Transoral CO2 laser epiglottectomy for early epiglottic carcinomas / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To compare the functional results of transoral CO2 laser epiglottectomy with transcervical supraglottic laryngectomy and to find the landmarks for CO2 laser surgery.</p><p><b>METHODS</b>Forty-nine preoperatively untreated patients diagnosed as clinical T1-2N0M0 epiglottic carcinomas enrolled from June 1, 2006, to November 1, 2009 in the Second Affiliated Hospital of Harbin Medical University were studied retrospectively. Seventeen cases were treated by CO2 laser whereas 32 by open surgeries. The upper edge of thyroid cartilage and mucosal recess infra epiglottic tubercle could be used as intraoperation landmarks for transoral CO2 laser surgery. Optional neck dissections (II, III) were performed for 34 patients with tumors on laryngeal face, but not for 15 with tumors on the edges of epiglottis or small laryngeal face tumors.</p><p><b>RESULTS</b>The follow-up for this study covers a period ranging from 3 to 6 years postoperatively. Four local recurrences were found for this study, 2 for laser surgery who underwent additional repeated exisions and 2 for conventional techniques, one received radiotherapy (60 Gy) and another with total laryngectomy. The incidence of lymph node metastasis was 10.2% (5/49) in all cases. Time of naso-feeding or hospitalisation was significantly shorter for CO2 laser treated patients than that for open techniques. Overall 3 year's survival rates were 100% and 90.6% for CO2 laser and the open techniques respectively.</p><p><b>CONCLUSIONS</b>Compared to the open technique, transoral CO2 laser epiglottectomy is a well-tolerated and promising resection technique with low morbidity for early epiglottic carcinomas, and the identification of landmarks is useful for entire resection of epiglottis.</p>

Expression of alpha-v integrin subunit in the laryngeal and hypopharyngeal squamous cell carcinomas and its relationship with tumor angiogenesis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the expression of integrin alpha-v subunit in laryngeal and hypopharyngeal squamous cell carcinomas (LHSCC) and to correlate the expression ratio with clinic and pathologic features of LHSCC, meanwhile, to investigate the relationship between the expression of integrin alpha-v subunit and tumor angiogenesis.</p><p><b>METHODS</b>A tissue microarray of LHSCC was designed and made. Using this microarray, the expression of integrin alpha-v subunit in LHSCC was studied by immunohistochemistry, and the expression disparity in different clinic and pathologic staging of LHSCC was analyzed. The immunohistochemical staining of CD105 was done in the same microarray, the intratumor microvessel density (IMVD) was calculated by CD105 staining. The relationship between integrin alpha-v subunit expression and the IMVD was analyzed.</p><p><b>RESULTS</b>In primary cancer tissue, the expression ratio of integrin alpha-v subunit was 68.0% (51/75), significantly higher than normal tissue beside cancer (10.3%, 3/29, chi2 = 28.68, P < 0.001); the expression ratio of integrin alpha-v subunit in lymph node metastatic carcinoma was 100.00% (20/20), significantly higher than normal tissue (chi2 = 38.77, P < 0.001) and primary cancer tissue (chi2 = 12.69, P < 0.05); in group with lymph node metastasis, the expression ratio of integrin alpha-v subunit was significantly higher than group without lymph node metastasis (chi2 = 10.87, P < 0.001); the IMVD of the group with integrin alpha-v subunit positive expression was significantly higher than the group with integrin alpha-v subunit negative expression (P < 0.001).</p><p><b>CONCLUSIONS</b>There was significant relationship between integrin alpha-v subunit expression and lymphatic metastasis of LHSCC. Overexpression of the integrin alpha-v subunit may have contributed to the tumor angiogenesis and lead to lymphatic metastasis. Integrin alpha-v subunit may become a novel lymphatic metastasis marker of LHSCC.</p>

Epidemiological study on traffic accident in Shanghai from 2000 to 2002 / 中华流行病学杂志

<p><b>OBJECTIVE</b>Data on traffic accident from year 2000 to 2002 were collected and testified. Epidemiological study was carried out to find the main risk factors of traffic accident.</p><p><b>METHODS</b>The spatial distribution was conducted by means of Geographic Information System (GIS) and were marked on Shanghai digitalized map with different layers by different colors.</p><p><b>RESULTS</b>Results showed that during 2000, 2001 and 2002, 69,669 , 68,894, and 47,088 traffic accident episodes occurred in Shanghai, resulting in 1747, 1724, 1557 deaths respectively with direct economic lost: 2.1, 2.4, 3.0 billion RMB. The main risk factors causing traffic accident deaths would include drinking alcohol before driving, fatigue and speeding. The leading causes of death were head injury and complex injury of body. GIS showed that there was a homocentric circle with more traffic accidents in downtown city, but more deaths in the urban city. Disease burden caused by traffic accident was very heavy.</p><p><b>CONCLUSION</b>In Shanghai, traffic accident has great impact on social and economic issues thus should be controlled effectively. Focus should be layed on control of traffic accident in downtown area and to decrease the number of deaths related to traffic accident in the urban area.</p>