BackgroundPierre Robin sequence (PRS) is a congenital craniofacial deformity characterized by micrognathia, glossoptosis and airway obstruction. Some affected neonates are born with severe life-threatening upper airway obstruction that requires surgery. If without timely treatment, it is possible to cause not only organ damage and developmental abnormalities but also early newborn mortality.Case presentationIn this report, a 51-hours-old neonate was diagnosed with PRS, who had severe upper airway obstruction and required surgery. We performed the modified mandible traction with wires at four days old and achieved a satisfactory result in improving airway obstruction. No other complications were observed except for mild local infection. No overlap of other more complex syndromes was found, such as ocular abnormalities, hearing loss, other skeletal abnormalities, cardiac abnormalities or other atypical abnormalities. At the present follow-up until 2 years old, there were no significant differences in the maxillofacial appearance, teeth growth, breathing, feeding, growth and development between the patient and normal children.ConclusionThe modified mandible traction with wires can safely and effectively resolve micrognathia, the key to treating PRS, which is minimally invasive, simple and provides immediate relief of airway obstruction with no long term complications compared with other surgical methods. This report aims to provide more evidence of the successful treatment of neonatal PRS micrognathia by modified mandible traction with wires.

Background: Increasing studies revealed that circular RNAs (circRNAs) and immune cell infiltration were associated with tumor development. However, its role in infantile hemangioma (IH) remains unclear. This study will explore a novel circRNA hsa_circ_0006903-based ceRNA network and validate dendritic cells activated expression in IH. Methods: Differentially expressed circRNAs(DECs) were identified from Gene Expression Omnibus (GEO) database. Regulatory networks and functional enrichment analysis were constructed. CIBERSORT was used to characterize immune cells composition. RT-qPCR was performed to detect the expression of hsa_circ_0006903 in cell lines. Then, the biological functions of hsa_circ_0006903 were validated in vitro using transwell assay. Immunofluorescence was applied to the colocalization of CD11b for dendritic cells activated as a biomarker in IH tissues. Results: Using GEO database, a total of 67 DECs were identified in IH. Hsa_circ_0006903 was selected as the most significant DECs in this study. Then, a novel hsa_circ_0006903-ceRNA network was constructed. Mechanistically, functional enrichment analysis showed that the p53 signaling pathway played the most important roles, and hsa_circ_0006903/miR-6721-5p/CACNA2D2 and hsa_circ_0006903/miR-4786-3p/ATP13A4 axis were identified. We found that CACNA2D2, ATP13A4, and P53 were significantly downregulated in IH cell lines. In this study, we validated that dendritic cell activated was significantly overexpressed. Moreover, CD11b as a biomarker of dendritic cells activated were tested in IH tissues. Finally, hsa_circ_0006903 was significantly overexpressed, and hsa_circ_0006903 promoted infantile hemangioma cell proliferation, invasion, and migration in vitro. Conclusion: We revealed a novel hsa_circ_0006903-mediated ceRNA network and explored the landscape of immune cells infiltration, especially CD11b overexpression as a biomarker of dendritic cells activated in IH.