0.05 ),respectively. Conclusions:Modified radical neck dissection with internal jugular vein preservation may have similar therapeutic effect to radical neck dissection.

Objective:To investigate the feasibility of modified combined radical neck dissection remaining integrality of mandible in the surgical management of advanced tongue squamous cell carcinoma.Methods:39 cases of advanced tongue squamous cell carcinoma received modified combined radical operation remaining integrality of mandible,7-year follow-up was conducted.Results:Integrality of mandible and the function of mastication were remained in all the cases.1 and 3 years after operation there were 1 case and 9 cases of recurrence respectively.Metastasis was found in 5 cases.The 3-year survival rate was(61.72?5.44)%.Conclusion:The modified combined radical neck dissection remaining integrality of mandible is feasible in the treatment of advanced tongue squamous cell carcinoma.

Objective To discuss the management and selection of donor and recipient veins in the transfer of vascularied autogeneous submandibular gland (SMG).Methods The SMGs of 48 patients with severe keratoconjunctivitis were transfered to the temporal region by microsurgery from June,2002 to June,2013.The secreted saliva was used as the substitute of tear.Donor and accepting-site vessels,vessels crisis and managements,survival of grafts were retrospectively analysed.Results Transplantation succeeded in 45 patients and failed in 3.For donor veins,39 were facial veins,12 were venae comitantes of facial artery,1 was vein near the duct.For revipient veins,41 were superficial temporary veins,6 were deep temporary veins and 5 were veins in the upper neck.For revipient artery,except superficial temporary artery,deep temporary artery was also a good selection.After surgery,2/5 venous crisis cases were rescued by reanastomosising veins.TC99m examination suggested that the 49 TSMGs were survived,and the ducts were unobstructed.Follow up lasted for 6 months to 10 years,the symptoms of photophobia and anemophobia were alleviated,the symptoms of corneal xerosis disappeared.Good clinical efficacy was obtained after transplantion.Conclusion During SMGs transplantion,facial veins,venae comitantes of facial artery or vein near the duct can be used for donor vein.For recipient veins,except the superficial temporary veins as major,deep temporary veins or veins in the upper neck is also a secection.Correct selection and microsurgical management of donor and revipient veins are keys to successful SMGs transplantion.

Objective To evaluate the clinical efficacy of pingyangmycin (PYM) injection on infantile hemangioma located in the parotid gland region. Methods Twelve patients were treated by intralesional injection of PYM. When necessary, the injections were repeated at an interval of one week, but not more than 3-4 sessions within a therapeutic period. Normally, the secondary therapeutic period was performed 1 month later. The general and local adverse responses were recorded and the clinical outcomes were assessed with a follow-up of 1 to 3 years. Results Complete clinical resolutions were achieved in 10 patients. 2 patients received one injection, 3 patients received 2 injections, 3 patients received 3 injections, and 2 patients received 4 injections. The remaining 2 patients with partial resolution received 6 and 7 injections respectively. No clinical recurrence was observed during the follow-up of 1 to 3 years. No ulcerations or postoperative sears in injection regions were presented. The function of facial nerve was remained normality in all patients. The systematic side effects included transient pyrexia and poor appetite appeared in partial patients. No allergy cases were found. Conclusion Treatment of infantile hemangioma located in parotid gland region with PYM injection reveals a high rate of complete clinical resolution, with fair cosmetic results and short treatment time, and it does not damage the facial nerve or form local scar.The treatment time of PYM injection seems to be positively related to size of the lesions.

Objeetive To investigate the outcome of microvascular reconstruction of the tongue with anterolateral thigh flaps in the treatment of middle-late stage tongue cancer patients. Methods From December 2003 to March 2007,nine patients underwent simultaneous reconstruction of the tongue and oral floor defects with anterolateral thigh flaps after resection of squamous cell carcinoma of tongue.The flaps ranged from 7 cm×10 cm to 10 cm×12 cm in size,and were adjusted to the defect of the tongue and oral floor.The vascular pedicle included descending branch of the lateral femoral circumflex artery and the accompanying veins.The outcome of reconstruction was evaluated by follow-up examinations,considering the contour and mobility of the reconstructed tongues,the swallowing function and the speech function.Results All of the donor sites were closed directly,with minimal donor-site morbidity. All patients recovered unevenffully from surgery,with no immediate postoperative complications:no flap necrosis,no wound infection or wound dehiscence.The transplanted flaps survived well.The average follow-up period was 18 months.During the follow-up period there was no tumor recurrence and the contour of the reconstructed tongues showed sufficient bulk.The patients demonstrated good mobility of the reconstructed tongue.The swallowing and speech function recovered satisfactory.Two months postoperatively the patients were able to ingest a solid or semisolid diet,and six months postoperatively the patients developed intelligibe language.Conclusion The anterolateral thigh flaps are suitable and reliable for the microsurgical reconstruction of the large defects caused by middle-late stage tongue cancer.

OBJECTIVETo explore the myeloid-derived suppressor cell (MDSC) expression in the peripheral blood and lesions of 4NQO-induced tongue carcinoma in mouse.

METHODSThe established 4NQO mouse model was used to analyze the distribution of MDSC and T cell subsets in the peripheral blood by flow cytometry. The relations of MDSC with T cell subsets and CD4⁺/CD8⁺ changes were evaluated. The distribution of MDSC in the lesions of tongues was analyzed by immu- nohistochemistry, and the expression of arginase 1 (ARG-1) in tongue tissues was detected by real-time polymerase chain reaction.

RESULTSDuring tumor progression, a significant increase was observed in the frequency of MDSC in the peripheral blood of 4NQO treated mice (P < 0.01). The frequency of MDSC was positively correlated with systemic CD3⁺CD8+T cells but negatively correlated with the CD4⁺/CD8⁺ ratio. Squamous cell carcinomas were extensively infiltrated with MDSC, whereas dysplastic area and normal tongue mucosa had only sparse MDSC infiltration. The majority of MDSCs were located in the stroma, particularly along the tumor invasive front. Moreover, 4NQO-treated mice showed significantly higher ARG-1 mRNA levels in the tumor site (P<0.01).

CONCLUSIONMDSC may contribute to oral tumor progression and represents a potential target for immunotherapy of oral cancer.

4-Nitroquinoline-1-oxide ; Animals ; Arginase ; Cell Count ; Flow Cytometry ; Mice ; Models, Animal ; Myeloid-Derived Suppressor Cells ; immunology ; Real-Time Polymerase Chain Reaction ; T-Lymphocyte Subsets ; immunology ; Tongue Neoplasms ; immunology

Objective: To evaluate the expression of HAase in Oral Squamous Cell Caricinoma (OSCC). Methods : The distribution and expression of HAase in 21 patients with OSCC and their resecetions with tumor-free margins were examined by immunohistochemistry method. Results: HAase were mainly immunostained in tumor tissue. The expression of HAase in oral cancer with nodal metastasis and low pathological grades were higher than that with no nodal metastasis and high pathological grades (P < 0.05), whereas no difference between the TNM stages (P > 0. 05). Conclusion The HAase levels were high in oral squamous cell carcinoma tissues, and rising in patients with lymph node metastasis and poorly differentiated.

OBJECTIVETo explore the expression of Notch signaling receptors Notchl, Notch3 and its ligand Jaggedl, Jagged2 in tongue squamous cell carcinoma (TSCC).

METHODSmRNA and protein expression levels of tissue samples from 74 cases of tongue cancer patients and human tongue cell line Cal-27 were detected by reverse transcriptase-polymerase chain reaction (RT-PCR), immunohistochemistry and Western blot. Its relationship with cell proliferation and clinical pathology was analyzed.

RESULTSmRNA and protein expression were detected in tongue cancer tissues, adjacent tissues and cell lines. Notchl and Notch3 protein expression in tongue cancer was higher than the adjacent tissues. Jaggedl and Jagged2 protein expression in tongue cancer and adjacent tissues had no difference. Notchl and Notch3 protein had correlation with tongue cancer clinical staging. Pathway protein expression had no correlation with pathological grade, age, gender. Notchl protein expression in lymph node metastasis-positive cases was higher than in lymph node metastasis-negative cases. The expression of Notch3 and Jagged2 had correlation. Jaggedl expression grade in metastasis-positive cases was higher than in negative cases.

CONCLUSIONNotch signaling molecules have active expression in TSCC and may play important roles in tongue cancer development.

Blotting, Western ; Carcinoma, Squamous Cell ; Cell Line ; Cell Proliferation ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Neoplasm Staging ; RNA, Messenger ; Receptors, Notch ; Tongue ; Tongue Neoplasms

Deglutition is one of the basic physiological functions of humans. The surgical treatment of oral cancer can cause impairment in swallowing functions and even dysphagia in serious cases. Currently, there are many types of methods for assessing dysphagia, including bedside evaluation, scale evaluation, radiographic assessment, and stress or electromyographic evaluation during swallowing. However, each of these methods has advantages and disadvantages, and there is no uniform standard. This article briefly introduces the current status of methods for assessing dysphagia related to oral cancer.

Objective:To analyze the diagnostic and prognostic value of routine bone marrow examination in patients with extranodal NK/T-cell lymphoma (ENKTCL) based on PET-CT staging.Methods:Clinical data of 186 patients who received bone marrow biopsy and bone marrow aspiration in Fujian Medical University Union Hospital from 2013 to 2021 were retrospectively analyzed. All patients were divided into bone marrow biopsy + bone marrow aspiration group ( n=186) and PET-CT + bone marrow biopsy group ( n=139). The sensitivity, specificity, positive and negative predictive values were compared between two groups. The data were analyzed and plotted. Survival analysis was performed using Kaplan-Meier method and log-rank test. Results:In the whole cohort, 45 patients were positive for bone marrow biopsy, and 30 of them were positive for bone marrow aspiration. A total of 141 patients who were negative for bone marrow biopsy also achieved negative results for bone marrow aspiration. A total of 139 patients completed PET-CT staging and bone marrow biopsy. And 30 patients were diagnosed with positive bone marrow by PET-CT, in which 22 of them were confirmed positive by bone marrow biopsy. Among 109 patients diagnosed with negative bone marrow by PET-CT, 5 of them were confirmed positive by bone marrow biopsy. All these cases were classified as stage Ⅳ due to distant metastases. PET-CT had a diagnostic sensitivity of 81.5%, a specificity of 92.9%, a positive predictive value of 73.3%, and a negative predictive value of 95.4%. Among early stage (Ⅰ-Ⅱ stage) patients diagnosed with PET-CT, all of them were negative for bone marrow biopsy (the negative predictive value was 100%). In stage Ⅳ patients ( n=55), the 1-year overall survival of patients with bone marrow involvement by bone marrow biopsy or PET-CT ( n=35) compared with their counterparts with the involvement of other organs ( n=20) was 28.7% vs.42.0% ( P=0.13), and 1-year progression free survival rates was 23.2% vs. 23.3% in ( P=0.94). Conclusions:Routine bone marrow biopsy does not change the original staging of patients with early stage ENKTCL based on PET-CT staging. Advanced stage patients with positive bone marrow biopsy tend to obtain worse prognosis, indicating that bone marrow biopsy still has certain value.