Immune, targeted therapy and related issues of relapsed/refractory multiple myeloma / 国际肿瘤学杂志

The new immune and targeted therapy medicines of multiple myeloma and recurrence of refractory multiple myeloma mainly include immunomodulatory drugs, proteasome inhibitors, monoclonal antibody, immune monitoring point inhibitors, histone deacetylase and chimeric antigen receptor. Although the emergence of new drugs and the application of autologous hematopoietic stem cell transplantation have significantly improved the prognosis of patients, more effective treatment methods and treatment strategies are still required to deal with the adverse reactions and the condition of recurrence during treatment.

Clinical analysis of 91 cases of primary parapharyngeal space tumors / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To summarize and analyze the clinical features, diagnosis methods, surgical approaches and treatment outcomes of patients with primary parapharyngeal space tumors.</p><p><b>METHODS</b>A retrospective review of 91 cases with primary parapharyngeal space tumors treated from January 1999 to December 2011 was performed. All patients underwent preoperative enhanced CT scan and postoperative histopathologic examination. Intraoperative frozen section biopsies were performed in 36 of 91 cases. The surgical approaches included trans-cervical approach in 73 cases, trans-parotid approach in 5 cases, trans-oral approach in 5 cases, and mandibulotomy in 8 cases.</p><p><b>RESULTS</b>The postoperative pathological diagnoses consisted of 29 variants, including 20 for benign tumors and 9 for malignant tumors. Of the 80 cases with benign tumors, 6 cases were lost to follow-up and 74 cases were followed up for 31-84 months with no recurrence. Eleven cases with malignant tumor were followed up for 8-51 months (median 29 months), of them 7 cases died and 1 case was lost to follow-up. The post-operative complications included Horner syndrome in 3 cases, hoarseness in 2 cases, hypoglossal nerve palsy in 1 case, accessory nerve palsy in 1 case, upper airway obstruction in 1 case, and internal carotid artery cavernous sinus fistula in 1 case.</p><p><b>CONCLUSIONS</b>Parapharyngeal space tumors are rare, with atypical clinical manifestation, and have pathological types of diversification. CT or MRI is helpful to evaluate the tumor size, location and possible sources, and to make operation scheme. Surgery is the first choice for parapharyngeal space tumors. Trans-cervical approach can be applied to most tumors. Parapharyngeal benign tumors have good prognosis, but malignant tumors have poor prognosis.</p>

Surgical treatment of differentiated thyroid carcinoma with laryngeal or tracheal invasion / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the clinical characters, surgical treatments and prognosis of differentiated thyroid carcinoma (DTC) with laryngeal or tracheal invasion.@*METHOD@#Forty-six cases including 33 papillary and 13 follicular were retrospectively reviewed. Thirty-four cases with tracheal invasion received conservative resection (17), window resection (11) and sleeve resection (6). One case with subglottic invasion was performed subglottic partial laryngectomy. Eleven cases with trachea-laryngeal invasion received total laryngectomy(4), 3 shave technique and 4 preservative laryngectomy.@*RESULT@#Complications included infections and hypocalcaemia, 15 patients got permanent fistula. 5-year survival rate in cases of tracheal shave resection was 88.2%, while 63.6% in those of window resection and 83.3% in those of sleeve resection. Survival rate within 5 years of patients received preservative laryngectomy was 62. 5%. Conclusion: With meticulous preoperative examination and positive surgical treatment, both survival rate and quality of life could be improved in patients of DTC with laryngeal or tracheal invasion.

Metallothionein lower under-expression in benign tumors than that in malignant tumors: systematic review article and meta-analysis

Metallothionein [MT] manifests varying expression levels in carcinomas, and they may be considered as valuable cell cancerization biomarkers for diagnosis of patients with cancers. A meta-analysis was conducted to evaluate comprehensively the MT expression difference in various benign tumors and malignant tumors, which compared the high with low MT expression levels in patients of the available studies. Finally, a total of 13 studies dealing with various tumors were involved for this meta-analysis. The results indicated that lower expression of MT in various benign tumors tissue than that in corresponding malignant tumors with the pooled OR of 0.52 [95 % CI 0.18-1.47, P <0.001]. In conclusion, MT expression difference is associated with tumor various stages in tumor patients and could be a useful clinical criteria of distinguishing benign tumors and malignant tumors for those patients

Diagnosis and treatment of nasal sinus osteoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the clinical characteristic and surgical treatment of nasal sinus osteoma.@*METHOD@#Fifty-one cases with nasal sinus osteoma were diagnosed by nasal sinus X ray or CT scan. All of these osteoma patients were cured by surgical resection. Supraorbital Lynch approach were applied in forty-two cases, lateral rhinotomy Moure approach in 4 cases, Caldwell-Luc approach in 3 cases and Dandy approach that combined with cranium and facial route in 2 cases.@*RESULT@#Operative incisions in all cases healed in 1 period, no complications such as brain spinal fistula occurred. All cases were followed up for 6 months to 5 years, there were no recurrence of osteomas and occurrence of mucus cysts.@*CONCLUSION@#Osteomas in nasal sinus grow slowly. X ray or CT scan is helpful to confirm the diagnosis and choose the surgical approach reasonably.