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 summarize the experience on bronchiallavage to cure pulmonary atelectasis and pulmonary infection after thoracotomy.Methods 48 patients were selected and treated by bronchiallavage under monitoring,and antibiotics was used according to sputum culture and drug sensitive test.The out come was analyzed and evaluated.Results All patients of the pulmonary atelectasis were cured and those with pulmonary infection were controled.There was no serious complication.Conclusion Bronchiallavage is applied to treat pulmonary atelectasis and pulmonary infection after thoracotomy,the curative rate is significant.The appliance of antibiotics is guided by drug sensitivity.It is such a safe and feasible therapeutic tool that the bronchofibroscope is applied to cure pulmonary atelectasis and pulmonary infection after thoracotomy.

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.

Many studies show that excision repair cross-complementing gene 1 (ERCC1),ribonucleotide reductase subunit M1 (RRM1),p53,epidermal growth factor receptor (EGFR),and vascular endothelial growth factor (VEGF) are closely related to the curative effect and prognosis of non-small cell lung cancer (NSCLC).In recent years,many studies have investigated the association between polymorphisms of these factors and the curative effect and prognosis in patients with NSCLC.The polymorphisms of these factors may be potential biomarkers to predict the clinical outcome in patients with NSCLC.

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

The congenital stricture (idiopathic urethral stricture) mostly lies in the anterior urethra and mainly occurs in boys. Hemangioma is the most common symptom of the idiopathic urethral stricture. Acquired strictures are due to four main causes. latrogenic urethral stricture is mainly caused by performing the transurethral resection, prostate, cystoscopy, prolonged catheterization, hypospadias repair and prostatectomy and so on. Bacteriuria is especially nosocomial with post operative infection in urethral strictures. Virus such as condylomata is another cause. Lichen sclerosis is a chronic progressive inflammatory condition of unknown cause and has the development of urethral strictures. Blunt anterior urethral injury is commonly associated with perineal straddle injury, while posterior urethral injury is accompanied pelvic fracture, penetrating injuries predominantly comes from gunshots involve both anterior and posterior urethra. Urethral injuries in children and females are rare. Here, we mainly investigated the causes of idiopathic and acquired urethral stricture.

Objective To study the morbidity of Toxoplasma (TOX) and Cytomegalovirus (CMV) infection in in patient infants and their clinical character Methods The serum CMV IgG/IgM and TOX IgG/IgM ware measured by enzyme linked immunosorbant assay (ELISA) Results The positive rate of CMV IgG, CMV IgM, TOX IgG and TOX IgM were 86.7%, 5.2%,13.9% and 0.4% respectively in in patient infants. The main clinical manifestication of neonatal TOX and CMV infection were premature, small for gestational age, neonatal pneumonia, sepsis, encephalopathy, hepatitis syndrome Conclusion TOX and CMV infection were widely noticed in in patient infants, and their potential damage should be greatly considered in our clinical practice.

Objective T o observe the therapeutic effect of Radix Astragali Injectio on psoriasis and it s possible pharmaceutical mechanism. Methods Two groups of patients with psoriasis vulgaris were treated with either comprehensive regi men or comprehensive regimen plus Radix Astragali Injectio. The clinical respons es in both groups were compared. Meanwhile, the effects of Radix Astragali Decoc tion and Injectio on proliferation of vaginal epithelium, PCNA expression, diffe rentiation of tail scale epidermis and plasma ET－1 were assessed in mouse mode l. Results It was shown that psoriatic lesions began to fade significantly earli er in Radix Astragali group than in routine comprehensive treatment group. The c linical cure rate was significantly higher in Radix Astragali group also. Animal experiment indicated that Radix Astragali Injectio had effects on all 4 indices mentioned above and the effects of the Injectio was stronger than that of the D ecoction. Conclusions Radix Astragali Injectio is effective for psoriasis vulgar is. Its therapeutic effects may be explained by blocking multiple pathogenetic l inkage.

Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Neoplasm Recurrence, Local ; surgery

Objective To investigate the expression and clinical significance of leptin receptor (OBR) and phosphorylation of signal transducer and activator of transcription (p-STAT3) in patients with diffuse large B-cell lymphoma (DLBCL).Methods Immunohistochemical analysis was used to detect the expression of OBR and p-STAT3 in 80 patients with DLBCL and 10 patients with reactive lymphoid hyperplasia (RLH).Using a panel of immunohistochemical markers (CD10,bcl-6 and Mum-1),all cases of DLBCL were further divided into two groups,GCB (germinal center B-cell-like) or non-GCB.Results Immunohistochemistry revealed high expression of OBR and p-STAT3 in 45.0 ％ (36/80) and 28.8 ％ (23/80) cases of DLBCL,respectively,and minimal straining in 100.0 ％ (10/10) cases of RLH (P ＜ 0.05).Compared with GCB group (8.7 ％,2/23),non-GCB group had higher p-STAT3 high expression rate (36.8 ％,21/57) (P ＜ 0.05).There was no significant difference in the expression of OBR between these two groups.Compared with clinical stage Ⅰ-Ⅱ [46.2 ％ (18/39) and 25.6 ％ (10/39)],stage Ⅲ-Ⅳ had higher OBR and p-STAT3 high expression rate [61.9 ％ (13/21) and 38.1％ (8/21)] (P ＞ 0.05).The expression of OBR and p-STAT3 were not correlated with age,gender,extranodal infiltrations,LDH level,B-symptoms and IPI(international prognostic index)(P ＞ 0.05).The expression of OBR was positively related with that of p-STAT3 in DLBCL patients (r =0.232,P =0.039).Conclusion OBR could stimulate the JAK-STAT signaling pathway and induces the phosphorylation of STAT3.This may be involved in carcinogenesis and prognosis of DLBCL.