Chenping Zhang

Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai Shi, China

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Publications (42)78.88 Total impact

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    ABSTRACT: The objectives of this study were to analyze the regional characteristics of the cervical lymph node metastasis and to investigate the factors associated with the risk of lymph node involvement. One hundred seventy-one patients suffering from early primary squamous cell carcinoma (SCC) of the tongue (cT1-2N0) were enrolled. Gender, age, growth site, T stage, histological grade, and neurovascular invasion were statistically analyzed by K-M survival analysis and Cox multivariate analysis to evaluate the relationship between the factors and the neck lymph node metastasis. Of the 171 cases divided into the neck dissection group and observation group, 40 ended up with lymph node metastasis, of which 17 were metastasized to level I, 27 to level II, 10 to level III, 2 to level IV, and 1 to level V. Histological grade and neurovascular invasion were significantly associated with lymph node involvement in univariate and multivariate analyses. Age distribution was found to be significantly associated with the lymph node metastasis in multivariate analysis. The metastasis of early tongue SCC has a certain regularity at different sites. Age was not a critical risk factor for cervical lymph node metastasis after surgery. Tumor size was suspected to exert a negative effect on metastasis by influencing tumor invasion. Histological grade and neurovascular invasion were significantly associated with the risk of cervical lymph node metastasis of early tongue SCC.
    Molecular Neurobiology 04/2015; DOI:10.1007/s12035-015-9175-5 · 5.29 Impact Factor
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  • Journal of Cranio-Maxillofacial Surgery 04/2015; DOI:10.1016/j.jcms.2015.03.040 · 2.60 Impact Factor
  • 02/2015; 76(S 01). DOI:10.1055/s-0035-1546509
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    ABSTRACT: To elucidate the clinical characteristics of malignancies involving the pterygopalatine and infratemporal fossa and identify the outcome-related predictors. A retrospective review of the patients diagnosed with malignancies involving these spaces between 2006 and 2013 was conducted. We investigated the 5-year recurrence free survival, metastasis free survival and overall survival, and univariate and multivariate analysis were used to identify the outcome-related factors. A total of 80 patients (46 male and 34 female) aged from 1 to 82 years were retrospectively analysed. The most frequent location for involved malignancies included the pterygopalatine fossa (n = 35, 43.8%), followed by the infratemporal fossa (n = 25, 31.2%) and the pterygopalatine and infratemporal fossa together (n = 20, 25%). In multivariate analysis, gender (HR: 2.59, 95% CI: 1.034-6.488, p = 0.042), margin status (HR: 6.158, 95% CI: 2.115-17.932, p = 0.001) and adjuvant radiotherapy (HR: 3.116, 95% CI: 1.057-9.191, p = 0.039) were predictors for the 5-year recurrence-free survival rate, and brain invasion (HR: 6.218, 95% CI: 1.375-28.115, p = 0.018) and surgical margin (HR: 21.961, 95% CI: 2.383-202.418, p = 0.006) were predictors for the 5-year overall survival rate. These results indicate that malignancies involving the pterygopalatine and infratemporal fossa have a poor prognosis. Brain invasion is a dangerous sign for decreased survival. An ideal surgical margin is associated with a lower recurrence and higher survival rate. Adjuvant radiotherapy should be performed to achieve better local control. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
    Journal of Cranio-Maxillofacial Surgery 02/2015; DOI:10.1016/j.jcms.2015.02.001 · 2.60 Impact Factor
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    ABSTRACT: The use of vascularized nerve graft models has been limited because of the complexity of the operation. The authors sought to develop a simple and effective rabbit model for facial nerve repair and evaluated its advantages over conventional nerve grafts. Rabbits were divided into three groups consisting of six rabbits each. The central auricular nerve and its nutrient vessels were used as a vascularized graft. Rabbits were grafted with a vascularized facial nerve graft (vascularized nerve graft group), with a free nerve graft (free nerve graft group), or with a vascularized nerve graft and a free nerve graft on each side of the face (vascularized nerve graft/free nerve graft group). Four months after surgery, facial performance and electrophysiologic monitoring were evaluated. The rabbits were then killed to prepare the nerve specimens for histologic, immunohistochemical, and transmission electron microscope study. At 4 months after the facial nerve repair, the functional recovery of the facial nerve was observed and analyzed. The side grafted with vascularized nerve graft was superior to the side grafted with free nerve graft. Regenerated nerve fibers were observed in all groups, and rabbits grafted with vascularized nerve grafts had more regenerated axons than those that underwent free nerve grafting, although the regenerated nerves were not as good as the natural nerves. This study demonstrates that it is feasible to establish a vascularized nerve graft model in rabbits. The model offers the obvious advantages of operability and reliability. The vascularized nerve graft is demonstrated to have a superior value for facial nerve repair.
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    ABSTRACT: Purposes The continuity and integrity of the enveloping nutritive periosteum may be compromised during the installation of the dental implant distractor (DID) device. This novel animal experiment aims to study the influence of the periosteum on the bony regenerate in 3 scenarios of periosteal coverage: whole periosteum (WP), half periosteum (HP) and no periosteum (NP). Materials and methods Twelve goat tibias were vertically osteotomised into two segments each and divided into the three groups of WP, HP and NP. A DID device was surgically installed onto each segment, followed by 10 days of distraction at a rate of 0.35mm twice daily. Fluorescence-labeling and trabeculae count per high powered field (TBC/HPF) measurements were performed and statistically compared across the various groups. Implant stability quotients (ISQ) of all fixtures were also done. Results New bone formation of WP and HP groups were found to be faster than the NP group under fluoroscopy. The TBC/HPF values had no statistically significant differences across all three groups. All WP groups showed significantly higher ISQ values (0.93) compared to the HP (0.85) and NP (0.84) groups. Conclusion Vertical distraction osteogenesis can be successfully performed with the dental implant distractor to obtain bone of adequate stock and density. However, the enveloping periosteum should be preserved as much as possible during the installation of the DID device.
    Journal of Oral and Maxillofacial Surgery 10/2014; 72(10). DOI:10.1016/j.joms.2014.06.440 · 1.28 Impact Factor
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    ABSTRACT: Purpose Reconstruction of lower lip defect with Karapandzic flap often leads to greater rounding of commissure. The aim of this study was to provide a new design of bilateral Karapandzic flap, which is useful in large lower lip defect reconstruction. Methods In this retrospective study of case series, a modification of the Karapandzic lip reconstruction technique was used with an additional incision to recruit more tissue. The esthetic outcome of the reconstruction was assessed in a 4 point scale with regard to the shape of commissure, lip symmetry, appearance of the scar and lip projection. The functional outcome were assessed in terms of speech, preservation of oral competence, lip sensory, facial expression, diet and denture usage. Results Seventeen lower lip squamous cell carcinoma patients underwent single-stage lip reconstruction (13 males, 4 females) with an age range of 52 to 82 years. The lip defects post tumor resection ranged from 50 to 90% of the lower lips. All patients achieved oral competence, without leading to greater rounding of the commissure. The esthetic outcome was considered excellent/good in 88% of cases and the reconstruction did not lead to functional impairments of speech, oral competence, lip sensory, facial expression, diet or denture usage. Conclusions Modified bilateral Karapandzic flap is a reliable technique to reconstruct large lip defects without leading to rounding of the commissure. With this technique, good esthetic and functional outcomes could be achieved.
    Journal of Oral and Maxillofacial Surgery 10/2014; 72(10). DOI:10.1016/j.joms.2014.04.014 · 1.28 Impact Factor
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    ABSTRACT: Flap complications still present challenges in the field of microsurgical reconstruction. The aim of this study was to explore the role of diabetes mellitus in free flap prognosis in elderly patients (≥60 years) after oral tumor resection. The data of aged oral cancer patients who had undergone reconstructions with free flaps in our institution were gathered in this retrospective cohort study. The samples were classified into diabetic and nondiabetic groups. The predictive roles of diabetes status and other factors in free flap prognosis were analyzed. The primary outcome variable was the presence of flap complications, which was subdivided into major (requiring re-exploration or local surgery) and minor (dressing or drug treatment) groups. Major complications were defined as the second outcome variable. Univariate and multivariable analyses were used for data statistics. A total of 309 patients (176 men [57%] and 133 women [43%]) aged 60 years or older were included in this study. There were 105 diabetic patients (34%) and 204 nondiabetic patients (66%). A total of 75 flap complications occurred during the perioperative period, with an overall incidence of 24.3% (44 diabetic patients [41.9%] and 31 nondiabetic patients [15.2%], P ≤ .001). The odds of susceptibility for flap complication development in elderly diabetic patients was 3.413 times that of nondiabetic patients (odds ratio, 3.413; P ≤ .001). Of 75 flap complications, 43 (13.9%) were deemed major complications (24 diabetic patients [22.9%] and 19 nondiabetic patients [9.3%], P ≤ .001). This statistical association was further confirmed by multivariate analysis (odds ratio, 2.885; P = .002). Diabetes mellitus increases the risk of the development of free flap complications in elderly patients when dealing with oral reconstruction after tumor removal. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
    Journal of Oral and Maxillofacial Surgery 08/2014; 73(2). DOI:10.1016/j.joms.2014.08.009 · 1.28 Impact Factor
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    ABSTRACT: Purpose To evaluate the use of the buccal fat pad (BFP) in theimmediate reconstruction of oncological palate defects and the influence of postoperative radiotherapy on reconstruction. Methods Patients who were diagnosed with moderate- to high- grade malignancies of palate underwent partial maxillectomy. BFP was used as a pedicled flap to reconstruct the defects. All patients received postoperative radiotherapy 4-5 weeks after surgery. Results Eighteen patients (9 males, 9 females) with an age range of 37 to 81 years underwent surgery and subsequent radiotherapy. The size of all defects ranged from 7.5-19.2cm2. Adequate closure of the defects was achieved during surgery and all the flaps were epithelialized within 3 weeks after operation with no complications of dehiscence or flap failure. Furthermore, there were no complications derived from the postoperative radiotherapy. Conclusions Our study suggests that the BFP is an effective and reliable method for the reconstruction of small to medium sized palate defects. Furthermore, postoperative radiotherapy doesn’t influence the success of the reconstruction.
    Journal of Oral and Maxillofacial Surgery 07/2014; DOI:10.1016/j.joms.2014.06.459 · 1.28 Impact Factor
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    ABSTRACT: Purpose The aim of the study is to estimate the impact of different defect size and used flaps on post-operative soft palate functional outcomes. Methods The study included 45 consecutive patients who were treated by three different reconstructive flaps for their soft palate defect. Post-operative speech and swallowing functions were assessed to measure the relationships between the defect size and postoperative function of soft palate, the different flap reconstructed and postoperative function. The one-way ANOVA test was computed. P <.05 was considered significant. Results Postoperative evaluation revealed that both speech and swallowing functions were normal or near normal in patients with type II defects but poor in the patients of type III and IV defects. No significant changes in postoperative soft palate functions using different flap sizes for the same defect type. Conclusions The study confirms that the size of defect, rather than the type of the flap, has the most critical influence on the soft palate post-operative functions. Defect size of 50% or less has a better outcomes than those with a defect of more than 50%.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 07/2014; DOI:10.1016/j.joms.2014.01.012 · 1.28 Impact Factor
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    ABSTRACT: Background Kallmann syndrome 1 sequence gene (KAL1) protein is an extracellular matrix associated protein which plays vital roles in neurons development and cell migration. However, its biological functions and clinical implications have yet not been revealed in oral carcinogenesis. The objective of the study was to evaluate the role of KAL1 in oral cancer and determine clinical significance of KAL1 in oral squamous cell carcinomas (OSCCs).Methods The expression pattern of KAL1 was examined in a testing cohort including OSCCs (n = 42) and paired adjacent tissues (PATs) (n = 14) by real-time PCR. The result was further validated in a validating cohort of OSCCs (n = 32). Correlation between clinicopathological parameters and KAL1 mRNA levels was analyzed by Kruskal–Wallis test. In vitro, the effects of KAL1 ablation through siRNA-mediated knockdown on the proliferation of OSCC cells were determined by CCK-8, BrdU, and colonies formation assays, respectively. In addition, cell cycle distribution was further evaluated by cytometry.ResultsWe observed that remarkably decreased expression of KAL1 mRNA in two independent cohorts (P = 0.0002 and P = 0.033, respectively). Furthermore, downregulated KAL1 mRNA was significantly associated with worse pathological grade (P = 0.013 and P = 0.035, respectively). Upon KAL1 silencing, the proliferation and colonies formation potentials of OSCC cells were notably promoted by accelerating G1 to M phase transition.Conclusion These data indicated that KAL1 plays a potential suppressive role on OSCC initiation and progression, and KAL1 gene may serve as an adjuvant biomarker for the identification of pathological grade.
    Journal of Oral Pathology and Medicine 07/2014; 44(2). DOI:10.1111/jop.12206 · 1.87 Impact Factor
  • Chenping Zhang
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    ABSTRACT: Purpose: To present the clinical, imaging, pathological and immunohistochemical features of giant cell angiofibroma (GCA). In this paper we report an atypical case of a GCA extending from the parotid to the parapharyngeal space. The lesion was being treated as a vascular malformation for one year prior to surgical removal. We summarize the clinical manifestations, imaging, pathological and molecular features of this rare disease.After complete surgical removal of the tumor, immunohistochemical analysis revealed strong positivity for the mesenchymal markers vimentin, CD34, CD31 and CD99 in neoplastic cells. Tumor proliferation antigen marker Ki67 was partly positive (<5% of cells). Tumor cells were negative for muscle-specific actin, epithelial membrane antigen, smooth muscle actin, cytokeratin pan, S100, desmin, glial fibrillary acidic protein, myogenin, MyoD1 and F8. The morphological and immunohistochemical profile was consistent with the diagnosis of GCA. GCA is a rare soft tissue tumor that can easily be misdiagnosed in the clinical preoperative setting. In view of the clinical, pathological and molecular features of the tumor, complete surgical removal is the current optimal treatment option, providing accurate diagnosis and low to minimal recurrence rate.
    World Journal of Surgical Oncology 04/2014; 12(1):117. DOI:10.1186/1477-7819-12-117 · 1.20 Impact Factor
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    ABSTRACT: Toll-like receptor 4 (TLR4) is expressed in head and neck squamous cell carcinoma (HNSCC) cells and is associated with HNSCC cancer progression. Rapamycin has been proven to be efficient for the treatment of HNSCC in vivo, yet the mechanism is not understood and rapamycin demonstrates little effect in vitro. In the present study, the HNSCC cell lines CAL27 and SCC4 were pre-treated with rapamycin then stimulated with a TLR4 ligand lipopolysaccharide (LPS). Cell proliferation, migration, invasion, resistance to TRAIL-induced apoptosis, cytokine production, NF-κB and p65 activation were determined. The results indicated that LPS significantly stimulated HNSCC cell proliferation, cytokine production, migration, invasion and resistance to apoptosis induced by tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL). Pretreatment with rapamycin significantly attenuated LPS-induced pro-oncogenic effects by inhibiting the activation of NF-κB by LPS. siRNA knockdown of TLR4 in HNSCC cells demonstrated that rapamycin attenuated LPS-induced pro-oncogenic effects via TLR4. Hence, this study suggests rapamycin may be efficient for the treatment of HNSCC by attenuating TLR4-induced pro-oncogenic effects.
    Oncology Reports 04/2014; 31(6). DOI:10.3892/or.2014.3134 · 2.19 Impact Factor
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    ABSTRACT: Increasing evidence suggests that communication between tumor and immune cells can alter the tumor microenvironment in ways that promote tumor development. The purpose of this study was to characterize the immune response elicited by TLR-9-activated OSCC cells, to identify the cytokines involved in the signaling pathway and to elucidate the molecular mechanism of this pathway in OSCC cells. MTS, flow cytometry and ELISA assay were used to evaluate T-cell immune responses, cancer cell proliferation and pro-inflammatory cytokine secretion, respectively. Western blot analysis, EMSA and ChIP assay were employed to detect the activity of the NF-κB and AP-1 signaling pathways. A marked response was observed when T-cells were co-cultured with supernatants from CpG-ODN-treated OSCC cells. This response was characterized by increased CD4+ and CD8+ T-cell proliferation and an increase in IFN-γ production by the CD4+ T-cell population. Treatment of OSCC cells with CpG-ODN resulted in an increase in IL-6 secretion as well as an increase in AP-1 binding activity to the IL-6 promoter. Moreover, blockage of the TLR-9/AP-1 pathway significantly decreased IL-6 expression and T-cell immune response. In human OSCC, the TLR-9 pathway, when stimulated by CpG-ODNs, promotes a T-cell immune response mediated by AP-1-activated IL-6 secretion. Although the complete molecular mechanism has yet to be understood, these findings provide evidence linking tumor cell activities to immune system responses. In addition, the TLR-9/AP-1/IL-6 pathway provides new therapeutic targets for the prevention and treatment of OSCC.
    International Journal of Oncology 03/2014; 44(6). DOI:10.3892/ijo.2014.2356 · 2.77 Impact Factor
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    ABSTRACT: Activation of Toll like receptors (TLRs) signaling has been implicated in promoting malignant cell invasion and metastatic potential. Previously we demonstrated that increased TLR-9 expression predicted poor survival in oral cancer patients. The objective of this study is to further investigate the roles and potential molecular mechanisms of TLR-9 signaling in human oral cancer cell invasion. Cell migration, invasion and protein expression were detected by wound healing assay, Transwell chambers model and western blot. The secretion and activity levels of metalloproteinases-2/9 were quantified by ELISA and Gelatin zymography. EMSA and ChIP assays were employed to detect the activity of AP-1signal pathway. TLR-9 siRNA transfection was used to regulate the expression and activity of TLR-9 in oral cancer cell line HB cells. The results of both wound healing assay and in vitro Transwell assay revealed that activation of TLR-9 induced dose- and time- dependent migration and invasion of HB cells. An increased expression, secretion and activity of MMP-2 were observed upon the treatment of CpG-ODN. The TLR-9 signaling-mediated MMP-2 expression appeared to be a consequence of AP-1 activation, because that their DNA binding activity was enhanced by CpG-ODN treatment. All these influences were efficiently repressed by the knockdown of TLR-9 through siRNA or pretreatment of an AP-1 inhibitor. Activation of TLR-9 signaling could promote human oral cancer HB cells invasion with the induction of MMP-2 presentation by attenuating AP-1 binding activity, suggesting a novel anti-metastatic application for TLR-9 targeted therapy in oral cancer in the future.
    PLoS ONE 03/2014; 9(3):e92748. DOI:10.1371/journal.pone.0092748 · 3.53 Impact Factor
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    ABSTRACT: The purpose of this study was twofold: (i) to compare vertical bone height (VBH) after tumor resection through grafting with either a double-barrel fibula (DBF) technique or vertical distraction osteogenesis of the fibula (VDOF); (ii) to compare the performance of loaded dental implants following either DBF or VDOF with special focus on implant survival, implant success, and bone resorption. This retrospective clinical study involved 19 patients who underwent implant placement following DBF (group A, n = 9) or VDOF (group B, n = 10) for mandibular reconstruction from March 2006 to May 2008. Clinical and radiographic assessments, including VBH, modified Plaque Index (mPI), modified Sulcus Bleeding Index (mSBI), and marginal bone level (MBL), were taken for both groups after delivery of the final prostheses and annually thereafter. Nine patients underwent DBF with 24 implants placed and 10 patients underwent VDOF with 27 implants placed for mandibular reconstruction after tumor resection. Overall, all DBF and VDOF procedures were successful for group A and group B. VBH for group A and group B were 20 and 17 mm. There was no statistically significant difference of mSBI scores between group A and group B in the 3-year follow-up (P = 0.40). In four cases with eight implants of group A and two cases with three implants of group B, granulomatous soft tissue grew. There was no statistically significant differences of MBL between group A and group B in the 3-year follow-up (p = 0.736). The cumulative survival and success rates of implants for group A were 100% and 87.5%, and for group B were 100% and 85.2% in 3-year follow-up, respectively. On the basis of the study of 19 patients who received a total of 51 implants, reconstruction of the mandible with DBF flap or VDOF flap, combined with dental implant therapy, was considered a predictable option. Compared with implants placed in VDOF bone, implants placed in DBF bone had a relative higher incidence of associated gingival inflammation. The DBF bone seems more resistant to peri-implant resorption processes than VDOF bone during functional loading.
    Clinical Oral Implants Research 12/2013; 26(2). DOI:10.1111/clr.12300 · 3.12 Impact Factor
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    ABSTRACT: Oral squamous cell carcinoma (OSCC) accounts for >80% of head and neck malignancies. p21, p27 and survivin proteins are abnormally expressed in OSCC and have been previously reported to correlate with cell proliferation and apoptosis. However, the prognostic significance of p21, p27 and survivin remains controversial. The aim of the present study was to investigate the association of clinical parameters and prognosis with the levels of p21, p27 and survivin expression in patients with OSCC. The levels of the three biomarkers were evaluated by immunohistochemical staining in specimens from 110 patients with OSCC and each section was scored according to the percentage of positive tumor cells and staining intensity. Log-rank test and Cox proportional hazards regression were performed to assess the correlation between biomarkers and clinical events. The association between the immunoexpression of p21, p27 and survivin and clinical pathological variables were analyzed by the χ(2) test and a non-parametric analysis. The expression of p21 in patients with OSCC was found to correlate with the expression of p27 and survivin. The results of the current study revealed that the five-year survival rate was significantly lower in patients with high p21 expression. In addition, the expression of p27 also showed a negative correlation with the five-year survival rate of OSCC, but to a lesser extent. By contrast, the expression of survivin was not a prognostic factor for OSCC. A Kaplan-Meier analysis and Cox proportional hazards model showed that lymph node metastasis and p21 expression were independent prognostic factors of OSCC.
    Oncology letters 08/2013; 6(2):381-386. DOI:10.3892/ol.2013.1381 · 0.99 Impact Factor
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    ABSTRACT: Over-expression of the proto-oncogene pleomorphic adenoma gene 1 (PLAG1) plays a crucial role in the formation of pleomorphic adenoma, which is the most common type of salivary gland tumor. To understand the molecular mechanisms governing PLAG1-mediated tumorigenesis, we used a microarray-based approach to identify PLAG1 target genes. We validated the expression of several genes, including Bax, Fas, p53, p21, p16, Cyclin D1, Egfr, Trail-R/DR5, c-Fos, c-myc and Igf2, by real-time RT-PCR or western blotting. Using luciferase reporter gene assays, we determined that the promoters of Bax, Fas, p53, TRAIL-R/DR5, and c-Fos were transactivated by PLAG1. PLAG1 not only activates genes that promote cell proliferation and tumor formation but also genes that inhibit these cellular processes. Therefore, we conclude that PLAG1 may play a dual role in tumor formation.
    Biotechnology Letters 05/2013; 35(9). DOI:10.1007/s10529-013-1213-7 · 1.74 Impact Factor

Publication Stats

152 Citations
78.88 Total Impact Points

Institutions

  • 2012–2015
    • Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
      Shanghai, Shanghai Shi, China
  • 2008–2015
    • Shanghai Jiao Tong University
      • Department of Oral and Maxillofacial Surgery
      Shanghai, Shanghai Shi, China
  • 2003–2008
    • Second Military Medical University, Shanghai
      Shanghai, Shanghai Shi, China
  • 2005
    • Shanghai University
      Shanghai, Shanghai Shi, China