OBJECTIVE: To analyze the recurrencerelative factors of early glottic carcinoma after carbon dioxide laser treatment. METHOD: A retrospective analysis of 134 early glottic carcinoma patients' clinical data was taken to analyze the relationships between recurrence and gender, age, pathologic degree, T stage, involvement of anterior commissure and involvement of thyroarytenoid muscle. RESULT: Recurrent ratio of well-differentiated, middle-differentiated and poorly-differentiated squamous cell carcinoma were 11.83%, 18.42% and 33.33% (P > 0.05) respectively. Recurrent ratio of T1a, T1b, T2 were 13.24%, 18.92%, 23.08% (P > 0.05) respectively. The recurrent rate was 33.33% of tumors offended the anterior commissure, versus 5.43% with no involvement of anterior commissure (P < 0.01). The recurrent rate was 59.09% of tumors offended the thyroarytenoid muscle, versus 5.36% with no involvement of thyroarytenoid muscle (P < 0.01). Unvaried and multivariate analysis indicated that the involvement of anterior commissure and the involvement of thyroarytenoid muscle were the factors of recurrence. CONCLUSION Recurrence of early glottic carcinoma after carbon dioxide laser treatment is effected by the involvement of anterior commissure and the involvement of thyroarytenoid muscle. Resection can be performed conservatively according to evaluation of macroscopic tumour extension.
Carcinoma, Squamous Cell ; surgery ; Glottis ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Laser Therapy ; Lasers, Gas ; Microsurgery ; Neoplasm Recurrence, Local ; Retrospective Studies

Objective To investigate effect of dexmedetomidine on safety,validity and superiority in patients undergoing scoliosis surgery under propofol sufentanil anesthesia.Methods Forty patients undcrgoing elective posterior scoliosis surgery were randomly divided into groups D and C (n =10 each).Dexmedetomidine 0.8 μg/kg followed by 0.2 μg/(kg · h) and equal volume were infused at the 10 min before anesthesia induction in two groups,respectively.Hemodynamic parameters were observed at the 10 min before anesthesia induction (T1),3 min (T2) after anesthesia induction,1 min (T3) after intubation,at the beginning of wake-up test (T4),at the end of the test (T5),and 6 min (T6) after deepen anesthesia,respectively.Meanwhile the wake-up time,hemodynamic parameters,success rate of arousal,incidence agitation,and the bleeding volume during the test were also recorded.Results Successive rate of arousal awakening time between two groups had no statistical significance (P ＞ 0.05).Less incidence of agitation was found in group D compared to group C (P ＜ 0.05).The bleeding volume during the test was significantly less in group D (P ＜ 0.05).The hemodynamics was more smoothly during the operation in group D compared to group C (P ＜ 0.05).Conclusions Dexmedetomidine auxiliary propofol and sufentanil anesthesia can effectively implement intraoperative wake-up,reduce the amount of bleeding,and the incidence of agitation during the wake-up.The hemodynamics was more smoothly.

Objective To explore the role of cancer stem cells in EMT-induced acquired resistance to EGFR-TKIs in NSCLC. Methods The EGFR del E746-A750 mutated human lung adenocarcinoma PC-9 cell line and gefitinib acquired resistance cell line PC-9/AB were used in this study. EMT was assessed by western blotting assay. The sensitivity to gefitinib was tested with CCK8. Flow cytometry for antibody analysis was used to quantify CSCs within the cell lines. Results Compared with PC-9, PC-9/AB underwent EMT and showed no-table resistance to gefitinib (P < 0.01). Compared with PC-9, the proportions of CSCs were much higher in PC-9/AB. Conclusion EMT plays an important role in the acquired resistance to EGFR-TKIs in NSCLC , possibly through the up-regulation of CSCs.

Aim To prepare soluble global human C1 q and tumor necrosis factor related protein-2 in Escherichia coli. Methods Recombinant expression plasmid was transformed into strain BL21-codonplus (DE3),and the recombinant protein of Trx-gH2 was expressed by IPTG induction and then purified by Ni-NTA affinity and gel filtration chromatography.Results The purified recombinant Trx-gH2 was shown to be active under in vi-vo and in vitro assay conditions.Conclusion Active recombi-nant global hCTRP2 is efficiently prepared from Escherichia coli protein expression system.

Due to the subjective and objective constraints of universities in China,PBL Teaching Mode failed to gain its popularity in China's medical education.In its teaching reform,Guangzhou Medical University put forward a new teaching model--Web-based PBL Teaching Mode(hereinafter referred to as WPBL).by integrating the classical concept of PBL education with the real situation of the university and carried it out among students in bilingual classes of Clinical Medicine.The resuIts showed that by effectively overcoming the difficulties during the implementation of classical PBL teaching,Web-based PBL Teaching Mode not only succeeded in achieving the teaching objectives,but also improved the learning efficiency and utilization of teaching resources greatly by means of network technology.

OBJECTIVE: To analyze the related factors of difficult laryngeal exposure under retaining laryngoscope. METHOD: We did a retrospective analysis of 287 retaining laryngoscope surgery patients' clinical datas to observe the relationship between difficult glottis exposure and patients' gender, degree of mouth opening, BMI, neck circumference, head and neck flexion, TMD, HMD and SMD. RESULT: By ROC curve analysis, we determine the optimal threshold for TMD was 7.35 cm, HMD was 6.33 cm, SMD was 14.75 cm. Univariate analysis showed that gender, and glottis exposure had no significant correlation with difficult laryngeal exposure under retaining laryngoscope. Degree of mouth opening, BMI, neck circumference, head and neck flexion, TMD, HMD and SMD had correlation with difficult laryngeal exposure. Multivariate analysis showed that neck circumference, head and neck flexion, TMD, SMD were independent factors of difficult laryngeal exposure under retaining laryngoscope. CONCLUSION Measurement of neck circumference, head and neck flexion, TMD, SMD before the operation is important for the prediction of difficult laryngeal exposure under retaining laryngoscope.
Glottis ; Head ; Humans ; Laryngoscopes ; Laryngoscopy ; adverse effects ; methods ; Larynx ; Neck ; Posture ; ROC Curve ; Retrospective Studies

OBJECTIVE: To analyze the correlated factors of cervical lymphatic metastasis of T3 and T4 glottic carcinoma. METHOD: We did a retrospective analysis of 91 glottic carcinoma patients' clinical data to analyze cervical lymph node metastasis on different T stage, pathologic degree and the tumor sites. RESULT: The cervical lymph node metastasis rate of 91 cases of T3 and T4 glottic carcinoma was 21.98%. T3 group's metastasis rate was 18.06% (13/72), T4 group's metastasis rate was 36.84% (7/19), P > 0.05. Grouped according to the degree of pathological differentiation, well-differentiated squamous cell carcinoma metastasis rate is 13.89% (5/36), middle-differentiated squamous cell carcinoma metastasis rate is 26.00% (13/50), and poorly-differentiated squamous cell carcinoma metastasis rate is 40.00% (2/5), P > 0.05. Cervical lymph node metastasis rate was 16.22%, when the tumor invading supraglottic region. Cervical lymph node metastasis rate was 15.38%, when the tumor invading subraglottic region. Cervical lymph node metastasis rate was 46.15%, when the tumor invading supraglottic and subraglottic region (P < 0.01). CONCLUSION Cervical lymph node metastasis in cN0 patient with supraglottic carcinoma is effected by T classification, cervical lymphatic metastasis of T3 and T4 glottic carcinoma is not entirely effected by T stage and pathologic degree. When the tumor invades supraglottic and subraglottic region, cervical lymph node metastasis is significantly higher. Therefore, the area of tumor invasion is an important factor for lymph node metastasis.
Humans ; Laryngeal Neoplasms ; pathology ; Lymph Nodes ; Lymphatic Metastasis ; Lymphatic Vessels ; Neck ; Neck Dissection ; Neoplasm Staging ; Retrospective Studies

Objective:To investigate the effects of moxibustion on the serum metabolism in healthy human body based on the 1H nuclear magnetic resonance (1H NMR) metabolomics technology, and to find the differences in metabolites, as well as to elucidate the effects of moxibustion on healthy human body from the viewpoint of global metabolism. Methods:Sixty subjects of healthy young men from the enrolled students were randomly divided into a moxibustion group and a control group using random number table, with 30 cases in each group. Subjects in the moxibustion group accepted mild moxibustion on the right Zusanli (ST 36), once a day, 15 min for each time, and continuous treatment for 10 d; those in the control group did not receive any intervention. There were 28 cases in the moxibustion group and 23 cases in the control group after interventions. On the 1st day, 5th day and 10th day of the intervention, serum samples were collected from subjects of the two groups, and metabolic spectra were obtained by the1H NMR technology. Results: Before and after the intervention, serum1H NMR of the moxibustion group was significantly different, while the difference was insignificant in the control group. Metabolite changes in the moxibustion group were mainly in low density lipoprotein (LDL)/very low density lipoprotein (VLDL), valine, isoleucine, leucine, lactic acid, glutamine, citric acid, polyunsaturated fatty acids, creatine, glycine, glycerol, glucose, tyrosine, histidine, formic acid, alanine, lysine, acetic acid, and glutamic acid. Conclusion:Moxibustion can cause changes of serum metabolic patterns in healthy human by influencing the concentrations of branched-chain amino acids, polyunsaturated fatty acids, and other metabolites to strengthen body's metabolisms of amino acids and fatty acid.

Objective To explore the effect of preoperative platelet (PLT) count on the prognosis of patients with laryngeal squamous cell carcinoma.Methods The clinical data of 286 patients with laryngeal squamous cell carcinoma were retrospectively analyzed to determine the optimal critical value of PLT count for end point of recurrence and death.The effects of preoperative PLT count on the recurrence and 5-year survival rates of patients with laryngeal squamous cell carcinoma after surgery were analyzed.Results The optimal critical value of PLT count for end point of recurrence was 242.5 × 109/L.The patients were divided into PLT ≥242.5 × 109/L group (n =115) and PLT ＜242.5 × 109/L group (n =171).Single factor analysis indicated that the recurrence was not related to age (x2 =0.005,P =0.942),gender (x2 =0.309,P =0.579) and pathological differentiation (Z =2.858,P =0.240),and was related to T staging (x2 =10.509,P =0.001),lymph node metastasis (x2 =7.297,P =0.007),primary tumor site (x2 =16.797,P ＜ 0.001) and preoperative PLT count (x2=12.081,P =0.001).Multivariate analysis indicated that T staging (OR =0.518,95 ％ CI:0.281-0.954,P =0.035),primary tumor site (OR =2.371,95 ％ CI:1.283-4.382,P =0.006),and PLT count (OR =2.885,95％ CI:1.607-5.179,P ＜ 0.001) were the independent factors affecting the recurrence of laryngeal squamous cell carcinoma.The optimal critical value of PLT count for end point of death was 251.5 × 109/L.The patients were divided into PLT≥251.5 × 109/L group (n =94) and PLT ＜ 251.5 ×109/L group (n =192).Single factor analysis indicated that the 5-year survival rate was not related to age (x2 =0.030,P =0.863),gender (x2 =0.000,P =0.945) and pathological differentiation (x2 =4.050,P=0.133),and was related to T staging (x2 =41.630,P ＜ 0.001),lymph node metastasis (x2 =58.110,P ＜0.001),primary tumor site (x2 =36.250,P ＜ 0.001) and preoperative PLT count (x2 =4.790,P =0.029).Multivariate analysis indicated that T staging (HR =0.353,95％ CI:0.193-0.645,P =0.001),primary tumor site (HR =2.151,95 ％ CI:1.312-3.526,P =0.002),lymph node metastasis (HR =2.819,95 ％ CI:1.633-4.867,P＜0.001),and PLT count (HR=1.853,95％CI:1.160-2.960,P=0.010) were the independent factors affecting 5-year survival rates of laryngeal squamous cell carcinoma.Kaplan-Meier survival analysis indicated that the 5-year survival rate of PLT≥251.5 × 109/L group and PLT ＜ 251.5 × 109/L group were 58.23％,67.87％,with significant difference (x2 =4.79,P =0.029).Conclusion Preoperative PLT count is the influence factor of recurrence and 5-year survival rate of laryngeal squamous cell carcinoma patients,which has important significance to the prognosis of laryngeal squamous cell carcinoma patients.

Objective To explore the effect of preoperative neutrophil lymphocyte ratio (NLR) on the prognosis of patients with laryngeal carcinoma.Methods Clinical data of 202 patients with laryngeal carcinoma treated from January 2004 to October 2009 were retrospective analyzed to determine the optimal critical value of NLR.To study whether NLR is an independent factor affecting the recurrence and 5-year survival rate of patients with laryngeal cancer after surgery,single factor and multivariate analyses were performed.The factors included age,gender,T stage,pathological differentiation,lymph node metastasis,primary tumor site and NLR value.The relationship between NLR and cervical lymph node metastasis was analyzed.Results The optimal critical value of NLR was 2.85,by which cases were divided into high NLR group (NLR≥2.85) and low NLR group (NLR ＜ 2.85).Single factor and multivariate analyses indicated that T staging,lymph node metastasis,primary tumor location,and NLR were the independent factors affecting the recurrence of laryngeal carcinoma.T stage and lymph node metastasis were the independent factors affecting 5-year survival rate of laryngeal carcinoma.The increase of NLR value increased the rate of cervical lymph node metastasis.Conclusion Preoperative NLR level influences the recurrence and cervical lymph node metastasis of laryngeal carcinoma and can be considered a prognosis factor of laryngeal cancer.