Free jejunal segment transplantation to reconstruct the esophageal defect caused by tumor resection and fol-low-up observation by endoscopy / 中华显微外科杂志

Objective To investigate the method and curative effect of the posterior cervical esophageal de-fect after the reconstruction of lower pharyngeal carcinoma by dissociation of the lower pharyngeal carcinoma. Meth-ods From August,2015 to June,2017, we used the jejunum segment. to reconstruct five patients' esophageal defect in the neck segment enlarged after the enlargement of the hypopharyngeal carcinoma. The length of the jejunum was 8.0 -15.0 cm, We used microvascular stapling to anastomosis vein in surgery. The morphological and functional changes of the graft tube were observed by endoscopic follow-up. Results All 5 patients were discharged from the hospital with an average of 12 days in hospital.The mean time of heat ischemia was 8 minutes,and the average oper-ation time was 5.2 hours. After endoscopic follow-up for 12 months, no stricture or anastomotic leakage occurred in the transplanted bowel, and the intestine moves downward autonomously, the morphological and functional remodeling of transplanted intestinal tract was observed. Conclusion Free jejunal reconstruction of hypopharyngeal carcinoma resection for cervical esophageal is a safe method with a good outcome in morphological and functional remodeling.It' s one of the ideal methods to reconstruct cervical esophageal defect.

Analysis of related factors in vocal cord adhesion after CO2 laser laryngeal surgery and prevention / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the related factors of vocal cord adhesion after CO2 laser assisted laryngeal surgery.METHODS Clinical data of 219 patients who received CO2 laser assisted laryngeal surgery in our department from October 2012 to December 2016 were analyzed retrospectively.Correlation analysis of the vocal cord adhesion with patient's gender, age, lesion nature, lesion location,type of operation,laser power, and postoperative granulation hyperplasia were carried out. RESULTS Of the 219 cases, vocal cord adhesion occurred in 31 cases, accounted for 14.16%. The vocal cord adhesion were associated with the lesion nature, lesion location, the laser power, postoperative granulation hyperplasia (P<0.05). CONCLUSION According to the related factors, the appropriate surgical procedure and cutting power, perioperative measures can help to reduce the occurrence of postoperative vocal cord adhesion.

Up-regulation of the CXCR4 expression by hypoxia in maxillary sinus carcinoma cells IMC3 / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of CXCR4 in maxillary sinus carcinoma cells IMC3 under hypoxia.@*METHOD@#IMC3 cells were cultured for 6 h, 12 h, 24 h and 48 h under normoxia and hypoxia. Real-Time PCR was applied to detect the expression of mRNA of CXCR4 and immunohistochemisrty was applied to investigate its protein level.@*RESULT@#CXCR4 mRNA level was about 0.035 under normal conditions, which was obviously upregulated by hypoxia. The mRNA levels after culturing under hypoxia for 6 h, 12 h, 24 h and 48 h were 0.283, 0.313, 0.426, 0.510 respectively. There was statistically significant difference between the mRNA levels of each two groups (P < 0.05, Mann-Whiney Test) with a time dependent course, except for the difference between the groups of 6 h and 12 h. Immunohistochemistry showed that there was almost negative staining for CXCR4 in the cell cultured in nomoxia, while stong positive staining of CXCR4 was observed in cells cultured in hypoxia . The positive staining was located mainly in the cell membrane and cytoplasm and little in the nucleus.@*CONCLUSION@#Hypoxia could induce expression of CXCR4 in IMC3 cells at both mRNA and ptrotein levels. The upregulation of CXCR4 by hypoxia showed an obvious time dependent course.

Obstructive sleep apnea hypopnea syndrome:risk factors for perioperative / 中华急诊医学杂志

Objective To analyze the emergency-event in patients with obstructive sleep apnea-hypopnea syndrome( OSAHS), and to discuss the risk factors and preliminary strategies for prevention of emergency-event. Method A total of 257 OSAHS patients in Zhejiang Provincial Peoples Hospital, were enrolled from January 2000 to December 2009 for the retrospective study. Demographics of patients include age, sex,height, weight, related diseases, AHI and LSaO2 before operation , the way of anesthesia and operation,when and how the emergency-events happened, the way to cure and the results. Risk facts of emergency-event were analyzed by using univariate analysis and multiple logistic regression analysis. Results Of the 257patients, the incidents of emergency-event was 7.3%. The independent risk factors of emergency-event were general anesthesia, multiple level surgery in one time, BMI and AHI. Performing CPAP treatment before operation had a beneficial effect to the avoidance of emergency-event. Conclusions Emergency-event are more common in severe OSAHS patients, especially when they were operated under general anesthesia and multiple level surgery in one time. Performing CPAP treatment before operation had a beneficial effect to the avoidance of emergency-event.

A study of intratumor microvessel density and lymph node micrometastases of pN0 supraglottic laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the correlation between intratumor microvessel density(IMVD) and lymph node micrometastases.@*METHOD@#IMVD and lymph node micrometastases were stained with CD105 and CK19 antibody by immunohistochemical method of SABC respectively.@*RESULT@#IMVD marked with CD105 antibody correlated with T stage and lymph node micrometastases (P < 0.01).@*CONCLUSION@#The result show that IMVD marked with CD105 antibody highly correlated with lymph node micrometastases. It could be a index to evaluate the prognosis of patients with pN0 supraglottic laryngeal squamous cell carcinoma.

A study of intratumor microvessel density and lymph node micrometastasesof pN0 supraglottic laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the correlation between intratumor microvessel density (IMVD) and lymph node micrometastases. Method: IMVD and lymph node micrometastases were stained with CD105 and CK19 antibody by immunohistochemical method of SABC respectively. Result:IMVD marked with CD105 antibody corre-lated with T stage and lymph node micrometastases(P<0.01). Conclusion: The result show that IMVD marked with CD105 antibody highly correlated with lymph node micrometastases. It could be a index to evaluate the prog-nosis of patients with pN_0 supraglottic laryngeal squamous cell carcinoma.

The significance of intraoperative frozen section for prognosis evaluation of laryngeal carcinoma in partial laryngectomy / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the frozen section and surgical margin predicting the prognosis of laryngeal carcinoma after partial laryngectomy and decides the circumscription of surgical margin because of the balance between the function of the larynx and the recurrence rate of cancer.METHODS 77 cases of laryngocarcinoma were reviewed in this retrospective study.All of the laryngocarcinoma patients were treated in our hospital during 1996.1～2001.12 frozen section, surgical margin, and pathological section were compared to the recurrence rate of cancer and the survival rate of patients.RESULTS To those Partial laryngectomy whose surgical margin are larger than 0.5 cm, whether carrying out the frozen section is not significant.But to those Partial laryngectomy whose surgical margin are smaller than 0.5 cm, we should carry out the surgical margin to decrease the positive rate of the pathological section.Recurrent rate of the negative group is lower than the positive group(P