Objective:To propose an automatic planning approach for Eclipse15.6 planning system based on Eclipse scripting application programming interface (ESAPI) and evaluate its clinical application.Methods:20 patients with nasopharyngeal carcinoma and 20 cases of rectal cancer were selected in the clinical planning. The developed automatic planning script SmartPlan and RapidPlan were used for automatic planning and dosimetric parameters were compared with manual planning. The differences were compared between two groups by using Wilcoxon signed rank test. Results:The dosimetric results of automatic and manual plans could meet clinical requirements. There was no significant difference in target coverage in nasopharyngeal carcinoma planning between two groups ( P>0.05), and automatic plans were superior to manual plans in organs at risk sparing ( P<0.05). Except for the homogeneity index of PTV and the maximum dose of bowel in rectal cancer plans, the other dosimetric parameters of the automatic plans were better than those of the manual plans (all P<0.05). Conclusions:Compared with the manual plans, the automatic plans have the same or similar target coverage, similar or better protection of organs at risk, and more convenient implementation. The developed SmartPlan based on ESAPI has clinical feasibility and effectiveness.

Objective To localize the upper airway obstruction of patients with obstructive sleep apnea hypopnea syndrome (OSAHS)with the Cinema Magnetic Resonance(Cine-MR) and fiber optic laryngoscope with Müller maneuver(FLMM)before operation and discuss the clinical application values.Methods Before operation, FLMM and Cine-MR were applied to 22 patients diagnosed as OSAHS by Polysomnography(PSG).Medical examinations conducted in this study from September 2015 to April 2016 to examine the obstruction of the soft palate region, the lingual region and epiglottis.Results There were complete agreements between the Cine-MR and FLMM at locating obstruction sites of the soft palate (n=22/n=22),and there were moderate agreements between the Cine-MR and FLMM in locating obstruction sites of the retroglottal region(n=13/n=6),epiglottal region (n=4/n=2)and multiple level(n=13/n=6), respectively.Conclusion For those moderate and severe OSAHS patients with multiple sites obstruction , the preoperative application of the Cine-MR and FLMM together will be better in locating the obstruction sites.

Objective: To evaluate the quality of life (QOL) in elderly patients with tongue cancer who underwent immediate free flap reconstruction surgery. In addition, the efficacy of the anterolateral thigh perforator free flap (ALTFF) and the radial free forearm flap (RFFF) for reconstruction was compared in patients with glossectomy. Methods: Ninty-eight patients undergoing complete or partial glossectomy and reconstruction with free flaps were grouped according to flap type. Oral functions were assessed using The University of Washington Quality of Life (UW-QOL), and the 14-item Oral Health Impact Profile questionnaires (OHIP-14) at 6 and 12 months after reconstructive surgery. Results: Eighty-six of 98 questionnaires (88%) were returned. There was significant difference between the 2 groups in the style of resection (P<0.05). For all oral function domains, the score improved progressively after the operation (6 and 12 months after the procedure). The UW-QOL questionnaire showed a significant difference between the 6 months postoperatively (ALTFF: 290.0 ± 7.8, RFFF: 236.6 ± 24.2) and 12 months postoperatively (ALTFF: 302.0±21.1, RFFF: 331.1±20.4) (P<0.05). The OHIP-14 questionnaire showed a total score of ALTFF (422.0± 15.2) which was significantly less than RFFF (434.0±38.7) at 6 months postoperatively (P<0.05). There were no meaningful differences between the 2 flap types for all oral function domains at 12 months. Conclusions Using the RFFF or ALTFF for reconstruction of tongue defects after cancer resection influences oral function. There was no significant difference in quality of life between the two flaps at 12 months postoperatively.

Objective To study the clinical effects of different surgical treatments for laryngotracheal steno-sis .Methods The clinical data of 56 patients with laryngotracheal stenosis from July 2006 to July 2014 were ana-lyzed .Of all 56 cases ,7 cases were children ,49 cases were aducts ;9 cases underwent CO2 laser resection ,5 cases underwent temperature controlled radiofrequency ablation and 5 cases received laryngeal mold under self -retaining laryngoscope ,6 cases received Keel placement after laryngofissure ,23 cases received T -shape tube implantation af-ter laryngoplasty or tracheoplasty and 8 cases underwent end-to -end tracheal anastomosis after cervical tracheoto-my .Results All the patients had been followed up for 6 months to 2 years postoperatively .Thirty nine cases of 56 were cured after single-operation ,and 10 of 56 were cured after repeated operations .No one suffered from laryn-gotracheal stenosis again .Five cases failed and survived with tracheal tube .2 cases lost to follow -up .No people die or had complications .Among all cases ,5 cases with laryngeal mold and 8 cases with tracheal anastomosis were cured after single-operation .Among 9 cases with lasere scar removal surgery ,5 cases were cured after an operation ,3 cases were cured after two operations ,1 case failed because of laryngeal cancer recurrence .Among 5 case with tem-perature controlled radiofrequency ablation ,3 cases were cured afrter an operation ,1 case was cured after two opera-tions ,1 case had no effect .Among 6 cases with keel place -ment ,4 cases were cured after one operation ,1 case was cured after two operations ,1 case had no effect .Among 23 cases with T -shape tube implantation ,14 cases were cured after an operstion ,5 cases were cured after two and more operations ,2 cases had no effects and 2 cases were lost .Conclusion In order to improve the therapeutic effects of laryngotracheal stenosis ,the treatment strategy should be personalized according to the degree of stenosis ,the position of stemtis ,and the impairment of laryngotra-cheal framework .

OBJECTIVE: To evaluate the clinical effect of acellular dermal matrix (ADM) on the repair of different tissue defects in pharyngeal and laryngeal cancer. METHOD: Twenty-three cases of pharyngeal and laryngeal cancer were analyzed retrospectively, including 16 patients with pharyngeal cancer, and 7 patients with laryngeal cancer. After surgery, the patients appeared two types of tissue defects respectively: hypopharynx tissue defect and neck skin tissue defect. These defects were repaired with ADM, and the clinical effects were observed. RESULT: Sixteen cases of hypopharynx tissue defect and 7 cases of neck skin tissue defect were repaired with ADM. One case in hypopharynx tissue defect group and 2 cases in neck skin tissue defect group undergone pharyngeal fistula postoperatively. CONCLUSION The repair of tissue defects in pharyngeal and laryngeal cancer with ADM had some advantages, such as good histocompatibility, low immune rejection, wide material sources and simple method. There were some differences in clinical effects between hypopharynx cavity defect and neck skin tissue defects, so the emphasis of the need to pay attention to is different in the clinical.
Acellular Dermis ; Dermatologic Surgical Procedures ; Humans ; Hypopharynx ; surgery ; Laryngeal Neoplasms ; surgery ; Mucous Membrane ; surgery ; Neck ; surgery ; Otorhinolaryngologic Surgical Procedures ; Retrospective Studies

OBJECTIVE: To compare the clinical results between stapled and traditional suture closure total laryngectomy. METHOD: Fifty-three cases of laryngeal cancer with total laryngectomy were divided into 2 groups: 32 cases with traditional suture closure total laryngectomy (group A) and 21 cases with stapled total laryngectomy group (group B). Compare two groups in pharyngeal fistula, postoperative bleeding, dysphagia, and nasal regurgitation. RESULT: There was no difference of postoperative pharyngeal fistula between group A and B (P>0. 05). The incidence of dysphagia, nasal regurgitation, and postoperative bleeding in group B were 23. 8%, 14. 3% and 14. 3% respectively, which were obviously higher than that in group A (P<0. 05). CONCLUSION Stapled total laryngectomy has the advantages of reducing the operative time and simplifying the operation with some disadvantages such as higher standards of operation indications, higher incidence of dysphagia, higher nasal regurgitation, higher postoperative bleeding, and poor medical economic profit. Traditional suture closure total laryngectomy is recommended in clinical practice.
Deglutition Disorders ; Fistula ; pathology ; Humans ; Incidence ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Pharynx ; pathology ; Postoperative Complications ; Suture Techniques ; Sutures

Objective To investigate the effect of RNA interference (RNAi) targeting NRP-1 gene on the growth and proliferation of nasopharyngeal carcinoma(NPC) CNE-2Z cells.Methods Short hairpin RNA(shRNA) plasmids targeting NRP-1 were designed and synthesized.These plasmids were respectively transfected into human NPC CNE-2Z cells and xenograft tumors in nude mice.The expressions of Fluorescein-labeled plasmids in NPC CNE-2Z cells and xenograft tumors were observed by fluorescence microscopy.Cell proliferation was detected by MTT assay.The inhibitory effects on target genes were evaluated with RT-PCR and Western blotting,respectively.The inhibitory effect of plasmids with the most effective sequence on xenograft tumors in nude mice was observed.Results CNE-2Z cell proliferation was significantly inhibited by NRP-1/shRNA silencing.RT-PCR showed NRP-1 mRNA expression was significantly decreased.Western blotting demonstrated the NRP-1/shRNA silencing can effectively inhibit the expression of target proteins in CNE-2Z cells.After six weeks,there were significant differences in the mean tumor volumes in nude mice between plasmid group and negative control group [(0.599 ± 0.002) vs (1.141 ± 0.013) cm3,P ＜ 0.05] or blank control group [(0.599 ± 0.002) vs (1.165 ± 0.308) cm3,P ＜0.05],and the inhibitory rate of tumor growth was 48.6％.Conclusion RNA interference targeting NRP-1 can remarkably inhibit the growth of CNE-2Z cells in vitro and in vivo.

OBJECTIVE: The purpose of this study is to explore the effect of reconstruction for the nose cranial base defects after removal of tumor with ADM. METHOD: Thirteen patients with the nose skull base defects after tumors resection underwent cranial base reconstruction with ADM at the same time. Postoperatively, routine endoscopic and CT scan were performed on all patients at regular intervals. RESULT: The successful cranial base reconstruction was achieved in 13 patients with ADM. Intracranial infection occurred in 3 patients and recovered after two weeks postoperatively, given combination of antibiotics, dexamethasone anti-inflammatory, mannitol, reduce intracranial pressure with diuretics and cooling, sedation processing. All patients developed no delayed complications. CONCLUSION Our experience has demonstrated that the cranial base reconstruction with the ADM "I" shaped sandwich has harvest the satisfactory effect.
Acellular Dermis ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Skull Base ; surgery ; Transplantation, Homologous ; Young Adult

OBJECTIVE: To investigate the inhibitory effect of NF-kappaB p65siRNA on human laryngeal carcinoma xenograft model in nude mice. METHOD: Human laryngeal carcinoma cell line Hep-2 was seeded in the subcutaneous layer of 15 nude mice to build laryngeal carcinoma xenograft model. Then they were randomly divided into three groups. NF-kappaB p65siRNA was given in siRNA group and FAM-Control siRNA was given in negative control group while phosphoric-buffered saline (PBS) was used in normal control group for 3 weeks. Tumor size and body weight of the mice were measured. TUNEL method and immunohistochemical S-P method were used for detecting the expression of NF-kappaB p65 and Bcl-xL protein. RESULT: The volume of tumors in siRNA group was reduced and the average weight of tumors in siRNA group was lower than the other two groups (P < 0.05). In siRNA group, the expression of NF-kappaB p65 and Bcl-xL protein was down-regulated and the apoptotic rate was increased obviously as compared with the negative control group and the normal control group. CONCLUSION NF-kappaB p65siRNA can significantly inhibit the expression of NF-kappaB p65 and the growth of human laryngeal carcinoma xenograft in nude mice. Its mechanism may be related to inducing the apoptosis in tumor cells by down-regulating the expression of Bcl-xL protein.
Animals ; Apoptosis ; Carcinoma, Squamous Cell ; genetics ; pathology ; Cell Line, Tumor ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Laryngeal Neoplasms ; genetics ; pathology ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; RNA, Small Interfering ; Transcription Factor RelA ; genetics ; Xenograft Model Antitumor Assays ; bcl-X Protein ; metabolism

Objective To investigate the clinical effect of laparoscopic surgery on gynecologic malignancies,providing information for the clinical therapy.Methods 35 patients with gynecologic malignancies treated with laparoscopic surgery were selected as the observation group.While 35 cases of abdominal surgery patients were selected as control group at the same period.The incidence of postoperative complications,survival rate and other conditions of the two groups were observed and compared.Results The operation time of laparoscopic surgery group was longer than open surgery group,no significant difference between the two groups(P ＞ 0.05 ).Blood loss,hospital slay and recovery time of body temperature of the laparoscopic surgery group was significantly lower than open surgery group ( P ＜0,05).2 cases had urinary retention,1 urinary tract infection and 1 deep vein thrombosis occured in observation group; while 3 urinary retention cases,1 intestinal obstruction case,1 deep vein thrombosis case,1 abdominal wound infection case occured in control group,and the difference was significant ( P ＜ 0.05 ).2 patients lost in each group.3-year survival rate of laparoscopic surgery group was similar with open surgery,the difference between the two groups was not statistically significant( P ＜ 0.01 ).Conclusion Excision and pelvic lymph node dissection under laparoscopy is an effective method in treatment of gynecologic cancer,and with less trauma and faster recovery.