Head and neck cancers contain a wide range of diseases which put threats to public health. Training of specialized head and neck surgeon is a must for the development of the specialty. Surgical treatment of head and neck cancers can easily compromise normal appearance and function of patients owing to the complicated anatomical structures of the area. Therefore, treatments often demand multidisciplinary involvement led by surgeons. Attentions should be paid to diverse cancers, multiple techniques, distinct surgeries, complex anatomy and function protection when training a specialized head and neck surgeon. A specialized surgeon must be devoted to basic research, have a full picture of the disease, be involved in multidisciplinary treatment and focus on specialized surgical maneuvers. To become a specialized head and neck surgeon, one should go through basic knowledge of the area, read extensively, keep up with the literature and never stops practicing. The undisputed factor is that an extraordinary head and neck surgeon can not only benefit patients but also promote the profession.

Adenoid cystic carcinoma is regarded as one of the most common malignant tumors in parotid gland. The local control rate and long term survival rate of salivary gland adenoid cystic carcinoma, which tends to spread along the perinerve and metastasis distantly, are not good. This review focused on the advances in the treatment of adenoid cystic carcinoma of parotid gland.

Activation of HGF/Met has been complicated in tumorigenesis, invasion and metastasis of various tumors. We summarize current knowledge on their association with invasion of thyroid carcinoma. By discussing the expression of Met and its possible mechanism and analyzing the activation of Met with tumor motility, angiogenesis and inflammatory reaction, we conclude that the research of the possible role of HGF/Met in thyroid carcinoma will advance knowledge on the diagnosis and management of this disease,as well as tumor invasion.

Thyroid cancer is uncommon in children and adolescents. This article analyzed the current data and stated the treatment progress of the thyroid cancer in children and adolescents. Even though in the advanced stage at diagnosis, the prognosis is good for pediatric patients. Surgery is the treatment for pediatric thyroid cancer. Although there is no optimal surgery recommendation, most surgeons preferred total and (or) subtotal thyroidectomy. Hemi-thyroidectomy could also be considered in the low-risk patients with small unifocal tumors. We recommend routine central compartment clearance in pediatric thyroid cancers to reduce the local recurrence. Radioactive iodine therapy is also recommended in particular pediatric patients. Recurrences after treatment in childhood thyroid cancer may take place over a long period of time. Therefore, a life-long follow-up is mandatory.

Purpose:To investigate the type of surgery appropriate for substernal benign thyroid tumor. Methods:A study of 19 substernal benign thyroid tumors operated between 1990 and 1999 was made. Surgery via cervical collar incision were performed in all cases. Results:Among them 4 cases was adenoma, 16 cases goiter. There were no complications except for 1 case with recurrent laryngeal nerve paralysis. Conclusions:Surgery via cervical collar incision for substernal benign thyroid tumors is safe.

Objective To investigate serum T_3? T_4? TSH alterations after hemithyroidectomy in patients suffering from thyroid benign nodules.Methods Forty-eight patients were divided into two groups by age of 45.All patients were treated with hemithyroidectomy and without substitutional therapy after operation.The levels of serum TT_3? TT_4? FT_3? FT_4? TSH were assessed on day 5, first month, 3rd month, 6th month and one year after operation and compared with pre-operative levels.Results The change of serum T_3? T_4 was not significant; while the levels of serum FT_3? FT_4 in patients over 45 years decreased on day 5 post-op and on the first month ( F=7.853, F=4.247, P

OBJECTIVE: To explore the relationship between metabolic syndrome( MS) and occupational stress among workers in high altitude area. METHODS: A cross-sectional study was conducted in 940 workers as research subjects who were engaged in petroleum smelting,thermal power generation and financial management et al. in high altitude area. A questionnaire survey was conducted using the Occupational Stress Inventory-Revised for occupational stress, The occupational health examination was performed to measure waist circumference,blood pressure,blood sugar and blood lipids. RESULTS: The abnormal rates in obesity,triglycerides,high-density lipoprotein,blood pressure and fasting blood glucose were 28. 3%,16. 3%,14. 3%,13. 3% and 6. 5%, respectively. The detection rate of MS was 5. 0%( 47/940). The multivariate logistic regression analysis showed that the risk of elevated MS decreased with the increased of occupational stress level( P < 0. 05),and the risk of elevated MS increased with the increased of occupational stress reaction severity( P < 0. 05),after adjusting the confounding factors of gender and labor nature. CONCLUSION: The higher occupational stress reaction of the workers in high altitude area,the higher the risk of MS.

OBJECTIVE: To comprehend the status of knowledge-attitude-practice( KAP) and its effect on blood lead in workers exposed to lead.METHODS: Three hundred and fifty-one first-line lead exposed workers in the smelting industry were chosen as study subjects by cluster sampling method.Blood lead levels in peripheral venous blood were detected.Questionnaire survey was conducted by self-compiled Questionnaire of Knowledge-attitude-practice on Occupational Health in Lead Workers.RESULTS: Among the study subjects,145 workers had abnormal blood lead level( ≥600 μg/L),the abnormal rate was 41.3%.The correct scoring rate in occupational knowledge,attitude,and practice were 25.1%,45.3% and 15.7%,respectively.Multivariate logistic regression analysis results showed that the four risk factors of high blood lead level were wearing no personal protective equipment,not bathing and changing clothes before returning home,not gargling and washing hands before meals,smoking and eating in workplace.CONCLUSION: Poor occupational behaviors can increase the risk of high blood lead level in lead exposed workers.

Purpose:To explore the regularity of lymph node metastasis in thoracic esophageal carcinoma.Methods:From March 2000 to June 2001,100 patients with thoracic esophageal carcinoma underwent radical esophagectomy with three field lymphadenectomy. Dissection was done through a right lateral thoracotomy followed by repositioning and simultaneous laparotomy and neck incision. Results:The hospital mortality rate was 0%.Nodal metastases occurred in 54% (54/100) of patients. The rate of metastasis to neck, mediastinum and abdomen were 31%, 34% and 26%. Cervical nodal metastasis was not correlated with the depth of tumor penetration. There was a higher frequency in nodal metastasis near the bilateral recurrent laryngeal nerves than that in the bilateral supraclavicular region. Conclusions:①Neck, mediastinum and abdomen nodal metastases occurred frequenthy in thoracic esophageal carcinoma. ②Cervical nodal metastasis could occur in early stage of tumor infiltration.③Cervical lymphadenectomy was a very important factor for accurate staging of thoracic esophageal cancer.

Objective To analyze the results of neck dissection in patients who failed in cervical lymph nodes after radiotherapy for nasopharyngeal carcinoma.Methods Eighty-three patients who received neck dissection due to lymph node persistence or recurrence after definitive radiotherapy were analyzed retrospectively according to the following relevant factors: age, sex, the interval between completion of radiotherapy and surgery, rN stage, postoperative radiotherapy given or not, the adjacent tissues involved or not and the number of positive nodes. Kaplan-Meier method, Log-rank method and Cox method were used in the statistical analysis.Results The 1-, 3- and 5-year overall survival rates were 80.7%, 47.1% and 34.9%. The interval between completion of radiotherapy and surgery, postoperative radiotherapy given or not, the adjacent tissues involved or not were significantly prognostic factors in statistic analysis. Conclusions Neck dissection can be applied in the management of cervical lymph node failure in nasopharyngeal carcinoma after radiotherapy. Postoperative radiotherapy should be considered in patients with capsular invasion and/or adjacent tissue involvement.