Objective To study the value of CT in confirming the diagnosis of schwannoma of the cervical sympathetic nerve ( SSN) or vagus nerve (SVN) before operation.Methods From October 1988 to March 2001,45 SSNs and 14 SVNs confirmed by surgery and pathology were analyzed to discover the rules of displacement of common carotid artery (A),internal carotid artery (I) and internal jugular vein (V). Results 43 SSNs located at the level of common carotid bifurcation or/and upper neck with A or/and I abutting against and displacing to the lateral periphery of the tumor.In 35 SSNs with enhanced CT,the V was also abutted against and displaced to the lateral periphery of the tumor.The rest two SSNs located at the root of the neck with A and V anterolateral to but not abutting against the tumor.The growth of 12 SVNs all resulted in separation between the A or I and the V.The A or I was displaced to the medial periphery of SVN and the V to the lateral periphery.Their distance was 90? to 180?. Conclusion During the growth of SSN or SVN,the CT axial scan can still accurately reflect the anatomical positional relationships among A,I,and V with the cervical sympathetic nerve or vagus nerve.So CT is a very valuable tool in confirming the diagnosis of SSN or SVN preoperatively.

Schwannomas of the vagus nerve (SVN) and schwannomas of the cervical sympathetic nerve (SSN) are the two most common schwannomas in the carotid space. Because schwannomas are asymptomatic, moreover, the vagus nerve and the cervical sympathetic nerve have adjacent anatomical location, it is diffcult to differentiate SVN or SSN. In addition, the current surgical treatment of schwannomas still remains controversial. This article summarized the studies on SVN and SSN, and meanwhile discussed the advances in the diagnosis and management of the disease.

Thyroid papillary carcinoma harbors higher rate of lymph node metastasis, so neck dissection is an important part of the treatment. Due to better prognosis, attention to postoperative function and appearance of the patients increased. Low-collar incision with cervical sensory nerve plexus preservation modiifed neck dissection can improve appearance and function in postoperative patients and is gradually applied in clinic. This review mainly examines the thoroughness and safety of this new neck dissection in thyroid papillary carcinoma patients.

Human papillomavirus is an oncogenic DNA virus and has more than 90 subtypes. High risk types (HPV 16, 18, 33) are associated with many kinds of malignant neoplasms of head and neck. The HPV DNA can induce mutations of p53, RB genes and increase cell transformation and over proliferation. The frequences of HPV positive are different in malignant neoplasms from different head and neck sites. HPV was more often detected in squamous cell carcinoma of oral cavity, oropharynx and larynx. In nasopharyngeal carcinoma, adenocarcinoma or lymphoma, the expression of HPV was quite low. The detection of HPV in cervical metastatic lymph nodes can improve diagnosis of primary sites.

Thyroid neoplasm is one of the most common endocrinal tumors. In general, thyroid cancer patients are usually presented with asymptomatic neck nodules. A differential diagnosis between malignant and benign thyroid neoplasm is very important for these patients. This review article primarily discusses biological markers used to aid the differential diagnosis of thyroid neoplasia, which may lead to a more rational approach to the treatment. It mainly describes the recent development of molecular biological markers VEGF-C, Cytokeratin-19, HBME-1, Pax8-PPAR and Galectin-3 for the differential diagnosis of thyroid neoplasms.

Background and purpose:Although cervical lymph node metastases is commonly found, papillary thyroid cancer(PTC) has a fairly good prognosis. The microarray or gene chip technique is an effective method to explore the biological behavior of cancers. This study aims to measure the differential expression of genes between papillary thyroid cancer with lymph node metastasis and normal thyroid tissue with the new technology. Methods:The total mRNA was extracted from the specimens of papillary thyroid cancer with lymph node metastasis and normal thyroid tissues. Both of samples were labeled with fluorescent Cy5 or Cy3, and then hybridized to the gene chip which it includes 14 112 human functional gene fragments. Differentially expressed genes were screened out by scanning and analyzing the fluorescent signals.Results:There are 1 212 differentially expressed gene fragments between the two groups that it account for 8.71% of the total sites. Among them, 22 sites showed remarkable difference with either upregulation or downregulation more than 8 times fold, 2 of 6 downregulation sites represent one same gene sequence: NM-001920, which is the mRNA of the protein decorin.Conclusions:Gene chip is an effective method to study the change of gene expression during the progression of a disease. As to PTC, it involves many genes. Decorin may be an important biomarker for the prediction of metastases to the cervical lymph nodes in PTC.

Objective To investigate the clinical, radiological features and therapy of spinal actinomycotic infection complicated with spinal cord compression.Methods The data of three patients confirmed by histopathology were analyzed retrospectively.Results All three patients presented with infection of cervical thoracal vertebral bodies and soft tissue, and with syndrome of spinal cord compression. MRI examination revealed destruction of vertebral bodies, extradural soft tissue mass and spinal cord compression. Histopathological examination confirmed the infection of actinomycete in all three patients. Granulomatous inflammation could be seen in two cases, while extradural abscess was found in the other one case. Three patients all received the operation of abscess draining and vertebral canal decompression. Large-dose of Penicillin G following operation was administrated intravenously for 4～8 weeks, and then changed to oral application for another 4～6 months. Follow-up showed significant clinical effect in these three patients.Conclusions Radiologic and clinical findings of spinal actinomycotic infection complicated with spinal cord compression are nonspecific, and the diagnosis of this disease depends on pathological and microbiologic exams. Treatments with abscess draining, vertebral canal decompression and large-dose of antibiotic may achieve good clinical outcome.

Purpose:To analyze the patterns of cervical lymph node metastasized from different primary sites of head and neck cancers based on computed tomography (CT) imaging study.Methods:We studied the CT showing the positional relationship between 160 patients with different primary sites of head and neck squamous cell carcinoma and their cervical lymph node metastases using our new modified classification retrospectively.Results:The metastatic rates of level Ⅱa, Ⅱc and Ⅴ were significantly different between nasopharyngeal and non nasopharyngeal carcinoma ( P

Objective To retrospectively analyze the treatment outcomes and failure patterns in patients with head?and?neck cancer of unknown primary head?and?neck cancer of unknown primary, and to compare the efficacy between elective mucosal irradiation and ipsilateral neck treatment. Methods The clinical data of patients with head?and?neck cancer of unknown primary who were admitted from January 2007 to December 2013 were retrospectively collected. Thirty?one patients received elective pharyngeal mucosal irradiation and 61 patients only received ipsilateral neck treatment. The SPSS 19. 0 software was used for comparison of the survival and local control between the two groups. Results In the 92 patients, the median age was 57 years;79. 3% had metastasis to level Ⅱ lymph nodes;the median follow?up time was 36. 5 months;the 3?year overall survival, mucosal control, and neck control rates were 89. 0%, 86. 6%, and 82. 4%, respectively. Primary sites were found in 15 patients, containing nasopharynx in 4 patients, oropharynx in 3 patients, oral cavity in 3 patients, throat and hypopharyngeal part in 3 patients, maxillary sinus in 1 patient, and esophagus in 1 patient. The patients undergoing elective pharyngeal mucosal irradiation had significantly higher 3?year mucosal control and neck control rates than those undergoing ipsilateral neck treatment ( 100% vs. 74. 9%, P= 0. 040;87. 5% vs. 62. 2%, P= 0. 037 ) . There was no difference in the 3?year overall survival rate between the two groups ( 83. 5% vs. 88. 7%, P= 0. 910 ) . Conclusions For patients with head?and?neck cancer of unknown primary, elective pharyngeal mucosal irradiation can reduce the incidence of primary site and increase the neck control rate. A new standard for target volume delineation should be established as soon as possible for elective prophylactic pharyngeal mucosal irradiation.

为了克服康复研究的局限性,需要建立针对康复和相关研究的专门学科领域。基于在基础科学、应用科学和专门学科中的普遍特征,与康复相关的特征以及基于WHO的ICF模型的整合性观点,可以将功能性的生物医学领域划分出5个专门的人类功能和康复研究的学科领域。这些学科结构基于整合性观点,涉及人类功能学科和整合性康复学科,以及部分基于该观念建立的生物学科和生物医学康复学科和工程学,还有处于研究和实践分界边缘的专门康复学科。人类功能学科的目的在于明确人类功能,确定综合性干预目标,以达到人类所体验到的残疾程度最小化。康复中的生物学科的目标是解释身体损伤和修复,并且确定生物医学干预的目标。整合性的康复学科要设计和研究综合性的评定以及干预的方法,这种方法将生物医学的个人的因素以及环境的因素结合起来以达到人类活动的最佳表现。生物医学康复学科和工程研究适于将损伤最小化,包括疾病控制、对人的最佳能力的诊断方法和干预措施。专门康复学科研究如何提供最好的保健以使已经残疾或可能残疾的人在与环境的交互作用中达到和维持最佳功能。将人类功能和康复的研究划分为五个专门的学科领域,可以促进专业培训项目和职业生涯的发展,也可以促进建立人类功能和康复研究的研究架构。