[Advances in the surgical treatment of cholesteatoma of the middle ear].

Middle ear cholesteatoma, as a common ear disease, has been further understood in terms of its molecular mechanism, classification and staging, and it is generally believed that surgical treatment is the first choice, but there is no final conclusion on its surgical choice. Microscopic surgery includes complete or open radical mastoidectomy with or without reconstruction of the middle ear cavity, and their pros and cons have been debated for decades. In the past decade, a variety of surgical methods have been developed, including various improvements and combined operations that combine the advantages of traditional open radical mastoidectomy and complete mastoidectomy. On the other hand, the emergence of ear endoscopic surgery has opened up new surgical methods, as well as the use of laser and other new technologies to improve the surgical effect and prognosis, but also can not avoid their limitations and shortcomings. The purpose of this paper is to summarize the advantages and disadvantages of various surgical treatments for middle ear cholesteatoma in order to provide guidance and help for otologists in the treatment of middle ear cholesteatoma.

[Observation on the efficacy of Eustachian tube dilation hormone under the guidance of endoscope in the treatment of sudden deafness].

Objective:To evaluate the efficacy of Eustachian tube dilation hormone under the guidance of otoscope in the treatment of patients with sudden deafness. Methods:One hundred and seventy-six patients（185 ears） with sudden deafness treated by otorhinolaryngology head and neck surgery in Shaanxi Provincial People's Hospital from January 2020 to December 2020 were selected. According to the inclusion and exclusion criteria, 176 patients（185 ears） were randomly divided into control group（n=86, 90 ears） and study group（n=90, 95 ears）. The control group was treated with intratympanic injection of methylprednisolone（methylprednisolone sodium succinate for injection）, and the study group was treated with tympanic tympanoplasty under otoendoscope. The pure tone hearing threshold, effective rate and the incidence of adverse reactions were compared between the two groups before and after treatment. Results:The total effective rate of the study group was 84.21%（80/95）, slightly lower than that of the control group（84.44%）, but there was no significant difference between the two groups. The hearing threshold of pure tone in the two groups was significantly higher than that before treatment, and the average improvement of hearing in the study group（25.47±6.29） dB was slightly lower than that in the control group（27.33±7.55） dB, but there was no significant difference between the two groups（P>0.05）. There was no significant difference in the incidence of mild adverse reactions between the two groups（P>0.05）. There were no serious adverse reactions. Conclusion:The total effective rate, hearing improvement level and adverse reaction rate of patients with sudden deafness treated with Eustachian tube tympanic dilatation hormone under endoscope are the same as that of tympanic hormone injection.

Local sympathetic innervations modulate the lung innate immune responses.

Local immunity of the lung needs to be under tight control. However, how efferent neural signals influence lung immunity remains incompletely understood. Here, we report the development of a modified iDISCO-based protocol, iDISCO(ace), for whole-tissue 3D assessment of neural innervations and immune reactions in intact, unsectioned lung tissues. We observed that genetic, pharmacologic, or surgical removal of local sympathetic innervations promoted LPS-elicited innate immune response in the lung. Also, sympathetic ablation enhanced IL-33-elicited type 2 innate immunity. We further show that the sympathetic neurotransmitter norepinephrine, or specific agonists of the ß2-adrenergic receptor, can inhibit the LPS- or IL-33-elicited immune response in a cell-intrinsic manner. Moreover, genetic deletion of the ß2-adrenergic receptor produced immunomodulatory effects similar to those observed with sympathetic ablation. Together, this study elucidates the critical function of local sympathetic innervations in negatively modulating the lung innate immune responses.

Panicle-Shaped Sympathetic Architecture in the Spleen Parenchyma Modulates Antibacterial Innate Immunity.

The nervous system can modulate the body's immunity. However, how efferent neural signals reach out to control the local immunity remains incompletely understood. Here, we report the ImmuView procedure for whole-tissue 3D assessment of neural innervations in the intact immune organs of adult mice. This advanced imaging technique revealed an intricate, panicle-shaped sympathetic architecture in the parenchyma of the spleen but not other immune organs, including the lymph nodes, Peyer's patch, and thymus. In contrast, we observed the minimal presence of parasympathetic innervations in the parenchyma of all of the classic immune organs examined. Specific deletion of the TrkA receptor abolishes the sympathetic architecture in the spleen and such genetic ablation significantly enhanced the spleen antibacterial innate immunity. Moreover, the sympathetic neurotransmitter norepinephrine could inhibit the LPS-elicited innate immunity cell-intrinsically via ß2-adrenergic receptor signaling. This study exemplifies the key link that specifically connects the efferent sympathetic signal with the spleen innate immunity.

Three-dimensional volume fluorescence-imaging of vascular plasticity in adipose tissues.

OBJECTIVE: The vascular system is central to sustaining tissue survival and homeostasis. Blood vessels are densely present in adipose tissues and exert essential roles in their metabolism. However, conventional immunohistochemistry methods have intrinsic limitations in examining the 3D vascular network in adipose tissues as well as other organs in general. METHODS: We established a 3D volume fluorescence-imaging technique to visualize the vasculatures in mouse adipose tissues by combining the optimized steps of whole-mount immunolabeling, tissue optical clearing, and lightsheet volume fluorescence-imaging. To demonstrate the strength of this novel imaging procedure, we comprehensively assessed the intra-adipose vasculatures under obese conditions or in response to a cold challenge. RESULTS: We show the entirety of the vascular network in mouse adipose tissues on the whole-tissue level at a single-capillary resolution for the first time in the field. We accurately quantify the pathological changes of vasculatures in adipose tissues in wild-type or obese mice (ob/ob, db/db, or diet-induced obesity). In addition, we identify significant and reversible changes of the intra-adipose vasculatures in the mice subjected to cold challenge (i.e., 4°). Furthermore, we demonstrate that the cold-induced vascular plasticity depends on the sympathetic-derived catecholamine signal and is involved in the beiging process of white adipose tissues. CONCLUSIONS: We report a 3D volume fluorescence-imaging procedure that is compatible with many areas of vascular research and is poised to serve the field in future investigations of the vascular system in adipose tissues or other research scenarios.