Conclusions: The vascular endothelial growth factor (VEGF)-mediated mechanism of endothelial progenitor cell (EPC) mobilization, migration, and differentiation may occur in response to noise-induced acoustic trauma of the cochlea, leading to the protection of cochlear function. Objective: The purpose of this study was to analyze changes in the cochlear vessel under an intensive noise environment. Methods: Sixty male Sprague-Dawley rats were randomly divided into six groups. Acoustic trauma was induced by 120 dB SPL white noise for 4 h. Auditory function was evaluated by the auditory brainstem response threshold. Morphological changes of the cochleae, the expression of VEGF, and the circulation of EPCs in the peripheral blood were studied by immunohistochemistry, Western blotting analysis, scanning electron microscopy, and flow cytometry. Results: Vascular recovery of the cochlea began after noise exposure. The change in the number of EPCs was consistent with the expression of VEGF at different time points after noise exposure. We propose that VEGF evokes specific permeable and chemotactic effects on the vascular endothelial cells. These effects can mobilize EPCs into the peripheral blood, leading the EPCs to target damaged sites and to exert a neoangiogenic effect.
Objective To validate the feasibility and security of the facial nerve decompression through transmastoid extralabyrinthine subtemporal approach To get the data about this approach. Methods Under the operation microscope 20 adult temporal bones and 20 sides of cadaveric skulls were dissected through transmastoid extralabyrinthine subtemporal approach . Various distances of facial nerve and key mark were measured. Results 20 adult temporal bonesSD 1 the distance between choleariform process and the angle point of proximal end to distal end in geniculate ganglion was3.80±0.72 mm. 2 the length of horizontal segment was 11.14±0.73 mm.3 the length of labyrinthine segment was 3.35±0.68 mm. 4 the distance between basal turn of the cochlea and the labyrinthine segment was 1.04±0.14 mm. 5 the tegmen thickness in most distal point of labyrinthine segment was 2.82±0.64 mm. 6the shortest distance between facial canal in horizontal segment and the lateral semicircular canal was 1.27±0.21 mm.7the distance between facial canal in horizontal segment and middle point of anterior semicircular canal ampulla was 2.47±0.21 mm. 20 sides of cadaveric skullsSD 1the distance between long process of incus and horizontal segment was 2.33±0.26 mm. 2 the distance between short process of incus and facial nerve was 3.06±1.01 mm. 3 the distance between capitulum of malleus and the horizontal segment was 2.17±0.87 mm. 4 the distance between capitulum of malleus and tegmen tympani was 2.31±0.87 mm. 5 the length of vertical segment was 16.27±0.58mm. 6the angle of proximal end to distal end in geniculate ganglion was 74.3±2.47°. 7 7the angle of pyramidal segment was 110.2±8.30°. Conclusion This study provided the safe scope manipulation room and the angle of the transmastoid extralabyrinthine subtemporal approach and these data can be reference for the surgeon.
Spindle cell lipoma is a rare, uncommon type of benign lipomatous tumor, a distinct group of lipomas composed of mature adipocytes, uniform spindle cells, and multinucleated giant cells associated with ropey collagen. Immunohistochemically, spindle cell lipoma is characterized by the diffuse expression of CD34.We present a rare case of a 56-year-old man who complained of vomiting out of a smooth and giant mass in the oral cavity provoked by an intra-abdominal pressure increase. Oral examination revealed an elongated mass protruding from the mouth. Computed tomography of the patient showed a mass from left pyriform to oral cavity, with 2.38 × 2.78 × 16.86 cm in size. The flexible fiberscope showed that the pedicle of the elongated mass originated from the posterior wall of the hypopharynx, corresponding to the left pyriform fossa.Histopathologically, the tumor was mainly composed of hyperplastic adipocytes, admixed with small blood vessels, and scattered inside adipose tissue spindle cells. The immunohistochemical profile revealed positivity of spindle cells for CD34, negativity for S100, and low proliferation with Ki67, which confirmed the diagnosis of spindle cell lipoma and revealed its benign behavior.The patient underwent hypopharyngeal mass resection using transoral suspension laryngoscopy.No recurrence was found after 5 months of follow-up.Spindle cell lipoma is difficult to diagnose early because of slow growth and subtle symptomatology. This entity should be differentiated from several benign or malignant subtypes of lipomas, including liposarcomas. In this case, the spindle cell lipoma is large and originates from the hypopharynx, which is a rare entity and presents with atypical symptoms. This case gave rise to further studies on the clinical and pathologic characteristics of this tumor in the future.
To analyze the outcomes of lacrimal bypass surgery using the high-density porous polyethylene (HDPP) coated tear drain and to evaluate the validity and safety of this procedure.Twenty-six patients (26 eyes) with severe epiphora who could not be cured by canaliculo-anastomosis and dacryocystorhinostomy were treated by the lacrimal bypass surgery with the HDPP coated tear drain. HDPP tube insertion: 10 patients with defect of the punctum or the canaliculi and in the presence of lacrimal sac were treated by conjunctiva-dacryocystorhinostomy with HDPP coated tear drain implantation. 16 patients with defect of the punctum or the canaliculi and without lacrimal sac were treated by simple HDPP coated tear drain insertion.No tube extrusion or severe malposition occurred after 4 - 28 months follow-up. Complete or significant improvement of epiphora was achieved in 88.5% cases. Most patients (80.8%) satisfied with the therapeutic result of this procedure. Complications included obstruction (9 eyes), discomfort (4 eyes), improper tube length (2 eyes), malposition (1 eye), infection (1 eye), diplopia (1 eye), abrasion of cornea (1 eye) and nasal secretion countercurrent (1 eye).The lacrimal bypass surgery with the HDPP coated tear drain could be expected to improve epiphora significantly in most cases of lacrimal obstruction. This surgery has a higher successful rate and fewer complications than that of Jones tube insertion and is a safe and efficient procedure.
Background:: ALD is a chronic liver disease caused by chronic excessive alcohol consumption, for which there are no drugs with better efficacy. Ancient literature and modern studies have shown that Massa Medicata Fermentata (MMF) has a hangover effect and ameliorates hepatic inflammation, so we believe that MMF has a potential role in the treatment of alcoholic liver disease. Methods:: UPLC-Q-Orbitrap HRMS was used to characterize the chemical constituents in MMF. The database was utilized to collect targets for the components and diseases, and cross-targeting analysis of the targets was performed. PPI, KEGG, GO enrichment analysis and molecular docking were performed using the core cross-targeting information to preliminarily validate the mechanism of action of MMF on disease. Finally, animal validation was carried out using male KM mice of the alcoholic liver injury model. Results:: MMF could play a role in the therapeutic prevention of alcoholic liver disease through the core targets AKT1, TNF, TP53, IL6 and CASP3 to regulate cancer pathways, lipid, and atherosclerosis, targeting IL-17 signaling, TNF signaling pathway, and hepatitis C, which was confirmed by animal pharmacodynamic experiments Conclusion:: This study serves as a rationale to support MMF in the treatment of ALD and meets the urgent need for clinical treatment of ALD. At the same time, it broadens the scope of clinical application of MMF.
Orbital implant–associated complications always affect patients, resulting in multiple operations. One-stage replacement of complicated implants has been attractive for reducing operation times and preventing long-time appearance without artificial eye. We retrospectively analyzed the outcomes of 1-stage replacement surgery of orbital implant. A total of 21 eyes in 21 cases with noninfectious complications, who failed conservative therapies and surgical repairs, were treated with 1-stage orbital implant replacement. After a detailed ophthalmic history was obtained and examinations performed, patients with apparent purulent secretion in conjunctival sac were excluded. The preexisting orbital implant was carefully removed, and a new hydroxyapatite sphere was implanted simultaneously. Wound healing status, prosthesis movement, and cosmetic features were evaluated and recorded after at least 6 months' follow-up. Orbital implant exposure(16 cases) was the main indication of the replacement surgery; other causes included superior orbital area depression (2 cases), conjunctival fistula (1 case), orbital implant malposition (1 case), and the metal material of implant obstructing magnetic resonance imaging scan in 1 case. Eye-socket hollow was redressed in all cases immediately, and 95.23% cases (20/21) could wear an artificial eye and had a good cosmetic appearance, whereas conjunctival sac fistula reoccurred in 1 patient, and the implant was removed ultimately. Conjunctival sac constrictions occurred in 4 cases after operation and were treated by secondary conjunctival sac reconstruction 6 months later. In conclusion, 1-stage replacement of orbital implants offers an effective and efficient strategy for dealing with severe postimplantation noninfectious complications in achieving a symmetrically cosmetic appearance without delay.
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