The latest research findings on bidirectional regulation of neuro-immunity through traditional neural circuits shed new light on the theoretical basis of the role of vidian neurectomy (VN). This article aims to provide a comprehensive understanding of VN, including the history of VN, the principle of neuroimmuno-interaction, the applied anatomy of VN as well as the methods of transnasal endoscopic surgery. Additionally, we introduce the concept of the nose-brain axis, which was proposed based on the advancement in the area of neuro-immune interactions.

Objective:To assess the prognosis of sinonasal adenoid cystic carcinoma with hard palatine invasion treated by transnasal endoscopic total maxillectomy. Methods:Clinical data of twenty-six patients with sinonasal adenoid cystic carcinoma invading hard palatine treated by transnasal endoscopic total maxillectomy between May 2014 and December 2020 was analyzed retrospectively. Survival rate, local recurrence and distant metastasis were analyzed using Kaplan-Meier method. Cox regression was used to investigate the prognosis factors. Masticatory function after maxillectomy has also been assessed using the questionnaire of patients' satisfaction about masticatory function. Results:Margins in 8 patients（30%） were positive. The median time of follow-up was 38 months（6 to 85 months）. Twenty-five patients recurred. Four patients died of distant metastasis. The 5-year overall survival rate and relapse-free survival rate was 79.5% and 89.1%, respectively. Independent predictors of outcome on multivariate analysis were positive margin（P=0.018）, recurrence（P=0.006） and distant metastasis（P=0.04）. Conclusion:Transnasal endoscopic total maxillectomy could be performed for the treatment of the sinonasal adenoid cystic carcinoma with hard palatine invasion. Positive margin, local recurrence and distant metastasis were important predictors for patients' prognosis.
Humans ; Carcinoma, Adenoid Cystic/pathology* ; Paranasal Sinus Neoplasms/pathology* ; Retrospective Studies ; Neoplasm Recurrence, Local/pathology* ; Prognosis

OBJECTIVE To investigate the improvement effect of Dihuang yinzi on neurological function of APP/PS1 double transgenic positive mice and its possible mechanism. METHODS APP/PS1 double transgenic positive mice were randomly divided into APP/PS1 positive model group， Dihuang yinzi low-dose， medium-dose and high-dose groups （12， 24， 48 g/kg，by the amount of crude drug）， western medicine group （donepezil hydrochloride 0.8 mg/kg）； APP/PS1 transgenic negative mice were included in as APP/PS1 negative normal group， with 6 mice in each group. Administration groups were given relevant medicine intragastrically； APP/PS1 positive model group and APP/PS1 negative normal group were given constant volume of normal saline intragastrically， once a day， for consecutive 28 d. After the last medication， the ability of learning and memory， intestinal flora diversity （only medium-dose group of Dihuang yinzi）， pathological changes of neural cells in hippocampus， and the expressions of Bcl-2， Bax and brain-derived neurotrophic factor （BDNF） in mice of each group were investigated. RESULTS Compared with APP/PS1 positive model group， escape latency of mice was shortened significantly in Dihuang yinzi medium-dose and high-dose groups， while the times of crossing the platform significantly increased （P＜0.05）. Compared with APP/PS1 positive model group， Chao1 index of Dihuang yinzi medium-dose group was lower， while Shannon index was higher （P＜0.05）； OTU abundance of microbial flora was decreased to some extent； dominant flora was Clostridia o_ Clostridia_ vadinBB60_ Group， verruca G_ UCG_ 005. Compared with the APP/PS1 positive model group， the pathological changes of the nerve cells in the hippocampal CA1 area of mice were improved in the medium-dose and high-dose groups of Dihuang yinzi； the protein expressions of Bcl-2 and BDNF in the hippocampal tissue were significantly increased， while the protein expression of Bax was significantly decreased （P＜0.05）. CONCLUSIONS Dihuang yinzi can enhance the diversity of flora， change the type of dominant flora， and can inhibit the apoptosis of brain neurons， and increase the level of BDNF； its mechanism may be to protect nerve cells by means of gut-brain axis， thereby improving the learning and memory ability of APP/PS1 positive model mice.

Objective:To investigate the feasibility of endoscopic salvage surgery for patients with rT2 recurrent nasopharyngeal carcinoma (rNPC) and to analyze their prognostic factors.Methods:The clinical data of 33 patients with rT2 rNPC who underwent endoscopic extended nasopharyngectomy in Eye & ENT Hospital Affiliated to Fudan University from January 2015 to July 2020 were analyzed, including 29 males (87.9%) and 4 females (12.1%), aging (51.7±10.6) years. The clinicopathological characteristics of these patients were recorded and analyzed, in terms of gender, sex, alcohol and cigarette use, interval between primary treatment to recurrence, adjuvant therapy, lymph node metastasis, internal carotid artery (ICA) invasion, necrosis, margin and reconstruction materials. Kaplan Meier analysis was used to plot the overall survival rate and progression free survival rate curve, Log-rank test was used to analyze the prognostic factors among patients, and multivariate Cox proportional hazards regression was used to determine the independent risk factors of tumor progression free survival.Results:Among 33 patients with rT2 rNPC, the recurrence interval of 24 patients with rNPC after primary radiotherapy was more than 2 years. A total of 25 patients received primary radiotherapy and adjuvant chemotherapy at the same time. There were 6 cases with cervical lymph node metastasis, 12 cases with ICA invasion, 8 cases with positive surgical margin, 7 cases underwent ICA embolization before operation. A total of 18 cases underwent pedicled tissue flap repairment after operation, including 12 pedicled nasal septal mucosa flaps and 6 temporalis muscle flaps. The median follow-up time was 15 months. Five patients died because of disease progression (in 2 cases), post surgical ICA hemorrhage (in 1 case), liver metastasis (in 1 case) and dysphagia (in 1 case). The 1-year, 2-year and 3-year overall survival rates of all patients were 93.9%, 81.8% and 81.8%, respectively. The 1-year, 2-year and 3-year progression free survival rates were 74.7%, 59.7% and 40.9%, respectively. Log-rank statistical analysis showed that the positive surgical margin ( P=0.060) and recurrence interval ( P=0.151) were possibly related to the prognosis of rT2 rNPC. Multivariate Cox regression analysis showed that the positive surgical margin was an independent risk factor for patients with rT2 rNPC ( P=0.034). Nasopharynx hemorrhage occurred in 4 patients, skull base bone necrosis occurred in 2 patients, trismus occurred in 3 patients, and no obvious brain complications occurred in 7 patients with ICA embolization. Conclusion:Endoscopic salvage surgery for rT2 rNPC is a safe and effective surgical option, but the long-term effect still needs long-term follow-up in bulk cases.

Objective: To discuss the treatment, pathological subtypes and recurrence of sinonasal chondrosarcoma, and to identify the prognostic factors. Methods: Between January 1994 and May 2018, 47 patients with sinonasal chondrosarcoma who were treated in Eye, Ear, Nose and Throat Hospital, Shanghai Medwal College, Fudan University were retrospectively reviewed, including 19 males and 28 females, aging from 7 months to 71 years old, with a median age of 38 years old. The clinical symptoms, location of tumor, surgical method, pathological subtype, recurrence and prognosis were collected and analyzed. Kaplan-Meier method was used to calculate the disease-specific survival rate, disease-free survival rate and draw survival curve. Log Rank was used to analyze the prognostic factors. Cox regression was used for multivariate analysis. Results: Except for one patient who gave up treatment after tumor biopsy, other 46 patients underwent radical resection, including 31 cases of endoscopic resection and 15 cases of extranasal approach resection. Thirty-nine patients were diagnosed as conventional intramedullary chondrosarcoma with pathological grade Ⅰ of 24 cases and grade Ⅱ of 15 cases. Six cases were diagnosed as mesenchymal chondrosarcoma while 2 cases were diagnosed as myxoid chondrosarcoma. During an average follow-up period of 56.1 months (17-156 months), 23 patients had recurrence (54.8%, 23/42), among whom 9 patients had re-operations and 5 patients died. Thirty-seven patients survived, including 25 patients survived without tumors. In addition, 5 patients were lost to follow-up, including the patient who gave up treatment after tumor biopsy. Five-year overall survival rate and disease-free survival rate was 84.7% and 34.3%, respectively. Multivariate analysis showed that invasion of skull base was an independent risk factor affecting disease-free survival rate (95% confidence interval: 1.089-5.825, P=0.031). Conclusions Radical resection is the primary treatment for sinonasal chondrosarcoma. The most common pathological subtype is conventional intramedullary chondrosarcoma. Sinonasal chondrosarcoma has a high local recurrence rate. The long-term prognosis is well after complete excision of the lesion. The most important cause of death is uncontrollable local disease and invasion of adjacent key structures.

Objective:To explore the correlations between circulating tumor cells (CTCs) level in peripheral venous blood and clinicopathological characteristics and biomarkers of lung cancer patients using CI-101 cell search immunomagnetic bead enrichment technology combined with fluorescent cytochemical staining.Methods:Blood samples were collected from 100 patients with first-diagnosed lung cancer treated in Department of Thoracic Surgery and Department of Cardiothoracic Surgery of Yunnan Cancer Hospital from March 2014 to September 2014, 40 patients with lung benign tumor (all confirmed by pathological biopsy) and 30 healthy volunteers from the physical examination center. CTCs in peripheral blood were enriched by CI-101 cell search immunomagnetic bead, the morphology of CTCs was analyzed by immunocytofluorescence technique, and tumor cells were identified using HE cell staining method. The recovery rate, sensitivity and specificity of CI-101 cell search instrument for CTCs were detected. The difference of positive rate of CTCs in peripheral blood among lung cancer patients, lung benign tumor patients and healthy volunteers was compared. The relationship between the positive rate of CTCs and the clinicopathological characteristics of patients with lung cancer was analyzed. The correlations between CTCs and serum tumor markers were analyzed by coefficient of contingency in patients with lung cancer and lung benign tumor.Results:The recovery rate of CTCs by CI-101 cell search instrument was 72.0%-89.0%, and there was a significant linear correlation between the number of recovered cells and the number of incorporated cells. The correlation coefficient r=0.998 ( P<0.001), the linear regression equation was y=0.781 x+ 11.307, the sensitivity was 85.0%, and the specificity was 71.4%. The positive rate of CTCs in lung cancer patients (85.0%, 85/100) was higher than that in lung benign tumor patients (15.0%, 6/40) and healthy volunteers (46.7%, 14/30) ( χ2=62.798, P<0.001). The positive rate of CTCs in lung cancer patients was correlated with TNM stage ( χ2=19.059, P<0.001), tumor size ( χ2=13.830, P<0.001) and distant metastasis ( χ2=6.005, P=0.014). Coefficient of contingency analysis showed that the positive of CTCs was positively correlated with serum tumor markers CEA ( φ=0.217, P=0.011), CA125 ( φ=0.198, P=0.020), CA199 ( φ=0.169, P=0.049), CA742 ( φ=0.186, P=0.037) and cytokeratin 19 fragment ( φ=0.461, P<0.001) in patients with lung cancer and lung benign tumor. Conclusion:The application of CI-101 cell search instrument combined with immunomagnetic bead method can successfully enrich CTCs in peripheral venous blood of lung cancer patients. The positive rate of CTCs in patients with lung cancer has obvious correlation with tumor size, TNM stage, distant metastasis, serum tumor markers. It can be used as an auxiliary indicator for monitoring the condition of lung cancer patients.

外泌体是一种纳米级别的生物膜结构，由机体的多种细胞分泌，广泛分布于唾液、血浆、乳汁等体液中。外泌体中含 有蛋白质、mRNA、miRNA、lncRNA、细胞因子、转录因子受体等多种生物活性物质。肿瘤细胞或肿瘤旁细胞分泌的外泌体可将 一些肿瘤特有的生物信息转移到邻近细胞，甚至远处细胞，并且通过这种细胞间通信传递肿瘤的特性，从而促进肿瘤的发生发 展。本综述旨在着重讨论肿瘤细胞及癌旁细胞分泌的含lncRNA的外泌体对肿瘤微环境，肿瘤的生物学特性的影响，为肿瘤的基 础研究及临床诊断治疗提出新的思路。

肺癌的发病机制非常复杂，目前仍未明确。研究发现miRNA是肿瘤中的一组重要的调节因子，与肺癌的发生发展密 切相关，异常表达后可作为致癌miRNA或抑癌miRNA参与调控信号通路基因的表达，影响肺癌细胞的增殖、迁移、侵袭、转移等 过程。本文就miRNA作为抑癌或致癌基因在肺癌发生发展中机制的最新研究进展进行综述。

[Abstract] MicroRNA (miRNA) is non-coding RNA molecule consisting of 20-25 nucleotides. It plays an important role in regulation of tumorigenesis and progression, including proliferation, differentiation and apoptosis of cancer cells, which directly affect the progress of tumors. Peripheral blood miRNA is relatively more stable, and easier to acquired and detected than tissue miRNA. It is a new generation biomarker for early detection and early diagnosis of tumors. It is also one of the main development directions of research and application in precision medicine. Methods commonly used in peripheral blood miRNA detection are RT-PCR, electrochemical detection, NanoString Technologies, genechip and high-throughput sequencing etc. Multiple miRNAs in peripheral blood are the early diagnostic markers for non-small cell lung cancer, esophageal squamous cell carcinoma, pancreatic cancer, squamous cell carcinoma of the head and neck, ovarian cancer, colorectal cancer, breast cancer, prostate cancer and hematological malignancies. Combined detection of multiple peripheral blood miRNAs, as well as combined detection of tumor-specific miRNAand serological, imaging and other auxiliary methods, can improve the sensitivity and specificity of tumor diagnosis at early stage.

微小RNA（microRNA，miRNA）是一种内源性的长度为18~25个核苷酸的非编码RNA，通过与蛋白质编码基因的 mRNA结合来发挥重要的基因调控作用，与恶性肿瘤的发生发展密切相关。miR-32作为miRNA家族的重要成员，在不同肿瘤中 表达水平存在明显差异，因其与恶性肿瘤的相关性及本身表达的正反作用双向性， 在miRNA领域受到了更多的关注。近年来研 究发现，miR-32对恶性肿瘤细胞的增殖、迁移与侵袭、自噬和凋亡均有影响。此外，miR-32与其上游靶基因、肿瘤代谢及临床诊 断和治疗也有密切的关系。本文就miR-32在恶性肿瘤发生发展中的作用及其机制、临床诊治中应用等最新研究进展作一综述。