China Journal of Oral and Maxillofacial Surgery

Inhibition of chitosan oligosaccharide on skull resorption in mice induced by lipopolysaccharides

GUO Ke, HE Jia-jia, LIU Zong-lin, ZHANG Yao-sheng, WANG Wen-chao, WANG Ye-xin, XU Wei-feng, ZHANG Shan-yong

2018, 16 (2): 97-101. doi: 10.19438/j.cjoms.2018.02.001

Abstract ( 370 )

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PURPOSE: To study the effect of low molecular weight chitosan (low-molecular chitosan oligosaccharide, LMCOS) on lipopolysaccharides (LPS) -induced bone resorption in mice. METHODS: Six-week c57/bl6 male mice were randomly divided into 5 groups: phosphate buffer saline (PBS) group, LPS group, LPS+0.005% LMCOS group, LPS+0.05% LMCOS group and LPS+0.5% LMCOS group. There were 5 mice in each group, LPS was used at 10 mg/kg. After mild anesthesia, 300 μL corresponding reagents were injected into the skull bone. The mice were injected 3 times a week and sacrificed 2 weeks later. The skull bone was removed for micro-CT scan, H-E staining, TRAP staining. SPSS21.0 software package was used for statistical analysis. Bone damage area, osteoclast formation was observed and recorded. RESULTS: After LMCOS was added to LPS-induced skull resorption, bone destruction area decreased obviously; and with the increase of LMCOS concentration, bone destruction area and number of osteoclasts decreased gradually. CONCLUSIONS: LMCOS can inhibit the damage of skull bone in LPS-induced mice, which may have a therapeutic effect on osteolytic diseases.

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Bmi1 mediated migration, invasion and proliferation of stem cells of tongue squamous cell carcinoma

HE Qian-ting, TANG Lei-le, SUN Jing-jing, LU Zhi-yuan, WANG An-xun

2018, 16 (2): 102-107. doi: 10.19438/j.cjoms.2018.02.002

Abstract ( 313 )

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PURPOSE: To investigate the mechanism of Bmi1 mediating migration, invasion and proliferation of stem cells of tongue squamous cell carcinoma (TSCC). METHODS: SP (side population cell, SP) and non-SP (non-side population cell) cells were sorted by FCM using Hoechst33342 method. Transwell assay was performed to detect migration and invasion of SP cells after Bmi1 knockdown. Sphere forming assay was conducted to detect sphere forming rate of SP cells after Bmi1 knockdown. Colony forming assay was used to detect colony forming rate of SP cells after Bmi1 knockdown. CCK8 assay was used to detect proliferation of SP cells after Bmi1 knockdown. Western blot assay was used to detect expression of invasion and metastasis related genes (SOD2 and Slug) and stem cell markers (ABCG2 and Nanog) in SP cells after Bmi1 knockdown. The data was analyzed using SPSS 17.0 software package. RESULTS: After knockdown of Bmi1 in SP cells, migration and invasion were significantly inhibited compared to control siRNA transfection. SP cells transfected with Bmi1 siRNA displayed significantly decreased sphere formation and colony formation compared to the cells transfected with control siRNA. The proliferation of SP cells was significantly inhibited after transfection with Bmi1 siRNA. The expression of SOD2, Slug and stem cell markers (ABCG2, Nanog) in SP cells were significantly decreased after transfection with Bmi1 siRNA. CONCLUSIONS: Bmi1 knockdown inhibited migration, invasion and proliferation of cancer stem cells in TSCC.

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Effect of RAC1 on migration and invasion of human squamous cell carcinoma of tongue cell line of CAL27

HE Zong-xuan, WANG Wei, WANG Qi-min, TONG Lei, SHENG Shan-gui, CHEN Zheng-gang

2018, 16 (2): 108-113. doi: 10.19438/j.cjoms.2018.02.003

Abstract ( 416 )

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PURPOSE: To investigate the effect of RAC1 on invasion and migration of human squamous cell carcinoma of tongue cells of CAL27, as well as the possible molecular mechanism. METHODS: The specific small interfering RNAs (siRNAs) was designed and constructed on the basis of RAC1 gene sequence. Through liposome mediation, these three RAC1 siRNAs were transfected into CAL27 cells to inhibit RAC1 expression. Meanwhile, negative control group and blank control group were transfected with random sequence NC-siRNA and liposome, respectively. The mRNA of RAC1 were detected by real-time fluorescence quantitative polymerase chain reaction and the protein expression of RAC1, PAK1, LIMK1 were examined by Western blotting. The migration and invasion ability were analyzed by wound healing assay and Transwell chamber test. One-Way ANOVA and student's t test were used for data analysis with SPSS 18.0 software package. RESULTS: The protein expression of RAC1 was decreased significantly 48h after transfection (P<0.05), the expression of PAK1 and LIMK1 were suppressed (P<0.05), the migration and invasion ability of CAL27 cells was also significantly inhibited (P<0.05). CONCLUSIONS: Silencing RAC1 gene can inhibit migration and invasion ability of human squamous cell carcinoma of tongue CAL27 cells, and the mechanism may be related to down-regulation of PAK1 and LIMK1 expression in tongue cancer cells.

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Primary study of the perineural invasion related genes of salivary adenoid cystic carcinoma by RNA-Seq

LI Huan, YANG Xin-jie, WANG Wei-qi, LEI De-lin

2018, 16 (2): 114-119. doi: 10.19438/j.cjoms.2018.02.004

Abstract ( 324 )

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PURPOSE: To investigate the perineural invasion(PNI) related genes, the level of gene expression in single culture group and co-culture group of salivary adenoid cystic carcinoma (SACC) was analyzed by RNA-Seq technique. METHODS: Two groups of salivary adenoid cystic carcinoma (SACC) cells were analyzed for gene expression by co-culture system with rat Schwann cells (SCs). Then, cluster analysis, gene ontology (GO) function enrichment analysis, Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis were used to analyze gene function, qRT-PCR was used to verify the 6 key-genes. Differential expression analysis of two conditions was performed using edgeR package (3.12.1). P value of 0.05 and log2 (fold change) of 1 were set as the threshold for significantly differential expression. RESULTS: The results showed that a total of 395 genes were differentially expressed in two groups (P≤0.05, |logFC|≥1.0), 135 genes were up-regulated (34.2%) and 260 genes were down-regulated (65.8%). GO enrichment analysis results showed that these PNI related DEGs involved in angiogenesis, extracellular matrix, cell proliferation, apoptosis and epithelial morphogenesis; KEGG pathway enrichment analysis displayed that these genes participated in histidine metabolism, interactions of tumor necrosis factor, chemotactic factor and cytokine receptor. qRT-PCR was used to validate 6 key-genes, and the results were consistent with RNA-Seq. CONCLUSIONS: Differentially expressed genes related to PNI of SACC were obtained, which provides important experimental basis for elucidating the mechanism of PNI of SACC, and also provides a new strategy and target for treatment of perineural invasion.

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CDH1 gene methylation and E-cadherin in salivary malignant pleomorphic adenoma

XIA Liang, HU Yu-hua, WANG li-zhen, GU Ting, LI Jiang, TIAN Zhen

2018, 16 (2): 120-125. doi: 10.19438/j.cjoms.2018.02.005

Abstract ( 280 )

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PURPOSE: To analyze the correlation between CDH1 promoter methylation and E-cadherin expression in MPA, evaluate the role of CDH1 promoter methylation in E-cadherin silencing, explore the correlation between CDH1 methylation and clinicopathological parameters of MPA, and assess its potential prognostic value. METHODS: Immunohistochemistry and BSP were used to detect the expression of E-cadherin and the degree of CDH1 promoter methylation in MPA samples, and correlation analysis was performed. The data of patients were collected and followed up, and the correlation between CDH1 methylation and clinical pathological parameters and survival rate was analyzed. SPSS16.0 software package was used for statistical analysis. RESULTS: CDH1 hypermethylation was positively correlated with E-cadherin silencing expression. The degree of CDH1 methylation was significantly correlated with gender, tumor differentiation, histological grade, lymph node metastasis and TNM staging. The survival rate of patients with CDH1 hypermethylation was poor. Lymph node metastasis was an independent predictor of prognosis in patients with MPA. CONCLUSIONS: CDH1 gene hypermethylation is one of the important regulatory mechanisms of E-cadherin silencing in MPA. CDH1 methylation may be one of the predictors for clinical prognosis in patients with MPA.

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Effect of alpha2-macroglobulin on osteoradionecrosis of mandible in rats

LI Jie, KONG Xiang-bo, CHEN Xue-ying, LIU Yang, ZHONG Wan-zhen, FANG Si-lian

2018, 16 (2): 126-131. doi: 10.19438/j.cjoms.2018.02.006

Abstract ( 322 )

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PURPOSE: To investigate the effect of alpha2-macroglobulin (α2M) injected before irradiation on mandibular osteoradionecrosis (ORN) in rats. METHODS: Eighteen male Sprague-Dawley rats were divided randomly into 3 groups: group A (control group), group B (radiotherapy alone) and group C (α2M applied 30 minutes before radiotherapy). All the rats were fixed by 3D-printed fixator after anesthesia. Rats in group B and C underwent 7 Gy irradiation for 5 days to the left hemimandible; at the same time, rats in group A underwent shame irradiation. Rats in group C were injected 0.5 mL 2000 mg/L α2M in sterile saline solution along the left mandible, and rats in group A and group B were injected 0.5mL sterile normal saline. Seven days after irradiation, all left molar teeth were extracted. 21days later, the rats were sacrificed and the left mandible were examined by gross manifestation, microcomputed tomography, and histology. SPSS 13.0 software package was used for statistical analysis. RESULTS: Compared with group A, 5 rats in group B developed mandibular ORN. On gross observation, serious weight loss, alopecia of the irradiated skin, oral ulcer and occlusive disorder were seen in the rats of group B. Lack of new bone formation within the socket was seen on Micro-CT three-dimensional reconstruction. Haematoxylin-eosin and Masson's staining showed that inflammations, necrosis, and fibrosis in the medulla. The rate of mandibular ORN in group was 5/6. However, the rats in group C exhibited less weight loss, alopecia and no occlusive disorder, and slight inflammation in the bone marrow. The cortical bone was close to the normal bone on Micro-CT . The rate of osteocytic lacunae was decreased compared with group B (P<0.001). The rate of mandibular ORN in group C was zero. CONCLUSIONS: Application of α2M before radiotherapy could well prevent mandibular ORN and had a good application prospects.

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Effect of simvastatin combined with simiR-21 on migration and invasion of human salivary adenoid cystic carcinoma

WANG Chao, LI Ting, YAN Fei, CAI Wen-yan, JIANG Xing-yu, SUN Jin-hu

2018, 16 (2): 132-137. doi: 10.19438/j.cjoms.2018.02.007

Abstract ( 249 )

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PURPOSE: To investigate the effect of simvastatin combined with miR-21 on migration and invasion of human salivary adenoid cystic carcinoma cell line (SACC-LM) and its underlying mechanism. METHODS: SACC-LM cells were divided into 4 groups randomly. In NC group, unrelated nucleotides sequence was transfected and a blank reagent was added; in SIM group, unrelated nucleotides sequence was transfected and simvastatin was added; in simiR-21 group, miR-21 inhibitor was transfected and a blank reagent that did not contain simvastatin was added; in simiR-21+SIM group, miR-21 inhibitor was transfected and simvastatin was added. qRT-PCR was used to detect the expression of miR-21. CCK-8 method was used to measure the IC₅₀ of SACC-LM while simvastatin (10,20,30,40,50,60 μmol/L) was added for 48 h. Transwell chamber method was used to observe the migration (without matrigel) and invasion (adding matrigel) ability. Western blot was used to detect the expression of EMT relative proteins (E-Cadherin, Snail1). Student's t test or one-way ANOVA were performed to analyze the data using SPSS 22.0 software package. RESULTS: The expression of miR-21 was remarkably down-regulated in the groups with transfected inhibitor(P<0.01). Simvastatin had no effect on the expression of miR-21(P>0.05). Simvastatin could inhibit the proliferation of SACC-LM cells in a dose-dependent manner. miR-21 was effective in reducing the resistance of SACC-LM to simvastatin. The abilities of migration and invasion on SACC-LM cells in simiR-21+SIM group were significantly inhibited compared with other groups (P<0.01). The expression of E-cadherin in the combined group was significantly higher than other groups (P<0.01) with decreased Snail1 expression(P<0.001). CONCLUSIONS: MiR-21 inhibitor transfection can effectively reduce the resistance of SACC-LM to SIM. In simiR-21+SIM group, the abilities of migration and invasion on SACC-LM cells were more greatly inhibited than other groups, indicating the mechanism may be related to down-regulation of Snail1 expression and up-regulation of E-Cadherin expression.

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Intermittent nasal obstruction causes early effects on chondrogenesis of mandibular condylar chondrocytes

SUN Hui-jun, WANG Xiao-ling, ZHU Yan-fei, YU Qian, NIE Ping, ZHU Min

2018, 16 (2): 138-143. doi: 10.19438/j.cjoms.2018.02.008

Abstract ( 301 )

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PURPOSE: In this study, we investigated the early effects of intermittent nasal obstruction on chondrogenesis of mandibular condylar chondrocytes (MCCs) via animal model. METHODS: Sixty four 4-week-old SD rats were randomly divided into 4 groups, each group contained 16 rats. Group A: control group; Group B: 4-day mouth breathing caused by nasal obstruction; Group C: 8-day mouth breathing caused by nasal obstruction; Group D: 16-day mouth breathing caused by nasal obstruction. The time of nasal obstruction was from 8:00 to 16:00 every day. Bilateral condylar MCCs were harvested and cultured in vitro, on 4th day, 8th day, 12th day and 16th day, respectively. Toluidine blue staining was used to identify MCCs,real-time polymerase chain reaction (RT-PCR) was used to detect the difference of gene expression of MCCs chondrogenic marker genes (SOX9,COL2a,ACAN,PTHrp). The data were statistically analyzed using SPSS19.0 software package. RESULTS: On 4th day of modeling, the expression of SOX9, COL2a and ACAN was lower in group B, C and D compared with group A (P<0.05); but the expression of PTHrp was higher in group B, C and D compared with group A (P<0.05). On 8th day of modeling, the expression of SOX9,COL2a,ACAN and PTHrp was higher in group B, C and D, but much higher in group B than in group C and D(P<0.05). On 12th day of modeling, group B, C and D showed a higher expression of PTHrp (P<0.05), and an equal or lower expression of COL2a, ACAN. On 16th day of modeling, the expression of COL2a, ACAN and PTHrp was increased in group C than in group A(P<0.05). CONCLUSIONS: It is suggested that during mouth breathing caused by nasal obstruction in young rats, the chondogenisis of MCCs decreased followed by a compensatory increase and finally decrease. Furthermore, early removal of nasal obstruction can cause a compensatory increase of MCCs chondrogenisis, but still causes a long-term negative influence.

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Effect of hyperthermia on Id-1,HSF1 expression in Cal27 cell line

SUN Jun-wei, LUO Dan, LIU Hao, WANG Sheng-zhi

2018, 16 (2): 144-148. doi: 10.19438/j.cjoms.2018.02.009

Abstract ( 266 )

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PURPOSE: To investigate the influence of hyperthermia on expression of Id-1, HSF1 in Cal27 cell and the effect on Cal27 cell proliferation and migration. METHODS: Cal27 cell lines were hyperthermia-treated (43℃ for 1 h); 4 h later, real-time quantitative transcriptase-polymerase chain reaction was used to detect the expressions of Id-1, HSF1. Cell proliferation and migration were observed by CCK-8 and wound healing. SPSS 19.0 software package was used to analyze the data. RESULTS: The mRNA level of Id-1 was decreased and the mRNA level of HSF1 was increased after hyperthermia. The proliferation of Cal27 cell descended at 2 h post-hyperthermia. Migration of Cal27 cell descended after hyperthermia treatment. The difference was statistically significant (P<0.05). CONCLUSIONS: Hyperthermia can inhibit Cal27 cell proliferation and migration ability, reduce the mRNA level of Id-1 and increase the mRNA level of HSF1.

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Association of ABO blood groups with cleft palate in 274 patients in the northeast China

SHI Chun-ling, LI Duo, LIU Yi

2018, 16 (2): 149-152. doi: 10.19438/j.cjoms.2018.02.010

Abstract ( 435 )

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PURPOSE: To evaluate the relation between blood grouping and the presence of cleft palate. METHODS: From October 2012 to January 2017,the clinical records of 274 patients (age range 0-61 years) with congenital cleft palate who were treated at the Stomatological Hospital of China Medical University were selected as case group. There were 113 males and 161 females(male:female=1:1.42); the control group was consisted of 978 patients without cleft lip and/or palate who visited the hospital due to other problems. Statistical analysis was performed on the blood group distribution of patients with cleft palate and the control group using SPSS 22.0 software package. RESULTS: Blood type frequency of patients with cleft palate and controls was B>O>A>AB. Chi-square test showed that association of blood groups with cleft palate was not statistically significant(P>0.05).Congenital incomplete cleft palate and unilateral complete cleft palate(75.55%) were the most common types, followed by submucosal cleft palate(22.26%) and bilateral complete cleft palate(2.19%) was the least one. Women with cleft palate (58.76%) were more than men (41.24%) and the rural patients(54.74%) were more than the urban ones(45.26%). CONCLUSIONS: Congenital incomplete cleft palate and unilateral complete cleft palate are the most common types, followed by submucosal cleft palate and bilateral complete cleft palate is the least one. The occurrence of cleft palate is unrelated to ABO blood groups, it is possibly related to gender and urban and rural areas.

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Analysis of procedure factors contributing to postoperative difficult airway management of head neck and maxillofacial surgery

YANG Ya-qiong, YAN Jia, HUANG Yan

2018, 16 (2): 153-156. doi: 10.19438/j.cjoms.2018.02.011

Abstract ( 228 )

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PURPOSE: To summarize the experience in postoperative difficult airway management of head neck and maxillofacial surgery. METHODS: Between January 2015 and December 2015, 180 patients undergoing head neck and maxillofacial surgery with artificial airway in SICU were analyzed retrospectively. The patients were divided into 3 groups according to the type of the operation: tumor resection group (60 cases), congenital malformation correction group (60 cases) and trauma group (60 cases). SPSS13.0 software package was used for perioperative statistical analysis. RESULTS: The operation and anesthesia time, the ratio of awake tracheal intubation and the amount of bleeding during operation in the tumor resection group were significantly higher than those in the other two groups (P<0.05), the postoperative tube time was also significantly longer (P<0.05) in the tumor resection group. The incidence of sedation and restlessness was highest in the trauma operation group (P<0.05). CONCLUSIONS: Head neck and maxillofacial surgery often has airway obstruction due to local anatomical structure change, hemorrhage and edema. Use of sedation and analgesia drugs, retained tracheal intubation and delayed extubation can avoid the occurrence of serious complications.

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Investigation of the treatment effect of pingyangmycin plus corticosteroids on cheilitis granulomatosa

GU Ling, HUANG Di-yan, FU Chong-jian, WANG Zhao-ling, WANG Dong, YANG Lu, ZHU Guo-xiong

2018, 16 (2): 157-161. doi: 10.19438/j.cjoms.2018.02.012

Abstract ( 452 )

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PURPOSE: To explore the treatment effect of pingyangmycin plus corticosteroids on cheilitis granulomatosa. METHODS: A retrospective study on 78 patients with cheilitis granulomatosa treated by a new method at our hospital between March 2008 and March 2016 was performed. Pretherapeutic and post-therapeutic medical histories were obtained, and criteria for the success of treatment were evaluated. The outcomes and effects of therapy were analyzed. RESULTS: All patients received intralesional injection of pingyangmycin plus dexamethasone. The number of injections ranged from 1 to 5, with a median of 3 injections. The outcomes were encouraging. Seventy-three cases were cured, 5 cases were improved and none was found ineffective. Swelling of the lips subsided and the skin color returned to normal in all cases. In cases of orofacial involvement, facial asymmetry and orofacial swelling were removed to attain a good esthetic appearance. CONCLUSIONS: The results demonstrated positive responses to the treatment. It is a safe, effective and inexpensive treatment to correct persistent labial swelling and improve lip aesthetics.

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Accuracy and function rehabilitation of occlusion guided jaw reconstruction in 60 patients

WANG Ming-yi, ONG Hui-shan, YANG Jie, LIU Jian-nan, QU Xing-zhou, ZHANG Chen-ping

2018, 16 (2): 162-166. doi: 10.19438/j.cjoms.2018.02.013

Abstract ( 435 )

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PURPOSE: To investigate the principle of occlusion plane priority during jaw reconstruction for accurate occlusion guided jaw reconstruction and prosthesis restoration, and provide guidance for clinical practice. METHODS: Virtual surgical plans were draw up and the occlusion plane was determined as the reference plane. Jaw reconstruction and implant-retained prostheses were completed with the guidance of occlusion plane. The accuracy of mandibular reconstruction and implant placement was analyzed with CT data preoperatively and 1 month and 6 months postoperatively, the distribution of occlusal force was measured and compared. RESULTS: One month postoperatively, the accuracy of maxillary reconstruction with fibular and iliac bone grafts was (90.28±0.29)% and (89.87±0.41)%, respectively; while the accuracy for mandible reconstruction was (82.21±0.32)% and (89.52±0.18)%. The accuracy of implant placement in maxilla and mandible was (91.72±0.21)% and (86.07±0.26)%, respectively. Six months postoperatively, the accuracy of maxillary reconstruction with fibular and iliac bone grafts was (89.24±0.20)% and (89.86±0.37)%, respectively; while the accuracy for mandible reconstruction was (75.39±0.25)% and ( 85.02±0.17)%. The accuracy of implant placement in maxilla and mandible was (90.22±0.27)% and ( 85.57±0.31)%, respectively. The occlusal force distribution of unilateral defect was (68.14±8.32)% and (35.22±5.73)% in the unaffected and affected side, respectively, while (52.18±1.75)% and (47.82±2.41)% in the left and right side for bilateral defects, respectively. CONCLUSIONS: Occlusion guided jaw reconstruction can be predetermined by the space location of bone grafts and the site and direction of implants, and finally achieve accurate occlusion reconstruction and masticatory function, which can be a powerful guarantee for functional reconstruction of the maxilla and mandible.

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Prophylactic percutaneous endoscopic gastrostomy in patients with head and neck cancer undergoing radiotherapy and chemotherapy

QIAN Li, GE Kui, XU Bing, WU Jia-jun, WANG Fan-lin, FAN Jing-xian, ZHANG Lin

2018, 16 (2): 167-170. doi: 10.19438/j.cjoms.2018.02.014

Abstract ( 385 )

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PURPOSE: To investigate the timing of percutaneous endoscopic gastrostomy (PEG) in patients with head and neck cancer undergoing radiotherapy and chemotherapy. METHODS: This retrospective study analyzed the data of patents with head and neck cancer who underwent radio-chemotherapy from January 2016 to December 2016 (patients required gastrostomy according to nutritional risk assessed by radiotherapy physicians). With informed consent the patients were divided into chemotherapy before gastrostomy (prophylactic PEG group) and chemotherapy during gastrostomy (reactive PEG group). There were 234 cases in prophylactic PEG group and 93 cases in reaction PEG group. BMI and albumin level of patients were recorded and analyzed before and after cathetering. Wound infections and extubation rates of the two groups were also recorded and compared. SPSS 11.5 software package was used for comparison between the two groups. RESULTS: After chemotherapy and radiotherapy, BMI, albumin and extubation rates of the prophylactic PEG group were significantly higher than those of the reactive PEG group (P<0.01), while the infection rate in the prophylactic PEG group was significantly lower than that in the reactive PEG group (P<0.05). CONCLUSIONS: Prophylactic PEG can improve the nutritional status of patients with head and neck cancer after radiotherapy and chemotherapy, and reduce complications of radiotherapy and chemotherapy.

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Clinical analysis of 70 cases of odontogenic descending necrotizing mediastinitis

XIA Yun-hui, QU Lu-yao, LIANG Xiang, JIANG Bin, QIAN Wen-tao, CAI Xie-yi, ZHANG Wei-jie, GUAN Xin

2018, 16 (2): 171-175. doi: 10.19438/j.cjoms.2018.02.015

Abstract ( 428 )

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PURPOSE: To analyze the clinical features of patients with odontogenic descending necrotizing mediastinitis (DNM) in order to provide prompt diagnosis and treatment. METHODS: A retrospective study was conducted on 70 patients receiving treatment for odontogenic DNM from January 2014 to December 2016. Demographics, etiology of infection, clinical symptom, laboratory tests, bacterial cultures, treatment and outcomes were collected and analyzed. Statistical analysis of the results was performed using SPSS 22.0 software package. RESULTS: There were 57 males and 13 females, with a mean age of 57.8±11.42 years. The most frequent teeth involved were the lower posterior molars (38.6%). Periapical periodontitis was the most frequent triggering cause in 50 cases. Treatments consisted of antibiotic therapy and aggressive transcervical drainage (63 cases) and thoracotomy (7 cases). The mortality was 5.7%. The risk factors for mortality were associated complications (P<0.005) and severe sepsis or septic shock(P<0.002). CONCLUSIONS: Success in management of odontogenic DNM is based on prompt identification of suspected symptoms, quick CT scanning and aggressive mediastinal drainage.

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Experience and thinking on the development of continuing medical education in oral surgery

YU Hai, HOU Rui, XU Guang-jie, YANG Xia, HUI Xiao-yong, ZHOU Hong-zhi, DING Yu-xiang, XUE Yang, HU Kai-jin

2018, 16 (2): 176-179. doi: 10.19438/j.cjoms.2018.02.016

Abstract ( 302 )

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Continuing medical education is a lifelong medical education system. The development of continuing medical education in oral surgery is facing the problems of lacking policy support, doctors' attention and education programs. The Department of Oral Surgery of the Fourth Military Medical University has successfully developed continuing medical education through accumulating advanced project, improving policy support, standardizing education process. In order to develop continuing medical education in oral surgery even better, multiple publicity approaches, innovative content and form, and targeted policy support should be considered.

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Clinical practice guidelines for Klippel-Trenaunay syndrome (translation version)

ZHAO Ze-liang, ZHENG Jia-wei

2018, 16 (2): 180-184. doi: 10.19438/j.cjoms.2018.02.017

Abstract ( 499 )

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Klippel-Trenaunay syndrome (KTS) is a rare congenital vascular disorder with three clinical features: port-wine stain, abnormal overgrowth of soft tissues and bones, and venous/lymphatic malformations. The etiology and pathogenesis remain unknown. Symptoms and severity of KTS vary greatly among each individual. The goals of treatment are to alleviate symptoms and minimize the risk of complications. This article reviewed the clinical presentation and diagnostic studies, and provided management guidelines to help care for patients with this syndrome.

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