OBJECTIVEThe aim of this study was to investigate the value of free anterolateral thigh myocutaneous flap (ALTMF) and computed tomography angiography (CTA) for the reconstruction of mouth-floor defects after the resection of middle-late stage carcinoma of the mouth floor.

METHODSSixteen cases of middle-late stage carcinomas of the mouth floor underwent radical resection, and mouth-floor and tongue defects were reconstructed with ALTMF. CTA was applied to plan the lateral circumflex femoral artery (LCFA) and its perforating vessel, which was verified during the operation.

RESULTSThe position of the perforating vessel in the operation was fully consistent with that designed by the preoperative CTA. All 16 flaps completely survived. The appearance and function of all cases were both satisfactory. All donor sites were primarily closed and healed without functional morbidity. During the follow-up period of 6-36 months, 15 cases survived with acceptable aesthetic and functional results in mouth floor and tongue reconstruction, except for 1 case (T4N2M0) that died of metastasis carcinoma 10 months after operation.

CONCLUSIONCTA can accurately locate the LCFA and artery perforator. Preoperative perforator planning using CTA in ALTMF transplantation is a reliable and useful method thatresults in safe operation with optimal outcome. The ALTMF is an ideal choice for the reconstruction of soft tissue defects after the resection of middle-late staie carcinoma of the mouth floor

Angiography ; Carcinoma ; Free Tissue Flaps ; Humans ; Mouth Floor ; Myocutaneous Flap ; Patient Care Planning ; Reconstructive Surgical Procedures ; Thigh ; Tomography ; Tongue

Objective To evaluate the efficacy of probiotics on chemotherapy-induced intestinal mucositis in rats.Methods The databases including PubMed,EMbase,Cochrane,CBM,CNKI,WanFang and VIP were retrieved from their establishment to April 2016.The related randomized controlled trials(RCT) on the effects of probiotics for treating chemotherapy-induced intestinal mocositis in rats were included.The relevant literatures were screened according to the inclusion and exclusion criteria,then the data were extracted and analyzed.Results Total 6 RCT were included.Compared with the control group,the intestinal secretion and absorption function in the probiotics group was strengtnened[SMD=1.73,95 ％CI(0.79,2.68),P＜0.01],jejunal anti-oxidant capacity was increased [SMD=-2.12,95％CI(-3.56,-0.67),P＜0.01],however low dose probiotics (＜1 × 109 cfu/d)had no protective effect on small intestine[SMDjejunum =-0.06,95％CI(-0.51,0.40),SMDileum =0.02,95％ CI(-0.71,0.75);P ＞0.05],while high dose probiotics(≥ 1 × 109 cfu/d) could reduce the intestinal pathological damage[SMDjejunum =-0.64,95 ％ CI (-1.20,-0.09),SMDileum=-0.85,95％ CI(-1.59,-0.12);P＜0.05].Conclusion High dose probiotics can reduce chemotherapy-induced intestinal mucositis in rats.Because of less included literatures and the influence of publication bias,the effect of probiotics on chemotherapy induced mucositis could be overestimated.