The application of the simultaneous modulated accelerated radiotherapy in the treatment of suspected positive lymph nodes in head and neck / 中国医师进修杂志

Objective:To explore the clinical effect and application value of simultaneous modulated accelerated radiotherapy (SMART) in the suspicious positive lymph nodes of head and neck.Methods:From January 2017 to February 2019, 60 patients with suspected positive lymph nodes in the head and neck in the Hanzhong Central Hospital of Shaanxi Province were divided into experimental group and control group according to different treatment plans, and 30 patients in each group were included. In the experimental group, 63.36 to 66.66 Gy patients were treated with SMART, while in the control group, 54.12 to 60.06 Gy patients were treated with conventional neck prophylactic radiation. In order to evaluate the feasibility of the method, the change of the short diameter of the largest cross section of the suspicious positive lymph nodes in the two groups were observed, and the adverse reactions in the treatment of the two groups were analyzed.Results:There was no significant difference between the two groups before treatment ( P>0.05). After treatment, the size of short diameter of lymph nodes in the two groups was smaller than that before treatment. The maximum short diameter of the largest cross section of lymph nodes in the experimental group was smaller than that before treatment: (0.43 ± 0.07) cm vs. (0.72 ± 0.10) cm, and the difference was statistically significant ( P<0.05). In the control group, the maximum short diameter of the largest cross section of lymph node decreased after treatment, and the difference was not statistically significant ( P>0.05). After treatment, the reduction of the short diameter in the experimental group was more obvious than that in the control group. The maximum short diameter of the largest cross section between the two groups: (0.43±0.07) cm vs. (0.66±0.08)cm was statistically significant ( t = 11.523, P<0.05). Before treatment, hemoglobin (HGB) levels of the two groups were in the normal physiological range, and there was no significant difference between the two groups ( P>0.05); the white blood cell (WBC) levels of the two groups at different time after treatment were compared: in the first week (7.83 ± 2.53) × 10 9/L vs. (8.26 ± 3.16) × 10 9/L, in the third week (7.14 ± 3.65) × 10 9/L vs. (7.08 ± 2.53) × 10 9/L, in the fifth week (5.47 ± 2.81) × 10 9/L vs. (6.41 ± 2.57) × 10 9/L, and in the seventh week (4.36 ± 2.59) × 10 9/L vs. (4.98 ± 1.64) × 10 9/L, and there were statistical differences ( P<0.05), which indicated that the WBC index levels of the two groups were gradually decreased during the treatment, and the decreased degree of the experimental group was higher than that of the control group. The levels of HGB and PLT were maintained in the normal physiological range before and after treatment, and there was no significant difference between the two groups ( P>0.05). The main complications in the treatment of the experimental group were xerostomia and stomatitis. The adverse reactions in the control group were pain in the target area of radiotherapy. There was no significant difference between the two groups ( P>0.05). Conclusions:The application of IMRT is an effective method for the treatment of occult lymph node metastasis, and it is also a therapeutic diagnostic method, which can provide evidence for the study of the law of lymph node metastasis in the head and neck. The safety and tissue tolerance of IMRT in the treatment of suspicious positive lymph nodes in the head and neck are good, which can be used for the suspicious lymph nodes in the head and neck. The treatment of positive lymph nodes and the evaluation of patients′ prognosis provide an effective way of clinical treatment.

Analysis of 33 children with deep neck infection / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the effective treatment of deep neck infection in children.</p><p><b>METHODS</b>Thirty-three cases of deep neck infection treated from September 2005 to May 2015 were retrospectively reviewed. To observe the effect of antibiotics and surgical drainage.</p><p><b>RESULTS</b>All cases were cured, including one case who was complicated with carotid artery rupture and was timely cured by vascular interventional therapy, and the cure rate was 100%.</p><p><b>CONCLUSION</b>Combined application of broad-spectrum antibiotics and effective surgical drainage are key to treat deep neck infection in children. The emergence of repeated small amount of bleeding in the nose and throat in children is an indicator for big neck vessel rupture and interventional vascular therapy may be considered.</p>

The clinical analysis of thyriod carcinoma showing thymus-like differentiation / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical diagnosis, treatment and prognosis of carcinoma showing thymus-like differentiation (CASTLE) of thyroid, and to improve the understanding of CASTLE.@*METHOD@#In 6 patients with CASTLE, we performed region VI lymph node dissection, the lesion resection of thyroid lobe and isthmus. After the operation, except one case of 68 years old patient, the rest patients were treated with radiotherapy 60 Gy in anterior cervical region after third week of operation and 5 courses of chemotherapy with cisplatin, each interval of 2 weeks. Insist on the oral Euthyrox.@*RESULT@#All patients were alive without recurrence and metastasis.@*CONCLUSION@#The diagnosis of CASTLE depends on the histology and immunohistochemistry. Operation was the main treatment. CASTLE is a rare type of thyroid carcinoma with slow progress and good prognosis.

Homology analysis of Pseudomonas aeruginosa isolated from nasopharyn-geal carcinoma patients undergoing radiotherapy / 中国感染控制杂志

Objective To study the risk factors of Pseudomonas aeruginosa (PA)infection and homology of PA isolated from nasopharyngeal carcinoma patients undergoing radiotherapy,and prevent and control the spread of in-fection.Methods Bacteria isolated from clinical specimens were identified by BD Phoenix automated microbiology system. Gene homology were analyzed with randomly amplified polymorphic DNA (RAPD)technique.Results Forty-nine strains of PA were mainly isolated from 43 nasopharyngeal carcinoma patients,the major specimens were nasopharyngeal swab (46.94% ),sputum(32.65% ),and oral secretion (10.20% ).All these strains were amplified 46 electrophore-sis diagrams,and 19 genotypes were identified. The highly homologous genotypes of type H and J strains were mainly isolated from patients in the second section (57.14% ,4/7)and fourth section (60.00% ,3/5)of radiotherapy department respectively. Conclusion Localized epidemic of highly homologous PA exists in different sections of ward,transfer of patients between different sections is the risk factor for homology PA infection/colonization. Gen-otyping technique such as RAPD for analyzing the homology of pathogenic bacteria in healthcare-associated infection has important value in preventing and control Ling infection spread.

Analysis of hypopharyngeal squamous cell carcinoma of the selective neck lymph dissection of lymph nodes detected by quantitative correlation with prognosis / 中国医师进修杂志

Objective To explore the correlation between the patients with hypopharyngeal squamous cell carcinoma of the selective neck lymph dissection of lymph nodes detected quantity and prognosis.Methods Retrospective analysis of the clinical data of 96 cases underwent selective dissection of cervical lymph node in patients with squamous cell carcinoma of the hypopharynx.Results All patients with unilateral selective neck dissection of lymph nodes detected a number of 19.3 ± 11.0,the number of positive lymph nodes 0.8 ± 0.6.Preoperative radiotherapy patients (43 eases) was detected in lymph nodes and the number of positive lymph nodes was 13.8 ± 7.9 and 0.2 ± 0.2,without radiotherapy patients (53 cases) of lymph nodes detected number 23.2 ± 11.9 and 1.0 ± 0.2,the comparison between the two (P ＜ 0.01).According to the number of positive lymph nodes were divided into ≤ 15 group (42 cases) and ＞ 15 group (54 cases),＞ 15 group,the overall survival rate at 3 years and 3 years disease free survival rate and neck control rate was significandy higher than that of ≤ 15 group [70.4％(38/54) vs.38.1％(16/42),61.1％(33/54) vs.33.3％ (14/42),96.3％(52/54) vs.76.2％(32/42)] (P ＜ 0.01 or ＜ 0.05).Multivariate analysis showed that lymph nodes detected a number ＞ 15 was the survival rate of the independent risk factors for overall survival in patients with and without effect (P ＜ 0.05).Conclusion Selective neck dissection of lymph nodes detected number can be used to predict prognosis in patients with squamous cell carcinoma of the hypopharynx.

Expression of Survivin and Bcl-2 in sinonasal inverted papilloma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of Survivin and its relationship with the expression of Bcl-2 in sinonasal inverted papilloma (SNIP).@*METHOD@#Immunohistochemical method was used to determine the expression of Survivin and Bcl-2 in 30 cases of SNIP, 10 cases of sinonasal squamous cell carcinoma (SCC) and 10 cases of normal inferior concha tissues.@*RESULT@#Survivin was expressed in 22 of 30 (73.3%) cases of SNIP, 8 of 10 (80.0%) cases of SCC and not expressed in 10 (0%) cases of normal inferior concha tissues. Expression of Survivin was significantly higher in SNIP and SCC than in normal tissues. Bcl-2 was expressed in 9 of 10 (90.0%) cases of SCC and 2 of 10 (20.0%) cases of normal inferior concha tissues. Expression of Bcl-2 was significantly higher in SCC than in normal tissues. Bcl-2 was expressed in 14 of 30 (46.7%) cases of SNIP, higher than normal tissues. Expression of Bcl-2 was positively related to expression of Survivin.@*CONCLUSION@#Survivin may play an important role in the pathway of progression of SNIP and SCC. It may be identified as a new therapeutic target. Bcl-2 may play a synergic role with Survivin in progression of SNIP.

Expression of Survivin and Bcl-2 in sinonasal inverted papilloma / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the expression of Survivin and it's relationship with the expression of Bcl-2 in sinonasal inverted papilloma (SNIP).Method:Immunohistochemical method was used to determine the expression of Survivin and Bcl-2 in 30 cases of SNIP,10 cases of sinonasal squamous cell carcinoma(SCC) and 10 cases of normal inferior concha tissues.Result:Survivin was expressed in 22 of 30(73.3%)cases of SNIP,8 of 10(80.0%)cases of SCC and not expressed in 10(0%)cases of normal inferior concha tissues.Expression of Survivin was significantly higher in SNIP and SCC than in normal tissues.Bcl-2 was expressed in 9 of 10(90.0%)cases of SCC and 2 of 10(20.0%)cases of normal inferior concha tissues.Expression of Bcl-2 was significantly higher in SCC than in normal tissues.Bcl-2 was expressed in 14 of 30(46.7%)cases of SNIP,higher than normal tissues.Expression of Bcl-2 was positively related to expression of Survivin.Conclusion:Survivin may play an important role in the pathway of progression of SNIP and SCC.It may be identified as a new therapeutic target.Bcl-2 may play a synergic role with Survivin in progression of SNIP.