Objective:To explore the feasibility and efficacy for the dissection and ligation of the superior laryngeal artery in endoscopic surgery for hypopharyngeal cancer.Methods:Eight cadaveric heads were selected, and the laryngopharynxes were harvested. The positions of the superior laryngeal arteries entering the larynxes were dissected and observed under endoscopic vision, and their anatomical characteristics were summarized. Twenty-nine patients (all were male, aged 39-74 years old) with hypopharyngeal cancer who underwent transoral endoscopic surgery at the Department of Otorhinolaryngology Head and Neck Surgery of the Second Xiangya Hospital, Central South University from January 2018 to December 2019 were selected, and the patients were randomly divided into two groups by drawing lots, namely, the superior laryngeal artery was actively dissected and occluded during surgery in observation group ( n=15) or not in control group ( n=14). The differences in surgical time, bleeding volume, postoperative complications, and postoperative disease-free survival rate were compared between the two groups. Statistical analysis was conducted using SPSS 25.0 software. Results:The entry point of the superior laryngeal artery into the larynx was approximately at the level of the superior edge of the thyroid cartilage, and entered the larynx at the posterior one-third of the lateral wall of the pyriform fossa. The superior laryngeal artery might be determined through endoscopic exploration in all patients of observation group. The endoscopic surgery time [(40.00±7.56) minutes] and intraoperative bleeding volume [(24.00±8.28) ml] in the observation group were respectively less than those [(48.57±14.06) minutes and (42.86±15.41) ml] in the control group, and the differences were statistically significant ( t=-2.064, P=0.049; t=-4.064, P=0.001). There was no case with postoperative bleeding in the observation group, but with one case of postoperative bleeding in the control group. Total disease free survival rate was 86.2% and there was no significant difference in disease free survival rates between the two groups during a follow-up period of at least 36 months ( P=0.986). Conclusion:Dissection of the superior laryngeal artery during endoscopic surgery for hypopharyngeal cancer is feasible, and pre-management and occlusion of the superior laryngeal artery can effectively reduce intraoperative bleeding.

As an important element of medical and health sector innovation, the translation of scientific and technological achievements plays a key role in promoting their clinical application and meeting the medical needs of the people. The authors sorted out the problems in such translation at these affiliated hospitals in terms of " people", " finance", " material", and " system". Starting from 2017, the Tenth People′s Hospital Affiliated to Tongji University has explored such practices as establishing hospital-led clinical medical science and technology innovation parks and technology service limited companies. These practices aimed to address the issues of insufficient hospital scientific and technological innovation capabilities and the gap between the hospital′s operation mechanism to translate its scientific and technological achievements and the enterprises and the market. The clinical medical science and technology innovation park integrating administration, industry, education, research, medicine and application, has taken multiple measures to attract excellent research talents and projects from within and beyond the hospital, promote the implementation of innovative scientific research projects. The hospital also established a health industry mode with engagement of social capital from large enterprises. The Technology Services Co., Ltd. was based on the incubation and translation of hospital achievements, combining market and clinical needs, promoting multi-party cooperation between hospitals and external enterprises, improving the chain operation mechanism of hospital scientific and technological achievements translation work, and alleviating the problem of insufficient research pilot funds and productibility funds by means of hospital-led fundraising. The number of patent authorizations of hospitals had increased from 23 cases in 2018 to 105 in 2022, and the amount of patent conversion had increased from 2 million yuan in 2020 to 11 million yuan in 2022. It is recommended that affiliated hospitals of universities further improve the organizational structure of achievement translation, strengthen their professional talent teams, improve their operation mechanism of achievement translation, build a platform for medical school-enterprise cooperation, and improve the evaluation mechanism of translation assessment, in order to promote a virtuous cycle of hospital′s scientific and technological achievement translation work.

Objective:This study was performed to investigate the feasibility of preservation of internal branch of superior laryngeal nerve(ibSLN) during transoral endoscopic surgery for hypopharyngeal squamous cancer(HSCC) and the influence on patient′s swallowing function after operation.Methods:From May 2020 to June 2021, the data of 29 HSCC patients who required for transoral endoscopic surgery in the Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University were prospectively included, and the included patients were divided into two groups randomly by lottery. According to whether ibSLN was actively dissected during operation, they were divided into ibSLN preservation group ( n=15) and control group ( n=14, without ibSLN preservation). Operation time, intraoperative hemorrhage, intraoperative neck dissection, postoperative radiotherapy, postoperative recurrence within 1 year, retention and swallowing function, the recovery of oral soft diet and the quality of life were compared between two groups. SPSS 25.0 software was used for statistical analysis. Results:The study included 29 eligible patients, including 25 males and 4 females.The age ranged from 42 to 67 (56.07±5.93) years. There were no significant differences( P>0.05) between 2 groups in the following data,including age( t=-0.56), gender( χ2=0.01), TNM stage(T stage χ2=0.29, N stage χ2=0.02), pathological diagnosis( χ2=0.03), preoperative swallowing function( χ2=0.00) and M. D. Anderson Dysphagia Inventory(MDADI) score(global t=0.55, emotional t=0.16, functional t=0.60, physical t=0.64), operation time( t=1.62) and intraoperative hemorrhage( t=-1.46), intraoperative neck dissection( χ2=0.01), postoperative radiotherapy( χ2=0.32), postoperative recurrence within 1 year( P>0.050). The swallowing function was evaluated by water swallowing test after operation. The swallowing function of ibSLN preservation group was better than control group, and the difference between two groups was statistically significant on the 1st ( χ2=4.44, P=0.035), 5th ( χ2=4.24, P=0.039) and 7th ( χ2=4.55, P=0.033) day after operation. On the 14th day after operation, the MDADI scores of patients in the ibSLN preservation group were higher than those in the control group in global ( t=2.45, P=0.021), functional ( t=2.54, P=0.017) and physical ( t=2.24, P=0.034) dimensions, except for emotional dimension ( t=1.89, P=0.070). The median time of oral soft diet( U=23.00, P<0.001), normal oral diet( U=21.00, P<0.001) and the nasogastric tube removal time ( U=18.50, P<0.001) in ibSLN preservation group was 2 days, 5 days and 6 days respectively, earlier than that in control group, which had statistically significant difference. Conclusion:Our results show that it is feasible to preserve the ibSLN during HSCC transoral endoscopic surgery, which can achieve rapid recovery of postoperative swallowing function.

Objective To analyse the expression and significance of CD44 variant (CD44v17) in the process of cervical intraepithelial neoplasia (CIN) to cervical cancer,and to explore the relationship of CD44v17 with CIN and cervical cancer.Methods The expressions of CD44v17,matrix metalloproteinase 9 (MMP9) and Ki67 in normal cervical tissue,CIN Ⅰ,Ⅱ,Ⅲ and cervical carcinoma tissues were detected by real-time quantitative RCR.The expressions of CD44v17,MMP9 and Ki67 in human cervical cancer cell lines HeLa and SiHa after transfecting with CD44v17 siRNA were detected,as well.The tumor-bearing nude mice were treated with lentivirus particles of CD44v17,and the influence of CD44v17 siRNA on tumorigenicity in nude mice was analysed.Results The expression level of CD44v17 increased gradually from CIN Ⅰ,Ⅱ,Ⅲ to cervical carcinoma tissues.Compared with normal cervical tissue,the expression levels of CD44v1 7,MMP9 and Ki67 were significantly increased in CIN Ⅱ,Ⅲ and cervical carcinoma tissues (P＜0.05),while no significant difference was found between normal cervical tissue and CIN Ⅰ tissue (P＞0.05).The expression levels of MMP9 and Ki67 in human cervical cancer cell lines HeLa and SiHa were decreased significantly after transfecting with CD44v17 siRNA (P＜0.01).The tumor volume and weight were decreased by treatment with CD44v17 siRNA transfection (P＜0.01),and the tumorigenicity in nude mice was decreased.Conclusion CD44v17 may promote the development of CIN to cervical cancer.It is expected to be an indicator in predicting malignant potential of CIN.

Objective To explore the feasibility and clinical application value of total laparoscopic radical resection of Ⅳ-type hilar choangiocarcinoma. Methods Clinical data of 2 patients receiving total laparoscopic radical resection of Ⅳ-type hilar choangiocarcinoma in Hunan Provincial People's Hospital from April 2015 to December 2015 were analyzed retrospectively. The informed consents of both patients were obtained and the local ethical committee approval was received. Case 1, male, 73 years old, hospitalized for icteric skin and sclera for more than 1 month. Case 2, female, 62 years old, hospitalized for icteric skin and sclera for more than 2 months. The admitting diagnosis were both Ⅳ-type hilar choangiocarcinoma. The bilateral hepatic ducts and left portal vein were invaded by tumor in the 2 cases. Before the operation, the patients received symptomatic and supportive treatments for liver protection, jaundice alleviation etc., and then received total laparoscopic radical resection of hilar choangiocarcinoma. The lymph nodes were resected from far to near, the common bile duct was dissected and cut off, the left and caudate lobe was resected, hilar bile duct plasty and Roux-en-Y bilioenterostomy were performed. Results Operations were performed successfully in both patients and the digestive tract was reconstructed. The operative duration were 430, 410 min respectively, the intraoperative blood loss was 800, 600 ml respectively. No perioperative complication was observed.Two patients received abdominal enhanced CT examination 1 year after operation, no tumor recurrence or metastasis was observed. Conclusion Total laparoscopic radical resection of hilar choangiocarcinoma is safe and feasible, in which hemihepatectomy or extended hemihepatectomy including caudate lobe, lymphadenectomy, bile duct plasty and biliary-enteric reconstruction can be performed.

Objective To investigate the dynamic changes and its significance of inflammatory factors in cervical secretions and prior cervical tissues after cervical conical resection.Methods Women who received prior cervical conization during December 2013 and December 2015 in this hospital were selected,then the cervical tissue and secretion were collected regular interval after the conization.The expression of tumor necrosis factor-α(TNF),interleukin 6 (IL-6) and high mobility group protein 1 (HMGB1) were quantitative detected and analyzed.The expression and infiltration of inflammatory cell were detected by HE and immunohistochemical staining.Results The expression of TNF-α,IL-6 and HMGB1 in cervical tissues and secretions increased gradually after priorcervical conization,which reached the peak at 1 to 2 weeks after priorcervical conization,and then gradually decreased,the differences were statistically significant when compared with the preoperative control group (P＜0.05).The inflammatory cell infiltration and the inflammatory response were most severe at 1st week after the conization.The expression of TNF-α,IL 6 and HMGB1 was at 1st week after the conization were significantly higher than that of the 4thweek group.Conclusion The cervical inflammatory were most severe after the prior cervical conization about 1-2weeks,and the hysterectomy should be avoided at this stage.

Objective To investigate the expression and significance of ABCG2 and ALDH1 in malignant transformation of ovarian endometriosis.Methods The protein expressions of ABCG2 and ALDH1 were detected with immunohistochemistry in 38 cases of malignant transformation of ovarian endometriosis(EMs malignant transformation group),35 cases of endometriosis(EMs group)and 30 cases of normal endometrium(control group).Results The positive rates of ABCG2 and ALDH1 expressions in EMs malignant transformation group were significantly higher than those in EMs group and control group(P<0.05).The expressions of ABCG2 and ALDH1 were significantly associated with the serum CA125 level,differentiation and clinical stage of malignant transformation of ovarian endometriosis (P<0.05),but were not related to the patient′s age,dysmenorrhea history and pathology type(P>0.05).There was no correlation between the expression of ABCG2 and ALDH1 in malignant transformation of ovarian endometriosis(P>0.05).Conclusion The expressions of ABCG2 and ALDH1 might be involved in malignant transformation of ovarian endometriosis.

Objective To analyze the CT and MRI features of pancreatic serous micro-cystic cystadenoma (SMCA).Methods CT and MRI data of 17 patients with SMCA confirmed by pathology were analyzed retrospectively.Tumor's location,diameter,septation,contrast-enhancement features,calcification,central scar, and the extent of pancreaticobiliary duct dilatation were recorded.Results Seventeen patients were enrolled.10 underwent CT,6 underwent MR(2 patients also underwent MRCP), and 1 underwent both CT and MR.Tumors were located at pancreatic head in 2 cases,neck in 2 cases,and body/tail in 13 cases.Lesion size ranged from 1.7 cm to 14 cm with an average of 5.2 cm.Septation was seen in 16 cases.Central scar was seen in 9 cases Septation and scar were enhanced and cystic component was not enhanced on contrast enhancement.6 patients presented the main pancreaticduct dilation.Conclusion Pancreas SMCA has certain imaging features.It is always manifested as lobulated mass with multiple small capsules(<2 cm) and fiber separations.The fiber separation enhance significantly,but lower than normal pancreatic tissue.Central scar is the characteristic manifestation of SMCA, and it manifests iso or slightly lower signal on T1WI and T2WI.Typical SMCA can be diagnosed according to the CT and MR imaging manifestations.

ABSTRACT:Objective To investigate CA125 and ALDH1 levels in diagnosis and postoperative follow‐up of endometriosis (EMs) .Methods Serum CA125 and ALDH1 levels were tested by enzyme‐linked immunosorbent assay (ELISA) in 105 patients with EMs and 100 healthy subjects who came to our hospital between January 2011 and June 2013 .Results The preoperative serum CA125 and ALDH1 levels of EMs patients were significantly higher than those in the control group ( P<0 .05) .Serum ALDH1 levels in stages I and II of EMs were significantly higher than those in the control group (P<0 .05) ,but there was no difference in serum CA125 level between the two groups ( P>0 .05) .Taking CA125≥35 U/mL and ALDH1≥2 .0 pg/mL as the boundary values ,the specificity , sensitivity ,positive predictive value and negative predictive value of serum CA 125 combined with ALDH1 for diagnosis of EMs were 87 .1% ,91 .6% ,84 .6% and 89 .3% ,respectively .One month after operation ,serum CA125 and ALDH1 levels of EMs patients were decreased significantly (P<0 .05) ,but they were still higher than those in the control group ( P<0 .05) .Six months after operation ,their serum CA125 and ALDH1 levels did not differ from those in the control group (P>0 .05) .Relapse occurred in 1 patient 1 year after treatment and in 6 patients 2 years after treatment ;all these patients had a higher serum ALDH1 level than the control group ,but only 2 of them had a higher serum CA125 level .Conclusion The combined detection of serum CA125 and ALDH1 has a higher sensitivity in diagnosis of EMs .Serum ALDH1 level increases in stages Ⅰ and Ⅱ and recurrent patients and can become a better serum marker for early diagnosis and detection of the recurrence of EMs in patients .

Background and objectiveIt is so far not clear that how myasthenia gravis (MG) affected the prognosis of thymoma patients. The aim of this assay is to compare the postoperative survival between patients with thymoma only and those with both thymoma and MG.MethodsThe Chinese Alliance for Research in Thymomas (ChART) registry recruited patients with thymoma from 18 centers over the country on an intention to treat basis from 1992 to 2012. Two groups were formed according to whether the patient complicated MG. Demographic and clinical data were reviewed, Patients were fol-lowed and their survival status were analyzed.Results There were 1,850 patients included in this study, including 421 with and 1,429 without MG. Complete thymectomy were done in 91.2% patients in MG group and 71.0% in non-MG group (P<0.05). There were more percentage of patients with the histology of thymoma AB, B1, or B2 (P<0.05) in MG group, and more percentage of patients with MG were in Masaoka stage I and II. The 5 year and 10 year OS rates were both higher in MG group (93%vs 88%; 83%vs 81%,P=0.034) respectively. The survival rate was signiifcantly higher in patients with MG when the Masaoka staging was III/IV (P=0.003). Among patients with advanced stage thymoma (stage III, IVa, IVb), the constitu-ent ratios of III, IVa, IVb were similar between MG and Non-MG group. Histologically, however, there were signiifcantly more proportion of AB/B1/B2/B3 in the MG group while there were more C in the non-MG group (P=0.000). Univariate analyses for all patients showed that MG, WHO classiifcation, Masaoka stage, surgical approach, chemotherapy and radiotherapy and resectability were signiifcant factors, and multivariate analysis showed WHO Classiifcation, Masaoka stage, and resectability were strong independent prognostic indicators.ConclusionAlthough MG is not an independent prognostic factor, the sur-vival of patients with thymoma was superior when MG was present, especially in late Masaoka stage patients. Possible reasons included early diagnosis of the tumor, better histologic types, an overall higher R0 resection and less recurrence.