Objective:To evaluate the therapeutic effect and the prognosis of the laryngeal function preserving surgery (LFPS) and total laryngectomy in hypophngeal carcinoma.Method:Ninety-three cases of laryngopharynx carcinoma were retrospectively analyzed from September 1974 to September 2006.Among which 57 cases were primary pyriform sinus cancer,20 cases were postero-cricoid cancer and 16 cases were postero-pharyngeal wall cancer.53 cases were treated by LFPS,and 40 cases were treated by total laryngectomy.The treatment effectiveness,complication,survival rate and repair materials were analysed.Result:Adopting Kaplan-Meier survival analysis,the 3-year survival rates were 69.9%and 5-year survival rates were 43.0%.The 3-year survival rates of LFPS and Non-LFPS were 73.6% and 67.5%, and the 5-yenr survival rates of LFPS and Non-LFPS were 49.1% and 32.5%. There was no significant difference between the two groups(χ~2=2.566,P>0.05). Single element analysis indicated survival rates concerned with T-stage(χ~2=9.764,P<0.05), neck lymphatic transfer(χ~2=10.472,P<0.01) and the degree of pathological differentiation(χ~2=25.894,P<0.01).Cox regression analysis suggested that T-stage,the degree of pathological dfferentiaton and wheather going through the surgical operation were the independent elemant of the patient's prognosis.There was no significant difference between LFPS and No-LFPS in the neoplasms location, complication,neoplasms residuum and neoplasms recurrence.Conclusion:LFPS did not affect the survival rates and LFPS was feasible.LFPS can increase the living quality of laryngopharynx careinoma patients.

Objective To explore the outcome of children with mental retardation after 3 years follow-up. Methods The subjects were 237 children with mental retardation, selected from Beijing Municipal Investigation for Children with Disability in 2004. Gesell Developmental Schedule and Wechsler Intelligence Scale for Children were used to estimate the children's intelligence. Results After 3 years, the outcome showed non-mental retarded, 124 subjects (52.32%); mild mental retarded, 46; moderate mental retarded, 32; severe mental retarded, 16; profound mental retardation, 19. The related factors include urban/suburban (B=-0.622), parental knowledge about rehabilitation training (B=-0.470) and score of personal social interaction in Gesell Test(B=-0.040). Conclusion The outcomes of children with mental retardation are different. But some problems still exist even in non-mental retarded children.

Objective　To find out the clinical features and the regular patterns of lung cancer among Yunnan Tin miners and get ready for the further clinical practices. Methods　From 1975 to 1998 the clinical data in 2?261 patients with primary lung cancer from Yunnan Tin Corporation were retrospectively analyzed. Results　The male patients were obviously more than female (male to female was 97.3∶1). The ratio of age ranging from 50 to 69 years old was 74.3％. Of the whole group, 60.4％ was squamous cell carcinoma and 71.4％was in stage Ⅲ or Ⅳ. The 5-year survival rates of the three groups, which were respectively treated with surgical resection, non-surgical therapy and palliatively supporting therapy, were 43.4％, 7.5％ and 1.2％ respectively (P＜0.01). Conclusion　There are some features in patients with lung cancer from Yunnan Tin Corporation. Early diagnosis for lung cancer and healthy quality education will be still important for our future work.

ObjectiveTo study the outcome of 3 kinds of disabled children. Methods269 disabled children found in 2004 Beijing Disabled Children Sampling, which including 237 children with mental retarded disability, 57 with physical disability and 26 with psychological disability, were followed up in 2007. Results52.32% of mental disabled children, 8.77% of physical disabled, and 15.38% of psychological disabled children would not be seen as "disability" any longer. ConclusionThe disability before 6 years old is a kind of developmental disability, which may be recovery as development.

OBJECTIVETo investigate the effects of thoracic epidural blockade (TEB) on plasma fibrinogen (FIB) levels.

METHODSThirty cases of dilated cardiomyopathy (DCM) were selected randomly into a TEB group and a control group. TEB patients were subjected to a persistent TEB (T1 - 5), and injected with 0.5% lidocaine 3 - 5 ml every two or four hours for four weeks in addition to routine medicine, while patients in the control group were given routine medicine only. Plasma concentrations of FIB were measured using the micro-capillary assay. Doppler echocardiography was performed before and after the treatment.

RESULTSPlasma concentrations of FIB in two groups were greater than the normal value before the treatment. There was a significant decrease of plasma concentrations of FIB in the TEB group after the treatment (4.2 +/- 1.3 g/L vs 3.6 +/- 0.9 g/L, P < 0.05), but there was no significant change in the control group (4.2 +/- 1.2 g/L vs 4.3 +/- 1.9 g/L, P > 0.05). After four weeks of treatment, the left ventricular end diastolic diameters (LVEDD) of TEB patients were reduced (72 +/- 10 mm vs 69 +/- 10 mm, P < 0.05) and the left ventricular ejection fraction (LVEF) of TEB patients increased significantly (33% +/- 13% vs 44% +/- 14%, P < 0.05). In contrast, LVEDD (73 +/- 11 mm vs 73 +/- 12 mm, P > 0.05) and LVEF (32% +/- 14% vs 33% +/- 12%, P > 0.05) did not change significantly in the control group.

CONCLUSIONSThe results suggest that plasma FIB levels in patients with DCM were decreased by performing a TEB, in addition to a reduction of the enlarged cardiac cavity and an improvement in cardiac systolic dysfunction. TEB might contribute to lowering the occurrence of thrombus and thromboembolism in patients with DCM. TEB might be a promising therapeutic method to improve the prognosis of DCM patients.

Adult ; Aged ; Anesthesia, Epidural ; Autonomic Nerve Block ; Cardiomyopathy, Dilated ; blood ; therapy ; Female ; Fibrinogen ; analysis ; Humans ; Male ; Middle Aged

A 20-year-old male patient presented with myalgia of upper limbs and myasthenia of extremities for more than 1 month. Physical examination showed diffuse erythema on the cheeks, upper eyelids, upper chest, neck and dorsa of the hands. The myodynamia of the proximal and distal muscles of upper and lower extremities was grade Ⅳ, Ⅴ, Ⅲ and Ⅴ respectively. Laboratory examinations revealed that the serum levels of creatine kinase, CK-MB and lactate dehydrogenase were 2103 U/L, 83 U/L and 489 U/L respectively, which were all above the normal range. Electromyogram revealed myopathic abnormality and normal nerve conduction velocity. Histopathology of gastrocnemius muscle showed hypertrophy and swelling of muscle fibers, disappearance or fuzziness of transverse striation, and intermuscular lymphoid cell infiltration. A biopsy of the skin lesion from the upper chest showed liquefaction degeneration of and colloid bodies in basal cell layer, perivascular lymphoid cell infiltration in the dermis. A diagnosis of dermatomyositis was established based on the clinical and laboratory findings. After management with intravenous prednisolone 80 mg once daily and symptomatic treatment for 4 weeks, the myodynamia of upper limbs was improved, serum levels of creatine kinase,CK-MB and lactate dehydrogenase reached the normal ranges. However, the myodynamia of lower limbs progressively deteriorated with the emergence of paresthesia. Enhanced MRI scan showed a tumor in the vertebral canal at the level of thoracic vertebra 11 to 12. A spherical encapsulated tumor measuring 3 cm in diameter was surgically removed. The tumor was diagnosed as paraganglioma in vertebral canal according to pathological and immunohistochemical findings. The patient was finally diagnosed with paraganglioma in vertebral canal superimposed on dermatomyositis.

OBJECTIVE: To evaluate the therapeutic effect and the prognosis of the laryngeal function preserving surgery (LFPS) and total laryngectomy in hypopharyngeal carcinoma. METHOD: Ninety-three cases of laryngopharynx carcinoma were retrospectively analyzed from September 1974 to September 2006. Among which 57 cases were primary pyriform sinus cancer, 20 cases were postero-cricoid cancer and 16 cases were postero-pharyngeal wall cancer. 53 cases were treated by LFPS, and 40 cases were treated by total laryngectomy. The treatment effectiveness, complication, survival rate and repair materials were analysed. RESULT: Adopting Kaplan-Meier survival analysis, the 3-year survival rates were 69.9% and 5-year survival rates were 43.0%. The 3-year survival rates of LFPS and Non-LFPS were 73.6% and 67.5%, and the 5-year survival rates of LFPS and Non-LFPS were 49.1% and 32. 5%. There was no significant difference between the two groups (chi2 = 2.566, P > 0.05). Single element analysis indicated survival rates concerned with T-stage (chi2 = 9.764, P < 0.05), neck lymphatic transfer (chi2 = 10.472, P < 0.01) and the degree of pathological differentiation (chi2 = 25.894, P < 0.01). Cox regression analysis suggested that T-stage, the degree of pathological differentiation and whether going through the surgical operation were the independent element of the patient's prognosis. There was no significant difference between LFPS and No-LFPS in the neoplasms location, complication, neoplasms residuum and neoplasms recurrence. CONCLUSION LFPS did not affect the survival rates and LFPS was feasible. LFPS can increase the living quality of laryngopharynx carcinoma patients.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; surgery ; Female ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Larynx ; physiology ; surgery ; Male ; Middle Aged ; Pharyngectomy ; methods ; Retrospective Studies