To introduce a case of local skin necrosis by hematoma after alar reduction. A 20-year-old female patient underwent comprehensive rhinoplasty with ear cartilage paddind nose tipand and alar reduction. After 7 days, the right nasal alar wound was covered with blood scabs, and poorly healed. Debridement and suturing were performed. On the 7th day after debridement, there was sudden blackening of the incision edge which enlarged the area. The patient was treated with dressing change for 18 days but did not improve. She came to the First Affiliated Hospital of Guangxi University of Chinese Medicine for treatment. The hematoma was cleared and the bleeding points were explored. After multiple routine dressing changes, the skin on the wound edge became necrotic, turning black and dry before removal. After 25 days of dressing changes, no skin flap repair was performed, and the wound healed without obvious scars. The nose was basically on the opposite side. Therefore, attention should also be paid to preventing hematoma during alar reduction. For small amounts of hematoma in special areas, timely treatment should be taken to avoid skin necrosis and ulceration.

To introduce a case of local skin necrosis by hematoma after alar reduction. A 20-year-old female patient underwent comprehensive rhinoplasty with ear cartilage paddind nose tipand and alar reduction. After 7 days, the right nasal alar wound was covered with blood scabs, and poorly healed. Debridement and suturing were performed. On the 7th day after debridement, there was sudden blackening of the incision edge which enlarged the area. The patient was treated with dressing change for 18 days but did not improve. She came to the First Affiliated Hospital of Guangxi University of Chinese Medicine for treatment. The hematoma was cleared and the bleeding points were explored. After multiple routine dressing changes, the skin on the wound edge became necrotic, turning black and dry before removal. After 25 days of dressing changes, no skin flap repair was performed, and the wound healed without obvious scars. The nose was basically on the opposite side. Therefore, attention should also be paid to preventing hematoma during alar reduction. For small amounts of hematoma in special areas, timely treatment should be taken to avoid skin necrosis and ulceration.

Depressive disorder is manifested as emotional and physical abnormality. Theoretically, the governor vessel is distributed along the spine, related to the brain and communicated with five zang and six fu organs. It is the key meridian for understanding the various symptoms of depressive disorder. Depressive disorder is caused by dysfunction, stagnation or emptiness of the governor vessel, resulting in malnutrition of the brain. In clinical diagnosis and treatment, based on the theory of the governor vessel, the etiology and pathogenesis are analyzed in the patients with depressive disorder. In order to achieve harmonizing mutually the mental and physical conditions, acupuncture is delivered to adjust the spirit and physical state, moving cupping is to regulate the governor vessel, tuina manipulation is to promote meridians and collaterals and physical exercise is to coordinate the body and the spirit.
Humans ; Acupuncture Therapy/methods* ; Meridians ; Acupuncture ; Brain ; Depressive Disorder ; Acupuncture Points

Plexiform neurofibromas (pNF) is significant hallmark of type Ⅰ neurofibromatosis, posing substantial negative impacts on patients’ quality of life and daily functionality. Surgical intervention remains the primary modality of treatment. However, the surgery is fraught with challenges due to the rich vascularization, intricate neural involvement, and ill-defined borders of the tumors. The risk of recurrence and complications further complicates the surgical approach. Through extensive literature review and integrative analysis, this article summarizes the current surgical treatment options and adjunctive techniques available for pNF management. Preoperative radiological assessments, vascular embolization, intraoperative neural monitoring, and fluorescence navigation are among the ancillary techniques that can effectively mitigate surgical risks. The timing of surgery should be guided by specific indications and contraindications, while the surgical plan must be individualized based on the patient’s unique presentation, sometimes necessitating a multidisciplinary approach. Overall, a comprehensive assessment of the patient’s condition and the implementation of multifaceted adjunctive measures are imperative for maximizing tumor resection while minimizing the risks of recurrence and complications.

Plexiform neurofibromas (pNF) is significant hallmark of type Ⅰ neurofibromatosis, posing substantial negative impacts on patients’ quality of life and daily functionality. Surgical intervention remains the primary modality of treatment. However, the surgery is fraught with challenges due to the rich vascularization, intricate neural involvement, and ill-defined borders of the tumors. The risk of recurrence and complications further complicates the surgical approach. Through extensive literature review and integrative analysis, this article summarizes the current surgical treatment options and adjunctive techniques available for pNF management. Preoperative radiological assessments, vascular embolization, intraoperative neural monitoring, and fluorescence navigation are among the ancillary techniques that can effectively mitigate surgical risks. The timing of surgery should be guided by specific indications and contraindications, while the surgical plan must be individualized based on the patient’s unique presentation, sometimes necessitating a multidisciplinary approach. Overall, a comprehensive assessment of the patient’s condition and the implementation of multifaceted adjunctive measures are imperative for maximizing tumor resection while minimizing the risks of recurrence and complications.

The recent emergence of targeted therapies for neurofibromatosis type 1 (NF1) brings a new dawn for these patients and contributes to an increase in the number of patients seeking medical treatment, which was a great unmet medical need in the past. It puts forward higher requirement for the clinical standard diagnosis and treatment of NF1. As a rare autosomal dominant genetic disorder, the clinical manifestations of NF1 are various and could involve multiple organs and systems, which requires Multi-Disciplinary Treatment (MDT). However, as NF1 is a relatively rare disease and has insufficient attention in the past, current understanding for NF1 is still limited. Standardized multi-disciplinary consultation has not been established nationwide. Furthermore, due to the lack of unified patient registration, evaluation and follow-up system, it is difficult to conduct large-scale clinical cohort studies based on Chinese population. This article reviewed current challenges in the diagnosis, management, and research on NF1 in China. Meanwhile, we proposed several suggestions to improve the diagnosis and treatment abilities based on our long-term experience on NF1, to establish a high-quality Chinese NF1 diagnosis, management, and research system in the future.

Objective:To summarize the publications in the field of neurofibroma and malignant peripheral nerve sheath tumor in the past 25 years, to illuminate the cooperation among countries, academic institutions and researchers, and to compare the research topics between Chinese and English databases, and to predict the research trend.Methods:Web of Science and CNKI databases were searched, and literature about neurofibroma and malignant peripheral nerve sheath tumor(MPNST) resection from January 1st, 1997 to September 2nd, 2021 were included. Excel 2017 was used for statistical analysis. VOSviewer 1.6.16 software was used for clustering and visualization of countries, institutions, authors, and keywords.Results:A total of 9 620 English articles and 957 Chinese articles were included. Over the past 25 years, Chinese and English publications have been increasing quickly. In terms of countries and institutions, most of the countries with a large number of documents published in English literature (top 10) are developed countries and the institutional cooperation between them is relatively close. In terms of keywords clustering, the result of English literature are more comprehensive, including the pathogenesis, clinical manifestations, diagnosis and treatment of complications. The clustering result suggest that the potential research hotspots in the future may be the impact of tumor microenvironment on the development of neurofibroma and MPNST, molecular typing of neurofibroma, drug resistance mechanism of neurofibroma and so on. The clustering of Chinese literature can be summarized as the auxiliary diagnosis of neurofibroma and the treatment of complications.Conclusions:In the future, researchers may pay more attention to the role of tumor microenvironment in the development of neurofibroma, driving factors of neurofibroma and MPNST, molecular typing and drug resistance mechanism of neurofibroma.

The recent emergence of targeted therapies for neurofibromatosis type 1 (NF1) brings a new dawn for these patients and contributes to an increase in the number of patients seeking medical treatment, which was a great unmet medical need in the past. It puts forward higher requirement for the clinical standard diagnosis and treatment of NF1. As a rare autosomal dominant genetic disorder, the clinical manifestations of NF1 are various and could involve multiple organs and systems, which requires Multi-Disciplinary Treatment (MDT). However, as NF1 is a relatively rare disease and has insufficient attention in the past, current understanding for NF1 is still limited. Standardized multi-disciplinary consultation has not been established nationwide. Furthermore, due to the lack of unified patient registration, evaluation and follow-up system, it is difficult to conduct large-scale clinical cohort studies based on Chinese population. This article reviewed current challenges in the diagnosis, management, and research on NF1 in China. Meanwhile, we proposed several suggestions to improve the diagnosis and treatment abilities based on our long-term experience on NF1, to establish a high-quality Chinese NF1 diagnosis, management, and research system in the future.

Objective:To summarize the publications in the field of neurofibroma and malignant peripheral nerve sheath tumor in the past 25 years, to illuminate the cooperation among countries, academic institutions and researchers, and to compare the research topics between Chinese and English databases, and to predict the research trend.Methods:Web of Science and CNKI databases were searched, and literature about neurofibroma and malignant peripheral nerve sheath tumor(MPNST) resection from January 1st, 1997 to September 2nd, 2021 were included. Excel 2017 was used for statistical analysis. VOSviewer 1.6.16 software was used for clustering and visualization of countries, institutions, authors, and keywords.Results:A total of 9 620 English articles and 957 Chinese articles were included. Over the past 25 years, Chinese and English publications have been increasing quickly. In terms of countries and institutions, most of the countries with a large number of documents published in English literature (top 10) are developed countries and the institutional cooperation between them is relatively close. In terms of keywords clustering, the result of English literature are more comprehensive, including the pathogenesis, clinical manifestations, diagnosis and treatment of complications. The clustering result suggest that the potential research hotspots in the future may be the impact of tumor microenvironment on the development of neurofibroma and MPNST, molecular typing of neurofibroma, drug resistance mechanism of neurofibroma and so on. The clustering of Chinese literature can be summarized as the auxiliary diagnosis of neurofibroma and the treatment of complications.Conclusions:In the future, researchers may pay more attention to the role of tumor microenvironment in the development of neurofibroma, driving factors of neurofibroma and MPNST, molecular typing and drug resistance mechanism of neurofibroma.

Objective:To investigate the efficacy of microsurgical treatment in cavernous sinus tumors.Methods:The clinical data of 87 patients with cavernous sinus tumor treated by microsurgery from January, 2010 to August, 2019 were analysed retrospectively. The surgical approaches and microsurgical skills for common tumors in Cavernous Sinus region were discussed. The follow-up included outpatient and telephone follow-ups, and the follow-up results were evaluated by KPS score.Results:Among the 87 cases, 57 were totally resected (65.5%), 14 were subtotal resected (16.1%) and 16 were major resected (18.4%). Hospitalisation ranged from 14 to 98 days, with an average of 29 days. Postoperative complications occurred in 30 cases with cranial nerve injury, 2 brain stem injury, 4 postoperative bleeding, 5 cerebrospinal fluid leakage, 4 infection, 1 Pituitary damage and 1 death. Prognosis and follow-up analysis showed 68 cases with KPS>60 and 66 with KPS>80 at 1 month after surgery; 74 with KPS>70 and 72 with KPS>80 at 3 months after surgery; 78 with KPS>80 by 12 months after surgery. During the follow-up period of 6-120 months, 3 cases died. Recurrence: 6 of incomplete resection of meningioma, were in 1-6 years after the surgery, 4 of incomplete resection of schwannoma in 1-8 years, 2 of pituitary adenoma respectively in 13 and 16 months after the surgery. There was no recurrence after reoperation. Two cases of chondrosarcoma, 3 of chordoma and 3 of germinoma were treated with radiotherapy, and during the follow-up, there was no progress of the focus. No tumor progression or recurrence was found in other cases during follow-up.Conclusion:Surgery of cavernous sinus tumor is difficult due to frequent postoperative complications. Reasonable preoperative plan, surgical approach and precise microsurgical techniques are the keys in reduction of postoperative complications and in the improvement of prognosis.