Application of supraclavicular fasciocutaneous island flap for reconstruction after removal of tumors in parotid and auricle area / 中华耳鼻咽喉头颈外科杂志

Objective: To evaluate the efficacy of supraclavicular fasciocutaneous island flap (SIF) for repairing the defect of parotid or auricle regions after tumor resection. Methods: From February 2019 to June 2021, 12 patients (11 males and 1 female, aged 54-77 years old), of whom 4 with parotid adenoid cystic carcinoma and 8 with auricular basal cell carcinoma underwent reconstruction surgery for postoperative defects in the parotid gland area and auricular area with SIF in the Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University and their clinical data were retrospectively analyzed. Size of the SIF, time for harvesting SIF, neck lymph node dissection and postoperative complications were recorded. Results: The flap areas were (6-9) cm × (8-13) cm, and the harvesting time for SIF ranged from 40 to 80 min, averaging 51.7 min. The donor sites were directly closed. All patients underwent ipsilateral levels Ⅰ-Ⅲ neck dissection, with 4 cases undergoing additional level Ⅳ neck dissection and 2 cases undergoing level Ⅳ-Ⅴ neck dissection. Of the 12 SIF, 10 were completely survival and 2 had flap arterial crisis with partial flap necrosis, in addition, 1 had donor site wound dehiscence. With follow-up of 10-42 months, there were no tumor recurrences in 10 patients, 1 patient was lost to follow-up at 10 months postoperatively, and 1 patient experienced local tumor recurrence at 11 months after surgery and died 15 months later. Conclusion: SIF is an easily harvested flap with good skin features matching the skin in parotid and auricle regions and less damage to donor site, and this flap has no need for microvascular anastomosis technique. SIF is feasible and effective for repairing defects in parotid and auricle area.

The application of intraoperative neurophysiological monitoring in selective dorsal neurotomy for primary premature ejaculation: a prospective single-center study / 亚洲男科学杂志(英文版)

Selective dorsal neurotomy (SDN) is a surgical treatment for primary premature ejaculation (PE), but there is still no standard surgical procedure for selecting the branches of the dorsal penile nerves to be removed. We performed this study to explore the value of intraoperative neurophysiological monitoring (IONM) of the penile sensory-evoked potential (PSEP) for standard surgical procedures in SDN. One hundred and twenty primary PE patients undergoing SDN were selected as the PE group and 120 non-PE patients were selected as the normal group. The PSEP was monitored and compared between the two groups under both natural and general anesthesia (GA) states. In addition, patients in the PE group were randomly divided into the IONM group and the non-IONM group. During SDN surgery, PSEP parameters of the IONM group were recorded and analyzed. The differences in PE-related outcome measurements between the perioperative period and 3 months' postoperation were compared for the PE patients, and the differences in effectiveness and complications between the IONM group and the non-IONM group were compared. The results showed that the average latency of the PSEP in the PE group was shorter than that in the normal group under both natural and GA states (P < 0.001). Three months after surgery, the significant effective rates in the IONM and non-IONM groups were 63.6% and 34.0%, respectively (P < 0.01), and the difference in complications between the two groups was significant (P < 0.05). IONM might be useful in improving the short-term therapeutic effectiveness and reducing the complications of SDN.

Research progress of selective dorsal penile neurotomy in the treatment of primary premature ejaculation / 医学研究生学报

Selective dorsal penile neurotomy is a surgical method proposed for the treatment of primary premature ejaculation in recent years. In view of the inconsistency of surgical methods and the controversy of the operation itself, Large-scale, multi-center research evidence is needed for comprehensive evaluation. This article starts with the etiology of premature ejaculation, and reviews the anatomical basis, indications, contraindications, surgical methods, efficacy evaluation, complications and combined treatment methods of selective dorsal neurotomy.

Advances in the studies of testicular microlithiasis / 中华男科学杂志

With the increased attention to men's health and development of ultrasound imaging technology, clinicians are achieving a better understanding of testicular microlithiasis. This review presents an overview on recent studies of the etiology, pathogenesis, and imaging characteristics of testicular microlithiasis, its impact on male reproductive function, and its relation ship with testis tumors and other related diseases, as well as its treatment strategies and follow-up proposals, aiming to provide some new evidence for further understanding and management of the disease.

Effects of combining tumor necrosis factor related apoptosis-inducing ligand with PI3-K-Akt inhibition on nasopharyngeal carcinoma cell / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the effects of combinative therapy of tumor necrosis factor related apoptosis-inducing ligand (TRAIL) and PI3-K-Akt inhibitor on the growth and apoptosis of nasopharyngeal carcinoma (NPC) cells and underlying mechanisms.</p><p><b>METHODS</b>With cell growth assay, flow cytometric analysis and Western blotting, the effects of TRAIL and PI3-K-Akt special inhibitor (LY294002) on cell growth, apoptosis and related proteins expressions in CNE-2 cell lines were studied.</p><p><b>RESULTS</b>When concentrate of TRAIL>1 ng/ml, viability rate of cells in combinative treatment group with TRAIL and LY294002 was higher than that in the single treatment group with TRAIL (all P<0.05). When concentrate of TRAIL were 10 ng/ml and 100 ng/ml, the combinative treatment induced CNE-2 apoptosis more obviously than single treatments (t were 7.167 and 7.206, all P<0.05). The combination group showed more cleavage of Caspase-8, Caspase-3, Caspase-9 than single treatment groups.</p><p><b>CONCLUSIONS</b>Combinative application of TRAIL and PI3-K-Akt pathway inhibitor inhibits the growth of CNE-2 and induces apoptosis. The mitochondrial dependent pathway is implicated for the underlying mechanism.</p>

Updated application of prostate-specific membrane antigen to the diagnosis and treatment of prostate cancer / 中华男科学杂志

Prostate-specific membrane antigen (PSMA), the research of which has flourished in recent years, is a specific prostate cancer marker. PSMA plays a more and more important role in the early diagnosis, gene treatment and prognosis of the disease course of prostate cancer. This review focuses on the progress in researches of the structure, function, expression traits and gene expression of the PSMA protein, prostate cancer radioimmunoimaging, DNA vaccines and suicide gene therapy based on PSMA, as well as the role of PSMA in the clinical diagnosis and treatment of prostate cancer.

Distribution of projection neurons of the superior olivary complex in the auditory brainstem in cats / 中南大学学报(医学版)

OBJECTIVE@#To investigate the distribution and morphology of olivocochlear neurons of superior olivary complex in cats.@*METHODS@#Eight adult cats were divided into 2 groups randomly. Cholera toxin B subunit was injected to the left cochlea and fluoro-gold was injected to the right cochlea in the experimental group (n=5). Saline was injected to bilateral cochlea in the control group (n=3). Brainstem tissue was sectioned serially. All of the sections were immunohistochemically treated with ABC and stained with DAB, and then the labelled olivocochlear neurons were observed.@*RESULTS@#The labelled olivocochlear neurons in the experimental group were 2 518 in total. Of them, the number of lateral olivocochlear (LOC) neurons was 1 738 (69.0%), mainly located in the middle of the pons, predominantly projected ipsilaterally. The total of medial olivocochlear (MOC) neurons was 780 (31%), mainly located in dorsomedial periolivary nucleus, medial nucleus of the trapezoid body and ventral nucleus of the trapezoid body, mainly distributed in the rostral extent of the pons, predominantly projected contralaterally.@*CONCLUSION@#In the distribution of olivocochlear neurons in cats, LOC neurons mainly project to the ipsilateral. While the projection of MOC neurons is predominantly contralateral, the distribution of MOC neurons is more adjacent to the rostral extent of the pons than LOC neurons.

Percutaneous epididymal sperm aspiration: an effective diagnostic method for azoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To introduce the application of percutaneous epididymal sperm aspiration (PESA) in the differential diagnosis between obstructive and non-obstructive azoospermia, and to investigate the association of the results of PESA with testis volume and the level of serum follicle stimulating hormone (FSH).</p><p><b>METHODS</b>A total of 118 patients with diagnosed azoospermia were included. Their testis volume was measured by model method, the serum gonadal hormone level examined by chemoluminescence assay, and the epididymal fluid obtained by puncturing the head of the epididymis with a size-7 butterfly needle.</p><p><b>RESULTS</b>Sperm was found in the epididymal fluid in 60 of the patients, 56 with normal and 4 with smaller testis volume, and 55 with normal and 5 with higher FSH level. No sperm was detected in the other 58 cases, 34 with normal and 24 with smaller testis volume, and 38 with normal and 20 with higher serum FSH level. The rate of successful PESA was significantly higher in patients with normal testis volume or normal serum FSH level than in those with smaller testis volume (P < 0.05) or higher serum FSH level (P < 0.05).</p><p><b>CONCLUSION</b>PESA is a quick, convenient and effective method for the differential diagnosis between obstructive and non-obstructive azoospermia.</p>

Reconstructive methods for hypopharynx and cervical esophagus / 中南大学学报(医学版)

OBJECTIVE@#To review the surgical treatment for reconstructing hypopharynx and cervical esophagus after hypopharyngo-oesophagectomy, and to evalue its efficacy.@*METHODS@#Different methods were adopted to reconstruct the hypopharynx and cervical esophagus among 25 cases, including 14 cases of carcinoma of the hypopharynx and 11 of carcinoma of hypopharynx and cervical esophagus. In accordance with the standard of the International Union Against Cancer in 1997, the 25 cases were divided into different clinic stages, among which 5 were in T(2)N(0), 2 in T(2)N(1), 4 in T(3)N(0), 3 in T(3)N(1), 7 in T(4)N(1) and 3 in T(4)N(2). Treatment protocol was as follow: Pure operation for 5 cases, re-operation after radiotherapy for 2 cases, operation plus radiotherapy for 18 cases, laryngeal conservation operation for 8, and neck dissection for 21 cases. Reconstruction was done by using free jejunal transplantation, gastric pull-up, the laryngotracheal flap, and myocutaneous flap.@*RESULTS@#After the reconstruction, 3 cases of free jejunal graft and gastric pull-up, 4 of laryngotracheal flap recovered oral fleeding within 2 weeks. No serious complications occurred. After 18 cases underwent the myocutaneous flap reconstruction, no complications occurred in 10 patients, but there were different complications in 8 cases, including pharyngocutaneous fistula (6 cases), haryngoesphageal stenosis (7 cases), and pectoralis major myocutaneous flap necrotic (1 case). The 3-year survival rate was 38.9% (7/18).@*CONCLUSION@#Reconstruction with free jejunal graft, gastric pull-up, and laryngotracheal flap constitutes is a safe and reliable method to restore the continuity of the upper digestive tract after pharyngo-laryngo-oesophagectomy. After the reconstruction with myocutaneous flap, there is high incidence of pharyngocutaneous fistula and haryngoesophageal stenosis.

A dopaminergic projection from the dorsal raphe nucleus to the inner ear / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the efferent pathway from the dorsal raphe nucleus to the inner ear.</p><p><b>METHODS</b>Eleven adult cats weighing 2.0 - 3.0 kg were used. The animals had no middle-ear disease and their auricle reflex was sensitive to sound. They were divided into experimental group (8 cats) and control group (3 cases). The fluorescent tracer cholera toxin subunit-B (CTB) was injected into cat cochlea and the CTB-labelled neurons of dorsal raphe nucleus (DRN) were identified using an immunofluorescence technique after a survival period of 7 days. For studying other fluorescence labelling, the sections containing CTB-labelled neurons were divided into four groups and incubated in antisera directed against tyrosine hydroxylase (TH), serotonin (5-HT), gamma-aminobutyric acid (GABA) and dopamine B-hydroxylase (DBH), respectively. Single-and double-labelled neurons were identified from the DRN.</p><p><b>RESULTS</b>(1) A subpopulation of dorsal raphe nucleus (DRN) neurons were intensely labelled with CTB and these CTB-labelled neurons were densely distributed in a dorsomedial part of the DRN; (2) Four immunolabelling, TH, 5-HT, GABA and DBH were presented throughout the DRN. Of the total population of CTB-labelled neurons, 100% were TH-labelled neurons (double labelling) and no double-stained neuron with 5-HT, GABA and DBH was observed in the DRN.</p><p><b>CONCLUSIONS</b>There was a projection from DRN to the inner ear and this pathway might be a dopaminergic projection.</p>

Clinical observation of sensorineural hearing loss in patients suffering from nasopharyngeal carcinoma after radiotherapy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the extent and incidence of sensorineural hearing loss (SNHL) after radiotherapy (RT).</p><p><b>METHODS</b>Twenty-eight patients with diagnosed nasopharyngeal carcinoma (NPC) were selected. The pure-tone audiography, auditory brain stem evoked response (ABR), impedance audiometry and evoked otoacoustic emissions (EOAE) recordings were performed before RT, 1 month, 1, 2 and 5 years after RT.</p><p><b>RESULTS</b>At 1 month after RT, there were 7.1 and 25.7 dB increased mean bone conduction (BC) thresholds at speech (0.5 - 4.0 kHz) and at high frequency (8.0 kHz), and their BC thresholds were statistically significant increase than those before RT, respectively (P < 0.001). At 1 year after RT, there were 17.6 and 28.1 dB increased respectively, and their thresholds were statistically significant increase than those at pre-irradiation (P < 0.001). There were also significant increases in thresholds than those at 1 month of post-irradiation (P <0.001 or P < 0.05). At 2 years after RT, 21 and 27.4 dB were increased at respective those two frequencies, and there was a statistically difference only at speech frequencies when compared with those at 1 year after RT (P < 0.05). At 5 years after RT, 26.7 and 35.8 dB were increased at these two frequencies, and there were significant increases in threshold than those before, 1 month, 1 and 2 years after RT, respectively (P < 0.001). From 1 month to 5 years after RT, 37. 5% to 94. 7% of ears had a BC hearing threshold of at least 15 dB losses at speech frequency, whereas the percentage at high frequency was 85.4 to 97.4%. Up to 63.2% and 73.7% of ears had 30 dB SNHL at least at speech and high frequency, respectively. Furthermore, the degree of mean threshold loss was greater at high frequency than at speech frequency. The mean value of wave I, III and V latency, and I -V interpeak latency intervals of ABR had no significant difference between at 1 month after RT and before RT (P > 0.05). The wave I , III and V latency, and I - V interpeak latency intervals at 1 year and 2 years were significantly prolonged when compared with those before and 1 month after RT (P < 0.05), but there were no significant difference between 1 year and 2 years after RT (P > 0.05). The wave I, III and V latency, and I -V interpeak latency intervals at 5 years after RT were also significantly longer than those before RT (P < 0.001). There were significant difference in wave I , III and V latency (P < 0.05), and no significant difference in wave I - V interpeak latency intervals (P > 0. 05) between 5 years after RT and 1 year or 2 years after RT. Seven of 10 ears at 1 year after RT and 4 of 7 ears at 5 years after RT had normal EOAE, but they all had abnormal ABR response.</p><p><b>CONCLUSIONS</b>SNHL in NPC patients start soon after completion of RT, especially more commonly in high frequency. The incidence and the extent of hearing loss are increased with time of follow-up. The hearing impairment could occur in the cochlea and/or the retrocochlear auditory pathway, which show that the sensitivity of radiation damage may be different in different patient and anatomic site of auditory system.</p>