OBJECTIVE To establish an modified model of osteonecrosis in the rat and observe the clinical, pathological and imaging manifestations dynamically. METHODS Healthy male SD rats were divided into 5 groups randomly, including the control group (N, 8 rats), and radiation groups (a, b, c and d, 6 rats each group). For radiation groups, the left mandible of each rat was irradiated at doses of 7.0 Gy for 5 fractions, other rats were sham irradiated, serving as control groups.7 days after irradiation, the left mandibular molars of all rats were extracted. The radiation groups rats were sacrificed at 7, 14, 21, 28 days after irradiation randomly, the 2 rats in control group were sacrificed respectively. All the rats' mandibles were taken and examined by clinical manifestation and Micro-CT and histology methods. The data was analyzed with SPSS 18.0 software package. RESULTS In clinical observation, ulcers were seen in the irradiated site at the 7th day, after then, alopecia, occlusion disorder, and pus discharged from buccal side were seen. Weight loss rightly after radiation and weight gain were seen at the 14th day. In pathological observation, marrow cavity changed first. Many adipose cell was first seen at the 7th day, and inflammations, necrosis, and fibrosis were found in medulla in the irradiated groups after that. Significant increment of empty lacunae and decrement of osteocytes were observed in all irradiated groups at the 7th day. Necrotic bone of the irradiated mandible was only found at the 28th day. Lack of new bone formation within the socket was seen in the Micro-CT three-dimensional at 28th day, and there are no more changes at the early-stage in this model. CONCLUSION An modified rat model of osteoradionecrosis was successfully established, which can shorten experimental period, and this model early stage and deserved to be further researched. Can be used to observe clinical, pathological and imaging magnification, which play a basic role in the protection in early stage and deserved to be further researched.

Objective: To evaluate the feasibility and outcomes of the reconstruction of large anterior palatal fistulae by anteriorly based dorsal tongue flaps to provide a rational reference of anteriorly based dorsal tongue flaps for clinicians. Methods : Five patients with anterior hernia had a defect range of 1.0 cm × 1.0 cm to 1.5 cm × 2.0 cm, and the anterior tongue was 1.3 cm × 3.5 cm to 2.0 cm × 3.5 cm. The defects were all repaired with anteriorly based dorsal tongue flaps. The clinical efficacy was evaluated after operation, including whether the mucosal flap was infected, whether there was any shedding before the pedicle, and whether there was any perforation after operation. Thereafter, patients who were satisfied with their chewing, swallowing, speech function and appearance were followed up Results: All patients underwent successful reconstruction of palatal defects by anteriorly based tongue flaps, and no case of spontaneous detachment of the tongue flap occurred. Patients with palatal fistulae were followed up for 16-28 months, and no recurrence was encountered. The operation had no effect on the speech, agitation and swallowing function of the tongue, and patients were satisfied with the appearance. Conclusion The dorsal lingual mucosal flap pedicled with the anterior tongue is a safe and reliable method for repairing large anterior palatal fistula.

Objective : To investigate the changes of α2-macroglobulin in different stages of radiotherapy in patients with nasopharyngeal carcinoma, and to explore its feasibility as a marker of serum markers reflecting radiotherapy injury. Methods : We collected the blood samples of 23 cases of newly diagnosed patients with nasopharyngeal carcinoma before the simple radiotherapy, the 10, 20, 30 and 33 times after simple radiotherapy, detected the α2- macroglobulin levels. The difference among the five stages was analysed by paired t-test using SPSS17.0 software package. Results : The serum level of α2- macroglobulin elevated with the increase of number of radiotherapy. After 10 times’ radiotherapy, the serum α2-MG concentration in patients with nasopharyngeal carcinoma was significantly higher than that before radiotherapy (12.04 ± 5.72 vs. 10.81 ± 5.38 U/L), the difference was statistically significant (t=4.818, P < 0.05). After 20 times’ radiotherapy, the serum α2-MG concentration in patients with nasopharyngeal carcinoma was significantly higher than that before radiotherapy (12.26 ± 5.77 vs. 10.81 ± 5.38 U/L), and the difference was statistically significant (t=5.237, P < 0.001). After 30 times’ radiotherapy, the serum α2-MG concentration in patients with nasopharyngeal carcinoma was significantly higher than that before radiotherapy (12.91 ± 5.55 vs. 10.81 ± 5.38 U/L), the difference was statistically significant (t=6.076, P < 0.05). At the end of radiotherapy, the serum α2-MG concentration in nasopharyngeal carcinoma patients was significantly (13.43 ± 6.05 vs. 10.81 ± 5.38 U/L) higher than that before radiotherapy (t=5.189, P < 0.05). Conclusion The serum level of α2- macroglobulin changes with the radiotherapy, so it can be a serum marker reflecting the damage of maxilla induced by ionizing radiation.