Trimeric HIV-1 gp140 fused with APRIL, BAFF, and CD40L on the mucosal gp140-specific antibody responses in mice.

HIV-1 envelope (Env)-specific antibody present at mucosal surfaces can block entry of HIV-1 into these portals and thus should be elicited by an HIV-1 preventive vaccine. Since three molecules of tumor necrosis factor superfamily (TNFSF), APRIL, BAFF, and CD40L, could promote mucosal antibody responses, we made fusion constructs of them with an HIV-1 gp140 trimer and tested the mucosal gp140-specific antibody elicited by the fusion constructs in mice using a DNA prime-protein boost vaccination regimen. The fusion constructs formed trimers and displayed both broadly neutralizing antibody epitopes and non-broadly neutralizing antibody epitopes. Compared with the control construct, trimeric gp140, trimeric gp140-APRIL and gp140-BAFF fusion proteins mildly promoted B cell proliferation in vitro, enhanced HIV-1 gp140-binding IgG responses in vaginal lavage or fecal pellets, respectively, and decreased HIV-1 gp140-binding IgA in sera. Gp140-APRIL also augmented HIV-1 gp140-binding IgG in sera. Surprisingly, gp140-CD40L did not promote B cell proliferation in vitro and inhibited mucosal and systemic HIV-1 gp140-binding IgG or IgA. These results suggest that APRIL and BAFF should be further explored as molecular adjuvants for HIV-1 vaccines to enhance mucosal antibody responses, but covalent fusion of TNFSFs to gp140 may hinder their adjuvancy due to steric interactions.

Using autogenous mastoid cortical bone cap to cover the mastoidectomy defect during cochlear implantation.

OBJECTIVES: Assessment of autogenous mastoid cortical bone cap to cover the mastoidectomy defect via transmastoid and posterior tympanotomy approach surgical technique during cochlear implantation. METHODS: A chart review of the autogenous mastoid cortical bone cap to cover the mastoidectomy defect via transmastoid and posterior tympanotomy approach surgical technique in 540 patients undergoing cochlear implantation was undertaken from January 2010 and December 2013 in Anhui Provincial Hospital. RESULTS: The mastoidectomy defect was reconstructed using autogenous cortical bone cap in all cochlear implantation patients. No depression was found in the postauricular site. None of the patients had experienced any immediate or delayed postoperative infection complication such as wound infection, post-auricular abscess or intracranial complication. CONCLUSIONS: The technique of autogenous mastoid cortical bone cap to cover the mastoidectomy defect is a good option during cochlear implantation via transmastoid and posterior tympanotomy approach. It can prevents depression of the postauricular site, and also may be able to prevent infection of the wound and the implanted processor. Autogenous cortical bone cap is easy to handle, ready available, stable, resorption resisting, also cost-saving in cochlear implantation surgery.

Electrode array misplacement into the superior semicircular canal: as a rare complication of cochlear implantation.

OBJECTIVE: To report electrode array misplacement into the superior semicircular canal occurring as an rare complication of cochlear implantation through round window insertion, and to explore the causative association between electrode array misplacement and cochlear implantation surgical techniques. METHODS: A chart review of the electrode array misplacement into the superior semicircular canal and their management in 695 patients undergoing cochlear implantation was undertaken from January 2003 and January 2014 in Anhui Provincial Hospital. RESULTS: There were two children of electrode array misplacement into the superior semicircular canal complication, and the rate was 0.28%. CONCLUSIONS: Electrode array misplacement into the superior semicircular canal associated with cochlear implantation is rare. Surgeons should be aware of that the smaller round window maybe the reason of electrode array misplacement through round window insertion. Intra-operative neural response telemetry and X-ray can alert the surgeon the problem with the array's misplacement, which can be identified by postoperative CT.

[Endoscopic transnasal prelacrimal recess-maxillary sinus approach for tumors in the pterygopalatine fossa].

OBJECTIVE: To explore the application of endoscopic transnasal prelacrimal recess-maxillary sinus approach in surgery for lesions in the pterygopalatine fossa. METHODS: Five patients with tumors of pterygopalatine fossa were treated by endoscopic transnasal prelacrimal recess-maxillary sinus surgery between May 2008 and May 2011. The lesions treated included 4 schwannoma. and 1 neurofibroma. The operation began with endoscopic transnasal lateral nasal wall approach to maxillary sinus. Then after opening posterior wall of maxillary sinus, the pterygopalatine fossa was entered and the tumor was removed. The operation was performed under hypotension anaesthesia. RESULTS: The tumors were removed totally in all 5 patients. No complication was found. After the surgery, all patients fully recovered and were discharged from the hospital in 5 to 12 days. No recurrence and death occurred during the follow up periods ranging from 5 to 28 months. CONCLUSIONS: Endoscopic transnasal prelacrimal recess-maxillary sinus approach is safe and effective management for benign tumors in the pterygopalatine fossa. This approach reserved nasolacrimal duct and turbinate, maintained the structure and function of the nose, with decreased morbidity and shorter recovery periods.