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.

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.

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.

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.

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.

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.

Objective To compare the features of activity and participation difficulty of children with cerebral palsy, intellectual disability and autism. Methods 42 children with cerebral palsy, intellectual disability, and autism aged 3-6 years were evaluated with ICF-CY Questionnaire. Results There were mild barriers in the domains of learning and applying knowledge, communication, mobility, self-care, domestic life and major life areas, and the moderate barriers in the domains of general tasks and demands, interpersonal interactions and relations. There were more barriers in learning and applying knowledge in children with cerebral palsy and intellectual disability than those with autism. Conclusion There are various features in activity and participation difficulty in children with cerebral palsy, intellectual disability or autism, which required diversity of educational rehabilitation strategies.