1.Validation of retinoblastoma mouse model based on fluorescence imaging technology
Cailing DAI ; Wei YANG ; Limei WANG ; Jinlong DAI ; Yuying WEN ; Jianmin GUO
International Eye Science 2025;25(5):706-713
AIM: To provide references for the non-clinical evaluation of therapeutic targets or drugs for retinoblastoma, fluorescently labeled Y79 cells are injected into the vitreous body of BALB/c-nu mice to establish a retinoblastoma model, and the Melphalan treatment group is used as a positive control, which is verified by fluorescence imaging technology.METHODS: BALB/c-nu mice were intravitreous injected with GFP transfected Y79 cells(1.0×107 cell/mL, 3 μL)to establish the model. On the 27th day, the mice were randomly divided into model control group and different doses of Melphalan groups(1, 3, 10 μg/eye groups)according to the fluorescence value of in vivo imaging, with vitreous body single administrated and ocular symptoms observed daily. Slit-lamp examination was performed at 12, 20, 29, 35, 42, 48, 55, 76, and 83 d after modeling. In vivo imaging was performed on 12, 20, 27, 41, 48, 55, 62, 69, 76, and 83 d. At the last treatment, the eyeball, brain and cerebellum tissues were removed for histopathological examination.RESULTS: From the sixth day of modeling, cloud-like substances could be seen in the eyes of the animals, and the cloud-like substances occupied the whole eyeball of the mice in the model control group at the later stage, accompanied by irregular growth of blood vessels. After 27 days of modeling, the fluorescence value was detected in all the animals, and the fluorescence value continued to increase with the extension of modeling time. The fluorescence value of the tumor reached the peak after 69-83 days of modeling. Histological examination showed severe proliferation of intraocular tumor cells in the model control group, and tumor cells were observed in the brain of 1 model animal. In the 10 μg/eye Melphalan group, the fluorescence value was significantly decreased at 17 d after administration. The fluorescence value of the 3 μg/eye Melphalan group was significantly inhibited at 59 d after administration. No tumor cells were found in the brain tissue of animals in all Melphalan groups.CONCLUSION: After vitreous injection of Y79/pCDH-LUC-copGFP cells in BALB/c-nu mice, significant ocular lesions and proliferation of tumor cells were observed in the eyes. Meanwhile, Melphalan intervention significantly inhibited tumor cells in a dose-dependent manner, indicating that the mouse model of retinoblastoma was successfully constructed.
2.Feixin Decoction Treats Hypoxic Pulmonary Hypertension by Regulating Pyroptosis in PASMCs via PPARγ/NF-κB/NLRP3 Signaling Pathway
Junlan TAN ; Xianya CAO ; Runxiu ZHENG ; Wen ZHANG ; Chao ZHANG ; Jian YI ; Feiying WANG ; Xia LI ; Jianmin FAN ; Hui LIU ; Lan SONG ; Aiguo DAI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):1-9
ObjectiveTo investigate the mechanism by which Feixin decoction treats hypoxic pulmonary hypertension (HPH) by regulating the peroxisome proliferator-activated receptor gamma (PPARγ)/nuclear factor-kappa B (NF-κB)/NOD-like receptor pyrin domain containing 3 (NLRP3) signaling pathway. MethodsForty-eight male SD rats were randomly allocated into normal, hypoxia, and low-, medium- and high-dose (5.85, 11.7, 23.4 g·kg-1, respectively) Feixin decoction groups, with 8 rats in each group. Except the normal group, the remaining five groups were placed in a hypoxia chamber with an oxygen concentration of (10.0±0.5)% for 8 h per day, 28 days, and administrated with corresponding drugs during the modeling process. After 4 weeks of treatment, echocardiographic parameters [pulmonary artery acceleration time (PAT), pulmonary artery ejection time (PET), right ventricular anterior wall thickness (RVAWd), and tricuspid annular plane systolic excursion (TAPSE)] were measured for each group. The right ventricular systolic pressure (RVSP) was measured by the right heart catheterization method, and the right ventricular hypertrophy index (RVHI) was calculated by weighing the heart. The pathological changes in pulmonary arterioles were observed by hematoxylin-eosin staining. The co-localization of α-smooth muscle actin (α-SMA) with NLRP3, N-terminal gasdermin D (N-GSDMD), and cysteinyl aspartate-specific proteinase-1 (Caspase-1) in pulmonary arteries was detected by immunofluorescence. The protein levels of PPARγ, NF-κB, NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), N-GSDMD, interleukin-1β (IL-1β), interleukin-18(IL-18), and cleaved Caspase-1 in the lung tissue was determined by Western blot. The ultrastructural changes in pulmonary artery smooth muscle cells (PASMCs) were observed by transmission electron microscopy. ResultsCompared with the normal group, the hypoxia group showed increased RVSP and RVHI (P<0.01), decreased right heart function (P<0.01), increased pulmonary vascular remodeling (P<0.01), increased co-localization of α-SMA with NLRP3, N-GSDMD, and Caspase-1 in pulmonary arterioles (P<0.01), up-regulated protein levels of NF-κB, NLRP3, ASC, N-GSDMD, IL-1β, IL-18, and cleaved Caspase-1 in the lung tissue (P<0.05, P<0.01), a down-regulated protein level of PPARγ (P<0.05, P<0.01), and pyroptosis in PASMCs. Compared with the hypoxia group, Feixin decoction reduced RVSP and RVHI, improved the right heart function and ameliorated pulmonary vascular remodeling (P<0.05, P<0.01), decreased the co-localization of α-SMA with NLRP3, N-GSDMD, and Caspase-1 (P<0.05, P<0.01), down-regulated the protein levels of NF-κB, NLRP3, ASC, N-GSDMD, IL-1β, IL-18, and cleaved Caspase-1 in the lung tissue (P<0.05, P<0.01), up-regulated the protein level of PPARγ (P<0.05, P<0.01), and alleviated pyroptosis in PASMCs. ConclusionFeixin decoction can ameliorate pulmonary vascular remodeling and right heart dysfunction in chronically induced HPH rats by regulating pyroptosis in PASMCs through the PPARγ/NF-κB/NLRP3 pathway.
3.Screening and genotyping of Mur blood group among voluntary blood donors in the population of Hezhou,Guangxi
Weiquan YUAN ; Shaohua DING ; Jianmin LI ; Xueming WU ; Shengming WEN ; Houquan LIN ; Weisheng HE ; Xi-Aoming LI ; Jiajie ZHANG ; Longming XIAO ; Shengbao DUAN ; Shengwang CHEN
Chinese Journal of Blood Transfusion 2024;37(7):773-778
Objective To screen the distribution frequency of Mur blood group among voluntary blood donors in Hezhou,Guangxi,and further analyze the molecular basis of of Mur antigen positive samples.Methods The Mur pheno-type of voluntary blood donors in Hezhou was serologically screened using microplate method,and the distribution frequency of Mur antigens in different ethnic groups was analyzed.Genetic typing was performed on these positive samples with PCR-SSP method to verify the accuracy of the serological method,and the genetic background was sequenced and analyzed.Re-sults Among 3 298 samples from voluntary blood donors in Hezhou,432(13.10%,432/3 298)were screened positive for Mur antigen,and PCR-SSP genotyping validation showed that all 432 samples were electrophoretic positive.Among them,the proportion of Han blood donors with positive Mur antigen was12.79%(331/2 587),Yao ethnic group was13.25%(64/483),Zhuang ethnic group was 16.51%(36/218),and no statistically significant difference was found in the three groups(P>0.05).Further sequencing results showed that 428 samples were GYP(B-A-B)Mur,also known as GYP.Mur type(12.98%,428/3 298),the other 4 samples were GYP(B-A-B)Bun,also known as GYP.Bun type(0.12%,4/3 298).Conclusion The Mur blood type frequency is high in the voluntary blood donors in Hezhou,Guangxi,and is predominant characterized by GYP.Mur genotype.Due to ethnic integration,no significant difference was noticed in the frequency of Mur blood type distribution between Han,Zhuang and Yao population.Therefore,conducting extensive Mur blood group antigen and antibody testing in Hezhou is of great significance for ensuring clinical blood transfusion safety.
4.Correlation of contrast-enhanced ultrasound parameters of adenomyoma before and after MR-guided focused ultrasound surgery with therapeutic efficacy
Peidi ZHANG ; Xiao YANG ; Jianmin ZHENG ; Haijing LIU ; Lina PANG ; Lei DING ; Wen LUO
Chinese Journal of Interventional Imaging and Therapy 2024;21(5):257-261
Objective To explore the correlation of contrast-enhanced ultrasound(CEUS)parameters of adenomyoma before and after MR-guided focused ultrasound surgery(MRgFUS)with the therapeutic efficacy.Methods Uterine ultrasound and CEUS data of 26 patients with adenomyoma before and 24 h,1 and 6 months after MRgFUS,as well as MRI before and immediately after MRgFUS were retrospectively analyzed.The lesion volume shown on CEUS and MRI before MRgFUS,the non perfusion volume(NPV)of adenomyoma on MRI immediately after and CEUS 24 h after MRgFUS were compared.The ablation rate of lesions was calculated based on CEUS 24 h after MRgFUS.The focal blood flow score before,24 h after MRgFUS and the sum of the two,also the numerical rating scale(NRS)score before and 1,6 months after MRgFUS and the change rate were analyzed.The correlations of CEUS parameters with the efficacy of MRgFUS for treating adenomyoma were observed.Results No significant difference of lesion volume nor NPV on CEUS or MRI was found(both P>0.05).The ablation rate of lesions 24 h after treatment was(58.11±24.92)%.The focal blood flow score before,24 h after MRgFUS and the sum of the two was 2.00(2.00,2.00),1.00(1.00,1.00)and 3.50(3.00,3.50),respectively,with significant difference between before and 24 h after MRgFUS(Z=-4.463,P<0.001).NRS score was 5.00(4.00,6.00),3.00(2.00,4.00)and 2.00(1.00,3.00)before treatment,1 and 6 months after treatment,respectively,with significant differences at different time points(all P<0.01).The change rate of NRS score 1 and 6 months after treatment was 35.42%(23.75%,50.00%)and 60.00%(50.00%,77.08%),respectively.The lesion blood flow score before and 24 h after MRgFUS and the sum of the two were all negatively correlated with ablation rate(rs=-0.552,-0.820,-0.745),while positively correlated with NRS scores 6 months after treatment(rs=0.513,0.552,0.496)but negatively correlated with the change rate of NRS scores 6 months after treatment(rs=-0.525,-0.479,-0.531).The ablation rate 24 h after treatment was negatively correlated with NRS scores(rs=-0.462)while positively correlated with the change rate of NRS scores 6 months after treatment(rs=0.500).Conclusion CEUS parameters before and after treatment were correlated with the therapeutic efficacy of MRgFUS for treating adenomyoma.
5.Research Progress on Chemical Composition,Pharmacological Effect and Safety Evaluation of Forsythiae Fructus
Xuebaihe MA ; Jianmin GUO ; Yuying WEN ; Cailing DAI ; Wei YANG
Traditional Chinese Drug Research & Clinical Pharmacology 2024;35(7):1093-1100
Forsythiae fructus,a traditional Chinese medicine for heat clearing and detoxifying,is commonly used in clinic.It mainly contains phenylethanol glycosides,lignans,terpenoids,volatile oils,flavonoids and other chemical components.Numerous studies have confirmed that forsythiae fructus has anti-inflammatory,antibacterial,antiviral,anti-cancer and other pharmacological effects.Moreover,it has high safety.In this paper,the chemical composition,pharmacological action and safety of forsythiae fructus were reviewed.The aim of this study is to collect the relevant research achievements of forsythiae fructus,and to provide ideas and references for its further research and clinical application.
6.The characteristics of laboratory findings and multimorbidities in elderly patients with rheumatoid arthritis
Zitao WANG ; Ting XIANG ; Wen WANG ; Jianmin XIE
Chinese Journal of Geriatrics 2022;41(4):411-416
Objective:To analyze the characteristics of laboratory test results and multimorbidities in elderly patients with rheumatoid arthritis(RA)and thus to provide a basis for the treatment of RA in the elderly.Methods:Retrospective analysis was performed on RA patients admitted to the Second Affiliated Hospital of Nanjing Medical University from March 2018 to December 2020.Patients were divided into an elderly RA(ERA)group(≥60 years)and a non-elderly RA(NERA)group(<60 years).The prevalences of multimorbidities and laboratory results were compared between the two groups, and influencing factors of multimorbidities in ERA patients were analyzed by using binary Logistic regression.Results:There were 215 patients in this cohort, of whom 156 patients were in the ERA group and 59 patients were in the NERA group.The prevalences of comorbid hypertension, diabetes mellitus, coronary heart disease(CHD)and interstitial lung disease in the ERA group were higher than those in the NERA group( χ2=19.890, 6.977, 5.964, 7.484, all P<0.05).The disease duration in the ERA group was longer than that in the NERA group[117.5(36.0, 240.0)months vs.72.0(10.5, 123.5)months, Z=3.142, P=0.002], and the levels of serum C-reactive protein(CRP), erythrocyte sedimentation rate(ESR), urea, creatinine and cystatin C were higher than those in NERA group[9.7(3.2, 24.8)mg/L vs.3.1(3.0, 8.3)mg/L, 31.0(13.0, 53.3)mm/h vs.17.0(11.0, 31.5)mm/h, (5.38±1.54)mmol/L vs.(4.75±1.46)mmol/L, (63.82±15.33)μmol/L vs.(57.31±11.38)μmol/L, (1.23±0.42)mg/L vs.(0.90±0.23)mg/L]( Z=4.275, 2.770, t=2.714, 2.966, 5.714, all P<0.05).The levels of serum magnesium, albumin and hemoglobin were lower than those in the NERA group[(0.84±0.08)mmol/L vs.(0.86±0.06)mmol/L, (37.46±5.32)g/L vs.(40.77±4.95)g/L, (114.52±18.06)g/L vs.(124.32±16.40)g/L]( t=2.653, 4.147, 3.648, all P<0.05).Correlation analysis showed that the level of serum CRP in the ERA group was negatively correlated with serum albumin and magnesium( r=-0.449, -0.329, all P<0.05).Uric acid was positively correlated with rheumatoid factor(RF), cystatin C, urea, age and disease duration( r=0.259, 0.416, 0.210, 0.232, 0.179, all P<0.05), but negatively correlated with hemoglobin and magnesium( r=-0.262, -0.207, all P<0.05).RF was positively correlated with uric acid, urea, total cholesterol, low density lipoprotein, the 28-joint Disease Activity Score(DAS28 score), age and disease duration( r=0.259, 0.177, 0.205, 0.234, 0.248, 0.225, 0.211, all P<0.05), but negatively correlated with albumin and hemoglobin( r=-0.301, -0.182, all P<0.05).Serum magnesium was negatively correlated with CRP, ESR, urea, uric acid and cystatin C( r=-0.273, -0.192, -0.175, -0.207, -0.315, all P<0.05).These correlations were not found in the NERA group.Multivariate Logistic regression analysis showed that factors affecting hypertension in ERA patients were age, RF and albumin.Influencing factors of CHD were age, disease duration, serum magnesium and triglycerides.Factors that affect interstitial lung disease were RF, DAS28 score and albumin. Conclusions:Compared with NERA patients, ERA patients show an elevated level of systemic inflammation and poorer nutrition assessed by relevant parameters.CRP, RF and uric acid have complex correlations with serum magnesium, hemoglobin, and albumin.ERA patients have higher prevalences of multimorbidities.Age, disease duration, RF, triglycerides, DAS28 score, serum magnesium and albumin affect the occurrence of multimorbidities in ERA patients.
7.Reconstruction of anterior maxilla defect with fibula musculocutaneous flap assisted by digital surgical technology
Guowen SUN ; Xudong YANG ; Jianmin WEN ; Xin CHEN ; Qingang HU
Chinese Journal of Plastic Surgery 2021;37(10):1122-1128
Objective:To investigate the precise reconstruction method of anterior maxillary defect with fibula musculocutaneous flap assisted by digital surgical technology.Methods:The clinical data of the patients with anterior maxillary defect repaired by fibular free flap from January 2014 to January 2020 in Nanjing Stomatological Hospital were analyzed retrospectively. Mimics 23.0 software was used to perform computer virtual surgery using preoperative CT data of patients. Then the design of the focal osteotomy guide plate, fibular plastic guide plate and fibular reduction guide plate as well as the surgical plan was completed. The navigation registration point was designed by the Accunavi-A navigation system. The surgical guide plates were 3D printed. During the operation, the fibular musculocutaneous flap was harvested to cover the defect after resection of the anterior maxillary lesion with the assistance of the surgical guide plate and navigation technology. The facial appearance and function were followed up after operation.Results:A total of 12 cases, 9 males and 3 females, aged from 33 to 56 years, were included. There were 5 cases of gingival carcinoma, 4 cases of ameloblastoma, 1 case of chondrosarcoma, 1 case of mucoepidermoid carcinoma and 1 case of odontogenic myxoma. The size of the defect after resection was 5 cm×4 cm-6 cm×5 cm. In 12 patients, the focal osteotomy guide plate and fibula plastic guide plate were designed accurately, and the fibular reduction guide plate was successfully placed with accurate navigation and no displacement during the operation. The position of transplanted fibula was consistent with the normal maxillary position. The length of fibula was 8 -10 cm, and the size of the fibular free flap was 5 cm× 4 cm-6 cm×5 cm. All fibular musculocutaneous flaps survived. The patients were followed up for 1 to 72 months, with an average of 24.5 months. The patients had clear pronunciation, no oral and nasal reflux during diets, and presented in good facial appearance. No tumor recurrence occurred in 12 patients during follow-up.Conclusions:It is an accurate and feasible method to repair the anterior maxilla defect with fibula free flap assisted by digital surgical technology. The function of oral and nasal closure and speech was well maintained. A satisfactory facial appearance was obtained.
8.Role of interleukin-6 in human umbilical vein endothelial cell to mesenchymal cell transformation
Ling GUO ; Jing HE ; Li CUI ; Junwei MI ; Shu ZHANG ; Jianhui SUN ; Juan DU ; Dalin WEN ; Huacai ZHANG ; Jianxin JIANG ; Jianmin WANG ; Hong HUANG
Chinese Journal of Burns 2021;37(5):420-428
Objective:To observe the effect of interleukin-6 (IL-6) on the phenotype and function of human umbilical vein endothelial cells (HUVECs) and explore the role of IL-6 in the process of endothelial-to-mesenchymal transition (EndMT).Methods:The experimental research method was used. Fresh umbilical cord discarded after normal maternal delivery was collected. On the second day of the primary cell isolation and cultivation, the cell morphology was observed under inverted phase contrast microscope. HUVECs of the 4th passage were identified by immunofluorescence method, and 2 batches of HUVECs ofthe 3rd to 5th passages were used for the subsequent experiments. The first batch of cells were divided into 6 groups according to the random number table (the same below): blank control group, 5 ng/mL IL-6 group, 10 ng/mL IL-6 group, 25 ng/mL IL-6 group, 50 ng/mL IL-6 group, and 100 ng/mL IL-6 group. The second batch of cells were divided into 4 groups: blank control group, 10 ng/mL IL-6 group, 25 ng/mL IL-6 group,and 50 ng/mL IL-6 group; the cells in blank control group was cultured with complete culture medium only, while the cells in the other groups were added with IL-6 of the corresponding final mass concentrations.Cells from the 1st batch were cultured for 72 hours after grouping, the morphology of HUVECS in the 6 groups was observed under inverted phase contrast microscope. At 72 h after grouping culture, the positive expressions of coagulation factor Ⅷ and α vascular smooth muscle actin (α-SMA) in HUVECs in the 6 groups were detected by immunofluorescence method, and the ratio of the number of double positive cells to the number of coagulation factor Ⅷ positive cells (the ratio of double positive cells for short) was calculated, with 6 samples per group; mRNA expression levels of vascular endothelial cadherin and α-SMA of HUVECs in 6 groups were detected by reverse transcription-polymerase chain reaction, with 3 samples per group.Cells from the 2nd batch were cultured 72 hours after grouping, the protein expression levels of vascular endothelial cadherin, α-SMA, and type Ⅰ collagen in the 4 groups were detected by Western blotting, with 3 samples per group. Data were statistically analyzed with one-way analysis of variance and Bonferroni correction.Results:On the 2nd day after isolation and cultivation, the primary cells were in short spindle shape or polygon, cells of the 4th passage were identified as HUVECs by immunofluorescence method. At 72 hours of culture after grouping, the cells from the 1st batch in the 6 groups changed to long spindle shape morphologically along with the increase of IL-6 concentration, the intercellular connections decreased or disappeared with the gap between cells becoming larger. At 72 h after grouping culture, compared with that inblank control group, the ratio of double positive cells in 25 ng/mL IL-6 group, 50 ng/mL IL-6 group, and 100 ng/mL IL-6 group were significantly increased ( P<0.01); compared with that in 5 ng/mL IL-6 group, the ratio of double positive cells in 25 ng/mL IL-6 group, 50 ng/mL IL-6 group, and 100 ng/mL IL-6 group were significantly increased ( P<0.01); compared with that in 10 ng/mL IL-6 group, the ratio of double positive cells in 50 ng/mL IL-6 group and 100 ng/mL IL-6 group were significantly increased ( P<0.01); the ratio of double positive cells in 100 ng/mL IL-6 group was significantly increased compared with those in 25 ng/mL IL-6 group and 50 ng/mL IL-6 group ( P<0.01). At 72 h after grouping culture, compared with that in blank control group, the mRNA expression levels of vascular endothelial cadherin of cells in 25 ng/mL IL-6 group, 50 ng/mL IL-6 group, and 100 ng/mL IL-6 group were significantly decreased ( P<0.01 or P<0.05); compared with that in 5 ng/mL IL-6 group, the mRNA expression levels of vascular endothelial cadherin of cells in 50 ng/mL IL-6 group and 100 ng/mL IL-6 group were significantly decreased ( P<0.01); compared with that in 10 ng/mL IL-6 group, the mRNA expression levels of vascular endothelial cadherin of cells in 50 ng/mL IL-6 group and 100 ng/mL IL-6 group were significantly decreased ( P<0.01); compared with that in 25 ng/mL IL-6 group, the mRNA expression levels of vascular endothelial cadherin of cells in 50 ng/mL IL-6 group and 100 ng/mL IL-6 group were significantly decreased ( P<0.01). At 72 h after grouping culture, compared with that in blank control group, the mRNA expression levels of α-SMA of cells in 5 ng/mL IL-6 group, 10 ng/mL IL-6 group, 25 ng/mL IL-6 group, 50 ng/mL IL-6, group, and 100 ng/mL IL-6 group were significantly increased ( P<0.05 or P<0.01). Cells from the 2nd batch were cultured for 72 hours after grouping. Compared with 1.391±0.026 in blank control group, the protein expressions of vascular endothelial cadherin of cells in 10 ng/mL IL-6 group (1.185±0.063), in 25 ng/mL IL-6 group (0.717±0.078), and in 50 ng/mL IL-6 group (0.239±0.064) were significantly decreased ( P<0.05); compared with that in 10 ng/mL IL-6 group, the protein expressions of vascular endothelial cadherin of cells in 25 ng/mL IL-6 group and 50 ng/mL IL-6 group were significantly decreased ( P<0.01); compared with that in 25 ng/mL IL-6 group, the protein expression of vascular endothelial cadherin of cells in 50 ng/mL IL-6 group was significantly decreased ( P<0.01). At 72 h after grouping culture, compared with that in blank control group, the protein expression levels of α-SMA of cells in 10 ng/mL IL-6 group, 25 ng/mL IL-6 group, and 50 ng/mL IL-6 group were significantly increased ( P<0.01); compared with that in 10 ng/mL IL-6 group, the protein expression levels of α-SMA of cells in 25 ng/mL IL-6 group and 50 ng/mL IL-6 group were significantly increased ( P<0.01). At 72 h after grouping culture, compared with that in blank control group, the protein expressions of type Ⅰ collagen of cells in 25 ng/mL IL-6 group and 50 ng/mL IL-6 group were significantly increased ( P<0.05). Conclusions:After IL-6 treatment, the phenotype and function of HUVECS showed the characteristics of mesenchymal cells in a concentration-dependent manner. The inflammatory factor can promote the process of EndMT, and become one of the important factors regulating the mechanism of tissue fibrosis.
9.Reconstruction of anterior maxilla defect with fibula musculocutaneous flap assisted by digital surgical technology
Guowen SUN ; Xudong YANG ; Jianmin WEN ; Xin CHEN ; Qingang HU
Chinese Journal of Plastic Surgery 2021;37(10):1122-1128
Objective:To investigate the precise reconstruction method of anterior maxillary defect with fibula musculocutaneous flap assisted by digital surgical technology.Methods:The clinical data of the patients with anterior maxillary defect repaired by fibular free flap from January 2014 to January 2020 in Nanjing Stomatological Hospital were analyzed retrospectively. Mimics 23.0 software was used to perform computer virtual surgery using preoperative CT data of patients. Then the design of the focal osteotomy guide plate, fibular plastic guide plate and fibular reduction guide plate as well as the surgical plan was completed. The navigation registration point was designed by the Accunavi-A navigation system. The surgical guide plates were 3D printed. During the operation, the fibular musculocutaneous flap was harvested to cover the defect after resection of the anterior maxillary lesion with the assistance of the surgical guide plate and navigation technology. The facial appearance and function were followed up after operation.Results:A total of 12 cases, 9 males and 3 females, aged from 33 to 56 years, were included. There were 5 cases of gingival carcinoma, 4 cases of ameloblastoma, 1 case of chondrosarcoma, 1 case of mucoepidermoid carcinoma and 1 case of odontogenic myxoma. The size of the defect after resection was 5 cm×4 cm-6 cm×5 cm. In 12 patients, the focal osteotomy guide plate and fibula plastic guide plate were designed accurately, and the fibular reduction guide plate was successfully placed with accurate navigation and no displacement during the operation. The position of transplanted fibula was consistent with the normal maxillary position. The length of fibula was 8 -10 cm, and the size of the fibular free flap was 5 cm× 4 cm-6 cm×5 cm. All fibular musculocutaneous flaps survived. The patients were followed up for 1 to 72 months, with an average of 24.5 months. The patients had clear pronunciation, no oral and nasal reflux during diets, and presented in good facial appearance. No tumor recurrence occurred in 12 patients during follow-up.Conclusions:It is an accurate and feasible method to repair the anterior maxilla defect with fibula free flap assisted by digital surgical technology. The function of oral and nasal closure and speech was well maintained. A satisfactory facial appearance was obtained.
10.Clinical analysis of vulvar lichen simplex chronicus
Xiaoman GAO ; Ming LI ; Min YANG ; Wei WEN ; Kailyu SUN ; Jianmin CHANG ; Yu FU
Chinese Journal of Dermatology 2020;53(2):113-116
Objective To investigate clinical features of vulvar lichen simplex chronicus (VLSC).Methods Clinical data were collected from 137 VLSC patients who visited a Vulvar Clinic in the Department of Dermatology,Beijing Hospital from 2017 to 2018,and analyzed retrospectively.Non-normally distributed measurement data (age and disease duration) were described as median (P25,P75),and analyzed by using rank sum test,and enumeration data were compared by using chi-square test.Results Among the 137 patients with VLSC,the age at onset was 32.0 (25.5,40.0) years,and the disease duration was 36.0 (15.0,72.0) months.Thirty-two (23.4%) patients had a history of atopic diseases,and the age at onset of VLSC was significantly lower in these patients with a history of atopic diseases (29.5 [25.0,35.8]years) than in those without a history of atopic diseases (33.0 [27.0,41.0] years,Z =2.03,P =0.042).The most frequently involved site was the labia majora (130/137,94.9%),and the labia minora was rarely involved (13/137,9.5%).Bilateral lesions were observed in 103 (75.2%) patients,and hypopigmentation occurred in 8 (5.8%) patients.All the patients experienced itching to different extents,including moderate itching in 44 (32.1%) cases and severe itching in 80 (58.4%).The ratio of patients with severe itching to those with disease duration > 2 years (68.1%) was significantly higher than that of patients with severe itching to those with disease duration < 2 years (47.7%,x2 =5.830,P =0.016).Patients reported that local wetness and sweating (55 cases,40.1%),spicy diet (41 cases,29.9%) and mental stress (36 cases,26.3%) could aggravate itching,Conclusions VLSC commonly occurs in patients aged 20-39 years,and atopic predisposition may be an important factor for VLSC.VLSC mostly involves bilateral labia majora,and the longer the disease duration,the more severe the itching.

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