Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Squamous Cell ; drug therapy ; radiotherapy ; Combined Modality Therapy ; Esophageal Diseases ; etiology ; Esophageal Neoplasms ; drug therapy ; radiotherapy ; Female ; Fluorouracil ; administration & dosage ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Particle Accelerators ; Platinum Compounds ; administration & dosage ; Radiation Injuries ; etiology ; Radiotherapy, High-Energy ; adverse effects

OBJECTIVETo investigate the diagnosis and treatment of serious pediatric airway obstruction.

METHODSSeventy three pediatric cases with serious airway obstruction, admitted to Shantou hospital from 1995 to 2005, were analyzed retrospectively.

RESULTSAmong the 73 cases, 28 cases (38.4%) with inflammatory disease and 33 cases (45.2%) with foreign body. In addition, 8 cases of laryngeal papilloma, 3 cases of laryngotracheobronchial spasm and 1 case of pharyngeal dysembryoma were also included in this study. The patients who had endotracheal intubation or tracheotomy were 39 cases (53.4%) and 27 cases (36.9%) respectively. Ten cases received non-surgery treatment. Seventy two cases diagnosis was confirmed and the related serious airway obstruction condition got stable within 12 hours. While serious complications occurred in 23 cases (31.5%) and operative complications occurred in 3 cases (4.1%). Four cases ( 5.5%) died and 68 cases (93.2%) were cured. One case refused to be treated.

CONCLUSIONSThe condition of serious pediatric airway obstruction patients is usually critical, the related causes could be complicated, quick diagnosis and timely removal of the obstruction factors are imperative.

Adolescent ; Airway Obstruction ; diagnosis ; therapy ; Child ; Child, Preschool ; Critical Illness ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the operative effect and value of window partial laryngectomy for the treatment of stage T2-3 glottic laryngeal carcinoma.

METHODSFrom Oct. 2000 to Dec. 2006, the stage T2-3 glottic laryngeal carcinoma of 48 patients by properly selected were performed with window partial laryngectomy and laryngeal reconstruction. Twenty nine males and 19 females were included. Their ages ranged from 43 to 78 years (median 57.0 years). Before operation and in the 6 months after operation, these targets including auditory mental evaluation of hoarse degree, active degree and symmetry of vocal cord, glottic width in the time of quiet breathing, glottic closing degree in the time of phonating, respiratory function and swallowing function were surveyed. In addition, the things of recurrence and metastasis of tumors together with survival time of patients were following investigated.

RESULTSAll patients were decannulated successfully and incisions were healed smoothly. No operative complication occurred. Except active degree of vocal cord (P = 0.343), there were respectively significant difference between two group targets of auditory mental evaluation of hoarse degree (all P <0.01), symmetry of vocal cord (P = 0.000), glottic width in the time of quiet breathing (P = 0. 001), glottic closing degree in the time of phonating (P = 0.001) and respiratory function (P=0.001) those were investigated before operation and after operation. The swallowing function wasn't influenced (P= 0.310). There were laryngostenosis in 1 case, recurrence in 1 case (2.1%), cervical lymph node metastasis in 1 case and hepatic metastasis in 1 case. Two cases died. 3-year and 5-year overall survival rate were respectively 96.9% and 88.9%.

CONCLUSIONSThe study showed that window partial laryngectomy was successful for treating stage T2-3 glottic laryngeal carcinoma by properly selected. This operation was effective for reducing surgical invasion and beneficial to resume respiratory and vocal function.

Adult ; Aged ; Female ; Humans ; Laryngeal Cartilages ; surgery ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Treatment Outcome ; Vocal Cords

From the perspective of the physiological basis of liver and kidney sharing the common source in traditional Chinese medicine(TCM),and by integrating the theory of kidney dominating bone,liver dominating tendon,and meridian sinew of TCM as well as the bone resorption and collapse theory,and non-uniform settlement theory and lower-limb musculoskeletal bowstring structure theory of modern orthopedics,the pathogenesis of osteonecrosis of the femoral head(ONFH)under the system of non-uniform settlement during bone resorption and multidimensional composite bowstring working in coordination with the theory of liver-kidney and muscle-bone was explored.The key to the TCM pathogenesis of ONFH lies in the deficiency of the liver and kidney,and then the imbalance of kidney yin-yang leads to the disruption of the dynamic balance of bone formation and bone resorption mediated by osteoblasts-osteoclasts,which manifests as the elevated level of bone metabolism and the enhancement of focal bone resorption in the femoral head,and then leads to the necrosis and collapse of the femoral head.It is considered that the kidney dominates bone,liver dominates tendon,and the tendon and bone together constitute the muscle-bone-joint dynamic and static system of the hip joint.The appearance of collapse destroys the originally balanced muscle-bone-joint system.Moreover,the failure of liver blood in the nourishment of muscles and tendons further exacerbates the imbalance of the soft tissues around the hip joint,accelerates the collapse of the muscle-bone-joint dynamic and static system,speeds up the process of femoral head collapse,and ultimately results in irreversible outcomes.Based on the above pathogenesis,the systematic integrative treatment of ONFH should be based on the TCM holistic concept,focuses on the focal improvement of internal and external blood circulation of the femoral head by various approaches,so as to rebuild the coordination of joint function.Moreover,attention should be paid to the physical constitution of the patients,and therapy of tonifying the kidney and regulating the liver can be used to restore the balance between osteogenesis and osteoblastogenesis,and to reconstruct the muscle-bone-joint system,so as to effectively delay or even prevent the occurrence of ONFH.