Nasal Endoscopic Incision and Drainage Transnasal Retropterygoid Approach to Upper Parapharyngeal Abscess: A Novel Technique.

Parapharyngeal infection is a well-known disease of otorhinolaryngologists. Rapid onset, short duration, severe symptoms, and manifestations such as sore throat and dysphagia are common characteristics treated primarily by surgical incision and drainage. Traditional surgical approaches encompass endoscopic transoral/nasal, transparotid, transcervical, or a combination thereof. We report a novel technique of nasal endoscopic incision and drainage transnasal retropterygoid approach to an upper parapharyngeal abscess. This report presents a case of a 14-year-old man presented with severe right neck and head pain, who was found to have an upper parapharyngeal abscess during a nasal endoscopic parapharyngeal exploration via a retropterygoid approach. The intraoperative frozen section revealed chronic mucosal inflammation and mild to moderate dysplasia of the squamous epithelium, but no carcinoma.

LncRNA REG1CP promotes tumorigenesis through an enhancer complex to recruit FANCJ helicase for REG3A transcription.

Protein products of the regenerating islet-derived (REG) gene family are important regulators of many cellular processes. Here we functionally characterise a non-protein coding product of the family, the long noncoding RNA (lncRNA) REG1CP that is transcribed from a DNA fragment at the family locus previously thought to be a pseudogene. REG1CP forms an RNA-DNA triplex with a homopurine stretch at the distal promoter of the REG3A gene, through which the DNA helicase FANCJ is tethered to the core promoter of REG3A where it unwinds double stranded DNA and facilitates a permissive state for glucocorticoid receptor α (GRα)-mediated REG3A transcription. As such, REG1CP promotes cancer cell proliferation and tumorigenicity and its upregulation is associated with poor outcome of patients. REG1CP is also transcriptionally inducible by GRα, indicative of feedforward regulation. These results reveal the function and regulation of REG1CP and suggest that REG1CP may constitute a target for cancer treatment.

[Effects of Mushroom Residue Application Rates on Net Greenhouse Gas Emissions in the Purple Paddy Soil].

China is the leading country for production of edible mushrooms and also outputs numerous mushroom residues. The recycling of mushroom residue can solve environmental pollution problems, provide nutrients for the farmland, and play an important role in reducing greenhouse gas emissions and increasing soil carbon sequestration capacity. In order to investigate the effects of mushroom residue amounts on net greenhouse gas emissions in purple paddy soil, potted experiments using static opaque chamber and gas chromatography methods were used to study the changes of greenhouse gases, soil carbon sequestration, and net greenhouse gas emissions (NGHGE) in the paddy soil with five treatments: no fertilizer (CK), conventional fertilization (NPK), 9 t·hm-2 mushroom residue+NPK (LM), 18 t·hm-2 mushroom residue+NPK (MM), and 36 t·hm2 mushroom residue+NPK (HM) from March 2017 to September 2017.The results showed that: ① The greenhouse gas emissions (including CH4, CO2, and N2O) increased with increasing additions of mushroom residue. The emissions of CH4 from highest to lowest followed: HM > MM > LM≈NPK > CK. The HM treatment significantly increased the CH4 emission flux (P<0.01) more than the other treatments and showed an obvious single peak curve, while the CH4 emission flux with the LM treatment showed a bimodal curve, and the MM treatment showed a multiple peak curve. The CO2 emission flux followed: MM > NPK≈LM > HM > CK; and the curves for the LM, MM, and HM treatments were a single peak curve, bimodal curve, and multiple peak curve, respectively. The N2O cumulative emission from the NPK treatment was significantly higher than with the other treatments. The N2O emission flux of the NPK treatment was a bimodal curve and that of the HM treatment was a single peak curve, while the N2O emission flux of treatments LM and MM showed multiple peak curves. ② The carbon sequestration capacity with the LM treatment was lower than that of the other treatments and that from the MM treatment was the highest. The carbon sequestration capacity of the MM treatment increased by 59.2% compared to that of the NPK treatment and increased by 87.79% and 65.65% compared to that of the LM and HM treatments. The LM treatment has the highest carbon sequestration capacity, which was higher than that of the NPK and MM treatments and about 2.1 times greater than the CK treatment and HM treatment. ③ The minimum NGHGE value was -490.29 kg·hm-2 for the whole rice production period, and 18 t·hm-2 mushroom residue applied to the soil was the best way to reduce net greenhouse gas emissions in purple paddy soil.

Soil threshold values of total and available cadmium for vegetable growing based on field data in Guangdong province, South China.

BACKGROUND: Human exposure to cadmium (Cd) is largely attributed to consumption of vegetables grown in polluted soils. In China, guidelines set for Cd in soils are uniform for different crops and diverse soil types, but not risk based. A high-density sampling of 711 paired soil and vegetables was carried out across Guangdong, South China. We aimed to model the transfer of Cd from soil to leafy, rootstalk and fruit vegetables, and to set regional guidelines of Cd [total and diethylenetriaminepentaacetic acid (DTPA) -extractable] in soil for vegetable safe production. RESULTS: Both total and DTPA-extractable Cd concentrations in soil were good predictors for Cd in vegetables. The transfer of Cd in soil to vegetables could be estimated by nonlinear models, with better fit when using DTPA-extractable Cd than total Cd in soil. The calculated thresholds of soil total Cd were 2.42, 0.94 and 1.57 mg kg(-1) whereas those of soil DTPA-extractable Cd were 1.08, 0.33 and 0.63 mg kg(-1) for leafy, rootstalk and fruit vegetable fields in Guangdong, respectively, all higher than the national soil Cd threshold. CONCLUSION: Cadmium-contaminated risk for vegetable production in Guangdong province might have been over-estimated according to the Chinese Environmental Quality Standard for Soil.

[Mitomycin C related complications shouldn't be neglected in the pterygium surgery].

Mitomycin C (MMC), as it could reduce tissue adhesions and scar formation, has been widely adopted in pterygium surgery to lower the recurrence rate.Upon a certain therapeutic effect obtained, a variety of ocular complications was combined and always occupies a quite long time after MMC application.once occurred, it was tough to cure. Compared to autologous limbal-conjunctival grafts, MMC has no apparent advantage to reduce reoccurrence of pterygium. Therefore, it is advised to abandon the use of MMC in pterygium surgery.

[CTLA4-FasL protein for the prevention of immune rejection in mouse corneal transplantation].

OBJECTIVE: To investigate the therapeutic effect of double-functioned CTLA4-FasL protein for the prevention of immune rejection in murine corneal allografts. METHODS: It was a experimental study. C57BL/6 mice (n = 45) were as donors and BALB/c mice (n = 90) as recipients. BALB/c mice accepted penetrating keratoplasty were randomly divided into 3 groups including no therapy (A), CsA DDS implanted in anterior chamber (B), 10 microg/mL CTLA4-FasL (C). Survival time of corneal allografts was observed and routine assays were performed including immunohistochemistry, reverse-transcription polymerase chain reaction (RT-PCR), TdT-mediated dUTP nick end labeling (TUNEL). RESULTS: Survival time of corneal transplants was (14.3 +/- 1.3) days, (58.0 +/- 2.8) days, (106.3 +/- 17.5) days respectively. There was significant difference between groups in statistics analysis (P = 0.000). Inflammatory cells, predominant for CD4 + T cells, showed an increasing tendency for rejected corneal allografts in A group, peaked on postoperative 7 d and then decreased in C group compared with invisible in B group. CD80 or CD86 was detected on postoperative 3 d or 7 d respectively in excised cornea and iris of both A and B group, while either showed weakening expression in C group. On postoperative 14 d, IL-10, TNF-alpha, IFN-gamma mRNA were only detected in rejected cornea allograft of A group other than clear allografts of B or C group. Compared with no apoptosis in the other groups, abundant apoptosis cells were visible in cornea and iris of C group on postoperative 7 d. CONCLUSIONS: CTLA4-FasL is able to prolong survival time of corneal allografts by dual action mechanism to exert immunosuppressive effects, both blockade of CD28-CD80/86 pathway and induction of apoptosis of T cell.

[Ocular surface reconstruction for severe symblepharon resulting from eye burns].

OBJECTIVE: To evaluate the efficacy of lamellar keratoplasty (LKP) using fresh graft with limbus, combined with conjunctival limbal autograft transplantation (CLAT) and amniotic membrane transplantation (AMT), in treating severe symblepharon resulting from eye burns. METHODS: Patients with severe symblepharon visited our hospital between February 1998 and February 2003 were divided into 4 degrees based on impairment of visual function. Pseudopterygium was partially dissected after separation of conjunctival adhesion, the corneal lesion was covered with partial (17 eyes) or total (9 eyes) lamellar corneal graft. Autologous limbal graft was placed onto the most seriously damaged limbus. Then the preserved pseudopterygium was receded with AMT to reconstruct fornix. All cases were followed up for 8 months to 3 years. Eye movement, diplopia, development of corneal grafts, preserved pseudopterygium and transplanted amniotic membrane were observed. RESULTS: 25 eyes, except that 1 eye because of irreformable lagophthalmos, got considerable improvement. Conjunctival adhesion was completely relieved and diplopia disappeared in 17 eyes. Adhesion recurred in the area covered only with amniotic membrane in 8 eyes, and 5 of them were completely relieved after one or two adhesion excisions combined with autologous conjunctival transplantation. Mild adhesion still remained in 3 eyes. Amniotic membrane began autolyzing at 1 week and completely disappeared 3 months after operation. Pseudopterygium began thinning at 1 to 3 months. Immune rejection occurred in 6 eyes, and 2 of them had second LKP. CONCLUSIONS: LKP using fresh graft with limbus, combined with CLAT and AMT, is an ideal treatment for severe symblepharon resulting from eye burns. Pseudopterygium can partly substitute conjunctiva to reconstruct fornix. Amniotic membrane facilitates ocular surface reconstruction by temporary protection of lesions.

[Combined penetrating keratoplasty with keratolimbal allograft transplantation in the treatment of severe corneal burns].

OBJECTIVE: To study the clinical results of combined penetrating keratoplasty with keratolimbal allograft transplantation in the treatment of severe corneal burns. METHODS: The present study consisted of 35 eyes (34 patients) with full thickness corneal opacities and extensive corneal conjunctivalization after severe corneal burns. The duration between the injury and the time of presentation ranged from four months to 23 years. Group A: Combined penetrating keratoplasty (PK) with annular keratolimbal allograft transplantation (KLAT) was performed in 19 eyes (18 patients). Group B: Total PK with a scleral rim was performed in 16 eyes (16 patients). Post-operative visual acuity, intraocular pressure, graft rejection and complications were monitored. The average follow up time was 24 (range from 15 to 28) months. RESULTS: (1) Vision: The number of eyes that obtained best corrected visual acuity > 0.05 was 18 eyes (95%) in group A and 14 eyes (84%) in group B at 6 months postoperatively (P = 0.582); 16 eyes (88%) in group A and 6 eyes (38%) in group B at 12 months (P = 0.006); 12 eyes (63%) in group A and 3 (7%) in group B at 24 months (P = 0.016). (2) Graft rejection: Nine allografts (47%) in group A and 8 grafts (50%) in group B developed limbal stem cell rejection (P = 1.000); 6 allografts (32%) in group A and 11 allografts (69%) in group B developed endothelium rejection (P = 0.044). The difference of endothelium rejection rate between group A and B was not significant at different times postoperatively. (3)COMPLICATIONS: Corneal epithelium defect occurred in 2 eyes (11%) in group A and 7 (44%) eyes in group B (P = 0.049); hyphema occurred in 2 eyes (11%) in group A and 8 eyes (50%) in group B (P = 0.022); hypotony occurred in 1 eye (5%) in group A and 6 eyes (38%) in group B (P = 0.032). CONCLUSIONS: PK combined with KLAT is an effective treatment for severe corneal burns at a late stage irrespective of the etiology. This procedure can restore visual function in severely damaged eyes. Patients treated with PK combined with KLAT show less complication and better prognosis as compared with patients treated with total PK with a scleral rim.

Enhanced hippocampal noradrenaline and serotonin release in galanin-overexpressing mice after repeated forced swimming test.

Basal and forced swimming (FS) stress-induced release of noradrenaline (NA) and serotonin (5-HT) were determined by in vivo microdialysis in the ventral hippocampus of mice overexpressing galanin under the platelet-derived growth factor B promoter (GalOE/P) or under the dopamine beta-hydroxylase promoter (GalOE/D) (only NA). WT mice served as controls. Intraventricular infusion of galanin significantly reduced basal extracellular NA in WT mice and in GalOE/P mice (albeit less so). Microdialysis sampling during a 10-min FS showed that NA and 5-HT release were elevated to 213% and 156%, respectively, in the GalOE/P group, whereas in the WT group the increases were only 127% and 119%, respectively. The second (repeated) 10-min FS (RFS) caused a marked enhancement of NA and 5-HT release in the GalOE/P mice to 344% and 275%, respectively. However, the RFS caused only a 192% increase of extracellular NA levels in the GalOE/D mice. Pretreatment with the putative peptidergic galanin receptor antagonist M35 almost completely blocked the elevation of NA and 5-HT levels in the GalOE/P after RFS. These results suggest that the NA and 5-HT hippocampal afferents in GalOE/P mice are hypersensitive to both conditioned and unconditioned stressful stimuli, such as FS, and that this effect is mediated by galanin receptors. The present findings support a role of galanin in the regulation of release of NA and 5-HT, two neurotransmitters involved in mood control.

[Clinical study of the treatment of acanthamoeba keratitis by penetrating keratoplasty].

OBJECTIVE: To evaluate the influence of accurate diagnosis and peri-operative management on the recurrence of acanthamoeba keratitis after penetrating keratoplasty. METHODS: A retrospective study of 18 cases of medically unresponsive keratitis in Shandong Eye Institute and Hospital that were confirmed as acanthamoeba keratitis based on laboratory examination or histopathological studies. The diagnosis of acanthamoeba keratitis was made prior to the surgery in 12 cases and delayed until histopathological results in six cases. All cases ran a course of one to four months prior to penetrating keratoplasty with lesions measuring larger than 7 mm at the time of surgery. Corresponding anti-microbial agents were given pre-operatively based on the suspected etiological agents. Corticosteroids were given to two eyes diagnosed as acanthamoeba keratitis, three eyes misdiagnosed as herpes simplex keratitis and two eyes misdiagnosed as bacterial keratitis. RESULTS: In 13 cases without recurrence (72%), 11 cases were correctly diagnosed as acanthamoeba keratitis prior to the surgery. In five cases with relapse (28%), four cases were misdiagnosed prior to the surgery. Seven cases received corticosteroid therapy more than one week in early post-operative period and four cases developed recurrence. In the four cases with relapse, two were misdiagnosed as herpes keratitis and two were misdiagnosed as bacterial keratitis. The odds ratis of the effect of two factors (misdiagnosis and using of corticosteroid in early post-operative period) on the rate of recurrence were 22 (P = 0.021) and 13 (P = 0.047), respectively. CONCLUSIONS: Penetrating keratoplasty is an effective treatment for medically unresponsive acanthamoeba keratitis. Accurate pre-operative diagnosis, appropriate peri-operative amoebicidal therapy and avoidance from the use of corticosteroid in the early post-operative period can decrease the incidence of recurrence of acanthamoeba keratitis after penetrating keratoplasty.