Objective:To investigate the clinical characteristics, differential diagnosis, treatments and prognosis of facial nerve hemangioma and schwannoma at genicular ganglion, so as to provide reference for clinical diagnosis and treatments of facial nerve tumor at genicular ganglion.Methods:Clinical data of 13 patients with facial nerve tumors at genicular ganglion confirmed by postoperative pathology in the Ninth People′s Hospital affiliated to Shanghai Jiaotong University School of Medicine from March 2018 to April 2020 were retrospectively analyzed, including seven cases of hemangioma and six cases of schwannoma. There were eight males and five females. Their ages ranged from 20 to 65, with an average age of 40. The course of disease ranged from 3 to 118 months, with an average of 52 months. All the patients underwent preoperative HRCT of the temporal bone and facial nerve dynamic contrast-enhanced(DCE) MRI examinations. All the patients had detailed surgical procedures and at least one-year postoperative follow-up.Results:On HRCT of the temporal bone, (4/7) hemangioma at geniculate ganglion showed characteristic honeycomb appearance, while 6/6 schwannoma and 3/7 hemangiomas showed expansive bone changes. On DCE-MRI, geniculate ganglion hemangioma (7/7) showed characteristic "point-to-surface" enhancement, and schwannoma (6/6) showed characteristic "face-to-surface" enhancement. For five hemangioma-patients with HB-Ⅱ-Ⅳ before surgery, the facial nerve anatomy was completely preserved through transcanal endoscopic approach(TEA), and the facial nerve function improved one year after surgery (two cases of HB-I, two cases of HB-Ⅱ, and one case of HB-Ⅲ). For two patients, with preoperative facial nerve function HB-Ⅴ-Ⅵ, since their tumors was inseparable from the nerves, they were performed with facial nerve anastomosis during the surgery, and the facial nerve function was improved to HB-Ⅳ level one year after surgery. For six patients with meningioma whose facial nerve function was greater than or equal to HB-Ⅲ, based on the preoperative hearing level, the involved segments, and duration of facial paralysis, three of them were conducted surgeries through middle cranial fossa approach, one by translabyrinthine approach, and one via mastoid approach. Two patients among them with complete facial paralysis over three years preoperatively were not performed facial nerve anastomosis after total resections of the tumors, and there was no improvement in facial nerve function one year after surgery. Three patients underwent facial nerve anastomosis after total tumor resections, and their facial nerve function was HB-Ⅲ in one patient, HB-Ⅳ in two patients one year after surgery. One patient (preoperative HB-Ⅲ) had a normal hearing level preoperatively, and the tumor involved the labyrinth segment. To protect the hearing, partial tumor was resected through the middle cranial fossa approach, and facial nerve function improved to HB-Ⅱ one year after surgery.Conclusions:Temporal bone HRCT combined with DCE-MRI are useful for the differential diagnosis of hemangioma and schwannoma at geniculate ganglion and provide references for preoperative clinical decision makings. It is extremely necessary to select the appropriate surgical approach based on the patient′s hearing and involved segments. For geniculate ganglion hemangioma, early surgery can improve the possibilities of anatomical integrity of facial nerve, thereby improving facial nerve function postoperatively.TEA is a kind of surgical method worth consideration, with the characteristics of minimally invasive, favorable postoperative features, and so on. For schwannoma, one-stage functional reconstruction of the facial nerve is recommended during the resection of the tumors because of the inevitable damage to the anatomical integrity of the facial nerve.

Objective To set up a living mice colonoscopy platform to establish an orthotopic model of colorectal cancer in mice under direct vision,and to observe its biological behavior such as metastasis.Methods Eighteen-week-old male C57/BL mice were anesthetized,and the intestinal lumen of the mice was examined by a self-developed living mice colonoscopy and Olympus URF-P5 ureteroscopy,respectively.The imaging effects of the two methods were compared.Human colon cancer HT-29 cells were injected into the colonic mucosa of BALB/c-nu mice under direct vision.The colonoscopy was performed on the 3rd,7th and 15th day after the injection to observe the tumor formation in the intestinal lumen.The mice were sacrificed when the body weight decreased significantly or cachexia appeared,and then the abdominal cavity was examined including the tumor formation and metastasis.Results The self-developed living mice colonoscopy platform can provide clear vision of enteric cavity,and no mice died in the colonoscopy examination.In vivo subcutaneous injection of HT-29 cells in mice was performed with a perforation rate of 15％,a mortality rate of 33.3％,a tumor formation rate of 62.5％,an abdominal metastasis rate of 60％,a liver metastasis rate of 25％,and an abdominal wall transfer rate of 25％.Conclusion The self-developed mice colonoscopy platform can be used for the study of colorectum in living mice.The imaging effect is no less than that of Olympus URF-P5 ureteroscopy.In addition,an orthotopic colorectal cancer model can be established by this platform combing with submucosal injection technology.

Objective: To analyze the recent postoperative and long-term postoperative complications of open-splenectomy and disconnection in patients with portal hypertension. Methods: There were 1 118 cases with portal hypertension who underwent open splenectomy and azygoportal disconnection from April 2010 to September 2015 at Department of Surgery, People′s Liberation Army 302 Hospital. Retrospective case investigation and telephone follow-up were conducted in October 2016. All patients had history of upper gastrointestinal bleeding before operation. Short-term complications after surgery were recorded including secondary laparotomy of postoperative abdominal hemostasis, severe infection, intake disorders, liver insufficiency, postoperative portal vein thrombosis and perioperative mortality. Long-term data including postoperative upper gastrointestinal rebleeding, postoperative survival rate and incidence of postoperative malignancy were recorded, too. GraphPad Prism 5 software for data survival analysis and charting. Results: Postoperative short-term complications in 1 118 patients included secondary laparotomy of postoperative abdominal hemostasis(1.8%, 21/1 118), severe infection(2.9%, 32/1 118), intake disorders(1.0%, 11/1 118), liver dysfunction (1.6%, 18/1 118), postoperative portal vein thrombosis(47.1%, 526/1 118)and perioperative mortality(0.5%, 5/1 118). After phone call following-up, 942 patients′ long-term data were completed including 1, 3, 5 years postoperative upper gastrointestinal rebleeding rate(4.4%, 12.1%, 17.2%), 1, 3, 5-year postoperative survival rate(97.0%, 93.5%, 90.3%); the incidence of postoperative malignant tumors in 1, 3 and 5 years were 1.7%, 4.4% and 6.2%. Conclusions Reasonable choosing of surgical indications and timing, proper performing the surgery process, effective conducting perioperative management of portal hypertension are directly related to the patient′s short-term prognosis after portal hypertension. Surgical intervention can reduce the rates of patients with upper gastrointestinal rebleeding, improve survival, and do not increase the incidence of malignant tumors.

OBJECTIVE To explore the methods of preoperative diagnosis, evaluation and surgical treatment of the subglottic web in children. METHODS We analyzed the clinical manifestations, electronic laryngoscopy results, tracheal endoscopy and airway CT results of 4 children cases with congenital laryngeal cartilaginous subglottic web (1 case of type IV and 3 cases of type III) from August 2014 to March 2018. All of the 4 patients underwent a laryngofissure plus submucosal resection of cartilage web and short-term stenting. RESULTS Two cases underwent preoperative tracheotomy at 13 month old, 1 case at 6 month old. One case underwent tracheotomy at the same time of laryngoplasty. Two children indwelled the stents for 7 days and 11 days after operation and removed the stent by themselves. Other 2 cases removed the stent by the doctor at 14 day after operation. After removing the stents, the 4 cases underwent a pluging of the tracheotomy instantaneously. After 3 to 5 months of continuously pluging of the tracheotomy, all cases successfully removed the tracheal cannula. CONCLUSION For children with congenital laryngeal cartilaginous subglottic web of type III or type IV, the operation of laryngofissure plus submucosal resection of cartilage web and short-term stenting is the good choice with a high extubation rate and no complications.

Objective To explore the FOXP3-related mechanism underlying head and neck squamous cell carcinoma.Methods We used cbioportal to identify the co-expressed genes of FOXP3 in 279 samples from head and neck squamous cell carcinoma in TCGA database.We used String database to establish the co-expression network of FOXP3.The function of co-expression network was identified through DAVID database.We used miRTarBase and StarBase database to screen the microRNA,lncRNA and circRNA that regulate FOXP3.Finally,Cytoscape software was used to establish FOXP3-related ceRNA network.Results We found 950 FOXP3 related co-expressed gene.(Spearman score over 0.5) These genes were enriched in immune response including T cell,leukocyte and lymphocyte activation.CeRNA network revealed that 2 microRNAs (i.e.,miR-31-5p and miR-210-3p),42 lncRNAs (e.g.,XIST,TUG1,JRK and LINC00473) and 31 circRNAs (e.g.,ZNF223 _hsa_ circ_ 000898 and ISY1 _hsa _circ _001090) could regulate FOXP3.Conclusion We established FOXP3-related ceRNA network and identified 42 lncRNAs and 31 circRNAs that regulate FOXP3.The data generated from this study could provide a new cut point in research and treatment of head and neck squamous cell carcinoma.

Objective Screening the functional gene modules that can play important roles in hypopharyngeal cancer and the potential anti-cancer drugs.Methods GEO database and MeV software were employed to screen the differentially expressed genes in hypopharyngeal cancer.Using STRING database,the protein-protein interaction network was identified.MCODE plugin of Cytoscape was used to identify the functional gene modules in the network.Based on DAVID database,the functions of modules were identified.DrugBank was used to screen the potential drugs that regulate the target genes of modules.Results 1 222 differentially expressed genes including 219 interaction pairs were i-dentified in whole genome profiling(P <0.05 ).Seven functional modules were identified in the network.The results of function analysis showed the module genes were enriched in cancer development related-function ‘regulation of angiogenesis’,‘cell adhesion’,‘DNA meta-bolic process’.A total of 50 potential drugs that regulating the 5 modules were screened.Conclusion Five functional modules that regulate the progress of hypopharyngeal cancer were identified,and maybe they can promote hypopharyngeal cancer through some functions such as regulation of angiogenesis 18 up-regulated protein kinases were identified.Their kinase inhibitors may potential have a role in anti-cancer, which provides a new target point for molecular therapy of nasopharyngeal cancer.

Objective To explore the differences among CT angiography(CTA) at different doses in both lower extremity arteries,and the relationship among volume rendering(VR) image quality,CT number and standard deviation(SD) value.Method CTA in lower extremity artery was performed in 90 patients.The participants were randomly divided into three groups,including a routine group (120 kV,150 mAs),120 kV and 80 mAs group,and 100 kV and 130 mAs group with 30 cases in each group.The images were processed with VR and classified into three degrees,the first class,the second class and the third class,and VR image quality levels of three groups were compared.The receiver operating characteristic curve(ROC) was used to analyze the correlation among VR image quality level,CT number and SD value.Results The percentage of VR image level at the first class was 93.3％ in the routine group,86.6％ in the 120 kV and 80 mAs group and 96.6％ in the 100 kV and 130 mAs group.According to the correlation analysis between the SD value and VR image quality of CTA in lower extremity artery,the area under curve in ROC analysis was 0.9078.According to the correlation analysis between the CT number and VR image quality of CTA in lower extremity artery,the area under curve in ROC analysis was 0.9116.Conclusions The low-dose CAT in lower extremity artery is feasible.Application of 100 kV and 130 mAs could ensure better image quality.

OBJECTIVE: By watching the effects of cochlear implants in the children with cochlear nerve defects, to evaluate the relationship and efficiency of HRCT AND MRI in diagnostic for cochlear nerve defects. METHOD: The imaging dates and the post-operative effects of the 10 cochlear nerve defect patients were retrospectively analyzed. RESULT: Three patients with bilateral IAC stenosis by HRCT and cochlear nerve defects by MRI but no other abnormal. Seven other patients showed normal IAC by HRCT including 1 showed type IP- I plus vestibular semi circular canal dysplasia. These 7 patients MRI showed 3 bilateral cochlear nerve absent and 4 bilateral cochlear nerve dysplasia. Ten cases of children after 12-32 month follow-up, 3 patients began speaking simple language, whose MAIS scale, CAP and SIR scores improved. One case just began speaking but pronunciation vague. Four cases had reactions to sounds, and can say monosyllabic words. Two cases without effects (1 CI abolished). Compared with other patients with normal cochlear nerve, the effects of the 10 cases were disappointed. CONCLUSION The effects of cochlear implant for the patients with cochlear nerve defects were poor. The preoperative MRI as sessment including oblique sagittal view for cochlear nerve is necessary. The preoperative communication with the parents telling ineffective result possibility is important.
Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Cochlear Nerve ; abnormalities ; Female ; Humans ; Infant ; Male ; Retrospective Studies

OBJECTIVE: To evaluate the applicative value of computer assisted navigation system in endoscopic sinus and skull base surgery. METHOD: Forty-nine endoscopic surgery procedures were performed with the help of computer assisted navigation system, among which there were 25 cases of recurrent sinusitis and nasal polyps, 9 cases of nasal and sinus tumour, 7 cases of cerebrospinal fluid rhinorrhea, 2 cases of meningoencephalocele, 4 cases of congenital choanal atresia, 1 case of pituitary tumor and 1 case of foreign body in middle cranial fossa. RESULT: The preoperative time was 5-13 minutes for preparation, 7 minutes in average. The target error was less than or equal to 1.5 mm. All the 49 cases had successful surgery without complications. CONCLUSION Computer assisted navigation system can help the surgeon to determine the sinus, skull base and adjacent anatomic landmarks correctly, improve surgical accuracy and safety, and reduce intraoperative and postoperative complications.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Computer Systems ; Female ; Humans ; Infant ; Male ; Middle Aged ; Paranasal Sinuses ; surgery ; Skull Base ; surgery ; Surgery, Computer-Assisted ; methods ; Young Adult

OBJECTIVETo study the efficacy and safety of Naoxintong capsule treatment of stroke recovery with Qi-deficiency and blood-stasis syndrome (cerebral infarction), and to compared the non-inferiority analysis with the positive drug Tongxinluo capsule.

METHODTaking Tongxinluo capsules as control, randomized, double-blind, controlled, multi-center clinical experiments were studied. The evaluating indexes included the decrease of integral value of stroke patients, changes in traditional Chinese medicine, the improvement of the patient viability status (disability level), Chinese stroke scale (CSS), activities of daily living (DAL) scale and barthel index (BI ) points.

RESULTThe total effect of the two groups, Chinese and other symptoms, showed no significant statistical significance.

CONCLUSIONNaoxintong capsule stroke recovery, with Qi-deficiency and blood-stasis syndrome (cerebral infarction) has a therapeutic effect, and more secure.

Activities of Daily Living ; Adult ; Aged ; Capsules ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Qi ; Stroke ; drug therapy ; Treatment Outcome