Zhi-yuan Zhang

Shanghai Jiao Tong University, Shanghai, Shanghai Shi, China

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Publications (128)160.54 Total impact

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    ABSTRACT: Myositis ossificans (MO) is a disease where heterotropic bone forms within a muscle or other type of soft tissue. MO is classified into two groups, MO progressiva and post-traumatic MO. It rarely occurs in the masticatory muscles and thus, only 20 cases involving the masticatory muscles have been reported since 2001. The majority of the reported cases occurred due to trauma, repeated injury or surgical manipulation. However, in a small number of cases, no specific traumatic event was identified as the cause of MO. To the best of our knowledge, this is the first case of post-infectious MO to be reported in the medial and lateral pterygoid muscles.
    Oncology letters 02/2015; 9(2):920-926. DOI:10.3892/ol.2014.2710 · 0.99 Impact Factor
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    ABSTRACT: Oral squamous cell carcinoma (OSCC) is one of the most deadly malignant tumors with high invasive potential and frequently cervical lymph node metastasis. AP-1 plays a critical role in tumor invasion and metastasis, but there are few reports on the role of c-Fos in OSCC carcinogenesis and metastasis. Investigate c-Fos expression in clinical samples from 58 primary patients with OSCC by immunohistochemistry. c-Fos knockdown stable cell lines were established by lentiviral infection and transwell cell invasion assay to detect the effects of c-Fos knockdown on tumor cell invasion. Nuclear and cytoplasmic c-Fos protein were both overexpression in cancerous tissues compared with adjacent non-malignant epithelia (nuclear: P < 0.001, cytoplasmic: P = 0.005). Higher level nuclear c-Fos expression was found in the tumor samples of patients with lymph node metastasis than those without lymph node metastasis (4.85 ± 1.43 vs. 3.61 ± 1.28, P = 0.002). Higher level of c-Fos expression was also found in tumor invasive front margin than tumor center and high nuclear expression of c-Fos indicated poor survival. Knockdown of c-Fos greatly suppressed tumor cell proliferation and invasion and downregulated CD44 and CyclinD1 expression in HN6 and SCC9 cells. However, CyclinD3, c-myc, and Erk1/2 were found no changes to c-Fos depletion. c-Fos promoted cell invasion and migration via CD44 pathway in OSCC. c-Fos could be used as a potential therapeutic target gene and an additional marker for evaluation of lymph node metastasis. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
    Journal of Oral Pathology and Medicine 12/2014; DOI:10.1111/jop.12296 · 1.87 Impact Factor
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    ABSTRACT: Purpose To investigate the application of the medial sural artery perforator flap in hemiglossectomy reconstruction and evaluate the value of preoperative computed tomographic angiography for perforator location. Patients and Methods Nine patients received medial sural artery perforator flaps for tongue reconstruction between August 2013 and January 2014. There were 5 males and 4 females, with a mean age of 51 years (range, 22 to 67 years). The number, location, and course of the perforators were measured on the computed tomographic angiogram preoperatively. Results 8/9 of the medial sural artery perforator flaps survived and one with necrosis. Thirteen perforators were visualized by angiogram and 10 of these were used in the operation. There was no significant difference between the computed tomographic angiography location and intraoperative findings in the perforator’s distribution. The mean diameter of the medial sural artery was 1.0 ± 0.3mm and the concomitant vein was 2.0 ± 0.7mm. The mean pedicle length was 9.7 ± 1.0cm, with 5.1 ± 1.7cm of main trunk and 4.6 ± 2.1cm of perforator. The average number of muscular vessel branches was 23.9 ± 6.9, with 12.2 ± 5.1 of main trunk and 10.1 ± 4.4 of perforator. There were 1 (10%) septocutaneous and 9 (90%) myocutaneous perforators. Conclusions The medial sural artery perforator flap is appropriate for medium-sized tongue defect reconstruction, with a long pedicle of matching caliber, adequate tissue volume, and minimal donor site morbidity. Computed tomographic angiography is a valuable and necessary method for preoperative assessment of the perforator’s location.
    Journal of Oral and Maxillofacial Surgery 11/2014; 72(11). DOI:10.1016/j.joms.2014.05.019 · 1.28 Impact Factor
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    ABSTRACT: The aim of this study is to eliminate more cancer cells by promoting them from quiescence into cell cycle or by changing their molecular events, leading them to be sensitive to radiation or chemotherapy. Protein phosphatase 2A plays an important role in many cellular functions and regulates various biological processes. It is unclear that LB1, which is an inhibitor of protein phosphatase 2A, has enhanced anticancer activity on chemotherapy (cisplatin and 5-fluorourcil) and radiation in head and neck squamous cell carcinoma (HNSCC). Herein, we performed both in vitro and in vivo studies to determine the anticancer activity of LB1 on chemotherapy and radiation in HNSCC, with detection of p53 expression, AKT and MDM2 phosphorylation. In vitro studies indicated that, LB1 could significantly enhance the cytotoxicity of cisplatin, 5-fluorourcil, and radiation; LB1 could also significantly enhance the treatment effect of cisplatin in nude mice. The anticancer activity of LB1 was mediated by increased AKT phosphorylation and decreased p53 expression with increased MDM2 phosphorylation, especially when combined with cisplatin. Our data suggest a strategy of improving treatment effect through the enhanced anticancer activity of LB1 on cisplatin-based chemotherapy and radiation in HNSCC. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Cancer Letters 10/2014; DOI:10.1016/j.canlet.2014.10.024 · 5.02 Impact Factor
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    ABSTRACT: Glutathione S transferase pi (GSTP1) is a member of phase II detoxification enzymes as a major regulator of cell signaling in response to stress, hypoxia, growth factors, and other stimuli. The clinical role of GSTP1 in cancer is still unclear. The aim of this study was to investigate the serum GSTP1 level in patients with oral squamous cell carcinoma (OSCC) and the GSTP1 expression in tissue samples from patients with OSCC and OSCC lines.
    Journal of Oral Pathology and Medicine 07/2014; DOI:10.1111/jop.12229 · 1.87 Impact Factor
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    ABSTRACT: Purpose: The aim of this study was to introduce our classification of the neurovascular compression (NVC) in trigeminal neuralgia and the radiologic indications for microvascular decompression (MVD) based on magnetic resonance tomographic angiography. Methods: From 2003 to 2011, 322 patients with primary trigeminal neuralgia were treated with MVD. The score of NVC was from 0 to 3. Three scores, separately from axial, oblique sagittal, and coronal images, were added together. The degree of NVC was classified as follows: grade 0 (0-1), grade 1 (2-3), grade 2 (4-6), and grade 3 (7-9). Results: In summary, 88.3% (182/206) patients with absolute indication, 78.3% (65/83) patients with relative indication, and 90.9% (30/33) without indication showed excellent results. Among the 27 patients with good result, 13 patients (48.1%) were in grade 1, and 3 (11.1%) were in grade 0. Among the 18 patients with poor result, 5 patients (27.8%) were in grade 1 preoperatively. Five patients with severe complications were all in grade 0 with vague NVC. Conclusion: The patients with grades 2 and 3 (absolute indications) NVC were recommended with MVD.
    Journal of Craniofacial Surgery 07/2014; 25(4):e384-e388. DOI:10.1097/SCS.0000000000000969 · 0.68 Impact Factor
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    ABSTRACT: Adenoid cystic carcinoma (ACC), formerly known as cylindroma, is a malignant epithelial neoplasm typically derived from the salivary glands. Of all salivary gland tumors, the incidence of malignant salivary gland tumor has been 15 to 32% in the parotid glands, 70 to 90% in the sublingual glands, and about 50% in the minor salivary glands. Intraosseous ACC of the jaw has rarely been reported and is poorly understood. The aim of the present study was to analyze this tumor clinically and histopathologically to improve the diagnosis, management, and treatment. We collected the records of 16 patients with intraosseous ACC from 1998 to 2013, who had been treated at our hospital, including clinical data and follow-up information. We then analyzed the patients' clinical features, diagnosis, treatment, and prognosis. The average age of the 16 patients was 56.8 years, and the male/female ratio was 0.8. The primary manifestations of the tumor were obviously different. Tumor excision was performed and followed by radiotherapy or chemotherapy, or both. The average follow-up period was 57.2 months, and the average follow-up period for patients who were alive and tumor free was 52.3 months. The survival rate was 68.8% after treatment. All these results were generally in agreement with those from previous reports. The differential diagnosis of intraosseous ACC from other common tumors of jaws should be determined by the clinical, radiographic, and histopathologic subtypes. For treatment, surgery is the first choice for patients, and radiotherapy or chemotherapy might improve the prognosis in the postoperative period. In addition, the histopathologic subtypes and biologic processes of ACC are related to patient prognosis.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 12/2013; 72(4). DOI:10.1016/j.joms.2013.11.032 · 1.58 Impact Factor
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    ABSTRACT: Background: We compared outcomes and xerostomia grade after postoperative IMRT and conventional radiotherapy in patients with oral and oropharyngeal carcinoma. Methods: Eighty-eight patients with oral cavity (n=77) and oropharyngeal (n=11) carcinoma underwent postoperative IMRT (n=44) or conventional radiotherapy (CRT) (n=44). Outcomes, failure patterns, volume, doses, salivary gland V30, and xerostomia grade were evaluated. The median follow-up was 53 months (range, 48-58 months). The median interval from surgery to RT was 4 weeks (range, 3-6 weeks). Results: Twenty-one patients (7 and 14 for the IMRT and CRT groups, respectively) experienced local-regional failure. For the IMRT group, all 7 local-regional failures occurred in the high-dose target volumes. For the CRT group, there were 12 in-field failures, 1 at the margin, and 1 out-of-field. Nine patients experienced distant failure (5 and 4 for the IMRT and CRT groups, respectively). The 4-year local-regional control, disease-free survival, overall survival, and distant-metastasis rates for the IMRT and conventional radiotherapy groups were 84.1% vs. 68.2% (p = 0.055), 68.2% vs. 52.3% (p = 0.091), 70.5% vs. 56.8% (p = 0.124), and 11.4% vs. 9.1% (p = 0.927), respectively. Xerostomia grade after radiotherapy was lower for IMRT compared with conventional radiotherapy (p<0.001). Conclusions: Postoperative IMRT for oral and oropharyngeal carcinoma significantly improves mean dose, salivary gland V30, and xerostomia grade when compared with conventional radiotherapy. The predominant failure pattern was local. No differences were found in survival outcomes between both groups. There was a marginal difference in local-regional control. Head Neck, 2013.
    Head & Neck 08/2013; 36(10). DOI:10.1002/hed.23488 · 2.83 Impact Factor
  • Lai-Ping Zhong, Zhi-Yuan Zhang
    Journal of Clinical Oncology 08/2013; 31(23):2972-3. DOI:10.1200/JCO.2013.50.4639 · 17.88 Impact Factor
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    ABSTRACT: The benefit of induction chemotherapy in locally advanced oral squamous cell carcinoma (OSCC) remains to be clearly defined. Induction chemotherapy is likely to be effective for biologically distinct subgroups of patients and biomarker development might lead to identification of the patients whose tumors are to respond to a particular treatment. Annexin A1 may serve as a biomarker for responsiveness to induction chemotherapy. The aim of this study was to investigate Annexin A1 expression in pre-treatment biopsies from a cohort of OSCC patients treated with surgery and post-operative radiotherapy or docetaxel, cisplatin and 5-fluorouracil (TPF) induction chemotherapy followed by surgery and post-operative radiotherapy. Furthermore we sought to assess the utility of Annexin A1 as a prognostic or predictive biomarker. Immunohistochemical staining for Annexin A1 was performed in pre-treatment biopsies from 232 of 256 clinical stage III/IVA OSCC patients. Annexin A1 index was estimated as the proportion of tumor cells (low and high, <50% and >=50% of stained cells, respectively) to Annexin A1 cellular membrane and cytoplasm staining. There was a significant correlation between Annexin A1 expression and pathologic differentiation grade (P=0.015) in OSCC patients. The proportion of patients with low Annexin A1 expression was significantly higher amongst those with moderate/poorly differentiated tumor (78/167) compared to those with well differentiated tumor (18/65). Multivariate Cox model analysis showed clinical stage (P=0.001) and Annexin A1 expression (P=0.038) as independent prognostic risk factors. Furthermore, a low Annexin A1 expression level was predictive of longer disease-free survival (P=0.036, HR=0.620) and locoregional recurrence-free survival (P=0.031, HR=0.607) compared to high Annexin A1 expression. Patients with moderate/poorly differentiated tumor and low Annexin A1 expression benefited from TPF induction chemotherapy as measured by distant metastasis-free survival (P=0.048, HR=0.373) as well as overall survival (P=0.078, HR=0.410). Annexin A1 can be used as a prognostic biomarker for OSCC. Patients with moderate/poorly differentiated OSCC and low Annexin A1 expression can benefit from the addition of TPF induction chemotherapy to surgery and post-operative radiotherapy. Annexin A1 expression can potentially be used as a predictive biomarker to select OSCC patients with moderate/poorly differentiated tumor who may benefit from TPF induction chemotherapy.
    BMC Cancer 06/2013; 13(1):301. DOI:10.1186/1471-2407-13-301 · 3.32 Impact Factor
    This article is viewable in ResearchGate's enriched format
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    ABSTRACT: OBJECTIVES: To evaluate the relation of tea consumption with the risk of oral cancer incidence. SUBJECTS AND METHODS: A multicenter case-control study based on hospitalized population was conducted for evaluating the association of tea consumption with oral cancer risk in China. Black tea and green tea were separately analyzed. 723 cases and 857 controls were included. Unconditional multiple logistic regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of oral cancer for tea consumption. RESULTS: The ORs for green tea consumption⩾8g/day compared with<4g/day were 0.72 (95% CI 0.54, 0.93) for men, and 0.93 (95% CI 0.74, 1.26) for women. The ORs for black tea consumption⩾6g/day compared with<2g/day were 0.97 (95% CI 0.74, 1.20) for men, and 0.91 (95% CI 0.68, 1.23) for women. Green tea intake was significantly associated with reduced risk of oral cancer in men, but not in women, and the association was stronger in heavily smoking men. There was no indication that black tea consumption was associated with decreased oral cancer risk. CONCLUSION: The results of this study indicated that green tea consumption may decrease the risk of oral cancer in men especially for those smoking heavily.
    Oral Oncology 05/2013; DOI:10.1016/j.oraloncology.2013.05.002 · 3.03 Impact Factor
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    ABSTRACT: BACKGROUND: Although molecular mechanism of growth differentiation factor 15 (GDF15) in tumorigenesis of oral squamous cell carcinoma (OSCC) is not clear, the diagnostic and prognostic value of serum GDF15 detection has been noticed. However, serum GDF15 levels in patients with oral leukoplakia and GDF15 as a potential predictive biomarker for response to induction chemotherapy in patients with OSCC have not been reported. METHODS: Pretreatment serum GDF15 concentration was detected using an enzyme-linked immunosorbent assay in 30 healthy persons, 24 patients with oral leukoplakia, and 60 patients with OSCC. RESULTS: Serum GDF15 concentration was significantly higher in patients with oral leukoplakia and OSCC, compared with healthy controls (F = 13.701, df = 2, P < 0.001). From a diagnostic standpoint, a cutoff value of 346.9 ng/l of serum GDF15 concentration was calculated using receiver operating characteristic curve, with a sensitivity of 0.750, specificity of 0.867, Youden's Index of 0.617, and area under curve of 0.863. From a prognostic standpoint, patients with serum GDF15 concentration <346.9 ng/l had an improved 3-year disease-free survival rate (64.3% vs 56.5%) compared with those above 346.9 ng/l, but the difference was not statistically significant. A decreased concentration of GDF15 (<346.9 ng/l) showed a predictive trend toward an improved response to induction chemotherapy compared with elevated concentration with clinical response rates of 100% and 71.4%, respectively, but the difference was not significant. CONCLUSION: Elevated GDF15 level may be not only a diagnostic biomarker for oral leukoplakia, but also a prognostic/predictive biomarker associated with decreased survival and diminished response to induction chemotherapy for patients with OSCC.
    Journal of Oral Pathology and Medicine 05/2013; DOI:10.1111/jop.12091 · 1.87 Impact Factor
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    ABSTRACT: BackgroundG protein-coupled receptor family C group 5 member A (GPRC5A), a member of G protein-coupled receptor family, has been shown to function as a tumor suppressor in lung tissue. The biological functions of GPRC5A have therefore been linked to lung tissue. However, the biological significance of this gene product remains obscure. In this study, we investigated the expression of GPRC5A proteins in normal oral tissue and oral squamous cell carcinoma (OSCC), and we characterized its biological activity in OSCC cell lines. Methods Western blot analysis and immunohistochemical staining were used to investigate the expression of GPRC5A in both OSCC cell lines and clinical samples. GPRC5A stable transfectants and their parental OSCC cells were characterized for their biological activities in anchorage-independent growth. ResultsHigh levels of immunohistochemical GPRC5A expression were detected in normal oral tissue, especially differentiated area. In contrast, GPRC5A expression was dramatically repressed in OSCCs (P<0.01). The immunohistochemical GPRC5A expression was moderately well differentiated, but greatly repressed in moderately differentiated OSCCs and completely repressed in poorly differentiated OSCCs. Overexpression of GPRC5A in OSCC CAL27 cells resulted in a suppressed anchorage-independent growth activity, a transforming phenotype. ConclusionsGPRC5A is expressed in normal oral epithelium. Repression of GPRC5A is associated with poorly differential grade of OSCCs. Overexpression of GPRC5A in OSCC cell line reversed the malignant phenotype. Thus, GPRC5A is important for homeostasis in oral tissue, and deletion or repression of this gene may involve in tumorigenesis of OSCCs and may serve as a prognostic marker for malignant type of OSCCs.
    Journal of Oral Pathology and Medicine 05/2013; 42(10). DOI:10.1111/jop.12077 · 1.87 Impact Factor
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    ABSTRACT: Induction chemotherapy is likely to be effective for biologically distinct subgroups of cancer patients with biomarker detection. In order to investigate the prognostic and predictive values of cyclin D1 expression in patients with oral squamous cell carcinoma(OSCC) who were treated in a prospective, randomized, phase 3 trial evaluating standard treatment with surgery and post-operative radiotherapy preceded or not by induction docetaxel, cisplatin and 5-fluorouracil(TPF). Immunohistochemical staining for cyclin D1 was performed in pretreatment biopsy specimens of 232 out of 256 clinical stage III/IVA OSCC patients randomized to the clinical trial. Cyclin D1 index was estimated as the proportion of tumor cells with cyclin D1 nuclear staining. A low cyclin D1 expression predicted significantly better overall survival(P=0.001), disease-free survival(P=0.005), locoregional recurrence-free survival(P=0.003) and distant metastasis-free survival(P=0.002) compared to high cyclin D1 expression. Cyclin D1 expression levels were not predictive of benefit from induction TPF in the population overall. However, patients with nodal stage cN2 whose tumors had high cyclin D1 expression treated with TPF had significantly greater overall survival(P=0.025) and distant metastasis-free survival(P=0.025) when compared to high cyclin D1 cN2 patients treated with surgery upfront. Patients with low cyclin D1 level or patients with cN0 or cN1 disease did not benefit from induction chemotherapy. This study indicates that cN2 OSCC patients with high cyclin D1 expression can benefit from the addition of TPF induction chemotherapy to standard treatment. Cyclin D1 expression could be used as a biomarker in further validation studies to select cN2 patients that could benefit from induction therapy.
    Molecular Cancer Therapeutics 03/2013; 12(6). DOI:10.1158/1535-7163.MCT-12-1013 · 5.60 Impact Factor
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    ABSTRACT: BACKGROUND: Induction chemotherapy has been investigated as a possible strategy to shrink or downstage locally advanced head and neck cancers, providing opportunity to remove the lesions completely after induction chemotherapy, especially in the patients with resectable advanced disease. The aim of this study was to investigate the definitive effect of induction chemotherapy in patients with resectable head and neck squamous cell carcinoma. METHODS: A meta-analysis of randomized trials (1965--2011) was performed on the impact of induction chemotherapy on survival, disease control, and toxicity in this population of patients. Kaplan-Meier curves were read by Engauge-Digitizer. Data combining was performed using RevMan. RESULTS: Fourteen trials (2099 patients) were involved in this analysis. There was no significant difference on overall survival, disease free survival, or locoregional recurrence between the patients treated with and without induction chemotherapy (P >0.05). However, the patients treated with induction chemotherapy had a lower rate of distant metastasis by 8% (95% confidence interval 1%--16%, P = 0.02) than those treated without induction chemotherapy. In patients with laryngeal cancer, comparing to radical surgery, the larynx could be preserved in responders to induction chemotherapy without survival decease (P >0.05). Induction chemotherapy-associated death was 0%--5%. CONCLUSIONS: Based on the results above, there is a significant benefit of induction chemotherapy on decreasing distant metastasis in patients with resectable head and neck squamous cell carcinoma. In patients with laryngeal cancer, induction chemotherapy provides larynx preservation in responders to induction chemotherapy.
    World Journal of Surgical Oncology 03/2013; 11(1):67. DOI:10.1186/1477-7819-11-67 · 1.20 Impact Factor
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    ABSTRACT: OBJECTIVES: Functional role of Annexin A1 in tumorigenesis is poorly understood. The aim of this study was to investigate the relationship between Annexin A1 protein expression and pathological differentiation grade in biopsy samples from a large cohort of patients with oral squamous cell carcinoma (OSCC); and to evaluate the potential role of Annexin A1 on cell proliferation and tumorigenesis of OSCC. MATERIALS AND METHODS: We investigated the relationship between Annexin A1 expression by immunohistochemical staining and pathological differentiation grade of biopsy samples from 232 OSCC patients, and the relationship between Annexin A1 expression and cell proliferation as well as tumor formation using both in vitro and in vivo OSCC models. RESULTS: Annexin A1 expression correlated significantly with pathological differentiation grade in OSCC patients, a lower Annexin A1 expression correlating with a poorer differentiation grade. Forced Annexin A1 overexpression in OSCC cell lines, CAL27 and Tca8113, significantly reduced the cell proliferation whereas down-regulation of Annexin A1 expression in OSCC cell line, HB96, significantly increased proliferation of HB96 cells. Tumors formed from CAL27 cells overexpressing Annexin A1 grown significantly slower compared to the parental CAL27 cells in nude mice and showed a significantly reduced nuclear Ki-67 labeling index. Interestingly, these tumors also showed a well differentiated histology pattern whereas the tumors formed from the parental cells were consistently moderately differentiated. CONCLUSIONS: These data support a significant correlation between Annexin A1 expression and pathological differentiation grade, and a functional role of Annexin A1 in inhibiting cell proliferation and cell differentiation in OSCC.
    Oral Oncology 02/2013; DOI:10.1016/j.oraloncology.2013.01.002 · 3.03 Impact Factor
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    ABSTRACT: Osteoarthritis (OA) is a slow progressing degenerative disease that affects the joints, including the temporomandibular joint. In the present study, transforming growth factor-β1 (TGF-β1) and matrix metalloproteinase 3 (MMP-3) in synovial fluid (SF) were examined in detecting cartilage synthesis and degradation in progression of temporomandibular joint osteoarthritis (TMJ OA) combined with disc displacement (DD) diseases. SF was obtained from 16 patients with TMJ OA combined with DD and 10 normal volunteers. TGF-β1 and MMP-3 levels were measured by enzyme-linked immunosorbent assay. In addition, TMJ OA combined with DD was classified into three stages based on radiographic signs on the preoperative tomograms and surgical findings at operation, and different treatment options were administered according to the stages. SF from TMJs with TMJ OA combined with DD showed higher levels of TGF-β1 and MMP-3 compared with the asymptomatic control TMJs. With the progression of TMJ OA combined with DD, TGF-β1 levels in SF were lower, while MMP-3 levels in SF were significantly higher. In conclusion, these data suggest that MMP-3 is not only involved in the pathological destruction process of TMJ OA combined with DD initially, but also has a positive correlation with the degree of pathological changes. Furthermore, a significant increase of TGF-β1 levels was found in the SF that were able to counteract the deleterious effects of MMP-3 at the early stage of TMJ OA combined DD, providing the scientific basis on repositioning displaced disc as early as possible for these patients.
    01/2013; 1(2):218-222. DOI:10.3892/br.2012.41
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    ABSTRACT: PURPOSETo evaluate induction chemotherapy with docetaxel, cisplatin, and fluorouracil (TPF) followed by surgery and postoperative radiotherapy versus up-front surgery and postoperative radiotherapy in patients with locally advanced resectable oral squamous cell carcinoma (OSCC). PATIENTS AND METHODSA prospective open-label phase III trial was conducted. Eligibility criteria included untreated stage III or IVA locally advanced resectable OSCC. Patients received two cycles of TPF induction chemotherapy (docetaxel 75 mg/m(2) on day 1, cisplatin 75 mg/m(2) on day 1, and fluorouracil 750 mg/m(2) on days 1 to 5) followed by radical surgery and postoperative radiotherapy (54 to 66 Gy) versus up-front radical surgery and postoperative radiotherapy. The primary end point was overall survival (OS). Secondary end points included local control and safety.ResultsOf the 256 patients enrolled onto this trial, 222 completed the full treatment protocol. There were no unexpected toxicities, and induction chemotherapy did not increase perioperative morbidity. The clinical response rate to induction chemotherapy was 80.6%. After a median follow-up of 30 months, there was no significant difference in OS (hazard ratio [HR], 0.977; 95% CI, 0.634 to 1.507; P = .918) or disease-free survival (HR, 0.974; 95% CI, 0.654 to 1.45; P = .897) between patients treated with and without TPF induction. Patients in the induction chemotherapy arm with a clinical response or favorable pathologic response (≤ 10% viable tumor cells) had superior OS and locoregional and distant control. CONCLUSION Our study failed to demonstrate that TPF induction chemotherapy improves survival compared with up-front surgery in patients with resectable stage III or IVA OSCC.
    Journal of Clinical Oncology 11/2012; 31(6). DOI:10.1200/JCO.2012.43.8820 · 17.88 Impact Factor
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    ABSTRACT: OBJECTIVE: The aim of this study was to analyze the clinical management of hamartomas in the head and neck region (HNH). STUDY DESIGN: From January 1996 to December 2011, a retrospective analysis of 194 patients with HNH was performed. The preoperative examinations, surgical treatment, and prognosis were recorded and analyzed. RESULTS: Of the 194 patients, 107 were male and 87 female. Their ages ranged from 1 month to 82 years with a mean of 33 years. The most common locations were the oral mucosa (68.6%) and head and neck skin (27.3%). The course of disease ranged from 1 to 264 months with a mean of 66 months. Routine laboratory examinations were within normal limits. All patients underwent surgical removal of the lesions and prognosis was good. CONCLUSIONS: The clinical characteristics of HNH are not specific, and the clinical manifestation is always the same for benign tumors. The first choice of treatment is surgical excision, which results in a good prognosis.
    08/2012; 115(3). DOI:10.1016/j.oooo.2012.03.034
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    ABSTRACT: The definitive effect of induction chemotherapy (IC) on locally advanced head and neck squamous cell carcinoma (HNSCC) remains uncertain and although randomized controlled trials are supposed to provide high levels evidence for clinical guidelines, the data thus far has been conflicted. In an effort to elucidate the potential benefit of IC, a meta-analysis of randomized controlled trials (1965-2011) was performed investigating the impact of IC on survival, locoregional control, distant metastasis, and toxicity in HNSCC. Kaplan-Meier curves were read by a digitizing software-Engauge Digitizer. Data combination was performed using the software-RevMan and trial level log hazard ratio (HR) and variance were pooled and presented. Among the 40 eligible trials, 28 trials encompassing 4189 patients receiving locoregional treatment with or without IC were included in the analysis. The cumulative benefit of IC on overall survival and distant metastasis was 6% (HR=0.94, 95%CI=0.87-1.01, P=0.11) and 7% (95%CI=0-13%, P=0.05) respectively while for locoregional control a benefit was not observed as seen by the -2% (95%CI=-11% to 8%, P=0.73) improved control rate. In a subsite analysis specifically for laryngeal preservation, IC did not significantly improve survival (P=0.47). There was a significant benefit from the cisplatin and 5-fluorouracil (PF) protocols with an increase in overall survival of 13% (HR=0.87, 95%CI=0.78-0.97, P=0.01), and a reduction in the 5-year distant metastasis rate of 11% (95%CI=0-21%, P=0.04). The occurrence of grade 3/4 mucositis, leukopenia and emesis was significantly lower in patients receiving IC compared to patients receiving concomitant chemoradiotherapy. In conclusion, there is not a significant benefit of the pooled IC regimens in HNSCC on survival or locoregional control. In contrast, IC does show significant benefit in the reduction of distant metastasis. When protocols using a PF regimen are analyzed independently, a significant improvement in survival and rate of distant metastases is observed while there is not a benefit in locoregional control. The routine use of IC is still debatable. IC could be applied on larynx preservation strategy.
    Oral Oncology 07/2012; 48(11):1076-84. DOI:10.1016/j.oraloncology.2012.06.014 · 3.03 Impact Factor

Publication Stats

503 Citations
160.54 Total Impact Points


  • 2008–2015
    • Shanghai Jiao Tong University
      • • Department of Oral and Maxillofacial Surgery
      • • School of Medicine
      Shanghai, Shanghai Shi, China
  • 2009–2013
    • Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
      Shanghai, Shanghai Shi, China
  • 2010
    • Shanghai Putuo District People's Hospital
      Shanghai, Shanghai Shi, China
  • 2006
    • Qingdao University
      • Department of Oral and Maxillofacial Surgery
      Tsingtao, Shandong Sheng, China
  • 2005–2006
    • Shanghai University
      Shanghai, Shanghai Shi, China
    • University of Florida
      Gainesville, Florida, United States
    • Xiangya Hospital of Central South University
      Ch’ang-sha-shih, Hunan, China
  • 2002–2005
    • Second Military Medical University, Shanghai
      Shanghai, Shanghai Shi, China
  • 2004
    • West China Hospital of Stomatology
      Hua-yang, Sichuan, China
  • 2003
    • Fudan University
      Shanghai, Shanghai Shi, China