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PURPOSE: To analyze a single institution's experience of solitary venous malformation (VM) in the accessory parotid region. METHODS: From 2002 to 2009, a total of 10 consecutive patients with solitary venous malformation (VM) in the accessory parotid region were retrospectively analyzed. Clinical records were reviewed for patient demographic data, presenting symptoms and signs, imaging modalities used, histological and immunohistochemical results, surgical data, and clinical outcomes. RESULTS: The sample consisted of 5 males and 5 females with a mean age of 42.8 years. The course of disease ranged from 0.5 to 168.0 months with a mean time of 64.9 months. The mean size of the masses was 1.7 cmx1.5 cm (1.0 cmx0.8 cm to 2.5 cmx2.5 cm). Investigations included Doppler ultrasonography (US) and computed tomography (CT) scanning. Surgical excision using various surgical approaches was performed in all patients. Postoperative pathologic examination confirmed the diagnosis of VM. The mean follow-up period was 41.2 months (range 2 months to 94 months) with no recurrence reported. CONCLUSIONS: For solitary VM in the accessory parotid region, investigations, such as Doppler US or CT scanning or the use of fine needle aspiration cytology, may aid in clinical diagnosis. The primary treatment of these lesions is surgical excision, and the prognosis is good with fewer recurrence. [ABSTRACT FROM AUTHOR]

PURPOSE: To figure out the expression of EGFR in locally advanced oral squamous cell carcinoma and the relationship between EGFR expression and TPF induction chemotherapy. METHODS: Two hundred and fifty-six patients with locally advanced oral squamous cell carcinoma in a prospective randomized controlled trial were included in this study. Using immunohistochemical staining against EGFR, expression of EGFR was detected in the oral squamous cell carcinoma tissues before treatment. The relationship between EGFR expression and clinicopathologie indicators was analyzed as well as the relationship between EGFR expression and TPF induction chemotherapy. Statistical analysis was performed using SPSS18.0 software package. RESULTS: There was a significant correlation between the EGFR positive expression and the age of patients (P=0.015), younger patients had higher EGFR expression level. No significant correlation between EGFR expression and other clinicopathologie indicators was found. According to the pathological and clinical response to TPF induction chemotherapy, there was no significant correlation between EGFR expression level and the response to TPF induction chemotherapy. The correlation between EGFR expression and the prognosis of oral squamous cell carcinoma patients was not significant as regards to tumor recurrence, overall survival, disease free survival, locoregional reccurrence free survival and distant metastasis free survival. CONCLUSIONS: EGFR expression was related to the age of patients with oral squamous cell carcinoma. Further studies are suggested on the clinical application of EGFR expression as target therapy in oral squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

PURPOSE: To establish a rabbit model of micrometastasis in sentinel lymph node (SLN) from tongue carcinoma, so the mechanism of regional lymph node metastasis from tongue carcinoma as well as its management may be studied through this model. METHODS: First, lymph node metastatic specimen of rabbit tongue Vx-2 carcinoma was orthotopically and serially transplanted into the tongue of disease-free rabbit at 4-week interval (8 rabbits for each passage) for screening carcinoma specimens with high lymphatic metastasis potential. Then, the selected specimens were orthotopically re-transplanted into tongues of 40 disease-free rabbits; SLNs of the developed Vx-2 tumor were harvested at 8th, 10th, 12th, 14th and 16th day (8 rabbits for each harvest) respectively after the transplantation, and thorough work-up of the SLNs was done by serial sectioning and immunohistochemistry for evidence of micrometastasis. RxC table Chi-square test was used for comparison among multi-ratio using SPSS 17.0 software package. RESULTS: Increased SLN metastasis was noted with serial passages of transplanting lymphatic metastasis specimens in the tongue: 3/8 (37.5%) in the first passage, 5/8 (65%) in the second, 8/8 (100%) in both the third and the fourth. After orthotopic transplantation of the harvested nodal carcinoma specimen with high metastatic potential, micrometastasis was detected in SLN in 5/8 rabbits (62.5%) of group 8th, day, 8/8 (100%) of both group 10th day and group 12th day, 6/8 (75%) of group 14th day and 3/8 (37.5%) of group 16th day respectively. CONCLUSION: Specimens with high lymphatic metastasis potential can be achieved by serial and orthotopic transplantation of lymphatic metastasis specimens from Vx-2 carcinoma in rabbit tongue; and the rabbit of group 10-12 days after orthotopic re-transplantation of them is an ideal model of micrometastasis in SLN from tongue carcinoma. [ABSTRACT FROM AUTHOR]

PURPOSE: To compare the effectiveness of the tools on assessing quality and risk of bias between Jadad scale and Cochrane collaboration' s tool for assessing risk of bias in randomized controlled trials (RCTs). METHODS: A systematic literature search on induction chemotherapy for head and neck squamous cell carcinoma using the database of MEDLINE and EMBASE was performed as an example for evaluating the quality and risk of bias of RCTs. The Jadad scale and the Cochrane collaboration' s tool for assessing risk of bias were used for evaluating the RCTs, respectively. The different RCTs evaluated by the two kinds of tools were further analyzed on their quality and risk of bias. RESULTS: Thirty-seven RCTs were eligible for this analysis. Using the Jadad scale, 23 trials should be excluded because of the low quality of RCTs; while using the Cochrane collaboration's tool for assessing risk of bias, 7 trials should be exclude because of the high bias of RCTs. Among the 16 low bias RCTs, which were scored as low quality of RCTs by Jadad scale, the most common reasons for exclusion were no description of the blindness and generation of the allocation sequence. However, the quality of these RCTs was good enough for systemic analysis. CONCLUSIONS: In order to improve the quality of systemic analysis, proper tools of assessing quality and risk of bias should be considered, and the Cochrane collaboration' s tool for assessing risk of bias is recommended, especially for open RCTs. [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate the proportion of salivary gland tumors in the elder patients in the past ten years, in order to provide reference for clinical diagnosis and treatment. METHODS: The medical data of salivary gland tumors treated in our department from January 2000 to December 2009 were reviewed and analyzed. The changes of three periods between 21cl0s, 20c90s and 20c80s were compared. RESULTS: The number of salivary gland tumors in elder patients increased rapidly in recent years, especially that of benign tumors. Warthin's tumor was the most common benign tumors, and adenoid cystic carcinoma was most often found in malignant tumors. Carcinoma ex pleomorphic adenoma rose to the third among malignant tumors of salivary gland and first among parotid gland malignancies. The proportion of benign tumor was almost equal to malignant tumor in minor salivary gland. The benign-malignant ratio of palatal salivary gland was 1.34:1, which was opposite to the previous figure. The parotid gland was the most common site, followed by palatal and submandibular gland. CONCLUSIONS: The proportion of salivary gland tumors in elder patients in 2000s was different from that in 1980s and 1990s. The changes should be taken into attention in daily clinical works. [ABSTRACT FROM AUTHOR]

PURPOSE: To analyze a single institution's experience in the clinical management of intraoral lymphoepithelial cyst (LEC) based on clinical examinations differential diagnosis, treatment and prognosis. METHODS: From 1993 to 2010, a total of 120 consecutive patients with intraoral LEC undergoing surgery were retrospectively investigated with regards to gender, age, primary site, symptom, clinical examination, treatment and prognosis. RESULTS: Of the 120 patients, 37 were males and 83 were females, their age ranged from 2 to 75 years with a mean age of 44.1 years. The course of disease ranged from 2 months to 10 years with a mean period of 8.0 months, and 75.8% of the patients had a course of disease shorter than 6 months. The most common location was the tongue (50%) and floor of mouth (38.3%). All patients underwent complete surgical removal of the lesions. During the follow-up period, no lesion recurred. CONCLUSIONS: The clinical characteristics of intraoral LEC are not specific and may be mixed with other intraoral lesions. The first choice of treatment is surgical excision, which results in a good prognosis. Supported by Program for Innovative Research Team of Shanghai Municipal Education Commission and Research Fund of Science and Technology Commission of Shanghai Municipality(1052nm04700, 10140902200). [ABSTRACT FROM AUTHOR]

PURPOSE: Primary desmoids type fibroma arising from the oral and maxillofacial region is uncommon. The purpose of this study was to analyze the clinicoepidemiological characteristics of this rare disease. METHODS: Epidemiological and clinicopathological data on 20 patients were reviewed from the hospital records and analyzed accordingly. The data were processed with SPSS 10.0 software package. RESULTS: Twelve males and 8 females with a ratio of 3:2 were involved. The mandible was the most common site of presentation. Suspected malignant change was found in 6 cases and an extremely high recurrence rate was also found in up to 53%. Abnormally high blood levels of alkaline phosphatase were found in 65% of patients, which had a close relation with bone resorption. CONCLUSIONS: Desmoids type fibroma arising from the oral and maxillofacial region hold the character of local invasion and regional recurrence; surgery is chosen as the most effective treatment combined with postoperative radiotherapy; elevated serum alkaline phosphatase levels may be used as an indicator for bone resorption. Supported by Natural Science Foundation of Shanghai Municipality(11ZR1420600) and Shanghai Leading Academic Disciplines Project (S30206). [ABSTRACT FROM AUTHOR]

PURPOSE: To analyze accessory parotid lesions in terms of clinical appearance, clinical differential diagnosis, treatment and prognosis. METHODS: From April 1999 to November 2008, 32 patients with accessory parotid lesions was treated. The patients' general condition, clinical symptoms and signs, preoperative examinations, surgical treatment, and prognosis were recorded and analyzed. RESULTS: Among the 32 patients, there were 8 males and 24 females with an average age of 45 years. The patients always presented without obvious symptoms, and the masses were moderate to hard in hardness without tenderness, mobile with clear boundary. The pathological diagnosis was 24 benign lesions and 8 malignant lesions, including 19 pleomorphic adenomas, 3 benign lymphoepithelial lesions, 1 basal cell adenoma, and 1 chronic inflammation among benign lesions, while 2 acinic cell carcinomas, 2 lymphoepithelial carcinomas, 1 papillary cystadenocarcinoma, 1 basal cell adenocarcinoma, 1 myoepithelial carcinoma, and 1 mucoepidermoid carcinoma among malignant lesions. Surgery and surgery plus radiotherapy were performed in patients with benign and malignant lesions respectively with good prognosis. CONCLUSIONS: Accessory parotid lesions are rare and the clinical manifestations are similar to benign tumors. Surgical resection and surgical resection plus radiotherapy are the primary treatment for benign and malignant lesions, respectively. The prognosis is always good. [ABSTRACT FROM AUTHOR]

PURPOSE: Through three dimensional measurement and analysis of normal adult mandible, to establish the mandibular contour parameters (MCPs) which are applied to conduct the design and fabrication of fibular osteotomy guide (FOG). METHODS: A total of 55 normal mandibular CT data (Dicom) was collected and delivered to the image workstation of Shanghai Jiao Tong University for detailed analysis by use of self-edited software of Surgical Plan of the Jaws. The real-size mandibular model was established on which 7 anatomic bony marks were set up and 14 linear/angular variables were measured. The data was analyzed using SAS8.0 software package. After that, MCPs were established to conduct the design and fabrication of FOG. A female patient with LCL mandibular defect underwent mandibular reconstruction with vascularized fibular flap, where FOG was applied to contour the grafted fibula. RESULTS: There were significant sex and individual differences in the linear variables (P<0.05) of mandible against the angular variables (P>0.05). Meanwhile, the morphological difference of anterior mandible was less than that of posterior mandible. The MCPs were mandibular body anglel40°, mental angle 120° and mental length 30mm which were successfully applied to shape the grafted fibula in an operation of mandibular reconstruction. Postoperatively the patient achieved excellent cosmetic result. CONCLUSION: FOG can rapidly and accurately realize four-segment-osteotomy of fibula in the mandibular reconstruction. However further improvement of the device is needed. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the anti-tumor effect of co-cultured sensitized dendritic cell (DC) and cytokine-induced killer cell (CIK) separated from peripheral blood to human tongue SCC nude mice cancer model in vivo. METHOD: Both DC and CIK were separated and cultured in vitro from peripheral blood of oral tongue cancer patients. The sensitized DC was co-cultured with CIK. Tca8113 cells were injected into the right oxter of 24 BALB/c nude mice which were divided into control group A, experiment group B and group C. 24 hours later, group A received normal saline injection in one site with Tea 8113 transplantation, group B were injected DC-CIK in opposite side, group C were injected the same dose of DC-CIK in right oxter. The number and size of induced tumors were observed in the next 4 weeks. The data was analyzed with SAS 6.12 software package for student's t test, ANOVA and Chi-square test. RESULTS: The average day of tumor induction was 7.63 days, 9.5 days and 12 days for group A, B and C, respectively, which showed significant difference between group A and C (P=0.0132). Two weeks after Tca8113 injection, 100% of mice in group A developed tumors, 87.5% in B and 62.5% in C developed tumors, which showed no significant difference in 3 groups. The curve of induced tumors size showed that group A developed faster, group C was the slowest with significant difference (P= 0.036). CONCLUSION: The co-cultured sensitized DC-CIK showed a certain anti-tumor effect nude mice with Tea 8113 model in vivo. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the distribution of biomechanical stress on the craniofacial skeleton for bilateral maxillectomy reconstruction by using the vascularized fibula graft and zygoma implants,in order to provide theoretical references for restoration of maxillary defects. METHODS: Based on digital imaging and communications in medicine (DICOM) data and the image process technology, a modularized geometrical and finite element model of the human skull was built to simulate the bilateral defect pattern of the maxilla. Biomechanical properties of the zygomatic implants and the connected implants were evaluated by using finite element analysis (FEA) method. RESULTS: The deformation tendency of the zygomatic implants was identical and the displacement of bending was not noticeable. The displacement of the zygoma fixture near the zygoma was close to zero. The neck of the zygoma fixture on the fibula bone and on the zygoma bored the largest stress, while the rest of the peri-implant bones bored a lower stress. CONCLUSIONS: Stress from occlusal forces is mainly supported by the zygomatic bone and the fibular bone. The occlusal force is effectively transmitted and the stress distribution of the peri-implant bone of such reconstruction protocol is reliable. Reconstitution of the buttresses system ensures a stable support for occlusion and stress. This is a safe and effective method to optimize bilateral maxilla rehabilitation. Supported by Combined Engineering and Medical Project of Shanghai Jiao Tong University (YG2010MS56). Dr. WU Yi-qun and YE Chen contributed equally to the study. [ABSTRACT FROM AUTHOR]

PURPOSE: Using the computational fluid dynamics to analyse the alteration of flow field of free forearm flap with 4 different venous anastomotic techniques, and to preliminarily explore its clinical significance. METHODS: Three dimensional geometric models of radial forearm flap with 4 types of anastomotic techniques between radial vein and recipient vessels were established by Pro/E (Wildfire 4.0) as follow: type I (matched anastomosis), type H (stump anastomosis), type III (angular anastomosis) and type IV (end-to-side anastomosis). Then the established geometric models were transferred to the SC/Tetra 8.0 software for mesh generation and calculation. Porous model was applied to the flap to simulate capillary structure as before, inlet velocity of radial artery was set as 20mm/s and outlet pressure of recipient vein as 0 Pa. By comparing pressure and velocity distribution on different cross sections of blood vessels, hemodynamic feature of the flap with 4 types of anastomotic techniques was studied, focusing on the alternation of flow field of drainage system of the flap, especially at the anastomotic sites. The data was analysed using SAS8.0 software package for ANOVA. RESULTS: The pressure on the four sections of the flap circulatory system was significantly higher in type I compared with type II, III and IV (F = 40.99, P < 0.001). Type II presented with vortex in the anastomotic site, and type III, IV with smooth flow. Type IV had an absorption effect at the anastomotic site. The pressure loss of the flap circulation was maximal in the radial vein of vascular pedicle (F = 97.00, P < 0.001). CONCLUSIONS: Type HI and IV are considered appropriate techniques to deal with caliber discrepancy of recipient site. Theoretically, reasonable reduction of the vascular pedicle length and choice of the concomitant radial vein with wider radius for anastomosis can effectively decrease the resistance of circulation in the flap. Supported by Medical and Engineering Project of Shanghai Jiao Tong University (YG2009MS41). [ABSTRACT FROM AUTHOR]

Vagal paraganglioma (VP) is a tumor of very low incidence that often appears as a painless mass in the neck or parapharyngeal space. There are no special symptoms and no cough, hoarseness or other neurological symptoms in early stage, so preoperative diagnosis is difficult. It is easily misdiagnosed as Schwannoma and given mistreatment. MRI is helpful for the diagnosis through distinctive images. Surgical excision is the conventional method, but the patients must take neurotrophic drugs after operation for a long term. Conservative therapy, such as radiotherapy, can slow down the tumor growth and delay the emergence time of neurological symptoms. Supported by Key Project of Biomedicine and Pharmacology of Shanghai Municipality (10DZ1951300). [ABSTRACT FROM AUTHOR]

PURPOSE: To preliminarily establish a hemodynamic 3D numeric model of radial forearm free flap with vascular pedicle of radial artery' and vein, and discuss its scientific workability. METHODS: The 3D geometric model of 50mmx80mmxl0mm radial forearm flap was established by Pro/E(Wildfire 4.0). The vascular pedicle was 50mm in length including radial artery. (inside diameter was 1.9mm) and concomitant radial vein (inside diameter was 0.84mm). The half-embedded vessels went through the flap paralleling the long axis. Then the established geometric model was transferred to the SC/Tetra 8.0 software for mesh generation and calculation. According to the virtual flow volume of the radial artery, the inlet velocity was set as 20mm/s. With the different blood pressure of 53mmHg between the feeding artery and draining vein, the tentative porous values were achieved. Then porous model was applied to the flap to simulate the capillary structure. The pressure distribution on the central axis of radial artery and vein and the radial velocity distribution in three different cross sections of vessels were figured out. RESULTS: A model with 10355473 meshes and 2104014 nodes was built. When porous model was applied, the pressure difference between radial artery and vein was calculated to 7050 Pa (52.8mmHg), which was close to clinical value. The computational fluid dynamic analysis results showed that with porous model, the central pressure of radial artery was continuously kept to a higher level. When blood flowed in and flows out of the flap, the blood velocity decreased and increased greatly. While the central pressure of radial vein significantly decreased at the moment of blood flowing out of the flap. These results basically agreed with the features of normal blood circulation of the forearm flap. CONCLUSIONS: Porous model effectively simulates hemodynamic status of forearm flap, which provides a new method for the study of mechanism of blood circulation in radial forearm flap and also lays a foundation for the following hemodynamic study of vascular anastomosis. Supported by Combined Medical-Engineering Project of Shanghai Jiao Tong University (YG2009MS41). [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate the role of NF-κB signal transduction pathway in apoptosis induced by shikonin in human tongue squamous cell carcinoma Tca-8113 cell line. METHODS: Expression of iκBa, phosphalase-lκBa, bcl-2 and Bax proteins were detected by Western blot, NF-κB DNA-binding activity was detected by electrophoretic mobility shift analysis (EMSA), and activities of caspase 3, caspase 8 and caspase 9 were analyzed by enzyme linked immunosorbent assay (ELISA). The data was analyzed by one-way ANOVA test and / test using SPSS 12.0 software package. RESULTS: The expression of phosphatase-1κBa protein and the nuclear NF-κB DNA-binding activity was significantly decreased in shikonin treated cells by Western and EMSA. Bel-2 protein expression was also decreased in the process. The activity of all the three proteases was elevated and pancaspase inhibitor Z-Asp-CH2-DCB could protect Tca8113 cells from shikonin-induced apoptosis(P=0.02). CONCLUSIONS: Anti-tumor effects of shikonin in Tca-81 13 cells act at least partially through the inactivation of NF-κB pathway and subsequent activation of protease caspase family. Pharmacologic inhibition of the NF-κB activity by shikonin might be a powerful treatment option for OSCC. Supported by National Natural Science Foundation of China (Grant No.30772430) and Research Fund of Excellent Young Teachers of Shanghai Municipality (Grant No.jdy-08). [ABSTRACT FROM AUTHOR]

PURPOSE: To analyze the clinical manifestation, image features, treatment and prognosis of Castleman disease hyaline vascular type in the parotid and neck region. METHODS: From 2004 to 2008, clinical data from ten patients with Castleman disease hyaline vascular type in the parotid and neck region were retrospectively reviewed, including sex, age, primary site, course of disease, symptom, physical examination, image examination, treatment protocol, pathological diagnosis, and follow-up result. RESULTS: Among the ten patients, there were four men and six females, their age ranged from 13 to 54 years with a mean age of 26.6 years. The course of disease ranged from 3 months to 4 years with a mean of 12.5 months. The primary lesions included the parotid region in 3 patients, neck in 5 patients, parotid and neck region in 2 patients. All patients had no obvious complaint and the laboratory examination was within the normal range. Computerized tomography and magnetic resonance imaging /angiography showed some clinical value for differential diagnosis. All patients received surgical operation, during the follow-up period from 6 to 57 months, mean 35.9 months, no recurrence of the lesion occurred. CONCLUSIONS: Castleman disease hyaline vascular type in the parotid and neck region is difficult to be diagnosed clinically, computerized tomography and magnetic resonance/ angiography are somewhat useful for differential diagnosis. Surgical operation is the first-line treatment of choice for this disease with good prognosis. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate a reconstructive method in repairing the defect after resection of the osteoradionecrosis of the mandible. METHODS: 12 cases of the osteoradionecrosis of mandible from July 2003 to July 2008, underwent partial mandibulectomy. The reconstructive Ti-plate with pectoralis major myocutaneous flap was used to reconstruct the mandibular defects with or without adjacent soft tissue defects. The post-operative effects and flap successful rate were evaluated with a follow-up period of 3 months to 5 years. RESULTS: All the 12 flaps were 100% survival, and no plate exposure was found after operation in the follow up period. One plate fracture was found 2 and half years after reconstruction. The mouth opening was 2.0-2.5 cm and the occlusive deviation was limited to half to one tooth. 6 patients were satisfactory with the outlook, 4 patients felt fair with the outlook, and 2 patients had a little disappointment with the outlook. CONCLUSION: The reconstructive Ti-plate with pectoralis major myocutaneous flap is a cost-effective, safe method in reconstruction of the mandibular defects from osteonecrosis with or without adjacent soft tissue defects, especially in case of low quality of head and neck vascular donor sites for microsurgical reconstruction. [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate the clinical application value of serum tumor markers detection combined with support vector machine (SVM) model in the diagnosis of oral squamous cell carcinoma. METHODS: Serum levels of neuron-specific enolase (NSE), cancer antigen 242 (CA242), cancer antigen 19-9 (CA199), carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), cancer antigen 72-4 (CA724), cancer antigen 21-1 (CA211) and alpha fetoprotein (AFP) were detected with enzyme-linked immunosorbent assay (ELISA} and time-resolved fluoroimmunoassay (TRFIA) in 163 oral squamous cell carcinoma patients and 160 healthy persons. All the data was analyzed with SVM; the SVM models for diagnosis of oral squamous cell carcinoma were created, trained and validated by cross validation. RESULTS: Among the 163 oral squamous cell carcinoma patients, there were 128 males and 35 females with the male-to-female ratio of 3.66 : 1; the age ranged from 30 to 85 years old with a mean age of 59.3 years old; according to the primary site of human, 72 cases in tongue, 34 in gingival, 22 in buccal mucosa, 15 in palatal mucosa, 13 in floor of mouth, 4 in lip and 3 in retromolar region; according to the TNM-UICC classification, there were 33 patients at stage T1, 72 at T2, 44 at T3, 14 at T4, 119 at N0. 42 at N1, 2 at N2, 159 at M0, 4 at M1, 27 at clinical stage I, 51 at stage II, 52 at III, and 33 at IV; according to the pathological differentiation grade, 109 tumors were well differentiated, 42 were moderately differentiated and 12 were poorly differentiated. Five serum tumor markers of CA211, CA199, TPA, CA724 and NSE were selected optimally to create the optimal SVM model for diagnosis of oral squamous cell carcinoma. The accuracy, specificity, sensitivity and positive predictive value of the optimal SVM model were 88.54%, 93.13%, 84.05% and 92.57%, respectively. CONCLUSION: From the results, SVM model combined with 5 optimal serum tumor markers is suggested to be used in the diagnosis of oral squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate the clinical manifestation of branchial cleft cyst (fistula) and provide some clinical experience on its diagnosis and treatment. METHODS: From June 1993 to December 2006, two hundred and eighty-four patients with branchial cleft cyst or fistula underwent surgical treatment were retrospectively reviewed, the preoperative examinations, preoperative diagnosis and postoperative pathological diagnosis were recorded, and the data was analyzed with SAS6.12 software package. RESULTS: Among the 284 patients with branchial cleft cyst or fistula confirmed by postoperative pathological diagnosis, there were 132 patients (46.5%) with first branchial cleft cyst or fistula, one hundred and forty-five patients (51.1%) with second branchial cleft cyst or fistula, and 7 patients (2.4%) with third branchial cleft cyst or fistula. First branchial cleft cyst or fistula often occurred in patients older than 40 years, second and third branchial cleft cyst or fistula often occurred in patients younger than 40 years. The pathological diagnosis confirmed 188 primary lesions, thirty-three recurrent lesions, forty-four lesions with internal fistula, fourteen lesions with secondary infection and external fistula, and three lesions with both internal and external fistulae. One patient was found with tuberculosis simultaneously, two patients with multiple cysts, one patient with venous malformation. Six lesions were found malignant, five from first branchial cleft and one from second branchial cleft. The highest accuracy of preoperative diagnosis was 66.20% using ultrasonography. During the follow-up period, 5.98% of patients had recurrence. CONCLUSIONS: First and second branchial cleft cysts (fistula) are the most common lesions. Preoperative ultrasonography is the first choice for diagnosis of branchial cleft cyst (fistula). Complete resection including the cyst and fistula is the key to successful surgical treatment. [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate the expression of fibroblast activation protein alpha (FAPA) gene in oral squamous cell carcinoma (OSCC) and paired normal tissue. METHODS: Differential FAPA gene expression paired normal and cancerous tissues from 30 OSCC patients were detected by reverse transcription-PCR (RT-PCR). The data was analyzed with SAS6.12 software for Chi-square test and t Student's test. RESULTS: RT-PCR results demonstrated that the positive rate of FAPA mRNA in 30 cancerous tissues and paired normal samples were 83%(25/30) and 40%(12/30), respectively (P<0.001); the relative expression level of FAPA mRNA in 30 cancerous tissues and paired normal samples were 3.58±0.46 and 1.27±0.21, respectively (P<0.0001), up-regulated 2.82-fold OSCC cancerous tissues. CONCLUSIONS: FAPA mRNA overexpression may play an important role in OSCC carcinogenesis and could be a potential target of OSCC therapy. [ABSTRACT FROM AUTHOR]

PURPOSE: To establish a standardized and modularized finite element model of a normal human skull to simulate the unilateral defect pattern of the maxilla and the stress distribution of craniofacial skeleton with repair subject to the bite force, and to make biomechanical evaluation and functional design of the unilateral maxillary reconstruction method using the microsurgery bone graft and zygomatic implant. METHODS: Based on CT scan and image process technology, a modularized geometrical and finite element model of the human skull was built to simulate unilateral defect pattern of the maxilla and design of the position, direction, length of the zygoma fixture, and the number of the conventional fixtures. Biomechanical properties of the design were evaluated using finite element analysis (FEA) method. RESULTS: The highest stress peaks concentrated at the neck of the zygomatic fixture on the zygoma, while the rest of the peri-implant bone appeared to bear lower stress. The zygomatic fixture played an important role in transmitting the occlusal force substituting the zygomatic process brace. CONCLUSIONS: The transmission of the occlusal force and stress distribution of the peri-implant bone of this reconstruction protocol is satisfied. Reconstitutions of the buttresses system ensure a stable base for occlusion and stress, which is secure and feasible to optimal unilateral maxillary rehabilitation. Supported by Shanghai Leading Academic Discipline Project (Grant No. Y0203). [ABSTRACT FROM AUTHOR]

PURPOSE: To explore the efficacy of combination of biological target therapy and chemotherapy in 71 patients with advanced head and neck squamous cell carcinoma(SCC). METHODS: Seventy-one patients (54 men and 17 women, aged from 30 to 83 years, mean 60 years) with locally advanced head and neck SCC (no indication for surgery, radiotherapy ) confirmed by histology and radiology, were enrolled in this study. The chemotherapy regimen was CDDP 75 mg/m² dl, TAX 75 mg/m² dl, 5-Fu 750 mg/m² dl-d5 and nimotuzumab 200 mg/m² per week. RESULTS: The patients completed 2 to 4 cycles of chemotherapy (mean 3 cycles). Nimotuzumab were used for 2 to 8 times (mean 5 times).The prognosis was as follows: CR in 4 cases, PR in 39 cases, SD in 18 cases, PD in 3 cases and 7 cases could not be evaluated. The total effective rate which was calculated by PR plus CR was 61%. Forty cases of them received surgery after bio-chemotherapy. No serious adverse reaction was found during the course of the treatment, only two cases with slight erythra. CONCLUSION: Nimotuzumab was equally effective in the increase of chemosensitivity and good tolerability profiles. Supported by International Co -operative Program from Science and Technology Commission of Shanghai Municipality (10410711200,11495802000). [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the role of maxillary wings guiding plate in rehabilitation of combined defects of maxilla and mandible in convalescent stage. METHODS: Combined resection of maxilla and mandible without reconstruction acre performed in 10 patients with oral cancers. The impressions were got in 2 patients preoperatively and 8 patients postoperatively because of preoperative limited mouth opening. The clasps were designed to provide the retentive force according to the remained teeth. The plastic palate baseboard with wings guiding plate was made. The patients wore the plate 1 week after surgery. RESULTS: All the patients get good velopharyngeal competence and occlusion without leakage from nose after using this prosthesis for 1 to 3 months. CONCLUSIONS: Palate baseboard combined with wings guiding plate can not only obstruct the nasal-oral fistula but also correct malocclusion. It's convenient for taking dental prosthesis in late stage and improving patient's quality of life. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality (Grant No.08DZ2271100). [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate mRNA expression of T-cell differentiation protein (MAL) gene in oral squamous cell carcinoma (OSCC) and paired normal tissues. METHODS: Differential MAL gene expression in 30 cases of paired normal and cancerous tissues were detected by reverse transcription-PCR (RT-PCR). The data were analyzed with SAS6.12 software package for Chi-square and t test. RESULTS: RT-PCR results demonstrated that the positive rate of MAL mRNA in 30 cancerous tissues and paired normal samples were 36.7%(11/30) and 40% 86.7%(26/30), respectively (P<0.001); relative expression level to MAL mRNA in 30 cancerous tissues and paired normal samples were 1.20±0.18 and 2.96±0.36, respectively (P<0.0001), totally down-regulated 2.47-fold. Additionally, the expression of MAL mRNA level was found between sexes, clinical stages, and cervical lymph node metasis. CONCLUSIONS: MA mRNA overexpression may plat a significant role on OSCC carcinogenesis and may be a potential molecular marker of OSCC. [ABSTRACT FROM AUTHOR]