Over the past years, more cases using buccal mucosa for urethral reconstruction have been reported.(1-4) The excellent early results with this tissue led some authors to extend their indications for its use. However, ...Over the past years, more cases using buccal mucosa for urethral reconstruction have been reported.(1-4) The excellent early results with this tissue led some authors to extend their indications for its use. However, patients with complex, long-segment urethral strictures and significant scar tissue formation after the failure of previous urethroplasty, still present an operative challenge. The buccal mucosa may not be useful for the treatment of the complicated lengthy urethral strictures because of limited material. To explore the possibility of urethral reconstruction with a graft of colonic mucosa for the treatment of complicated lengthy strictures, we investigated the use of colonic mucosa as a novel substitute for urethral reconstruction in dogs with severe lengthy urethral structure.(5,6) The objects of the present study were to investigate further whether the colonic mucosal graft is an ideal substitute material, for urethral reconstruction, in place of buccal mucosal graft and their pathological characteristic after long-term exposure to urine.展开更多
Aim： To report the experience with single stage dorsal inlay buccal mucosal grafts using the Snodgrass technique for complex redo cases. Methods： From May 2004 to December 2005, a total of 53 patients aged from 3 to...Aim： To report the experience with single stage dorsal inlay buccal mucosal grafts using the Snodgrass technique for complex redo cases. Methods： From May 2004 to December 2005, a total of 53 patients aged from 3 to 34 years old （average 11.62 ± 7.18 years） with failed previous hypospadias surgery were included in the present study. Indications included urethral strictures and repair breakdown. The unhealthy urethra was unroofed from the meatus in the ventral midline, a buccal mucosal graft was inlayed between the incised urethral plate and fixed to the corpora cavernosa. The neourethra was tubularized, and covered with subcutaneous （dartos） tissue and penile skin. Glanuloplasty was also performed in all cases. Outcome analysis included clinical follow-up, and endoscopy in 2 selected cases. Results： The buccal mucosal graft was 3.0-7.5 cm in length and 0.7-2.0 cm in width. All patients required glanuloplasty, with buccal mucosal grafts extended to the tip of the glans. After a follow-up of 14-30 months （mean 22.6 months）, the total complication rate was 15.1%, with five cases of fistula and three cases of stricture. Conclusion： Inlaying dorsal buccal mucosal grafts applying the Snodgrass technique is a reliable method for creating a substitute urethral plate for tubularization. The recurrent rate of urethral stricture and fistula is at an acceptable level for redo cases. This approach represents an effective, simple and safe option for reoperations.展开更多
Aim To investigate the role of the Chinese herbal medicine Xianhuayin on the reversal of 7,12-dimethylbenz[a]anthracene （DMBA）-induced premalignant mucosal lesions in the oral buccal pouch of golden hamsters. Method...Aim To investigate the role of the Chinese herbal medicine Xianhuayin on the reversal of 7,12-dimethylbenz[a]anthracene （DMBA）-induced premalignant mucosal lesions in the oral buccal pouch of golden hamsters. Methodology The animals were randomly divided into a non-diseased control group （n=5） and an experimental group including 50 animals in which the buccal mucosa had been painted with DMBA （0.5% in acetone） to generate an oral mucosa premalignant lesion. Animals in the experi- mental group were further divided into Xianhuayin-treated group （n=30）, untreated prem＇alignant lesion group （n=10） and normal saline （NS）-treated group （n=10）. The cheek （buccal） pouch mucosa of the golden hamsters in each group was observed with light and electron microscopy eight weeks after intragastric administration with NS or Xianhuayin. Results In the non-diseased control group, the buccal mucosa was keratinized and stratified squamous epithelium under a light microscope. In the untreated premalignant lesion group, variable degrees of epithelial dysplasia was observed. The irregular epithelial mucosa gradually became distinct in the Xianhuayin-treated group. Scanning electronic microscopic （SEM） analysis showed that surface of the cells exhibited honeycomb structures in the hamster of untreated- group. The cells were morphologically irregular, overlapped and loosened in the untreated premalignant lesion group. Most of the cell surface exhibited honeycomb structure in the Xianhuayin-treated group. Transmission electronic micro- scopic （TEM） analysis showed that buccal mucosal epithelial cells were morphologically regular in the non-diseased control group. Desmosomes and tonofibrils were reduced and the nucleus was morphologically irregular in the untreated premalignant lesion group. In the Xianhuayin-treated group, the widening intercellular gap was gradually reduced, desmosomes and the cells becoming morphologically regular. No significant difference was observed between the hamsters in N展开更多
Objective： To investigate the analgesic time-effect characteristics and changes in concentrations of rabbit＇s hypothalamic 5-hydroxytryptamine （5-HT） and noradrenaline （NE） caused by buccal acupuncture in the rh...Objective： To investigate the analgesic time-effect characteristics and changes in concentrations of rabbit＇s hypothalamic 5-hydroxytryptamine （5-HT） and noradrenaline （NE） caused by buccal acupuncture in the rheumatoid arthritis （RA） rabbits, and to reveal the analgesic central mechanism of buccal acupuncture, thereby providing a theoretical basis for the treatment of pain by buccal acupuncture. Methods： Forty rabbits were randomly divided into a normal group, a model group, a body acupuncture group, and a buccal acupuncture group, with 10 rabbits in each group. No model was established in the normal group, while equal dose of normal saline was injected at the matched site and time point; rabbits in other groups were subjected to the establishment of RA models using egg protein. From the 27th day of the experiment, rabbits in each group received the designated intervention. Rabbits in the normal group and the model group were fixed for 30 min every day using the same method as those in the other groups. In the acupuncture group, Dubi （ST 35） and Zusanli （ST 36） on bilateral hind limbs were selected. Perpendicular needling （using the needles with 0.25 mm in diameter and 25 mm in length） was performed with twirling manipulation for 15 s at intervals of 5 min. The needles were retained for 30 min and acupuncture was performed once a day. In the buccal acupuncture group, the knee point in the buccal acupuncture and needles with a diameter of 0.25 mm and a length of 15 mm were selected. Oblique needling was performed with twirling manipulation for 15 s at intervals of 5 min. The needles were retained for 30 min and acupuncture was performed once a day. The thermal pain thresholds at the O, 5, 15, 30, 60, 120 and 240 rain after the 1st and 10th acupuncture therapy were measured with a PL-200 thermal-inducing pain meter. After the 10th acupuncture therapy, rabbit＇s hypothalamus was removed, and the 5-HT and NE concentrations in the hypothalamus at the peak point of the acupuncture pain t展开更多
Objective： To observe the clinical efficacy of buccal acupuncture plus exercise therapy in treating scapulohumera periarthritis （SP）. Methods： Sixty-three SP patients were intervened by bucca once every day, 5 ses...Objective： To observe the clinical efficacy of buccal acupuncture plus exercise therapy in treating scapulohumera periarthritis （SP）. Methods： Sixty-three SP patients were intervened by bucca once every day, 5 sessions as a course, with a 2-3 d interval after 3 courses of treatment. acupuncture plus exercise therapy. The treatment was given between two courses. The therapeutic efficacy was observed Results： Thirty-five patients were recovered, 23 cases were improved, while 5 cases showed ineffective, and the total effective rate was 92.2%. Conclusion： Buccal acupuncture plus exercise therapy can produce a significant efficacy in treating SP, and thus is worth promotion in clinic.展开更多
Anterior urethral strictures, where the length is more kthan 2 cm, are best treated by substitution urethroplasty with either preputial/penile skin flaps or free grafts.1 The use of dartos pedicled flaps has many adva...Anterior urethral strictures, where the length is more kthan 2 cm, are best treated by substitution urethroplasty with either preputial/penile skin flaps or free grafts.1 The use of dartos pedicled flaps has many advantages in terms of increased survival thanks to its own vascularization. Recently, buccal mucosa has become increasingly popular among urologists for urethral replacement when local penile skin is unavailable. Both penile skin flaps and buccal mucosa grafts have emerged as reliable urethral substitutes with comparable long-term results. These urethral substitutes are traditionally placed on the ventral aspect of the stricture and have a success rate of about 85%.展开更多
Objective: To evaluate the usefulness of supraclavicular artery flap in reconstruc-tion of defects following resection of buccal mucosa cancer. Methods: Twenty-five patients who presented to R.L Jalappa Hospital and R...Objective: To evaluate the usefulness of supraclavicular artery flap in reconstruc-tion of defects following resection of buccal mucosa cancer. Methods: Twenty-five patients who presented to R.L Jalappa Hospital and Research centre and diagnosed as squamous cell carcinoma of buccal mucosa staged T2 and above were included in our study. All patients underwent wide excision of tumour and neck dissection. Six patients un-derwent hemi-mandibulectomy while 4 patients underwent marginal mandibulectomy depend-ing on extent of the tumour along with neck dissection. The defect following surgery was reconstructed using the supraclavicular artery flap and were followed up for minimum 6 months during which they were assessed for the functional and aesthetic outcome using a scoring system. The details of the scoring system comprised of 7 attributes. Each attribute was given a score of 10 if the patients experienced that attribute, while a score of 0 was given if the patient did not experience that particular attribute. Results: Seven (28％) patients had complete necrosis of the flap. One patient had a local recur-rence 2 months following surgery and was lost to follow up. The remaining 17 patients were followed up for a minimum of 6 months and a scoring system was adopted to evaluate the func-tional and aesthetic outcome of the supraclavicular flap. We observed that 14 patients had an excellent outcome score (58％), 3 patients had a good outcome score (13％), while 7 patients (28％) had flap necrosis.Conclusions: We find the supraclavicular flap to be safe, technically simple, sensate, thin, pliable and reliable regional fasciocutaneous flap in reconstructing intra oral defects. Preser-ving the external jugular vein and sacrificing supraclavicular nerves give good outcome.展开更多
Objective:To achieve transbuccal release of carbamazepine by loading in unidirectional release mucoadhesive buccal patches.Methods:Buccal patches of carbamazepine with unidirectional drug release were prepared using h...Objective:To achieve transbuccal release of carbamazepine by loading in unidirectional release mucoadhesive buccal patches.Methods:Buccal patches of carbamazepine with unidirectional drug release were prepared using hydroxypropyl methyl cellulose,polyvinyl alcohol,polyvinyl pyrrolidone and ethyl cellulose by solvent casting method.Water impermeable backing layer(Pidilite?Biaxially-oriented polypropylene film)of patches provided unidirectional drug release.They were evaluated for thickness,mass uniformity,surface pH and folding endurance.Six formulations FA2,FA8,FA10,FBI,FB14 and FB16(folding endurance above 250)were evaluated further for swelling studies,ex vivo mucoadhesive strength,ex vivo mucoadhesion time,in vitro drug release,ex vivo permeation,accelerated stability studies and FTIR and XRD spectral studies.Results:The ex vivo mucoadhesion time of patches ranged between 109 min(FA10)to 126 min(FB14).The ex vivo mucoadhesive force was in the range of 0.278 lo 0.479 kg/m/s.The in vitro drug release studies revealed that formulation FA8 released 84%and FB16 released 99.01%of drug in140 min.Conclusions:The prepared unidirectional buccal patches of carbamazepine provided a maximum drug release within specified mucoadhesion period and it indicates a potential alternative drug delivery system for systemic denvery of carbamazepine.展开更多
ObjectiveFemale urethral stricture (FUS) accounts for about 4%–13% of cases of female bladder outlet obstruction. FUS was and is still managed by repeated dilatations and/or direct visual internal urethrotomy. There ...ObjectiveFemale urethral stricture (FUS) accounts for about 4%–13% of cases of female bladder outlet obstruction. FUS was and is still managed by repeated dilatations and/or direct visual internal urethrotomy. There are many alternative options for reconstruction like buccal or vaginal mucosal graft urethroplasty. Our aim was to describe the technique of dorsal onlay buccal mucosal graft (BMG) urethroplasty for FUS and present the outcomes.MethodsBetween January 2014 and December 2021, 37 patients who underwent dorsal onlay BMG urethroplasty were included in the study. Their pre-operative diagnosis was confirmed with uroflowmetry, micturating cystourethrogram, urethral calibration, and on table cystoscopy. Bladder catheter was removed after 2 weeks. Patients were followed up at 3 months, 6 months, 1 year, and then annually with urine analysis, uroflowmetry, and post-void residual assessment. We defined success as a maximum flow rate (Q_(max)) above 15 mL/s without the need for an additional instrumentation.ResultsThe mean age of patients was 47.8 (standard deviation [SD] 11.3) years. Twenty patients had previously undergone urethral dilatations. The mean pre-operative Q_(max) was 7.79 (SD 3.73) mL/s. However, the mean Q_(max) improved to 23.20 (SD 8.25) mL/s after surgery. The mean post-void residual urine after surgery was 30.50 (SD 10.70) mL. This reduced from a mean value of 139.00 (SD 147.24) mL before surgery. The mean follow-up was 30.2 (SD 18.3, range 18–44) months. There was no post-operative incontinence. There were Clavien–Dindo Grade 1 complications in 6 out of 37 (16.2 %) patients during hospital stay. The only long-term complication was recurrence of stricture in 4 (10.8%) patients.ConclusionDorsal onlay BMG urethroplasty in females is a safe, effective technique which can avoid repeated painful dilatations and multiple urethrotomies. One should always consider reconstruction in FUS without any fear of incontinence.展开更多
OBJECTIVE:To explore the short-term and long-term efficacy of buccal acupuncture therapy in the treatment of patients with primary dysmenorrhea(PD).METHODS:A total of 90 patients with PD who were admitted to the Secon...OBJECTIVE:To explore the short-term and long-term efficacy of buccal acupuncture therapy in the treatment of patients with primary dysmenorrhea(PD).METHODS:A total of 90 patients with PD who were admitted to the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from January 2020 to December 2021 were included in this study and randomly divided into three groups,including the observation group,the control group,and the placebo group,with 30 patients in each group.Patients in the observation group were treated according to the syndrome types of Traditional Chinese Medicine,those in the control group were treated with Saridon,and those in the placebo group received a placebo.The visual analog scale(VAS)scores of these patients were evaluated at different time points(before treatment,5 min after needle retention,30 min after needle retention,1 h after treatment,2 h after treatment,1 d after treatment,and 2 d after treatment).The Cox Menstrual Symptom Scale(CMSS)scores were assessed before the treatment and after three courses of treatment.Besides,these two scales were also evaluated during follow-up.Moreover,the pain score and adverse reactions of these patients were assessed during treatment.RESULTS:After treatment,the VAS and CMSS scores in the observation group decreased significantly(P<0.05)5 and 30 min after needle retention and after treatment.CONCLUSION:Buccal acupuncture therapy is verified to have short-term efficacy in the treatment of PD.In addition,this therapy has an immediate analgesic effect and long-term efficacy in reducing the severity and frequency of PD.展开更多
Objective To investigate the effects of buccal acupuncture on analgesia,immune indicators,and expression levels of Survivin and Livin proteins in patients with advanced-stage primary liver cancer.Methods Eighty patien...Objective To investigate the effects of buccal acupuncture on analgesia,immune indicators,and expression levels of Survivin and Livin proteins in patients with advanced-stage primary liver cancer.Methods Eighty patients with advanced-stage primary liver cancer were selected and divided into control and treatment groups according to the difference in treatment modalities,with 40 patients in each group.The control group received transcatheter arterial chemoembolization(TACE),and the treatment group received buccal acupuncture in addition to TACE.The recent efficacy,analgesic effect,liver function,serum tumor markers,Survivin and Livin protein expression levels in liver cancer tissue,and immune indexes were analyzed and compared between the two groups.Results The objective response rate(ORR)and disease control rate(DCR)of the treatment group were 37.5%and 77.5%,respectively,which were significantly higher than those of the control group(22.5%and 52.5%),and the recent efficacy of the treatment group was significantly better than that of the control group(P<0.05).The onset of analgesia in the treatment group was significantly faster than that in the control group(P<0.05),the duration of analgesia was significantly longer than that in the control group(P<0.05),and the numeric rating scale(NRS)score of pain after treatment was significantly lower than that in the control group(P<0.05).In the treatment group,the aspartate aminotransferase(AST),alanine aminotransferase(ALT),and albumin/globulin(A/G)were significantly lower than those in the control group(P<0.05),and the serum levels of alpha-fetoprotein(AFP),alpha-L-fucosidase(AFU),and carcinoembryonic antigen(CEA)were significantly lower than those in the control group(P<0.05),and the expression levels of Survivin and Livin in liver cancer tissue were significantly lower than those in the control group(P<0.05);CD4^(+)and CD4^(+)/CD8+in the treatment group were significantly higher than those in the control group,and CD8+was significantly lower than that in the control gr展开更多
Objective:Secondary pyeloplasty for recurrent ureteropelvic junction obstructions may be a safe and feasible surgical option for patients.This study aimed to demonstrate outcomes of utilizing a non-transecting buccal ...Objective:Secondary pyeloplasty for recurrent ureteropelvic junction obstructions may be a safe and feasible surgical option for patients.This study aimed to demonstrate outcomes of utilizing a non-transecting buccal mucosa graft ureteroplasty for management of recurrent ureteropelvic junction obstruction after prior failed pyeloplasty.Methods:We performed a retrospective review of our Collaborative of Reconstructive Robotic Ureteral Surgery database for all consecutive patients who underwent buccal mucosa graft ureteroplasty between April 2012 and June 2022 for management of recurrent ureteropelvic junction obstructions after prior failed pyeloplasty.The primary outcome included surgical success which was defined as the absence of flank pain and no obstruction on imaging.Results:Overall,ten patients were included in our analysis.The median stricture length was 2.5(interquartile range[IQR]1.8-4.0)cm.The median operative time was 230.5(IQR 199.5-287.0)min and median estimated blood loss was 50.0(IQR 28.8-102.5)mL.At a median follow-up of 10.3(IQR 6.2-14.8)months,80%of patients were surgically successful and there were no major(ClavieneDindo Grade>2)complications.Conclusion:Buccal mucosa graft ureteroplasty is a valuable non-transecting surgical option for patients with recurrent ureteropelvic junction obstructions who failed prior pyeloplasty and has comparable outcomes to the literature regarding standard transecting techniques.展开更多
The aims of this study were to prepare and characterize hydroxypropyl methylcellulose(HPMC)/polycarbophil(PC) mucoadhesive blend films saturated with propranolol hydrochloride(PNL)-loaded nanoparticles to improve perm...The aims of this study were to prepare and characterize hydroxypropyl methylcellulose(HPMC)/polycarbophil(PC) mucoadhesive blend films saturated with propranolol hydrochloride(PNL)-loaded nanoparticles to improve permeability of drugs that undergo firstpass metabolism. An ionic cross-linking method and film casting technique was used to prepare nanoparticles and mucoadhesive blend films, respectively. Increasing concentrations of PNL(70, 80, 90 mg/film) in HPMC/PC blend films containing PNL-loaded nanoparticles(PN-films) and HPMC/PC blend films containing PNL(80 mg/film) without nanoparticles(PPfilms) were prepared to test swelling, mucoadhesiveness, release, permeation and physicochemical properties. Scanning electron microscope(SEM) images showed a partially smooth surface with a wrinkled occurrence and spherically shaped, well-dispersed nanoparticles on the surface of PN-films containing PNL 80 mg/film(PN-films-80). The size of the nanoparticles on the surface of PN-films-80 was around 100 nm, which was similar to the nanoparticle size observed using light scattering technique. The swelling index(SI)of all PN-films and PP-films increased greatly in the first period time(10–20 min) and reached swelling equilibrium at 20 min and 30 min, respectively. For the PN-films, the concentration of PNL influenced the mucoadhesive properties and tended to be higher when the amount of PNL increased. Immediate release of all blend film formulations was found in early time points(10–30 min). After 120 min, the release of PN-films-70 was lower than the other PNfilms. Permeation studies using porcine buccal mucosa showed that inclusion of nanoparticles in the films increased the permeability of PNL compared to PP-films. Therefore, buccal administration of mucoadhesive blend films containing PNL-loaded nanoparticles could be a promising approach for drugs that undergo first-pass metabolism.展开更多
Extraction of the first molar or premolar is the commonest cause of oro-antral fistula. Management involves identification of the same, removal of any foreign body from the maxillary sinus, if present, followed by app...Extraction of the first molar or premolar is the commonest cause of oro-antral fistula. Management involves identification of the same, removal of any foreign body from the maxillary sinus, if present, followed by appropriate flap for closer. A case is presented when a gutta percha (GP) point was accidentally dislodged into the right maxillary sinus during preliminary diagnosis of the oro-antral fistula. The surgical management of the case is described and is the appropriate treatment plan.展开更多
Mucoadhesion can be defined as a state in which two components, of which one is of biological origin, are held together for extended periods of time by the help of interfacial forces. Among the various transmucosal ro...Mucoadhesion can be defined as a state in which two components, of which one is of biological origin, are held together for extended periods of time by the help of interfacial forces. Among the various transmucosal routes, buccal mucosa has excellent accessibility and relatively immobile mucosa, hence suitable for administration of retentive dosage form. The objective of this paper is to review the works done so far in the field of mucoadhe- sire buccal drug delivery systems （MBDDS）, with a clinical perspective. Starting with a brief introduction of the mucoadhesive drug delivery systems, oral mucosa, and the theories of mucoadhesion, this article then proceeds to cover the works done so far in the field of MBDDS, categorizing them on the basis of ailments they are meant to cure. Additionally, we focus on the various patents, recent advancements, and challenges as well as the future prospects for mucoadhesive buccal drug delivery systems.展开更多
Introduction: The presence of a recurrent proximal penile hypospadius represents a surgical challenge to the urologist due to the presence of excessive scarring and fibrosis of the tissues. This problem is more pronou...Introduction: The presence of a recurrent proximal penile hypospadius represents a surgical challenge to the urologist due to the presence of excessive scarring and fibrosis of the tissues. This problem is more pronounced in circumcised patients, in whom there is no enough skin for one stage procedures. Buccal mucosal grafts represent a good surgical option. The aim of this study was to evaluate the results of two stages buccal mucosal urethroplasty in pediatric & adolescent patients, presenting with recurrent proximal penile hypospadias who are circumcised. Methods: Thirty seven pediatric & adolescent patients underwent two stages buccal mucosal urethroplasty for recurrent proximal penile hypospadius. In all cases the buccal graft was placed dorsally followed by the second stage closure after 6 months. Results: The mean age was 17.7 (14-20) years. With a mean follow-up of 28.3 months, 33 patients (89.2%) had a final successful outcome. Of the 4 cases that were considered as failure, 3 patients (8.1%) developed urethra-cutaneous fistula that required closure after 3 months. The remaining patient developed meatal stenosis. Conclusion: Although buccal mucosal urethroplasty is a two staged procedure, it is feasible option for pediatric & adolescent patients presenting with recurrent proximal penile hypospadius, who had no skin available for penile flaps, with a success rate approaching 89.2%.展开更多
文摘Over the past years, more cases using buccal mucosa for urethral reconstruction have been reported.(1-4) The excellent early results with this tissue led some authors to extend their indications for its use. However, patients with complex, long-segment urethral strictures and significant scar tissue formation after the failure of previous urethroplasty, still present an operative challenge. The buccal mucosa may not be useful for the treatment of the complicated lengthy urethral strictures because of limited material. To explore the possibility of urethral reconstruction with a graft of colonic mucosa for the treatment of complicated lengthy strictures, we investigated the use of colonic mucosa as a novel substitute for urethral reconstruction in dogs with severe lengthy urethral structure.(5,6) The objects of the present study were to investigate further whether the colonic mucosal graft is an ideal substitute material, for urethral reconstruction, in place of buccal mucosal graft and their pathological characteristic after long-term exposure to urine.
文摘Aim： To report the experience with single stage dorsal inlay buccal mucosal grafts using the Snodgrass technique for complex redo cases. Methods： From May 2004 to December 2005, a total of 53 patients aged from 3 to 34 years old （average 11.62 ± 7.18 years） with failed previous hypospadias surgery were included in the present study. Indications included urethral strictures and repair breakdown. The unhealthy urethra was unroofed from the meatus in the ventral midline, a buccal mucosal graft was inlayed between the incised urethral plate and fixed to the corpora cavernosa. The neourethra was tubularized, and covered with subcutaneous （dartos） tissue and penile skin. Glanuloplasty was also performed in all cases. Outcome analysis included clinical follow-up, and endoscopy in 2 selected cases. Results： The buccal mucosal graft was 3.0-7.5 cm in length and 0.7-2.0 cm in width. All patients required glanuloplasty, with buccal mucosal grafts extended to the tip of the glans. After a follow-up of 14-30 months （mean 22.6 months）, the total complication rate was 15.1%, with five cases of fistula and three cases of stricture. Conclusion： Inlaying dorsal buccal mucosal grafts applying the Snodgrass technique is a reliable method for creating a substitute urethral plate for tubularization. The recurrent rate of urethral stricture and fistula is at an acceptable level for redo cases. This approach represents an effective, simple and safe option for reoperations.
基金supported by grants from the highly distinguished Oncology Subject Foundation of Colleges in Hebei Province
文摘Aim To investigate the role of the Chinese herbal medicine Xianhuayin on the reversal of 7,12-dimethylbenz[a]anthracene （DMBA）-induced premalignant mucosal lesions in the oral buccal pouch of golden hamsters. Methodology The animals were randomly divided into a non-diseased control group （n=5） and an experimental group including 50 animals in which the buccal mucosa had been painted with DMBA （0.5% in acetone） to generate an oral mucosa premalignant lesion. Animals in the experi- mental group were further divided into Xianhuayin-treated group （n=30）, untreated prem＇alignant lesion group （n=10） and normal saline （NS）-treated group （n=10）. The cheek （buccal） pouch mucosa of the golden hamsters in each group was observed with light and electron microscopy eight weeks after intragastric administration with NS or Xianhuayin. Results In the non-diseased control group, the buccal mucosa was keratinized and stratified squamous epithelium under a light microscope. In the untreated premalignant lesion group, variable degrees of epithelial dysplasia was observed. The irregular epithelial mucosa gradually became distinct in the Xianhuayin-treated group. Scanning electronic microscopic （SEM） analysis showed that surface of the cells exhibited honeycomb structures in the hamster of untreated- group. The cells were morphologically irregular, overlapped and loosened in the untreated premalignant lesion group. Most of the cell surface exhibited honeycomb structure in the Xianhuayin-treated group. Transmission electronic micro- scopic （TEM） analysis showed that buccal mucosal epithelial cells were morphologically regular in the non-diseased control group. Desmosomes and tonofibrils were reduced and the nucleus was morphologically irregular in the untreated premalignant lesion group. In the Xianhuayin-treated group, the widening intercellular gap was gradually reduced, desmosomes and the cells becoming morphologically regular. No significant difference was observed between the hamsters in N
文摘Objective： To investigate the analgesic time-effect characteristics and changes in concentrations of rabbit＇s hypothalamic 5-hydroxytryptamine （5-HT） and noradrenaline （NE） caused by buccal acupuncture in the rheumatoid arthritis （RA） rabbits, and to reveal the analgesic central mechanism of buccal acupuncture, thereby providing a theoretical basis for the treatment of pain by buccal acupuncture. Methods： Forty rabbits were randomly divided into a normal group, a model group, a body acupuncture group, and a buccal acupuncture group, with 10 rabbits in each group. No model was established in the normal group, while equal dose of normal saline was injected at the matched site and time point; rabbits in other groups were subjected to the establishment of RA models using egg protein. From the 27th day of the experiment, rabbits in each group received the designated intervention. Rabbits in the normal group and the model group were fixed for 30 min every day using the same method as those in the other groups. In the acupuncture group, Dubi （ST 35） and Zusanli （ST 36） on bilateral hind limbs were selected. Perpendicular needling （using the needles with 0.25 mm in diameter and 25 mm in length） was performed with twirling manipulation for 15 s at intervals of 5 min. The needles were retained for 30 min and acupuncture was performed once a day. In the buccal acupuncture group, the knee point in the buccal acupuncture and needles with a diameter of 0.25 mm and a length of 15 mm were selected. Oblique needling was performed with twirling manipulation for 15 s at intervals of 5 min. The needles were retained for 30 min and acupuncture was performed once a day. The thermal pain thresholds at the O, 5, 15, 30, 60, 120 and 240 rain after the 1st and 10th acupuncture therapy were measured with a PL-200 thermal-inducing pain meter. After the 10th acupuncture therapy, rabbit＇s hypothalamus was removed, and the 5-HT and NE concentrations in the hypothalamus at the peak point of the acupuncture pain t
基金supported by National Natural Science Foundation of China(No.81260559)~~
文摘Objective： To observe the clinical efficacy of buccal acupuncture plus exercise therapy in treating scapulohumera periarthritis （SP）. Methods： Sixty-three SP patients were intervened by bucca once every day, 5 sessions as a course, with a 2-3 d interval after 3 courses of treatment. acupuncture plus exercise therapy. The treatment was given between two courses. The therapeutic efficacy was observed Results： Thirty-five patients were recovered, 23 cases were improved, while 5 cases showed ineffective, and the total effective rate was 92.2%. Conclusion： Buccal acupuncture plus exercise therapy can produce a significant efficacy in treating SP, and thus is worth promotion in clinic.
文摘Anterior urethral strictures, where the length is more kthan 2 cm, are best treated by substitution urethroplasty with either preputial/penile skin flaps or free grafts.1 The use of dartos pedicled flaps has many advantages in terms of increased survival thanks to its own vascularization. Recently, buccal mucosa has become increasingly popular among urologists for urethral replacement when local penile skin is unavailable. Both penile skin flaps and buccal mucosa grafts have emerged as reliable urethral substitutes with comparable long-term results. These urethral substitutes are traditionally placed on the ventral aspect of the stricture and have a success rate of about 85%.
文摘Objective: To evaluate the usefulness of supraclavicular artery flap in reconstruc-tion of defects following resection of buccal mucosa cancer. Methods: Twenty-five patients who presented to R.L Jalappa Hospital and Research centre and diagnosed as squamous cell carcinoma of buccal mucosa staged T2 and above were included in our study. All patients underwent wide excision of tumour and neck dissection. Six patients un-derwent hemi-mandibulectomy while 4 patients underwent marginal mandibulectomy depend-ing on extent of the tumour along with neck dissection. The defect following surgery was reconstructed using the supraclavicular artery flap and were followed up for minimum 6 months during which they were assessed for the functional and aesthetic outcome using a scoring system. The details of the scoring system comprised of 7 attributes. Each attribute was given a score of 10 if the patients experienced that attribute, while a score of 0 was given if the patient did not experience that particular attribute. Results: Seven (28％) patients had complete necrosis of the flap. One patient had a local recur-rence 2 months following surgery and was lost to follow up. The remaining 17 patients were followed up for a minimum of 6 months and a scoring system was adopted to evaluate the func-tional and aesthetic outcome of the supraclavicular flap. We observed that 14 patients had an excellent outcome score (58％), 3 patients had a good outcome score (13％), while 7 patients (28％) had flap necrosis.Conclusions: We find the supraclavicular flap to be safe, technically simple, sensate, thin, pliable and reliable regional fasciocutaneous flap in reconstructing intra oral defects. Preser-ving the external jugular vein and sacrificing supraclavicular nerves give good outcome.
基金supported by RR college of Pharmacy affiliated to Rajiv Gandhi University of Health Sciences,Bangalore,India(Grant No.RRCP\PCEUTICS\IHR&D\231)
文摘Objective:To achieve transbuccal release of carbamazepine by loading in unidirectional release mucoadhesive buccal patches.Methods:Buccal patches of carbamazepine with unidirectional drug release were prepared using hydroxypropyl methyl cellulose,polyvinyl alcohol,polyvinyl pyrrolidone and ethyl cellulose by solvent casting method.Water impermeable backing layer(Pidilite?Biaxially-oriented polypropylene film)of patches provided unidirectional drug release.They were evaluated for thickness,mass uniformity,surface pH and folding endurance.Six formulations FA2,FA8,FA10,FBI,FB14 and FB16(folding endurance above 250)were evaluated further for swelling studies,ex vivo mucoadhesive strength,ex vivo mucoadhesion time,in vitro drug release,ex vivo permeation,accelerated stability studies and FTIR and XRD spectral studies.Results:The ex vivo mucoadhesion time of patches ranged between 109 min(FA10)to 126 min(FB14).The ex vivo mucoadhesive force was in the range of 0.278 lo 0.479 kg/m/s.The in vitro drug release studies revealed that formulation FA8 released 84%and FB16 released 99.01%of drug in140 min.Conclusions:The prepared unidirectional buccal patches of carbamazepine provided a maximum drug release within specified mucoadhesion period and it indicates a potential alternative drug delivery system for systemic denvery of carbamazepine.
文摘ObjectiveFemale urethral stricture (FUS) accounts for about 4%–13% of cases of female bladder outlet obstruction. FUS was and is still managed by repeated dilatations and/or direct visual internal urethrotomy. There are many alternative options for reconstruction like buccal or vaginal mucosal graft urethroplasty. Our aim was to describe the technique of dorsal onlay buccal mucosal graft (BMG) urethroplasty for FUS and present the outcomes.MethodsBetween January 2014 and December 2021, 37 patients who underwent dorsal onlay BMG urethroplasty were included in the study. Their pre-operative diagnosis was confirmed with uroflowmetry, micturating cystourethrogram, urethral calibration, and on table cystoscopy. Bladder catheter was removed after 2 weeks. Patients were followed up at 3 months, 6 months, 1 year, and then annually with urine analysis, uroflowmetry, and post-void residual assessment. We defined success as a maximum flow rate (Q_(max)) above 15 mL/s without the need for an additional instrumentation.ResultsThe mean age of patients was 47.8 (standard deviation [SD] 11.3) years. Twenty patients had previously undergone urethral dilatations. The mean pre-operative Q_(max) was 7.79 (SD 3.73) mL/s. However, the mean Q_(max) improved to 23.20 (SD 8.25) mL/s after surgery. The mean post-void residual urine after surgery was 30.50 (SD 10.70) mL. This reduced from a mean value of 139.00 (SD 147.24) mL before surgery. The mean follow-up was 30.2 (SD 18.3, range 18–44) months. There was no post-operative incontinence. There were Clavien–Dindo Grade 1 complications in 6 out of 37 (16.2 %) patients during hospital stay. The only long-term complication was recurrence of stricture in 4 (10.8%) patients.ConclusionDorsal onlay BMG urethroplasty in females is a safe, effective technique which can avoid repeated painful dilatations and multiple urethrotomies. One should always consider reconstruction in FUS without any fear of incontinence.
基金Zhejiang Traditional Chinese Medicine Science and Technology Plan:Mechanism Study and Clinical Application of Cheek Acupuncture in the Treatment of Primary Dysmenorrhea(No.2020ZB113)。
文摘OBJECTIVE:To explore the short-term and long-term efficacy of buccal acupuncture therapy in the treatment of patients with primary dysmenorrhea(PD).METHODS:A total of 90 patients with PD who were admitted to the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from January 2020 to December 2021 were included in this study and randomly divided into three groups,including the observation group,the control group,and the placebo group,with 30 patients in each group.Patients in the observation group were treated according to the syndrome types of Traditional Chinese Medicine,those in the control group were treated with Saridon,and those in the placebo group received a placebo.The visual analog scale(VAS)scores of these patients were evaluated at different time points(before treatment,5 min after needle retention,30 min after needle retention,1 h after treatment,2 h after treatment,1 d after treatment,and 2 d after treatment).The Cox Menstrual Symptom Scale(CMSS)scores were assessed before the treatment and after three courses of treatment.Besides,these two scales were also evaluated during follow-up.Moreover,the pain score and adverse reactions of these patients were assessed during treatment.RESULTS:After treatment,the VAS and CMSS scores in the observation group decreased significantly(P<0.05)5 and 30 min after needle retention and after treatment.CONCLUSION:Buccal acupuncture therapy is verified to have short-term efficacy in the treatment of PD.In addition,this therapy has an immediate analgesic effect and long-term efficacy in reducing the severity and frequency of PD.
文摘Objective To investigate the effects of buccal acupuncture on analgesia,immune indicators,and expression levels of Survivin and Livin proteins in patients with advanced-stage primary liver cancer.Methods Eighty patients with advanced-stage primary liver cancer were selected and divided into control and treatment groups according to the difference in treatment modalities,with 40 patients in each group.The control group received transcatheter arterial chemoembolization(TACE),and the treatment group received buccal acupuncture in addition to TACE.The recent efficacy,analgesic effect,liver function,serum tumor markers,Survivin and Livin protein expression levels in liver cancer tissue,and immune indexes were analyzed and compared between the two groups.Results The objective response rate(ORR)and disease control rate(DCR)of the treatment group were 37.5%and 77.5%,respectively,which were significantly higher than those of the control group(22.5%and 52.5%),and the recent efficacy of the treatment group was significantly better than that of the control group(P<0.05).The onset of analgesia in the treatment group was significantly faster than that in the control group(P<0.05),the duration of analgesia was significantly longer than that in the control group(P<0.05),and the numeric rating scale(NRS)score of pain after treatment was significantly lower than that in the control group(P<0.05).In the treatment group,the aspartate aminotransferase(AST),alanine aminotransferase(ALT),and albumin/globulin(A/G)were significantly lower than those in the control group(P<0.05),and the serum levels of alpha-fetoprotein(AFP),alpha-L-fucosidase(AFU),and carcinoembryonic antigen(CEA)were significantly lower than those in the control group(P<0.05),and the expression levels of Survivin and Livin in liver cancer tissue were significantly lower than those in the control group(P<0.05);CD4^(+)and CD4^(+)/CD8+in the treatment group were significantly higher than those in the control group,and CD8+was significantly lower than that in the control gr
文摘Objective:Secondary pyeloplasty for recurrent ureteropelvic junction obstructions may be a safe and feasible surgical option for patients.This study aimed to demonstrate outcomes of utilizing a non-transecting buccal mucosa graft ureteroplasty for management of recurrent ureteropelvic junction obstruction after prior failed pyeloplasty.Methods:We performed a retrospective review of our Collaborative of Reconstructive Robotic Ureteral Surgery database for all consecutive patients who underwent buccal mucosa graft ureteroplasty between April 2012 and June 2022 for management of recurrent ureteropelvic junction obstructions after prior failed pyeloplasty.The primary outcome included surgical success which was defined as the absence of flank pain and no obstruction on imaging.Results:Overall,ten patients were included in our analysis.The median stricture length was 2.5(interquartile range[IQR]1.8-4.0)cm.The median operative time was 230.5(IQR 199.5-287.0)min and median estimated blood loss was 50.0(IQR 28.8-102.5)mL.At a median follow-up of 10.3(IQR 6.2-14.8)months,80%of patients were surgically successful and there were no major(ClavieneDindo Grade>2)complications.Conclusion:Buccal mucosa graft ureteroplasty is a valuable non-transecting surgical option for patients with recurrent ureteropelvic junction obstructions who failed prior pyeloplasty and has comparable outcomes to the literature regarding standard transecting techniques.
基金the financial support provided by Thammasat University under the TU Research Scholar,Contract No.TP 2/68/2556
文摘The aims of this study were to prepare and characterize hydroxypropyl methylcellulose(HPMC)/polycarbophil(PC) mucoadhesive blend films saturated with propranolol hydrochloride(PNL)-loaded nanoparticles to improve permeability of drugs that undergo firstpass metabolism. An ionic cross-linking method and film casting technique was used to prepare nanoparticles and mucoadhesive blend films, respectively. Increasing concentrations of PNL(70, 80, 90 mg/film) in HPMC/PC blend films containing PNL-loaded nanoparticles(PN-films) and HPMC/PC blend films containing PNL(80 mg/film) without nanoparticles(PPfilms) were prepared to test swelling, mucoadhesiveness, release, permeation and physicochemical properties. Scanning electron microscope(SEM) images showed a partially smooth surface with a wrinkled occurrence and spherically shaped, well-dispersed nanoparticles on the surface of PN-films containing PNL 80 mg/film(PN-films-80). The size of the nanoparticles on the surface of PN-films-80 was around 100 nm, which was similar to the nanoparticle size observed using light scattering technique. The swelling index(SI)of all PN-films and PP-films increased greatly in the first period time(10–20 min) and reached swelling equilibrium at 20 min and 30 min, respectively. For the PN-films, the concentration of PNL influenced the mucoadhesive properties and tended to be higher when the amount of PNL increased. Immediate release of all blend film formulations was found in early time points(10–30 min). After 120 min, the release of PN-films-70 was lower than the other PNfilms. Permeation studies using porcine buccal mucosa showed that inclusion of nanoparticles in the films increased the permeability of PNL compared to PP-films. Therefore, buccal administration of mucoadhesive blend films containing PNL-loaded nanoparticles could be a promising approach for drugs that undergo first-pass metabolism.
文摘Extraction of the first molar or premolar is the commonest cause of oro-antral fistula. Management involves identification of the same, removal of any foreign body from the maxillary sinus, if present, followed by appropriate flap for closer. A case is presented when a gutta percha (GP) point was accidentally dislodged into the right maxillary sinus during preliminary diagnosis of the oro-antral fistula. The surgical management of the case is described and is the appropriate treatment plan.
文摘Mucoadhesion can be defined as a state in which two components, of which one is of biological origin, are held together for extended periods of time by the help of interfacial forces. Among the various transmucosal routes, buccal mucosa has excellent accessibility and relatively immobile mucosa, hence suitable for administration of retentive dosage form. The objective of this paper is to review the works done so far in the field of mucoadhe- sire buccal drug delivery systems （MBDDS）, with a clinical perspective. Starting with a brief introduction of the mucoadhesive drug delivery systems, oral mucosa, and the theories of mucoadhesion, this article then proceeds to cover the works done so far in the field of MBDDS, categorizing them on the basis of ailments they are meant to cure. Additionally, we focus on the various patents, recent advancements, and challenges as well as the future prospects for mucoadhesive buccal drug delivery systems.
文摘Introduction: The presence of a recurrent proximal penile hypospadius represents a surgical challenge to the urologist due to the presence of excessive scarring and fibrosis of the tissues. This problem is more pronounced in circumcised patients, in whom there is no enough skin for one stage procedures. Buccal mucosal grafts represent a good surgical option. The aim of this study was to evaluate the results of two stages buccal mucosal urethroplasty in pediatric & adolescent patients, presenting with recurrent proximal penile hypospadias who are circumcised. Methods: Thirty seven pediatric & adolescent patients underwent two stages buccal mucosal urethroplasty for recurrent proximal penile hypospadius. In all cases the buccal graft was placed dorsally followed by the second stage closure after 6 months. Results: The mean age was 17.7 (14-20) years. With a mean follow-up of 28.3 months, 33 patients (89.2%) had a final successful outcome. Of the 4 cases that were considered as failure, 3 patients (8.1%) developed urethra-cutaneous fistula that required closure after 3 months. The remaining patient developed meatal stenosis. Conclusion: Although buccal mucosal urethroplasty is a two staged procedure, it is feasible option for pediatric & adolescent patients presenting with recurrent proximal penile hypospadius, who had no skin available for penile flaps, with a success rate approaching 89.2%.
