Most of the patients with oral and maxillofacial malignancy are in the middle and advanced stages at diagnosis and the incidence rate is increasing in recent years. Chemotherapy alone is difficult to benefit the survival of patients with advanced oral and maxillofacial malignancy. Ultrasound hyperthermia is a new and effective treatment for malignant tumor, which is developing rapidly in addition to conventional treatment. However, at present, ultrasound hyperthermia has not been widely used in the treatment of oral and maxillofacial malignancy. Therefore, formation of a guideline on ultrasound hyperthermia for oral and maxillofacial malignancy is mandatory, in order to promote and standardize the clinical practice of ultrasound hyperthermia in this field, and improve the long-term survival rate and quality of life of patients.

口腔颌面-头颈部恶性肿瘤发病率位居人类恶性肿瘤的第6位,大部分患者就诊时已到局部晚期阶段,经过手术、放化疗后仍有很高比例的患者会发生局部复发和/或远处转移.针对复发和/或转移性口腔颌面-头颈部鳞癌患者,以EGFR靶向治疗药物为基础的靶向化疗是目前一线治疗常规应用方案.国际上已批准的治疗头颈部肿瘤的靶向药物有尼妥珠单克隆抗体(单克隆抗体,以下简称单抗)和西妥昔单抗,目前西妥昔单抗的指南很多,而尼妥珠单抗在口腔颌面-头颈部恶性肿瘤的应用尚无明确规范.本文结合文献及相关专家的经验,制定专家共识,对尼妥珠单抗的抗肿瘤机制以及目前临床应用情况进行阐述,制定了尼妥珠单抗治疗口腔颌面-头颈部鳞癌的建议方案,供临床医师参考.

头颈黏膜黑色素瘤(HNMM)是一类高度恶性的实体肿瘤,5年生存率长期徘徊在20％左右,其致病因素、驱动基因、临床表现及治疗手段等与皮肤黑色素瘤差异较大.2015年,国内首个头颈黏膜黑色素瘤诊治专家共识建立,经过6年多的推广应用,HNMM临床诊治规范性有了很大提高.随着黏膜黑色素瘤临床与基础研究的不断深入,HNMM的诊治与预后在近些年发生了较大变化,特别是头颈部各分支学科的蓬勃发展,口腔、鼻腔鼻窦、眼部等黏膜黑色素瘤各自发展出独特的诊治模式,该共识已不能满足当前临床的实际需求.对此,专家组认为头颈部黏膜包含的解剖范围较广,涉及的临床科室较多,不同学科之间黑色素瘤诊疗模式差异明显,临床亟须符合个体化治疗及精准治疗的更加专科化的诊治共识.为了进一步提高口腔黏膜黑色素瘤(OMM)的远期生存率和生存质量,让共识更好地指导临床工作,专家组聚焦OMM,深入讨论,基于循证医学证据和经验医学,完成专家共识的制定.考虑到患者的个体化差异,本共识可作为OMM临床实践的参考.

The first gene therapy product, recombinant adenovirus human p53 (rAd-p53), has been approved by CFDA since 2013. During these years, most of the clinical trials and the relevant basic research were carried out by Chinese oncologists. Gendicine was proved to be a safe and promising gene therapy drug for patients who suffered from head and neck squamous cell carcinoma (HNSCC). The basic therapeutic theories of gene therapy were totally different from the traditional ones, such as surgeries or radio- and chemotherapy, and the evaluation of treatment outcomes should also be changed simultaneously. However, there still existed a lot of misunderstandings about gene therapy, which resulted in improper administration, insufficient dosage calculation, and treatment cycles, and the treatment outcomes were unsatisfactory, especially for inexperienced oncologists or hospitals. Therefore, we will provide some practical guidance here on the gene therapy of rAd-p53 based on our previous research and experience, which focused on the basic theories and clinical issues, to answer the questions arising during the clinical of gene therapy and to accelerate the development of gene therapy for the benefit of patients bearing malignant tumors.

静脉血栓栓塞症(VTE)是临床常见病,其在口腔颌面外科围手术期发病率较低,但危害极大.临床上关于VTE评估的评分量表很多,且相关预防的指南也很多,但目前国内外对于口腔颌面外科围手术期VTE评估的评分量表以及相关预防的指南尚无明确规范.为尽量减少该疾病的发生,该文结合相关专家的经验,制定专家共识,对VTE的病因及临床表现、口腔颌面外科患者VTE的危险因素、评分量表以及预防措施进行阐述,制定了改良Caprini评分量表(口腔颌面外科试用版)、口腔颌面外科患者VTE的临床诊断流程图以及术后VTE预防流程图的建议方案,供临床医师参考.

Chemotherapy is one of the primary methods for the treatment of oral squamous cell carcinoma, and it is also an essential part of the comprehensive treatment of oral squamous cell carcinoma. However, the “double-edged sword” effect of chemotherapeutic drugs in killing both cancer cells and normal cells in vivo has restricted its clinical application to a certain extent. Chrono-chemotherapy based on human circadian rhythm is safer and more effective than traditional chemotherapy, which has been confirmed by a large number of studies. In order to promote and standardize the clinical application of this technology, we organized relevant experts to discuss and formulate the Chinese expert consensus. The consensus provides standardized suggestions on the related concepts, principles, drug selection, administration time, and methods of chrono-chemotherapy for oral squamous cell carcinoma, which can provide a reference for clinical practice.

目的 应用个性化基台一体烤塑冠解决在后牙垂直咬合间隙不足的口腔种植患者的义齿固位问题。 方法 选取34例后牙缺牙区骨水平种植体植入后，咬合距离（骨水平种植体顶部至对面）低于5 mm的患者，共植入40枚种植体，随机分为实验组与对照组，每组20枚种植体。实验组使用CAD/CAM制作的个性化基台一体烤塑冠修复种植体牙冠，使用基台螺栓固基台一体烤塑冠（扭矩30N.cm）。对照组使用成品分体式直基台，先使用基台螺栓固位基台（扭矩30N.cm），再以粘接剂将钴铬烤塑全冠粘接在分体式基台上。观察比较实验组与对照组修复后的义齿固位保存情况。 结果 34例患者均在种植体植入3月后顺利完成种植体上部固定义齿修复，经1年随访，实验组一体冠未见松动或脱落；对照组基台未见松动或脱落，在修复后1月开始陆续有7例牙冠与基台分离，经重新粘接后其中5例牙冠再次脱落，改为基台一体烤塑冠修复后未见松动或脱落。实验组与对照组在义齿固位上差异有统计学意义。 结论 种植体与基台界面的螺栓固位不受上部牙冠是基台一体冠还是基台粘接冠设计的影响；个性化基台一体冠可以解决粘接面积不足所致的牙冠脱落问题。

我国恶性黑色素瘤的发病率较欧美发达地区低,2009年上海市恶性黑色素瘤的发病率约为0.42/10万.但是由于我国人口基数大,因此临床上恶性黑色素瘤人数众多.2009年、2011年已经发布了2版《中国黑色素瘤诊治指南》,主要针对皮肤恶性黑色素瘤.在我国,黏膜恶性黑色素瘤是最常见的类型之一,但对黏膜恶性黑色素瘤的研究较少.而黏膜黑色素瘤的治疗手段和预后与皮肤黑色素瘤有许多不同.因此,制订符合我国国情的黏膜恶性黑色素瘤临床实践共识非常必要.

This study aimed to evaluate the accuracy of surgical outcomes in free iliac crest mandibular reconstructions that were carried out with virtual surgical plans and rapid prototyping templates.

Purpose: This study sought to introduce 3-dimensional (3D) virtual surgical planning and digital rapid-prototyping templates for zygomaticomaxillary complex (ZMC) injuries associated with orbital volume change and to evaluate the surgical outcomes quantitatively.Patients and Methods: Eight patients who underwent open reduction and fixation for a ZMC injury with orbital volume change were studied. Computed tomographic (CT) scan of the zygomaticomaxillary area was performed before the operation in each case. Scanned data were converted into 3D models using Mimics software (Materialise, Brussels, Belgium) for surgical designs. Virtual surgical reductions and correlated guiding templates were designed using Mimics and Magics software (Materialise). The operations were performed with the help of prefabricated templates to reduce the fractures. A postoperative CT scan of each patient was obtained within 2 weeks after surgery, and quantitative measurements were made to assess the surgical outcomes. Preoperative volumes of the bilateral orbits were compared, and concordance with postoperative volumes of the bilateral orbits was assessed. Twenty-one pairs of distances from 7 marker points to 3 reference planes were measured to assess postoperative facial symmetry.Results: Volumes of the injured orbits were significantly different from volumes of the uninjured orbits preoperatively (P < .05), whereas bilateral orbital volumes showed no statistically significant difference postoperatively (P > .05). In addition, 19 of the 21 pairs of bilateral distances showed no significant difference postoperatively (P > .05).Conclusions: Quantitative assessment showed that digitally designed, rapid-prototyping templates for ZMC fractures have a positive impact on restoring facial symmetry and concordance of bilateral orbital volumes. (C) 2013 American Association of Oral and Maxillofacial Surgeons

Objective To explore the effect of the young and middle-aged overweight and obesity on the prevalence of hypertension subtype. Methods We selected 300 subjects who had medical examination and without taking antihypertensive drugs in our hospital in Sep 2012, and analysed complete data containing height, weight, blood pressure measurements and biochemical parameters. Compared the effect of young and middle-aged overweight and obesity on the prevalence of hypertension subtypes and serum homocysteine (Hcy) levels. Results The overweight rate and obesity rate were 35% and 10.33%, respectively, and the male is higher. The peak prevalence of overweight and obesity in the age of 30 to 49. Male and female systolic blood pressure, diastolic blood pressure and mean blood Hcy levels were gradually increased with the increasing of BMI levels. In overweight and obesity group, gender differences disappeared in blood pressure. In obesity group, Hcy levels had no difference in different gender. The total hypertension prevalence rate was 16%, and the overweight and obese group reached 20%and 45.16%, respectively. The prevalence rate systolic and diastolic hypertension (SDH) and isolated diastolic hypertension (IDH) higher than that of isolated systolic hypertension (ISH). SDH and IDH were the main hypertension subtypes in the age of 30 to 49 populations. 2/3 of the overweight or obese combined SDH or IDH were distributed in young and middle-aged crowd. There were 37.5%and 42.85%obese subjects had hyperhomocysteinemia in the age of 30~49. Conclusion There was no sexual difference of blood pressure and serum homocysteine in overweight and obesity group. The main hypertension subtypes were SDH and IDH. The majority of overweight or obesity subjects combined with SDH or IDH were distributed in 30~49 years old. These people should be intensively offered healthy promotion measurements to prevent hypertension and hyperhomocysteinemia..

Objective Observe middle-old age which above 45 years old cases serum thymidine kinase 1 (STK1)on tumor mass screening. Methods 620 cases on physical examination testing STK1 by using sensitive chemiluminescence’s dot blot assay. Assess the significance of STK1 in diagnosis and prognosis of cancer. Results Positive group(STK1 value 6.72±4.05pmol/L) was higher than negative group(STK1 value 0.86±0.35pmol/L) (P<0.05). Both group STK1 value was not significant difference with gender(P>0.05). There were 35 positive cases(positive rate 5.6%) including cancer 2 cases, benign tumor 18 cases, pre-malignant tumor 5 cases, nontumor profiferation disease 5 cases and infectious disease 5 cases. Conclusion STK1 can act as general tumor marker on carsinoma mass screening in middle-old ages and fit in with cost-effect because it is not expensive and just serum testing.

Objective To investigate the association of arterial structure and endothelial function with interventricular septum thickness in healthy subjects.Methods Carotid intima-media thickness ( IMT ) represented arterial structural change.Brachial artery flow mediated dilation ( FMD ) was used to reflex the change of vascular endothelial function.Carotid intima-media thickness,brachial artery flow mediated dilation and interventricular septum thickness ( IVST ) were measured by ultrosonography in 68 healthy subjects ( 16 male,52 female ).Results There was a positive correlation between IMT and IVST ( r =0.394,P=0.001 ) in healthy subjects.IVST was negatively cor related with FMD.In addition,IVST were also positively correlated with age and systolic blood pressure.Multiple regression analysis showed IMT and FMD were independent factors for IVST.Conclusions IMT and FMD correlate with IVST in healthy subjects,which suggests arterial structural and functional changes may have effects on interventricular septum thickness.

Objective. We report preliminary results of an ongoing study that assesses the efficacy of tacrolimus on Kimura's disease (KD).Study Design. A patient with refractory KD after surgery and treatment with prednisone was treated with tacrolimus. Tacrolimus (FK-506) was administered at an initial dosage of 1 mg every 12 hours, and FK-506 concentration in the blood was monitored monthly. FK-506 blood concentration was controlled within 5 to 15 mu g/L. After 6 months, the dosage of tacrolimus was reduced to 0.5 mg daily for another 2 months and then treatment was stopped.Results. Swelling of the bilateral salivary glands disappeared within the first week. No serious side effects were noted and the disease has not recurred in the 2 years of follow-up.Conclusions. Tacrolimus may be an effective treatment for patients with KD, but more research is needed to determine its long-term efficacy and safety as well as its mechanism of action.

目的了解广州地区健康人群指骨骨密度(bone mineral density,BMD)的变化规律及骨质疏松症(osteporosis,OP)的患病情况。方法采用放射吸收法对11 419例健康体检人群进行指骨BMD检测,同时进行问卷调查和人体学测量。结果对11 419例健康体检者指骨BMD的研究发现,随着年龄的增长,人群指骨BMD呈下降趋势(r=-0.43,P<0.001)。男性指骨BMD峰值位于30～岁,指骨BMD均值为(0.346±0.029)g/cm2;女性峰值位于40～岁组,指骨BMD均值为(0.336±0.030)g/cm2。40～岁组以后,男、女性BMD值均进入快速下降期。各年龄段女性BMD均小于男性,差异均有统计学意义(均有P<0.001)。本次研究共检出OP病例1 531例,占总人数的13.4%。随着年龄的增加,男、女OP检出率均呈上升趋势,骨量正常人群比例呈下降趋势。结论广州地区健康人群BMD随年龄增长而降低,OP发病率也随年龄增加而增加,除40～岁组外,同年龄组女性OP检出率高于男性。本次研究结果为广州地区OP的防治奠定了基础。

Objective To present students with direct view of the anatomy of pterygopalatine fossa.Methods A 3D virtual pterygopalatine fossa was reconstructed using Dicom data.Sphere objects were created in the virtual pterygopalatine fossa and foramens that connected to it in the intersectional view window.The movements of the sphere objects were observed in 3D view window simultaneously.Results Not only slices of different orientations but also 3D images could be shown to students simultaneously,which made it possible for them to understand the anatomy of this area easily.Conclusion Better effect can be achieved in the teaching of anatomy of pterygopalatine fossa by using 3D reconstruction technique.

This research sought to asses the efficacity of a new type of tissue engineering bone developed by PDLLA/ PLA-PEG-PLA and BMP as a kind of bone graft substitute in the rabbit model of mandibular defects; 15 mm x 6 mm bilateral mandibular periosteum bone defects were made surgically in 20 New Zealand adult rabbits. The porous scaffolds impregnated with rhBMP-2 were used for the purpose, and the scaffolds without rhBMP-2 were used as control. The methods adopted in this research were: macroscopy, histomorphologic exam, X-ray exam, SEM micrography, computer-aided analysis and graphics. The experimental group was shown to have an earlier inception of bone forming. New bone formation was seen along the border of the original mandibular bone and in the middle. At 12 weeks after surgery,the defects were almost filled with new bone. In the control group, the defects could not be repaired in its entirety, and there was no new bone in the middle. The porous scaffold is a promising carrier for BMP. This kind of bone graft substitute can serve as an osteoconductive and osteoinductive matrix.

OBJECTIVETo investigate the biocompatibility of new bone tissue engineering scaffolds, A:D, L-polylactic acid (PDLLA)/polylactic acid-polyethylene glycol-polylactic acid-polylactic acid (PLA-PEG-PLA)/Tricalcium phosphate and B: PDLLA/PLA-PEG-PLA in vivo, compared with PDLLA in repair of a rabbit mandibular body defect.METHODS24 New Zealand adult rabbits were divided into 4 groups randomly. 15 mm x 6 mm defects were made surgically in the bilateral mandibular bodies and each hemi-mandible was assigned as an experimental unit. The defects were randomly repaired with scaffold materials in each group. Specimens obtained were evaluated with general observation, X-ray, histomorphology and computerized graphical analysis at 2, 4 , 8, 12 weeks after surgery.RESULTSCompared with PDLLA, the new scaffold materials B showed biocompatibility. At the same time the quantity of new bone produced was much more than that in control group (P<0.05). The new scaffold materials A showed the clear chronic granulomatous inflammation.CONCLUSIONNew scaffold material B had sound biocompatibility. It was much better than PDLLA. So it may be an ideal bone tissue engineering scaffold material. A is not adapted to be used as scaffold material.

BACKGROUND:Foreign bodies located at the base of the skull pose a surgical challenge. Here, a customized computer-designed surgical guide bar was designed to facilitate removal of a skull base foreign body.METHODS:Within 24h of the patient's presentation, a guide bar and mounting platform were designed to remove a foreign body located adjacent to the transverse process of the atlas and pressing against the internal carotid artery.RESULTS:The foreign body was successfully located and removed using the custom designed guide bar and computer operative planning. Ten months postoperatively the patient was free of complaints and lacked any complications such as restricted opening of the mouth or false aneurysm. The inferior alveolar nerve damage noted immediately postoperatively (a consequence of mandibular osteotomy) was slightly reduced at follow-up, but labial numbness persisted.CONCLUSIONS:The navigation tools described herein were successfully employed to aid foreign body removal from the skull base.

The aim of this paper is to test implantation outcomes and osteogenic efficacy of plasma micro-arc oxidation (MAO)-treated titanium implants in dogs. Thirty-six pure titanium implants (18 MAO-treated, 18 untreated) were inserted into the mandibles of nine adult beagles and allowed to heal under non-weight-bearing conditions. Implant stability and interface characteristics were evaluated at 4, 8 and 12 weeks post-implantation. Methods included scanning electron microscopy, mechanical testing, histological analysis and computer-quantified tissue morphology. Osseointegration was achieved in both groups, but occurred earlier and more extensively in the MAO group. Areas of direct bone/implant contact were approximately nine times higher in the MAO group than in the control group at 12 weeks (65.85% versus 7.37%, respectively; p < 0.01). Bone-implant shear strength in the MAO group (71.4, 147.2 and 266.3 MPa at weeks 4, 8 and 12, respectively) was higher than in the control group (4.3, 7.1, and 11.8 MPa at weeks 4, 8 and 12, respectively), at all assessments (all, p < 0.01). MAO treatment of titanium implants promotes more rapid formation of new bone, and increases bone-implant shear strength compared to untreated titanium implants.