Fungal rhinosinusitis (FRS) is commonly caused by various Aspergillus species (spp) and Mucorales fungi, and the treatment and prognosis of cases differ depending on the causative fungus. The present study describes a novel immunohistochemical method that has high sensitivity and specificity for distinguishing between these two types of fungi in patients with FRS. Three groups were included in the study. Group A included formalin‑fixed paraffin‑embedded blocks of 51 nasal tissue specimens of patients with FRS (27 Aspergillus spp and 24 Mucorales) that were continuously obtained from the Department of Pathology of Tongren Hospital in Beijing as the experimental group and 34 cultures (26 Aspergillus spp and 8 Mucorales) of FRS that were randomly selected from the bacterial laboratory of Tongren Hospital in Beijing to verify the staining results of the paraffin‑embedded blocks. Formalin‑fixed paraffin‑embedded blocks of 10 esophageal cancer specimens were included in Group B as the positive control group. All specimens in Groups A and B were stained with interferon‑γ (IFN‑γ) antibody. Group C consisted of the same specimens as described in Group A, however, when performing the immunohistochemical assay, IFN‑γ antibody was replaced by PBS and this served as the negative control group. The differences in IFN‑γ immunohistochemical staining between Aspergillus spp and Mucorales were analyzed. Staining of IFN‑γ in paraffin‑embedded samples was positive in 92.6% (25/27) of specimens in which Aspergillus spp were the causative pathogen, which was significantly higher compared with specimens in which Mucorales was causative (P<0.001), with only 4.2% (1/24) of specimens staining positive for IFN‑γ. Immunohistochemical staining of cell cultures was 100% positive for Aspergillus spp, whereas all Mucorales were negative. Thus, the results of the current study indicated that IFN‑γ antibody immunohistochemical staining may be used as a novel diagnostic tool to distinguish between Aspergillus spp and Mucorales when identifying the causative agent in FRS, providing a useful supplementary test to the current immunohistochemical methods in the clinical diagnosis of FRS.

Objective To explore the CT and MRI imaging and clinicopathological features of extranodal NK/T cell lymphoma (NK/TCL). Methods Sixty-six patients with NK/TCL diagnosed from 2002 June to 2016 April in Beijing Tongren Hospital with intact CT and/or MRI imaging results were enrolled in this study. All the patients had tailed clinical information and follow-up. The imaging and clinicopathological features were analyzed retrospectively and their prognostic value on overall survival was analyzed. Results There were 49 males and 17 females with median age of 42 years. The median follow-up time was 18 months. The cases showed surrounding invasions including 10 cases (15.2 %) in soft palate, 5 cases (7.6 %) in hard palate, 2 cases(3.0 %) in tonsil, 8 cases(12.1 %) in upper lip, 13 cases(19.7 %) in maxillofacial soft tissue, 9 cases (13.6 %) in eyelid, 10 cases (15.2 %) in orbital, 3 cases (4.5 %) in maxilla, 6 cases (9.1 %) in pterygopalatine fossa,6 cases(9.1 %)in infratemporal fossa,3 cases(4.5 %)in skull base, 3 cases(4.5 %) in eyeball and 2 cases (3.0 %) in brain tissue. Kaplan-Meier survival analysis found that the 2-year overall survival rates of the patients with the involvement of hard palate, upper lip, maxillofacial soft tissue, eyelid, orbital, maxillary, eyeball and brain organizer were lower than those of the patients without the involvement of these sites(χ2values were 4.470,4.041,4.456,13.933,8.986,4.000,44.121,6.527,16.822,respectively, all P< 0.05). Further multivariate Cox regression analysis showed that maxilla and brain involvement were independent adverse factors (RR=34.717, 95 % CI 3.404-354.035, P=0.003; RR=37.545, 95 % CI 3.188-442.187, P= 0.004). Conclusions MRI and CT examinations are of great value in diagnosis and prognostic assessment of NK/TCL. Clinicians can make correct and timely diagnosis by comprehensive clinical, radiological and pathological features and can make a detailed clinical assessment to give patients appropriate treatment,thus improving the outcome of the NK/TCL patients.

OBJECTIVE:To investigate the clinical prognostic impact factors of adult sinonasal rhabdomyosarcoma (SNRMS).METHOD:The clinical features, treatment methods, and disease outcome were reviewed retrospectively for twenty-three adult SNRMS between 2006 January and 2014 December. The survival analysis was performed by Kaplan-Meier estimate and the comparison between groups by Log-rank test. Multivariate analysis was carried out by Cox proportional hazard model.RESULT:Patients' ages ranged from 18 to 59 years (median, 23.2 years). With a median follow-up of 20 moths (3-47 moths), 14 cases dead and 9 cases alive, the 1-year and 2-year overall survival (OS) rates were 77.1% and 35.0%, respectively. Within the 1-year and 2-year OS rates,early stage group had a higher overall survival rates than advanced diease group (100.0%, 66.7% and 83.3%, 10.5%, P < 0.05); combined therapy group had a higher overall survival rates than single treatment group (86.7%, 50.0% and 50.8%, 0, P < 0.05). In the non-metastasis group (21 cases), 1-year and 2-year distant metastasis rates were 38.1% and 70.5%, respectively. Multivariate analysis showed that radiotherapy, chemotherapy and tumor diameter less than 5 cm were good prognostic factors (P < 0.05), while the lymph node metastasis, meningeal involvement and orbital involvement were poor prognostic factors (P < 0 05). In the 14 cases of dead patients, 92 8% (13/14) died of distant metastasis.CONCLUSION:Adult RMS had a high advanced rate with poor prognosis. Distant metastasis is the leading cause of death. Controlling distant metastasis is a key to improve the survival rate.

PURPOSE:To develop a new approach of endoscopic resection for benign parotid tumor through a cosmetic retroauricular incision with a water sac establishing the operative space. MATERIALS AND METHODS:Fifty-eight patients with benign parotid superficial lobe tumor were randomly assigned to an endoscopic (29 patients) or a conventional (29 patients) surgery group. The maximum diameter of the tumors was 6 cm. The subjective satisfaction scores with the incision scar, incision length, operative bleeding volume, postoperative complications, and recurrence rate were compared between the groups. RESULTS:All operations were successfully performed. The endoscopic incision length (4.3±0.5 cm), bleeding volume (26.6±10.4 mL), and incidence of temporary facial paresis (6.9%) differed from the conventional surgery group (P<.05). The scars were almost invisible behind the ear. The mean patient satisfaction score was 8.9±0.7 in the endoscopic surgery group and 6.7±1.8 in the conventional surgery group (P<.05). Otherwise, Frey's syndrome and salivary fistula incidences were 3.4% (1/29) and 3.4% (1/29), respectively, in the endoscopic surgery group, which was not significantly different from the conventional surgery group (P>.05). No tumor recurrence was found during the 3-72 months of follow-up. CONCLUSIONS:Endoscopic resection through a cosmetic retroauricular incision with a water sac establishing operative space is a feasible method for treatment of benign parotid superficial lobe tumor. Its main advantages are that the small and concealed operative scars improved the cosmetic results, and it provided a novel method for establishing the operation working space that could reduce the operative trauma.

Objective To develop a rat model of acute invasive fungal rhinosinusitis ( AIFR) which is stable and easy to operate in order to promote the basic and clinical researches of AIFR.Methods Sprague?Dawley (SD) rats were divided randomly into four groups.Immunosuppression,right nasal packing Merocel sponge and nasal inoculation with Aspergillus fumigatus spores were all in?volved in group A.Only right nasal packing Merocel sponge and nasal inoculation with A.fumigatus spores were involved in group B. Only immunosuppression and nasal inoculation with A.fumigatus spores were involved in group C.No treatment was involved in group D.A.fumigatus was dropped into rat nasal for three consecutive days in group A,B and C.All rats were killed four days after the first fungi intranasal instillation. Hematology, fungal culture and histopathology investigations were performed. Results The neutrophil quantities reduced after immunosupression,and less than 0.1×109/L on the first administration day of A.fumigatus spores.An AIFR rat model was established successfully only in group A with an incidence rate of 90% (9/10).A.fumigatus invasion was also observed in 10% (1/10) of the lungs in group A and 20% (2/10) in group C.Positive rates of fungal culture of nasal tissue was about 71%(5/7) in group A,while the remaining groups was zero.Conclusion Immunosupression,nasal obstruction,and fungal inoculation were the three essential conditions for successfully developping a stable AIFR rat model.This model is stable,easy to operate,and closely mimics the pathophysiology of anthropic AIFR.It can be used in a further study in immunity,pathology,drug of AIFR.

Acute invasive fungal rhinosinusitis (AIFR) is a lethal disease afflicting immunocompromised individuals. Knowledge about this disease is limited due to the scarcity of AIFR animal models. Mast cells (MCs) are immune cells that participate in allergic and inflammatory conditions. Limited attention has been given to MCs in AIFR. Our objectives were to create a rat model of AIFR based on analyzing the impact of different fungal concentrations on establishing infection, and to examine the relationship between MCs and rat AIFR. Rats were divided randomly into four groups. The inoculated Aspergillus fumigatus concentration was 5 × 107 conidia/mL in group A, 107 conidia/mL in group B, and 106 conidia/mL in group C. Group D was the control set. Hematology and histopathology investigations were performed. An AIFR rat model was established successfully with an incidence rate of 90% in group A, 50% in group B and 10% in group C. The total number of MCs in the experimental groups was not significantly increased, but MCs degranulation was only found in infected nasal cavities. This investigation illustrates that various fungal concentrations have different effects on AIFR incidence, and MCs may play a role in the protection of sinuses against acute A. fumigatus infection. Acute invasive fungal rhinosinusitis (AIFR) is a lethal disease afflicting immunocompromised individuals. Knowledge about this disease is limited due to the scarcity of AIFR animal models. Mast cells (MCs) are immune cells that participate in allergic and inflammatory conditions. Limited attention has been given to MCs in AIFR. Our objectives were to create a rat model of AIFR based on analyzing the impact of different fungal concentrations on establishing infection, and to examine the relationship between MCs and rat AIFR. Rats were divided randomly into four groups. The inoculated Aspergillus fumigatus concentration was 5 × 107 conidia/mL in group A, 107 conidia/mL in group B, and 106 conidia/mL in group C. Group D was the control set. Hematology and histopathology investigations were performed. An AIFR rat model was established successfully with an incidence rate of 90% in group A, 50% in group B and 10% in group C. The total number of MCs in the experimental groups was not significantly increased, but MCs degranulation was only found in infected nasal cavities. This investigation illustrates that various fungal concentrations have different effects on AIFR incidence, and MCs may play a role in the protection of sinuses against acute A. fumigatus infection.

Acute invasive fungal rhinosinusitis is a lethal infectious process afflicting immunocompromised individuals. Knowledge about this disease is still limited due to the scarcity of animal models designed to study the pathogenesis of this infection. Mast cells are tissue-resident immune cells that participate in a variety of allergic and inflammatory conditions. Limited attention has been given to the role of mast cells in acute invasive fungal rhinosinusitis. Therefore, the objectives of this study were to create a rat model of acute invasive fungal rhinosinusitis based on analyzing the impact of different fungal concentrations on establishing infection, and to observe the changes of mast cells in rats with this disease.