OBJECTIVE: To discuss the function recovery and treatment effect of extended supraglottic orizontal-partial laryngectomy in the treatment of advanced laryngeal carcinoma and vallecula carcinoma. METHOD: Forty-four patients who received extended supraglottic orizontal partial laryngectomy were followed up on the survival, breath function, pronunciation and swallowing function. RESULT: The 2-year, 3-year survival rates of this group were 72.7% and 71.4%, respectively. There were no recurrence cases in this group. All cases of death were due to cervical lymph node metastasis or recurrent cervical lymph node metastasis after cervical lymph node dissection. The extractive rate of tracheostomy tube was 97.7%. Forty-two patients own good pronunciations. Two patients who received partial arytenoid cartilage resection own weaker pronunciations. After practising, all the patients can eat without the nasal feeding tube. CONCLUSION Extended supraglottic orizontalpartial laryngectomy give complete resection of the primary lesion. Patients who received extended supraglottic orizontalpartial laryngectomy have good breath, swallowing and pronunciation function.
Arytenoid Cartilage ; surgery ; Epiglottis ; pathology ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Neck Dissection ; Neoplasm Recurrence, Local ; Survival Rate ; Tracheostomy

Objective To observe the efficacy and adverse effect of IHDA [Idarubicin(IDA) + high-dose Cytarabine(HD-Ara-C)] as a remedy regimen in the treatment of pediatric patients with refractory acute lymphoblastic leukemia(ALL).Methods Twelve children with refractory ALL were treated by IHDA regimen as follows:IDA,10 mg/(m2·d),d1-3;Ara-C,1.0g/m2,q12h,d1-3.The children who achieved complete remission(CR)could get into the following sequential regimens or allogeneic hematopoietic stem cell transplantation (allo-HSCT).The same regimen was given to the children who didn't achieve CR when WBC ＞2.0×109/L.The efficacy and hematology or non-hematology adverse effect were evaluated.Results CR/partial remission (PR)/non-remission (NR) were respectively 4/3/5 cases after giving the first regimen,and CR/PR/NR were 5/3/4 cases after giving the second regimen,respectively.The overall remission was 66.7％ (8/12 cases),of which 5 cases(41.7％) achieved CR,3 cases (25.0％) reached PR and 4 cases(33.3％) reached NR.Grade Ⅳ myelosuppression occurred in all patients,but no severe infection and hemorrhage happened after the application of granulocyte colony stimulating factor (G-CSF),platelet transfusion and anti-infection treatment.Some reversible side effects like liver toxicity,myocardial damage and nerve injury were observed in some patients.There was no chemotherapy related mortality in all the patients.Two cases relapsed again followed up to October 2015.One achieved CR after applying chimeric antigen receptor T-cell immunotherapy and was receiving allo-HSCT now.Another was dead after applying FLAG (Prednisone+Fludarabine+Ara-C+G-CSF) save regimen.The time of the other 3 cases achieving CR was 26,10,4 months,respectively.Among the remaining 7 cases,3 cases were forced to receive hematopoietic stem cell transplantation,2 cases abandoned treatment and 2 cases failed to follow up.Conclusions The IHDA regimen is a well-effective and tolerated treatment for pediatric patients with refractory ALL,and could create an opportunity for the application of allo-HSCT.

Objective: To compare regeneration of motor fibers with that of sensory fibers by end to side neurorrhaphy and compare the effect of end to side neurorrhaphy with that of end to end neurorrhaphy. Methods: 20 SD rats were randomly divided into two groups: group A and group B. In group A, the right peroneal nerve was sectioned and the distal end was sutured laterally to the tibial nerve; in group B, the right peroneal nerve was sectioned and sutured with end to end neurorrhaphy. All left sides of two groups were used as control. Retrograde transportation of HRP was observed after 28 weeks. Results: The labelled neurons were also found in the anterior horn of the spinal cord and the spinal ganglia. Conclusion: The regenerative nerve fibers had motor fibers as well as sensory fibers by end to side neurorrhaphy. The effect of end to side neurorrhaphy is not as good as that of end to end neurorrhaphy. [

Objective:To evaluate the effect how Subtilisin FS33 affect thrombotic and fibrinolytic systems in vitro and in vivo. Method:Activity of Subtilisin FS33 was measured by clot liquefaction time(CLT) . On the model of 10% FeCl3 induced thrombi of carotid arteries in rats,various doses of Subtilisin FS33 were injected to the rats,and the fibrinolytic effect was observed. Results:0.5 g of the unheated blood clots gradually dissolved within 45 min,whereas the blood clots heated at 80℃ for 30 min dissolved within 3 h. This indicated that the enzyme was able to degrade blood clots in the absence of endogenous fibrinolytic factors. The experiment in vivo indicated that high dose subtilisn group could significantly prolong CT(coagulation time ) ,PT(prothrombin time) ,TT(thrombin time ) ,APTT(activated partial thromboplastin time) ,reduce ELT(euglobulin lysis time) ,decrease the content of FIB(fibrinogen) ,increase the content of FDP(fibrinogen degradation products) . D-dimer of all experimental groups waspositive. The venous thrombus in lung and kidney was dissolved totally or partly as observed by pathological section. Conclusion:Both thrombolytic effects of Subtilisin FS33 in vitro and in vivo were significant and the mechanisms might be associated with enhancing anticoagulation activity and fibrinolysis.

Objective To investigate the risk factors for postoperative delirium in patients after vascular free flap reconstruction performed under general anesthesia.Methods Two hundred and sixteen ASA Ⅰ-Ⅲ patients aged 18-80 yr undergoing vascular free flap reconstruction surgery were enrolled in this study.Patient characteristics before and during operation were recorded.The patients were followed up for 5 days after operation.Their level of consciousness,severity of pain and sleep quality were evaluated daily.The patients were divided into 2 groups according to the occurrence of delirium during the 5 days after operation:delirium group and non-delirium group.The method of CAM-ICU was reed in the diagnosis of postoperative delirium.Multivariate logistic regression was used to analyze the risk factors for postoperative delirium.Results logistic regression analysis showed that old age,history of alcohol abuse and sleep diacrder after operation were risk factors for delirium developed after free flap surgery.Conclusion Old age,history of alcohol abuse and sleep disorder after operation were the risk factors for postoperative delirium in patients after vascular free flap reconstruction performed under general anesthesia.

Objective To evaluate the effieaey of test bolus technique with multi-slice spiral CT (MSCT) for determining the optimal scan delay time in CT Hepatic artery (HA)-portal vein (PV) angiography and multi-phase scanning.Methods MSCT liver angiography and multi-phase scanning were performed in 187 patients divided randomly into two groups.In group A (n =59),the scan delay time was set according to the subjective experiences of operators; in group B (n=128),the scan delay time was determined by test bolus technique.Abdominal aorta and superior mesenteric,vein were selected as target blood vessels,and 50 HU was set as enhancement threshold value.20 ml contrast agent was injected intravenously and time-density curve of target blood vessels were obtained,then HA-PV scanning delay time were calculated respectively.The quality of CTA images obtained by using these 2 methods were compared and statistically analysed using Chi-square criterion.Resuits For hepatic artery phase,the images of group A are:excellent in 34(58%),good in 17(29%),and poor in 8 (13%),while those of group B are excellent in 128( 100%),good in 0(0%),and poor in 0(0%).For portal vein phase,the images of group Aare:excellent in 23(39%),good in 27(46%),and poor in 9(15%),while those of group B are excellent in 96 (75%),good in 28 (22%),and poor in 4 (3%) respectively.There was statistically significant difference between the ratios of image quality in group A and group B (X2=14.97,9.18,P < 0.05).Conclusion Accurate scan delay time was best determined by using test bolus technique,which can improve the image quality of liver angingraphy and multi-phase scanning.

OBJECTIVE: To explore the relationship between the level of expression and hypermethylation of the CHFR gene and the occurrence and development of laryngeal squamous cell carcinoma (LSCC). METHOD: The mRNA expression and promoter hypermethylation were detected by Realtime fluro-genetic quantitative PCR and methylation specific PCR in 50 LSCCs (LSCC group) and 15 normal laryngeal tissue (control group). RESULT: 1) CHFR mRNA was shown in the control group, while the mRNA was loss expression in the 2 LSCC (4%), and the level of mRNA expression was significantly lower in the LSCC group. The relative ratio was 0.50 +/- 0.12, which is 0.30 +/- 0.04 at the early stage of the LSCC and 0.70 +/- 0.21 at the advanced stage, respectively. The discrepancy had statistical significance (P<0.01). 2) The methylation rate of CHFR was 22% (11/50) in the LSCC tissues, which was not found in the normal tissues. The aberrant methylation of CHFR was observed in 10 of the patients at the stage I and stage II of LSCC , in 1 of the patients at the stage III, and was absent at the stage IV. There was significant difference between the aberrant methylation of CHFR and the stage of carcinoma (P<0.01). 3) The mRNA expression level of the aberrant methylation patients was 0.11 +/- 0.05, which was significantly lower than that of the unmethylation patients 0.75 +/- 0.13. Gene inactivation was observed in 2 of the 11 patients with the aberrant promoter methylation. The methylation was associated with the expression of mRNA, with the correlation coefficient 0.387 (P<0.05). CONCLUSION Hypermethylation of CHFR gene promoter is associated with loss or lower expression of CHFR mRNA in the LSCCs, and it may contribute to the occurrence and development of LSCC. The promoter aberrant methylation of CHFR may be one of the early diagnostic and therapeutic marker genes.
Adult ; Aged ; Carcinoma, Squamous Cell ; genetics ; pathology ; Cell Cycle Proteins ; genetics ; CpG Islands ; DNA Methylation ; Female ; Gene Silencing ; Humans ; Laryngeal Neoplasms ; genetics ; pathology ; Male ; Middle Aged ; Neoplasm Proteins ; genetics ; Neoplasm Staging ; Poly-ADP-Ribose Binding Proteins ; Promoter Regions, Genetic ; RNA, Messenger ; genetics ; Ubiquitin-Protein Ligases

OBJECTIVE: To explore the effects of 5-Aza-2'-deoxycitydine(5-Aza-dC) and trichostatin A (TSA) on the expression and methylation of CHFR in human laryngeal carcinoma cell line. METHOD: The mRNA expression and promoter hypermethylation and were detected by Realtime fluro-genetic quantitative PCR and methylation specific PCR in Hep-2 cell line, which were cultured in vitro and then treated with different concentrations of 5-Aza-dC and TSA. RESULT: Compared with the control team, 5-Aza-dC alone reactivated expression of the CHFR in Hep-2 cell line (1.75 +/- 0.21). TSA had no effect on gene expression (1.05 +/- 0.13). The combined treatment with 5-Aza-dC and TSA increased gene expression (2.15 +/- 0.18). The cell lines showed a characteristic DNA methylation status. 5-Aza-dC and combined 5-Aza-dC and TSA resulted in demethylation of CHFR. In contrast, TSA alone did not affect the DNA methylation status of CHFR. CONCLUSION Hypermethylation of CHFR gene promoter is a common event in the occurrence and development of laryngeal carcinoma. The promoter aberrant methylation of CHFR is a main cause for down-expression of CHFR. After either treatment with 5-Aza-dC alone or in combination with TSA, the expression of CHFR is up-regulated duo to the reversal methylation. It can be a new idea to the therapy of laryngeal carcinoma.
Azacitidine ; analogs & derivatives ; pharmacology ; Cell Cycle Proteins ; genetics ; metabolism ; DNA Methylation ; drug effects ; Decitabine ; Gene Expression ; drug effects ; Hep G2 Cells ; Humans ; Hydroxamic Acids ; pharmacology ; Laryngeal Neoplasms ; metabolism ; Methylation ; drug effects ; Neoplasm Proteins ; genetics ; metabolism ; Poly-ADP-Ribose Binding Proteins ; Promoter Regions, Genetic ; Ubiquitin-Protein Ligases

OBJECTIVE: To explore the correlation between histone H3-K9 methylation, DNA methylation and expression of carcinoma suppressor gene MGMT in laryngeal carcinoma Hep-2 cell line. METHOD: 5-Aza-dC was used to deal with Hep-2 cell cultured in vitro. ChIP, MSP and Realtime-PCR were used to detect H3-K9 methylation, DNA methylation, of MGMT gene promoter region and MGMT gene expression before and after treatment with drugs. RESULT: (1) In Hep-2 cell line, gene MGMT was characterized by DNA methylation and histone H3-K9 hypermethylation. (2) 5-Aza-dC was able to reduce H3-K9 methylation of MGMT gene histone in Hep-2 cell line, 5-Aza-dC was able to reverse DNA methylation of MGMT gene histone in Hep-2 cell line, 5-Aza-dC was able to upregulate the down-regulated gene expression of tumor suppressor genes MGMT. CONCLUSION Promoter methylation of cancer suppressor gene MGMT may induce the gene inactivity. DNA methylation may increase H3-K9 methylation. 5-Aza-dC can reduce H3-K9 methylation of tumor suppressor gene MGMT histone by reversing DNA methylation of tumor suppressor gene MGMT, and then the expression of tumor suppressor genes is increased and tumor development is inhibited.
Cell Line, Tumor ; DNA Methylation ; DNA Modification Methylases ; genetics ; metabolism ; DNA Repair Enzymes ; genetics ; metabolism ; Genes, Tumor Suppressor ; Histones ; metabolism ; Humans ; Laryngeal Neoplasms ; genetics ; metabolism ; pathology ; Tumor Suppressor Proteins ; genetics ; metabolism

Objective To investigate the MRI findings of combined hepatocellular cholangio-carcinoma(cHCC-CC)and their correlation with pathologic types. Methods Twenty-nine patients with surgical pathology-confirmed cHCC-CC(20 patients with 24 cHCC-CCs were categorized as classical, and 9 patients with 10 cHCC-CCs as subtypes with stem cell features)were retrospectively analyzed. The clinical features, morphological and MRI signal characteristics on T1WI, T2WI, dynamic enhancement patterns and diffusion-weighted imaging were evaluated in detail and compared these imaging findings with pathologic types. The ADC values of 17 patients with 24 cHCC-CCs were measured. The imaging features were compared by using t test and Fisher test. Results The average maximum diameter of classical type and stem cell feature type were (3.8 ± 2.5) cm and (4.5 ± 1.8) cm, respectively, there was no significant difference(t=0.749,P=0.462). Seven cHCC-CCs showed heterogeneously high signal and twenty-seven cHCC-CCs showed low signal on T1WI. Seventeen cHCC-CCs showed hypointense in the central with mixed high and low signal on T2WI. Twenty-one cHCC-CCs showed peripheral enhancement and 13 lesions showed heterogeneously enhancement during arterial phase. The enhancement pattern of quickly wash-in and quickly wash-out were seen in 17 lesions, the other 17 lesions showed reversal enhancement. Twenty-five lesions presented with pseucapsule. There was no significant difference in clinical features and MRI findings between the two pathologic tumor types(classical type versus stem cell feature type)except for the enhancement pattern in arterial phase and peri-tumoral bile duct dilatation(P<0.05).The mean ADC value of the tumors with stem cell feature type(1.41 ± 0.52) × 10-3mm2/s was mildly lower than that of classical type (1.60 ± 0.39) × 10-3mm2/s, and no statistical differences were found(t=-1.005,P=0.326). Conclusions The MRI findings of cHCC-CCs has specificity. However, it is not easy to distinguish the classical type and stem cell feature type of cHCC-CC only by MRI findings.