The Effects of Composite Alkali-Stored Spent Hypsizygus marmoreus Substrate on Carcass Quality, Rumen Fermentation, and Rumen Microbial Diversity in Goats.

The objective of this study was to investigate the effects of composite alkali-stored spent Hypsizygus marmoreus substrate (SHMS) on carcass quality, rumen fermentation, and rumen microbial diversity in goats. Twenty-four 6-month-old Chuanzhong black goats with similar body weights (20 ± 5 kg) were selected and randomly divided into four groups (n = 6 per group) and received four treatments: 0% (control group, CG); 20% (low-addition group, LG); 30% (moderate-addition group, MG); and 40% (high-addition group, HG) of SHMS-replaced silage corn and oat hay. The experiment lasted for 74 days (including a 14 d adaptation period and a 60 d treatment period). The results of this study showed that MG and HG significantly improved the marble score of goat meat (p < 0.05). The flesh color score significantly increased in each group (p < 0.05). The fat color scores significantly increased in LG and MG (p < 0.05). There were no significant effects on the pH value or shear force of the longissimus dorsi in each group (p > 0.05). The cooking loss in MG was higher than that in CG (p < 0.05). The histidine and tyrosine contents in each group of muscles significantly increased (p < 0.05), with no significant effect on fatty acids (p > 0.05). The rumen pH of MG significantly decreased (p < 0.05), while the total volatile fatty acids (TVFAs) and ammoniacal nitrogen (NH3-N) increased by 44.63% and 54.50%, respectively. The addition of the SHMS altered both the alpha and beta diversities of the rumen microbiota and significant differences in the composition and structure of the four microbial communities. The dominant bacterial phylum in each group were Firmicutes and Bacteroidetes, with Prevotella 1 as the dominant bacterial genus. Correlation analysis revealed that rumen bacteria are closely related to the animal carcass quality and rumen fermentation. In the PICRUSt prediction, 21 significantly different pathways were found, and the correlation network showed a positive correlation between the Prevotella 1 and 7 metabolic pathways, while the C5-branched dibasic acid metabolism was positively correlated with nine bacteria. In summary, feeding goats with an SHMS diet can improve the carcass quality, promote rumen fermentation, and alter the microbial structure. The research results can provide a scientific reference for the utilization of SHMS as feed in the goat industry.

Efficacy of Icotinib, an EGFR Tyrosine Kinase Inhibitor in Non-Small Cell Lung Cancer Patients with Exon 19 Deletion and Exon 21 L858R: A Retrospective Analysis in China.

INTRODUCTION: The effect of icotinib on non-small cell lung cancer (NSCLC) patients with EGFR exon 19 deletions (19-Del) or L858R point mutation in exon 21 (21-L858R) remains inconsistent. This study aimed to evaluate the efficacy and safety of icotinib in patients with advanced NSCLC harboring these 2 EGFR mutations. METHODS: We retrospectively assessed the clinical effects of first-line icotinib on advanced NSCLC patients with 2 classic EGFR mutations. Kinase activity assays were used to reaffirm the preclinical efficacy. RESULTS: Among 2,757 patients, 2,365 (86%) harbored 19-Del (1,346/2,757, 49%) or 21-L858R (1,019/2,757, 37%) mutation. Patients with 19-Del had a higher response rate (ORR; 67.8 vs. 62.1%; p = 0.0039) and disease control rate (98.5 vs. 97.2%; p = 0.0223) than those with 21-L858R mutation. The median progression-free survival (PFS) in the 19-Del group (22.3 months, 95% confidence interval [CI]: 21.3-23.4) was significantly longer than that in the 21-L858R group (20.4 months, 95% CI: 19.5-21.7) (p = 0.004). In multivariate analysis, mutation types, clinical stage, and smoking history were significant factors for PFS. Additionally, an in vitro study indicated the 50% inhibitory concentrations (IC50) of icotinib was lower for EGFR 19-Del than 21-L858R. CONCLUSION: These results suggest that EGFR 19-Del confers superior PFS and response to the icotinib treatment compared to 21-L858R.

Activity pattern study of Asiatic black bear (Ursus thibetanus) in the Qinling Mountains, China, by using infrared camera traps.

The study of activity patterns is important for understanding the capacity of animals for adapting their behavior based on their habitat conditions. Among bears, daily activity patterns are considered to be strongly influenced by regional climate conditions. We monitored the activity patterns (active vs. inactive) of the Asiatic black bear (Ursus thibetanus) using infrared camera traps (from May 2013 to November 2016) in the Qinling Mountains, China. We used 125 photos, with 19,132 camera days from 55 camera locations. Based on relative independent capture (RIC), bears were found to be intensively active during June (5.86 ± 1.05 SE), July (8.45 ± 2.74), September (14.83 ± 6.13), and October (8.70 ± 3.43), with activity levels gradually decreasing beyond October. After this decline, activities eventually come to a halt when the bears enter in hibernation. We found that their hibernation period was shorter in the Qinling bears, with only 3 months of denning from January to March. Based on their daily patterns, bears were predominantly active during the daytime both in spring (70.83 ± 35.41%) and summer (52.09 ± 28.89%), but more active at twilight during autumn (51.12 ± 42.88%). We assumed that food preferences and food availability (due to warmer regional climatic conditions) might be responsible for such deviations in daily and monthly activity patterns.

[Pharmacology and Clinical Evaluation of Ensartinib Hydrochloride Capsule].

Lung cancer is one of the most common malignancies with the highest incidence rate and mortality rate worldwide, and non-small cell lung cancer (NSCLC) accounts for about 85%. Only 5% NSCLC patients are anaplastic lymphoma kinase (ALK) rearrangement positive NSCLC, but the prognosis of these patients is poor, and treatment is urgent. Ensartinib (X-396), a next-generation ALK tyrosine kinase inhibitor (ALK-TKI), has shown greater potency on inhibiting ALK activity and controlling brain metastases than crizotinib, which is indicated for the treatment of crizotinib-resistant, ALK-positive NSCLC patients. Several phase I to III clinical trials included both healthy volunteers and NSCLC patients have been conducted both in China and abroad. In this review, we briefly summarized the results of these trials, and preliminary efficacy, safety, pharmacology and pharmacokinetics/pharmacodynamics of ensartinib were discussed.

Comparison of tracheal intubation with controlled ventilation and laryngeal mask airway with spontaneous ventilation for thoracoscopic bullectomy.

General anesthesia with double-lumen endobronchial intubation is considered mandatory for thoracoscopic bullectomy. We assessed the safety and feasibility of thoracoscopic bullectomy for treatment of primary spontaneous pneumothorax (PSP) under intubating laryngeal mask airway (ILMA) with spontaneous breathing sevoflurane anesthesia combined with thoracic paravertebral block (TPB).From January 2018 to December 2018, some 34 consecutive patients with PSP were treated by thoracoscopic bullectomy under ILMA with spontaneous breathing sevoflurane anesthesia combined with TPB (study group). To evaluate the safety and feasibility of this new technique, these patients were compared with the control group consisting of 34 consecutive patients with PSP who underwent thoracoscopic bullectomy using tracheal intubation with controlled ventilation from January 2017 to December 2017. The demographic characteristics, intraoperative surgical and anesthetic results, and postoperative results were assessed.The 2 groups had comparable anesthetic time, operation time, chest drainage time, postoperative hospital stays, and hospitalization cost. Visual analogue score (VAS) scores at 3 hours at rest and at coughing were significantly lower in the study group than in the control group (mean, 0.9 vs 2.0 and 1.8 vs 4.0, P = .024 and P = .006, respectively). No differences were seen in PaO2 values between the 2 groups in the intraoperative stage and postoperative stage (P > .05, respectively). The pH value was significantly lower in the intraoperative stage (mean, 7.28 vs 7.40, P = .01) and higher in the postoperative stage (mean, 7.35 vs 7.33, P = .014) in the study group than in the control group. The PaCO2 value was significantly higher in the intraoperative stage in the study group than in the control group (mean, 57.0 mm Hg vs 42.0 mm Hg, P = .015). In the study group, no cough reflex was found, and the level of collapse of the operative lung was excellent in 31 cases and good in 3 cases.Our study demonstrated that thoracoscopic bullectomy for treatment of PSP can be safely and feasibly performed in highly selected patients under ILMA with spontaneous breathing sevoflurane anesthesia combined with TPB.

Characteristics of heavy metal concentrations and risk assessment for giant pandas and their habitat in the Qinling Mountains, China.

High concentrations of heavy metals in the environment threaten the quality of ecosystems and the health of human beings and animals. Giant panda (Ailuropoda melanoleuca), which is endemic to China and a global conservation icon, has the largest density in the Qinling Mountains. This paper investigated the spatiotemporal variation of heavy metal concentrations in soil (N = 44) at the regional scale with three zones of urban areas, mountain edges, and central mountains, the temporal variation of heavy metal concentrations in three bamboo species (N = 19) and two types of feces (N = 10), and assessed the ecological risk and health risk for giant pandas and their habitat in the Qinling Mountains. The results showed that the median concentrations of studied eight heavy metals mercury (Hg), arsenic (As), copper (Cu), manganese (Mn), zinc (Zn), chromium (Cr), lead (Pb), and cadmium (Cd) in soil exceeded the background values of Shaanxi Province except Pb. The median concentrations of Hg, Zn, Cr, Pb, and Cd in bamboo surpassed the reference standard (RS) of national food safety limits in vegetables for human intake, but the concentration of Zn was within the nutrient range in the bamboo plants. Heavy metals were enriched more in feces of captive than the wild giant pandas, which illustrated either higher ingestion or lower digestibility for captive giant panda. Ecological risk assessment of soil by the geo-accumulation index (Igeo) and risk index (RI) showed strong pollution by Hg and moderate pollution by Cd. Health risk assessment by the hazard index (HI) showed a potential to strong risk for giant pandas exposed to Pb, As, and Hg. In addition, the concentrations of heavy metals in feces showed a higher exposure risk for captive giant pandas than wild giant pandas. We suggest that attention should be paid to and all effective measurements should be taken for reducing the emission of Hg, As, Pb, and Cd in the study area.

Congenital Middle Ear Malformation with Common Deafness Gene Mutation Analysis: A Review of 813 Profound Sensorineural Hearing Loss Child Patients.

Deafness gene variants play a key role in inner ear malformations. However, the relationship between congenital middle ear malformations and common deafness genes (GJB2, SLC26A4, and mtDNA) in profound sensorineural hearing loss (SNHL) child patients remains poorly investigated. Here we showed that there was no statistical significance in the total mutation frequency of the three common deafness genes in the middle ear malformation group (21.2%, 41/193) in comparison with the normal middle ear and inner ear group (21.0%, 116/553) (χ2 = 0.0061, p = 0.940). Moreover, the mutation ratio of GJB2 and SLC26A4 in the middle ear malformation group (18.7%, 36/193; 2.6%, 5/193) was not significantly different from that in the normal middle ear and inner ear group (17.7%, 98/553; 2.4%, 13/553) (χ2 = 0.084, p = 0.772; χ2 = 0.0000, p = 1.000). The mutation ratio of GJB2 235delC and GJB2 79G>A in the middle ear malformation group (8.8%, 17/193; 8.8%, 17/193) was almost the same to that in the normal middle ear and inner ear group (8.6%, 48/553; 6.7%, 37/553) (χ2 = 0.0030, p = 0.957; χ2 = 0.9556, p = 0.328). The high jugular bulb subgroup analysis also showed the same results. Our findings suggested that GJB2, SLC26A4, and mtDNA mutations might not be related to the middle ear malformations in profound SNHL child patients. Anat Rec, 303:594-599, 2020. © 2019 American Association for Anatomy.

Diversity and activity patterns of sympatric animals among four types of forest habitat in Guanyinshan Nature Reserve in the Qinling Mountains, China.

Environmental heterogeneity contributes to various habitats and may influence the diversity and activity patterns of wildlife among habitats. We used camera traps to assess wildlife habitat use in Guanyinshan Nature Reserve from 2009 to 2012. We focused on four types of habitat including open areas with gentle slope (<15°) (Type1), low elevation areas (about 1500-1700 m) with high bamboo coverage (Type2), high elevation areas (about 2100-2300 m) with high canopy coverage (Type3), and wildlife migration passages (Type4). We analyzed the differences in species richness, relative abundance index (RAI), species diversity, and animals' activity pattern among habitats. Total six species were analyzed on activity pattern, which are Takin (Budorcas taxicolor), tufted deer (Elaphodus cephalophus), Himalayan goral (Naemorhedus goral), wild boar (Sus scrofa), golden pheasant (Chrysolophus pictus), and porcupine (Hystrix hodgsoni). The results are (1) that there were significant differences in richness and RAIt among habitats; (2) Type4 habitat had the highest richness and RAIt while Type2 had the highest species diversity; giant pandas were found in these two habitats; (3) there were significant differences in species' activity during daytime and nighttime; and (4) differences appeared in habitat preference of the most abundant species. Takin and tufted deer preferred Type1, Himalayan goral preferred Type2, and golden pheasant preferred Type3. Type4 habitat was used by most animals. All these revealed that habitat heterogeneity plays an important role in species diversity and the importance for conservation.

Reconstruction of human oncological tracheal defects with xenogenic acellular dermal matrix.

OBJECTIVE: This study aimed to explore the effectiveness of xenogenic acellular dermal matrix (xeno-ADM) in tracheal reconstruction. METHOD: Two patients were treated with this surgical method to reconstruct the trachea in 2013. The patients were diagnosed with tracheal adenoid cystic carcinoma by histopathological biopsy. The tumor was resected with half of the tracheal circumference and repaired by xeno-ADM. The patients were followed up for 31 and 33 months, respectively. RESULT: No infection or tracheal fistula was observed. The grafts were clear. Both patients were successfully decannulated without dyspnea and could breathe and speak without prosthesis. The cervical mobility was not impaired. CONCLUSION: Xeno-ADM was successfully used to reconstruct a stable and well-functioning trachea. This surgical method is simple, safe, and effective with fewer complications.

Application of xenogenic acellular dermal matrix in reconstruction of oncological hypopharyngeal defects.

Acellular dermal matrix (ADM) can be used as a new membrane substitute for repairing mucosal defects. The objective of this study is to explore the effectiveness of xenogenic acellular dermal matrix (xeno-ADM) in hypopharynx reconstruction. A total of 40 patients were treated with this surgical method to reconstruct hypopharynx in our department between February 2011 and October 2012. Patients were diagnosed had hypopharyngeal cancer located at lateral and/or postpharyngeal wall. The mucosal defect size after hypopharyngeal resection was 3 × 4 cm-6 × 7 cm, and was repaired by xeno-ADM. Patients were followed up for 11-36 months. 4 patients got infected, and two developed into pharyngeal fistula. Patients regained eating function 2-5 weeks after surgery. No membrane was removed; no severe stenosis of hypopharynx was observed. All patients were successfully decannulated. The overall 3-year survival rate is 67.5 %; the 3-year disease-free rate is 47.5 %. Reconstruction of hypopharynx by xeno-ADM is proved to be a simple, safe and effective method with fewer complications.

Imaging assessment of profound sensorineural deafness with inner ear anatomical abnormalities.

OBJECTIVE: To explore the value of a combined computed tomography (CT) and magnetic resonance imaging (MRI) in evaluating profound sensorineural deafness patients before cochlear implant (CI) surgery. METHODS: A retrospective analysis of 1012 cases of profound sensorineural deafness that received CI was performed. RESULTS: A total of 96 cases were diagnosed with inner ear abnormalities including large vestibular aqueduct syndrome (LVAS, n = 61), Michel deformity (n = 3), cochlear incomplete partition I (n = 2), cochlear incomplete partition II (n = 6), cochlear hypoplasia with vestibular malformation (n = 3), cochlear ossification (n = 3), bilateral internal auditory canal obstruction (n = 5) and internal auditory canal stenosis (n = 2). CONCLUSION: High resolution CT (HRCT) can display bony structures while MRI can image the membranous labyrinth in preoperative evaluation for cochlear implantation. The combination of these two modalities provides reliable anatomical information regarding the bony and membranous labyrinths, as well as the auditory nerve.

Xenogeneic acellular dermal matrix in combination with pectoralis major myocutaneous flap reconstructs hypopharynx and cervical esophagus.

The aim of this study was to explore xenogeneic acellular dermal matrix (ADM) in combination with pectoralis major myocutaneous flap in hypopharynx and cervical esophagus reconstruction. A total of five patients were treated with this surgical method to reconstruct hypopharynx and cervical esophagus in Second Xiangya Hospital between January 2012 and April 2013. Four of them had hypopharyngeal carcinoma with laryngeal and cervical esophageal invasion, while the fifth patient with hypopharyngeal cancer had developed scars and atresia after postoperative radiotherapy. The defect length after hypopharyngeal and cervical esophageal resection was 6-8 cm, and was repaired by a combination of ADM and pectoralis major myocutaneous flap by our team. Interestingly, the four patients had primary healing and regained their eating function about 2-3 weeks after surgery, the fifth individual suffered from pharyngeal fistula, but recovered after dressing change about 2 months. Postoperative esophageal barium meals revealed that the pharynx and esophagus were unobstructed in all five patients. Xenogeneic ADM in combination with pectoralis major myocutaneous flap for hypopharynx and cervical esophagus reconstruction is a simple, safe and effective method with fewer complications. Nevertheless, according to the defect length of the cervical esophagus, the patients need to strictly follow the medical advice.

[Management and prognosis of differentiated thyroid carcinoma with tracheal invasion].

OBJECTIVE: To evaluate treatment modalities and prognosis differentiated thyroid carcinoma (DTC) with tracheal invasion. METHODS: Clinical data were reviewed and analyzed in 50 patients treated for DTC with tracheal invasion between January 1990 and June 1998. The different surgical modalities were applied according to the extent of tracheal invasion: shave excision (20 cases), tracheal sleeve resection or tracheal partial resection (23 cases), total laryngectomy or laryngeal closure surgery (7 cases). Thirty-eight cases received postoperative (131)I therapy. Survival rate was evaluated using the Kaplan-Meier analysis. RESULTS: The 5-, 10- and 15-year survival rates of all the cases were 90.0%, 74.0% and 56.0%, respectively. The 5-, 10- and 15-year survival rates were 94.7%, 81.6% and 65.8% respectively in 38 cases with postoperative (131)I therapy and were 75.0%, 50.0% and 25.0% respectively in 12 cases without postoperative (131)I therapy, with statistically significant differences in 5-, 10- or 15-year survival rates between the patients of two groups. CONCLUSIONS: The tumors can be resected radically by corresponding surgery based on the extent of tracheal invasion. Postoperative (131)I therapy can enhance the survival rate of the patients with differentiated thyroid carcinoma involving in trachea.

[Impact of pregnancy terminations before 28 weeks of gestation on the overall prevalence of neural tube defects in two counties of Shanxi province].

OBJECTIVE: To examine the impact of pregnancy termination before 28 weeks of gestation on the overall prevalence of neural tube defects (NTDs). METHODS: Data collected during the period of 2004 and 2010 from a birth defects surveillance system in Pingding county and Taigu county of Shanxi province were used. Number of births≥28 weeks of gestation and number of cases with major birth defects among the births were collected. Terminations of pregnancies before 28 weeks of gestation due to prenatal diagnosis were also collected. The total prevalence of neural tube defects, prevalence before 28 weeks of gestation, and prevalence of ≥28 weeks gestation were calculated using the total number of pregnancies of ≥28 weeks of gestation as denominator. The prevalence data were compared to examine the impact of pregnancy termination on the total prevalence. The proportions of pregnancy terminations before 28 weeks of gestation due to prenatal diagnosis of an NTD against the total number of NTD cases were also calculated. RESULTS: During 2004-2010, 52 366 births were recorded, and 485 NTD cases were ascertained. The overall prevalence of NTDs was 92.6 per 10,000 births, with prevalence of <28 weeks gestation due to pregnancy terminations as 60.9 per 10,000 births, while the prevalence of ≥28 weeks of gestation was 31.7 per 10,000 births. NTD prevalence of ≥28 weeks gestation was 66.0% lower than the total NTD prevalence. In the last two years, the proportion of NTDs ascertained ≥28 weeks gestation accounted for about 40.0% of the total NTD cases. CONCLUSION: A birth-defect-surveillance program that covered only pregnancies≥28 weeks of gestation resulted in a severe underestimation of the total birth prevalence of NTDs, especially for anencephaly. We would recommend that the current national birth defects surveillance system should include pregnancy terminations before 28 weeks of gestation and the calculation of total NTD prevalence should also include these cases into the numerator, so as to better estimate true population NTD prevalence, upon which the related public health policy is based.

Treatment of recurrent head and neck carcinoma involving the carotid artery: carotid reconstruction with ePTFE graft.

The aim of our study is to investigate the feasibility of reconstructing the carotid artery using expanded polytetraflouroethylene (ePTFE) in patients with recurrent head and neck carcinoma involving the carotid artery. Ten patients, who had recurrent head and neck carcinoma involving the carotid artery, received carotid artery resection and reconstruction with ePTFE, tissue defects were repaired by pectoralis major myocutaneous flap. Results show that eight patients did not present any vascular and neurologic complications. One patient presented slight hemiparesis, another patient developed wound infection and pharyngocutaneous fistula. The mean follow-up period was 33.1 ± 16.0 months. The 2-year survival rate was 50% (5/10), and there was one patient who survived for 60 months without locoreginal recurrence or distant metastasis. En bloc resection of tumor and involved carotid-associated ePTFE reconstruction provide effective improvement in the locoregional control of the recurrent head and neck carcinoma. The pedicle pectoralis major myocutaneous flap can provide not only wound bed with affluent blood supply for the vascular grafts, but also reparation of skin or the tissue defects of oropharynx and hypopharynx.

[Clinical features and treatment of closed rupture of cervical trachea].

OBJECTIVE: To study the clinical manifestations and treatments of closed injuries of the cervical trachea. METHOD: We carried out a retrospective study of the clinical manifestations, diagnosis and treatment of patients with closed injuries of the cervical trachea that have been treated in our hospital over the last ten years. We analyzed commonly occurring clinical problems, key points of surgical treatment, and postoperative recovery. Fourty-one patients with acute closed injuries of the cervical trachea underwent emergency tracheotomy or anesthesia orotracheal intubation and surgical repair of the trachea within 24 to 48 hours. Twenty six patients had their tracheotomy tubes extubated after surgery and had their anesthesia orotracheal tubes extubated within 48 hours postoperatively; tracheotomy tubes remained in the airway in 15 patients postoperatively, and of them, 12 had extubation successfully in 2 weeks postoperatively, while the remaining 3 were left intubated due to laryngotracheal stenosis. Among the 3, 2 underwent further surgical repair and recovery, and 1 had a stent inserted. RESULT: Twenty-eight patients fully recovered postoperatively. Ten patients mostly recovered postoperatively exception for hoarseness, and their fundamental phonation function recovered within 2 to 3 months but with poor movement of the vocal cords. The breathing and swallowing function of the other 3 patients recovered after the surgery, but they suffer from hoarseness. CONCLUSION: In the treatment of closed disruption of the cervical trachea, prompt diagnosis and timely surgical repair of the structure and function of the trachea are key to saving the patients' lives and avoiding tracheal stenoses.

[Effect of brain-derived neurotrophic factor gene transfected bone-marrow mesenchymal stem cells on damaged cochlear spiral ganglion cells of guinea pigs].

OBJECTIVE: To investigate the protective role of brain-derived neurotrophic factor (BDNF) gene transfected bone-marrow mesenchymal stem cells (BMSC) on cochlear spiral ganglion cells (SGC) impaired by aminoglycoside antibiotics (AmAn). METHODS: The differentiation of BMSC transfected by BDNF gene (BDNF-BMSC) were detected with immunohistochemical examination of Nestin, neuron-specific enolase (NSE), and glial fibrillary acid protein (GFAP) antibody in vitro. BDNF gene transfected BMSC were transplanted into the cochleae of guinea pigs deafened by amikacin, while the control groups were designed in which artificial perilymphatic fluid (APF), BMSC or BDNF gene was injected into cochleae alone. The cochleae were obtained on the week 1, 2 and 4 after injection, respectively, paraffin-embedded, and cut in a paramodiolar plane subsequently. The histopathological changes of cochleae were observed, the density of SGC was calculated by staining with HE, and the corresponding optical density (COD) was calculated with immunohistochemical staining using NSE antibody. And the protective role of various groups on the cochlear SGC were compared. RESULTS: The positive staining rate of BDNF gene transfected BMSC with Nestin, NSE and GFAP antibody were all higher than that of BMSC in vitro (P < 0.01). After transplantation into cochleae, the differences of SGC density and COD among various groups were all significant on the same time points (P < 0.05). The SGC density and COD of the BDNF gene transfected BMSC group were the highest. The SGC density and COD of various groups on week 4 were all obviously decreased than those on week 1 and 2 (P < 0.05). CONCLUSION: AmAn-induced SGC damage could be depressed by BMSC, BDNF gene or BDNF gene transfected BMSC transplantation into cochleae, while BDNF gene transfected BMSC showed the best protective role.

[Clinical analysis of extramedullary plasmacytomas in the head and neck].

OBJECTIVE: To summarize the clinical features and the experiences of diagnosis and treatment of extramedullary plasmacytomas (EMPs), and to enhance the cure rates of EMPs. METHOD: Clinical data of 8 patients with EMPs in head and neck, who treated in our hospital from Jan. 1990 to Dec. 2004, were reviewed. Of 8 cases, 3 cases with the tumors occurred in nasal cavities, 1 in maxillary sinus, 2 in nasopharynx, 1 in posterior wall of oropharynx. RESULT: Eight patients who were all pathologic confirmed EMP accepted surgical resections of the tumors, and 4 of 8 cases were boosted radiation therapy post-operation. Four cases were still alive disease-free for more than 1, 5, 10 and 12 years after treatments, respectively. One died of local recurrence in 2 years, 1 died of multiple myeloma in 3 year, and 1 died of heart attack in 2 years after treatments, respectively. One lost follow-up. CONCLUSION: EMPs in head and neck are low potential malignancy tumors. The diagnosis of EMPs mainly depends on clinical manifestations and pathological results. Surgery and radiation therapy are the main treatments for EMPs in head and neck.

[Diagnosis and surgical treatment of the carotid body tumors].

OBJECTIVE: To enhance the cure rate and lower the complication rate and the mortality rate through summarizing the clinical features and experiences in diagnosis and therapy of carotid body tumor (CBT). METHOD: Retrospectively analyzed the clinical data of 21 cases (23 sides) of CBT from 1995-2095 occurring in our hospital. RESULT: The accurate diagnosis rates hy using digital subtraction angiography (DSA) and magnetic resonance imaging (MRI) were 100%. Seventeen cases (19 sides) accepted surgical operation with different kinds of procedures. The tumors of 8 cases were simplex isolated from the carotid artery. Both the tumour and the external carotid artery were resected in 9 cases. One case underwent resection of both the internal and external carotid artery and the tumour without carotid reconstruction. One case underwent resection of the internal, external carotid artery and the tumor with reconstruction of the internal carotid artery. No operative mortality was observed. The ventricular arrhythmia which had not been controlled pre-operation occurred in 1 case who was finally self-cured. One case had hoarseness and completely recovered in one week. and 1 case without carotid reconstruction had a frequent headache and gradually recovered in 5 months. The others had no complications. CONCLUSION: OSA and MRI are the best methods for diagnosing CBT. Surgery is the first choice concerning the treatment of CBT. Accurate preoperative evaluation, correct therapeutic decision exquisite vascular surgical techniques can help to significantly decrease, even avoid the complications.

[Reconstructive methods for hypopharynx and cervical esophagus].

OBJECTIVE: To review the surgical treatment for reconstructing hypopharynx and cervical esophagus after hypopharyngo-oesophagectomy, and to evalue its efficacy. METHODS: Different methods were adopted to reconstruct the hypopharynx and cervical esophagus among 25 cases, including 14 cases of carcinoma of the hypopharynx and 11 of carcinoma of hypopharynx and cervical esophagus. In accordance with the standard of the International Union Against Cancer in 1997, the 25 cases were divided into different clinic stages, among which 5 were in T(2)N(0), 2 in T(2)N(1), 4 in T(3)N(0), 3 in T(3)N(1), 7 in T(4)N(1) and 3 in T(4)N(2). Treatment protocol was as follow: Pure operation for 5 cases, re-operation after radiotherapy for 2 cases, operation plus radiotherapy for 18 cases, laryngeal conservation operation for 8, and neck dissection for 21 cases. Reconstruction was done by using free jejunal transplantation, gastric pull-up, the laryngotracheal flap, and myocutaneous flap. RESULTS: After the reconstruction, 3 cases of free jejunal graft and gastric pull-up, 4 of laryngotracheal flap recovered oral fleeding within 2 weeks. No serious complications occurred. After 18 cases underwent the myocutaneous flap reconstruction, no complications occurred in 10 patients, but there were different complications in 8 cases, including pharyngocutaneous fistula (6 cases), haryngoesphageal stenosis (7 cases), and pectoralis major myocutaneous flap necrotic (1 case). The 3-year survival rate was 38.9% (7/18). CONCLUSION: Reconstruction with free jejunal graft, gastric pull-up, and laryngotracheal flap constitutes is a safe and reliable method to restore the continuity of the upper digestive tract after pharyngo-laryngo-oesophagectomy. After the reconstruction with myocutaneous flap, there is high incidence of pharyngocutaneous fistula and haryngoesophageal stenosis.