Intraparotid facial nerve schwannoma (IFNS) is a rare benign tumor. The management of IFNS is very challenging because of the lack of appropriate methods for preoperative diagnosis, which is often conducted intraoperatively in most cases. This article reviewed the literature on IFNS recorded in PubMed from 1958 to 2014 and described in detail its clinical manifestations, diagnoses and differential diagnoses, and treatment options. Accurate diagnosis for IFNS mainly depends on intraoperative observation and postoperative histological examination. Preoperative facial nerve function, localization, and adherence, as well as preferences of IFNS patients are important factors to consider in the decision-making process for IFNS management to optimize the outcomes. Surgical resection is usually reserved for patients with facial function of House-Brackmann grade III or worse; otherwise, conservative treatment can be adopted.
Cranial Nerve Neoplasms ; Diagnosis, Differential ; Face ; Facial Nerve ; Humans ; Neurilemmoma ; Postoperative Period ; Retrospective Studies

Objective To compare the dose distribution of reserved planned tangential beam IMRT(2-field IMRT) with multifields beams IMRT(6-field IMRT) of the bulk-recurrent chest wall in postmastectomy breast cancer patients.Methods For 8 patients with chest wall in postmastectomy breast cancer bulk-recurrence,2-field IMRT and 6-field IMRT plans were generated on PTV in Pinnacle Planning System.The prescribed dose of PTV was 50 Gy in 25 fractions and GTV was 66-70 Gy which irradiated incrementally by subsequent plan in 8-10 fractions.The conformal index (CI) and homogeneity index (HI) of 95％ of prescribed dose over PTV were compared,while the dose distribution on ipsilateral lung and heart were evaluated.Results The CI of PTV by 6-field IMRT (0.66 ± 0.08) was higher than that of the2-field IMRT (0.53±0.10)(t=7.99,P＜0.05).The HI ofPTV by6-field IMRT (1.36±0.08)waslower than that of 2-field IMRT (2.19 ±0.78) (t =9.04,P ＜0.05).There was no statistical difference in V5,V10,V20 and V35 for ipsilateral lung and in D V35 and D for heart between two plans.Conclusions Compared with 2-field IMRT,6-field IMRT might have a better dose distribution on planning target volume(PTV) for chest wall in postmastectomy breast cancer bulk-recurrence patients,butthere is no significant difference in dose-volume of ipsilateral lung and heart between two plans.

Biomedical Research ; trends ; Carcinoma, Squamous Cell ; secondary ; Head and Neck Neoplasms ; pathology ; Humans ; Neck

Objective:To investigate the inhibitory effect of adenovirus-mediated herpes simplex virus-thymidine kinase (TK) gene combined with ?-IFN on renal clear-cell carcinoma. Methods: Adenovirus containing suicide gene TK, in combination with GCV or ?-IFN, was used to treat human renal clear-cell carcinoma cell line 786-0, and the in vitro cytotoxic effects against 786-0 were evaluated using MTT method. The subcutaneous transplantation model of 786-0 cells was established with nude mice. Adenovirus containing TK gene was injected intratumorally and the GCV (50 mg/kg) was injected intraperitoneally; ?-IFN (104 U/L) was injected intratumorally in combined therapy. The growth of tumors was observed after treatments. Results: The survival rate of 786-0 cells was (35.07?1.43)% in the TK+GCV+?-IFN group, (68.57?1.41)% in the TK+GCV group and (68.65?1.45)% in the ?-IFN group ( P=0.000). There was an obvious synergic effect between Ad-TK and ?-IFN in inhibiting 786-0 cells. Ad-TK combined with GCV and ?-IFN significantly suppressed the growth of 786-0 cells growth in nude mice model.Conclusion: Adenovirus-mediated TK plus prodrug GCV combined with ?-IFN has obvious therapeutic effect in treatment of human renal clear-cell carcinoma.

Abstract Type 2 diabetes mellitus (T2DM) has become a worldwide epidemic, which poses a great threat to the global healthcare system. Based on review of publications pertaining to T2DM health management in urban communities, this article focuses on the health management models of T2DM in foreign urban communities, including insurance companies and medical institutions, self-management plans, community management, community and home hybrid services, artificial intelligence + big data management, social media and online community management, precision health management, and proposes suggestions for T2DM health management in Chinese urban communities based on currently available national management models, including increasing the standardization of the management level, improving the supporting facilities of professional talents, mobilizing social forces to support, improving the scientific and technological level of management tools, strengthening the advantages of traditional Chinese medicine and exploring novel personalized models, so as to provide insights into promoting the sustainable development of T2DM health management in Chinese urban communities.

Objective To investigate the effect of different pore sized hydroxyapatite for promoting bone vascularization in tissue engineering.Methods Male Wistar rats were randomly divided into three groups,named group A,B and C,which were im-planted hydroxyapatite bioceramics compositing 4 μg bone morphogenetic protein with different aperture of 200 -300,350 -450, 500-600 μm in the back subcutaneously.The size of each block was 5 mm×5 mm×1 mm in a weight about of 40.0 mg.After im-plantation,the animals were killed and the implants and the surrounding tissue were taken out at the first,second,third and forth week respectively.HE staining of histological analysis was used to detect the situation of local neovascularization.Results There was significant difference between second and third week in group A.Comparing the area of vascularization at different time points in group B and group C,there were significant difference in the comparison of intragroup (P <0.05 ).During the first week after surgery,there was only group C that had the area of vascularization.During the second and forth week after operation,the area of vascularization in group B and group C were significant higher than group A (P <0.05).The C group showed a great deal of new-born blood vessels and clear formation of bone trabeculae.Conclusion The hydroxyapatite bioceramics of 500-600 μm could better promote vascalarization of tissue engineering in bone.

Objective To evaluate the clinical efficacy of early enteral nutrition combined with additional parenteral nutrition (EEN + PN) versus TPN (total parenteral nutrition) in patients after conventional pancreaticoduodenectomy (PD).Methods From January 2009 to January 2013, 340 consecutive patients who underwent conventional PD with Child's reconstruction at the First Affiliated Hospital of Xi'an Jiaotong University were enrolled into this single-center retrospective comparative study.There were 87 patients in the EEN + PN group and 253 patients in the TPN group.The preoperative baseline characteristics,histopathological types, intraoperative parameters and postoperative outcomes were recorded and compared between the two groups.Results There were no significant differences in the preoperative general characteristics data, pathological patterns, and intraoperative details.There were significantly higher rates in delayed gastric emptying (DGE), morbidity (15.9％ vs 6.7％, P ＜ 0.05), and pneumonia (10.3％ vs 3.6％, P ＜ 0.05);significantly prolonged nasogastric tube removal time (5.6 ± 0.2 days vs 3.9 ± 0.1 days, P＜0.05), and increase in hospitalization expenses (65 397.0 ± 861.2) Yuan vs (50 663.9 ± 239.2) Yuan, P ＜ 0.05) in the EEN + PN group when compared with the TPN group.Conclusions EEN + PN after conventional PD was associated with increased rates of DGE and pneumonia, prolonged nasogastric tube removal time, longer EN duration and increase in hospitalization expenses.Hence, EEN should only be performed prudently and selectively.

Objective To investigate the predictive value of coagulation state on the occurrence of no-reflow phenomenon after primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods A total of 187 consecutive patients with the first AMI underwent PCI within 12h post-onset of symptom. The clinical features and angiographic findings were collected. According to the thrombolysis in myocardial infarction (TIMI) flow grade with related artery and myocardial blush grade(MBG), the patients were divided into the no-reflow group (TIMI ≤ 2, or MBG ≤ 1) and the normal reflow group. Blood samples were taken immediately on admission before coronary angiography. The levels of plasma von Willebrand factor(vWF), P-selectin(Ps) and Tissue factor(TF) were measured by enzyme-linked immunosorbent assay. Results 23.5%patients of 187 patients developed the no-reflow phenomenon. The plasma level of vWF and Ps and TF were (4 574 ± 1 677) U/L and (16.8 ± 5.1) ng/mL and (283 ± 81) ng/L in the no-reflow group, and (4 074 ± 1 063) U/L and (14.8 ± 4.2) ng/mL and (254 ± 54) ng/L in the normal group, with significant differences (P = 0.020, 0.010 and 0.007, respectively). The hypercoagulation patients in the no-reflow group were much more than patients in the normal reflow group (P = 0.003). Multivariate stepwise logistic regression analysis revealed that hypercoagulation was independent predictor of no-reflow phenomenon ( OR = 2 . 361 , 95%CI 1 . 083 ~ 5 . 148 , P = 0.031). Conclusion The high levels of plasma vWF, Ps and TF present the evidences of hypercoagulation, which might imply the development of no-reflow after PCI.

Objective To compare the therapeutic effect between Kirschner wire- loop plating and clavicular hook plate in the treatment of distal clavicle fractures. Methods Forty- two patients with type Neer Ⅱ distal clavicle fracture were selected, among whom 23 patients were treated with Kirschner wire- loop plating (group A), and 19 patients were treated with clavicular hook plate (group B). The operative time, fluoroscopy time, length of incision, intra- operative bleeding volume and hospitalization time etc were recorded. The patients were followed up at 6 weeks, 3 months, 6 months and 12 months after operation. The American shoulder and elbow society (ASES) score was evaluated, and the therapeutic effect was evaluated by Karlsson standard. Results The operative time and fluoroscopy time in group B were significantly lower than those in group A: (63.5 ± 12.4) min vs. (71.5 ± 11.1) min and (3.6 ± 1.9) s vs. (4.8 ± 1.5) s, but the intra- operative bleeding volume, length of incision and cases of postoperative shoulder pain in group A were significantly lower than those in group B:(91.5 ± 18.5) ml vs. (108.7 ± 32.5) ml, (6.6 ± 0.7) cm vs. (11.3 ± 0.9) cm and 2 cases vs. 14 cases, and there were statistical differences (P<0.05 or <0.01). There was no statistical difference in hospitalization time between 2 groups (P>0.05). There was no statistical difference in ASES score at 6 weeks and 3 months after operation between 2 groups (P>0.05); but the ASES score at 6 and 12 months in group A was significantly higher than that in group B: (89.9 ± 12.6) scores vs. (79.7 ± 12.6) scores and (96.1 ± 4.8) scores vs. (86.1 ± 12.4) scores, and there was statistical difference (P<0.05 or <0.01). There was no statistical difference in the cases of good and excellent at 6 weeks, 3 months and 6 months after operation (P>0.05);but the cases of good and excellent at 12 months in group A was significantly more than that in group B:23 cases vs. 13 cases, and there was statistical difference (P<0.05). Conclusions Kirschner wire- loop plating provides a new treatment option for type Neer Ⅱ distal clavicle fractures. It is conducive to decrease the incidence of shoulder pain and improve the range of motion of should joint. Besides, this technology has advantage of small incision, relatively simple operation steps and small damage to the surrounding soft tissues of the acromioclavicular joint. It may be superior to the clavicular hook plate.

Objective To investigate the distribution characteristics of serum pepsinogen (PG) in healthy people and its reference interval establishment .Methods 3 753 healthy people were enrolled and divided into <45-year old ,45- <60-year old and ≥60-year old group according to their ages .Double antibody sandwich enzyme-linked immunosorbent assay was used to detect PG Ⅰ ,Ⅱ . Results Detection results of serum PG Ⅰ ,PGⅡ and PGⅠ /PGⅡ of male and female healthy people in different age group showed a skewed distribution(P<0 .05) .Serum PGⅠ and PGⅠ /PGⅡlevels of females were significantly higher than males(P<0 .01) .In the same age group ,difference of serum PGⅡ levels between males and females was not statistically significant (P>0 .05) .In the same gender ,pairwise comparison of PGⅠlevels was conducted in different age groups ,and the difference showed no statistical sig-nificance(P>0 .05) .PGⅡlevel increased with age increasing (P<0 .01) while PGⅠ /PGⅡlevel increased with age reducing (P<0 .05) .Percentile method was adopted to determine the 95% reference interval ,the bilateral reference intervals (P2 .5 - P97 .5 ) was taken for PGⅠ ,unilateral upper limit(≤ P95 ) for PGⅡ and unilateral limit (≥ P5 ) for PGⅠ /PGⅡ .Conclusion The establishment of serum PG Ⅰ ,PG Ⅱ ,PG Ⅰ /PG Ⅱ reference intervals of healthy people provides a basis for the prevention and treatment for stomach disease .