Objective: To discuss how to improve the level of diagnosis and treatment about the firstbranchial fistula. Method:16 cases with the first branchial fistula were analyzed retrospectively. Result :Of all thepatients underwent surgery, 14 cases were free from disease postoperatively within 0.5 years follow-up, 2patients underwent re-operation because of recurrence. Conclusion:Knowing about the disease fully, selectingproper surgical incision and possessing skilled surgical technique is important to improve the level of diagnosisand treatment about the first branchial fistula.

Objective:To investigate the clinicopathlogical significance of the CyclinE,p21WAF1/CIP1 and p53 expression in laryngeal carcinogenesis.Method:The expression of CyclinE,p21WAF1/CIP1 and p53 was examined by using immunohistochemical method in normal epithlia (20),dysplastic epithlia (40) and laryngeal cancers (60).Result:①In normal epithlium,dysplastic squamous epithlium and in squamous cell carcinoma of the larynx,the positive immunostaining rate of CyclinE protein was 5.0%(1/20),20.0%(8/40) and 45.0%(27/60) respectively (P＜0.001),and p21WAF1/CIP1 protein was 95.0%(19/20)，75.0%(30/40) and 63.3%(38/60) respectively (P＜0.01),while the rate of p53 was 0,30.0%(12/40) and 61.7%(37/60)(P＜0.001) respectively.②p21WAF1/CIP1 positive expression in highly、moderately and poorly differtiated carcinomas were 76.2%(16/21)、66.5%(19/29) and 30.0%(3/10) respectively (P＜0.05),p21WAF1/CIP1 protein expression was significantly associated with tumour cell differentiation.③The positive expression of CyclinE closely related with the positive expression of p53 (P＜0.05).No correlation was found between p21WAF1/CIP1 expression and p53 expression.Conclusion:①CyclinE and p53 could be an early molecular event in the carcinogenesis of larynx.②p21WAF1/CIP1 expression is associated with tumour cell differentiation.③The mutual mechenism of cell cycle regulators (CyclinE、p21WAF1/CIP1 and p53) play an important role in the laryngeal carcinoma.

0.05). Conclusion Acellular nerve allograft may be a substitute to autograft repairing facial nerve defects.

OBJECTIVE: To evaluate the clinical effect of acellular dermal matrix (ADM) on the repair of different tissue defects in pharyngeal and laryngeal cancer. METHOD: Twenty-three cases of pharyngeal and laryngeal cancer were analyzed retrospectively, including 16 patients with pharyngeal cancer, and 7 patients with laryngeal cancer. After surgery, the patients appeared two types of tissue defects respectively: hypopharynx tissue defect and neck skin tissue defect. These defects were repaired with ADM, and the clinical effects were observed. RESULT: Sixteen cases of hypopharynx tissue defect and 7 cases of neck skin tissue defect were repaired with ADM. One case in hypopharynx tissue defect group and 2 cases in neck skin tissue defect group undergone pharyngeal fistula postoperatively. CONCLUSION The repair of tissue defects in pharyngeal and laryngeal cancer with ADM had some advantages, such as good histocompatibility, low immune rejection, wide material sources and simple method. There were some differences in clinical effects between hypopharynx cavity defect and neck skin tissue defects, so the emphasis of the need to pay attention to is different in the clinical.
Acellular Dermis ; Dermatologic Surgical Procedures ; Humans ; Hypopharynx ; surgery ; Laryngeal Neoplasms ; surgery ; Mucous Membrane ; surgery ; Neck ; surgery ; Otorhinolaryngologic Surgical Procedures ; Retrospective Studies

OBJECTIVE: To compare the clinical results between stapled and traditional suture closure total laryngectomy. METHOD: Fifty-three cases of laryngeal cancer with total laryngectomy were divided into 2 groups: 32 cases with traditional suture closure total laryngectomy (group A) and 21 cases with stapled total laryngectomy group (group B). Compare two groups in pharyngeal fistula, postoperative bleeding, dysphagia, and nasal regurgitation. RESULT: There was no difference of postoperative pharyngeal fistula between group A and B (P>0. 05). The incidence of dysphagia, nasal regurgitation, and postoperative bleeding in group B were 23. 8%, 14. 3% and 14. 3% respectively, which were obviously higher than that in group A (P<0. 05). CONCLUSION Stapled total laryngectomy has the advantages of reducing the operative time and simplifying the operation with some disadvantages such as higher standards of operation indications, higher incidence of dysphagia, higher nasal regurgitation, higher postoperative bleeding, and poor medical economic profit. Traditional suture closure total laryngectomy is recommended in clinical practice.
Deglutition Disorders ; Fistula ; pathology ; Humans ; Incidence ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Pharynx ; pathology ; Postoperative Complications ; Suture Techniques ; Sutures

OBJECTIVE To investigate the opportunity and method of surgery for removing tracheobronchial foreign bodies. METHODS A retrospective study was carried out among 500 children with tracheobronchial foreign bodies treated in our hospital from June, 2005 to June, 2009. RESULTS The foreign bodies were successfully removed in 4(0.8%) patients with fiberoptic-bronchoscopy, 2(0.4%) patients with thoracotomy, 20(4%)patients with endoscope or rigid bronchoscopy via tracheostomy, 32(6.4%) patients with direct laryngoscopy, 436(87.2%)patients with rigid bronchoscopy . There were 6 patients (1.2%) need another operation to fully remove the foreign bodies. CONCLUSION Proper method should be choose for removing tracheobronchial foreign bodies according to the history, location and kind of the foreign bodies.

The paper describes the significance of clinical pathological congresses in clinical work. It argues that at present there is the tendency of laying stress on modern advanced diagnostic means at the expense of basic physical diagnostic means and traditional therapies, and traditional conduction of clinical pathological congresses for the purpose of summarizing medical experience and promoting medical advancement has even become a rarity, which is very harmful to the cultivation of qualified clinical doctors. The paper gives an account of how the authors' hospital encouraged performance of autopsies and persisted in holding clinical pathological congresses. Its experience is that clinical pathological congresses have many functions in clinical work, including solving knotty problems like multidisciplinary and multisystematic pathological changes by drawing upon all useful opinions; exchanging information, which is beneficial to doctors learning from one another and making common progress; cultivating personnel via tempering young doctors and updating senior doctors'knowledge; and strengthening the hospital's cohesive force.

Objective To investigate the clinical effect of laparoscopic surgery on gynecologic malignancies,providing information for the clinical therapy.Methods 35 patients with gynecologic malignancies treated with laparoscopic surgery were selected as the observation group.While 35 cases of abdominal surgery patients were selected as control group at the same period.The incidence of postoperative complications,survival rate and other conditions of the two groups were observed and compared.Results The operation time of laparoscopic surgery group was longer than open surgery group,no significant difference between the two groups(P ＞ 0.05 ).Blood loss,hospital slay and recovery time of body temperature of the laparoscopic surgery group was significantly lower than open surgery group ( P ＜0,05).2 cases had urinary retention,1 urinary tract infection and 1 deep vein thrombosis occured in observation group; while 3 urinary retention cases,1 intestinal obstruction case,1 deep vein thrombosis case,1 abdominal wound infection case occured in control group,and the difference was significant ( P ＜ 0.05 ).2 patients lost in each group.3-year survival rate of laparoscopic surgery group was similar with open surgery,the difference between the two groups was not statistically significant( P ＜ 0.01 ).Conclusion Excision and pelvic lymph node dissection under laparoscopy is an effective method in treatment of gynecologic cancer,and with less trauma and faster recovery.

Objective To provide a reliable differential diagnosis among the progressive supranuclear palsy ( PSP), striatonigral degeneration ( SND ) and Parkinson disease ( PD ) . Methods Conventional MRI data in clinically proved PSP(8 cases), SND(9 cases), PI)( 12 cases)and 12 normal controls were retrospectively analyzed. Midbrain area, pons area, ports diameter and middle eerebellar peduncles width were measured. The ratio of pons area over midbrain area (pons area/midbrain area) was calculated in all patients and normal controls. Then one way ANOVA and a Kruskal-Wallis H test were used for statistical analysis. Results Midbrain area of the PSP group [ (85. 8±12. 0) mm2 ] was the smallest, and there was statistically significant difference ( P < 0. 05 ) comparing with the SND group [ ( 133.2± 8. 4) nun2 ], PD group[ ( 133. 5±10. 8) mm2 ] and the control group [ ( 135.9±7.5 ) mm2 ]. There was no overlapping in the distribution of midbrain area between the PSP group(66.0-98. 2 mm2 ) and SND, PD and normal groups( 116. 2-142. 1, 110. 8-146. 2 and 121.7-145.8 mm2 ). The pons area-midbrain area ratio (P/M) of the PSP group (5.9±0. 8) was the largest in four groups, and there was statistically significant difference ( P < 0. 05 ) comparing with the SN D group ( 2. 9±0. 5 ), PD group ( 3.8±0. 3 ) and the control group (3. 8±0. 3 ). There was no overlapping in the distribution of P/M between the PSP group(5.0-7.2) and SND,PD and normal groups(2. 2-3.5, 3. 3-4. 6 and 3. 2-4. 2). SND group had the smallest P/M, pens area, pons diameter and middle cerebellar peduncles width [ 2.9±0. 5, ( 384. 8±62. 6) mm2 , ( 18. 6±2. 0) nun and( 12. 9±2. 4) mm ] in all groups, and significant difference ( P < 0. 05 ) was found comparing with the PSP group[5.9±0. 8, (500.1±21.8)mm2, (22. 7±1.7)mm and( 16. 3±1. 1) nun],PD group[3.8±0.3, (500.2±25.8)mm2, (23.7±1.0)mm and(16.8±1. 1)mm]and the control group [3. 8±0. 3, ( 508. 8±20. 6 ) mm2, ( 23.2±1.2) nun and ( 16. 4±0. 9 ) mm]. But the PD group and control group had no statistically significant difference in the midbrain area, pans area, pons diameter, P/M and middle cerebellar peduncles width ( P > 0. 05 ). Conclusion MRI measurements helps in the differential diagnosis among PSP, SND and PD.

Objective To study the clinical effects of different surgical treatments for laryngotracheal steno-sis .Methods The clinical data of 56 patients with laryngotracheal stenosis from July 2006 to July 2014 were ana-lyzed .Of all 56 cases ,7 cases were children ,49 cases were aducts ;9 cases underwent CO2 laser resection ,5 cases underwent temperature controlled radiofrequency ablation and 5 cases received laryngeal mold under self -retaining laryngoscope ,6 cases received Keel placement after laryngofissure ,23 cases received T -shape tube implantation af-ter laryngoplasty or tracheoplasty and 8 cases underwent end-to -end tracheal anastomosis after cervical tracheoto-my .Results All the patients had been followed up for 6 months to 2 years postoperatively .Thirty nine cases of 56 were cured after single-operation ,and 10 of 56 were cured after repeated operations .No one suffered from laryn-gotracheal stenosis again .Five cases failed and survived with tracheal tube .2 cases lost to follow -up .No people die or had complications .Among all cases ,5 cases with laryngeal mold and 8 cases with tracheal anastomosis were cured after single-operation .Among 9 cases with lasere scar removal surgery ,5 cases were cured after an operation ,3 cases were cured after two operations ,1 case failed because of laryngeal cancer recurrence .Among 5 case with tem-perature controlled radiofrequency ablation ,3 cases were cured afrter an operation ,1 case was cured after two opera-tions ,1 case had no effect .Among 6 cases with keel place -ment ,4 cases were cured after one operation ,1 case was cured after two operations ,1 case had no effect .Among 23 cases with T -shape tube implantation ,14 cases were cured after an operstion ,5 cases were cured after two and more operations ,2 cases had no effects and 2 cases were lost .Conclusion In order to improve the therapeutic effects of laryngotracheal stenosis ,the treatment strategy should be personalized according to the degree of stenosis ,the position of stemtis ,and the impairment of laryngotra-cheal framework .