Objective: To assess the effect of balloon angiopl asty on circulating endothelin (ET) and TNF-α levels and tissue endothelin in experimental atherosclerosis in rabbits. Methods: After 20 New Z ealand rabbits had a high cholesterol diet for at least 8 weeks, successful ball oon angioplasty was performed in rihgt iliac arteries in 18 rabbits. Circulatin g levels of ET and TNF-α were measured before as well as immediately and 24 h after balloon angioplasty. Tissue endothelin immunoreactivity in atherosclerotic iliac artery wall after balloon angioplasty was assessed by immunohistochemica l technique. Results: Plasma levels of ET and TNF-α were signi ficantly increased immediately after ballon angioplasty (76.40±13.58)pg/ml vs (92.67±11.38) pg/ml and (31.35±6.23) U/ml vs (56.26±7.37) U/ml, resp ectively (P<0.05) .There was no change in plasma ET and TNF-α levels 24 h after balloon angioplasty (77.13±12.87) pg/ml vs (76.40±13.58) pg/ml and (33.41±6.79) U/ml vs (31.35±6.23) U/ml， respectively (P>0.05). T issue endothelin immunoreactiuvity was markedly increased in right iliac artery wall after balloon angioplasty than that in opposite iliac artery wall. Conclusion: The increase of plasma ET, TNF-α levels and tissue ET-IR in iliac artery wall after balloon angioplasty may be associated with the injury of l ocal vascular intima, suggesting that ET and TNF-α may take part in the corona ry constriction and the development of coronary restenosis after percutaneous tr ansluminal coronary angioplasty.

Objective：This study was designed to summarize the clinical characteristics, biological behavior, and treatment results of acinic cell carcinoma of parotid. Method： Twenty nine cases of acinic cell carcinoma of parotid were collected to make clinical analysis. Results： The clinical feature of acinic cell carcinoma of parotid were observed as following： the incidence of male and female was equal and happen in any age group. The tumor usual located at superficial lobe of parotid, and growth slowly. The course was long with a mean of 5 years. The incidence of cervical lymph node metastasis was 17.2％ and distant metastasis was much less, the local recurrence rate was 20.7％ and the prognosis was relatively better. The survival rates of 3 year,5 year,10 year were 82.7％ ,80％ , and 76.9％ ,respectively. Conclusion： The incidence of acinic cell carcinoma of parotid is low, and acinic cell carcinoma of parotid could be considered as lower malignant tumor. Radical surgical ressection is the most common modality for its treatment, while larger lesion or recurrent cases may receive postoperative radiotherapy so as to decrease local recurrence.

Objective To investigate prognostic factors of medullary thyroid carcinoma.Methods By using univariate analysis and multivariate analysis,the prognostic factors were investigated in 102 patients with medullary thyroid carcinoma treated at this hospital.Results Overall survival rates of 5-year,10-year and 15-year were 87.4%,74.6%and 54.2%respectively by Kaplan-Meier method analysis.In univariate analysis,gender,age,bilateral thyroid lobe tumors,tumor size＞4 cm,invasion of thyroid capsule,distant metastasis,and non-radical tumor resection were significant poor prognostic factors.In multivariate analysis,tumor size＞4 cm(X2=7.43,P=0.0035),distant metastasis(X2=23.50,P=0.0000),and non-radical tumor resection(X2=25.90,P=0.0000)remained as independent pmgnostic factors.Conclusions Tumor size＞4 cm,distant metastasis,and non-radical tumor resection are the independent predictors of patients survival.Early diagnosis and early therapy can improve significantly the prognosis of medullary thyroid carcinoma.

OBJECTIVETo detect the serum proteomic fingerprints in patients with hypopharyngeal squamous cell carcinoma (HPSCC) by surface enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS) protein chip array technique.

METHODSThe serum samples were obtained from 58 HPSCC patients for protein expression analysis using SELDI-TOF Protein Chip technique and cation-exchange (CM10) protein array. All the spectra were compared and the qualified mass peaks with mass-to-charge ratios (m/z) between 1 and 70 kD were autotimatically detected. The tree analysis pattern was generated using Biomarker Patterns Software.

RESULTSThe protein profiles of HPSCC serum were analyzed according to the clinical and pathological features of the patients and their treatment response. No significant difference was noted in the serum proteins between HPSCC patients with different statuses of cervical lympha node metastasis (P>0.05), and the difference between well differentiated and poorly differentiated HPSCC was only minor. No significant difference was found in the serum proteins between chemotherapy-sensitive patients and the insensitive patients (P>0.05), but 5 proteins were identified to be overexpressed in the sensitive patients (P < / = 0.05). Radiotherapy-sensitive HPSCC patients were segregated from the insensitive group with a sensitivity of 86.67% and specificity of 100%.

CONCLUSIONThe serum protein at the m/z value of 6115.74 is overexpressed in radiotherapy-sensitive HPSCC patients. Serum protein profiling allows the prediction of radiotherapy response in HPSCC patients, and the identified proteins may serve as candidate biomarkers for predicting the radiotherapy sensitivity of HPSCC.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; analysis ; Carcinoma, Squamous Cell ; genetics ; radiotherapy ; Female ; Humans ; Hypopharyngeal Neoplasms ; genetics ; radiotherapy ; Male ; Middle Aged ; Models, Biological ; Proteome ; analysis ; Radiation Tolerance ; Sensitivity and Specificity ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; methods

Objective:To observe the effect of percutaneous tr ansluminal coronary angioplasty (PTCA) on coronary circulating tumor necrosis fa ctor-α (TNF-α) activity. Methods: Plasma TNF-α levls were measured with radioimmunoassay and bioactive assay respectively. Result s: Plasma TNF-α activity in femoral artery (AO) was significantly incr eased immediately after PTCA ［(15.86±3.75) U/ml vs （41.32±4.36） U/ml， P<0.01］, and plasma TNF-α activity in coronary sinus was remarkably incre ased immediately after PTCA　［(16.72±4.14） U/ml vs （65.61±6.25） U/ml, P<0.01］. There was no change in plasma TNF-α activity in AO 24 h after PT CA ［(18.32±5.12） U/ml vs （15.86±3.75） U/ml, P>0.05］. Conclu sion: The increase in plasma TNF-α activity after PTCA may be associat ed with the injury of coronary artery caused by PTCA, suggesting that TNF-α ma y be involved in the coronary occlusion and the development of coronary restenos is after PTCA.

Objective To evaluate the value of using a linear stapler device for the cloure of the pharynx during total laryngectomy.Methods Sixteen total laryngectomies were performed between August 2010 and December 2011,during the operation,the TA 60 linear stapler was used for pharyngeal closure.Among these patients,two patients had the history of pre-operative radiotherapy,four patients recurred after radiotherapy,ten patients were treated for the first time.100 ml methylene blue was injected into the newly closed laryngopharyngeal cavity through the nasopharyngeal breather pipe for checking up whether it was watertight or not.Results Amnong the sixteen patients,methylene blue leakage from the mucosal joint of the gular cavity closed by the stapler were not found in fifteen patients,it was only found in one patient.The transudatory places were sutured with absorbable Vicryl sutures. This patient healed well without pharyngocutaneous fistula.Negative surgical margins were achieved in all patients.No patient needed to be tranfered to open surgery.Using a linear stapler device in total laryngectomy,45 minutes could be saved as compaired to manual suture. One patient developed a light pharyngocutaneous fistula.The incidence of pharyngocutaneous fistula was 6.25％ (1/16). Conclusions This stapled closed technique for pharyngoplasty is efficient,eliminates the risk of wound contamination,saves operation time and decreases the incidence of pharyngocutaneous fistula.This technique can be recommended as alternative for repairing the pharynx in patients undergoing total laryngectomy.

Objective： The aim of this study was to investigate the best choice of the three treatment modalities of preserving laryngeal functions in T3 laryngeal carcinoma. Methods： There were 94 cases with T3 laryngeal carcinoma (Stage Ⅲ and Ⅳ ) who were treated by three kinds of modalities of preserving laryngeal functions： definitive radiotherapy, salvage surgery for the failures of definitive radiotherapy, partial laryngectomy. We compared their survival curve, recurrence rate of the primary and secondary site, and the complications. Results： The survival curve of the partial laryngectomy groups was better than that of the definitive radiotherapy group in supraglottic carcinoma (P=0.0248). In glottial carcinoma, the survival curve of partial laryngectomy group and salvage surgery group were insignificantly different, both of them were better than that of definitive radiotherapy group (P=0.0075). The complication rate of the salvage surgery group was significantly higher than that of partial laryngectomy group (60％ Vs 16.7％ ); We regarded the definitive radiotherapy group and salvage surgery group as one group, it's primary site recurrence rate was significant higher than that of partial laryngectomy group (45.8％ Vs 19.4％ ). Conclusion： Partial laryngectomy is the most effective way among the three modalities of preserving laryngeal functions to treat T3 laryngeal carcinoma.

Objective To investigate the clinical manifestations, EB virus serology and treatment outcome of nasopharyngeal adenocarcinoma (NPAC). Methods Clinical records of NPAC patients between 1964 and 2000 in Cancer Center of SUN Yat-sen University were retrospectively reviewed. Results Among 48 patients with NPAC, 45.2% (7 cases of N1,8 cases of N2 and 4 cases of N3) of them presented with cervical metastasis. Pathologically, common type and salivary gland type of NPAC accounted for 58. 3% (28 cases) and 41.7% (20 cases) respectively. The positive rate of the EB virus antibody VCA-IgA was 56.7% in the whole group and only 23.7% in the salivary gland type of NPAC. The overall local control rate and the 5-year disease free survival rate by Kaplan-Meier method were 87.0% (40/46) and 65.2% respectively. Baseline data analysis showed that age, gender, N stage and M stage were not the significant factors, never the less the T stage was not balanced between the two groups (surgery plus radiotherapy vs radiotherapy alone, X2=4.801, P = 0.045) . The patients treated by surgery plus radiotherapy had significandy higher 5-year disease free survival rate than by radiotherapy alone (88.9% vs 74.7%, Log Rank test: X2 = 4.272, P = 0.039). Cox's multivariate analysis showed treatment modality and N stage were the significant factors influencing survival (RR were 15.276 and 6.529, P < 0.05). Conclusions NPAC is a distinct entity in all types of nasopharyngeal carcinoma. EB virus serology has limited value in its diagnosis. Surgery plus radiotherapy could be another choice of treatment for early lesions of NPAC.

Objective The study is to explore the extent, main-point and use of en bloc principle in re-operation of thyroid carcinoma. Methods Clinical data of 75 patients received re-operation from 2002 to 2006 because of nonstandard operation were reviewed, including 10 men, 65 women, age ranging from 21-56. lpailateral completing lobectumy, isthmectomy, ipsilateral anterior cervical muscle, and level Ⅵ dissetion were done in all the patients by en bloc principle. Results Residual tumor was found in 39 cases. There were, 10 in primary site, 8 in Ⅵ level, and 21 in beth. Therefore tumor residual rate was 52.0%. The total metastatic lymph nodes in Ⅵ level were 63. Among the eight patients with recurrent laryngeal nerves paralyses which were hurt in the first operation, 4 were found been cut completely, 4 were ligated. The ligated locations were all near the place which the nerve enter the larynx. The ligated nerves were released, and the patients voice was improved greatly. Conclusions Ipsilateral completing Iobectomy, isthmectomy, ipsilateral anterior cervical muscle and Ⅵ level dissetion is adequate for thyroid carcinoma patients who received nonstandard operation. The principle of en bloc resection can be used in the reoperation of thyroid carcinoma.

OBJECTIVETo analyze the correlation between prognosis and p53 expression in primary lesion and the surgical margin of laryngeal squamous cell carcinoma (SCC) as an indication of postoperative radiotherapy.

METHODSSixty-seven laryngeal SCC with pathological negative margin were analyzed retrospectively. Immunohistochemical method was used to detect the expression of p53.

RESULTSThe p53 positive rates in the primary tumor and the surgical margin were 19.4% (13/67) and 50.7% (34/67). In p53 positive primary tumor group, the survival rate was higher in patients who received postoperative radiotherapy than those without (60.6% vs 20.0%, P = 0.000 5) and the recurrent rate was just the reverse (42.1% vs 93.3%, P = 0.002), though these differences were not significant in p53 negative primary tumor group (87.5% vs 94.1%, P = 0.409 6; 25.0% vs 5.9%, P = 0.175). The recurrent rate and survival rate between patients with and without postoperative radiotherapy did not show any significant difference either in p53 positive surgical margin group (47.4% vs 20.0%, P = 0.378 1; 62.5% vs 80.0%, P = 1.0) or p53 negative ones (84.9% vs 66.6%, P = 0.074 3; 20.6% vs 40.7%, P = 0.248).

CONCLUSIONPostoperative radiotherapy should be given to patients with p53 positive primary laryngeal cancer. But those who are pathologically margin negative but p53 positive should not be taken, at least for the present, as candidates for postoperative radiotherapy.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; chemistry ; mortality ; radiotherapy ; Female ; Humans ; Laryngeal Neoplasms ; chemistry ; mortality ; radiotherapy ; Male ; Middle Aged ; Survival Rate ; Tumor Suppressor Protein p53 ; analysis