[Pathogenesis, diagnostic and therapeutic strategies for radiation-related caries].

Radiation-related caries is a common complication following head and neck tumor radiotherapy. It is a rapidly progressing and widespread destructive disease of tooth tissue after radiotherapy, which greatly affects the life quality of patients after radiotherapy. This article elucidates research progress in the pathogenic mechanisms, diagnosis and caries assessment, treatment, as well as prevention strategies for radiation-related caries, aiming to provide references for clinical prevention and treatment of radiation-related caries.

[Epidemiological characteristics of incident cases and risk factors of hepatitis C infection in Beijing City from 2004 to 2021].

Objective: To analyze the epidemiological characteristics and related factors of hepatitis C in Beijing City from 2004 to 2021. Methods: Descriptive epidemiological method and Joinpoint regression were used to analyze the trend and other epidemiological characteristics of hepatitis C in Beijing City from 2004 to 2021 in National Notifiable Disease Reporting System. According to a 1∶1 matched case-control study design, logistic regression was used to investigate the risk factors of hepatitis C infection in 2021. Results: From 2004 to 2021, the reported incidence of hepatitis C in Beijing City ranged from 2.37/100 000 to 10.46/100 000. The reported cases were mainly aged 30-60 years, and most of them were chronic. The reported incidence of hepatitis C showed an initial increase from 2004 to 2006 (APC=45.37%, 95%CI:-1.56%-114.69%), and declined after 2006 (APC=-9.21%, 95%CI:-10.70%-7.70%). Logistic analysis showed that history of surgery (OR=1.84, 95%CI: 1.08-3.14) and previous blood transfusion (OR=34.22, 95%CI: 8.05-145.41) were risk factors for hepatitis C infection. Conclusion: The reported incidence of hepatitis C in Beijing City increases first and decreases later. It currently remains at a low level. The risk factors of infection are surgery and blood transfusion history. Safe blood supply and preventing iatrogenic transmission should be focused on the prevention of hepatitis C transmission.

[Application of lateral upper arm free flap in the repair of postoperative defects of oral cancer].

Objective: To explore the clinical application and efficacy of lateral upper arm free flap (LUAFF) for one-stage repairing of soft tissue defect after oral cancer surgery. Methods: This article was a retrospective analysis of clinical data of 46 patients receiving treatment of one-stage repairing of soft tissue defect with LUAFF after oral cancer surgery in Hunan Cancer Hospital, from June 2019 to June 2021. Among these cases, 40 were males, and 6 were females. The patients' ages were from 23 to 64 years old. The clinical data of patients were reviewed and outcomes were evaluated. SPSS 23.0 software was used for statistical analysis. Results: In the LUAFF of 46 patients, flap area ranged from 5.0 cm×3.5 cm to 15.0 cm×7.0 cm; the mean pedicle length was 8.15±1.42 cm; the mean artery diameter was 1.20±0.41 mm (range, 1.5 to 2.5 mm); the mean diameter of the largest veins was 2.15±0.52 mm; and the median number of perforators was 2.6 (range, 1 to 4). All donor sites were closed primarily. Two cases had arterial anastomosis thrombosis, but their flaps were successfully saved with urgent re-anastomosis of the vessels. The overall flap survival rate was 93.5%(43/46), with flap necroses after operation in three cases. No patient received tracheotomy. The average hospital stay time of patients after operation was 9.4 days. The follow-up time was 6-24 months, elbow and wrist movements on the operative side were normal, and the upper limb muscle strength was not affected. Conclusions: LUAFF is a suitable choice for the repairs of small-moderate tissue defects in oral cancer surgery, with consistent perforators in the flap, simple harvest method, concealed donor-site scar, and high survival rate.

[Plasm trimethylamine-N-oxide level and association with lesion severity in coronary heart disease patients with type 2 diabetes mellitus].

Objective: To investigate the association between trimethylamine-N-oxide (TMAO) and the degree of coronary atherosclerosis in coronary heart diseases (CHD) patients with type 2 diabetes mellitus. Methods: Consecutive patients, who underwent coronary angiography due to suspected CHD in Beijing Hospital from November 2016 to January 2018, were screened in this cross-sectional study. According to blood glucose level, previous medical history and coronary angiography results, they were divided into CHD without type2 diabetes mellitus(CHD-nDM) group and CHD with type2 diabetes mellitus(CHD-DM) group. Plasma TMAO levels in each group were measured by LC-MS/MS. Spearman correlation analysis was used to evaluate the correlation between TMAO and the number of diseased vessels and Gensini scores. Multivariate logistic regression was used to analyze the correlation between TMAO and high Gensini scores. Results: A total of 590 patients were enrolled in the study, including 238 patients in CHD-DM group and 352 patients in CHD-nDM group. Patients were older, body mass index, blood pressure level, prevalence of history of hypertension and statins use were higher in CHD-DM group than in CHD-nDM group (all P<0.05). The proportion of patients with multivessel disease (2 or more vessels) was also higher in CHD-DM group than in CHD-nDM group (P<0.001). Gensini score was higher in CHD-DM group than in CHD-nDM group (P<0.05). Fasting blood glucose, glycosylated hemoglobin and urea were significantly higher, while low-density lipoprotein cholesterol and hemoglobin were significantly lower in CHD-DM group than in CHD-nDM group (all P<0.05). The levels of TMAO was significantly higher in CHD-DM group than in CHD-nDM group (P<0.001). Spearman correlation analysis showed that TMAO was positively correlated with the number of diseased vessels, Gensini score, age and blood glucose level (r=0.178, 0.189, 0.260, 0.111, respectively, all P<0.01). Multivariate logistic regression analysis showed that, TMAO level was still positively correlated with high Gensini score in CHD-DM group (OR=2.25, 95%CI 1.16-4.38, P=0.017), but not in CHD-nDM group (OR=1.29, 95%CI 0.72-2.31, P=0.386) after adjusting for age, sex, body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol, triglyceride, history of hypertension, hyperlipidemia, smoking and statin use. Conclusions: In CHD patients with tupe 2 diabetes mellitus, the plasma TMAO level is significantly increased and is independent and positively correlated with the degree of coronary artery disease.

[HBx promotes ubiquitination and degradation of ZO1 and increases the migration and invasion of liver cancer cells].

Objective: To study the effect of hepatitis B virus X protein (HBx) expression level on migration and invasion of zonula occludens protein-1 (ZO-1) in HepG2 liver cancer cells. Methods: Liver cancer cells were transfected with HBV full gene plasmid (pcDNA3.1-HBV1. 1 or pcDNA3.1-HBV1.3), empty plasmid (pcDNA3.1) and HBV-encoded protein plasmids (pHBc, pHBs, pHBp and pHBx), respectively. Western blot and RT-PCR were used to detect ZO1 protein and mRNA levels. Immunoprecipitation was used to detect transfected pHBx. Western blot was used to detect ZO1 ubiquitination levels. Transwell chambers were used to assess cell migration and invasion. Cell proliferation and lactate dehydrogenase assay was used to detect siRNA transfecting targeting ZO1. Flow cytometry was used to detect cell apoptosis and cycle. The data was compared between two and multiple groups by using an independent sample t-test and one-way analysis of variance. Results: Compared with the empty plasmid, ZO1 protein level in HepG2 cells after transiently transfected with pHBV1.1 and pHBV1.3 was decreased by 42.99% ± 6.8% and 55.0% 5 ± 4.56%, respectively, and their mRNA levels did not change significantly. ZO1 protein level in Huh7 cells was decreased by 17.46% ± 4.94% and 47.53% ± 3.38%, respectively. ZO1 protein level after transfection with pHBx was decreased by 47.02% ± 3.4%, while the ZO1 protein level after transfection with pHBc, pHBs and pHBp did not change significantly. ZO1 mRNA level was unaffected with pHBx transfection. ZO1 ubiquitin level and cell migration and invasion ability in HepG2 cells was significantly increased with transfected pHBx. HepG2 cells proliferation, apoptosis and cycle after transfection with ZO1-targeted siRNA did not change significantly, but the migration and invasion ability were significantly increased. Conclusion: HBx can increase the migration and invasion of liver cancer cells by promoting the ubiquitination and degradation of ZO1 protein level.

[Clinical analysis of 27 cases with descending necrotizing mediastinitis].

Objective: To explore the clinical manifestation and treatment strategy for descending necrotizing mediastinitis (DNM). Methods: A total of 27 cases diagnosed as DNM from January 2010 to August 2018 in the First People's Hospital of Foshan were reviewed. There were 16 males and 11 females, age ranged from 16 to 84 years. The clinical data were collected. SPSS 16.0 software and chi square test were used for statistical analysis. Results: ALL 27 cases were diagnosed as DNM by contrast-enhanced CT scan of the neck and chest. Among the 27 cases, 13 cases resulted from peritonsillar abscess, 8 cases from esophageal foreign body perforation, 5 cases from parapharyngeal and retropharyngeal space abscess, and one case from infection of oral cavity. These 27 cases were divided into three subtypes according to the sites of mediastinitis, including 11 cases for typeⅠ, 5 cases for type ⅡA and 11 cases for type ⅡB. Of 27 cases, 20 cases underwent transcervical drainage for DNM, of which 5 cases with tracheotomy and 6 cases with thoracic drainage, and finally 19 of the 20 patients were cured, and one patient died of bacteremia; 7 cases refused to received surgery and were routinely treated with antibiotics, of which, one case was cured and 6 cases died. The curative rate in patients underwent surgery was significantly higher than that in patients treated with medication (χ(2)=13.638, P<0.001). Among the 20 cured cases, 4 cases were combined with diabetes mellitus and 6 cases with necrotizing fasciitis, while in the 7 died cases, 5 cases were combined with diabetes mellitus and 6 cases with necrotizing fasciitis. The comorbidity rates of diabetes mellitus (χ(2)=4.074, P=0.044) and necrotizing fasciitis (χ(2)=4.457, P=0.035) in died cases were significantly higher than those in cured cases. Conclusion: DNM is a serious infection, with high mortality especially in patients with diabetes and necrotizing fasciitis. Timely cervical and chest enhanced CT scan play vital role in its diagnosis. DNM can be treated effectively with transcervical drainage.

A short follow-up of prosthesis-based breast reconstruction using TiLOOP® Bra surgical mesh.

BACKGROUND: A new approach for prosthesis-based breast reconstruction is the use of a titanium-coated polypropylene mesh TiLOOP® Bra. However, the safety and outcomes are currently unclear in Chinese breast cancer patients. METHODS: A retrospective study of patients undergoing prosthesis-based breast reconstruction using TiLOOP® Bra was carried out. Complications were divided into minor complications (require conservative treatment) and major complications (require surgical intervention). The influence of patient- and surgery-related characteristics on complications was analyzed. RESULTS: Postoperative hematoma and seroma were respectively found in one and two breasts and could be treated conservatively. In three breasts skin infection occurred immediately after surgery resulting in skin necrosis of two breasts and wound dehiscence of one breast. These three breasts were treated with mesh removal, and revisionary surgery. Increased risk of mesh removal and implant explantation were observed in case of skin infection (P = 0.011) and skin necrosis (P = 0.033). Neither patient-related characteristics including age >50 years, BMI >25 kg/m2, and postoperative radiotherapy/chemotherapy, nor surgery-related characteristics including sentinel lymph node biopsy or axillary dissection alone, and curative/prophylactic surgery were significantly correlated with minor and major complications. Ultrasound evaluation showed a well-incorporated mesh into surrounding tissue. CONCLUSION: This titanium-coated polypropylene mesh showed acceptable complications and could be used safely in prosthesis-based breast reconstruction by stabilizing the implant pocket. Longer follow-up data and more randomized trials are necessary to determine the clinical use of this mesh.

[Advances in the role of adenoid hypertrophy in the pathogenesis of otitis media with effusion in children].

Adenoid hypertrophy(AH) and otitis media with effusion (OME) are both common diseases in pediatric otorhinolaryngology and are often associated with each other. Children are often diagnosed with otitis media with effusion and adenoid hypertrophy(OME/AH). Adenoids are immune lymphoid tissues of children's upper respiratory tract, and are important barriers against upper respiratory tract infections.During an upper respiratory tract infection,bacteria or viruses repeatedly stimulate immune lymphoid tissue to cause hyperplasia,and pathological hypertrophy is often accompanied by OME and other related symptoms.In recurrent or chronic OME, hyperproliferative adenoids are usually excised indicating that the two diseases may have a certain correlation. Recently,more and more studies have shown that AH plays an important role in the pathogenesis of OME in children. This article elucidates the role of AH in the pathogenesis of childhood OME from adenoid mechanical obstruction,adenoid bacterial and bacterial biofilm, adenoid local immune regulation, and IgE-mediated allergic reaction.

SOX8 regulates cancer stem-like properties and cisplatin-induced EMT in tongue squamous cell carcinoma by acting on the Wnt/ß-catenin pathway.

A sub-population of chemoresistant cells exhibits biological properties similar to cancer stem cells (CSCs), and these cells are believed to be a main cause for tumor relapse and metastasis. In our study, we explored the role of SOX8 and its molecular mechanism in the regulation of the stemness properties and the epithelial mesenchymal transition (EMT) of cisplatin-resistant tongue squamous cell carcinoma (TSCC) cells. We found that SOX8 was upregulated in cisplatin-resistant TSCC cells, which displayed CSC-like properties and exhibited EMT. SOX8 was also overexpressed in chemoresistant patients with TSCC and was associated with higher lymph node metastasis, advanced tumor stage and shorter overall survival. Stable knockdown of SOX8 in cisplatin-resistant TSCC cells inhibited chemoresistance, tumorsphere formation, and EMT. The Wnt/ß-catenin pathway mediated the cancer stem-like properties in cisplatin-resistant TSCC cells. Further studies showed that the transfection of active ß-catenin in SOX8 stable-knockdown cells partly rescued the SOX8 silencing-induced repression of stem-like features and chemoresistance. Through chromatin immunoprecipitation and luciferase assays, we observed that SOX8 bound to the promoter region of Frizzled-7 (FZD7) and induced the FZD7-mediated activation of the Wnt/ß-catenin pathway. In summary, SOX8 confers chemoresistance and stemness properties and mediates EMT processes in chemoresistant TSCC via the FZD7-mediated Wnt/ß-catenin pathway.

[Treatment of glottic cancer involving the anterior commissure by transoral CO(2) laser surgery].

Objective: To study the clinical outcome of transoral CO(2) laser surgery for glottic cancer involving the anterior commissure. Methods: Thirty-two cases of glottic cancer involving the anterior commissure treated by transoral CO(2) laser surgery between March 2009 and December 2013 were retrospectively reviewed. Among these cases, 27 were T1bM0M0, 5 were T2N0M0. All cases were followed-up for more than 3 years. Results: All the 32 cases were successfully treated. Perioperative complications included injuries in the soft palate mucosa(13/32, 40.63%), loose incisors(3/32, 9.38%) and subcutaneous emphysema in the neck(2/32, 6.25%). During the follow-up period, granulation was found in all cases. Three cases had local recurrence. Two patients treated by a secondary transoral CO(2) laser surgery and the other case had total laryngectomy, all three cases were followed up for 5 years without recurrence. Two cases had regional recurrence but no primary site recurrence. One patient was treated by neck dissection, and followed up for 5 years without recurrence. The other patient died of supraclavicular and mediastinal lymph node metastasis and lung metastasis 40 months after operation. The overall 5-year survival rate was 90.6%. There was no significant difference in survival rate between T1bN0M0(92.6%) and T2N0M0(80.0%) (Log Rank χ(2)=0.788, P=0.375). The overall 5-year local regional control rate was 84.4%. In T1bN0M0 lesions, the 5-year local regional control rate was 92.6%, which was significantly higher than that in T2N0M0 lesions(40.0%) (Log Rank χ(2)=9.504, P=0.002). Conclusion: With appropriate surgical indication, detailed preoperative evaluation, good surgical skill, transoral CO(2) laser surgery may achieve satisfactory outcome in the treatment of glottic cancer involving the anterior commissure.

[Prospective study of riskfactors of difficult laryngeal exposure in suspension laryngoscopy].

Objective:The aim of this study was to demonstrate the risk factors which affect the exposure of glottis in suspension laryngoscopy.Method:We performed a prospective study about 90 cases of vocal cord lesions underwent microlaryngosurgery(including polyps,vocal nodules,cyst and papilloma).Then we recorded the clinical data related to glottic exposure, both preoperatively and intraoperatively. Result:Univariate analysis showed that parameters like age(P=0.038), Cormack-Lehane score(P=0.007),maximuminterincisors gap(P=0.007),hyoid-mental distance(HMD) in full extension(P=0.033), thyroid-mental distance(TMD) in full extension(P=0.014), vertical thyroid-mental distance(VTMD) in full extension(P=0.042), sternum-mental distance(SMD) in full extension(P=0.01) and degree of neck flexion-extension(P=0.003) were related to intraoperative difficult exposure of the glottic area.In logistic regression analysis, Cormack-Lehane score(P=0.003), maximuminterincisors gap(P=0.001) and degree of neck flexion-extension(P=0.002) were significantly risk factors of difficult laryngealexposure. Conclusion:Combination of Cormack-Lehane score, maximuminterincisors gap and degree of neck flexion-extensionmay help to predict the difficult laryngealexposure, so we should evaluate patients before operations of suspension laryngoscopy to decrease the surgical complication.

[Zinc finger E-box-binding homeobox 2 inhibits hepatitis B virus replication and expression].

Objective: To investigate the effect of zinc finger E-box-binding homeobox 2 (ZEB2) on hepatitis B virus (HBV) replication and expression. Methods: HepG2, HepG2.2.15, and HepAD38 cells were cultured separately, and Western blot was used to measure the expression of ZEB2. HepG2.2.15 cells were cultured and transfected with ZEB2 expression plasmids or shRNA targeting ZEB2. Western blot was used to measure the expression of ZEB2 and HBV core proteins, quantitative real-time PCR was used to measure HBV 3.5 kb RNA and HBV DNA, Southern blot was used to measure HBV replicative intermediate, and ELISA was used to measure the expression of HBsAg and HBeAg, in order to clarify the effect of ZEB2 on HBV replication and expression. The dual-luciferase reporter system was used to analyze the effect of ZEB2 on HBV promoter, and the chromatin immunoprecipitation assay was used to detect the binding of ZEB2 to HBV promoter. The t-test was used for comparison of means between groups. Results: The expression of ZEB2 was inhibited in the cells with HBV replication. Overexpression of ZEB2 reduced the level of HBV replication and expression by about 50% (P< 0.05). After ZEB2 was downregulated by shZEB2-1 or shZEB2-2, the level of HBV replicative intermediate increased from 58.53 ± 3.43 to 112.80 ± 5.03, and 128.30 ± 2.31, the relative expression level of HBV 3.5 kb RNA increased from 1.00 ± 0.01 to 2.03 ± 0.02 and 2.32 ± 0.03, the level of HBsAg increased from 35.63% ± 1.57% to 81.87% ± 0.43% and 100.00% ± 2.18%, and HBeAg increased from 37.00% ± 0.70% to 88.00% ± 2.60% and 100.00% ± 0.75%. Furthermore, ZEB2 could bind to HBV core promoter and inhibit its transcriptional activity. Conclusion: ZEB2 inhibits HBV replication and expression through binding to HBV core promoter and inhibiting its transcriptional activity.

[Study on the pharyngeal constriction and function of cricopharyngeal muscle in normal persons using dynamic magnetic resonance imaging].

OBJECTIVE: To investigate the superiority of dynamic magnetic resonance imaging as an assessment method of pharyngeal constriction and cricopharyngeal muscle function, and introduce a new way to measure the pharyngeal constriction ratio, anteroposterior diameter of esophageal entrance and thickness of cricopharyngeal muscle in healthy volunteers. METHODS: Twenty volunteers who were assessed as normal by fiberoptic endoscopic evaluation of swallowing and videofluoroscopic swallowing study were included in this study. With the use of 3.0T magnetic resonance imaging, Fiesta sequence and Asset technique, the median sagittal plane and intervertebral transverse plane from C1 to C5 were scanned repeatedly. Pharyngeal constriction ratio in the median sagittal and intervertebral transverse plane, anteroposterior diameter of esophageal entrance and thickness of cricopharyngeal muscle were assessed and the data were analysed by SPSS13.0. RESULTS: The intervertebral transverse plane between C1 and C2 was superior in observation of pharyngeal constriction ratio in the same way that the plane between C4 and C5 was superior in cricopharyngeal evaluation. The average of sagittal and intervertebral pharyngeal constriction ratio were estimated as 0.08±0.02, 0.09±0.04 respectively and the average of thickness of cricopharyngeal muscle and anteroposterior diameter of esophageal entrance were (6.50±1.69) mm, (1.99±0.76) mm respectively. CONCLUSION: Dynamic magnetic resonance imaging was superior in assessing the function of pharyngeal constriction and cricopharyngeal muscle by scanning the swallowing process in the median sagittal and intervertebral transverse plane.

Association of MyoD1a and MyoD1b gene polymorphisms and meat quality traits in rainbow trout.

In this study, we identified myogenic regulatory factors (MRFs) and analyzed the correlation between MRFs and meat quality in rainbow trout. The MyoD1a and MyoD1b genes were cloned from rainbow trout using a homology cloning method. Introns 1 and 2 in the MyoD1a and MyoD1b genes were cloned and submitted to GenBank (accession Nos. FJ623462 and FJ793566). Polymorphisms of MyoD1a and MyoD1b genes were analyzed using single-strand conformation polymorphism and sequencing, respectively. Two single nucleotide polymorphisms were detected in the MyoD1 gene, located at 129G→A in exon 1 and 37 G→A in exon 2. The 37 G→A mutation in exon 2 induced the R185K amino acid change in the polypeptide chain. Seven single nucleotide polymorphisms in the MyoD2 gene were detected, including 218T→C, 224T→C, 242A→C, 246T→A, 248T→C, 305T→C, and 329C→T. The 246T→A mutation in exon 1 induced the R83K change in the polypeptide chain. In the S3 fragment, meat quality traits of genotypes AA and AB significantly differed from those of genotype BB (P < 0.05). In the S5 fragment, meat quality traits of the genotypes AA and AC were significantly different from the genotypes BB and BC (P < 0.05). These results indicate that the MyoD1a and MyoD1b genes have an important influence on meat quality or were linked to the major genes in these strains. These genes can be used to control muscle fiber traits in rainbow trout, and the mutations in the S3 and S5 fragments can be used as molecular markers for selecting rainbow trout with better meat quality traits.

MicroRNA-183 promotes proliferation and invasion in oesophageal squamous cell carcinoma by targeting programmed cell death 4.

BACKGROUND: Dysregulated microRNAs (miRNAs) can serve as oncogenes or suppressors and are associated with many cancers, including oesophageal squamous cell carcinoma (ESCC). METHODS: An alignment miRNA array was used to identify differentially expressed miRNAs in ESCC tissues. The expression of miR-183 and programmed cell death 4 (PDCD4) in oesophageal tissues from ESCC and early oesophageal carcinoma patients was examined by quantitative reverse transcriptase PCR and western blotting. A luciferase assay was performed to confirm miR-183 target genes. The effects of miR-183 on ESCC cells and the associated mechanisms were established by in vitro experiments. RESULTS: We identified 51 upregulated miRNAs and 17 downregulated miRNAs in our array, and miR-183 was one of the most upregulated miRNAs. An inverse correlation between miR-183 and PDCD4 levels was found in ESCC tissues. Upregulated expression of miR-183 was not correlated with tumour stage or lymphatic metastasis in ESCC patients. The luciferase assay confirmed that miR-183 directly interacted with the PDCD4 mRNA 3'-untranslated region in ESCC cells. Overexpression of miR-183 led to decreased PDCD4 protein levels and promoted ESCC cell proliferation and invasion. Inhibition of the PI3K/Akt signalling pathway increased PDCD4 protein levels and decreased miR-183 expression in ESCC cells. CONCLUSIONS: MiR-183 promotes ESCC cell proliferation and invasion by directly targeting PDCD4, which suggests that it is involved in the pathogenesis of ESCC.

Imaging findings of solitary fibrous tumor in the abdomen and pelvis.

PURPOSE: The purpose of this study was to investigate the imaging characteristics of solitary fibrous tumor (SFT) in the abdomen and pelvis. METHODS: Nine cases of SFT confirmed by surgery and pathology were retrospectively analyzed in terms of computed tomography (CT, eight cases) and magnetic resonance imaging (MRI, one case). RESULTS: SFT were located in the retroperitoneum (4/9), abdominal cavity (1/9), pelvis (4/9). Eight cases were single (8/9) and one case (1/9) with three tumors. The average tumor size of 11 lesions was 9.7 cm (4.7-20 cm). Nine tumors were round or ovoid, and two lesions were irregular. The CT value of the plain scans ranged from 33 to 43 Hounsfield units (HU, mean 37.6 HU) in five cases. Arterial-phase CT found solid parts demonstrate avid enhancement (eight cases) and five of them presented with multiple circuitous vessels along the periphery with a CT value of 68-89 HU (mean 76.6 HU). In the venous and delayed phases, enhancement was strengthened progressively. The CT values at venous (eight cases) and delayed phases (five cases) were 108-115 and 112-123 HU respectively, with averages of 109.8 and 114.8 HU. Patch or nodular no-enhanced areas were observed in eight cases during the enhanced phases. One case showed isointensity on T1-weighted images and high signal intensity on T2-weighted images accompanied by linear or curvilinear hypointense lines. Intense enhancements along with linear no-enhancement areas are seen in the arterial and venous phases. CONCLUSION: The possibility of SFT should be considered when a single or multiple masses with sharp border, inhomogeneous density or signal are detected, especially, with inhomogeneous intense enhancement in the arterial phase being maintained in the venous and delayed phases.

Analyzed gene expression of oesophageal cells stimulated in a low pH environment by DNA microarray.

OBJECTIVE: The mechanism of gastroesophageal reflux disease (GERD) has gradually been understood at the molecular biological level, and acid is considered as the major cause of GERD. The aim of this study was to explore the molecular mechanism of GERD related with low pH by investigating the differential gene expression of oesophageal cells stimulated under a low pH environment for different time. MATERIALS AND METHODS: Comparisons were made between the control normal samples (stimulated for 0 min) and low pH treat samples for various time points, and differentially expressed genes (DEGs) were identified, further bioinformatics analysis were carried out, including functional annotation and PPI network construction. RESULTS: The result indicated that the number of DEGs was increased along with the time of acid exposure, and the EGR1, JUN and FOS were found in all enriched Gene Ontology terms with association scores between them was high. CONCLUSIONS: All results suggested that EGR1, JUN, FOS may play important roles in the development of GERD. In a word, our results may reveal the contribution of gastric acid to GERD and the pathogenesis of GERD.

Cervical oesophagostomy in patients with severe dysphagia following radiotherapy for nasopharyngeal carcinoma.

OBJECTIVE: This study aimed to investigate the validity and feasibility of cervical oesophagostomy as a treatment for patients with severe dysphagia after radiotherapy for nasopharyngeal carcinoma. METHODS: The study retrospectively analysed the clinical data, symptoms, physical signs, treatment and outcomes of 12 patients treated with cervical oesophagostomy for severe dysphagia after radiotherapy for nasopharyngeal carcinoma, from 2006 to 2010. RESULTS: In all 12 cases, the oesophageal stoma remained stable, without any complications such as pharyngeal fistula or inflammation. No oesophageal stricture or granuloma growth was observed. All patients reported significant improvement in their nutritional status and quality of life after the oesophagostomy surgery. CONCLUSION: Cervical oesophagostomy is a valid and feasible method of treating severe dysphagia following radiotherapy for nasopharyngeal carcinoma. Oesophagostomy shows specific advantages over nasogastric tubing, gastrostomy and jejunostomy. Patients' nutrition and quality of life can be improved significantly if cervical oesophagostomy is executed in a timely fashion, especially in cases with severe trismus and multiple radiation-induced cranial nerve palsies unresponsive to rehabilitation.