Purpose To study the expression of p53, p21 and Cdk1/p34cdc2 in the laryngeal cancer and its margin tissues and to ex-plore their relationship with local recurrence of laryngeal cancer. Methods A total of 85 patients with early laryngeal cancer were se-lected randomly during 2004 to 2010 in Tangshan Union Hospital, Hebei, China. SP immunohistochemical method was used to detect the expression of p53, p21 and Cdk1/p34cdc2 in the tumor and margin tissues. Pathological data were collected for follow-up. Results In more than 2 years of follow-up study, 14 of 85 patients with laryngeal cancer presented with recurrence (recurrent group), while 71 patients without recurrence (none recurrent group). The positive rate of p53 protein in laryngeal cancer and its margin tissues was 60. 0% and 36. 5%, respectively, the positive rate of p21 protein in laryngeal cancer and its margin tissues was 38. 8% and 21. 2%, respectively. The positive rate of Cdk1/ p34cdc2 in laryngeal cancer and its margin tissues was 70. 6% and 29. 4%, respectively. p53 protein in the surgical margin of the recurrent group and non recurrent group was 71. 4% and 29. 6% (P = 0. 003), that of p21 was 50. 0% and 15. 5%, (P =0. 004) and Cdk1/ p34cdc2 was 57. 1% and 23. 9% (P =0. 013), respectively. There was no correlation between expression of p53 with p21 protein and Cdk1/ p34cdc2 protein(P > 0. 05). Conclusion p53, p21 and Cdk1/ p34cdc2 may be involved in the occurrence, development and recurrence of laryngeal squamous cell carcinoma. Overexpression of p53, p21 and Cdk1/ p34Cdc2 in the surgical margin is closely related to local recurrence of laryngeal cancer.

Purpose To compare the therapeutic effects of CO2 laser resection and traditional split laryngeal surgery on the early laryn-geal cancer, and to examine relationship between the expression of p27 and PTEN and clinical prognosis in early laryngeal squamous cell carcinoma. Methods 85 patients who underwent CO2 laser resection surgery and 46 patients who underwent split laryngeal surger-y were selected and the occurrence rates after surgery were observed. SP immunohistochemical method was uesd to detect the expression of p27 and PTEN in tumor resection marginal and their surgical margine tissues. Clinical data were collected and all patients were fol-lowed up. Results In the more than two-year follow-up study, 14 of 85 patients in CO2 laser treatment group ( recurrent group) pres-ented with local recurrence and the recurrence rate was 16. 5%, while 6 of 46 patients in split laryngeal surgery group presented with local recurrence and the recurrent rate was 13. 0%. There was no statistical significance in recurrence rate between the two groups ( P> 0. 05). 10 of all the none recurrent patients did not follow the doctor’s advice to quit smoking after the operation, while 12 in the recurrent patients did not, the difference between the two groups was statistically significant (P<0. 01). The positive rate of p27 and PTEN in laryngeal carcinoma tissues and the cancer adjacent tissues ( negative surgical margin tissues ) was 43. 5% ( 57/131 ) , 80. 2% (105/131) and 48. 9% (64/131), 83. 2% (109/131), respectively, with a significant difference (P<0. 01). The positive rate of p27 and PTEN in laryngeal carcinoma tissues of the recurrent group and non recurrent group was 20. 0% (4/20), 47. 7% (53/111) and 10. 0% (2/20), 55. 9% (62/111), respectively, with a significant difference (P<0. 05). While the positive rate of p27 and PTEN in tumor resection marginal tissues of the recurrence group and non recurrence group was 50. 0% ( 10/20 ) , 85. 6% ( 95/111) and 40. 0% (8/20), 91. 0% (101/111), the difference was also statistically significant (P<0. 01). Conclusions There was no statistically significant difference in tumor recurrence rate between CO2 laser surgery and traditional split laryngeal surgery. Postoper-ative recurrence is closely related to resume smoking. The recurrence rate of p27 and/or PTEN negative patients was higher than that of the opposite ones which should be followed up closely after treatment.

Purpose To investigate the relationship between HPV infection and p53,p16,EGFR expression and prognosis in patients with salivary adenoid cystic carcinoma (ACC).Methods Totally 76 cases of adenoid cystic carcinoma specimens were selected,PCR-reverse dot blot hybridization was used to detect infection of HPV and SP immunohistochemical method was adopted to detect the expression of p53,p16,EGFR,Cdc2 in tumor tissues.Clinical data were collected and all the patients were followed up.The Kaplan-Meier method was used to estimate median overall survival and the Log-rank test to compare survival curves.Cox regression model was used for multivariate analyses.Results Infection rate of HPV in adenoid cystic carcinoma tissues was 0(0/76).The expression rate of p53,p16,EGFR,Cdc2 protein in adenoid cystic carcinoma tissues were 76.3％ (58/76),57.9％ (44/76),60.5％ (46/76) and 64.5％ (49/76)respectively.There was no correlation of the expression of p53,p16,EGFR and Cdc2 with gender,age,tumor location,TNM stage and histological type of patient.Kaplan-Meier survival analysis showed that EGFR-positive patients had shorter median overall survival rate (OS) than the negative ones (x2 =19.111,P ＜ 0.001).EGFR-positive patients had shorter median progression-free survival rate (PFS)than the negative ones (x2 =6.621,P ＜ O.01).Cdc2 positive patients had shorter median OS than the negative ones (x2 =3.870,P ＜ 0.05).Cdc2 positive patients had shorter median PFS than the negative ones (x2 =6.755,P ＜0.01).Cox regression analysis showed that expression of EGFR and Cdc2 was independent risk factors for the prognosis of patients with salivary gland ACC (relativerisk=13.417,13.075,P＜0.001).Conclusion There is no HPV infection detected in adenoid cystic carcinoma tissues.p53,p16,EGFR and Cdc2 are positively expressed in most salivary adenoid cystic carcinoma,p16 is unsuitable as a surrogate for HPV infection status of patient with ACC.Expression of EGFR and Cdc2 is independent risk factors in the prognosis of patients with salivary gland ACC.For the EGFR or Cdc2 positive patients should be followed up closely.

Purpose To explore the relationship between expression of PCNA and COX-2 in the early laryngeal cancer with negative surgical margins and the local recurrence of tumor. Methods Totally 63 patients with early laryngeal cancer were enrolled in this stud-y, CO2 laser surgery was adopted as treatment, the expression of PCNA and COX-2 was detected in the resected tumor tissue and surgi-cal margins, and the survival and tumor recurrence were also observed. Results The positive rate of the expression of PCNA and COX-2 in the 63 patients with early laryngeal cancer tumor tissues were 73. 02% and 71. 43%, while that in the cutting edge were 33. 33% and 30. 16%, respectively. The expression of PCNA and COX-2 in tumor tissue and cutting edge were of all positive in 41 cases and 13 cases, and the positive rate was 65. 08% and 20. 63%, respectively. In the all followed-up patients, 17 cases were detected of local recurrence, the recurrence rate was 26. 98%, and the recurrence rate in the patients with PCNA positive was 71. 43%, while in the patients with COX-2 positive was 73. 68% (P<0. 05). The combined detection of PCNA and COX-2 positive recurrence rate was significantly higher than that of single positive (P<0. 05). Conclusion PCNA and COX-2 in the early laryngeal cancer with negative surgical margins are important biological markers for the evaluation of prognosis of laryngeal cancer patients, and to formulate the subse-quent treatment regimen. The combined detection of two proteins is more reliable for postoperative management.

Objective To assess right ventricular(RV)regional systolic function in patients with tetralogy of Fallot(TOF)by ultrasound speckle tracking imaging(STI).Methods Longitudinal peak systolic velocity(V), strain(ε),strain rate(SRs)were measured in RV free wall and interventricular septum(IVS)for basal, mid and apical segment in 38 patients with TOF and 35 healthy controls by STI from the apical 4-chamber view and compared between groups.Results Compared with controls,ε and SRs of RV free wall and IVS for all segments were significantly impaired in patients with TOF(P<0.05 for all).Whereas, V of RV each segment were normal (P>0.05 for all).In patients with TOF and controls.V,εand SRs of RV free walI for all segments were higher than those of IVS except SRs of RV apical segment.Conclusions RV systolic function in patients with TOF was decreased, RV longitudinal systolic function is accurately and objectively studied by STI.

Objective To assess right ventricular systolic function in normal subjects and patients with pulmonary arterial hypertension (PAH) by using 2-dimensional strain (2DS) and tissue Doppler imaging(TDI), and to investigate the feasibility of 2DS for quantitative assessment of myocardial longitudinal systolic function. Methods Longitudinal peak systolic velocity (V), peak systolic strain(ε), peak systolic strain rate(SRS) were measured in right ventricular free wall for basal,mid and apical segment in 42 patients with PAH and 31 healthy controls by 2DS and TDI from the apical 4-chamber view and compared between 2DS and TDI. Results ①Compared with controls,ε and SRS of the mid segment of the right ventricular free wall by TDI were significantly reduced in patients with PAH (P<0.05),but these of the basal and apical segment were normal (P>0.05). ε and SRS of all segments by 2DS were markedly reduced in patients with PAH (all P<0.05), V of all segments by TDI and 2DS were not decreased (P>0.05). ②In normal subjects,values(V,ε,SRS) of basal and apical segment of right ventricular free wall measured by 2DS were significantly different from those by TDI (P<0.05), Values of mid segment by 2DS and TDI were not significantly different (P>0.05); In patients with PAH, values (V, ε, SRS) of apical segment of right ventricular free wall by 2DS were significantly different from those by TDI,values of basal and mid segment by 2DS and TDI were not significantly different. ③ There were good correlations between 2DS and TDI in patients with PAH (r = 0.406～0.760, P<0.05 for all). Conclusions Right ventricular longitudinal systolic function in patients with PAH was decreased, 2DS is more accurate and objective than TDI in assessment of right ventricular longitudinal systolic function.

Objective To analyze the left ventricular(LV) rotation and twist by two-dimensional ultrasound speckle-tracking imaging(STI),and evaluate the correlation between twist and other components of LV contraction in uremia patients. Methods Twenty-nine uremia patients and twenty-nine healthy volunteers were included. High frame rate two-dimensional images were recorded from the left ventricular short-axis views both of the basal and apical planes. Segmental and global LV rotation were recorded at both The peak systolic LV twist was significantly decreased in uremia patients(P <0. 001). The loss of LV twist occurred mainly by the impairment of maximal global counterclockwise apical rotation(P <0. 001),and was augmented by somewhat less reduction in global clockwise basal rotation although the differences was not significantly reduced(P<0.01), while only the posterior and inferior of the basal plane was significantly fraction(r=0.645,P=0.000), LV end-diastolic volume (r=-0.549,P=0.002), LV end-systolic volume(r=-0.673, P = 0.000) in uremia patients. Conclusions STI enables quantification of segmental and global LV rotation in an objective manner in uremia patients,and provides a new method for evaluation of segmental and global LV systolic function.

Objective To assess right ventricular(RV) global longitudinal function in patients with pulmonary arterial hypertension (PAH) by 2-dimensional ultrasound speckle tracking imaging (STI). Methods According to pulmonary artery systolic pressure, 42 patients with PAH were divided into mild (17) ,moderate(15) and severe(10) PAH groups. RV global longitudinal peak systolic strain (GLS), strain rate(GLSRs) ,early diastolic strain rate (GLSRe) and late diastolic strain rate (GLSRa) were measured in 42 patients with PAH and 31 healthy controls by STI from the apical 4-chamber view and compared between groups and assessed the determinants of the RV global longitudinal functional parameters. Results Right ventricular GLS,GLSRs,GLSRe, GLSRa were significantly impaired in patients with PAH compared with controls (P<0.05 for all). Right ventricular GLS were most altered in patients with the severe PAH group compared with mild PAH patients (P<0. 05). Right ventricular GLSRs, GLSRe, GLSRa were not significant between mild,moderate and severe PAH groups(P>0.05). Pulmonary vascular resistance and pulmonary artery systolic pressure were the determinants of RV global longitudinal systolic function(r= - 0.466～- 0. 549, r = - 0. 403～- 0. 425, respectively, P <0.05 for both). There were good correlations between tricuspid annular systolic peak velocity and RV GLS,GLSRs in patients with PAH (r = 0. 556～0. 585, P < 0.001). Conclusions RV global function decreases in patients with PAH, RV global longitudinal function can be accurately and objectively studied by STI.

Objective To assess right ventricular(RV)systolic function in patients with pulmonary arterial hypertension(PAH)by 2-dimensional strain(2DS).Methods According to pulmonary artery systolic pressure,patients with PAH were divided into mild(17),moderate(15)and severe(10)PAH groups.Logitudinal peak systolic strain values were measured in RV global and free wall for basal,mid and apical segment in 42 patients with PAH and 31 healthy controls by 2DS from the apical 4-chamber view,and compared between groups and assessed the determinants of the RV functional parameters.Results Logitudinal peak systolic strain of RV global and free wall for all segments were significantly impaired in patients with PAH compared with controls and were most altered in patients with the severe PAH group compared with mild patients(P＜0.05 for all).Pulmonary vascular resistance and pulmonary artery systolic pressure were the determinants of RV function (γ1=-0.491～-0.641 and γ2=-0.403～-0.489,respectively,P＜0.05 for both).There were good correlations between tricuspid annular systolic peak velocity and strain of all segments in patients with PAH(γ=0.463～0.587,P＜0.001).Conclusions RV function in patients with PAH was decreased,RV longitudinal systolic function can be accurately and objectively studied by 2DS.

Quantification of right ventricular (RV) volume and function remains a challenge because of RV complex geometry by conventional echocardiography. The purpose of this study was to assess RV global longitudinal function in patients with tetralogy of Fallot (TOF) by 2-dimensional ultrasound speckle tracking imaging (STI). Thirty-eight patients with TOF were enrolled in this study and divided into child group (n=25) and adult group (n=13) according to age. Thirty-eight age- and sex-matched normal subjects were selected as control groups including child control group (n=25) and adult control group (n=13). RV global longitudinal peak systolic strain (GLS), strain rate (GLSR(s)), early diastolic strain rate (GLSR(e)) and late diastolic strain rate (GLSR(a)) were measured in all subjects by STI from the apical 4-chamber view and compared between groups. Furthermore, the main factors affecting the RV global longitudinal functional parameters were assessed. Compared with those in controls, RV GLS, GLSR(s) and GLSR(e) were significantly reduced in patients with TOF (P<0.05 for all). RV GLSR(s) was significantly decreased in adult patients with TOF as compared with that in child patients (P<0.05). There was no significant difference in RV GLS, GLSR(e) and GLSR(a) between child and adult TOF groups (P>0.05). The diameter of right ventricle, main pulmonary artery and ventricular septum defect had correlations with RV GLSR(s) (r ( 1 )=-0.490, r ( 2 )=0.580, r ( 3 )=-0.528, respectively, P<0.05 for all). Tricuspid annular plane peak systolic velocity (Sm) was the independent predictor of RV global strain and strain rate (beta(1)=0.355, P (1)=0.031, beta(2)=0.307, P (2)=0.021). RV global longitudinal function is decreased in patients with TOF, especially in adult patients. STI is a sensitive and accurate technique in RV global functional assessment.