Parotidectomy in the management of squamous cell carcinoma of the external auditory canal.

PURPOSE: To investigate optimal approaches for appropriate removal of the parotid gland in the management of squamous cell carcinoma (SCC) of the external auditory canal (EAC) at different tumor stages. METHODS: In total, 39 patients with SCC of EAC treated at the Second Affiliated Hospital of Nanchang University between September 2003 and April 2019 were enrolled in this study. All patients underwent lateral temporal bone resection or subtotal temporal bone resection. Total parotidectomy was performed in patients with direct parotid invasion. Superficial parotidectomy was performed in patients with parotid node metastasis and patients with advanced stages without evidence of parotid involvement. RESULTS: The mean follow-up period was 68.7 months. Local recurrences or distant metastases occurred in five patients (12.8%). The 5-year overall survival rate was 78.4%. The 5-year survival rate was 100% in early stage (T1 and T2) patients, and 58.9 and 50.0% in patients staged III and IV, respectively. Direct parotid invasion was observed in only advanced-stage patients, while parotid node metastasis was noted in both early and advanced-stage patients preoperatively. There were no significant differences (χ2 = 0.1026; p = 0.749) between different tumor primary locations. However, soft tissue or preauricular organs became vulnerable once the anterior wall was infiltrated or eroded. CONCLUSION: Parotid management is important for achieving safer and wider tumor-free margins. Total parotidectomy should be mandatory for all advanced-staged (T3 and T4) patients. An optimal decision for parotid management in early stages depends on the infiltration or erosion of the anterior wall of the EAC.

Phylogeographic analysis of Siraitia grosvenorii in subtropical China provides insights into the origin of cultivated monk fruit and conservation of genetic resources.

Siraitia grosvenorii, an economically important plant species with high medicinal value, is endemic to subtropical China. To determine the population structure and origin of cultivated S. grosvenorii, we examined the variation in three chloroplast DNA regions (trnR-atpA, trnH-psbA, trnL-trnF) and two orthologous nuclear genes (CHS and EDL2) of S. grosvenorii in 130 wild individuals (selected from 13 wild populations across its natural distribution range) and 21 cultivated individuals using a phylogeographic approach. The results showed three distinct chloroplast lineages, which were restricted to different mountain ranges, and strong plastid phylogeographic structure. Our findings suggest that S. grosvenorii likely experienced ancient range expansion and survived in multiple refuges in subtropical China during glacial periods, resulting in population fragmentation in different mountainous areas. Our results also demonstrated that wild populations in Guilin (Guangxi, China) share the same gene pool as cultivated S. grosvenorii, suggesting that current cultivars were collected directly from local wild resources, consistent with the principles of "nearby domestication." The results of this study provide insights into improving the efficiency of S. grosvenorii breeding using a genetic approach and outline measures for the conservation of its genetic resources.

Middle ear adenomatous neuroendocrine tumors: suggestion for surgical strategy.

INTRODUCTION: Middle ear adenomatous neuroendocrine tumors are extremely rare neoplasms with epithelial and neuroendocrine differentiation, accounting for fewer than 2% of all middle and inner ear tumors. Universal standard surgical procedures for different stages of these tumors remain elusive due to the limitation of the small number of case reports or investigations. OBJECTIVE(S): This study intends to investigate proper surgical strategies for patients with middle ear adenomatous neuroendocrine tumors. METHODS: Six patients with middle ear adenomatous neuroendocrine tumors who were treated at the Second Affiliated Hospital of Nanchang University (Nanchang, China) and the Eye, Ear, Nose, and Throat Hospital of Fudan University (Shanghai, China) respectively. Clinical characteristics and management strategies of patients were reviewed. The mean follow-up time was 63.7 months (range, 13-153 months). All the information was collected from medical records and prognosis postoperatively. RESULTS: Three patients underwent canal wall-up tympanomastoidectomy, including one patient with recurrence who underwent a previous tympanotomy; the other three patients underwent lateral temporal bone resection All of these patients were followed up with no evidence of recurrence or metastasis. Patients underwent canal wall-up surgery treatment accompanied with hearing function preservation measurements during follow-up periods. CONCLUSIONS: Complete surgical resection provided good results for patients with middle ear adenomatous neuroendocrine tumors. The ossicular chain should be removed. Because of the propensity for local recurrence and invasiveness, as well as regional or distant metastasis of these tumors, it is necessary to schedule long-term follow-up and an observation plan postoperatively.

LINC00667 Sponges miR-4319 to Promote the Development of Nasopharyngeal Carcinoma by Increasing FOXQ1 Expression.

Accumulating evidence has indicated that lncRNAs regulate various biological and pathological processes in diverse malignant tumors. The roles of LINC00667 in cancer development have been explored in glioma, hepatocellular carcinoma and non-small cell lung cancer, but not in nasopharyngeal carcinoma (NPC). In the present study, we characterize the role and molecular mechanism of LINC00667 in NPC progression. It was found that LINC00667 was overexpressed in NPC cells compared to normal cells. Silencing LINC00667 suppressed the proliferation, migration, invasion and epithelial mesenchymal transition (EMT) in NPC cells. In addition, bioinformatics analysis revealed that LINC00667 acted as a ceRNA to absorb miR-4319. Further investigations illustrated that miR-4319 had low expression in NPC cells and functioned as a tumor suppressor in the progression of NPC. Mechanistic study identified forkhead box Q1 (FOXQ1) as a functional target of miR-4319. The effect of LINC00667 in NPC development was mediated by the miR-4319/FOXQ1 axis. Analysis on tumorxenograft mouse model demonstrated that knockdown of LINC00667 repressed NPC tumor growth in vivo and confirmed the in vitro results. Our present study suggested that LINC00667 promoted the malignant phenotypes of NPC cells by competitively binding to miR-4319 to up-regulate FOXQ1 expression. Our results reveled that LINC00667 could be a diagnostic and therapeutic target for NPC patients.

Endoscopic-Assisted Repair of Spontaneous Temporomandibular Joint Herniation Through a Transcanal Approach.

OBJECTIVE: To report of the presentation, diagnosis, and management of a spontaneous temporomandibular joint (TMJ) herniation. PATIENTS: A 69-year-old man with a spontaneous TMJ herniation. INTERVENTIONS: Diagnostic evaluation and surgical approaches. MAIN OUTCOME MEASURES: Imaging, and medical and surgical treatment outcomes. RESULTS: At 14 months follow-up, the patient reported improved tinnitus and on examination there was no evidence of a hypertrophic scar or canal stenosis, no recurrence of TMJ herniation, no signs of otorrhea, otalgia; and with normal TMJ function. CONCLUSIONS: The advantages of repairing spontaneous TMJ herniation through a transcanal approach using oto-endoscopy include a high definition video of surgical field, minimal invasiveness, and good postoperative cosmetic outcome.

An Alternative Hot Start PCR Method Using a Nuclease-Deficient ExoIII from Escherichia coli.

The Hot Start polymerase chain reaction (Hot Start PCR) is designed to reduce off-target amplification by blocking DNA polymerase extension at room temperature until the desired temperature is reached. In this study, we investigated a new method of Hot Start PCR that uses a modified Escherichia coli Exonuclease III (EcoExoIIIM) by substituting residues in the DNA-binding pocket and catalytic center. The results showed that PCR amplification yield and specificity were significantly promoted by the addition of EcoExoIIIM. We hypothesize that non-specific binding of primers at room temperature is prevented by binding of the primed template by EcoExoIIIM, which is then released from the DNA by heat denaturation before the first PCR cycle. Through this mechanism, PCR would be enhanced by reducing off-target extension at room temperature.

Middle ear adenomatous neuroendocrine tumors: suggestion for surgical strategy / Tumores neuroendócrinos adenomatosos da orelha média: sugestão de estratégia cirúrgica

Abstract Introduction Middle ear adenomatous neuroendocrine tumors are extremely rare neoplasms with epithelial and neuroendocrine differentiation, accounting for fewer than 2% of all middle and inner ear tumors. Universal standard surgical procedures for different stages of these tumors remain elusive due to the limitation of the small number of case reports or investigations. Objective(s) This study intends to investigate proper surgical strategies for patients with middle ear adenomatous neuroendocrine tumors. Methods Six patients with middle ear adenomatous neuroendocrine tumors who were treated at the Second Affiliated Hospital of Nanchang University (Nanchang, China) and the Eye, Ear, Nose, and Throat Hospital of Fudan University (Shanghai, China) respectively. Clinical characteristics and management strategies of patients were reviewed. The mean follow-up time was 63.7 months (range, 13-153 months). All the information was collected from medical records and prognosis postoperatively. Results Three patients underwent canal wall-up tympanomastoidectomy, including one patient with recurrence who underwent a previous tympanotomy; the other three patients underwent lateral temporal bone resection All of these patients were followed up with no evidence of recurrence or metastasis. Patients underwent canal wall-up surgery treatment accompanied with hearing function preservation measurements during follow-up periods. Conclusions Complete surgical resection provided good results for patients with middle ear adenomatous neuroendocrine tumors. The ossicular chain should be removed. Because of the propensity for local recurrence and invasiveness, as well as regional or distant metastasis of these tumors, it is necessary to schedule long-term follow-up and an observation plan postoperatively.

Resumo Introdução Os tumores neuroendócrinos adenomatosos da orelha média são neoplasias extremamente raras, com diferenciação epitelial e neuroendócrina, responsáveis por menos de 2% de todos os tumores de orelha média e interna. Os procedimentos cirúrgicos padrão universais para diferentes estágios desses tumores permanecem indefinidos, devido à limitação do pequeno número de relatos de casos ou investigações. Objetivo Este estudo foi feito com o objetivo de investigar estratégias cirúrgicas adequadas para pacientes com tumores neuroendócrinos adenomatosos da orelha média. Método Seis pacientes com tumores neuroendócrinos adenomatosos da orelha média foram tratados no Second Affiliated Hospital da Nanchang University (Nanchang, China) e no Eye, Ear, Nose, and Throat Hospital da Fudan University (Xanghai, China), respectivamente. As características clínicas e estratégias de tratamento dos pacientes foram revisadas. O tempo médio de seguimento foi de 63,7 meses (variação de 13 a 153 meses). Todas as informações foram coletadas dos prontuários e prognóstico no pós-operatório. Resultados Três pacientes foram submetidos à timpanomastoidectomia do tipo canal wall-up, inclusive um paciente com recorrência submetido a uma timpanotomia anterior; os outros três pacientes foram submetidos à ressecção lateral do osso temporal. Todos os pacientes foram acompanhados, sem evidência de recorrência ou metástase. Os pacientes foram submetidos ao tratamento cirúrgico com a técnica de canal wall-up acompanhado de medidas de preservação da função auditiva durante os períodos de seguimento. Conclusões A ressecção cirúrgica completa proporcionou bons resultados para pacientes com tumores neuroendócrinos adenomatosos da orelha média. A cadeia ossicular deve ser removida. Devido a propensão à recorrência e invasão local, bem como metástases regionais ou distantes desses tumores, é necessário um seguimento de longo prazo e um plano de seguimento no pós-operatório.

Survival outcomes of patients with temporal bone squamous cell carcinoma with different invasion patterns.

BACKGROUND: The correlation between the survival rate and various invasion patterns of patients with temporal bone squamous cell carcinoma (SCC) is unclear. This study was performed to compare the survival outcomes of these patients to disclose the correlation. METHODS: The cases of 39 patients with temporal bone SCC who underwent surgery between January 2004 and December 2012 were reviewed. RESULTS: The 2-year overall survival rate was 56.9%, and it was 22.3% for patients with stage IV disease, and 100% for patients with stage I-III disease. Patients with parotid invasion (n = 11), temporomandibular joint (TMJ) involvement (n = 8), and middle ear surgery (n = 7) before temporal bone malignancies were diagnosed had poor survival with statistical difference. CONCLUSION: Patients with parotid gland, TMJ involvement, and previous middle ear surgery for chronic otitis media had poor outcomes.

Attenuated infrared neuron stimulation response in cochlea of deaf animals may associate with the degeneration of spiral ganglion neurons.

HYPOTHESIS: We hypothesize that degenerated spiral ganglion neurons (SGNs) in guinea pigs reduces auditory brainstem responses evoked by pulsed infrared stimulation. BACKGROUND: Pulsed infrared laser excitation can directly evoke physiological responses in neuronal and other excitable cells in vivo and in vitro. Laser pulses could benefit patients with cochlear implants to stimulate the auditory system. METHODS: Pulsed infrared lasers were used to study evoked optical auditory brainstem responses (oABRs) in normal hearing and deafened animals. Aslo, the morphology and anatomy of SGNs in normal hearing and deafened guinea pigs were compared. RESULTS: By recording oABRs evoked by varying infrared laser pulse durations, it is suggested that degeneration of SGNs in deafened guinea pigs was associated with an elevated oABR threshold and with lower amplitudes. Moreover, oABR threshold decreased while amplitudes increased in both normal hearing and deafened animals as the pulse duration prolonged. Electron microscopy revealed that SGNs in deafened guinea pigs had swollen and vacuolar mitochondria, as well as demyelinated soma and axons. CONCLUSION: Infrared laser pulses can stimulate SGNs to evoke oABRs in guinea pigs. Deafened guinea pigs have elevated thresholds and smaller amplitude responses, likely a result of degenerated SGNs. Short pulse durations are more suitable to evoke responses in both normal hearing and deafened animals.

Clinical Characteristics and Management of External Auditory Canal Squamous Cell Carcinoma in Post-Irradiated Nasopharyngeal Carcinoma Patients.

OBJECTIVE: To describe the clinical characteristics and management of patients with external auditory canal (EAC) squamous cell carcinoma (SCC) that arose after they received radiotherapy for nasopharyngeal carcinoma (NPC) and to compare them with primary EAC SCC patients. STUDY DESIGN: Retrospective clinical analysis. SETTING: Hospital. PATIENTS: Nine irradiated NPC patients who subsequently developed secondary EAC SCC and 41 primary EAC SCC patients at a single hospital. INTERVENTION: Clinical characteristics and management outcomes of patients were reviewed. MAIN OUTCOME MEASURES: Clinical manifestations, regions of tumor involvement, the pathological staging, cumulative overall survival rates, Kaplan-Meier method, log rank test, and Mann-Whitney U test. RESULTS: The most common symptoms of both groups were otorrhea, otalgia, and hearing loss. The region most involved in both groups was the EAC. The proportions of early stage (T1,T2) tumors in the post-irradiated and primary EAC SCC group were 56 and 22%, respectively. The 6-month, 1-year, 2-year, and 3-year cumulative overall survival rates of the post-irradiated EAC SCC group were 100, 100, 89, and 89%, respectively. The incidence of radionecrosis was higher in the post-irradiation EAC SCC group than in the primary EAC SCC group. CONCLUSIONS: Post-irradiation EAC SCC has similar symptoms and invades similar regions as primary EAC SCC. The proportion of early stage tumors in the post-irradiated EAC SCC group was higher than that in the primary EAC SCC group. High incidence of radionecrosis was observed after the second course of radiotherapy. Aggressive surgical treatment is strongly recommended, but adjuvant radiotherapy for early stage EAC SCC should be provided cautiously.

[Efficacy and compliance of specific immunotherapy in allergic rhinitis].

OBJECTIVE: To evaluate the efficacy, safety and compliance of specific immunotherapy in allergic rhinitis. METHOD: Two hundred and eighty cases with allergic rhinitis were undertaken immunotherapy, and then were observed its symptoms, signs and treatment by graded score. RESULT: Total effective rate was 86.8%, 70.4%, 62.5% at 16 week, 6 months and 1 year after treatment. Of 280 patients treated, 74 patients stopped treatment after one year, compliance rate was 73.6%. CONCLUSION: Specific immunotherapy is a safe and effective treatment methods for allergic rhinitis and worthy of attention and promotion, while strengthening the health education is needed to improve treatment compliance of patients.

[The effect of the fluticasone propionate to the dynamic process of the nasal mucosal remodeling in allergic rhinitis of the rats model].

OBJECTIVE: To investigate the dynamic process of the nasal mucosal remodeling, and the effect of the fluticasone propionate (FP) to remodeling, by establish animal model of allergic rhinitis (AR). METHOD: One hundred and twenty Sprague-Dawley (SD) rats were randomly divided into three groups: the normal Group A used as controls and experimental groups: Group B and C, each group had 40 rats. After the animal model were established successfully by OVA+ Al (OH)3 and disposed, then, the dynamic process of the nasal mucosal remodeling was observed, through HE staining and transmission electron microscopic section in special times. RESULT: The Group B, C nasal epithelium and cilia were not complete, eosinophil-based inflammatory cell infiltration, basement membrane thickening, collagen deposition, and a small amount of fibrosis could be found, but the structure of cells were not damaged. While those changes could not be observed in the Group A. The morphological changes of the nasal mucosa of Group B aggravated gradually under persistent allergen exposure, even stripped to the basement membrane in whole epithelial layers, cell and tissue structure were destroyed seriously. The morphological changes of nasal mucosa of Group C did not further increase, but still showed varying degrees of cilia arranged in uneven fashion, basement membrane thickening, collagen deposition and fibrous hyperplasia after treatment by FP. CONCLUSION: Remodeling happens in the nasal mucosa, which would be aggravated, and even becomes irreversible if the allergen exposure continues persistently. The FP can relieve the clinical symptoms, slow down and even reverse the remodeling of AR. And it is ineffective when the changes become irreversible.

[The dynamic expression of the TGF-beta1 and FGF-2 in the nasal mucosa in the allergic rhinitis rat models].

OBJECTIVE: To investigate the dynamic expression of the TGF-beta1 and FGF-2 in the nasal mucosa of rat models of allergic rhinitis, at different stages of the process during pathogenesis. METHOD: One hundred and eighty Sprague-Dawley (SD) rats were randomly divided into three groups, the normal Group A used for contrast and experimental groups: Group B and C, each group were 60 rats. Then, observed the expression of the TGF-beta1 and FGF-2 in the nasal mucosa at different stages of the process by immunohistochemical staining. RESULT: The expression of the TGF-beta1 and FGF-2 in the nasal mucosa of the normal Group A was negative, while the Group B and Group C were varying degrees of positive both, and Group B, the level of the TGF-beta1 and FGF-2 were both decline after allergen avoidance, but still more not ability than the expression of the Group B (P < 0.05). CONCLUSION: The expression of the TGF-beta1 and FGF-2 in the nasal mucosa of rats models were varying degrees of positive , and it is decline while the allergen avoidance.