BACKGROUND: Chemotherapy drugs can kil both cancer cel s and normal tissue cel s. Molecular targeted therapy can reduce or avoid toxicity of chemotherapy drugs to normal cel s. OBJECTIVE: To study the therapeutic effect of folic acid magnetic nanoparticles containing cisplatin on laryngeal cancer. METHODS: Folic acid-cis-diaminodichloroplatinum (II)-aldehyde sodium alginate-magnetic nanoparticles (FA-CDDP-ASA-MNPs) were prepared. The FA-CDDP-ASA-MNPs, CDDP and FA-ASA-MNPs were cultured together with human laryngeal cancer Hep-2 cel s. To detect the effect of FA-CDDP-ASA-MNPs, CDDP and FA-ASA-MNPs on human laryngeal cancer Hep-2 cel s, MTT, flow cytometry and transmission electron microscopy examination were used in vitro. RESULTS AND CONCLUSION: Both FA-CDDP-ASA-MNPs and CDDP could inhibit the growth of human laryngeal cancer Hep-2 cel s, and there was no difference in their inhibitory rates (P > 0.05). FA-CDDP-ASA-MNPs and CDDP showed increased inhibitory rates of human laryngeal cancer Hep-2 cel s with the increase of CDPP concentration. The half maximal inhibitory concentrations of CDDP for inhibiting Hep-2 cel s were significantly different at 24 and 48 hours after culture (P < 0.05). Both FA-CDDP-ASA-MNPs and CDDP could cause apoptosis in Hep-2 cel s, and the number of apoptotic cel s was increased with the increase of drug concentrations (P < 0.05), but there was no difference between two kinds of drugs (P > 0.05). FA-CDDP-ASA-MNPs and CDDP at low concentrations could increase the percentage of cel s at G0/G1, but decrease the cel proportion at S and G2/M phases (P < 0.05). Under transmission electron microscope, Hep-2 cel s with the intake of FA-CDDP-ASA-MNPs appeared to have notable apoptosis. These findings suggest that folic acid magnetic nanoparticles containing cisplatin can inhibit the growth of human laryngeal cancer Hep 2 cel s, with no influence on the efficacy of cisplatin and with no cytotoxic effect.

Tracheostomy is to establish an artificial airway by making an opening at anterior tracheal wall. Due to the blossom of mechanical ventilation and intensive care unit after 1950s, tracheostomy is the most favorable surgical method to access airway at present. In addition to traditional surgical tracheostomy, percutaneous dilational tracheostomy have gained increasing popularity and become an alternative procedure because of its merits such as easier manipulation, shorter operative duration and less complications. This review summarized tracheostomy from definition, history and current status, anatomy and physiology, indications, contraindications, timing, complications and management. We also elaborate our understanding of current contraercy and give some suggestions based on our clinical experience.
Humans ; Intensive Care Units ; Respiration, Artificial ; Trachea ; surgery ; Tracheostomy ; methods

Objective To improve the surgical treatment of square mandible deformity. Methods Based on cephalometric and facial feature, an integrated therapeutic project was designed. Through an oral approach the bilateral prominent mandibular angles were reseeted. Meanwhile, genioplasty was applied to correct chin deformity. Results From March 2000 to December 2006, 18 cases of square mandible with chin deformity were corrected with this procedure. The postoperative appearance was improved greatly after 3～6 months. Beautiful chin outline was reconstructed in esthetical standard. Mentolabial sulcus became natural and harmonious. Conclusion Mandible angle osteotomy combined with genioplasty is an ideal methods to recontour square mandible with chin deformity. It is beneficial to whole facial con-tour improvement.

Objective To establish a single nucleotide polymorphisms genotyping (SNP) method for a convenient, accurate, and routine analysis of clinical samples. Methods Based on the design of oligonucleotide probe, the assay was performed through three steps:the conjunction of the detection probe, universal amplification, labeling and ELISA reaction. The genotype of each SNP was revealed by reading signals of each set of reaction tubes. This assay was applied to detect sixty-two plasma samples of lung cancer for circulating DNA for three SNPs of EGFR, c.2573T＞G(L858R), EGFR, c.2582T＞G＞T(G719C). Results were compared with those obtained by direct sequencing. Results The heterozygote mutation was identified for L858R by both methods, although no mutation was detected for L861Q and G719C. Six samples were identified as heterozygotes with the new method, and only two samples were unambiguously identified as heterozygotes by the direct sequencing. Two additional samples could not be identified as heterozygotes because the peak of mutant allele was very low compared with that of wild allele. Conclusion The developed method enabled accurate identification of SNP in a convenient manner, and which is adapted to routine analysis from heterogeneous samples unambiguously.

Objective To discuss the way of open reduction and internal fixation for fractured condylar neck and mandible ramus via intraoral approach aiming to avoid the facial incision. Methods Fifteen cases (17 sides) with mandibular condyle fractures underwent open reduction and osteosynthesis with plates and screws. After the mandibular ramus was under vertical osteotomy with an oscillating saw, the posterior border bone block of mandibular ramus as well as the free condyle neck were taken out. The fractured condyle neck and the posterior border bone block of mandibular ramus were fixated with a titanium miniplate in vitro. The reunion bone was implanted and reposited in the mouth incision. Of all, two cases suffered fracture of the condyle neck in the other hospital when they received esthetic surgery and resection of prominent mandible angle (PMA). Results Anatomic reduction was achieved in all cases, without damage to facial nerve and major auricular nerve or salivary fistula. There were slight bony resorption and good temporomandibular joint function one year after surgery, with range of mouth opening for 25-40 mm (mean 35.8 mm). Two cases regained their occlusion before their PMA operation. One case had premature contact of the buccal teeth,with 1 mm diverging to medline of the incisor teeth. Intraoral approach not only could avoid large facial scars and facial nerve injury, but also allow visualization of the occlusion during the procedure. Conclusions As more and more consideration is taken to cosmetology, the transoral approach is a reliable surgical alternative for fractures of the condyle neck, without leaving extensive visible scars or damaging facial nerve. The disadvantage is vertical osteotomy of the posterior border of the mandibular ramus.

BACKGROUND:Neural stem cel s have multi-directional differentiation potential, self-sustaining and self-renewal capacity as wel as have strong migration ability. Bushen Huoxue Recipe can reduce neuronal damage and promote nerve cel regeneration, to achieve neural function reconstruction. Underlying mechanisms of Bushen Huoxue Recipe combined with neural stem cel transplantation in rats with tinnitus induced by sodium salicylate are yet unclear. OBJECTIVE:To investigate the effects of Bushen Huoxue Recipe combined with neural stem cel transplantation in rats with tinnitus induced by sodium salicylate. METHODS:Sixty Sprague-Dawley rats were randomized into five groups (n=12):normal control group, tinnitus model group, Bushen Huoxue Recipe group, stem cel group and combined treatment group (Bushen Huoxue Recipe combined with neural stem cel transplantation). Animal models of tinnitus induced by sodium salicylate were made in al the groups except for the normal control group. Fifteen days after modeling, rats were given intragastric administration of Bushen Huoxue Recipe water decoction (3 mL, 2.592 g/mL) for consecutive 7 days in the Bushen Huoxue Recipe group, intravenous injection of neural stem cel s (1 mL, 1.0×109/L) in the stem cel group, or their combined treatment in the combined treatment group. RESULTS AND CONCLUSION:Bushen Huoxue Recipe, neural stem cel transplantation and their combination al could effectively promote the recovery of drinking water inhibitory rate that was ranked as fol ows:combined treatment group

Objective To compare efficacy, time consumed and complications among cricothyroid membrane puncture guided tracheostomy ( CMPGT ) , surgical tracheostomy ( ST ) , surgical cricothyroidotomy ( SC) , and percutaneous tracheostomy using Griggs'guide wire dilating forceps ( GWDF) for the establishment of airway in urgent need of medical attention.Methods Twenty miniature swine were randomly ( random number) divided into four groups.The procedures of CMPGT, ST, SC and GWDF were carried out when patients'SpO2 ( oxygen saturation of blood ) declined to 80% by suspension of oxygen supply after general anesthesia. Procedure performed time, ventilation resumed time, SpO2 and electrocardiograph ( ECG) and arterial blood gases ( ABG) analysis including SaO2 , PaO2 , PaCO2 , blood pH, and heart rate, blood pressure were recorded.Fiberoptic bronchoscope was used to assess any damage to the tracheal wall.Complications were noted and scored in a two-month follow-up period.Results Airways were successfully established in all swine.The times consumed for SC, GWDF, CMPGT, and ST were (86 ±12) s, (165 ±63) s, (174 ±34) s, and (519 ±128) s, respectively, however a shorter time for ventilation resumed was found in CMPGT procedure (23 ±4) s, P<0.01.ECG showed that SpO2 and T-wave decreased and Q-T shortened after oxygen suspension and recovered to normal level rapidly after ventilation.There were significant differences in ECG and ABG between pre-and post-operative periods ( P<0.05) in all groups.Minimal intra-operative bleeding was found in two swine of each group.In ST group, moderate intra-operative bleeding was encountered in three swine.Three pigs were suffered from hypotension owing to prolonged hypoxemia.There was minimal postoperative bleeding occurred in one swine, thus leading to stoma infection.In SC group, moderate intra-operative bleeding was noticed in one swine. One miniature swine had slight injury at laryngeal cartilage resulting in difficult decannulation happened in one swine.and moderate tracheal wall injury occurred in one swine of GWDF group.The complication scores of CMPGT, GWDF, SC and ST were 3, 5, 9, and 19, respectively.Conclusions A shorter time for ventilation resumed with fewer complications was found in the procedure of CMPGT than that in the other methods.This animal study suggested that CMPGT was a time-saving and secure technique for emergency surgical airway establishment which has been practiced in human being as well.Key words:Surgical airway establishment, Cricothyroidotomy, Tracheostomy, Percutaneous dilational tracheostomy.

OBJECTIVE: The purpose of this study was to investigate the expression of PKM2 and HIF-1α in laryngeal squamous cell carcinoma and to analyze their correlation in laryngeal squamous cell carcinoma. METHOD: Total 37 laryngeal carcinoma samples and para-carcinoma tissues were taken from the patients who accepted operation treatment in the Second Hospital of HeBei Medical University from 06/2013 to 06/2014. The protein expression levels of PKM2 and HIF-1α were detected with SP immunohistochemical methods. The data were analyzed by the SPSS 13.0 statistical software. RESULT: The positive expression of PKM2 in laryngeal carcinoma tissues and adjacent tissues were 62.16% and 13.15%. The difference was statistically significant (P < 0.01). The positive expression of HIF-1α in laryngeal carcinoma tissues and adjacent tissues were 64.86% and 21.62%. The difference was statistically significant (P < 0.01). The positive expression of PKM2 and HIF-1α in well differentiated laryngeal squamous cell carcinoma were both 47.83%, while in medium and poorly differentiated laryngeal squamous cell carcinoma were 85.71% and 92.86% respectively. The difference was statistically significant (P < 0.05). The positive expression of PKM2 and HIF-1α in patients with lymph metastasis were 90.00% and 100.00% respectively, 51.85% in those without lymph metastasis, the difference was statistically significant (P < 0.05). The rate of HIF-1α positive expression in I-II stage was 53.85%, 90.91% in III-IV stage. The difference between the two groups was statistically significant (P < 0.05). The expression of PKM2 and HIF-1α had no relationship with the age and smoking (P > 0.05). The expression of PKM2 was positively related with HIF-1α in laryngeal squamous cell carcinoma (P < 0.01). CONCLUSION The expression of PKM2 and HIF-1α are related with the proliferation, invasion and metastasis of laryngeal squamous cell carcinoma. It provides a certain theoretical basis for laryngeal cancer diagnosis and screening to measure the expression of PKM2 and HIF-1α as biological indicators.
Biomarkers, Tumor ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; Carrier Proteins ; metabolism ; Head and Neck Neoplasms ; metabolism ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Laryngeal Neoplasms ; metabolism ; Lymphatic Metastasis ; Membrane Proteins ; metabolism ; Squamous Cell Carcinoma of Head and Neck ; Thyroid Hormones ; metabolism

OBJECTIVE: To investigate the role of Keap1-Nrf2-ARE pathway in laryngeal carcinoma occurrence and development. METHOD: Thirty-five laryngeal carcinoma samples and para-carcinoma tissues were taken from the patients who accepted operation treatment in our hospital from Feb 2012 to Sep 2013. The expression levels of Nrf2 and Keap1 were detected in 35 cases of laryngeal carcinoma with SP immunohistochemical methods. The data were analyzed by the SPSS 13.0 statistical software. RESULT: The expression of Nrf2 in the 35 cases of laryngeal carcinoma was 77.14%, which in the para-carcinoma tissues was 8.57%, the difference between these two groups was statistically significant (P < 0.01). The expression of Keap1 in the 35 cases of laryngeal carcinoma was 71.43%, which in the para-carcinoma tissues was 31.43%, the difference between these two groups was statistically significant (P < 0.01). The expression of Nrf2 in I -II stage was 65.00% and in III-IV stage was 93.33%, the difference was significant (P < 0.05). The expression of Keap1 in I-II stage was 55.00% and in III-IV stage was 93.33%, the difference was significant (P < 0.05). Of the 35 cases, the positive expression rate of Nrf2 and Keap1 in laryngeal carcinoma with lymphnode metastasis were both 100.00%, compared with those without lymph nodes metastasis 68.00% and 60.00%, the difference was significant (P < 0.05). The expression of Nrf2 and Keap1 had no relationship with tumor differentiation, smoking and patient age (P > 0.05). CONCLUSION Keap1-Nrf2-ARE pathway may play an important role in progression of laryngeal squamous cell carcinoma.
Biomarkers, Tumor ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; Head and Neck Neoplasms ; metabolism ; Humans ; Intracellular Signaling Peptides and Proteins ; metabolism ; Kelch-Like ECH-Associated Protein 1 ; Laryngeal Neoplasms ; metabolism ; Lymphatic Metastasis ; NF-E2-Related Factor 2 ; metabolism ; Neoplasm Staging ; Squamous Cell Carcinoma of Head and Neck

Objective To summarize the use of the CT-guided mandibular angle plastic osteotomy.Methods The clinical data of mandibular angle plastic osteotomy were analyzed under the CT navigation in recent 3 years in our department.Thin-slice CT scans of the mandibular angle were performed before the operation.The CT data were input to the system of neuronavigation.The surgical procedures were then taken under the CT navigation.Results All of patients who received this new technology obtained good plastic effects and safe operation.The anatomic location accurately achieched with short operation time and less bleeding during the operation and distinct curative effect and fast recovery after operation.The effects of the treatment were fine.No visible complications occurred.Conclusions The CT navigation could fix accurately on position of important blood vessels and nerves which could be injured accidentally during operation and,of course,the safety of the operation is improved.The CT navigation can also determine the position and quantities of osteotomy from three dimensional angles,reduce effectively the surgical complications and the risk of surgery,reduce the psychological burden of patients efficiently and increase their confidence and credibility to the operation and surgeons.