OBJECTIVE To investigate the differential expression of CXC chemokine receptor 1(CXCR1)in chronic rhinosinusitis(CRS)and its correlation with neutrophil infiltration.METHODS A total of 60 CRS patients with nasal polyps(CRSwNP group),30 CRS patients without nasal polyps(CRSsNP group),and 30 patients with deviated nasal septum(control group)were enrolled in this study.ELISA,immunohistochemistry,and reverse transcription polymerase chain reaction were employed to measure CXCR1 expression levels.Correlation analysis was conducted to evaluate the relationship between CXCR1 expression,neutrophil infiltration,and clinical symptom scores.RESULTS CXCR1 was highly expressed in both tissues and serum of CRSwNP patients.Serum CXCR1 levels showed positive correlations with peripheral blood neutrophil counts(r=0.363,P=0.004 4),neutrophil percentage(r=0.323,P=0.011 7),visual analog scale(VAS)score(r=0.328,P=0.010 5),Lund-Kennedy endoscopic score(r=0.331,P=0.009 9),and Lund-Mackay CT score(r=0.262,P=0.045 0).Tissue CXCR1 levels were positively correlated with tissue neutrophil counts(r=0.506,P=0.011 6)and percentage(r=0.564,P=0.004 1).CONCLUSION CXCR1 is highly expressed in CRSwNP patients,and its expression level is positively correlated with the degree of neutrophil infiltration and clinical symptom scores.Higher CXCR1 levels are associated with increased neutrophil migration in both serum and tissues,as well as more severe clinical symptoms.

Objective:To analyze the efficacy of endoscopic nasal surgery for sinonasal squamous cell carcinoma (SNSCC) with orbital invasion, the factors affecting the prognosis of patients, and the treatment strategies for preserving the eyeball.Methods:This was a retrospective cohort study, including 60 cases of SNSCC with orbital invasion treated in the Department of Otolaryngology-Head and Neck Surgery, the Second Affiliated Hospital of Harbin Medical University from October 2009 to October 2019. The cohort comprised 39 males and 21 females, aged 33-72 years. Orbital invasion was graded: Grade Ⅰ (destruction of the orbital bone wall), Grade Ⅱ (involvement of the periorbita/orbital fascia, extraconal fat, or medial lacrimal sac), and Grade Ⅲ (involvement of extraocular muscles, eyeball, orbital apex, or optic nerve). All cases underwent multi-disciplinary treatment (MDT), including otolaryngology, ophthalmology and oncology radiotherapy departments, and endoscopic nasal surgery. Survival curves were calculated by Kaplan-Meier method, Log-rank test and Cox risk model were used for univariate and multivariate analysis, respectively.Results:Primary tumor sites were maxillary sinus in 19 cases (31.7%, including 6 cases of pterygopalatine fossa), ethmoid sinus in 25 cases (41.7%, 5 cases with skull base bone involvement but not dura mater), nasal cavity in 11 cases (18.3%), frontal sinus in 3 cases (5.0%), and sphenoid sinus in 2 cases (3.3%). Clinical stages included stage Ⅲ in 53 (88.3%) and stage Ⅳ in 7 (11.7%). The surgical methods of orbital invasion cases were as follows: 18 cases (30.0%) of grade I underwent orbital bone wall resection with orbital fascia and orbital contents preserved; 36 cases (60.0%) in Grade Ⅱ were resected the involved orbital fascia, extra-cone fat and lacrimal sac and preserved the internal cone structure of extra-ocular muscle. Six cases (10.0%) were grade Ⅲ, of which 2 cases were subjected to selective extraocular muscle resection with preserving eyeballs, and 4 cases were subjected to orbital contents removal. The 3-year and 5-year overall survival (OS) rates of all patients were 76.7% and 63.3%, respectively, and the 5-year survival rate of the local recurrence-free group was significantly higher than that of the recurrence group (69.4% vs. 36.4%, χ2=3.91, P=0.048). The 5-year survival rates were significantly negatively correlated with the degrees of orbital invasions (83.3% for grade Ⅰ, 58.3% for grade Ⅱ and 33.3% for grade Ⅲ, ( χ2=10.49, P=0.005). The effects of T stages (66.7% in stage T3 vs. 33.3% in stage T4, χ2=7.21, P=0.007) and clinical stages (67.9% in stage III vs. 28.6% in stage IV, χ2=11.80, P=0.001) on survival rates were statistically significant. The 5-year survival rate of patients with cervical lymph node metastases was significantly lower than that of patients without metastasis (37.5% vs. 67.3%, χ2=8.32, P=0.004). The tumor-free survival rate was 56.7%. Cox multivariate analysis identified T stage [ HR=3.53 (95% CI: 1.31-9.52)] and clinical stage [ HR=35.14 (95% CI: 1.88-658.62)] as independent prognostic factors (both P<0.05). Conclusions:The outcomes of patients with orbital invasion in SNSCC are associated with T stage and clinical stage. If the muscle cone and the structures within the muscle cone are not invaded, eye-preserving surgery is feasible.

Objective:To analyze the efficacy of endoscopic nasal surgery for sinonasal squamous cell carcinoma (SNSCC) with orbital invasion, the factors affecting the prognosis of patients, and the treatment strategies for preserving the eyeball.Methods:This was a retrospective cohort study, including 60 cases of SNSCC with orbital invasion treated in the Department of Otolaryngology-Head and Neck Surgery, the Second Affiliated Hospital of Harbin Medical University from October 2009 to October 2019. The cohort comprised 39 males and 21 females, aged 33-72 years. Orbital invasion was graded: Grade Ⅰ (destruction of the orbital bone wall), Grade Ⅱ (involvement of the periorbita/orbital fascia, extraconal fat, or medial lacrimal sac), and Grade Ⅲ (involvement of extraocular muscles, eyeball, orbital apex, or optic nerve). All cases underwent multi-disciplinary treatment (MDT), including otolaryngology, ophthalmology and oncology radiotherapy departments, and endoscopic nasal surgery. Survival curves were calculated by Kaplan-Meier method, Log-rank test and Cox risk model were used for univariate and multivariate analysis, respectively.Results:Primary tumor sites were maxillary sinus in 19 cases (31.7%, including 6 cases of pterygopalatine fossa), ethmoid sinus in 25 cases (41.7%, 5 cases with skull base bone involvement but not dura mater), nasal cavity in 11 cases (18.3%), frontal sinus in 3 cases (5.0%), and sphenoid sinus in 2 cases (3.3%). Clinical stages included stage Ⅲ in 53 (88.3%) and stage Ⅳ in 7 (11.7%). The surgical methods of orbital invasion cases were as follows: 18 cases (30.0%) of grade I underwent orbital bone wall resection with orbital fascia and orbital contents preserved; 36 cases (60.0%) in Grade Ⅱ were resected the involved orbital fascia, extra-cone fat and lacrimal sac and preserved the internal cone structure of extra-ocular muscle. Six cases (10.0%) were grade Ⅲ, of which 2 cases were subjected to selective extraocular muscle resection with preserving eyeballs, and 4 cases were subjected to orbital contents removal. The 3-year and 5-year overall survival (OS) rates of all patients were 76.7% and 63.3%, respectively, and the 5-year survival rate of the local recurrence-free group was significantly higher than that of the recurrence group (69.4% vs. 36.4%, χ2=3.91, P=0.048). The 5-year survival rates were significantly negatively correlated with the degrees of orbital invasions (83.3% for grade Ⅰ, 58.3% for grade Ⅱ and 33.3% for grade Ⅲ, ( χ2=10.49, P=0.005). The effects of T stages (66.7% in stage T3 vs. 33.3% in stage T4, χ2=7.21, P=0.007) and clinical stages (67.9% in stage III vs. 28.6% in stage IV, χ2=11.80, P=0.001) on survival rates were statistically significant. The 5-year survival rate of patients with cervical lymph node metastases was significantly lower than that of patients without metastasis (37.5% vs. 67.3%, χ2=8.32, P=0.004). The tumor-free survival rate was 56.7%. Cox multivariate analysis identified T stage [ HR=3.53 (95% CI: 1.31-9.52)] and clinical stage [ HR=35.14 (95% CI: 1.88-658.62)] as independent prognostic factors (both P<0.05). Conclusions:The outcomes of patients with orbital invasion in SNSCC are associated with T stage and clinical stage. If the muscle cone and the structures within the muscle cone are not invaded, eye-preserving surgery is feasible.

Objective:To investigate the roles of N6-methyladenosine (m 6A) modification in regulating RP11-426A6.5 in the development of laryngeal squamous cell carcinoma (LSCC). Methods:The methylation and expression levels of lncRNAs were identified and important lncRNAs were screened utilizing long non-coding RNA (lncRNA) m 6A methylation microarray. Cancer and para cancer tissue samples were taken from 48 LSCC patients hospitalized to the Department of Otolaryngology-Head and Neck Surgery of the Second Affiliated Hospital of Harbin Medical University between January and September 2017. Expression profiling microarray was performed in 3 of 48 LSCC samples, and methylated RNA immunoprecipitation-quantitative PCR (MeRIP-qPCR) and quantitative real-time fluorescent PCR (qRT-PCR) were performed in the remaining 45 LSCC samples to verify the m 6A modification and expression levels of RP11-426A6.5. Correlations between RP11-426A6.5 and clinical factors were anlysed. Laryngeal cancer cell line with low expression of RP11-426A6.5 was created in vitro using RNA interference (RNAi) technology. The 5-Ethynyl-2′-deoxyuridine (EdU) cell proliferation experiment, wound healing experiment, and transwell invasion experiment were used respectively to measure the proliferation, migration, and invasion of LSCC cells. The effect of RP11-426A6.5 down-regulation on the growth of transplanted tumors in vivo was verified by nude mice tumorigenesis assay. The Cancer Genome Atlas (TCGA) database and sequence-based RNA adenosine methylation site predictor (SRAMP) website were used to predict the enzymes and corresponding methylation sites. MazF digestion was chosen to validate the binding sites. RNAi technology was used to observe the changes in cell function after interfering with the expression of the corresponding genes of the modified enzymes. MeRIP-qPCR was used to detect the level of RP11-426A6.5 m 6A cell line treated with actinomycin D was used to observe the stability of RP11-426A6.5. Results:RP11-426A6.5 methylation and expression levels were significantly higher in LSCC tissues than those in paracancerous tissues (methylation levels: 23.828±4.975 vs 20.280±3.607; expression levels: 1.197±0.314 vs 1.015±0.170, all P values<0.05). RP11-426A6.5 expression levels were closely correlated with T stage (T1-2: 1.081±0.298 vs T3-4: 1.306±0.292, χ 2=5.35, P<0.05). The postoperative survival of patients with high RP11-426A6.5 expressions was significantly lower than that of patients with low RP11-426A6.5 expression ( P=0.046). Assays in vitro and in vivo showed that the downregulation of RP11-426A6.5 significantly decreased the proliferation, migration, and invasion abilities of LSCC cells and the growth of transplanted tumors. The binding of methyltransferase-like 3 (METTL3), an m 6A-modified enzyme, to the corresponding methylation site of RP11-426A6.5 enhanced its stability and mediated its regulation of malignant behaviors of LSCC cells. Conclusions:RP11-426A6.5 can regulate the malignant behaviors of LSCC cells, which is mediated by the m 6A modification process involving in the methyltransferase METTL3.

Objective To explore the curative effect of knee flexion deformity on spastic cerebral palsy treatment method.Methods All of 30 patients with spastic cerebral and knee flexion deformity were randomly divided into two groups:traditional operation group and modified operation group,using the commonly used operation (In 15 cases,with traditional hamstring post surgery) and) modified operation (In 15 cases,with modified hamstring post surgery),two groups of patients were treated with Ilizarov external fixation drafting device in the correction of knee flexion deformity after soft tissue release.Adjustment began 7 days after the soft tissue release operation of external fixation,and stretched approximately 0.2 degrees each time,3 times/d,until knee flexion deformity was corrected to hyperextension for 10 degree and maintained for 3 weeks,and the flexion contracture degree of knee joint was measured every 2 weeks;then the Ilizarov external fixation drafting device was removed.Then wear a walking straight leg brace for more than 3 months,until the knee walking function is good.Clinical evaluation included the joint pain index,walking function index,knee flexion deformity degree and range of joint motion score of Dimeglio standard.Results Flexion contracture deformity of knee joint in 30 cases (60 knees) was corrected when Ilizarov external fixator was removed,knee extension to 0 degrees-5 degrees.The two groups of patients had the knee flexion angle range of-1.2 degrees to 13.3 degrees,with an average of (7.32°±3.41°) after removed of the walking straight leg brace,in which 4 cases (8 joints) got recurrent deformity of 10°-15° at the time of removing of the walking straight leg brace.Knee activity significantly was improved at the end of treatment.60 cases of knee joint activity were close to normal,with flexion of 100 degrees to 135 degrees,extension of 0 degrees to 10 degrees.Two groups of patients were statistically significantly improved before and after surgery.Curative effect comparison:The walking function index of the modified operation group was obviously superior to that of the traditional operation group,there was significant statistical difference.There were no statistically significant differences in pain index,knee flexion,and range of joint motion.Conclusion For the treatment of flexion deformity of the knee joint in spastic cerebral palsy,traditional surgery using the semitendinosus and gracilis,post and semimembranosus lysis,combined with the Ilizarov draft external fixation could improve the walking function of the patients,simplify the surgical incision and reduce trauma.As a result,modified hamstring post surgery is an ideal,effective treatment method.