Objective To establish a method for simultaneously measuring L-citrulline and L-arginine concentration in plasma using reversed-phase high performance liquid chromatography (RP-HPLC)with ultraviolet detection,and the novel method is applied to the patients with digestive system tumor.Methods Plasma samples were deproteinized by trichloroacetic acid with heating method.Phenylisothiocyanate (PITC)was used as derivatization reagent and a gradient elution was adopted. The feasibility verification of method was carried out by detecting plasma L-citrulline and L-arginine acid concentration in 21 cases of advanced digestive tract malignant tumor patients,21 cases of non malignant tumor patients and 39 cases of healthy people.Results The linearity for L-citrulline and L-arginine ranged from 0 to at least 1 000 μmol/L.r=0.999 95 for both. The lower limits of quantification for L-citrulline and L-arginine were 0.240 μmol/L and 0.448 μmol/L respectively.The in-traday and interday coefficients of variation (CVs)were less than 3.4% and 7.2%,respectively.The average recovery rate was from 95.2% to 104.1%.The ratio of plasma L-citrulline/L-arginine in patients with digestive cancar was significantly higher than that in the healthy control group,t-test,P =0.009.The sensitivity and specificity of plasma L-citrulline/L-argi-nine ratio in the malignant tumor of digestive system were 81% and 71.4% respectively.Conclusion This method can pro-vide a reliable and efficient method for the clinical determination of the L-citrulline and L-arginine concentration in plasma. The ratio of plasma citrulline/arginine increased obviously in patients with digestive cancer,suggesting that this ratio is a more sensitive index than single concentration of L-citrulline or L-arginine when evaluating patients with digestive tumor.

OBJECTIVETo evaluate the effectiveness of the submental island pedicled flap (SIPF) for the repair of oral soft defects following oral cancer ablation.

METHODSThirty consecutive patients undergoing resection of oral cancer followed by reconstruction with SIPF from February 2010 to March 2013 were reviewed. The effectiveness complications, oral function recovering and oncologic outcomes after reconstructive operation with SIPF were evaluated.SPSS software was used to analyze the data.

RESULTSThe dimensions of SIPF ranged from a minimum of 4 cm×6 cm to a maximum of 6 cm×15 cm. Of the 30 flaps, 28 were survival completely, one had superficial necrosis but healed with treatments, and one failed due to complete necrosis, with a survival rate of 96.7% (29/30). Operative time ranged from a minimum of 4.5 hours to a maximum of 7.5 hours, mean 6.8 hours, and hospital stay time was 11-18 days, mean 13 days. Thirteen patients (43.3%) received tracheotomy before SIPF operation. Surgical or postoperative complications included temporary marginal mandibular never palsy in one case, neck hematoma in one case, hydrops in the mandibular region in 7 cases, and neck infectionin in 2 cases. Postoperative functional results showed mouth opening was normal in 23 patients, light limitation of mouth opening in 6 cases and obvious limitation of mouth opening in one case. The speech function was re-obtained satisfactorily in 29 patients, but one case with poor speech function. Most patients showed normal swallowing function, of them 26 patients on a full oral diet, 3 patients on a soft diet and one patient on a liquid diet only. Postoperative follow-up time was for 6-19 months (median 13 months), and 4 patients had local recurrence and 2 patients had cervical lymph node metastases.

CONCLUSIONThe SIPF is safe, reliable and simple for the reconstruction of middle-small oral soft defects following resection of early-stage oral cancer.

Humans ; Image Processing, Computer-Assisted ; Mandible ; Mouth Neoplasms ; surgery ; Neck ; Neoplasm Recurrence, Local ; Postoperative Complications ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Wound Healing

OBJECTIVETo evaluate the clinical outcomes of submental island pedicled flap (SIPF) combination with bio-membrane in reconstructing palate defects after maxillofacial or palatal neoplasm resection.

METHODSThere were 12 patients with squamous cell carcinoma and one patient with adenoid cystic carcinoma. The clinical stages of tumours were II in two patients, III in four patients, IV in six patients (UICC 2002), and one patient with adenoid cystic carcinoma no staged. SIPFs were designed and created, and the tissue sides of the SIPFs were covered with bio-membrane to reconstruct the oral and the nasal sides of the defects respectively. Speech and swallowing functions and opening mouth were evaluated 6 months postoperatively.

RESULTSAll flaps survived and no serious complications occurred. Ten patients achieved normal speech, two had intelligible speech, and one was with slurred speech; Nine patients resumed a solid diet, three with a soft diet, and one on a liquid diet. Eight patients recovered normal mouth opening, four emerged minor limitation of mouth opening, and one had serious limitation of mouth opening.

CONCLUSIONSSIPF combined with bio-membrane is a safe, simple, and reliable method for reconstruction of piercing palate defect following neoplasm ablation, with satisfactory oral functions.

Carcinoma, Adenoid Cystic ; surgery ; Carcinoma, Squamous Cell ; surgery ; Deglutition ; Humans ; Palatal Neoplasms ; surgery ; Palate ; pathology ; surgery ; Reconstructive Surgical Procedures ; Speech ; Surgical Flaps

Objective To explore the effects and possible mechanism of histone deacetylase inhibitor SAHA on the interstitial fibrosis induced by diabetes.Methods The SD rats were divided into three groups:control group (Con,n=9),diabetes mellitus (DM) group (n=9) and SAHA treatment group (n=9).The diabetic rat model was established by injecting streptozotocin (STZ) through tail vein.After 8 weeks,the SAHA treatment group rats were fed with a SAHA solution (25 mg· kg-1 · d-1) by gastric gavage.After 16 weeks,all rats were sacrificed to detect relevant biochemical parameters,and observe the changes of pathomorphology in kidney.In addition,immunohistochemistry staining and Western blotting were employed to detect the protein expressions of transforming growth factor-β1 (TGF-β1),Smad2,Smad3,p-Smad2,p-Smad3,Smad7,collagen-Ⅰ and collagen-Ⅲ,respectively.Results Compared with Con group,the levels of blood glucose (BG),urinary trace albumin/urinary creatinine (ACR),triglyceride (TG) and total cholesterol (TC) in the diabetic group were all increased significantly (all P ＜ 0.05),the protein expressions of TGF-β1,p-Smad2,p-Smad3,collagen-Ⅰ and collagen-Ⅲ in kidney were all increased in diabetic group (all P ＜ 0.05),and the expression of Smad7 was significantly reduced (P ＜ 0.05).Compared with DM group,the levels of ACR was reduced,the renal fibrosis was alleviated,the protein expressions of TGF-β1,p-Smad2,p-Smad3,collagen-Ⅰ and collagen-Ⅲ in SAHA group were all decreased (all P ＜ 0.05),and the expression of Smad7 was increased significantly (P ＜ 0.05).Conclusion SAHA may restore the protein level of Smad7 by enhancing protein stability,then promote the moderate transduction of TGF-β1/Smads signaling pathway,which reduce the fibrosis of renal tubules in diabetic rats.

Humans ; Severe Acute Respiratory Syndrome ; diagnosis ; therapy