Head and Neck Neoplasms ; surgery ; Humans ; Palliative Care

Head and Neck Neoplasms ; surgery ; Humans ; Reconstructive Surgical Procedures

o statistical difference between WMD group and control group (t = 1.83, t = 0. 88, P 0. 05). Conclusion Conventional MRI is able to quantify the brain maturation and prognosis of premature infants using TMS.

Surgery is the major treatment option for malignant tumors and some benign neoplasms of the thyroid, most of which are differentiated thyroid carcinoma. Despite the progresses that have been made in surgical techniques, iatrogenic injuries of the parathy-roid and laryngeal nerves, including superior and recurrent laryngeal nerves, could not be completely avoided in the surgical manage-ment of thyroid tumors. In this review, the causes of intraoperative injuries of parathyroid and laryngeal nerves are systematically ana-lyzed with respect to types and extents of surgical operations, changes in topical anatomy, and secondary thyroid surgeries. The princi-ples and strategies for protecting and restoring injuries of the parathyroid and laryngeal nerves are also elucidated for the effective prevention and adequate treatment of these major complications in the thyroid surgery.

Objective:To evaluate functional recovery of nerve and muscle after end-to-side neurorrhaphy.Methods:10 SD rats were randomly and evenly devided into group A and group B.Right common peroneal nerve was amputated in all the rats.Then the distal stump was sutured to the ipsilateral tibial nerve by the end-to-side way through a epineurial window in group A. The right common peroneal nerve was severed in group B as denervated control.After 1.5 months all the rats were subjected to walking track analysis,histological and ultrastructure observation.Results:In group A peroneal nerve index (PFI) achieved -41.634,density of collateral axons 51.437?12.041/1 000 ?m 2,synapsin (SYP) 439?120.5.In group B PFI was -100,SYP 0. In normal control PFI was 0, density of collateral axons 18.847?1.078/1 000 ?m 2,SYP 842?84.7.Conclusion:End-to-side neurorrhaphy may induce nerve sprout plenty of collateral axons.The axons can reach target muscle to reconstruct functional neuromuscular junction,and recover the function of the muscle in some degree.

Overexpression of the epidermal growth factor receptor (EGFR) is a common characteristic of head and neck squamous cell carcinomas (HNSCC) , and initiates important signal transduction pathways in carcinogenesis. Now the EGFR is a validated target for cancer therapies in HNSCC. However, the effect of EGFR-targeted therapies is only modest because of primary and/or acquired resistance. Therefore, an improved understanding of the molecular mechanisms of resistance to EGFR inhibitors may establish new treatment options to overcome resistance. In this review, the molecular mechanisms of resistance and the strategies to overcome it were summarized.
Antineoplastic Agents ; Carcinoma, Squamous Cell ; drug therapy ; Drug Resistance, Neoplasm ; ErbB Receptors ; Head and Neck Neoplasms ; drug therapy ; Humans ; Signal Transduction ; Squamous Cell Carcinoma of Head and Neck

OBJECTIVE: To-evaluate the role and clinical value of cetuximab in the treatment of head and neck squamous cell carcinoma (HNSCC), and figure out its effectiveness and application, so as to develop evidence-based recommendations for treatment. METHOD: We comprehensively searched the CBM, Pubmed, EMBASE, and the Cochrane databases to identify published studies on the effect of cetuximab in HNSCC patients. Primary outcomes included overall survival (OS), progression-free survival(PFS) and overall response rate(ORR). Secondary outcomes included serious adverse events, such as neutropenia, anemia, thrombocytopenia, skin reactions, hypokalemia, vomiting, asthenia, hypomagnesemia, dyspnea and sepsis. Results were dispalyed as risk ratio (RR), odds ratio (OR), mean difference (MD) and 95% CI. RESULT: A Meta-analysis was conducted on 4 randomized controlled trials, including 2 trials comprising 1,319 patients with locally advanced HNSCC and 2 trails comprising 559 patients with recurrent or metastatic HNSCC. For locally advanced HNSCC, the 2 year PFS and OS showed no significant differences in patients received cetuximab or not (PFS fixed effect: RR=1.02, 95%CI 0.92-1.12, P>0.05; OS fixed effect: RR=1.06, 95%CI 1.00-1.13, P>0.05, respectively). Grade 3-4 dysphagia was also similar in patients treated with cetuximab or no cetuximab (dysphagia: fixed effect: RR = 0.92; 95% CI 0.84-1.02, P>0. 05). Only grade 3-4 mucositis and skin reaction showed statistical significance between patients treated with cetuximab and patients with no cetuximab (mucositis: fixed effect: RR=1.21; 95%CI 1.07-1. 36, P<0. 05; skin reaction: fixed effect: RR=1.99; 95%CI 1.39-2.85, P<0.05, respectively). For recurrent or metastatic HNSCC, the OS overall mean difference was 2.41 (95% CI 0.96-3.86, P<0.05), the PFS overall mean difference was 2. 06 (95% CI 1.34 - 2.77, P<0.05), and the ORR overall Odds ratio was 2.38 (95% CI 1.60-3.54,P<0.05), suggesting significant effect of cetuximab in improving the prognosis of R/M HNSCC. Owing to small number of trials it was not possible to assess the presence of publication bias. Of note, the 1 year survival overall Odds ratio was 1.39 (95% CI 0.98-1.97, P>0.05). The grade 3 or 4 adverse effects were described in 83. 4% of patients in cetuximab group and 75. 5% of patients in no cetuximab group. The overall side effects risk ratio suggested statistically significant difference between patients treated with cetuximab and pa- tients with no cetuximab (RR=1.11, 95% CI 1.01-1.20, P<0.05, P =47%). CONCLUSION The 2 year progression-free survival and overall survival were similar between cetuximab group and no cetuximab group in patients with locally advanced head and neck squamous cell cancer. Data are limited and the benefits of cetuximab on this outcome remain uncertain. Impact of grade 3-4 dysphagia was similar in both groups, however, the incidence of grade 3-4 mucositis and skin reaction were lower in patients treated with cetuximab. Existing randomized controlled trials provided a scientific evidence for the use of cetuximab in R/M HNSCC. The conclusion of the study is based on limited number of RCT, so further investigation is still needed before firm recommendations of cetuximab can be made in the treatment of HNSCC.
Antibodies, Monoclonal, Humanized ; therapeutic use ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Squamous Cell ; drug therapy ; Cetuximab ; Disease-Free Survival ; Head and Neck Neoplasms ; drug therapy ; Humans ; Squamous Cell Carcinoma of Head and Neck

Ear ; Humans ; Keloid ; therapy

Hearing ; Hearing Tests ; Humans ; Mass Screening

Objective To study the relationship between pathological, immunohistochemical and ultrastructural changes of skeletal myodystrophy (SMD) and the development of the disease.Methods SMD tissue of 20 cases were routinely processed,the paraffin sections,the semi thin sections and the ultrasthin sections were observed by light microscopy and electron microscopy.Results 20 cases with SMD tissue were divided into three groups: Simple SMD for 8 cases, major changes were regional; Progressive SMD for 10 ca ses, the pathological changes were diffuse with large amount of degeneration of cell organs; SMD derived from nerve injury for 2 cases, pathological changes of the part controlled by the nerve were observed. While SMD was injured, myosin got deneration first.Conclusion The pathological and ultrastructure changes could be used to judge the progressive degree of myodystrophin. The amount of lost myosin could forecast the progression of the disease.