股前外侧穿支嵌合皮瓣修复头颈肿瘤根治术后缺损

目的:探讨股前外侧穿支嵌合皮瓣的制备要点及修复头颈肿瘤根治术后缺损的优缺点。方法:2007年12月—2011年3月制备股前外侧穿支皮瓣,同时解剖保护血管蒂上的肌分支,设计一蒂多岛的穿支嵌合皮瓣修复66例头颈肿瘤根治术后缺损。舌、口底癌32例,舌根、咽侧癌30例,颊癌2例,颌骨中央性鳞癌1例,腮腺癌1例。切取股前外侧皮瓣面积7cm×4cm～16cm×7cm,肌瓣约3cm×4cm,观察并发症及受、供区功能恢复情况,总结穿支嵌合皮瓣制取技术及优点。结果:65例穿支嵌合皮瓣成活,成活率98.5%。1例术后5d出现危象,最终放弃,创口均Ⅰ期愈合。2例发现无合适穿支血管,改用股前内侧穿支皮瓣修复成功。术后随访0.5～3a,皮瓣6个月后萎缩停止,局部外形丰满,语言及吞咽功能恢复满意。供区均拉拢缝合,瘢痕隐蔽,下肢无功能障碍。结论:逆行和顺行解剖技术相结合是制备穿支嵌合皮瓣的理想手段,能够帮助外科医师克服穿支血管的解剖变异。股前外侧穿支嵌合皮瓣能提供不同类型的组织进行三维修复,减少术后并发症(感染、瘘、血肿等)的发生率,是头颈肿瘤术后复合组织缺损修复的理想选择之一。     

Fusobacterium nucleatum GroEL induces risk factors of atherosclerosis in human microvascular endothelial cells and ApoE(-/-) mice

Infection and inflammation are risk factors in the initiation and progression of atherosclerosis. Periodontitis is one of the most prevalent chronic inflammations of the oral cavity, and has been reported to be associated with systemic disease. In this study, we evaluated whether the heat-shock protein GroEL of Fusobacterium nucleatum, one of the most prevalent bacteria in periodontitis, induces factors that predispose to atherosclerosis in human microvascular endothelial cells (HMEC-1) and apolipoprotein E-deficient (ApoE(-/-)) mice. GroEL induced the expression of chemokines such as monocyte chemoattractant protein-1 and interleukin-8 as well as cell adhesion molecules, such as intercellular adhesion molecule 1, vascular cell adhesion molecule 1, and E-selectin. GroEL induced the activity of tissue factor and reduced the activity of the tissue factor pathway inhibitor. Foam cell formation was induced by GroEL. GroEL-injected ApoE(-/-) mice showed significant atherosclerotic lesion progression compared with control mice. Serum levels of risk factors for atherosclerosis such as interleukin-6, C-reactive protein, and low-density lipoprotein were increased in GroEL-injected ApoE(-/-) mice compared with control mice, whereas serum levels of high-density lipoprotein were decreased. We could detect significantly higher levels of anti-F. nucleatum GroEL antibody in serum and F. nucleatum DNA in gingival crevicular fluid from patients with periodontitis than in that from healthy subjects. Our results indicate that the host response to the GroEL of periodontal pathogens like F. nucleatum may be a mechanism involved in atherosclerosis, supporting the association of periodontitis and systemic infection.     

Reliability of tumor primary cultures as a model for drug response prediction: expression profiles comparison of tissues versus primary cultures from colorectal cancer patients

Purpose  

Since primary tumor cells from patients have been used as a model for assessment of drug response for individual patients, this study aims to evaluate the reliability of such a model in colorectal cancer (CRC) in predicting the response of tumor tissues through comparison of their expression profiles.