African swine fever virus S273R protein antagonizes type I interferon production by interfering with TBK1 and IRF3 interaction.

African swine fever (ASF) is originally reported in East Africa as an acute hemorrhagic fever. African swine fever virus (ASFV) is a giant and complex DNA virus with icosahedral structure and encodes a variety of virulence factors to resist host innate immune response. S273R protein (pS273R), as a SUMO-1 specific cysteine protease, can affect viral packaging by cutting polymeric proteins. In this study, we found that pS273R was an important antagonistic viral factor that suppressed cGAS-STING-mediated type I interferon (IFN-I) production. A detailed analysis showed that pS273R inhibited IFN-I production by interacting with interferon regulatory factor 3 (IRF3). Subsequently, we showed that pS273R disrupted the association between TBK1 and IRF3, leading to the repressed IRF3 phosphorylation and dimerization. Deletion and point mutation analysis verified that pS273R impaired IFN-I production independent of its cysteine protease activity. These findings will help us further understand ASFV pathogenesis.

Nitric oxide blocks the development of the human parasite Schistosoma japonicum.

Human schistosomiasis, caused by Schistosoma species, is a major public health problem affecting more than 700 million people in 78 countries, with over 40 mammalian host reservoir species complicating the transmission ecosystem. The primary cause of morbidity is considered to be granulomas induced by fertilized eggs of schistosomes in the liver and intestines. Some host species, like rats (Rattus norvegicus), are naturally intolerant to Schistosoma japonicum infection, and do not produce granulomas or pose a threat to transmission, while others, like mice and hamsters, are highly susceptible. The reasons behind these differences are still a mystery. Using inducible nitric oxide synthase knockout (iNOS-/-) Sprague-Dawley rats, we found that inherent high expression levels of iNOS in wild-type (WT) rats play an important role in blocking growth, reproductive organ formation, and egg development in S. japonicum, resulting in production of nonfertilized eggs. Granuloma formation, induced by fertilized eggs in the liver, was considerably exacerbated in the iNOS-/- rats compared with the WT rats. This inhibition by nitric oxide acts by affecting mitochondrial respiration and energy production in the parasite. Our work not only elucidates the innate mechanism that blocks the development and production of fertilized eggs in S. japonicum but also offers insights into a better understanding of host-parasite interactions and drug development strategies against schistosomiasis.

[The treatment of otosclerosis using laser assisted stapedotomy with mini incision in external auditory meatus].

OBJECTIVE: To investigate the feasibility of the treatment of otosclerosis using laser stapedotomy with mini incision in the external auditory meatus. METHOD: Thirteen patients(15 ears) with otosclerosis evidence on clinic history. They were all operated using the laser assisted stapedotomy by mini incision in external auditory meatus because of the wide straight canal. Laser resection the tendo musculistapedius and anterior and postrior arch, breaking the articulatioincudostapedia, removing the stapes superstructure, making a hole of 6mm diameter in the rear of stapes footplate by laser drilling, implanting the corresponding length Piston artificial ossicle. RESULT: All the surgeries were successful and the operation time was about one hour. There was only one patient manifested vertigo and nausea after the operation. But the symptoms improved three days later after the expectant treatment. All the incisions were healed in the externals. There was significant difference between the preoperative and postoperative PTA. The air conduct improved in every frequent and the bone conduct improved in 1 kHz, 2 kHz and 4 kHz. CONCLUSION: Laser assisted stapedotomy by mini incision in the external auditory meatus in patients having wide straight canal with otosclerosis can shorten the operation time, minimize the tissue damage, fasten the healing of the incision and reduce the complications postoperatively. In addition, the mini incision is beauty and easy to nurse.

Multiple osteomas in middle ear.

Since the first description of middle ear osteomas by Thomas in 1964, only few reports were published within the English literatures (Greinwalid et al., 1998; Shimizu et al., 2003; Cho et al., 2005; and Jang et al., 2009), and only one case of the multiple osteomas in middle ear was described by Kim et al., 2006, which arose from the promontory, lateral semicircular canal, and epitympanum. Here we describe a patient with multiple middle ear osteomas arising from the promontory, incus, Eustachian tube, and bony semicanal of tensor tympani muscle. This patient also contracted the chronic otitis media in the ipsilateral ear. The osteomas were successfully removed by performing type III tympanoplasty in one stage.

The value of preoperative CT scan of tympanic facial nerve canal in tympanomastoid surgery.

CONCLUSIONS: The combined analysis of axial, coronal, and sagittal planes can increase the positive rate of diagnosis for dehiscence of the facial nerve canal. OBJECTIVE: The aim of this study was to evaluate the diagnostic value of high resolution computed tomography (HRCT) scanning of the condition of the tympanic portion of the facial nerve canal in patients with chronic otitis media. METHODS: A total of 76 ears of 72 inpatients with chronic suppurative otitis media and with cholesteatoma or granulation tissues in the attic were examined by routine HRCT. The condition (including dehiscence) of the tympanic portion of the facial nerve canal observed by CT on multi-planar images and surgical findings were recorded. RESULTS: The condition of the tympanic portion of the facial nerve canal observed by CT could be confirmed by surgical findings in 67/76 ears, but was not confirmed in 9/76 ears. Axial-transverse images could clearly show the position and length of dehiscence on the lateral wall of the facial nerve, while coronal images were superior to axial-transverse images in showing the bony circumference of the facial nerve, and sagittal images could show the inferior wall of the facial nerve canal more clearly than images on the former planes.

Reconstruction of lateral attic wall using autogenous mastoid cortical bone.

PURPOSE: To explore the outcomes of lateral attic wall (LAW) reconstruction using autogenous mastoid cortical bone in cases with poorly developed zygomatic root cells and/or a low tegmen or with significant anterior or lateral sigmoid sinus in tympanomastoid surgery. MATERIAL AND METHODS: Thirty-five ears with chronic suppurative otitis media, all of them either with poorly developed zygomatic root cells and/or a low tegmen (26/35 ears), or with significant anterior or lateral sigmoid sinus (9/35 ears), were included. LAWs were removed temporarily to offer exposure of the attic; after removal of the pathological conditions in the attic and the mastoid, LAW was reconstructed using autogenous mastoid cortical bone. The condition of the reconstructed LAW and tympanomastoid aeration was evaluated by computed tomographic scan or/and otoendoscopy. RESULTS: The pathological conditions in the attic, the antrum, and the mastoid could be removed with safety in all cases; no serious complications occurred, the new canal appeared to be of normal size and shape, and no dislocation or necrosis of the repaired part was noted. Most of the cases had no significant attic retraction and kept good tympanomastoid aeration postoperatively. CONCLUSION: The reconstruction of LAW is especially suited to the cases in our study, and the reconstructed LAW can produce an almost normal anatomical external auditory canal, prevent the formation of attic retraction, and restore the mastoid cavity aeration in most of the cases.

[High-resolution CT findings of inner ear malformations with cerebrospinal fluid leakage].

OBJECTIVE: To describe the HRCT appearances of congenital inner ear malformations with cerebrospinal fluid leakage. METHOD: Conducted a retrospective case review. The subjects comprised 11 patients who were decisively confirmed by HRCT and exploratory tympanotomy. The result of temporal bone computed tomography scans (HRCT) were analyzed. RESULT: Inner ear malformations were classified into 4 types according to HRCT findings. There were 4 patients with cochlear aplasia, 2 patients with common cavity anomaly, 2 patients with IP-I anomaly, and 3 patients with IP- II anomaly. Eight patients had defects in the lamina cribrosa of the internal auditory canal. The development and aeration in the mastoid of involved ears was normal. Soft tissues were seen near the oval window in all involved ears. CONCLUSION: HRCT image has an important value in the diagnosis and treatment of inner ear malformations with cerebrospinal fluid leakage.

The value of scutum erosion in the diagnosis of temporal bone cholesteatoma.

CONCLUSIONS: Scutum erosion has an important role in the diagnosis of attic cholesteatoma, but it does not appear in other types of cholesteatoma in temporal bone. Without scutum erosion, the existence of cholesteatoma cannot be excluded. OBJECTIVE: To evaluate the value of scutum erosion in the diagnosis of cholesteatoma in temporal bone and its limitations. SUBJECTS AND METHODS: CT scanning and otoscopy were used in all patients who were suspected of developing, or were probably diagnosed with, cholesteatoma in temporal bone. The condition of the scutum was recorded by otoscopy, CT scanning and surgical findings in all patients with cholesteatomas. RESULTS: Scutum erosion can be shown in attic retraction with cholesteatoma at an early stage, but not in marginal perforation or with posterior retraction with cholesteatoma, or in central perforation or intact tympanic membrane with cholesteatoma, even in relatively late stages.

[Congenital stenosis of external auditory canal with cholesteatoma and skin fistulae or sinuses].

OBJECTIVE: To investigate the clinical features, differential diagnosis and management of congenital stenosis of external auditory canal (CSEAC) with cholesteatoma. METHODS: The clinical information for 10 cases of CSEAC with cholesteatoma was retrospectively reviewed. RESULTS: The patients' ages ranged from 4.75 to 22 years (average 12 years). The diameter of the external auditory canal (EAC) was < 2 mm. All 10 ears had a history of postural fistulae or sinuses. Bone erosion of EAC was distinctly shown in high-resolution computed tomography (HRCT) of all cases, as well as soft tissue masses, which led to enlargement of the bony canals. All patients underwent canaloplasty; eight ears received hearing reconstructions at the same time. Cholesteatoma in EACs was confirmed during the operations, accompanied by compression and destruction of the post-superior and/or inferior bony wall. Postoperative pathologic examinations proved the diagnosis of cholesteatoma, and excluded any tissue of bronchial cleft cyst or fistula. After a follow-up 1 to 3 years, no recurrent cholesteatoma was found in any of the 10 cases. All reconstructed EACs were clean and smooth. The hearing levels in the eight ears that received hearing reconstructions improved 20 - 35 dBHL. CONCLUSIONS: In CSEAC with cholesteatoma, the bony wall of EAC is most commonly involved. This involvement will lead to bone erosion of the EAC and may subsequently lead to the formation of postural or cervical sinuses. HRCT of temporal bone can show characteristic signs of soft tissue mass in EAC, with adjacent bone erosion.

[Long-term results and an analysis of surgically related factors in myringoplasty with sandwich method].

OBJECTIVE: To evaluate the effect of the prognostic factors on long-term surgical outcome in myringoplasty. METHODS: Retrospective cohort 205 patients (223 ears) with sandwich temporal fascia myringoplasty were analyzed using the multiple logistic regression analysis. The charts of inpatients had undergone myringoplasty before at least 2 years between January 1999 and November 2003 at Beijing Tongren Hospital. Postoperative follow-up rate was 78.2%. Their ages ranged from 12 to 65 years (mean = 34. 3 years). Their durations of disease ranged from 1 month to 25 years (mean = 16.07 months). The effect of prognostic factors on myringoplasty were investigated by variables noted from patients' files such as age, sex, causes of disease, duration of disease, period of dry ear of disease, operation types, places of tympanic membrane perforation, size of tympanic membrane perforation, status of middle ear and status of eardrum. RESULTS: There were 11 ears with re-perforation of eardrum at the last follow-up. Successful closure of the tympanic membrane perforation was obtained in 95.1% of the ears (212 ears) with 2 to 5 years follow-up. There were 26 ears with other complications at the last follow-up. Operations were successful in 186 patients. The overall take rate of the myringoplasty was 83.4%. Multiple logistic regression analysis (ward) was subsequently carried out on these prognostic factors on overall take rate of the myringoplasty and yielded the following classification. Relative importance of the predictive variables was as follows: size of tympanic membrane perforation (OR = 1.900), duration of disease (OR = 1.003) and period of dry ear of disease (OR = 0.908). Hearing outcomes: the average air-bone gap improvement was 7.0 dB and the average air conduction improvement was 6.8 dB for all 175 myringoplasty procedures. CONCLUSIONS: A long term follow-up was important. Late atelectatic pocket was a late complication and a cause of failure. A relatively smaller tympanic membrane perforation, a relatively shorter duration of disease and a relatively longer period of dry ear of disease were found to be significant prognostic factors positively influencing the success rate of myringoplasty.

Facial nerve course in congenital aural atresia--identified by preoperative CT scanning and surgical findings.

CONCLUSIONS: The facial nerve courses shown by preoperative CT imaging coincide with the surgical findings in most congenital aural atresia cases. CT scanning is critical in evaluation of a patient's candidacy for atresia surgery. OBJECTIVES: To evaluate the diagnostic value of preoperative CT scanning of the facial nerve course in congenital aural atresia. SUBJECTS AND METHODS: All inpatients (135 cases) with congenital aural atresia had routine preoperative CT examination. The facial nerve courses were observed in the operation and compared with the preoperative CT imaging. RESULTS: CT imaging showed that the mastoid portions of the facial nerves in 57% of cases (77/135) were located at the level of the round window, and 17% (23/135) were located at the levels of the oval window and the cochlea. Differential overlapping of the oval window by the facial nerve could also be shown in most of the cases. In the majority of cases (75%, 61/81) the tympanic portions of the facial nerve on CT imaging could be confirmed by surgical findings. In severe overlapping of the oval window or cases with anterior displacement, stapedectomy or tympanoplasty, respectively, could not be performed as usual.

The formation of sinus in congenital stenosis of external auditory canal with cholesteatoma.

CONCLUSIONS: In congenital stenosis of the external auditory canal (CSEAC) with cholesteatoma, the bony wall of the external auditory canal (EAC) is most commonly involved. This involvement will lead to bone erosion of the EAC and may subsequently lead to the formation of postaural or cervical sinuses. High-resolution computed tomography (HRCT) of temporal bone can show characteristic signs of soft tissue mass in EAC, with adjacent bone erosion. OBJECTIVE: To investigate the clinical features, differential diagnosis and management of CSEAC with cholesteatoma. PATIENTS AND METHODS: The clinical information for 10 cases of CSEAC with cholesteatoma was retrospectively reviewed. RESULTS: The patients' ages ranged from 4.75 to 22 years (average 12 years). The diameter of EACs was < 2 mm. All 10 ears had a history of postaural fistulae or sinuses. Bone erosion of EAC was distinctly shown in HRCT of all cases, as well as soft tissue masses, which led to enlargement of the bony canals. All patients underwent canaloplasty; eight ears received hearing reconstructions at the same time. Cholesteatoma in EACs was confirmed during the operations, accompanied by compression and destruction of the post-superior and/or inferior bony wall. Postoperative pathologic examinations proved the diagnosis of cholesteatoma, and excluded any tissue of bronchial cleft cyst or fistula. After a follow-up of 1-3 years, no recurrent cholesteatoma was found in any of the 10 cases. All reconstructed EACs were clean and smooth. The hearing levels in the eight ears that received hearing reconstructions increased 20-35 dBHL.

Diagnosis of the pathological exposure of the mastoid portion of the facial nerve by CT scanning.

CONCLUSIONS: High resolution CT imaging can provide useful information about the pathological exposure of the mastoid portion of the facial nerve before mastoid surgery and can assess the injury site of the facial nerve after operation. OBJECTIVES: To evaluate the diagnostic value of high resolution CT scanning of pathological exposure of the mastoid portion of facial nerve and provide valuable information for otologic surgery, and to analyse the cause of facial nerve paralysis after operation. MATERIALS AND METHODS: Routine CT scanning was used to examine patients with chronic suppurative otitis media and external auditory canal cholesteatoma preoperatively by axial-transverse and coronal views. If there was any pathological exposure of the mastoid portion of the facial nerve on CT imaging, then this was compared with intraoperative findings. In addition, one patient who had suffered postoperative facial nerve paralysis was also examined by CT scanning to determine whether any pre-existing pathological exposure of facial nerve could be found. RESULTS: Through routine CT scanning six patients with chronic suppurative otitis media and three patients with external auditory canal cholesteatoma were found to have pathological exposure of the mastoid portion of the facial nerve. Coronal views could more clearly show the size and the position of the exposure; the corresponding surgical findings (pathological exposure) for the facial nerve could be confirmed in all nine patients. CT imaging could also show that the patient who had suffered postoperative facial nerve paralysis did indeed have pre-existing pathological exposure of the mastoid portion of the facial nerve.

Morphology of auditory hair cells in guinea pig cochlea after transgene expression.

It is very important to determine if recombinant adenoviral vector (Ad) can damage the auditory hair cells in guinea pig cochlea after transgene expression. In this study, the scanning electron microscope was used to determine if there was loss of the auditory hair cells after Ad.LacZ (Ad5 containing Escherichia coli galactosidase) was inoculated into the cochlea through the round window membrane. Seven days later all inner and outer hair cells were found to express the LacZ gene. Except for the sparse loss of outer hair cells in the basal turn and the second turn, there was insignificant loss in the other turns. All inner hair cells were present. The damage to auditory hair cells resulting from intracochlear inoculation of Ad is limited, and this vector can be used as one of the ideal delivery tools in gene therapy of the cochlea.

[Vestibulotomy about the displaced facial nerve].

OBJECTIVE: To investigate the feasibility of vestibulotomy above the displaced facial nerve. METHODS: From January 2000 to January 2002, eight patients with severe congenital conductive hearing loss underwent the vestibulotomy above displaced facial nerve and reconstruction of the ossicular chain with a total ossicular replacement prosthesis, which all for the congenital middle ear deformity and the facial nerve overhang and concealed the oval window niche or lied inferior to the oval window. In four of eight cases, the facial nerve was transposed in order to access the oval window niche. RESULTS: Hearing of this patients improved 15 dB in 2 ears, 16-25 dB in 3 ears and 26 dB or more in 3 ears. In no case was there a postoperative facial paresis. With 4 months to 28 months follow-up, the postoperative hearing gain was stable. CONCLUSIONS: Vestibulotomy above displacement of the facial nerve allows a final chance of achieving serviceable hearing through surgery. The lack of facial nerve injury and the potential for hearing restoration make this procedure feasible in otherwise marginal or poor surgical candidates.

[The expressions of telomerase activity and cyclinD1 protein in laryngeal squamous cell carcinoma].

OBJECTIVE: In order to investigate the telomerase activity and its relationship with the overexpression of cyclin D1 protein in laryngeal squamous cell carcinomas (LSCC). METHOD: TRAP(Telomeric repeat amplification protocol) assay and immunohistochemical method were used respectively to detect the telomerase activity and the overexpression of cyclin D1 protein in 38 LSCC and correspondent laryngeal mucosa. RESULT: The expressions of telomerase and cyclin D1 protein were 82%(31/38), 50%(19/38) respectively in LSCC, both of them were not associated with the age of patients, location of tumors, T stage and pathological grade(P > 0.05), but there was a significant difference among clnic stages (P < 0.05) in telomerase activity, no significant difference could be found among clinic stages in expression of cyclin D1. 18 out of 31 cases were expressed in both of them simultaneously there was significant association between them(P < 0.05). CONCLUSION: Telomerase is widely activated in LSCC, the overexpression of cyclin D1 protein may be one of the most important mechanisms of telomerase activation in LSCC.