Endoscopic surgery of cavernous sinus tumors originating from the extradura.

In the present study, we explored the effects of various endoscopic approaches in patients with cavernous sinus (CS) tumors. Five endoscopic approaches, including the endoscopic transseptal transsphenoidal approach, extended endoscopic transseptal transsphenoidal approach, extended transnasal transmaxillary approach, extranasal extended maxillary sinus approach, and endoscopic transnasal transpterygoid approach, were selected for the resection of CS tumors from 36 patients. Thirty gross total tumors and 6 subtotal tumors were removed. After a follow-up period of 6 months to 3 years, 30 patients were determined to be recurrence-free, and 2 patients had unchanged residual tumors. One patient with a recurrent pituitary adenoma underwent a second surgery, and 1 patient with chordoma died because of an intracavernous carotid artery rupture 18 months after the operation. Various endoscopic approaches tailored to the origin and extent of the CS tumor were proven efficacious for the maximal and precise removal of CS tumors while avoiding vital structures.

Targeted Inhibitory Effect of Nasopharyngeal Carcinoma Cells by Hre2.Grp78 Chimeric Promoter Regulating Fusion Gene TK/VP3.

OBJECTIVE: To construct plasmids with Hre2.Grp78 chimeric promoter regulating fusion gene TK/VP3 and elaborate the effects of overexpressed TK/VP3 on nasopharyngeal carcinoma cells. METHODS: Four plasmids were constructed, including pcDNA3.1-CMV-TK/VP3, pcDNA3.1-Hre2.TK/VP3, pcDNA3.1-Grp78.TK/VP3, and pcDNA3.1-Hre2.Grp78.TK/VP3. The human nasopharyngeal carcinoma cell line HNE1 cells were transfected with the 4 plasmids, respectively. Cell viabilities were evaluated using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, and apoptosis was conducted using flow cytometry analysis. The expression of TK, VP3, Grp78, and hypoxia-inducible factor 1α and apoptosis-related proteins was determined by real-time quantitative polymerase chain reaction and Western blotting. RESULTS: The recombinant plasmids that could steadily overexpress TK and VP3 were successfully constructed. Expression of TK and VP3 in cells transfected with pcDNA3.1-Hre2.TK/VP3 and pcDNA3.1-Grp78.TK/VP3 was significantly higher than pcDNA3.1-CMV-TK/VP3, and expression in cells transfected with pcDNA3.1-Hre2.Grp78.TK/VP3 was the highest. Under glucose deprivation or hypoxia condition, Grp78 or hypoxia-inducible factor 1α was overexpressed so that expression of TK and VP3 was significantly upregulated, which could further inhibit cell proliferation and enhance cell apoptosis. CONCLUSION: We successfully constructed 4 plasmids with Hre2.Grp78 chimeric promoter regulating fusion gene TK/VP3, which could significantly inhibit the proliferation as well as enhance the apoptosis of nasopharyngeal carcinoma cells under glucose deprivation or hypoxia condition.

[Killing effect improved by fusion gene HRE1.Egr-1. yCDglyTK on gene-radio therapy of nasopharyngeal cancer in vitro].

OBJECTIVE: To construct hypoxia/radiation inducible promotor HRE1.Egr-1, and to observe its promotive effect on the expression of yCDglyTK gene in nasopharyngeal cancer HNE-1 cells and the anti-tumor effect of yCDglyTK and to lay an experimental foundation for further exploration of new gene-radio therapy of nasopharyngeal cancer. METHODS: pcDNA3.1(-)HRE1.Egr-1.yCDglyTK was constructed by gene recombination technique. Stable yCDglyTK-expressing HNE-1 cells were generated by transfecting the recombinant plasmid into the target cells with liposome. The expression of yCDglyTK was detected by Western blot in 4 groups: a normoxia group, a radiation group, a hypoxia group, and a hypoxia and radiation group. The killing effect of 5-FC in different circumstances was determined by MTT. RESULTS: The expression of yCDglyTK/5-FC gene in all the groups was significantly different(P<0.01),especially in the hypoxia and radiation group. The killing effect of 5-FC on HNE1 cells varied under different conditions, especially in the hypoxia and radiation group. CONCLUSION: Hypoxia and radiation can induce the activity of fusion promoter HRE1.Egr-1, and obviously promote the anti-tumor effect of yCDglyTK/5-FC system, suggesting that yCDglyTK may be a candidate suicide gene for gene-radio therapy of NPC.

Resection of extensive sellar tumors with extended endoscopic transseptal transsphenoidal approach.

The endoscope has recently been used to extensive sellar lesions, but the extended areas of the lesions and operative techniques vary from each study. Here we present our experience with extended endoscopic transseptal transsphenoidal (EETT) approach to 16 patients with extensive sellar lesion and evaluate the feasibility of EETT in different extensive sellar tumor resection. Sixteen patients with extensive sellar lesion were operated by EETT approach in this study. The approach included unilateral posterior septum mucosa resection, posterior septectomy, extended ethmoidectomy and sphenoidoctomy, four tumoral circumferences (bilateral, superior, inferior aspects) isolated and subsequently tumoral removal from outside to inside of the tumors obtained. This surgical procedure is satisfactory for sellar lesion with different juxtasellar extension. After surgery, CT scan and MR image showed that total removal of the tumor was achieved in 10 patients. Six patients who received subtotal resection were treated with postoperative radiation therapy or gamma knife surgery. Two patients developed postoperative cerebrospinal fluid leak that was successfully managed by conservative treatment within 6 days after surgery. No other new postoperative endocrinological or neurological defects occurred. Six months to 5 years follow up indicated that all 16 patients with the visual disturbances and 4 patients with endocrine impairments have recovered or improved. One patient with malignant meningioma died due to recurrence of the tumor 2 years postoperation. Another one patient with malignant inverted papilloma recurred 1 year postoperation and underwent operation and radiation therapy again. The EETT approach might better facilitate the removal of different extensive sellar lesions with maximal preservation of important anatomical structures and nasal function.

[A preliminary study of endoscopic transoral trans-posteriorwall pharynx resection of hypo-clivus chordoma].

OBJECTIVE: To introduce a endoscopic surgical approach for hypo-clivus chordoma, and to explore the clinical value of the endoscopic resection of hypo-clivus chordoma. METHODS: Three hypo-clivus chordoma were resected by endoscopic transoral tans-posteriorwall pharynx approach. RESULTS: The MR image showed that total removal of the tumor was achieved in 2 patients and subtotal resection was received in one patient. No severe postoperative complications and sequelae occurred. In 6 months to 2 years' follow-up, the MRI showed that 2 patients had no residue tumor, and one patient died due to recurrence of the tumor 1 year after operation. CONCLUSION: The endoscopic transoral tans-posteriorwall pharynx approach might be valuable in the treatment of the hypo-clivus chordoma. The use of the endoscope allows for direct access to the hypo-clivus lesions while minimizing the chances of surrounding anatomic structure injury. In addition, this approach has the advantages of quick recovery, avoidance of catastrophic complications and sequelae. Especially, various angle view of the endoscope provides a panoramic view of the hypo-clivus, thus exposing and resecting hide lesion which can not be exposed by other approaches. This approach might facilitate complete resection of the chordoma with maximal preservation of normal tissues.

[Day-Night Variation and Source Apportionment of Carbonaceous Aerosols in PM10 During Spring and Summer of Lanzhou].

The purpose of this study was to investigate the characteristics and source apportionment of carbonaceous aerosols in PM10 for the daytime and nighttime during spring and summer over Lanzhou. The samples were collected from 1 April 2015 to 30 August 2015, daytime samples were collected during 08:00 to 20:00 and nighttime samples during 20:00 to 08:00 on the next day, and organic carbon (OC) and elemental carbon (EC) concentrations were measured. The results showed that PM10, OC and EC concentrations were (136.0±84.3), (12.4±3.2), (2.3±0.7) µg·m-3 during the daytime, and (196.0±109.2), (16.0±5.3), (5.0±2.1) µg·m-3 during the nighttime. The mass concentrations of PM10, OC and EC in the nighttime were higher than those during the daytime. The ratios of secondary organic carbon to total organic carbon were higher in the daytime than nighttime, suggesting that the secondary organic carbon pollution was more serious in the daytime. In sand-dust weather, the concentrations of PM10 and OC were higher than those in non-dust weather, while the EC concentration was close to that in non-dust weather. Secondary organic carbon and total carbon aerosols were higher in sand-dust weather, but the contribution to the PM10 was relatively low. In addition, principal component analysis on the eight carbon fractions of non-dust weather indicated that coal combustion, vehicle exhaust and biomass burning were the major sources for carbonaceous aerosol during the daytime, while coal combustion, dust, diesel exhaust and biomass burning played important roles in the nighttime.

[Combining FCU/5-FU suicide gene/prodrug system and radiation in treating nasopharyngeal carcinoma: an experimental study].

OBJECTIVE: To explore the in vitro, in situ and in vivo killing effects to CNE-2 cells of human nasopharyngeal carcinoma (NPC) by FCU/5-FC system combined with gamma irradiation for predicting the treatment effect on NPC. METHODS: Plasmid pcDNA3.1(-)CMVe.Egr-1. FCU was introduced into CNE-2 cells by electroporation. The transfected cells were selected by G418 (600 microg/ml) for 14 days to yield cells expressing FCU stably. The FCU protein in transfected CNE-2 cells was tested by Western blotting. In vitro response of FCU-expressing CNE-2 cells to 5-FC or gamma irradiation, alone or in combination was detected by MTT assay. Furthermore, A NPC model was employed by inoculating CNE-2 cells in the right flank of nude mice for in situ gene therapy, and after 12 days of inoculation, those rats were randomized to seven groups, then the suppression of NPC growth in model was observed after giving different treatments. Finally, FCU-expressing CNE-2 cells were inoculating in the right flank of nude mice to generate NPC xenografts for in vivo gene therapy, and after 5-day of implantation, those rats were randomized to seven groups, then the delaying of tumour growth was observed in xenografts treated with different conditions. RESULTS: A anticipated relative molecular quality 42,000 protein was obtained from total protein of FCU-expressing CNE-2 cells. The growth of FCU-positive CNE-2 cells were inhibited by 5-FC or gamma irradiation, alone or in combination, but cells treated with both 5-FC and gamma irradiation resulted in enhanced cell killing when compared with cells treated with gamma irradiation or 5-FC alone. In vitro study showed that the relative survival rates of FCU-expressing CNE-2 cells treated with gamma irradiation were 15.85% - 97.88%, while that of gamma irradiation + 5-FC (100 microg/ml) group were 6.58% - 50.00%, and there was a significant difference (P < 0.01). The MTT results also demonstrated that the relative survival rate has a striking different (P < 0.01) between 5-FC group (12.11% - 99.51%) and 5-FC + gamma irradiation (1.0 Gy) group (2.37% - 35.87%). Not only in situ but also in vivo, potent growth inhibition on the explanted NPC tumours was observed in mice treated with 5-FC or gamma irradiation, alone or in combination, among which interference of both 5-FC and gamma irradiation leaded to most distinct suppression of tumour growth. Tumour volumes in groups interfered by 5-FC and or gamma irradiation were extinctly different with the control group and PBS treatment group (P < 0.05). CONCLUSION: CNE-2 cells or nasopharyngeal carcinoma venograph could be killed by FCU/5-FC suicide gene prodrug system or gamma irradiation, and there is a synergistic therapeutic effect on NPC between FCU/5-FC and gamma irradiation.

[Killing effect of VP3 on human nasopharyngeal carcinoma cell line CNE-2 cells].

OBJECTIVE: To investigate the killing effects of VP(3) on nasopharyngeal carcinoma cell line CNE-2. METHODS: Plasmid expression vector pcDNA3.1(-) CMV.VP(3)-His was constructed and identified by Kpn I/EcoR I endonuclease analysis, and then sequenced to verify successful insertion in the sense direction of VP(3) gene. pcDNA3.1(-) CMV.VP(3)-His and pcDNA3.1(-)-His expression plasmid was transiently transfected into nasopharyngeal carcinoma cell line CNE-2 . VP(3) protein expression was detected by Western blotting. MTT assay was used to determine the killing effects of VP(3) gene on nasopharyngeal carcinoma cell line CNE-2. RESULTS: Endonuclease analysis and sequencing confirmed the recombinant plasmid contained the complete VP(3) CDS sequence. Western blotting detected a 14.03 kD protein expression from the transfected cells, which was the expecting band of VP(3) gene. The growth of CNE-2 cells that expressed VP(3) gene was inhibited,while the growth of CNE-2 cells that did not express VP(3) gene was not inhibited. CONCLUSION: VP(3) gene can kill nasopharyngeal carcinoma cell CNE-2.

[Clinical analysis of 170 cases head and neck lymphoma].

OBJECTIVE: To study the characteristics of head and neck lymphoma in order to improve its diagnose rate. METHODS: Review and analysis 170 patients with head and neck lymphoma in department of otolaryngology of Xiangya hospital from 1997 to 2005. RESULTS: Nasal cavity and nasal sinuses, neck, tonsil were the common place of the origin of head and neck lymphoma. There are 9 cases Hodgkin disease and 161 cases non-Hodgkin lymphoma (NHL). T cellularity, B cellularity lymphoma, the mixed pattern and nullityping accounted for 60.9%, 36.0% and 3.1% of these patients with NHL, respectively. CHOP and radiotherapy were the main treatment method. CONCLUSION: The clinical and imageology manifestation of head and neck lymphoma were of diversification and no specificity, whose final diagnosis depended on immunohistochemistry.

[Clinical analysis of pneumomediastinum or pneumothorax during the removal of brochial foreign bodies].

OBJECTIVE: To discuss the etiology, diagnosis, treatment, and prevention of pneumomediastinum or pneumothorax during the removal of bronchial foreign bodies in children. METHODS: We analyzed the clinical data of 10 cases of pneumomediastinum or pneumothorax during the removal of bronchial foreign bodies in children. RESULTS: Two patients died and the other 8 were cured. CONCLUSION: Pneumomediastinum or pneumothorax is mainly caused by the intrapulmonary hyper-pressure and fracture of pulmonary bubbles. The prognosis of pneumomediastinum or pneumothorax is closely related to such factors as correct and punctual diagnosis and quick removal of the airway obstruction.

[Primary functional analysis of CK13 gene 5' flanking region].

OBJECTIVE: To investigate the mechanism of cytokeratin 13 (CK13) gene expression control and the effects of different motifs of CK13 gene 5' flanking region on its transcriptional activity. METHODS: The molecular clone technique and reporter gene analysis were used to assay the effects of different motifs of 513 bp of CK13 gene 5' flanking region on its transcriptional activity. The pCAT enhancer vectors with different motifs of CK13 gene 5' flanking region were constructed and transferred to HeLa cells with the help of lipofectin. The instant CAT expression of different clones was detected and the effects of different motifs of the CK13 gene 5' flanking region on its transcriptional activity were evaluated. RESULTS: 119 bp from -nt.325 to -nt.207 upstream of the first ATG of CK13 gene 5' flanking region included a silent element. 113 bp region from -nt.206 to -nt.94 included an enhanced element. CONCLUSION: 513 bp of CK13 gene 5' flanking region includes a silent element and an enhanced element. Further locating these cis elements and detecting the related trans reaction factors may unveil some important clues to the details of the mechanisms for the CK13 gene expression and tissue-specific expression.

[Resection of parapharyngeal neoplasms via styloid diaphragm approach].

OBJECTIVE: To evaluate the surgical technique and efficacy of the resection of parapharyngeal space neoplasm via styloid diaphragm approach. METHODS: Thirty-three cases underwent the resection of parapharyngeal space tumors via styloid diaphragm approach from Jan 2005 to Jan 2011 were reviewed. Of the cases, 28 were with benign tumors treated by surgery alone, and 5 were malignant tumors treated by surgery plus postoperative radical radiotherapy. RESULTS: The parapharyngeal neoplasms in all cases were completely resected via styloid diaphragm approach. The postoperative follow-up ranged from 13 months to 7 years (median = 4.6 years). No tumor recurrence was found in 30 cases, but 3 cases experienced tumor recurrence, including 1 chondrosarcoma (3 years after surgery and chemoradiotherapy), 1 chordoma and 1 adenoid cystic carcinoma (5 years after surgery and radiotherapy). Severe postoperative complications were not observed, but 2 cases showed mild mouth askew and fully recovered after 3 months, and 1 case was complicated with hoarseness and cough symptoms that disappeared after heteropathy. CONCLUSION: Resection of parapharyngeal neoplasms via styloid diaphragm approach is an ideal surgical technique, with well-exposed surgical field, less tissue injury, and less postoperative complication.

[Size distribution properties of atmospheric aerosol particles during summer and autumn in Lanzhou].

Atmospheric particle size distributions (size range 0.5-20 microm) were measured using aerodynamic particle sizer (APS-3321) from August 1st to October 31st in Lanzhou. Variations of particle concentrations and properties of volume concentration distributions were analyzed through cluster analysis. The main objective of this study was to identify factors affecting the particle size distributions in Lanzhou. The hourly averaged particle number, surface area and volume concentrations are (108.1 +/- 92.2) cm(-3), (282.9 +/- 267.9) microm2 x cm(-3) and (92.2 +/- 127.3) microm3 x cm(-3), respectively. The number, surface area and volume concentrations of fine particles (0.5-2.5 microm) account for 98.7%, 73.8% and 52.9% of the total particle concentrations in 0.5-20 microm, respectively. The size distribution of number concentrations is unimodal with a peak at accumulation mode. The size distributions of surface area and volume concentrations are bimodal with peaks at accumulation mode and coarse mode, respectively. The size distributions of particle volume concentrations mainly have 7 clusters, indicating the effect of different sources and meteorological conditions. Coarse mode particles are dominant in particle volume size distributions affected by wind-borne dust and on dust days, while that affected by motor vehicle combustion emissions and traffic resuspended dust are characterized by bimodal with peaks at accumulation mode and coarse mode, respectively.

Effect of orange peel essential oil on oxidative stress in AOM animals.

The processing parameters of pump speed, inlet air temperature, outlet air temperature and homogenization pressure were evaluated. Encapsulation efficiency is high with a satisfied releasing rate. Then, acute otitis media (AOM) animal model was built and diet containing orange peel essential oil microcapsules were administrated to AOM animals. Pharmacological test showed that orange peel essential oil treatment could decrease serum and cochlea malondialdehyde (MDA), immunoglobulins A (IgA), immunoglobulins G (IgG), immunoglobulins M (IgM) levels and increase antioxidant enzymes activities. It can be concluded that orange peel essential oil treatment could decrease oxidative injury in acute otitis media rats.

[Endoscopic posterior septectomy for patients with nasopharyngeal tumor].

OBJECTIVE: To explore the techniques, advantages and disadvantages, indications and cautions of a surgical approach for the resection of nasopharyngeal tumor. METHODS: Ten cases with nasopharyngeal tumors were recruited in this study, of them, 3 cases with residual nasopharyngeal carcinoma after chemoradiotherapy, 2 cases with cavernous angioma, 2 cases with benign mixed tumor, 1 malignant mixed tumor, 1 adenoid cystic carcinoma, and 1 chordoma. All patients underwent endoscopic resection of posteroinferior quarter part of nasal septum, and then the removal of nasopharyngeal tumors through bilateral transnasal approach. RESULTS: Total resection of the tumor was achieved for all cases without severe surgical complications. All cases with benign tumors, with following-up of 6-18 months, showed no recurrence. Of 6 cases with malignant tumors, with following-up of 12-48 months, 5 cases showed no recurrence, and 1 case was suspected to relapse one year postoperatively, but not with any lesion enlargement after another 6 month follow-up. CONCLUSIONS: Posteroinferior quarter part of nasal septectomy is preferred for endoscopic resection of nasopharyngeal tumors because it can provide a panoramic view on nasopharyngeal cavity and tumors, thus, facilitating the removal of nasopharyngeal tumors.

[Tumor-targeted human telomerase reverse transcriptase promoter/tk gene therapy against human nasopharyngeal carcinoma cells in vitro].

OBJECTIVE: To investigate the targeted killing effect of human telomerase reverse transcriptase promoter (hTERTp)/tk gene on human nasopharyngeal carcinoma (NPC) cells. METHODS: The recombinant plasmid hTERTp/tk/pGL3 was transfected into human NPC HNE1 cells and the expressions of TK and telomerase were investigated. The targeted killing effect induced by hTERTp/tk on HNE1 cells was assessed using RT-PCR and MTT assay. RESULTS: TK gene expression was detected in HNE1 cells transfected by hTERTp/tk/pGL3, and the cells showed reduced telomerase and hTERT expression as compared with the control cells. hTERTp/tk/pGL3 resulted in target killing of HNE1 cells but not of the normal control cells. The tumor cell-killing effect of hTERTp/tk/pGL3 was slightly milder than that of the positive control CMV/tk/pGL3 that produced nonselective cell killing. CONCLUSION: hTERTp/tk, a tumor-specific expression system, allows targeted tumor cell killing and reduces the activity of telomerase in NPC cells in vitro.

[Prevention and management of complications of endoscopic surgery for nasal-skull base neoplasms].

OBJECTIVE: To analyze the surgical complications of endoscopic nasal-skull base surgery. The secondary objective was to propose the preliminary strategies for prevention and treatment of complications. METHODS: One hundred and thirty two patients with nasal-skull base tumors undergoing endoscopic or endoscope-assisted surgery were included in this study. Surgical approaches included endoscopic endonasal transethmoidal approaches, endoscopic endonasal transseptal transsphenoidal approach, extended endoscopic endonasal transseptal transsphenoidal approach, endoscopic transmaxillary posttrial wall approach, extended endoscopic transmaxillary posttrial wall approach, endoscopic nasal lateral wall dissection, maxillary osteotomy approach and endoscopic transoropharyngeal approach. These approaches were selectively used to resect the tumors in the area of nasal-skull base. RESULTS: The total resection of the tumors was obtained in 104 patients (104/132, 78.8%), with 29.5% (39/132) incidence of complications, including profuse bleeding, nerve injury, cerebrospinal fluid leakage, diabetes insipidus, electrolyte imbalance, hyperglycemia, and psychological disturbance. No catastrophic complications, sequelae and operative mortality encountered. Four months to 8 years' follow up (median 3.0 years) indicated that recurrence rate of the benign tumor was 9% (9/100) without died case, and 3-year and 5-year survival rates of the malignant tumor were 75.0% and 55.6%, respectively. CONCLUSIONS: Strategies proved to be effective in reduction of the overall incidence of the complications, especially in minimizing the catastrophic complications and sequelae. The strategies were as follows: first, according to original site, extension and characteristics of the tumor, designing appropriate endoscopic approaches for the treatment of skull base tumor; second, recognizing reliable surgical access points and safe plane of the dissection; third, predicting surgical risks preoperatively and proposing the corresponding plan to avoid these risks; fourth, acquainted with the endoscopic skills and familiarized the skull base structures; lastly, ensuring the correct management of the interdisciplinary problems with close collaboration with the interdisciplinary medical personnels.

[Gene expression profile changes in oral verrucous carcinoma and oral squamous cell carcinoma].

OBJECTIVE: To determine the difference in the gene expression between human oral verrucous carcinoma (OVC) and oral squamous cell carcinoma (OSCC). METHODS: cDNA chip was used to detect the mRNA of cancer tissue from 4 OVC and 4 OSCC. After profile blotted and handled by bioinformation, the gene expression of these two kinds of lesions was examined. RESULTS: Using the BioStarH-40 profile, 593 different expression of genes was found. The rate of different genes was 15.2%, of which the expression of 283 genes increased (59 genes significantly increased) and 310 genes decreased (98 genes significantly decreased) in OVC tissue than that in OSCC. CONCLUSIONS: The gene expression of OVC and OSCC was different, which many contribute to the different biological behavior of these two kinds of lesions.

[Surgical approaches for different stages of nasopharyngeal angiofibromas].

OBJECTIVE: To explore the optical surgical approaches for the resection of early and advanced stage of nasopharyngeal angiofibromas. METHODS: Twenty two male patients aged 9 - 30 years (median 16 years) hospitalized in Xiangya Hospital from June 2003 to July 2006 with nasopharyngeal angiofibroma were recruited. Five operative approaches were selected according classification of juvenile nasopharyngeal angiofibroma described by Fisch. Six cases with stage I nasopharyngeal angiofibroma underwent endoscopic transnasal surgery. Six cases with stage II and 2 cases with stage III underwent endoscopic endonasal middle meatal transmaxillary-antrum approach. Three cases with stage III and 2 cases with stage IV underwent endoscopic endonasal middle and inferior meatal approach with extended transmaxillary-antrum resection. One case with stage IV underwent microscopic preauricula infratemporal fossa approaches combined with endoscopic endonasal middle and inferior meatal transantral approach. Two cases with stage IV underwent nasomaxillary osteotomy approach. RESULTS: After surgery, CT scan or MR image showed that total removal of the tumor was achieved in 21 patients. One patient who received subtotal resection were performed by second endoscopic surgery and obtained total resection. No postoperative complications have been encountered in all treated patients. Nine months to 3 years follow up indicated that no cases recurred after surgery. CONCLUSIONS: Appropriate surgical approach should be selected according to the clinical classification and whether the tumor has extended into whole nasal cavity, lateral fossa infratemporalis, intracranial or not. Such approaches might better facilitate the complete removal of nasopharyngeal angiofibromas and reduce the surgery-related injury.

[Expression clinical significance of nm23-H1 and vessel endothelium growth factor protein in nasopharyngeal carcinoma].

OBJECTIVE: To study the prognostic predictor for nasopharyngeal carcinoma (NPC). METHODS: The expressions of nm23-H1 and vessel endothelium growth factor (VEGF) protein were examined by immunohistochemistry S-P staining in 108 NPC tissues, the expression of nm23-H1 and VEGF protein in NPC tissues with clinical stage of NPC, radiosensitivity of tumor, survival rate of patients, relapse and metastasis of carcinoma were studied. RESULTS: The positive rate of nm23-H1 and VEGF was 48.1% and 59.3% respectively. The clinical staging, metastatic potential of lymph nodes were correlated with low-level expression of nm23-H1 protein. The patients with negative nm23-H1 expression had worse prognosis than those with positive nm23-H1 expression. The clinical staging, metastatic potential and poor sensitivity of radiotherapy were correlated with high level expression of VEGF protein. The patients with positive VEGF expression had worse prognosis than those with negative VEGF expression. The expression of nm23-H1 protein was negatively correlated with the expression of VEGF protein (r = -0.577, P < 0.05). CONCLUSIONS: The low level expression of nm23-H1 protein and the high level expression of VEGF protein may be associated with the development and poor prognosis of NPC.