Thoracic radiotherapy using involved-field technique in patients with LSCLC resulted in a high failure rate of the supraclavicular fossa. Whether improving accuracy for the initial evaluation of clinical stage could reduce out-field failure in supraclavicular fossa need to be investigated.

No significant financial relationships to disclose.

Correlation between adiponectin polymorphisms and non-alcoholic fatty liver disease with or without metabolic syndrome in Chinese population

BACKGROUND

To investigate the effect of single nucleotide polymorphisms (SNP) 45 and 276 of the adiponectin gene on non-alcoholic fatty liver disease (NAFLD) with or without metabolic syndrome.

METHODS

A total of 165 NAFLD, 83 NAFLD with metabolic syndrome and 160 healthy controls from Chinese population were genotyped for the adiponectin gene (+45T>G and +276G>T) by PCR-restriction fragment length polymorphism methods. Plasma adiponectin and insulin levels were determined by enzyme-linked immunosorbent assay and radioimmunoassay, respectively. Insulin resistance (IR) was evaluated by using homeostasis model assessment of IR (HOMA-IR).

RESULTS

NAFLD with metabolic syndrome had further extent of IR and hypoadiponectinemia. No association of SNP45 or SNP276 was found in NAFLD or NAFLD with metabolic syndrome. Subjects carrying the G allele of SNP45 showed higher levels of triglyceride (TG), fasting blood sugar (FBS), HOMA, body mass index (BMI), and alanine transaminase (ALT), as well as lower plasma adiponectin levels. In the normal-weight group of SNP276, subjects carrying the G allele showed higher HOMA and subjects carrying the T allele showed lower BMI.

CONCLUSIONS

Our study observed further hypoadiponectinemia and IR in NAFLD with metabolic syndrome. The T45G and G276T of the adiponectin gene may not be the important determinants of NAFLD in Chinese people, but some of them still influence serum ALT, BMI, IR, lipid, glucose metabolism and plasma adiponectin concentration.

Spatial distributions and potential risk analysis of total soil selenium in Guangdong Province, China

A total of 260 soil profiles were examined to investigate the spatial distribution of total soil selenium (Se) in Guangdong province, China. In the investigated area, the soil Se concentrations follow an approximately lognormal distribution. The soil Se geometric mean concentration of 0.23 mg kg(-1) is higher than that of Chinese soils; however, Se concentration varies over the study area. The baseline concentration of 0.13 to 0.41 mg kg(-1) indicates that the soil Se concentration is mostly in the range of deficiency to medium level for surface soils in Guangdong province. In A-, B-, and C-horizon, soil Se spatial distribution is correlated with the nature of the parent material, with high Se concentration mainly located in limestone and sandshale areas and low Se concentration associated with purple shale and granite areas. The spatial distribution pattern of soil Se concentrations suggests that potential Se deficiency may be an issue for human health in this province. Moreover, due to soil degradation and erosion, calculated soil Se exported into surrounding waters could reach approximately 23,000 kg yr(-1) in the study area.

Total fluoride in Guangdong soil profiles, China: spatial distribution and vertical variation

A total of 260 soil profiles were reported to investigate the fluoride distribution and vertical variation in Guangdong province. The soil fluoride contents followed an approximately lognormal distribution. Although the soil fluoride geometric mean concentration of 407 mg/kg is lower than that of China, its content varied from 87 to 2860 mg/kg. An upper baseline concentration of 688 mg/kg was estimated for surface soils. In A-, B-, and C-horizon soil fluoride spatial distribution presented similar patterns that high fluoride concentration mainly located in limestone, purple shale, and sandshale areas, indicated that soil fluoride spatial distribution was primarily dependent on the regional bedrock properties rather than anthropogenic inputs. From A- to C- horizon soil fluoride geometric mean concentration had an increasing tendency of 407, 448, and 465 mg/kg. This vertical variation was the result of the intensive eluviation under the subtropical hydrothermal condition, and had closely related with soil properties, such as lower organic matters and clay content variations. Moreover, the soil degradation and erosion was also an important pathway of soil fluoride movement, as a result the soil fluoride exported into surface and groundwaters would reach about 4.1x10(4) t year-1 in the study area.

Polymorphism of HLA-DRB1 gene shows no strong association with ulcerative colitis in Chinese patients

The genetic factors predisposing to ulcerative colitis (UC) have remained totally unclear to date. This study aimed to investigate the role of HLA-DRB1 genetic polymorphism in the susceptibility to develop UC in Chinese patients. HLA-DRB1 genotyping was carried out in 72 unrelated patients with UC and 314 healthy controls by using polymerase chain reaction-sequence-specific primers (PCR-SSP). All of the patients and healthy controls are Han people in China. The frequency of DRB1*07 allele was increased in UC patients compared with healthy controls (19.4% vs. 9.2%, P = 0.0229, OR = 2.372, 95%CI: 1.181-4.766), but the significance disappeared when given Bonferroni correction (P(C) = 0.2977). Furthermore, compared with healthy controls, although HLA-DRB1*07, DRB1*16/DRB1*09 and DRB1*07/DRB1*12 genotypes were increased in frequency in the patients with extensive colitis, and the patients without extraintestinal manifestations (EIMs) carried an increased frequency of HLA-DRB1*07 and DRB1*07/DRB1*12 genotypes, these differences did not reach statistical significance after Bonferroni correction. HLA-DRB1 alleles showed no strong association with UC, and no HLA-DRB1 alleles or genotypes were strongly associated with clinical subgroups of UC in Chinese patients.

Effects of topical treatment of sodium butyrate and 5-aminosalicylic acid on expression of trefoil factor 3, interleukin 1beta, and nuclear factor kappaB in trinitrobenzene sulphonic acid induced colitis in rats

BACKGROUND AND AIMS

Butyrate enemas have been shown to be effective in treatment of ulcerative colitis, but the mechanism of the effects of butyrate is not totally known. This study evaluates effects of topical treatment of sodium butyrate (NaB) and 5-aminosalicylic acid (5-ASA) on the expression of trefoil factor 3 (TFF3), interleukin 1beta (IL1beta), and nuclear factor kappaB (NFkappaB) in trinitrobenzene sulphonic acid (TNBS) induced colitis in rats.

METHODS

Distal colitis was induced in male Wistar rats by colonic administration of TNBS and colonically treated with NaB, 5-ASA, combination of NaB and 5-ASA, and normal saline for 14 consecutive days. Colonic damage score, tissue myeloperoxidase (MPO) activity, TFF3 mRNA expression, serum IL1beta production, and tissue NFkappaB expression were determined, respectively.

RESULTS

Treatment of NaB, 5-ASA, and the combination improved diarrhoea, colonic damage score, and MPO activities, increased TFF3 mRNA expression, and decreased serum IL1beta production and tissue NFkappaB expression. The combination therapy of NaB and 5-ASA had better effects than any other single treatment.

CONCLUSIONS

The combination of topical treatment of NaB and 5-ASA was effective for relieving and repairing colonic inflammation and the effects were related to stimulation of TFF3 mRNA expression and down-regulation of IL1beta production and NFkappaB expression.

Suppression of transforming growth factor-beta1 gene expression by Danggui buxue tang, a traditional Chinese herbal preparation, in retarding the progress of renal damage in streptozotocin-induced diabetic rats

Danggui buxue tang (DBT), a preparation containing Angelica sinensis (danggui) and Astragalus membranaceus (huangqi) at a ratio of 1 : 5, is used widely in China for stimulating red blood cell production and enhancing cardiovascular function. The present study was undertaken to characterize the effects of this preparation on diabetic nephropathy using streptozotocin-diabetic rats as a model. Streptozotocin-dependent alterations in renal weight/body weight ratio, urinary albumin and beta (2)-microglobulin concentrations, urinary albumin excretion rate, and creatinine clearance were ameliorated after eight weeks of treatment with either DBT or the angiotensin-converting enzyme inhibitor, benazepril. DBT, but not benazepril, partially attenuated the increases in blood glucose, triglycerides and cholesterol in STZ-diabetic rats. Additionally, the increased expression of transforming growth factor-beta (1) mRNA in the renal cortex due to streptozotocin-induced diabetes was modestly attenuated by these treatments. However, eight weeks of treatment with DBT failed to modify the concentration of angiotensin II in plasma or kidney, indicating that the ability of the preparation to retard the progression of kidney disease was not attributable to inhibition of the renin-angiotensin system. We propose that DBT alleviates renal alterations in diabetes and slows the progression of diabetic nephropathy by suppressing transforming growth factor-beta (1) mRNA expression. The preparation may therefore be useful as an adjuvant therapy for controlling diabetes and its complications.