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    20 November 2019, Volume 17 Issue 6 Previous Issue    Next Issue
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    Special Column for Health Development in 70 Years
    Interpretation of updated NCCN guidelines for diagnosis and treatment of oral and oropharyngeal cancer issued in 2019
    SHANG Wei, ZHENG Jia-wei
    2019, 17 (6):  481-485.  doi: 10.19438/j.cjoms.2019.06.001
    Abstract ( 1167 )   PDF (2589KB) ( 570 )  
    In the 8th edition of AJCC Cancer Staging Manual published in 2017, TNM staging criteria for oral and oropharyngeal cancer has added indexes of invasion depth (DOI), extranodal extension (ENE), human papillomavirus (HPV), and classified oropharyngeal cancer into HPV positive (p16+) and HPV negative (p16-), establishing different TNM staging criteria. The National Comprehensive Cancer Network (NCCN) has proposed the diagnosis and treatment guidelines for HPV-positive (p16+) oropharyngeal cancer in 2018. NCCN Guidelines Version 1.2019 for head and neck cancers have been issued in March 6, 2019, among which oral and oropharyngeal cancer algorithms were partially revised. To meet the needs of clinical work, the changes of the two versions of oral and oropharyngeal cancer guidelines were partially interpreted in this paper.
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    Original Articles
    What is new in vascular anomalies: the updates from 2018 to 2019
    LIN Xiao-xi
    2019, 17 (6):  486-495.  doi: 10.19438/j.cjoms.2019.06.002
    Abstract ( 429 )   PDF (9467KB) ( 311 )  
    We briefly reviewed the most significant advances in the field of vascular anomalies,from January 2018 to March 2019, which have been published recently and ISSVA Workshop in 2018, updating the classification, diagnosis, differential diagnosis, and treatment of vascular anomalies,including surgical treatment, endovascular therapies, laser treatment and drug therapies. We also introduced the breakthroughs in basic research, genetic discoveries and animal model development, and expounded on our predictions of the proposed future to help shaping this field.
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    Investigation of circular RNA in oral squamous cell carcinoma
    WANG Feng, LI Xiang, WANG Yu-fan, YANG Hong-yu
    2019, 17 (6):  496-502.  doi: 10.19438/j.cjoms.2019.06.003
    Abstract ( 336 )   PDF (5318KB) ( 182 )  
    PURPOSE: Circular RNA(circRNA) is a special type of non-coding RNA, which is highly conserved and stable. CircRNAs have been reported to be closely associated with the development of various cancers. However, the role of circRNA in oral squamous cell carcinoma (OSCC) remains unclear. This research aimed to investigate the role of circRNAs in OSCC. METHODS: The circRNA expression profiles were obtained by screening 8 pairs of snap-frozen OSCC and paired adjacent normal tissues via high-throughput sequencing. The expression levels of identified circRNAs were further verified in 40 pairs of OSCC tissues by qRT-PCR. Through GraphPad Prism 5.0 analysis, the significantly expressed circRNAs (P<0.05) were selected for further investigation. CircRNA-microRNA (miRNA) network was predicted through various bioinformatics databases. RESULTS: High-throughput sequencing results showed circRNAs were abundantly expressed in OSCC tissues. Hsa_circ_0093229, hsa_circ_0006208 and hsa_circ_0006677 were significantly down-regulated in the cancer tissues. Bioinformatics analysis showed that hsa_circ_0093229, hsa_circ_0006208 and hsa_circ_0006677 might be novel biomarkers of OSCC. CONCLUSIONS: The results revealed that OSCC tissues have abundant circRNAs. Down-regulated hsa_circ_0093229, hsa_circ_0006208 and hsa_circ_0006677 might be novel biomarkers for OSCC.
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    Macrophage-derived IL-6 promotes oral cancer cell proliferation
    LI Jie, CHEN Ju-feng, XIAN Dan
    2019, 17 (6):  503-507.  doi: 10.19438/j.cjoms.2019.06.004
    Abstract ( 291 )   PDF (3269KB) ( 188 )  
    PURPOSE: To investigate the effect of macrophage-derived IL-6 on oral cancer cell proliferation. METHODS: The proliferation rates of SCC-15 and CAL-27 cells under different concentration of IL-6 were measured by MTT assay. THP-1 macrophages were induced by PMA, IL-6 mRNA level in LPS-stimulated THP-1 cells were measured by real-time qPCR, IL-6 protein contents in THP-1 conditional medium were measured by ELISA. SCC-15 and CAL-27 cells were co-cultured with THP-1 conditional medium, cell proliferation rate was measured by MTT assay. The data were analyzed by GraphPad 7.0 software package. RESULTS: Recombinant IL-6 in culture medium promoted SCC-15 and CAL-17 cell proliferation; LPS stimulated IL-6 expression in PMA-induced THP-1 macrophages. THP-1 conditional medium promoted SCC-15 and CAL-27 cell proliferation. CONCLUSIONS: IL-6 derived by LPS-stimulated macrophages could promote SCC-15 and CAL-27 cell proliferation.
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    "Five-point eight-line" anatomic flap design for precise hemiglossal reconstruction: evaluation of clinical outcomes
    WANG Jie-qi, LIAO Jun-kun, ZHONG Jiang-long, ZHANG Han-qing, LI Qun-xing, WANG Zhang-song, FANG Ze-zhen, FAN Song, LI Jin-song
    2019, 17 (6):  508-512.  doi: 10.19438/j.cjoms.2019.06.005
    Abstract ( 358 )   PDF (3935KB) ( 211 )  
    PURPOSE: To explore a new flap design technique called "five-point eight-line segment(FIPELS)" for precise hemiglossal reconstruction and to compare the treatment outcomes between "FIPELS" and conventional flap design. METHODS: Eighty patients were randomly divided into 2 groups, FIPELS group (42 patients) and a conventional flap design group(38 patients). Likert scale was applied to assess the functional and cosmetic outcomes. The outcomes were analyzed by SPSS 18.0 software package. RESULTS: FIPELS group had less operation time (P=0.02) due to the excellent match to hemiglossal defects without flap trimming. Swallowing functions, speech articulation, and cosmetic outcomes were superior to conventional group (P<0.05). CONCLUSIONS: Compared to conventional flap design, FIPELS technique yields improved functional and cosmetic outcomes.
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    Evaluation of digital 3D simulation model assisted in the precise reconstruction of cranio-orbital deformities
    JIANG Can-yang, HUANG Jian-ping, JIANG Yan, SHI Bin, HUANG Li, LIN Li-song
    2019, 17 (6):  513-517.  doi: 10.19438/j.cjoms.2019.06.006
    Abstract ( 286 )   PDF (4194KB) ( 102 )  
    PURPOSE: To explore the clinical value of digital 3D simulation model in precise reconstruction of cranio-orbital deformities. METHODS: A retrospective analysis was performed in 44 cases with cranio-orbital malformation from January 2013 to January 2019, 43 had traumatic cranio-orbital deformity and 1 was with congenital cranio-orbital malformation. Among them, patients with deformity were further divided into traditional group and model group. In addition to the traditional group, all patients underwent a thin-slice scan of the skull spiral CT (layer thickness<1.0 mm) preoperatively, the original DICOM image data were collected, and skull three-dimensional data (STL format) were reconstructed by computer digital software. Through rapid prototyping technology and reverse mirror engineering technology, STL data were imported to produce 3D simulation model. The surgical procedure was simulated by using digital software before surgery, and surgical exercises, pre-bending or pre-implantation materials were performed on the model, to guide the surgical approach and anatomical sites were confirmed during operation. The operation time, symmetry and satisfaction were collected postoperatively, the data was statistically processed using SPSS 25.0 software package. RESULTS: All patients were followed up for 3 months to 6 years, no serious complications such as intracranial hematoma, intracranial infection, blindness, cerebral hernia, and olfactory loss were noted, only 1 patient had cerebrospinal fluid rhinorrhea and recovered after conservative treatment. The operation time of the model group was significantly lower than that of the traditional group (P<0.05). The postoperative satisfaction degree and symmetry of the model group were significantly better than the traditional group (P<0.05). CONCLUSIONS: Digital 3D simulation model provides accurate medical information before surgery, improving the efficiency and accuracy of surgery and craniofacial shape of the patients.
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    Effect of postoperative gastric tube placement on oral health-related quality of life in patients with dental and maxillofacial deformity
    YUAN Wei-jun, LI Li, YANG Xia, LIU Ting, SHAN Ying, ZHU Yi
    2019, 17 (6):  518-521.  doi: 10.19438/j.cjoms.2019.06.007
    Abstract ( 415 )   PDF (3113KB) ( 147 )  
    PURPOSE: To explore the influence of postoperative feeding in patients with maxillofacial deformity, and to provide a reference for the selection of postoperative feeding mode in patients with oral and maxillofacial deformity. METHODS: The subjects were patients admitted to our hospital for orthognathic surgery from October, 2016 to May, 2017. They were divided into two groups: nasogastric feeding group (2 hours after nasal intubation was pulled out, feeding fluid with the gastric tube for more than 24 hours) and oral feeding group (2 hours after nasal intubation was pulled out, feeding fluid by oral cavity). The Oral Health Impact Profile (OHIP-14) was used to investigate the oral health-related quality of life. SPSS 18.0 software package was used to analyze the data. RESUILS: One hundred and two cases were enrolled, the average age was 24.1±4.4 years; 63.7% were female; 63.8% were undergraduate; 55.9% were in-service staffs and 28.4% were students; 82.4% patients were unmarried. There was no significant difference in age, sex, education level, occupational and marital status between the two groups. The scores of oral health of two groups were 35.2±9.295 and 31.36±7.505, respectively, with significant difference (P<0.05). The functional limitations and ability limit scores of each dimension were statistically significant (P<0.05) between the two groups. Indwelling gastric tube for 3 days postoperatively can increase the intake of nutrient solution, especially 1 d and 2 d postoperatively. The amount of nasal feeding nutrient solution was significantly higher than that of oral feeding (P<0.01). CONCLUSIONS: The indwelling gastric tube for 3 days after orthognathic surgery can improve the quality of life related to oral health, significantly increase the intake of postoperative nutrient solution, and provide guarantee for early recovery of patients after surgery.
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    Application of electromyography to evaluating facial nerve function
    FENG Lin-fei, WU Jiang-en, XUE Hao-wei, HOU Jun
    2019, 17 (6):  522-525.  doi: 10.19438/j.cjoms.2019.06.008
    Abstract ( 338 )   PDF (2870KB) ( 179 )  
    PURPOSE: To evaluate the role of eletroneurography(ENoG) and surface-electromyography(sEMG) in facial nerve function assessment, and provide experimental parameters for facial paralysis classification. METHODS: Regional House-Brackmann (HB) grading system and ENoG\sEMG were applied to evaluate iatrogenic injure degree of facial nerve caused by parotid gland surgery. ENoG was applied to 50 patients with unilateral parotid gland tumor before operation and 30 days postoperatively. Parameters including amplitude (Am) and motor unit action potential (MUAP) were recorded, and degeneration rate (DR) and inter-pulse interval (IPI) were calculated. At the same time, regional HB grading system evaluation classifications of patients were recorded. SPSS 20.0 software package was used to analyze the data. RESULTS: After surgery, the parameter of Am was lower in the affected side than healthy side, and the difference was significant(P<0.05). The lower the level of facial nerve function evaluated by regional HB grading system, the smaller the DR value. Meanwhile, MUAP and IPI parameters between the healthy and affected sides had significant difference in Ⅳ-Ⅴ levels compared to parameters before operation(P<0.05). CONCLUSIONS: Am and DR parameters acquired by ENoG can be used as objective parameters in facial nerve functional estimating system. Application of parameters acquired by sEMG need to be further studied in estimating facial nerve function.
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    Evaluation of postoperative maxillary stability of orthognathic surgery in patients with maxillary vertical dysplasia using three-dimensional measurement
    WANG Shu-ze, WANG Xu-dong
    2019, 17 (6):  526-530.  doi: 10.19438/j.cjoms.2019.06.009
    Abstract ( 591 )   PDF (3728KB) ( 319 )  
    PURPOSE: To evaluate maxillary skeletal stability after downward Le Fort I (LF1) osteotomy and to use three-dimensional measurements to investigate the effects of factors on postoperative stability. METHODS: Fifty patients were treated with LF1 osteotomy with downward and setback bilateral sagittal split osteotomy. The position of the maxilla was measured using spiral computed tomography data from preoperative (T0), 3 days postoperatively (T1), and more than 6 months postoperatively (T2) time points. To assess the postoperative maxillary changes, there 3-dimensional alterations in the landmarks [bilateral greater palatine foramen (GP), anterior nasal spine (ANS)at follow-up were measured. Statistical analysis was performed using SPSS 12.0 software package. RESULTS: In all 50 cases of downward LF1 osteotomy, the vertical dimensional relapse of the ANS from T2-T1 was 1.11 mm. The relapse was correlated with the amount of anterior maxillary vertical surgical movement and type of posterior vertical movement. CONCLUSIONS: LF1 osteotomy to move the maxilla downward is a high-risk surgical procedure that might result in relapse. Some factors contributing to relapse patterns include the amount of downward surgical movement, movement in the posterior maxilla. All of these factors should be considered during surgical treatment planning.
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    Impact of restoration on the quality of life of patients with dentition loss and AST and OPN levels of gingival crevicular fluid
    YANG Yi, ZHOU Shun-cheng, HE Hua-chun, LIU Qin, SHI Wei
    2019, 17 (6):  531-534.  doi: 10.19438/j.cjoms.2019.06.010
    Abstract ( 357 )   PDF (2959KB) ( 130 )  
    PURPOSE: To investigate the effect of dental implant prosthesis and conventional prosthesis on the quality of life and the levels of aspartate aminotransferase (AST) and osteopontin (OPN) in gingival crevicular fluid of patients with dentition loss. METHODS: One hundred and six patients with dentition defect were prospectively selected from October 2016 to October 2018 in the Department of Stomatology, Hankou Branch of General Hospital of Central Theater Command. The patients were divided into two groups by random number table method. Patients in the experimental group (53 cases) were treated with dental implant prosthesis, while patients in the control group (53 cases) were treated with conventional prosthodontics. The curative effect, quality of life, AST and OPN levels in gingival crevicular fluid of the patients were observed. SPSS 25.0 software package was used to analyze the data. RESULTS: The total effective rate of the experimental group was 90.57%, which were significantly higher than that of the control group (P<0.05). After treatment, the AST and OPN levels in gingival crevicular fluid in the experimental group were significantly lower than those in the control group (P<0.05). After treatment, the OHIP-14 scores of the experimental group were significantly lower than those of the control group in terms of functional limitation, physiological pain, psychological discomfort, physiological disorder, psychological disorder, social disorder and disability (P<0.05). CONCLUSIONS: Dental implant prosthesis can significantly improve the quality of life of patients with dentition loss, and has little impact on the levels of AST and OPN in gingival crevicular fluid.
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    Head and neck odontogenic myxoma: clinical, pathological and prognosis analysis of 79 consecutive cases
    SUN Zhong-yi, CHEN Yi-ming, TANG Yan-yi, JI Tong
    2019, 17 (6):  535-539.  doi: 10.19438/j.cjoms.2019.06.011
    Abstract ( 635 )   PDF (3393KB) ( 320 )  
    PURPOSE: To analyze the clinical pathological and prognosis factors of head and neck odontogenic myxoma. METHODS: A retrospective study was adapted for patients who received surgery in the Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital from 2001-2017. Clinical, pathological and prognosis data were collected and analyzed with SPSS 17.0 software package. RESULTS: Seventy-nine patients were finally selected, 71 could be followed up. Among 71 patients, 30 were male; 27 were ≤30 years, 39 were within 31-60 years. Twelve had smoking history, 3 had alcoholism history. Forty-two had tumor in mandible, 26 had tumor in the maxilla and skull base. The median of the largest diameter tumor was 3.5 cm, 36 were ≤3.5 cm. Sixty received block resection, 11 underwent curettage. Fifty-two were rich in fibrous content while 19 were rich in mucus content. Four had local recurrence within follow-up period. Patients receiving curettage had higher rate of local recurrence (36.36%) compared while those with block resection (P=0.001). CONCLUSIONS: Head and neck odontogenic myxoma was a kind of benign tumor with local recurrence, mostly located in the mandible and high incidence in patients within 31-60 years old. Block resection can provide good control of local recurrence compared with curettage.
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    Clinical research on therapeutic effect of pulling out the mandibular third impacted molar with piezosurgery and highspeed rotary handpiece
    SONG Yong, LI Xiang, CAI Man, WANG Yao-hui
    2019, 17 (6):  540-544.  doi: 10.19438/j.cjoms.2019.06.012
    Abstract ( 626 )   PDF (3815KB) ( 186 )  
    PURPOSE: This research aimed at evaluating the efficacy of different types of impacted mandibular third molars removed by piezosurgery and highspeed rotary handpiece. METHODS: One hundred and twenty low-positioned impacted mandibular third molars were assigned to 3 groups (vertically impacted group, mesially impacted group and horizontally impacted group) and each group included 40 teeth. Twenty teeth in each group were treated with piezosurgery and another 20 teeth with highspeed rotary handpiece. The operation time, degree of postoperative pain and swelling, mouth opening and serious complications (such as permanent nerve injury) were recorded. SPSS 17.0 software package were used for statistical analysis. RESULTS: All cases treated with piezosurgery showed minor postoperative pain at 1 d and 3 d than those with highspeed rotary handpiece, but no significant difference at 7 d. In vertically impacted group, no significance was shown in the operation time, swelling, mouth opening between two methods. In mesially impacted group, piezosurgery had the advantages of reducing operation time and mouth opening limitation than highspeed rotary handpiece, but with the same degree of swelling. In horizontally impacted group, piezosurgery was superior to highspeed rotary handpiece in all postoperative clinical indexes. No serious complication was observed in each group. CONCLUSIONS: Comparing to highspeed rotary handpiece, piezosurgery achieves minimally invasive surgery via selectively cutting bone tissue, accurate osteotomy, less postoperative trauma. It is recommended to use piezosurgery to remove low positioned mesially or horizontally impacted third molars to reduce postoperative trauma and improve surgical outcomes.
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    Free flap reconstruction in 21 pediatric patients with head and neck cancer: clinical considerations for comprehensive care
    GUO Yun, HE You-ya, CHEN Yi-ming, TANG Yan-yi, JI Tong
    2019, 17 (6):  545-549.  doi: 10.19438/j.cjoms.2019.06.013
    Abstract ( 336 )   PDF (3551KB) ( 205 )  
    PURPOSE: To analyze the clinical characteristics for free flap reconstruction of defects caused by head and neck cancer among patients aged 14 and below. METHODS: A retrospective study was performed in patients who were treated in the Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital from 2009 to 2011, all patients were aged 14 years and below and had reconstructions with free flap for head and neck cancer. Clinical, pathological records and image data were collected and analyzed. SPSS 17.0 software package was used for statistical analysis. RESULTS: Twenty-one patients were finally selected, 14 were male and 7 were female; 17 patients had ASA score grade Ⅰ and 4 patients had ASA score grade Ⅱ. The median operating time was 480 minutes, and median blood loss was 500 mL. Six patients had tracheotomy, 7 had medical complications (4 pulmonary infection, 3 diarrhea), 4 had surgical complications (1 hematoma beneath flap, 2 wound dihescence, 1 salivary fistula). Tracheotomy was related to medical complications(P=0.035) and overall complications (P=0.064). CONCLUSIONS: Free flap reconstruction could be applied in pediatric HNC patients. Postoperative complications were main negative factor for prognosis. Tracheotomy had relationship with postoperative complications and should be cautiously used.
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    Clinical Reports
    Application of deep inferior epigastric perforator flaps (DIEP) in total tongue reconstruction after resection of tongue carcinoma
    LI Jun, HUANG Jing, GAO Bing-ju, QIU Yu, LIN Yang, RUAN Zhao-wei, YE Zhuo, LIN Li-song
    2019, 17 (6):  550-553.  doi: 10.19438/j.cjoms.2019.06.014
    Abstract ( 341 )   PDF (3459KB) ( 188 )  
    PURPOSE: To evaluate the value of deep inferior epigastric perforator flap in repairing postoperative defects after total tongue resection due to cancer. METHODS: From January 2018 to July 2018, deep inferior epigastric perforator flap was used to repair 13 total tongue defect after tongue carcinoma resection. All the deep inferior epigastric arteries were anastomosed with superior thyroid anteries or facial arteries, while the venae eomitans were anastomosed with the external jugular venae or the branches of internal jugular venae. RESULTS: Thirteen DIEP flaps survived uneventfully, the shape of the flaps in reconstruction of total tongue was satisfactory, the function was also satisfying. The donor area was closed directly. Of 13 patients, only one had abdominal wound infection, which was cured by dressing change. All abdominal wounds were healed leaving linear scar, the function of rectus abdominis was not affected obviously, and no complications such as abdominal wall hernia and abdominal wall protuberance were found. CONCLUSIONS: DIEP flap is rich in tissue, reliable in blood supply, good in shape and function. The complications of donor area are minimized. It is a new and reliable technique for reconstruction of total tongue defect.
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    Clinical Guidelines
    Clinical practice guidelines for CLOVES syndrome (translation version)
    ZHANG Ling, CHEN Zheng-gang, ZHENG Jia-wei
    2019, 17 (6):  554-559.  doi: 10.19438/j.cjoms.2019.06.015
    Abstract ( 565 )   PDF (4535KB) ( 209 )  
    CLOVES syndrome is a rare congenital vascular disorder with the following clinical features: congenital lipomatous overgrowth, vascular malformations, epidermal nevi, scoliosis/skeletal/spional anomalie. The etiology and pathogenesis remain unknown. Symptoms and severity of CLOVES 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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    Review Articles
    History of minimally invasive exodontia
    ZHENG Xue-ni, LIU Ping, LIU Chuan, MA Yang, MO Jing-zhen, HU Kai-jin
    2019, 17 (6):  560-565.  doi: 10.19438/j.cjoms.2019.06.016
    Abstract ( 711 )   PDF (4891KB) ( 602 )  
    The concept of minimally invasive was put forward in 1985. With the development of minimally invasive surgery and minimally invasive dentistry, minimally invasive exodontia has begun to germinate. The rapid development of dental implantation promotes the application of minimally invasive tooth extraction. In this paper, the development of minimally invasive tooth extraction was briefly introduced in terms of the concept of minimally invasive exodontia, the innovation of minimally invasive instruments and the improvement of minimally invasive methods, in order to provide some help for clinical practitioners.
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    Research progress of using T2 mapping to diagnose articular cartilage diseases
    MAO Yi, CHEN Xu-zhuo, ZHANG Shan-yong
    2019, 17 (6):  566-570.  doi: 10.19438/j.cjoms.2019.06.017
    Abstract ( 312 )   PDF (4283KB) ( 177 )  
    Articular cartilage is one of the most important articulates, which plays an role in transferring the mechanical stress when exercising and decreasing friction between joint surfaces. Due to the lack of blood supply for articular tissue, injuries after articulate damage are difficult for self-healing. Thus, early diagnosis and treatment are necessary for articular damages. As a noninvasive diagnosis method in videography, nuclear magnetic resonance(NMR) is of vital importance in diagnosing articular injuries. T2-mapping enables the evaluation of early change of the articular cartilage by describing the transverse magnetization attenuation to reflect the semi-quantitative analysis of tissue character and has clinical potentials. This article was aimed to review the recent development of T2-mapping in diagnosis of articular cartilage diseases.
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    Detection and treatment progress of facial numbness
    HAO Yun-bo, ZHANG Wei-jie, CHEN Min-jie
    2019, 17 (6):  571-574.  doi: 10.19438/j.cjoms.2019.06.018
    Abstract ( 507 )   PDF (3399KB) ( 305 )  
    Numbness is a kind of sensory loss, commonly seen in the limbs and face. Because facial feeling is sensitive, numbness that occurs in the face brings great degree of disturbance to the patient's life, work, social intercourse and so on. At present, subjective evaluation method is used for detection of numbness, and the method of electrophysiological evaluation needs to be clarified. As for the treatment of numbness, in addition to removing the causes,use of neurotrophic drugs, nerve relaxation and other methods to promote nerve recovery were used increasingly. This review presented the methods of numbness detection and the treatment of numbness in recent years.
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    Case Reports
    Mixed skin tumor of the upper lip: a case report
    HU Yong, MA San-cheng, ZHAO Da-yong
    2019, 17 (6):  575-576.  doi: 10.19438/j.cjoms.2019.06.019
    Abstract ( 366 )   PDF (1318KB) ( 172 )  
    Mixed tumor of the skin is a rare neoplasm, which is characterized by asymptomatic subcutaneous mass, and surgery has a good prognosis. We presented a case of mixed tumor of skin located in the upper lip and reviewed the literatures, in order to improve understanding of this tumor.
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