Objective:To assess the effectiveness of free vascularized bone flap transfer for treatment of advanced osteoradionecrosis of the mandible (ORNM). Methods:We reviewed 53 patients who were treated for ORNM by radical resection and reconstruction with free vascularized bone flaps in our institute between January 2003 and January 2015. Results:Among the 53 vascularized bone flap patients, 48 (90.57%) had fibula osteocutaneous and 5 (9.43%) had deep circumflex iliac artery (DCIA). Postoperative complications occurred in 5 (10.42%) of the 48 fibula osteocutaneous patients (4 cases of vein thrombosis and 1 case of arterial crisis). In three of these patients, flap was salvaged back to normal in a timely manner by vascular exploratory surgery. However, pectoralis major myocutaneous flap was conducted as a second procedure for the other two patients. Meanwhile, complications occurred in 2 (40%) of the 5 DCIA transfer patients (1 case of vein thrombosis and 1 case of arterial crisis). None of these two flaps was salvaged back. Necrosis transfer bone was finally removed. No obvious donor site complications were noted. The mean follow-up time was 28 months. Our results showed that 88.57%of the patients with ORNM were stable, 85.71%of the patients can open their mouth at 2-3 figures, 85.72%of the patients can eat soft or semi-liquid food, and 80%patients can speak clearly and can be understood by others around them. No significant difference was found in mouth opening and face type of the patients with or without the intact condyle. However, the temporomandibular joint area discomfort of the patients with intact condyle was obviously less than that of patients with removed condyle. Conclusion:Radical resection, followed by vascularized bone flaps, especially fibula osteocutaneous, is still the best way to treat ORNM, as long as the indications are chosen appropriately, intraoperative work is conducted properly, and postoperative complications are controlled.

Galactinol synthase (GolS) genes play important roles in plant response to abiotic stress. In this research, the plant expression vector of soybean GmGolS2-2 gene was constructed and transformed into tobacco to study the drought tolerance of transgenic tobacco. A GmGolS2-2 gene with 975 bp coding sequence was cloned from soybean leaves by reverse transcription-polymerase chain reaction (RT-PCR). GmGolS2-2 was linked to the plant expression vector pRI101 by restriction enzyme sites Nde Ⅰ and EcoR Ⅰ, and transformed into tobacco by leaf disc method. Genomic DNA PCR and real-time PCR showed that three GmGolS2-2 transgenic tobacco plants were obtained. The growth status of GmGolS2-2 transgenic tobacco under drought stress was better than that of wild-type tobacco. After drought stress treatment, the electrolyte leakage and malondialdehyde content of transgenic tobacco were lower than those of wild-type tobacco, but the proline content and soluble sugar content were higher than those of wild-type tobacco. The results of real-time PCR showed that the heterologous expression of GmGolS2-2 increased the expression of stress-related genes NtERD10C and NtAQP1 in transgenic tobacco. The above results indicated that GmGolS2-2 improved drought resistance of transgenic tobacco.
Drought Resistance ; Tobacco/genetics* ; Soybeans/genetics* ; Plant Proteins/metabolism* ; Plants, Genetically Modified/genetics* ; Stress, Physiological/genetics* ; Droughts ; Gene Expression Regulation, Plant