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It is very challenging to expose and remove tumors above the hard palate in the retrostyloid space using the typical cervical approach. Other approaches, such as the cervical–parotid approach, may result in prominent scars, facial paralysis, or masticatory dysfunction. Here, we report a case of a vagal neurofibroma between the internal carotid artery and internal jugular vein in the retrostyloid space. We used a 3D model to design a surgical approach that reduced the risk to the surrounding vessels and nerves. We performed an endoscope-assisted resection of the tumor using a posterior styloid approach. Following surgery, there were no obvious scars on the face or neck, facial paralysis, or dysphagia, but mild hoarseness.

Since the outbreak of novel coronavirus disease (COVID-19) in December 2019, it has spread to various regions and countries, forming a global pandemic. Reducing nosocomial infection is a new issue and challenge for all healthcare systems. Otolaryngology is a high-risk specialty as it close contact with upper respiratory tract mucous, secretions, droplets and aerosols during procedures and surgery. Therefore, infection prevention and control measures for this specialty are essential. Literatures on the epidemiology, clinical characteristics and infection control measures of COVID-19 were reviewed, practical knowledge from first-line otolaryngologists in China, the United States, and Brazil were reviewed and collated. It was recommended that otolaryngology professionals should improve screening in suspected patients with relevant nasal and pharyngeal symptoms and signs, suspend non-emergency consultations and examinations in clinics, and rearrange the working procedures in operating rooms. The guidelines of personal protective equipment for swab sampling, endoscopy and surgery were listed. Indications for tracheotomy during the pandemic should be carefully considered to avoid unnecessary airway opening and aerosol-generation; precautions during surgery to reduce the risk of exposure and infection were illustrated. This review aimed to provide recommendations for otolaryngologists to enhance personal protection against COVID-19 and reduce the risk of nosocomial infection.

Face recognition techniques have been developed significantly in recent years. However, recognizing faces with partial occlusion is still a challenging problem. Although there are many works to solve the problem of obscuring the face, the occlusion is still a challenge in face recognition. To overcome this issue, firstly we should detect the occlusion position in the facial images. We construct a robust self-encoding machine to solve the occlusion detection problem in face images and uses synthetic occlusion data for training. We evaluated our method under various synthetic occlusion face images. Experiments show that our method can effectively detect various types of occlusion masks in an unsupervised manner and has better robustness to the occlusion categories.

To explore the clinicopathological characteristics of aggressive angiomyxoma (AAM) so as to boost the level of diagnosis and treatment.Seven cases of aggressive angiomyxoma were studied with light microscope and immunohistochemistry. Antibody of Vimentin, Desmin, CD34, smooth muscle actin (SMA), estrogen receptor (ER), progesterone receptor (PR), androgen receptor (AR), S-100, p53 and Ki67 were used.There were 3 males and 4 females with an average age of 43.1 years. Three patients had urinary compressive complaints while others were symptom-free. All underwent surgical resection. Three patients were recurrent after operation. The tumor was generally nodular and its cut surface appeared jelly-like. Histologically, on myxoid stroma background, it was composed of a mixture of spindle and stellar cells without atypical cell and mitosis. There were various-sized vessels with thin to thick walls. The scattered muscle-like cells had a perivascular distribution. Immunohistochemistry showed that tumor cells were positive for Vimentin(+)7/7, Desmin(+)7/7, CD34(+)3/7, SMA(+)2/7, ER(+)6/7, p53(+)4/7, Ki67(+) 1% - 8% and negative for PR, AR and S-100.As a rare soft tissue tumor, AAM extremely rare in males. Owing to its local invasion and high recurrence, extensive resection and long-term follow-up are necessary.

To study the morphologic characteristics, immunophenotype and differential diagnosis of a case of microcystic/reticular schwannoma occurring in cervical spine.The pathologic features and immunophenotypic profile of a case of microcystic/reticular schwannoma were studied. Immunohistochemistry was performed using EnVision two-step method.The patient was a 35-year-old male and presented with a bump over the fifth cervical spine on radiologic check up. Grossly, the bump was gray-white in color, soft, well-circumscribed but non-encapsulated. The tumor measured 3.5 cm × 3.0 cm × 1.8 cm in size. Histologically, it was composed of two distinctive components. One component resembled the conventional schwannoma but showed focally nuclear pleomorphism, reminiscent of changes in degenerating schwannoma. The other component consisted of epithelial-like cells arranged in a reticular or lace-like pattern, amongst a myxoid matrix. Immunohistochemical study showed that the tumor cells were strongly positive for vimentin, S-100 protein, glial fibrillary acidic protein and neuron-specific enolase, focally positive for CD68, CD10 and Ki-67, and negative for pan-cytokeratin, epithelial membrane antigen, neurofilament, carcinoembryonic antigen, smooth muscle actin, estrogen receptor, progesterone receptor and p53.Microcystic/reticular schwannoma is a novel variant of schwannoma, arising mainly in internal viscera but seldom in bone. Awareness of this entity is helpful in distinction from chordoma, other mucoid tumors or sarcomas.

Effective link-layer trigger mechanism can significantly influence the handover performance and determine whether the handover completes successfully. The predictive handover framework that employs the required handover time and predicted signal power level to generate link trigger was proposed. Because this scheme doesn't consider the moving condition of the mobile terminal (MT), it would increase unnecessary handover times when MT moves in low speed or changes moving direction. In this paper we propose an improved Link_Going_Down (LGD) trigger scheme-timetable mapping link trigger (TMLT) scheme. It constructs two timetables according to the required handover time and MT's moving condition. By comparing and mapping the two different timetables, the LGD trigger time can be dynamically determined to minimize the link trigger costs, including the unnecessary handover probability and resource consumption.

To study the significance of supratubal recess and its aeration pathway to epitympanum in the pathogenesis of cholesteatoma otitis media.Fifty-two ears of cholesteatoma were selected as study group. Sixteen ears of traumatic facial palsy with pneumatic mastoid, which had no history of chronic otitis media were selected as control group. The status of supratubal recesses of all and their aeration pathways to epitympanum were observed in operations.Sixteen ears from control group clearly presented supratubal recesses. Membrane closure was founded in four of them. The aeration pathways of fifty-two ears (100%) from study group were all completely closed. Comparing with control group, the difference was obviously significant (chi2 = 41.7144, P = 0.000). Among these cases, bony closure was observed in thirty-four ears (65.4%), while membrane closure in eighteen ears (34.6%). Their epitympanum space was very narrow and mastoid was sclerotic or poorly developed.Blockage of the aeration pathway between supratubal recess and epitympanum was possible one of the origins of negative-pressure status of epitympanum and mastoid, which might lead to the formation of aural cholesteatoma. Anatomy variation of the aeration pathway from supratubal recess to epitympanum might be a pathogenesis factor of cholesteatoma otitis media. It suggested that opening the aeration pathway in tympanoplasty with intact canal wall up technique might be helpful to prevent recurrence of aural cholesteatoma.

To investigate the diagnosis and treatment of pulmonary histoplasmoma.The clinical data of 3 patients with pulmonary histoplasmoma. 2 males, both 49-years-old, and 1 female, 27-years-old, were analyzed.Nodules in the lung, regardless solitary or multiple, with clear border and calcification, were the first radiological finding. All 3 patients were misdiagnosed as with tuberculosis or primary or metastatic lung neoplasm and underwent operation. The diagnosis was confirmed after surgery. Pathological examination showed caseous necrosis and a great amount of histoplasma in the multinuclear cells. Follow-up lasting 1, 2, and 3 years respectively showed no recurrence.Pulmonary nodule, regardless solitary or multiple, with clear border and calcification, is the first radiological finding of pulmonary histoplasmoma Autopsy is necessary for diagnosis of pulmonary histoplasmoma, difficult to diagnose, however, with a good prognosis.

To evaluate the clinical significance of expression levels of apoptosis-associated genes, bcl-2 and Fas in thymoma tissue from patients with myasthenia gravis.The study included 25 patients who underwent maximal thymectomy because of concurrent thymoma and myasthenia gravis. Clinical staging (Osserman classification) showed stage I in 6, IIA in 3, IIB in 13 and III in 3 cases. According to the WHO classification of thymomas (1999), 5, 3, 7, 7, and 3 patients had type A, AB, B1, B2, and B3, respectively, and no patient had type C. As a control group, the normal thymic tissue from 25 patients with congenital heart diseases was studied. The expression level of Bcl-2 and Fas in the tissue of thymoma and normal thymus was detected by immunohistochemistry.Bcl-2 and Fas expressions were significantly higher in thymomas compared with normal thymus by Radit analyses (U = 2.645, P0.05 and U = 3.200, P0.05, respectively). The expression level of Bcl-2 and Fas showed no relation to the course of the disease, age, Osserman classification and sex.The result suggests that the two apoptosis-associated factors, Bcl-2 and Fas, may play important roles in the pathogenesis of thymoma concurrent with myasthenia gravis.

To study apoptosis and expression of apoptosis-related proteins in experimental different denervated guinea-pig facial muscle.An experimental model was established with guinea pigs by compressing the facial nerve 30 second (reinnervated group) and resecting the facial nerve (denervated group). TUNEL method and immunohistochemical technique (SABC) were applied to detect the apoptosis and expression of apoptosis-related proteins bcl-2 and bax from 1st to 8th week after operation.Experimentally denervated facial muscle revealed consistently increase of DNA fragmentation, average from(34.4 +/- 4.6)% to (38.2 +/- 10.6)%, from 1st week to 8th week after operation; Reinnervated facial muscle showed a temporal increase of DNA fragmentation, and then the muscle fiber nuclei revealed decreased DNA fragmentation along with the function of facial nerve recovered, latterly normal, average from (32.0 +/- 8.03)% to (5.6 +/- 3.5)%, from 1st week to 8th week after operation. In denervated group, bcl-2 and bax were expressed strongly; in reinnervated group, bcl-2 expressed consistently, but bax disappeared latterly along with the function of facial nerve recovered.Expression of DNA fragmentation and apoptosis-related proteins in denervated muscle are general reaction to denervation. bcl-2 can prevent early apoptotic muscle fiber to survival until reinnervation. It is concluded that proteins control apoptosis may give information for possible therapeutic interventions to reduce the rate of muscle fiber death in denervated atrophy in absence of effective primary treatment.

A mammalian A-type cyclin, cyclin A1, is highly expressed in testes of both human and mouse and targeted mutagenesis in the mouse has revealed the unique requirement for cyclin A1 in the progression of male germ cells through the meiotic cell cycle. While very low levels of cyclin A1 have been reported in the human hematopoietic system and brain, the sites of elevated levels of expression of human cyclin A1 were several leukemia cell lines and blood samples from patients with hematopoietic malignances, notably acute myeloid leukemia. To evaluate whether cyclin A1 is directly involved with the development of myeloid leukemia, mouse cyclin A1 protein was overexpressed in the myeloid lineage of transgenic mice under the direction of the human cathepsin G (hCG) promoter. The resulting transgenic mice exhibited an increased proportion of immature myeloid cells in the peripheral blood, bone marrow, and spleen. The abnormal myelopoiesis developed within the first few months after birth and progressed to overt acute myeloid leukemia at a low frequency (≈15%) over the course of 7–14 months. Both the abnormalities in myelopoiesis and the leukemic state could be transplanted to irradiated SCID (severe combined immunodeficient) mice. The observations suggest that cyclin A1 overexpression results in abnormal myelopoiesis and is necessary, but not sufficient in the cooperative events inducing the transformed phenotype. The data further support an important role of cyclin A1 in hematopoiesis and the etiology of myeloid leukemia.