Esophageal cancer is one of the most common malignant tumors in clinic, and its morbidity and mortality are always high. Staging is the main basis for comprehensive treatment and prognosis evaluation. Accurate staging is essential for proper diagnosis, individualized treatment and good prognosis. Related technologies of endoscopic ultrasonography can determine the depth of tumor invasion and local lymph node metastasis, which makes the diagnosis of esophageal cancer more accurate, and plays an increasingly important role in the diagnosis and treatment of early esophageal cancer.

p53 Gene and proliferating cell nuclear antigen (PCNA) are both related closely to the ra-diotherapy of non-small cell lung cancer(NSCLC). The life span of NSCLC patients with both p53 and PCNA positive is shorter than that of NSCLC patients with both p53 and PCNA negative. Studying the expression of p53 and PCNA in NSCLC, and their relationship with the radiosensitivity and prognosis of NSCLC can play a positive role in individualized treatment and increasing curative effect.

Objective To evaluate the therapeutic efficiency and side effect of concurrent radiotherapy and weekly chemotherapy with low-dose eisplatin(DDP) and 5-fluorouracil(5-FU) for advanced cervical canc-er. Methods 73 patients with advanced cervical cancer were randomized into two groups: 37 cases in the chemo-radiotherapy group received radiotherapy combined with DDP 40 mg and 5-FU 500 mg weekly for 6-7 weeks. 36 cases in the only radiotherapy group received radiotherapy alone. Radiotherapy was given with conven-tional fraction,the total tumor dose was 50 Gy. Results The rate of overall response and three-year survival and local recurrenc and distant metastasis for the chemo-radiotherapy group and the only radiotherapy group were 97.30%, 89. 19%, 8. 11% and 10. 81%, and those for the only radiotherapy group were 77.78%,66. 67% ,30.56% and 33.33%. The difference of the four groups was statistically significant ( P <0. 05). The rate of bone marrow inhibition and reaction of digestive tract in chemo-radiotherapy group were higher than those in simple radiotherapy group, but most reactions were grade 1 and grade 2, without statistically significant dife-renee between two groups. Conclusion Concurrent radiotherapy and weekly chemotherapy with low-dose cis-platin and 5-fluorouracil for advanced cervical cancer can significantly improve local control rate and survival rate, and have slight side effects.

Objective:To evaluate the relationship between the effect of microlaryngoscopic surgery of vocal polyp and the change of all-parameters.Method:Acoustic parameters of 80 patients with vocal polyp were measured by Dr .Speech Sciente for Windows, and analyzed preoperatively and postoperatively.Result:The jitter, shimmer and NNE were different significantly between preoperative and postoperative,the NNE and shimmer were more sensitive than jitter.Conclusion:The NNE and shimmer of acoustic parameter are objective parameter to evaluate the effect of the microlaryngoscopic surgery of vocal polyp.

OBJECTIVE: To investigate the effect of operation on Benign thyroid nodules with hoarseness as primary symptom. METHOD: Twelve patients were underwent the operation of subtotal thyroidectomy and exposing of recurrent laryngeal nerve. We evaluating the effect by fibrolaryngoscope and voice acoustic analysis before and after operation. RESULT: All the 12 patients underwent surgery successfully. The hoarseness improved obviously and vocal cords were reactivate. Jitter, shimmer and dysphonia severity index showed significant difference pre and one month after surgery. CONCLUSION Benign thyroid nodules could also cause vocal cord paralysis and hoarseness, the effect can be satisfying by subtotal thyroidectomy and exposing of recurrent laryngeal nerve if it can be early diagnosed.
Adult ; Aged ; Female ; Follow-Up Studies ; Hoarseness ; etiology ; Humans ; Male ; Middle Aged ; Thyroid Nodule ; complications ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVE: To define the oncologic efficacy of transoral endoscopic CO2 laser surgery in early glottic carci noma. METHOD: A retrospective study of 112 patients with laryngocarcinoma treated. Surgical treatment included endoscopic CO2 laser cordectomies according to the classification of the European Laryngological Society. After the patients were given the general anesthesia and oral intubation, the tumors in the study group were resected along the margin of the tumor under larynscope, and the safety margin was reserved as 3-5 mm. All the patients were followed-up for 12-62 months. RESULT: Eight relapses were detected in 112 cases of glottic laryngeal carcinoma after CO2 laser surgery. The local recurernce rate was 7.14% (8/112),of the rate for T1a, T1b and T2 were 0.89%, 0.89% and 5.04% respectively, with significant differences among groups (chi2 = 5.306, P < 0.01) . The rate of local recurrence rate of anterior commissure involvement was 7.14% and that was 7.14% when this site was not compromised by the tumor, which has no statistically significant differences (chi2 = 0.000, P > 0.01). CONCLUSION According to our reaserch, endoscopic CO2 laser sur gery is an effective treatment for early laryngocarcinoma.
Adult ; Aged ; Aged, 80 and over ; Carbon Dioxide ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; surgery ; Laser Therapy ; Lasers, Gas ; therapeutic use ; Male ; Middle Aged ; Treatment Outcome

Objective To make a comparison of transthoracic echocardiography (TTE) and cardiac multi-slice spiral computed tomography (MSCT) in the diagnosis of partial anomalous pulmonary venous connection (PAPVC) in children.Methods One hundred and one patients admitted from February 2008 to April 2014 in Guangdong General Hospital primarily diagnosed with PAPVC with or without other congenital heart diseases were analyzed retrospectively,all the cases underwent routine TTE,which 74 cases underwent cardiac MSCT examination,and the TEE and cardiac MSCT diagnosis results were compared with final surgical findings,then the TTE and cardiac MSCT diagnosis accuracy was calculated.SPSS 13.0 software was used to analyze the data.Results All the patients underwent TTE examination,meanwhile,74 cases received cardiac MSCT examination.Ninety-three cases were confirmed by surgical findings,while 8 cases were misdiagnosed with PAPVC.Sixty-eight cases diagnosed by TTE coincided with surgical findings,and the diagnosis accuracy was 73.12％ (68/93 cases);65 cases diagnosed by cardiac MSCT coincided with surgical findings,and the diagnosis accuracy was 94.20％ (65/69 cases).Among the patients who received both TTE and cardiac MSCT examinations,66 cases were confirmed through final surgical operation,2 cases were mis-diagnosis,so the diagnosis accuracy was 97.06％ (66/68 cases).Conclusions In terms of the diagnosis accuracy of PAPVC,cardial MSCT examination is superior to TTE,as almost all of the cases could be diagnosed by TTE combined with cardial MSCT.In consideration of the acoustics window of children,apart from the conventional parasternal approach of detecting pulmonary veins,the importance of suprasternal and subcostal views should also be attached.

OBJECTIVE: To evaluate the application of flaps or musculocutaneous flaps in repairing cervical postradiation ulcer (cpu) at nasopharyngeal carcinoma. METHOD: Deltopectoral flaps and pectoralis major flaps were applied to repair cervical radiation ulceration with different size and depth in 19 cases. RESULT: Twelve cases repaired with deltopectoral flaps and 7 cases repaired with pectoralis major flaps, impaired wound healing happened at distal end of one deltopectoral flap, and the wound was healing hy second intention after debridement and dressing change. All the other deltopectoral flaps and pectoralis major flaps stayed alive. Flaps stayed alive without the recurrence of ulcer after the long-term follow-up for one to ten years. CONCLUSION The effectiveness of cervical radiation ulceration reconstruction by deltopectoral flaps and pectoralis major flaps was proved. The reconstruction could prevent the recurrence of ulcer. Refer to the poor prognosis of chronic radiation ulceration with expectant treatment, precautions do count.
Adult ; Aged ; Carcinoma ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; Neck ; Radiation Injuries ; etiology ; surgery ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps

Objective To study the influences of empowerment education on self-efficacy and activity of daily living in hemiplegic stroke patients with different psychological disorders.Methods Thirty eight hemiplegic stroke patients with different psychological disorders were randomly divided into control groupand observation group,each with 19 cases.Routine rehabilitation trainings were administered to all patients but the empowerment education was only administered to the patients in the observation group.After 3 months,general self-efficacy scale(GSES) and modified Barthel index were used respectively to evaluatethe patients'self-efficacy and activity of daily living.Results Before implementation of empowerment education,GSES scores and modified Barthel Indexes of patients in both groups were statistically meaningless (P ＞ 0.05).After the implementation,scores of GSES and modified Barthel Indexes in the observation group were (33.96 ± 5.25),and (73.34 ± 19.27),higher than those in the control group [(23.12 ±8.83) and (59.58 ±20.14)] (t =3.893,4.578;P ＜0.05).In both groups,GSES scores and modified Barthel Indexesafter the implementation were improved than before (P ＜ 0.05).Conclusions Empowerment education can significantly improve patients' self-efficacy,which then increases the patients' initiative and scientificity in participating in rehabilitation trains and thus improve the patients' activity of daily living.

Objective To evaluate the clinical efficacy of bypass combined with devascularization in the treatment of esophageal variceal bleeding in patients with cirrhotic portal hypertension.Methods Clinical data of 54 patients with cirrhotic portal hypertension who underwent surgery in the Third Affiliated Hospital of Sun Yat-sen University and Yuedong Hospital of the Third Affiliated Hospital of Sun Yat-sen University from January 2008 to January 2018 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among 54 patients,37 cases were male and 17 female,aged from 37 to 52 years with a median age of 45 years.According to the operation procedure,the patients were divided into bypass combined with devascularization group (BD group,n=22) and selective devascularization groups (SD group,n=32).The perioperative free portal vein pressure (FPP) and the venous pressure at the gastric fundus and cardiac region (GCP) were compared by t test.The incidence of postoperative complications was compared by Chi-square test.Results In BD and SD groups,the FPP was (22±5) and (22±7) mmHg (1 mmHg=0.133 kPa) respectively,significantly lower than the preoperative FPP (32±4) and (31±5) mmHg (t=-17.21,-22.54;P＜0.05);The GCP was (18±7)and (20±3) mmHg respectively,significantly lower than (30±5) and (29±3) mmHg before surgery (t=-13.39,-20.44;P＜0.05).No significant difference was observed in the postoperative GCP and FPP between two groups (t=1.44,0.95;P＞0.05).In BD group,the recurrent rate of esophageal varices and incidence of portal hypertensive gastropathy was 9％ and 18％ respectively,significantly lower than 28％ and 31％ in SD group (x2=5.31,4.89;P＜0.05).The incidence of rebleeding in BD group was 4％ and was 3％ in SD group,where no significant difference was observed (x2=0.21,P＞0.05).Conclusions Compared with selective devascularization,the combination of bypass and devascularization in treating esophageal variceal bleeding yields similar clinical efficacy,and has the advantages of lower postoperative recurrent rate of esophageal varices and incidence of portal hypertensive gastropathy.