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Background Restoration of HBV-specific T cell immunity is a promising approach for the functional cure of chronic Hepatitis B (CHB), necessitating the development of valid assays to boost and monitor HBV-specific T cell responses in patients with CHB. Methods We analyzed hepatitis B virus (HBV) core- and envelope (env)-specific T cell responses using in vitro expanded peripheral blood mononuclear cells (PBMCs) from patients with CHB exhibiting different immunological phases, including immune tolerance (IT), immune activation (IA), inactive carrier (IC), and HBeAg-negative hepatitis (ENEG). Additionally, we evaluated the effects of metabolic interventions, including mitochondria-targeted antioxidants (MTA), polyphenolic compounds, and ACAT inhibitors (iACAT), on HBV-specific T-cell functionality. Results We found that HBV core- and env-specific T cell responses were finely coordinated and more profound in IC and ENEG than in the IT and IA stages. HBV env-specific T cells were more dysfunctional but prone to respond to metabolic interventions using MTA, iACAT, and polyphenolic compounds than HBV core-specific T-cells. The responsiveness of HBV env-specific T cells to metabolic interventions can be predicted by the eosinophil (EO) count and the coefficient of variation of red blood cell distribution width (RDW-CV). Conclusion These findings may provide valuable information for metabolically invigorating HBV-specific T-cells to treat CHB. Graphical abstract

The optimal treatment for large helical rim keloids remains unclear.The authors evaluated patient outcomes when retro auricular flaps were used to reconstruct helical rim defects and adjuvant intralesional corticosteroids were prescribed after resection of large keloids.The authors evaluated 7 females with 12 large keloids of the helical rim (5 patients had lesions in both ears). All patients were aged 18 to 33 years. The authors used retro auricular flaps to reconstruct the helical rim defects and prescribed adjuvant intralesional corticosteroids after resection. The lesion area ranged from 2.5 × 2.0 to 3.5 × 3.5 cm2. The flap size ranged from 2.5 × 3.0 to 3.5 × 4.5 cm2. The flaps and wound bases received 3 steroid injections at approximately 1, 2, and 3 months postoperatively.No flap necrosis or complications were noted. The postoperative esthetic results were satisfactory in 8 patients and excellent in 4. All patients were followed up for 14 to 28 months (median, 20.6 months). No recurrence was noted, although 3 patients exhibited mild scarring of the wound flap base.A retro auricular flap is safe and effective for reconstructing helical rim defects; adjuvant intralesional corticosteroids prevent scarring of the flap wound base after resection of large keloids.

Osteoradionecrosis of the jaw (ORNJ) is one of the most devastating and progressive complications of head and neck radiotherapy. It can cause emaciation, deformity, and pathological fractures, resulting in decreased quality of life. The aim of this study was to evaluate the preoperative index and outcomes of treatment for ORNJ. A retrospective study of 252 ORNJ cases treated at one institution between January 2010 and January 2018 was made. The abnormal items from the preoperative examination and follow-up after different treatments were recorded, and the differences between the noteworthy items were compared using univariate and multivariate models. Most ORNJ patients in the middle and late stages had abnormal items, such as hypoproteinaemia, anaemia, and leucocytosis. Partial mandibulectomy with flap reconstruction was significantly more effective than without reconstruction. Advanced ORNJ patients tended to have more abnormal items, which might have a negative influence on treatment. For better outcomes, it is essential and effective to completely remove the necrotic lesion and reconstruct it with a flap. The surgeons should provide sufficient perioperative management and strive for suitable surgical treatment.

The purpose of this study was to evaluate the outcomes of survival and functional outcome of patients with Oral cavity squamous cell carcinoma (OCSCC) and HPV-negative oropharyngeal squamous cell carcinoma (HPV-negative OPSCC) using FSAIF reconstruction of the defects. The 275 patients were divided into OCSCC and HPV-negative OPSCC group were treated with surgery and oral cavity and oropharynx reconstruction with the FSAIF. The skin paddles in the OCSCC and OPSCC groups were 3 × 9 to 5 × 14 cm and 3 × 8 to 5 × 15 cm, respectively. The original primary tumor site was the oral cavity in 203 patients and the oropharynx in 72. No significant differences TNM or clinical stage, skin paddle of the flap, rate of flap failure, or local complications were observed between the OCSCC and HPV-negative OPSCC groups. Ten flap failures occurred, yielding a success rate of 96.4%. There are not differences of survival and speech function of patients with OCSCC and HPV--negative OPSCC using FSAIFs reconstruction of the defects following cancer ablation, but there are differences of the swallowing function. This flap is suitable for reconstructing the defect in the oral cavity or oropharynx.

Fibrous dysplasia (FD) is a benign, idiopathic skeletal disorder, in which the normal bone and marrow are replaced by fibrous tissue and immature woven bone. The authors aim to analyze the long-term results of patients diagnosed with FD of the paranasal sinuses via imaging or surgical biopsy.The authors retrospectively enrolled 21 patients with FD of the paranasal sinuses from 2006 to 2021.The mean age at the time of diagnosis of FD of the paranasal sinuses was very high at 45.9 years. The most common site ofoccurrence was the sphenoid sinus (71.4%). During the mean follow-up period of 52.8 months, there was no significant change in the size of FD of the paranasal sinuses, and there was no worsening of symptoms or complications. Endoscopic sinus surgery was performed in 16 patients (76.2%), of which 13 underwent only biopsy and 3 underwent partial resection.The most common site of FD of the paranasal sinuses was the sphenoid sinus, and the age at diagnosis was higher thanthat of patients with FD at other sites. Observation with serial radiologic examinations is recommended for asymptomatic FD of the para-nasal sinuses.

Objective To evaluate the feasibility and clinical effect of facial-submental artery island flap (FSAIF) in the repair of palatal defects, and to provide reference for the clinical application of submental artery island flap. Methods Nine patients with palatal defects, the range of nasal palatal perforation defects were 3 cm × 4cm to 3 cm × 6 cm (median 3 cm × 5.4 cm), were repaired by FSAIF, and the sizes of FSAIF were 4 cm × 9cm to 4 cm × 12 cm (median 4 cm × 10.4 cm,). Postoperative clinical efficacy was evaluated, including infection and necrosis of mucosal flap and postoperative palatal fistula perforation. Patients were followed up to evaluate their chewing, swallowing, speech function, and satisfaction of appearance. Results All patients were successfully repaired with FSAIF. Followed up 13∼35 months, there was no palatal fistula perforation in all patients. The speech, agitation, and swallowing function were not affected and the patients were satisfied with the appearance. Conclusion FSAIF is a safe and reliable method for palatal defect repair.

Background Reconstruction of hemiglossectomy defects requires careful flap design to avoid adverse functional and aesthetic outcomes. Methods Hemitongue specimens were obtained from minipigs to study the three-dimensional anatomy and to define anatomic landmarks for precise measurements of flap requirement. The concept developed in animal models was then applied to hemiglossectomy reconstruction in clinical practice. Sixty-one patients were randomly enrolled into the following two groups: a "five-point eight-line segment" (FIPELS) flap design group (28 patients) and a conventional group (33 patients). Functional and aesthetic outcomes were compared between the two groups. Results All flaps designed with the FIPELS technique matched the hemiglossectomy defects without the need for flap trimming, thus reducing the operating time (P = .03). Swallowing functions, speech intelligibility, and aesthetic outcomes were superior in the FIPELS group than that in the conventional group (P Conclusions The FIPELS flap design for hemiglossectomy reconstruction yields improved functional and aesthetic outcomes compared to a conventional flap design.

Abnormal expression of long-noncoding RNA is involved in the tumorigenesis and progression of various cancers, but the potential molecular regulatory mechanisms are unclear. Microbial flora and chronic inflammation, such as periodontitis, which is associated with oral cancer, affect the occurrence and progression of tumors. Accordingly, we stimulated the tongue squamous cell carcinoma (TSCC) cell lines CAL27 and SCC15 with a low concentration of lipopolysaccharide (LPS) from Porphyromonas gingivalis (P.g) for 6 days and then performed LncRNA sequencing on P.g-LPS-treated CAL27 cells and untreated CAL27 cells. LTSCCAT was upregulated in P.g-LPS-treated CAL27 cells compared with untreated CAL27 cells. LTSCCAT induced epithelial–mesenchymal transition and promoted the invasion and metastasis of TSCC in vitro and in vivo. LncRNA LTSCCAT was upregulated in TSCC patients with periodontitis and was correlated with metastasis and poor prognosis. We predicted through an online database and confirmed by dual-luciferase reporter assays that LTSCCAT is a competitive endogenous RNA for the regulation of miR-103a-2-5p. Another dual-luciferase reporter assay confirmed that miR-103a-2-5p has a binding site at the 3′-UTR of the histone methylation transferase SMYD3 and inhibits its translation. Chromatin immunoprecipitation experiments demonstrated that SMYD3 binds directly to the promoter region of TWIST1 and promotes its transcription, which is related to H3K4 trimethylation. The effect of pcDNA/LTSCCAT on expression was attenuated by miR-103a-2-5p mimics. The RF and SVM classifier predicts that LTSCCAT can bind to SMYD3, whereas the RNA immunoprecipitation (RIP) assay confirms that it cannot. In addition, we predicted the combination of LTSCCAT and SMYD3 through software, but the RIP assay confirmed that LTSCCAT could not be combined with SMYD3. For the first time, we showed that periodontitis promotes the invasion and metastasis of TSCC and clarified the molecular mechanism of LTSCCAT to promote invasion and metastasis of TSCC, providing a potential therapeutic target for clinical treatment of TSCC.

Objectives This study aimed to compare the quality of life (QOL) of patients, clinical results of the recipient site, and morbidities of the donor site between the use of free anterolateral thigh flaps (ALTFs) and radial forearm flaps (RFFs) for reconstruction of full cheek defects following tumor resection. Materials and methods We retrospectively reviewed 52 patients who underwent reconstruction of full cheek defects using free ALTFs and free RFFs following tumor ablation at our center. The range of mouth opening, speech, swallowing, facial appearance, donor site complications, and subjective symptoms based on the University of Washington Quality of Life (UW-QOL) questionnaire findings were assessed in the ALTF and RFF groups at 3, 12, and 36 months after surgery. Results Quality of life, range of mouth opening, facial appearance, mood and anxiety, donor site appearance, subjective feeling, and functional impairment were better in the ALTF group than in the RFF group based on the physical examination findings and questionnaire scores. Conclusion This study found better QOL and better functional results at the recipient site and minor morbidities at the donor site with the use of free ALTFs in the reconstruction of full cheek defects.

An alternating-lobe nozzle with nail-like crests and sword deep valleys (NSALN-1) was modified to achieve the ultimate mixing efficiency by enhancing the mixing in the core region. The main modifications included extending the sword deep valleys, adding a central plug between the sword deep valleys, and connecting the sword deep valleys to form arched deep valleys. The jet mixing of NSALN-1 and its modified configurations was numerically simulated, and the efficiency of the modifications was investigated. It was found that each modification can improve the thermal mixing efficiency, but also reduce the total pressure recovery coefficient. In particular, adding a central plug of an appropriate size can increase the thermal mixing efficiency to an extreme value while the reduction in the total pressure recovery coefficient remained within an acceptable range. The thermal mixing efficiency can reach 0.98 at 1.5d and exceed 0.99 at 2.0d. Furthermore, the shape and position of the longitudinal vortex determine the length of the path by which the cold stream is transported to mix with the hot stream by the longitudinal vortex. Regulating the mixing in each region to achieve balanced mixing speeds is thus helpful to achieve the ultimate mixing efficiency of the circularly lobe nozzle.

Made available in DSpace on 2018-12-11T17:13:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-08-01 Background Endoscopically assisted selective neck dissection (SND) has recently been applied in clinical N0 cases of oral squamous cell carcinoma (OSCC). However, nothing is known of the immune response after surgery. Methods A total of 60 patients with cT1-2N0 OSCC randomly underwent endoscopically assisted SND and open operations. The serum levels of IL-6, IL-8, IL-10, IL-1b, TNF-a, CRP, cortisol, ACTH, and growth hormone were analyzed before the start of the surgery (T0) and at 2 (T1), 6 (T2), 24 (T3), and 72 h (T4) after surgery. Results A total of 31 patients were randomized for endoscopic SND, whereas 29 underwent open procedures. The release of IL-6, IL-10 and CRP was significantly lower in the endoscopic group than in the open surgery group (p < 0.05), and cortisol levels were also lower in the endoscopic group (p < 0.05). Conclusions Endoscopic SND could effectively provide lower inflammatory responses and surgical stress, reducing peri-operative trauma and accelerating recovery. Department of Oral and Maxillofacial Surgery Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation of Sun Yat-Sen Memorial Hospital Department of Otorhinolaryngology Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University Department of Oral and Maxillofacial Surgery Dental School of Araçatuba Universidade Estadual Paulista (UNESP) Morphologic & Biochemical Lab of Pediatric Hematology Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University Department of Oral and Maxillofacial Surgery Dental School of Araçatuba Universidade Estadual Paulista (UNESP)

Objective Neurotropism of salivary adenoid cystic carcinoma (SACC) and pulmonary metastasis may lead to in treatment failure. miR-582-5p plays important roles in tumorigenesis, invasion and migration. Here, we aim to determine the effect of miR-582-5p and its role in SACC invasion and metastasis. Methods Six primary human SACC samples and matching adjacent normal tissues were analyzed by microarray analysis. Next, quantitative real-time PCR was carried out to evaluate miR-582-5p expression in 16 primary human SACC samples and matching adjacent normal tissues. Cell invasion and migration were also analyzed, and a luciferase reporter assay and western analysis were conducted. Cell growth and apoptosis assay were performed to confirm the effect of miR-582-5p and Forkhead box C1 (FOXC1) siRNA in cell proliferation and apoptosis. SACC tumorigenesis and metastasis were investigated in vivo experiment. Clinical samples from 110 patients were analyzed using in situ hybridization and immunohistochemistry. Results Microarray analysis revealed that miR-582-5p was significantly downregulated in the SACC samples compared with the matching adjacent normal tissues. Regulation of miR-582-5p expression significantly influenced the migration, invasion and proliferation ability of SACC cells by targeting FOXC1. E-cadherin was increased, while vimentin and snail were decreased with downregulation of FOXC1, suggesting that FOXC1 may regulate the epithelial-to-mesenchymal transition (EMT) of SACC cells by transactivating snail. In vivo, miR-582-5p overexpression suppressed the tumorigenesis and pulmonary metastasis of SACC. Lower expression of miR-582-5p expression predicts unfavorable prognoses and high rates of metastasis. Conclusions miR-582-5p could suppress effect on the process of invasion and migration in SACC cell lines, and this could occur through its target gene FOXC1.

Purpose Head and neck tumors that involve the craniomaxillofacial region are classified as stage IVb disease and are clinically challenging. In this study, the outcomes of craniofacial resection and craniofacial reconstruction in patients with recurrent malignant tumors involving the craniomaxillofacial region were evaluated. Patients and Methods This retrospective observational study was conducted from January 2008 to August 2015. Data collected for each patient included age, gender, tumor site, initial treatment, craniofacial resection, reconstruction flaps and complications after craniofacial resection, adjuvant treatment, and reported outcomes of craniofacial resection and craniofacial reconstruction. The χ2 test in SPSS was used to analyze the data. Results Twenty-four patients with recurrent malignant tumors involving the craniomaxillofacial region were identified who had undergone craniofacial resection at the Center of Craniomaxillofacial Surgery of Sun Yat-sen University (Guangzhou, Guangdong, China). The study population was comprised of 24 patients (15 men and 9 women; age range, 21 to 73 yr) with recurrent tumors (58.3% with squamous cell carcinoma [SCC], 41.7% with sarcoma [SA]) involving the craniomaxillofacial region who underwent craniofacial resection. Craniofacial resection consisted of orbital exenteration and maxillotomy; anterior skull base surgery, facial resection, and mandibulotomy; or ipsilateral radical neck dissection. The resultant craniomaxillofacial defects were reconstructed using extended vertical lower trapezius island myocutaneous flaps (TIMFs), temporalis myofascial flaps, or submental flaps. All patients with recurrent malignant tumor involving the craniomaxillofacial region underwent gross total resection of the tumor; 22 patients underwent craniofacial reconstruction. There were no major surgical complications. Minor flap failure and wound dehiscence in the donor site occurred in 4 patients. The follow-up period ranged from 8 to 36 months. Seven patients in the SCC group and 7 in the SA group were alive with no evidence of disease (AND), 3 in the SCC group and 2 in the SA group were alive with disease (AWD), and 4 in the SCC and 1 in the SA group died of the disease (DOD) after local recurrence or distant metastases at 8 to 18 months. There were no statistical differences among the AND, AWD, and DOD groups. Conclusions Craniofacial resection remains an effective salvage treatment for patients with recurrent SCC and SA involving the craniomaxillofacial region. The extended vertical lower TIMF is a large, simple, and reliable flap for reconstructing major defects after a craniofacial resection.

Objective The advantages and limitations of the endoscopy-assisted transoral approach (EATA) and external approaches (EAs) in resection of parapharyngeal space tumors (PSTs) remain unclear. In our study, we compared the use of the EATA and the EAs for the resection of large, benign PSTs. Study Design Forty-four patients with PSTs were divided into the EATA and EA groups. The perioperative and postoperative outcomes of the patients were evaluated. Results All of the tumors were completely removed. However, the procedure was converted to an open procedure for four patients in the EATA group and for six patients in the EA group who required endoscopic assistance. The intraoperative blood loss, amount and duration of drainage, postoperative pain, total hospital stay, and cosmetic outcomes were superior in the EATA group (P Conclusions Use of the EATA for resection of large, benign PSTs decreased the surgical invasiveness of the procedure and resulted in better aesthetic outcomes. However, use of the combined surgical approach allowed for improved access for the resection of PSTs.

Biomechanics are crucial for bony regeneration and survival of implants in functional maxillary and mandibular reconstructions. However, we know of no study that has included an analysis of biomechanics to guide the optimal position of a fibular graft in virtual surgery. This study was designed to evaluate the combination of biomechanics and accurate placement of implants for virtual surgery in reconstruction of the jaw using fibular grafts. Thirty-one patients had maxillary or mandibular reconstruction with vascularised fibular grafts and the immediate placement of dental implants. Virtual studies were made preoperatively to evaluate the biomechanics and to assess the position of the fibular grafts with minimal distribution of stress. All operations proceeded accurately and with no complications with a mean (range) of 14 (6-20) months' follow-up. According to the individual biomechanical evaluations, the optimal position for the fibular graft is probably the middle of the mandibular body or below the bottom of the maxillary sinus. The combination of biomechanical evaluation and accurate placement of dental implants is a new concept that could achieve good biomechanical positioning of fibular grafts in the jaw and a desirable level of accuracy for functional reconstruction.

By using the R language, this paper analyzes the spatial relationship between the value’s added value of various cities in Jiangxi province and the imbalance of regional economic development in Jiangxi province by using the Moran’s I index. The results show that there is an obvious imbalance between the economic development of Nanchang and the surrounding cities. The paper puts forward some Suggestions on how to implement the regional economy, adjust the economic development center of the region, improve the structural tax reduction, and use the location advantage to develop the economy.

A few modified approaches have been reported for performing endoscope-assisted dissections of benign parotid tumors, but none that use incisions totally hidden in a natural furrow. This study evaluated the feasibility of performing endoscope-assisted extracapsular dissections of benign parotid tumors using a single cephaloauricular furrow incision. Forty-six patients with benign parotid superficial lobe tumors were randomly divided into two groups: an endoscope-assisted (21 patients) group or a conventional (25 patients) surgery group. Perioperative and postoperative outcomes of the patients were evaluated, including the maximum diameter of the tumors, length of the incision, operating time, estimated blood loss during the operation, amount and duration of drainage, satisfaction scores based on the cosmetic results, perioperative complications, and follow-up information. The diameters of the tumors were comparable between the groups, and all operations were successfully performed as planned. The mean length of the incision in the endoscope-assisted group (3.6 ± 0.5 cm) was significantly shorter than that in the conventional group (9.1 ± 1.9). Meanwhile, the intraoperative blood loss, amount of drainage, perioperative complications, and cosmetic outcomes were all improved in the endoscope-assisted group. No tumor recurrence was found during 11–40 months of follow-up. Cephaloauricular furrow incisions were totally and naturally hidden in this procedure. Endoscope-assisted extracapsular dissections of benign parotid tumors via a small cephaloauricular furrow incision were found to be feasible and reliable, providing a minimally invasive approach and a satisfactory appearance.

Purpose Outcomes of salvage surgery and carotid artery (CA) management were evaluated in patients with oral and oropharyngeal cancer. Patients and Methods Eighteen patients with recurrent oral and oropharyngeal squamous cell carcinoma involving the CA underwent salvage surgeries consisting of wide resection of the tumor, CA resection without and with reconstruction, and CA subadventitial dissection without and with encapsulation. Major tissue defects were reconstructed using a flap. Results One patient showed postoperative transient hemiplegia, and wound dehiscence occurred at the recipient site in 2 patients. Two patients had carotid blowout. One patient who underwent CA resection and reconstruction had a carotid embolism. After 5 to 42 months of follow-up, 12 patients were free of disease, 2 remained ill, and 4 died of local recurrence or distant metastases. Conclusions Salvage surgery remains an effective treatment modality. CA sacrifice offers a viable treatment strategy. Major defects can be reconstructed with a trapezius flap.

Reconstruction of maxillary and midfacial defects due to tumor ablation is challenging to conventional operation. The purposes of this study are to evaluate the precise 3-dimensional position of the fibular flap in reconstruction of maxillary defects assisted by virtual surgical planning and to assess the postoperative outcomes compared with conventional surgery.We retrospectively reviewed 18 consecutive patients who underwent maxillary reconstruction with a vascularized fibular flap assisted by virtual surgical planning after maxillary or midfacial tumor ablation. Conventional surgery was performed in another 15 patients. Proplan CMF surgical planning (Materialise, Leuven, Belgium) was performed preoperatively in the virtual planning group. Fibular flaps were harvested and underwent osteotomy assisted by prefabricated cutting guides, and the maxilla and midface were resected and reconstructed assisted by the prefabricated cutting guides and templates in the virtual planning group. The operative time and fibular flap positions were evaluated in the 2 groups. Postoperative fibular positions of the maxillary reconstruction were compared with virtual plans in the virtual planning group. The postoperative facial appearance and occlusal function were assessed.The operations were performed successfully without complications. The ischemia time and total operative time were shorter in the virtual planning group than those in the conventional surgery group (P.05). High precision of the cutting guides and templates was found on both the fibula and maxilla in the virtual planning group. The positions of the fibular flaps, including the vertical and horizontal positions, were more accurate in the virtual planning group than those in the conventional surgery group (P.05). Bone-to-bone contact between the maxilla and fibular segments was more precise in the virtual planning group (P.05). Postoperative computed tomography scans showed excellent contour of the fibular flap segments in accordance with the virtual plans in the virtual planning group. All patients were alive with no evidence of disease. Functional mandibular range of motion, good occlusion, and an ideal facial appearance were observed in the virtual planning group.Virtual surgical planning appears to achieve precise maxillary reconstruction with a vascularized fibular flap after tumor ablation, as well as an ideal facial appearance and function after dental rehabilitation. The use of prefabricated cutting guides and plates eases fibular flap molding and placement, minimizes operating time, and improves clinical outcomes.

Purpose Although negative-pressure wound therapy (NPWT) for complicated wounds has been extensively studied, it is rarely used in cases involving a submandibular fistula due to radiation-induced osteoradionecrosis of the mandible. This study aimed to investigate the efficacy of NPWT for submandibular fistulas after reconstruction for osteoradionecrosis. Patients and Methods Nine patients with submandibular fistulas after reconstruction for osteoradionecrosis treated with NPWT between 2011 and 2014 were included in the study. The wound healing was documented. Results The NPWT device was removed postoperatively between days 7 and 12 (mean duration, 9.6 days). The wound bed was filled with healthy granulation tissue, and successful healing by second intention was observed in all patients within 2 weeks. No complications were observed. The follow-up ranged from 4 to 27 months (mean, 18 months); the fistulas exhibited excellent healing, and no recurrence or infection was observed. Conclusions NPWT is a safe, effective technique for managing submandibular fistulas after reconstruction for osteoradionecrosis.

Purpose The fibular flap donor site after skin paddle harvest is usually covered with abdominal full-thickness skin grafts. However, this kind of skin graft creates an inevitable third operative area and additional esthetic damage. The aim of this report was to present a novel approach to manage fibular donor site defects using a full-thickness skin graft from the adjacent area and avoid further esthetic damage in a third area. Materials and Methods Seventeen patients underwent mandibular and maxillary defect reconstruction using free fibular osteocutaneous flaps and the fibular donor-site defects were covered with full-thickness skin grafts from the adjacent area. The skin harvesting sites were closed primarily. Results The skin donor sites were closed without dehiscence in all cases. Fifteen full-thickness skin grafts survived completely, whereas 2 grafts were partial failures. There were no complete skin graft losses. All fibular osteocutaneous flaps were viable, and the recipient sites had no complications. Conclusions This study shows that adjacent full-thickness skin grafts provide a straightforward and reliable technique for closure of the free fibular osteocutaneous flap donor site. The primary advantage of this technique is the avoidance of a third surgical site, an additional surgical scar, and subsequent additional esthetic impairment.

Numerous findings have demonstrated that long noncoding RNA (lncRNA) dysregulation plays a key role in many human neoplasms, including tongue squamous cell carcinoma (TSCC), yet the potential mechanisms of lncRNAs in chemo-resistance remain elusive. Our research showed that the lncRNA KCNQ1OT1 was upregulated in chemo-insensitive TSCC tissues compared with chemo-sensitive TSCC specimens. Meanwhile, high KCNQ1OT1 expression was closely correlated with poor prognosis. Furthermore, KCNQ1OT1 promoted TSCC proliferation and conferred TSCC resistance to cisplatin-induced apoptosis in vitro and in vivo. Using online database analysis, we predicted that the lncRNA KCNQ1OT1 facilitates tumor growth and chemo-resistance by acting as a competing endogenous RNA (ceRNA) to modulate the expression of miR-211-5p. And miR-211-5p upregulation significantly impaired TSCC proliferation and resumed TSCC chemo-sensitivity, which is contrary to the function of lncRNA KCNQ1OT1. Luciferase experiments confirmed that miR-211-5p harbor binding sites for the 3′-UTRof Ezrin mRNA, and Ezrin/Fak/Src signaling was activated in cisplatin-resistant TSCC cells. Finally, miR-211-5p inhibition in sh-KCNQ1OT1-expressing TSCC cells rescued the suppressed cell proliferation and cisplatin resistance induced by KCNQ1OT1 knockdown. In summary, our study has elucidated the role of the oncogenic lncRNA KCNQ1OT1 in TSCC growth and chemo-resistance, which may serve as a new target for TSCC therapy.

To improve the flight efficiency and ensure the flight reliability of the aircraft, a data mining model for aero engine fault prediction based on fuzzy clustering is presented. On the basis of data acquisition and analysis, the engine data mining model is constructed, and the maintenance data of a certain type of aero engine is clustered by using fuzzy clustering theory. According to different threshold values, the fault prediction is carried out according to the different classification of samples. Finally, the result of example simulation shows that the fuzzy clustering can provide the basis for decision-making of aero engine fault prediction.

Purpose Modified endoscopically assisted resection of benign tumors in the accessory parotid gland region (APGR) has been reported, and the surgery confers a potential risk of injury to the great auricular nerve. This clinical research study provides an updated approach for the resection of benign tumors of the APGR. Patients and Methods Thirteen cases diagnosed with primary benign tumors in the APGR were treated by endoscopically assisted resection through a margin of the tragus, and its feasibility was evaluated. Results All tumors were completely resected. The procedures lasted 45 to 70 minutes (mean, 54 minutes). None of the endoscopically assisted surgeries proceeded to open surgery. The patients were followed for 3 to 14 months, without postoperative complications, including pain, facial or auricular nerve weakness, salivary fistula, infection, tumor recurrence, Frey syndrome, or depression deformity. The scars were concealed and esthetically satisfactory. Conclusion Endoscopically assisted resection of benign tumors through a margin of the tragus in the APGR is a safe technique that achieves excellent esthetic and functional results.

Background To achieve an ideal intraoral lining, we harvest the fibular osteomyofascial flap to avoid the common embarrassment caused by the fibular osteomyocutaneous flap, and we report on our experience with this technique in this article. Methods Twenty-eight patients underwent reconstruction of the maxilla and mandible using an osteomyofascial free fibula flap after oncologic ablation. Data, including the size of the fascial flaps, the number of debulking operations, the complications at both the donor and recipient sites, and the dental rehabilitation, were collected. Results All fascial flaps survived and were remucosalized, except one with partial necrosis. None of the patients in the osteomyofascial group required an additional debulking operation, and 82% of the patients (23 of 28) had conventional dentures and showed good chewing function and cosmetic results. Conclusion The fibular osteomyofascial flap yielded a more anatomic solution for oral mucosal defects, obviating the need for additional debulking and potentially reducing donor-site wound problems. © 2015 Wiley Periodicals, Inc. Head Neck, 2015

Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China.

Mitochondria play an important role in the initiation of apoptosis. However, whether cisplatin can induce apoptosis by initiating a mitochondrial fission pathway and the mechanism underlying this effect remain poorly understood. In this study, we show that the mitochondrial fission protein FIS1 is upregulated upon cisplatin treatment in tongue squamous cell carcinoma (TSCC) cells. FIS1 knockdown can attenuate mitochondrial fission and cisplatin sensitivity. We found that FIS1 is a direct target of miR-483-5p and that miR-483-5p can inhibit mitochondrial fission and cisplatin sensitivity in vitro and in vivo. Furthermore, we found that miR-483-5p and FIS1 are significantly associated with cisplatin sensitivity and with overall survival in patients with TSCC in a retrospective analysis of multiple centers. This study revealed that a novel mitochondrial fission pathway composed of miR-483-5p and FIS1 regulates cisplatin sensitivity. The modulation of miR-483-5p and FIS1 levels may provide a new approach for increasing cisplatin sensitivity.

Background The purpose of this study was to compare the use of an extended vertical lower trapezius island myocutaneous flap (TIMF) and a pectoralis major myocutaneous flap (PMMF). Methods A total of 39 patients with advanced recurrent oral and oropharyngeal squamous cell carcinoma (SCC) underwent salvage surgery followed by placement of either an extended lower vertical TIMF or PMMF for reconstruction. Twenty-one patients received extended lower vertical TIMFs, whereas 18 received PMMFs. Results The pedicle length of the TIMF was longer than that of the PMMF, and the skin paddle of the TIMF was both wider and longer than the PMMF. No major complication developed in any of the patients. The TIMF group experienced a lower rate of minor flap failure than did the PMMF group. Conclusion Use of an extended vertical lower TIMF, which has a longer pedicle flap and a larger skin paddle than a PMMF, is optimal for reconstruction of major defects. © 2015 Wiley Periodicals, Inc. Head Neck, 2015

We have evaluated the outcomes of endoscopically-assisted resection of large benign tumours of the parapharyngeal space by an intraoral approach. Six patients with primary benign tumours were treated in this way. The lesions were pleomorphic adenomas, Warthin's tumour, and schwannoma. The sizes of the tumours varied from 4×4 cm to 7×7 cm. All tumours were removed completely without rupture and without damage to the facial nerve. No patient developed any permanent postoperative complications such as damage to the facial nerve, salivary fistula, or limited mouth opening. The cosmetic effects were excellent. The patients were followed up for 8 to 21 months without recurrence. Endoscopically-assisted transoral resection of large benign tumours of the parapharyngeal space is a simple and safe technique that achieves excellent aesthetic and functional results.

Objective The donor site defect of a radial forearm free flap is typically repaired with a full-thickness or split-thickness skin graft. Reports of vacuum sealing drainage (VSD) therapy for the closure of a radial forearm flap donor site defect with a full-thickness skin graft are rarely presented. This clinical study evaluated the efficacy and safety of VSD therapy for the closure of radial forearm flap donor site defects with full-thickness skin grafts. Methods This study reviewed the cases of 28 patients (including eight patients with type 2 diabetes) who had undergone reconstruction of soft tissue defects resulting from resection of oral squamous cell carcinoma with radial forearm free flaps. VSD dressings were applied on the radial forearm flap donor sites in all patients. Results Complete coverage of the donor site defect with full-thickness skin graft was evident in (n = 27) 96% of patients. Only one patient (4%) exhibited a partial loss of the graft at its edge. No tendon exposure was noted. The long-term functional and esthetic results were excellent over 4–12 months of follow-up. Conclusions VSD therapy is a safe, effective, and simple technique for closing a radial forearm flap donor site defect with a full-thickness skin graft.

Purpose Fibular free flap transfer is a powerful tool available to the reconstructive surgeon when treating oral and maxillofacial defects, but complications still occasionally occur and predictive analysis focusing on this specific flap is limited in terms of risk factors for complication. The purpose of this study was to identify key variables associated with complications in patients undergoing fibular free flap transfer. Patients and Methods The data of 163 consecutive patients who underwent fibular free flap surgery at the Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, between 2012 and 2015 were reviewed retrospectively. Patient demographic data, laboratory data, surgical data, and fluid infusion–related data that may have an influence on free flap outcomes were recorded. Univariate and multivariate logistic regression analyses were used to identify relevant risk factors. Results A total of 163 fibular free flaps were transferred for mandibulofacial reconstruction in 163 patients with a mean age of 50.9 years. Postoperative complications developed in 33 (20.2%). Multivariate analysis showed that free flap complications were significantly associated with radiotherapy history (odds ratio [OR], 5.12; P = .001), postoperative anemia (OR, 1.048; P = .041), postoperative hypoalbuminemia (OR, 0.844; P = .002), and prolonged operative time (OR, 1.005; P = .004). Conclusions Radiotherapy history, decreased postoperative hemoglobin and albumin levels, and prolonged operative time are potential predictors of postoperative complications after fibular free flap reconstruction for mandibulofacial defects.

Background This study compared the outcomes of an extensive segmental pectoralis major myocutaneous flap (esPMMF) and a conventional pectoralis major myocutaneous flap (PMMF). Methods The study enrolled 91 patients with primary oral and oropharyngeal squamous cell carcinoma (SCC) who underwent radical resection followed by reconstruction of the defect using either an esPMMF via the anterior axillary line or a PMMF. The pedicle lengths of the esPMMF and PMMF were 22-28 and 18-22 cm, respectively. The esPMMF and PMMF had skin paddle dimensions of 5 × 8 to 7 × 14 cm and 6 × 7 to 8 × 17 cm, respectively. Results The esPMMF pedicle was longer than that of the PMMF. The range of shoulder abduction was significantly greater in the esPMMF group and the donor-site aesthetic results were better. Conclusion The esPMMF has a longer pedicle flap, enables a greater range of shoulder abduction, and has a better aesthetic result than the conventional technique.

This paper, in comprehensive consideration of the factors affecting the safety of civil aviation airport, by following the integration of theory with practice, expounds the construction of the civil aviation airport safety forewarning evaluation index system in terms of personnel, maintenance, environment and organizational management and application of multi-hierarchy comprehensive fuzzy method to carry out the early warning for assessment as well as computation to determine the safety status of civil aviation airport so as to prevent the hidden accident from occurrence.

Epithelial-to-mesenchymal transition (EMT) is implicated in embryonic development and various pathological events. Transforming growth factor beta (TGFβ) has been reported to induce EMT in tumor cells, which is a critical step in the process of metastasis leading to cancer spreading and treatment failure. However, the involvement of microRNA during the EMT process in tongue squamous cell carcinoma (TSCC) remains to be determined. To address this question, TSCC cell lines SCC9 and CAL27 were treated with human recombinant TGFβ1 for 48 h. miRNA microarray illustrated that miR-639 was significantly downregulated in TGFβ-treated SCC9 cells. Ectopic expression of miR-639 with miRNA mimics effectively blocked TGFβ-induced EMT in SCC9 and CAL27 cells, but inhibition of miR-639 in SCC9 and CAL27 cells with antisense oligonucleotides induced EMT. Computational microRNA target predictions detected a conserved sequence matching to the seed region of miR-639 in the 3'-UTR of FOXC1 mRNA. Luciferase reporter assays revealed that miR-639 targets FOXC1. Ectopic expression of FOXC1 induces EMT in TSCC cells. Silencing FOXC1 expression blocked TGFβ-induced EMT in SCC9 cells. Clinically, reduced miR-639 expression was associated with metastasis in TSCC and poor patient survival. The data from the present study suggest that reduced expression of miR-639 underscores the mechanism of TGFβ-induced EMT in TSCC by targeting FOXC1 and may serve as therapeutic targets in the process of metastasis.

Failure rate of transmission line and reliability of power system are significantly affected by Lightning meteorological factor. In view of the complexity and variability of Lightning meteorological factors, this paper presents lightning trip-out rate model of transmission line in considering distribution of ground flash density and lightning day hours. Meanwhile, presents a failure rate model of transmission line in different condition, and a risk analysis method for transmission line considering multiple risk factors based on risk quantification. This method takes Lightning meteorological factor as the main evaluation standard, and establishes risk degree evaluation system for transmission line including another five evaluation standard. Put forward the risk indicators by quantify the risk factors based on experience date of transmission line in service. Based on the risk indexes comprehensive evaluation is conducted, and the evaluation result closer to practice is achieved, providing basis for transmission line risk warning and maintenance strategy. Through the risk analysis for 220 kV transmission line in a certain power supply bureau, the effectiveness of the proposed method is validated.

Objectives Lymph node metastasis is a prominent clinical feature of tongue squamous cell carcinoma (TSCC) and is associated with a higher mortality rate. Carcinoma-associated fibroblasts (CAFs), a major component of the tumor microenvironment (TME), play an important role in tumor progression, and are associated with a poor prognosis. The aim of this study was to examine the role of CAFs in promoting the invasion of TSCC through the epithelial-to-mesenchymal transition (EMT). Materials and Methods A series of matched CAF and normal fibroblast (NF) pairs were assessed for cell morphology and for the expression of alpha smooth muscle actin (α-SMA), stromal cell-derived factor-1 (SDF1), fibroblast-activating protein (FAP), vimentin, and cytokeratin (CK) markers. Transwell assays, Western blot analysis, reverse transcription-PCR, and immunofluorescence staining were used to assess the role of CAFs, as compared to that of NFs, in promoting proliferation, migration, invasion, and EMT in TSCC. Results Both CAF and NF primary cultures expressed vimentin but not CK. CAFs showed significantly higher α-SMA protein levels, SDF1 secretion, and mRNA levels of α-SMA, SDF1, and FAP. We also found that co-culture with CAFs enhanced the proliferation and invasion of SCC9 cells. Moreover, co-culture with CAFs induced upregulation of the EMT markers fibronectin and vimentin, downregulation of E-cadherin, and enhanced invasion in SCC9 cells. Conclusion These results suggest that CAFs induce EMT marker expression and functional changes in TSCCs.

The transmission and Goos–Hanchen (GH) shift for charge carriers in gate-controllable ferromagnetic graphene induced by ferromagnetic insulator are investigated theoretically. Numerical results demonstrate that spin-up and spin-down electrons exhibit remarkably different transmission and GH shifts. The spin-dependent GH shifts directly demonstrate the spin beam splitting effect, which can be controlled by the voltage of gate. We attribute the spin beam splitting effect to the combination of tunneling through potential barrier and Zeeman interaction from the magnetic field and the exchange proximity interaction between the ferromagnetic insulator and graphene. In view of the spin beam splitting effect and the spin-dependent GH shifts, the gate-controllable ferromagnetic graphene might be utilized to design spin beam splitter.

The O-cell method which was applied on the pile testing was introduced, including the basic principle, test device and test technique. The advantages of O-cell method compared to traditional pile testing method were also illustrated. Based on the project of offshore structure in Mozambique, the O-cell test was performed on the long drilled rock socked pile. The results were converted to the traditional load-settlement curve to analyze the bearing behavior and load transfer characteristics. The regularity of axial force and shaft friction of rock socked pile were also revealed.

Introduction The dysregulation of glycolysis has been suggested to lead to the alteration of cell drug resistancesignals, proliferation and metastasis. Emerging evidence indicates that lncRNAs play a key role inthe cellular processes of tumour cells, including glycolysis, growth, and movement. However, therole of lncRNAs in glycolysis-mediated metastasis and the potential mechanism has not been explored. Material and methods First, microarrays were performed to explore the lncRNA, mRNA and miRNA profiles in 4 pair OSCC and adjacent non-tumour tissue samples. qRT-PCR and bioinformatic analysis were used to confirm the expression and coding capability of lnc-p23154 in OSCC cell lines. Then, functional experiment, the nude mouse model and RNA sequence were performed to demonstrated that lnc-p23154 could promote OSCC metastasis and glycolysis both in vitro and in vivo . Furthermore, we verified lnc-p23154 promoted OSCC metastasis via Glut1-mediated glycolysis through a rescue assay. At last, luciferase assay, FISH assay, RNA immunoprecipitation and RNA pull down was utilised to prove that lnc-p23154 inhibited miR-378a-3p transcription by interacting with its promoter region, then regulated miR-378a-3p targeted gene Glut1 expression and promoted Glut1-mediated OSCC metastasis. Results and discussions In this study, we identified a novel lncRNA, lnc-p23154, which is up-regulated in oralsquamous cell carcinoma (OSCC) tissues and cell lines, is associated with OSCC patientmetastasis and promotion of OSCC cell migration and invasion in vitro and in vivo . Furthermore,we found that lnc-p23154 also participates in OSCC glycolysis by facilitating Glut1 expression.Rescue of lnc-p23154 reversed the suppression of OSCC cell migration and invasion induced byGlut1 knockdown. More importantly, lnc-p23154 is mainly located in the nucleus and binds to thepromoter region of miR-378a-3p, which represses Glut1 expression by targeting to its 39UTRdirectly. Conclusion In summary, we described a novel mechanism of lnc-p23154-miR-378a-3p/Glut1 axis inGlut1-mediated glycolysis and OSCC metastasis regulation. Meanwhile, we provided evidencethat overexpression of lnc-p23154 is significantly associated with higher metastasis tendency inboth OSCC cells and patients with OSCC. These results indicated that lnc-p23154 may act as ametastasis driver in OSCC and a potential biomarker for OSCC diagnosis and treatment.

To evaluate the safety and advantages of using carbon dioxide (CO2) laser in the treatment of oral mucosal lesion, including vascular malformations, precancerous lesions, and verrucous nevus, a retrospective analysis was conducted for 73 patients with oral mucosal lesions who received CO2 laser treatment during June 2012 to December 2013, including 25 patients with vascular malformations, 22 patients with oral leukoplakia, 18 patients with oral mucosal lichen planus, and 8 patients with oral mucosal and labial mucosal verrucous nevus. The lesions ranged from 0.8 × 0.8 cm to 4 × 3 cm. Twenty patients with lesions removed using the traditional scalpel, assisted with an electric knife, were the control group. The operative time was from 3 to 10 minutes, with an average of 5.5 minutes; the average amount of intraoperative bleeding was 5 mL. None of the 73 patients had postoperative infections, and all wounds healed well after the surgery. The patients were followed up for 1 year. Two patients with oral leukoplakia showed recurrence after the surgery, and a reoperation achieved satisfactory treatment effects. The operative time of the control group was in the range of 4 to 15 minutes, with an average of 9.5 minutes, and the average amount of intraoperative bleeding was 10 mL. None of the 20 patients had postoperative infections, and the wounds also showed healing well after the surgery. The application of CO2 laser in the treatment of oral mucosal lesions has the advantages of reduced bleeding, a clear view during surgery, and a shorter operative time.

Lip mucous membrane venous malformations are common benign lesions in infants. This clinical study evaluates the efficacy and safety of liquid nitrogen cryotherapy used to treat this condition. A total of 84 pediatric patients undergoing liquid nitrogen cryotherapy for venous malformations involving the lips were reviewed, with 45 males and 39 females treated. The overall median age at mucous membrane venous malformation diagnosis was 5.6 months (range 2–18 months). The venous malformations involved the vermilion of the lower lip in 44 cases, the vermilion of the upper lip in 31 cases, and both vermilions in 9 cases. No complications due to anesthesia occurred. After a follow-up period of 2–38 months (mean 25 months), 65 lesions (77.4 %) were completely involuted, 14 lesions (16.7 %) were mostly involuted, and 5 lesions (5.9 %) were partially involuted; no lesions showed a minor amount of involution. Liquid nitrogen cryotherapy is an effective, simple, and safe management tool for mucous membrane venous malformations of the lip in infants.

Resonant transmission and Goos–Hanchen (GH) shift for Dirac fermion beams tunneling through graphene double velocity barrier structures (DVBs) are investigated theoretically. Analytical and numerical results demonstrate that strong resonant tunneling effect occurs in this structure and is highly dependent on the incident angle and the structure of velocity barriers. The resonant tunneling in graphene DVBs belongs to the Fabry–Perot resonance and leads to oscillated conduction at wide energy range. It is also found that GH shifts in this structure can be enhanced by the resonant tunneling and multi-GH shift peaks with giant magnitudes can occur at these resonant energy positions. These special properties of GH shifts in graphene DVBs may have good application in lateral manipulation of electron beams and valley or spin beam splitter.

Electronic transmission and Goos–Hanchen shift for Dirac fermions in asymmetric graphene double magnetic barrier structure are investigated theoretically. Numerical results for rectangular barriers demonstrate that a transmission gap appears owing to the magnetic confinement and the width of gap is dependent on the incident angle and changed by the width of barrier and the distance between the double barriers. At the edge of the transmission gap, the Goos–Hanchen shifts of electrons have strong peaks and are tuned by the structure parameters. Furthermore, for the real magnetic structure induced by ferromagnetic strips, the transmission gap and GH shift remain. The tunable transmission gap indicates that the graphene magnetic structure can be use as electron wave filter and the tunable GH shift shows that the structure can be applied to laterally manipulate Dirac fermions in graphene.

It is a very important problem that economic and environmental coordinated development in PLEEZ. This paper found economic and environmental systems, a quantitative method was proposed which systemic coordinated evaluation based on the principal component analysis and system index of sustainable development for PLEEZ, the conclusions provide a useful reference to economic development and environmental protection coordination of PLEEZ.

Background The purpose of this study was to evaluate tongue function in patients with tongue cancer after reconstruction with innervated supraclavicular fasciocutaneous island flaps (iSFIFs) with the cervical plexus (iSFIFs-SPN) or reinnervated SFIFs with neurorrhaphy of the cervical plexus and lingual nerve (rSFIFs-SPN-LN). Methods Forty-two tongue defects were reconstructed using iSFIFs-SPN and rSFIFs-SPN-LN. Two-point discrimination tests revealed a significant difference on the dorsal and ventral hemitongue reconstructed using rSFIFs-SPN-LN from control values. Results No statistical difference in swallowing, speech, or esthetic outcome was found in the iSFIFs-SPN or the rSFIFs-SPN-LN. A significant difference was noted in the dorsal aspect and ventral surface of hemitongues reconstructed with rSFIFs-SPN-LN from control values and between 6 and 12 months. Conclusion Sensation after hemitongue reconstruction with the iSFIF-SPN and the neurorrhaphy of the cervical plexus nerve was sutured to the lingual nerve, sensation after hemitongue reconstruction with the rSFIF-SPN-LN approached normal 6 to12 months postoperatively. © 2013 Wiley Periodicals, Inc. Head Neck 36: 66–70, 2014

The quantitative index was confirmed by analysis of system of energy-saving and emission-reduction for Poyang Lake Ecological Economic Region (PLEER). Two factors of energy-saving and emission-reduction can be obtained by analyzing the quantitative index. The quantitative index was divided into two controllable factors according to the variance contribution rate and rotating load value. Countermeasures should be given after we point out the key of energy-saving and emission-reduction according to the controllable factors.