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Purpose: Latissimus dorsi flap is a widely used technique in breast reconstruction. Here we describe a modified method, the partial latissimus dorsi muscle flap with vertical incision for immediate implant-based breast reconstruction which has been used at our institution since 2014. Our primary objective is to determine the safety, prognostic benefit, and cosmetic outcome of this surgical procedure., Methods: The study included a cohort of 31 breast cancer patients who underwent unilateral breast reconstruction with detailed follow-up information at Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2014 to March 2015. All procedures were performed by the same surgical team at the department of breast surgery. The data for selecting the appropriate implant and evaluating the surgical outcome were collected. The cosmetic outcome was evaluated by the BREAST-Q 1 y after surgery., Results: After a median follow-up of 69 mo, none of the patients showed local recurrence (although two patients had distant metastasis). The 5-y distant metastasis-free survival was 93.5%. The median duration of surgical procedure was 2 h and 24 min with few surgical and functional complications. Based on BREAST-Q, the outcome of Satisfaction with Breasts was "excellent" or "good" in 96.7% of the patients., Conclusions: Partial latissimus dorsi muscle flap with the vertical incision is a safe, effective, time-saving, and feasible alternative to the whole latissimus dorsi flap which has superior cosmetic outcome and reduces recovery time. It is, therefore, worth advocating for application in clinical practice., (Copyright © 2021. Published by Elsevier Inc.)

Background: Accurate evaluation of muscle strength and function is difficult. Commonly known as sarcopenia, skeletal muscle loss is closely correlated with the prognosis of patients diagnosed with gastric cancer (GC). We wondered the correlation between skeletal muscle measures combined with computed tomography and grip strength (GS) and short-term outcomes after radical gastrectomy (RG) in patients with GC., Materials and Methods: We analyzed 594 patients with GC who underwent RG. The skeletal muscle index (SMI), skeletal muscle density (Hounsfield unit average calculation [HUAC]), and GS were measured. The skeletal muscle gauge (SMG) was created by multiplying SMI and HUAC. Logistic regression modeling and multivariate analysis were used., Results: Univariate analysis showed that low SMI, low HUAC, low GS, and low SMG were predictors of short-term complications after surgery. Compared with other muscle-related factors (AUC HUAC  = 0.559, AUC SMI  = 0.575, AUC GS  = 0.580, AUC SMG  = 0.598, AUC SMI+GS  = 0.559), low GS plus SMG (AUC GS plus SMG  = 0.614, P < 0.01) was a more accurate independent risk factor for postoperative complications. Moreover, the risk model with SMG plus GS for the diagnosis of skeletal muscle loss was superior to the other models (c-index = 0.729)., Conclusions: Skeletal muscle measures using computed tomography and GS are closely correlated with short-term outcomes of patients diagnosed with GC after RG. The model contained SMG plus GS could effectively predict for patients with GC after RG at high risk of short-term outcomes. SMG plus GS has the highest accuracy for the several evaluation methods of sarcopenia., (Copyright © 2019. Published by Elsevier Inc.)

Background: The objective of this study was to investigate the effects of experimental sleep deprivation (SD) on the temporomandibular joint (TMJ) in rats by examining pain-related factors and to determine the possible involvement of estrogen and NF (nuclear factor) κB signaling in the TMJ synovial membrane., Methods: The influence of SD, conducted in rats using the modified multiple platform method, was estimated by observing behavioral manifestations and examining changes in serum hormone levels. The morphologic changes of synovial tissue were observed with light microscopy and the serum levels of estrogen were measured by radioimmunoassay. Activation of NF-κB in the synovial membrane was examined using an immunofluorescence technique, and the expression levels of interleukin (IL) 1β, IL-6, tumor necrosis factor α, cyclooxygenase 2, and inducible nitric oxide synthase were measured with real-time polymerase chain reaction., Results: The SD group showed evidence of elevated anxiety and stress, and increased plasma levels of estradiol compared with the control group. The activity of NF-κB was significantly enhanced and translocation of NF-κB p65 was evident in the synovial membrane after SD. The expression of pain-related factors IL-1β, IL-6, cyclooxygenase-2, tumor necrosis factor α, and inducible nitric oxide synthase in the synovial membrane significantly increased after SD., Conclusions: These results indicate that SD increases serum levels of estrogen and induces alterations in pain-related factors in the TMJ. The NF-κB pathway has been associated with the regulation of these inflammatory cytokines and plays an important role in temporomandibular disorders., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: Psychological stress is considered a possible pathogenic factor for temporomandibular joint disorders (TMJD), but few reports have supplied direct evidence. This study was designed to observe the effects of psychological stress on the masticatory muscles and condylar processes in rats to directly investigate the role of psychological stress in TMJD morbidity., Materials and Methods: A well-established rat communication box model was used to compare the myoelectric profiles of temporal and masseter muscles and condylar microstructure among rats in a control group, a psychological stress group (PS group), and a diazepam (anxiolytic agent) injection group (PS + DI group). Reverse-transcription polymerase chain reaction was also used to analyze the substance P mRNA and calcitonin gene-related peptide mRNA levels expressed in condylar cartilages during different phases of psychological stress., Results: At 1, 3, and 5 wk, both temporal and masseter muscles in the PS group exhibited a significantly higher electrical potential in relaxation than those in the control group (P < 0.01). The electrical potential during contraction of the temporal and masseter muscles was higher than in the relaxation or control group at 1, 3, and 5 wk (P < 0.01). Scanning electron microscopy demonstrated pathologic changes in condylar processes in the PS group that were not observed in the PS + DI group. Reverse-transcription polymerase chain reaction also showed that the expression of substance P and calcitonin gene-related peptide in rat temporomandibular joint was upregulated during each phase of the psychological stress (P < 0.05)., Conclusions: Psychological stress may play an important role in the formation of TMJD., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: To investigate whether low-intensity ultrasound accelerates healing in bone tissues close to dental implants with osteoradionecrosis (ORN) of the mandible and is suitable for development as a therapy in patients with dental implants receiving radiotherapy., Materials and Methods: Dog models of radiative bone injury surrounding dental implants in both sides of mandible were established by four treatment methods of radiotherapy, each 15Gy. After radiative treatment, antibiotics were administered and the left injury was treated with ultrasound and the right with debridement. Measures for evaluation included spiral computed tomography (SCT), Micro-CT, microvessel density, and pull-out experiment, and data were collected and analyzed., Results: After 4months of radiotherapy, both sides of mandible displayed preclinic symptom of radiative osteonecrosis. Microvessel density of the side treated by ultrasound was 6.2152±0.6508 and that of the debridement side was 3.8490±0.8954 (P<0.05). Micro-CT results showed that bone volume fraction of trabecula, thickness of trabecula, trabecula spacing, ratio of bone surface area to bone volume, and trabecula number of the ultrasound-treated mandible were 0.3605±0.0337, 0.0287±0.0045, 0.0369±0.0073, 71.6124±14.1649, and 7.2915±1.4937, whereas those of the debridement side were 0.1779±0.0178, 0.0151±0.0021, 0.6623±0.1125, 33.2686±5.949, and 5.0689±0.5028, respectively; statistical significance was observed (P<0.05). Pull-out experiment suggested that pull-out strength of the ultrasound-treated side was 0.5793±0.1066 whereas that of the debridement side was 0.2980±0.0243, representing a statistical significance (P<0.05)., Conclusions: Low-intensity ultrasound can accelerate the healing of bone tissues surrounding dental implants in osteoradionecrosis of the mandible animals., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objective: This study aimed to provide an experimental theoretical basis for the treatment of temporomandibular disorders by observing the effects of psychological stress and countermeasures on the rat temporomandibular joint (TMJ)., Methods: Rats were exposed to psychological stress via a communication box and the lateral pterygoid muscle and TMJ were observed with transmission electron microscopy and scanning electron microscopy. Furthermore, the expression of interleukin-1 and tumor necrosis factor-α was assessed in control animals and psychological stress (PS) and stress with diazepam (PS+DI) groups., Results: Transmission electron microscopy of the lateral pterygoid muscle fibers in the PS showed vacuolar changes in the mitochondria, loss of cristae, and reduced matrix density to variable degrees after 1, 3, and 5 wk of stress. After 5 wk stress+recovery, the cristae and matrix were normal in the PS and PS+DI groups. Scanning electron microscopy of PS rats showed some synovial membranes were detached from the surface of the articular disc after 1 wk. After 3 wk, collagen fibers appeared to have wider waves and worn strips changing in size on the articular disc; after 5 wk, the distribution of collagen fibers was distorted. In PS+recovery and PS+DI rats, no obvious changes were observed on the surface of the articular disc after 1 to 5 wk stress. In PS rats, interleukin-1 and tumor necrosis factor-α expression increased significantly but was at control levels in the PS+DI and PS+recovery groups., Conclusion: Counteracting psychological stress can antagonize its effects on the TMJ and provide a reference for the treatment of stress-related temporomandibular disorders., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Background: CD147/extracellular matrix metalloproteinase inducer (EMMPRIN) expressed by tumor cells stimulates peri-tumorous fibroblasts to produce matrix metalloproteinases (MMPs), thus contributing to tumor invasion and metastasis. To assess its suitability as a potential therapeutic target, as well as its association with the clinicopathologic features and the prognosis of patients, the expression of CD147/EMMPRIN in neoplastic tissues of the genitourinary system were analyzed., Methods: CD147/EMMPRIN expression in 52 patients with renal carcinoma, 58 patients with bladder carcinoma, 101 patients with prostate carcinoma, 17 patients of penis carcinoma, and 17 patients of testis carcinoma were examined by immunostaining on paraffin-embedded tumor specimens using monoclonal antibodies. Then, the association of its expression with clinicopathologic characteristics to the patients' prognosis was analyzed. The RNA interference approach was used to silence CD147/EMMPRIN expression in the human prostate carcinoma cell line LNCAP and human bladder carcinoma cell line J82. The in vitro proliferative ability of CD147/EMMPRIN-deficient cells was determined by a 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide MTT assay., Results: CD147/EMMPRIN was expressed in neoplastic tissues, but not in normal tissues. Positive expression was shown in 42 of 52 (80.77%) of the patients with renal carcinoma, 41 of 58 (70.69%) of the patients with bladder carcinoma, 67 of 101 (66.34%) of the patients with prostate carcinoma, 16 of 17 (94.12%) of the patients with penis carcinoma and testis carcinoma. Positive CD147/EMMPRIN staining was significantly associated with TNM stages and histological subtypes of patients with various urinary carcinomas (P < 0.05). In all five groups, for different expression levels of CD147/EMMPRIN, the patients with a highly positive expression of CD147/EMMPRIN had the poorest prognosis. The siRNA-treated cells exhibited significantly decreased growth ability compared with control cells in vitro., Conclusion: These results may assist in defining the suitability of CD147/EMMPRIN as a therapeutic target and as a method for predicting a poor outcome in patients with various urinary carcinomas., (Copyright (c) 2010 Elsevier Inc. All rights reserved.)