OBJECTIVE To investigate the selection strategy for recipient vessels in free flap reconstruction of head and neck defects.METHODS A retrospective analysis was conducted on 96 patients who underwent 99 free flap reconstructions for head and neck defects between January 2020 and December 2024.Recipient vessel selection,flap survival,and postoperative complications were analyzed based on defect location and flap type.RESULTS In 99 cases microvessel anastomosis,the recipient arteries were superior thyroid artery in 49 branches,facial artery in 28 branches,superficial temporal artery in 14 branches,lingual artery in 5 branches.external carotid artery in 1 branch,transverse cervical artery in 1 branch,and superior laryngeal artery in 1 branch.Venous anastomosis was performed in 104 branches,with 94 cases in 1 venous anastomosis and 5 cases in 2 venous anastomoses.The recipient veins selected were facial vein in 62 branches,external jugular vein in 21 branches,superficial temporal vein in 12 branches,retromandibular vein in 3 branches,middle thyroid vein in 2 branches,internal jugular vein in 2 branches,middle temporal vein in 1 branch,and superior thyroid vein in 1 branch.Complete flap necrosis occurred in 5 cases,and partial necrosis occurred in 4 cases.When the recipient vessels were deficient,the lingual artery was chosen in 3 cases,the facial artery in 1 case,the external jugular vein in 3 cases,the internal jugular vein with end-to-side anastomosis in 1 case,and the common facial vein with end-to-side anastomosis in 1 case.CONCLUSION In free flap reconstruction for head and neck defects,the superior thyroid artery,facial artery,and superficial temporal artery are commonly used as recipient arteries,while the facial vein,external jugular vein,and superficial temporal vein are frequently selected as recipient veins.When recipient vessels are scarce,the ipsilateral lingual artery,transverse cervical artery,and main trunk of the internal jugular vein can serve as alternative recipient vessels.

OBJECTIVE To explore the application of the facial artery musculomucosal(FAMM)flap for the reconstruction of head and neck defects.METHODS A retrospective analysis of 9 patients with head and neck defects reconstructed with the FAMM at the Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,between May 2019 and March 2024.Data regarding defect location,flap size,and postoperative complications were analyzed.RESULTS The defect locations among the nine patients were as follows:hard palate(3 cases),soft palate(2 cases),nasal septum and columella(1 case),oropharyngeal lateral wall(1 case),retromolar region and oropharyngeal lateral wall(1 case),and lower lip(1 case).The FAMM flap sizes ranged from 1.5 cm×2.5 cm to 4 cm×6 cm.Primary closure of the donor site was achieved by direct intermittent suturing in 7 cases;one case was repaired using acellular dermal matrix,and 1 case was repaired using a buccal fat pad graft.Postoperatively,eight flaps survived completely,while 1 flap experienced necrosis.None of the patients developed trismus or malocclusion.CONCLUSION The FAMM flap is suitable for reconstructing defects of the hard palate,soft palate,lower lip or oropharyngeal lateral wall.With reliable blood supply and an intraoral donor site,it offers relatively favorable aesthetic outcomes and is worthy of widespread adoption.

OBJECTIVE To investigate the clinical features and gene mutations of Multiple endocrine neoplasia 2A(MEN2A)combined with papillary thyroid carcinoma(PTC),and to provide reference for clinical treatment.METHODS A systematic clinical investigation was conducted on a pedigree of a patient with MEN2A combined with papillary thyroid carcinoma,and the clinical case data of family members(3 generations and 5 people)with MEN2A combined with papillary thyroid carcinoma were analyzed.Genomic DNA was extracted from the peripheral blood of family members,high-throughput sequencing was performed,and the target gene mutation sites were detected by Sanger sequencing.RESULTS Heterozygous mutations of C634W in exon 11 of the RET gene were found in 4 patients in this pedigree.Sanger sequencing was used to detect the target gene mutation sites,and the common mutation gene was RET gene mutation:exon11:c.1902C>G(p.Cys634Trp)site had a heterozygous mutation,which was a germline mutation.The proband in the family was diagnosed with bilateral medullary thyroid carcinoma of the thyroid gland,the proband's sister had bilateral medullary thyroid carcinoma of the thyroid gland,the proband's mother had bilateral medullary thyroid carcinoma of the thyroid gland with bilateral micro papillary carcinoma,accompanied by pheochromocytoma and cutaneous amyloidosis on the back,the proband's aunt had bilateral medullary thyroid carcinoma of the thyroid gland with right papillary carcinoma,accompanied by cutaneous amyloidosis on the back,and the proband's grandfather had bilateral medullary thyroid carcinoma of the thyroid gland with left papillary carcinoma,accompanied by cutaneous amyloidosis on the back.CONCLUSION There is a RET gene germline mutation in the pedigree of MEN2A combined with papillary thyroid carcinoma,and the mutation site is a heterozygous mutation of exon 11 C634W.Genetic mutation screening should be carried out as early as possible for family members of MEN2A with papillary thyroid carcinoma to provide guidance for early clinical diagnosis and treatment.

Objective:To identify the etiology and genetics of the human parainfluenza virus type 3 (HPIV3) virus which caused an acute respiratory tract infection outbreak in a primary school in Shenyang.Methods:Throat swab samples were collected from 17 students of the primary school where the epidemic of acute respiratory infection outbreak in December 2020 in Shenyang, Liaoning province. TaqMan low-density arrays (TLDA) real-time PCR was performed to simultaneously detect multiple respiratory pathogens. The HN gene was amplified using nested RT-PCR and sequenced, followed by phylogenetic analysis for those HPIV3 positive samples.Results:Of the 17 specimens, 10 were HPIV3 positive by TLDA Real-time PCR, and were accompanied by conditional pathogen infection, consequently, amplification result ed in 7 complete HN sequences. Phylogenetic analysis showed that the infected HPIV3 virus of the outbreak belonged to HPIV subtype C3a. All the 7 strains detected in this study belonged to subbranch C3a.1 evolutionary branch, with a nucleotide homology of 99.9%, a nucleotide homology of 94.56 with the prototype strain Wash/47885/57 and 99.5% with the most phylogenetically close strain of ZJ/11-s-165/KP690785/CHN/11.Conclusions:The HPIV3 virus caused the acute respiratory tract infection outbreak in Shenyang in 2020 and HPIV subtype C3a1 was detected firstly in Northeast China.

Although chromosomal mosaic embryos detected by trophectoderm(TE)biopsy offer healthy embryos available for transfer,high-resolution postnatal karyotyping and chromosome testing of the transferred embryos are insufficient.Here,we applied single-cell multi-omics sequenc-ing for seven infants with blastula chromosomal mosaicism detected by TE biopsy.The chromo-some ploidy was examined by single-cell genome analysis,with the cellular identity being identified by single-cell transcriptome analysis.A total of 1616 peripheral leukocytes from seven infants with embryonic chromosomal mosaicism and three control ones with euploid TE biopsy were analyzed.A small number of blood cells showed copy number alterations(CNAs)on seem-ingly random locations at a frequency of 0％-2.5％per infant.However,none of the cells showed CNAs that were the same as those of the corresponding TE biopsies.The blastula chromosomal mosaicism may be fully self-corrected,probably through the selective loss of the aneuploid cells dur-ing development,and the transferred embryos can be born as euploid infants without mosaic CNAs corresponding to the TE biopsies.The results provide a new reference for the evaluations of trans-ferring chromosomal mosaic embryos in certain situations.

T cell immune checkpoint pathways contribute to tumor immune escape. Many studies have shown that immune checkpoint is demonstrably correlated with tumor grade or prognosis in several types of malignancies and immune checkpoint has become a new biological index for tumor detection and prognosis. Immune checkpoint inhibitors have shown promising tumor outcomes in clinical trials for some advanced solid tumors and it will become a new target for cancer immunotherapy. In this review we will explore the correlation between expressions of immune checkpoint-associated genes and proteins in immune microenviroment and prognosis of head and neck squamous cell carcinoma, and specifically will discuss how this pathway can be manipulated with immune therapeutic drugs.

Objective To study the expression of Snail in laryngeal carcinoma and to explore its relationship with invasion and metastasis in subgroup laryngeal carcinoma cells. Method The expression of Snail protein was examined by immunohistochemistry staining in the tissue of laryngeal carcinoma. The statistical evaluation was performed to detect the correlation between the Snail protein expression and clinical features. In different subgroups of laryngeal carcinoma cells (CD 44+CD 133+cells, CD 44 and CD 133-cells), the expression of Snail and adhesion molecules E-cadherin were detected by RT-PCR,Western blot test and immunochemical staining which were studied in the correlation with invasion and metastasis. Results The result of immunohistochemical staining revealed that Snail was moderately or highly expressed in the tissue of laryngeal carcinoma significantly and higher than those in adjacent non-cancerous tissues(P<0.01). Expression of Snail was highly correlated with lymph node metastasis, tumor differentiation and clinical classification(P<0.05).However, it was not related to the age , gender and clinical type. RT-PCR and Western blot test results confirmed that the expression level of Snail was significantly higher in CD 44+CD 133+laryngeal cancer cells than in CD 44-and CD 133-laryngeal cancer cells, otherwise the expression level of E-cadherin in CD 44+CD 133+laryngeal cancer cells was significantly lower than in the CD 44-and CD 133-laryngeal cancer cells. Cell immunohistochemical staining confirmed the expression of Snail and E-cadherin were negatively correlated in CD 44+CD 133+laryngeal cancer cells. Conclusion Over expression of Snail in laryngeal carcinoma is closely related to the development of laryngeal cancer and lymph node metastasis. The expression of Snail in the CD 44+CD 133+laryngeal cancer cell subgroup is negatively correlated with adhesion molecules E-cadherin, which is a close correlation with invasion and metastasis of laryngeal cancer cells.