Iatrogenic injury to oral branches of the trigeminal nerve: records of 449 cases

The aims of this study were threefold: (1) to describe iatrogenic lesions to oral branches of the trigeminal nerve, signs and symptoms, and functional status, (2) to report on a simple neurosensory examination method, and (3) to discuss means of prevention of iatrogenic injury. The etiology and functional status of 449 injuries to oral branches collected over 18 years were retrospectively reviewed. A simple scheme of a clinical neurosensory examination was applied to enable a quantified rating of the perception. Injury to the lingual nerve (n = 261) is not only the most prevalent type of lesion, it also seems to be the most devastating type of lesion. Third molar surgery (n = 319) counts for the majority of injuries to the lingual, inferior alveolar, and buccal nerves. Lesions related to the injection of local analgesics was the second most frequent etiology (n = 78), and the lingual nerve was affected more frequently and severely than other oral branches of the trigeminal nerve. The female gender was overrepresented in incidence of injured nerves but no difference was found in the severity of affection between females and males. All grades of loss of neurosensory functions were found, and a range of neurogenic malfunctions was reported. Methodological obstacles in clinical neurosensory examination of trigeminal nerve injury and the magnitude of neurosensory impairment are discussed. Many nerve injuries are avoidable by critical reevaluation of indications, increased awareness of potential hazards, and modified surgical procedures.     

A synopsis of head and neck oncology and related papers published in the British Journal of Oral and Maxillofacial Surgery in 2009/10

This review summarises all head and neck oncology and related papers published in the British Journal of Oral and Maxillofacial Surgery (BJOMS) during the period 2009-2010. A similar review, covering the years 2007-2008 was published in the Journal in 2009 and was well received by readers, as evidenced by the high number of downloads from the BJOMS website. In this article, we include all head and neck oncology-related articles published in the print version of the journal during 2009/10 and concentrate on summarising the full length article papers. Compared to the previous 2-year period, there has been a 25% increase in number of articles published in this sub-specialty.     

Prosthetic Rehabilitation of a Patient with a Large Mid Face Defect Secondary to Basal Cell Carcinoma

The art of maxillofacial prosthetics restores esthetics and function in patients with gross developmental or acquired defects of face and helps them to restore hope and ambition to lead a useful life. This valuable service provided by maxillofacial prosthodontist lifts the morale of the patient and thus aids in physical well being and quality of life. Diagnosis and treatment planning should include attention to each detail prior to rehabilitation process. This paper describes a clinical case of mid face defect due to basal cell carcinoma, rehabilitated with facial prosthesis and intraoral obturator.     

阳极氧化处理后的新型钛合金表面成骨细胞OPG、RANKL基因表达研究

目的:新型钛合金Ti-24Nb-4Zr-7.9Sn(TNZS)经过阳极氧化(anodic oxidation,AD)技术处理后,分析其表面的人成骨样MG63细胞骨保护素(osteoprotegerin,OPG)、细胞核因子-κB受体活化因子配体(RANKL)基因表达水平.方法:将人成骨样MG63细胞接种于Ti-6Al-4V、TNZS、AD-TNZS表面,采用半定量RT-PCR法检测OPG、RANKL mRNA的表达量.结果:人成骨样MG63细胞在AD-TNZS表面的OPGm RNA表达量有所提高,而RANKL mRNA的表达量3组材料间无明显差异.结论:阳极氧化处理的TNZS钛合金可能通过影响骨保护素、细胞核因子-κB受体活化因子配体调节成骨细胞、破骨细胞的平衡,从而促进种植体植入后的骨重建.     

转录调控因子CBF1（RBP—Jκ）对Cbfal和Ose2元件启动子活性的影响

目的：探讨Notch信号转录调控因子CBF1(RBP—Jκ)对核心结合因子Cbfal基因启动子和骨钙素基因启动子区域Ose2元件启动子活性的影响。方法：构建CBF1真核表达载体pCMV—Tag4／CBF1；将梯度浓度pCMV—Tag4／CBF1和荧光素酶报告质粒共转染两成骨前体细胞系Kusa—A1和Kusa-O，用双荧光素酶报告基因方法检测Cbfa1和Ose2元件启动子活性。结果：随CBF1浓度增加，Kusa—A1和Kusa-O细胞中Cbfa1和Ose2元件启动子活性均逐渐提高。统计分析表明：Kusa—A1细胞中1／40μg／μL实验组两启动子活性均与对照组差异显著；Kusa-0细胞中1／40μg／μL实验组Ose2元件启动子活性与对照组差异显著。结论：转录调控因子CBF1可以促进Cbfa1和Ose2元件启动子活性，从而可能对细胞的成骨性分化有正调节作用。     

体内诱导法建立的Tca8113细胞耐卡铂细胞株的耐药性表达研究

目的探讨通过体内诱导法得到的耐药细胞株的耐药性表达情况。方法以人舌癌Tca8113细胞系为研究对象,实验组采用荷瘤耐药动物的肿瘤细胞培养获得,对照组为体外连续培养诱导其产生耐药性。用四唑蓝法检测细胞耐药指数,标记生物素链亲和素法免疫细胞化学检测耐药相关蛋白P糖蛋白、谷胱甘肽S转移酶π、多药耐药蛋白和拓扑异构酶Ⅱ的表达,逆转录PCR检测多药耐药基因、多药耐药蛋白、拓扑异构酶Ⅱ和谷胱甘肽S转移酶π的表达。结果免疫细胞化学和逆转录PCR显示2组细胞多药耐药蛋白、谷胱甘肽S转移酶π、拓扑异构酶Ⅱ等表达均升高,但体内诱导较体外诱导可以获得更高、更稳定的耐药性。诱导后的Tca8113细胞对氨甲喋呤、卡铂、平阳霉素、长春新碱耐药性明显升高,而对5-氟尿嘧啶耐药性增加不明显。结论体内诱导得到的细胞株耐药性明显高于体外诱导株,肿瘤细胞的耐药现象受多种基因的调节。体内诱导Tca8113卡铂耐药细胞株Tca8113/CBP-vo可以作为肿瘤耐药研究的平台。     

苯丙芘诱导口腔上皮细胞癌变过程的差异基因表达谱分析

目的：检测并分析苯丙芘诱导的口腔上皮细胞癌变过程中基因表达的变化，寻找在口腔上皮细胞癌变过程中起重要作用的基因。方法：使用课题组前期建立的一株永生化细胞系，以及经过苯丙芘诱导而逐步产生的具有成瘤性的肿瘤细胞系【首代成瘤细胞（HB-56P）及典型鳞状细胞癌细胞（HB-94P）】，通过Affymetrix U133 plus 2．0基因芯片。检测在永生化细胞（HIOEC）向成瘤细胞转化过程中的基因表达变化。使用GenSpring7．0进行标准化及单因素方差分析，通过Venn图分析差异基因在癌变不同阶段的变化，并进一步通过GO术语进行注释。对部分基因使用实时定量PCR在细胞系中进行了验证。结果：在HIOEC向HB-94P转化过程中，共有883条差异基因，大部分集中于肿瘤发生的早期阶段。差异基因主要涉及大分子代谢、信号传导等生物学过程。具有过渡金属离子结合能力、腺核苷酸结合能力及激酶活性。其蛋白产物主要是膜结合蛋白，位于核内或细胞骨架。IGFBP3、S100A8、MAP2K、KRT6B、GDF15和MET的表达基本符合芯片结果。结论：本研究检测了苯丙芘相关口腔上皮细胞癌变过程中基因表达的变化，为苯丙芘相关的口腔癌分子发病机制研究提供了基础。     

Possible involvement of extracellular signal-regulated kinases 1/2 in mitogenic response of periodontal ligament cells to enamel matrix derivative

The efficacy of enamel matrix derivative (EMD) as an adjunct to periodontal regenerative therapy has been demonstrated in recent clinical studies, however, little is known about its molecular mechanism (s). We examined the mitogenic response of cultured periodontal ligament (PDL) cells to EMD and characterized associated changes in proliferation-related intracellular signaling molecules, including mitogen-activated protein kinases (MAPK) and Akt kinases/protein kinase B (Akt/PKB) kinases. The DNA synthesis of PDL cells increased following treatment with EMD at concentrations higher than 1 microg ml(-1). This mitogenic response to EMD was associated with the selective activation of extracellular signal-regulated kinase (ERK) 1/2. No other MAPKs, or Akt/PKB kinases, responded to EMD stimulation. The EMD induction of DNA synthesis and activation of ERK 1/2 were diminished by pretreatment with suramin, an inhibitor of receptor tyrosine kinases (RTK). The signaling pathway induced by EMD from RTK to ERK 1/2 was similar to that activated by epidermal growth factor (EGF), although the specific binding of 125I-EGF to PDL cells was not affected by pretreatment or concomitant treatment with EMD. These findings suggest that EMD elicits its mitogenic signal through an EMD-specific RTK towards ERK 1/2.     

T‐cell independent production of salivary secretory IgA after hematopoietic stem cell transplantation in children

This study examined the recovery of secretory IgA (S‐IgA) in saliva after hematopoietic stem cell transplantation (HSCT) in 35 children and young people between the ages of 3 and 27 years (mean = 13.6), and compared this recovery with that of serum immunologic constituents. Reference values for human salivary S‐IgA in saliva were obtained from 77 healthy control subjects between the ages of 7 and 25 years (mean = 11.4). In the 35 patients, a nadir of secretory IgA concentrations in saliva (S‐IgA) was observed between the 3rd and the 4th month, and a return to normal values 1 year after HSCT. Serum IgA concentrations reached their nadir in the 6th month, and normalized in the 18 months after HSCT. The recovery of T‐helper cells (CD4⁺/3⁺) was also delayed to beyond 18 months. We found a significant correlation between the reconstitution pattern of S‐IgA and that of T‐helper lymphocytes, but no correlation was found between the post‐transplant evolutions of S‐IgA and serum IgA, or between S‐IgA and T‐helper cells. The recovery of S‐IgA was more rapid than that of serum IgA and appeared to be T‐helper cell independent.     

口腔生物膜体外模型的建立和应用评估

目的：通过建立体外生物膜模型，模拟口腔内生态环境以探索生物膜在龋病发生发展中的作用。方法：利用发酵罐与恒流培养室的组合构建简易的体外生物膜模型，通过恒流培养室内液体培养基连续的流动循环，模拟出口腔内液体持续冲刷的生态环境。在羟磷灰石片上定植4种口腔常驻菌，以形成实验性生物膜，并通过每12h定时给以蔗糖底物，模拟致龋环境，观察系统中实验菌CFU计数、pH动态变化等各项反应及不同环境下所形成生物膜的微结构变化。结果：本研究建立的系统能较好的控制各项实验参数，加入蔗糖底物后表现出明显的致龋反应。结论：本组建立的体外模型有着良好的可靠性与可重复性，可用于对口腔生物膜的各项体外研究。