Anesthesia for tracheobronchial foreign bodies removal via self-retaining laryngoscopy and Hopkins telescopy in children.

This study attempted to explore suitable anesthetic methods used for removal of tracheobronchial foreign body (FB) via self-retaining laryngoscopy and Hopkins telescopy in children. 92 cases had undergone FB removal via self-retaining laryngoscopy and Hopkins telescopy or rigid bronchoscopy in our hospital since 2006, of which 56 cases were under intravenous anesthesia and endotracheal intubation with muscle relaxation (IAEI with MR), and the other 36 cases were under intravenous anesthesia with spontaneous breathing (IASB). Operative parameters and intraoperative vital signs were analyzed. Tracheobronchial foreign body was successfully removed in 87 cases, and not found in the other 5 cases. SpO(2) was below 90% transiently in 41 cases, 29 cases of which were under IAEI with MR and 12 cases were under IASB. Laryngospasm and choke were found in 12 cases under IASB. Vital signs including P(ET)CO(2) and heart rate were stable in all the cases. The mean surgical time, anaesthetic induction and recovery time of IAEI with MR via self-retaining laryngoscopy group were (5.69 ± 3.43) min, (9.68 ± 1.66) min and (26.13 ± 6.94) min, IASB via self-retaining laryngoscopy group were (21.35 ± 17.25) min, (13.71 ± 3.79) min and (24.64 ± 5.44) min, IAEI with MR via rigid bronchoscopy group were (10.20 ± 5.01) min, (10.31 ± 3.56) min and (25.13 ± 6.21) min, and IASB via rigid bronchoscopy group were (25.35 ± 13.25) min, (14.71 ± 3.61) min and (26.22 ± 5.65) min. It's a new and wonderful surgical procedure that combining self-retaining laryngoscopy and Hopkins telescopy for removal of tracheobronchial foreign body. IAEI with MR is suitable for bronchial FBA cases via them, while IASB is better for tracheal FBA or complicated cases.

Removal of tracheobronchial foreign bodies via suspension laryngoscope and Hopkins telescope in infants.

OBJECTIVES: Tracheobronchial foreign body aspiration is a life-threatening accident in infants, and is still a formidable clinical emergency to both otorhinolaryngologists and anesthesiologists. In this study, we attempted to assess the safety and ease of tracheobronchial foreign body removal in infants via suspension laryngoscopy and Hopkins telescopy under general anesthesia with endotracheal intubation. METHODS: The retrospective clinical study from 2006 to 2010 included 50 infants with foreign body aspiration, of whom 35 underwent suspension laryngoscopy and Hopkins telescopy and the other 15 underwent rigid bronchoscopy. All of the procedures were under general anesthesia with endotracheal intubation. RESULTS: All of the patients underwent temporary extubation. The foreign body was successfully removed in 46 cases and was not found in the other 4 cases. The mean operation time in the rigid bronchoscopy group was 13.20+/-9.01 minutes, and that in the Hopkins telescopy group was 5.79+/-3.54 minutes. The oxygen saturation level was below 90% in 17 cases, of which 7 were in the rigid bronchoscopy group and 10 were in the Hopkins telescopy group. The vital signs, including the partial pressure of carbon dioxide in expiratory gas and the heart rate, were stable in all cases. CONCLUSIONS: Foreign body removal in infants via suspension laryngoscopy and Hopkins telescopy under general anesthesia with endotracheal intubation should be promoted, since it is relatively safe and easy for both anesthesiologists and otorhinolaryngologists to perform and has a remarkable success rate.

Potential Role of MicroRNAs in the Regulation of Antiviral Responses to Influenza Infection.

Influenza is a major health burden worldwide and is caused by influenza viruses that are enveloped and negative stranded RNA viruses. Little progress has been achieved in targeted intervention, either at a population level or at an individual level (to treat the cause), due to the toxicity of drugs and ineffective vaccines against influenza viruses. MicroRNAs (miRNAs) are small non-coding RNAs that play critical roles in gene expression, cell differentiation, and tissue development and have been shown to silence viral replication in a sequence-specific manner. Investigation of these small endogenous nucleotides may lead to new therapeutics against influenza virus infection. Here, we describe our current understanding of the role of miRNAs in host defense response against influenza virus, as well as their potential and limitation as new therapeutic approaches.

Evaluation of an Automated Falls Detection Device in Nursing Home Residents.

OBJECTIVES: To determine the concordance between falls recorded using an investigational fall detection device and falls reported by nursing staff in a nursing home. DESIGN: Six-month prospective study. SETTING: Hebrew SeniorLife nursing home units in Boston, Massachusetts. PARTICIPANTS: Nursing home residents with a documented history of at least one fall within 12 months before consent (N = 62, mean age 86.2 ± 8.1, 66% female). INTERVENTION: Subjects continuously wore an automated falls detection device on a pendant around their neck. The device contained triaxial accelerometers set to detect a rapid change in position that was interpreted as a fall. MEASUREMENTS: Healthcare staff reported daily falls, defined as unexpected events in which residents were found on the floor, and the number of these falls was compared with the number of falls recorded according to the device. RESULTS: Seven of 37 residents whom nursing staff found on the floor had a fall recorded according to the device (19%). The device did not identify any of the clinical fall events in 23 of the 37 fallers (62%). The device detected 17 of 89 total falls that nursing staff recorded (sensitivity 19%) within an 8-hour time window. Of 128 fall events that the device recorded, 17 were concordant with nursing reports (13%) within an 8-hour time window, and 111 (87%) were false positives. CONCLUSION: There is poor concordance between falls recorded using the investigational fall detection device and falls to the floor that nursing home staff report.

RNA-binding motif protein 5 inhibits the proliferation of cigarette smoke-transformed BEAS-2B cells through cell cycle arrest and apoptosis.

Cigarette smoking has been shown to be the most significant risk factor for lung cancer. Recent studies have also indicated that RNA-binding motif protein 5 (RBM5) can modulate apoptosis and suppress tumor growth. The present study focused on the role of RBM5 in the regulation of cigarette smoke extract (CSE)-induced transformation of bronchial epithelial cells into the cancerous phenotype and its mechanism of action. Herein, we exposed normal BEAS-2B cells for 8 days to varying concentrations of CSE or dimethylsulfoxide (DMSO), followed by a recovery period of 2 weeks. Next, the RBM5 protein was overexpressed in these transformed BEAS-2B cells though lentiviral infection. Later, the morphological changes, cell proliferation, cell cycle, apoptosis, invasion and migration were assessed. In addition, we analyzed the role of RBM5 in xenograft growth. The expression of RBM5 along with the genes related to cell cycle regulation, apoptosis and invasion were also examined. Finally, our results revealed that BEAS-2B cells exposed to 100 µg/ml CSE acquired phenotypic changes and formed tumors in nude mice, indicative of their cancerous transformation and had reduced RBM5 expression. Subsequent overexpression of RBM5 in these cells significantly inhibited their proliferation, induced G1/S arrest, triggered apoptosis and inhibited their invasion and migration, including xenograft growth. Thus, we established an in vitro model of CSE-induced cancerous transformation and concluded that RBM5 overexpression inhibited the growth of these transformed cells through cell cycle arrest and induction of apoptosis. Therefore, our study suggests the importance of RBM5 in the pathogenesis of smoking-related cancer.

Schisandrin B inhibits the proliferation of human lung adenocarcinoma A549 cells by inducing cycle arrest and apoptosis.

Lung cancer is the leading cause of cancer death in the world. Schizandrin B (Sch B) is one of the main dibenzocyclooctadiene lignans present in the fruit of Schisandra chinensis (Schisandraceae). Sch B has multiple functions against cancer. The aim of this study was to determine the effect of Sch B on the proliferation, cell cycling, apoptosis and invasion of lung adenocarcinoma A549 cells by MTT, flow cytometry, wound healing and transwell invasion assays. Treatment with Sch B inhibited the proliferation of A549 cells in a dose-dependent manner. Sch B induced cell cycle arrest at G0/G1 phase by down-regulating the expression of cyclin D1, cyclin-dependent kinase (CDK)4, and CDK6, but up-regulating p53 and p21 expression in A549 cells. Furthermore, Sch B triggered A549 cell apoptosis by increasing Bax, cleaved caspase-3, 9, Cyto C, but decreasing Bcl-2 and PCNA expression. In addition, Sch B inhibited the invasion and migration of A549 cells by down-regulating the expressions of HIF-1, VEGF, MMP-9 and MMP-2. Therefore, Sch B has potent anti-tumor activity and may be a promising traditional Chinese medicine for human lung carcinoma.

RNA-binding motif protein 5 negatively regulates the activity of Wnt/ß-catenin signaling in cigarette smoke-induced alveolar epithelial injury.

Cigarette smoking is closely associated with various respiratory diseases. Oxidants and carcinogens in cigarettes are reported to induce various airway epithelial injuries. However, the underlying mechanisms remain unclear. The aims of the present study were to determine the involvement of RNA-binding motif protein 5 (RBM5) and Wnt/ß-catenin signaling in cigarette smoke-induced alveolar epithelial injury, as well as the interaction between both. A549 cells were treated with cigarette smoke extract (CSE). The MTT assay was used to assess the effects of CSE on cell viability. The levels of RBM5 and Wnt/ß-catenin/GSK3ß were detected by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and western blot analysis. A luciferase assay was used to assess the activity of ß-catenin/T-cell factor (TCF) signaling. The results revealed that CSE inhibited A549 cell viability in both a dose- and time-dependent manner. Cytosolic and nuclear ß-catenin levels were significantly increased following CSE treatment, compared with those in the control cells (P<0.05). The luciferase activity in CSE-exposed cells transfected with the TCF luciferase reporter wild-type plasmid (pGL3-OT) was significantly greater than that in cells without CSE exposure (33,167±3,085 vs. 19,978±1,916, respectively, P<0.05). Both the mRNA and protein levels of RBM5 in the CSE-treated cells were significantly reduced compared to the levels in the controls (all P<0.05). The overexpression of RBM5 inhibited Wnt/ß-catenin signaling in the A549 cells, while silencing of RBM5 enhanced Wnt/ß-catenin signaling. The ß-catenin/TCF signaling inhibitor ICG-001 had no apparent effect on the RBM5 levels. Downregulation of RBM5 and activation of Wnt/ß-catenin signaling are involved in CSE-induced alveolar epithelial injury. RBM5 acts as an upstream molecule that negatively regulates the activity of Wnt/ß-catenin signaling.

Supracricoid partial laryngectomy with cricothyroidopexy: a treatment for anterior vocal commissure laryngeal squamous carcinoma.

BACKGROUND: The clinical efficiency and functional outcomes of supracricoid partial laryngectomy (SCPL) with cricothyroidopexy (CTP) were compared with those of the traditional SCPL with cricohyoidoepiglottopexy (CHEP) in treating laryngeal squamous carcinoma involving anterior vocal commissure (AVC). METHODS: From January 2000 to June 2009, 50 patients diagnosed with early- or intermediate-stage (T1b-T3 classification) glottic cancer involving AVC were treated with SCPL-CHEP or SCPL-CTP. Postoperative complications, local recurrence, survival rate, and speech performance were compared between these 2 surgical procedures. RESULTS: Patients undergoing SCPL-CHEP or SCPL-CTP manifested similar levels of postoperative complications, tumor recurrence, and survival rates. However, the SCPL-CTP group showed significantly lower Voice Handicap Index (VHI) scores, higher maximum phonation time, and improved glottic reconstruction and closure than the SCPL-CHEP group. CONCLUSION: The SCPL-CTP procedure better preserves postoperative speech performance than the SCPL-CHEP procedure, underscoring the moderate effectiveness of SCPL-CTP as a treatment for laryngeal squamous carcinoma involving AVC.

Middle frontal horizontal partial laryngectomy (MFHPL): a treatment for stage T1b squamous cell carcinoma of the glottic larynx involving anterior vocal commissure.

OBJECTIVE: The therapeutic effect of middle frontal horizontal partial laryngectomy (MFHPL) in treating stage T1b squamous cell carcinoma of the glottic larynx involving anterior vocal commissure (AVC) was compared with that of the anterior frontolateral vertical partial laryngectomy (AFVPL). The feasibility and practical significance of MFHPL in clinical application was discussed in the present study. METHODS: From January 1996 to January 2010, a total of 65 patients diagnosed with stage T1bN0M0 glottic laryngeal cancer were treated with MFHPL or AFVPL. The postoperative complications, glottic reconstruction, recurrence rate, voice quality and survival rates were evaluated and compared between two treatments. RESULTS: AFVPL and MFHPL were performed in 34 and 31 patients, respectively. Flexible fiberoptic laryngoscopy revealed that in the MFHPL-treated patients the reconstructed glottis was spacious and symmetric. In contrast, AFVPL treatment resulted in irregular glottic area with poor symmetry and tubular glottis. The incidence of postoperative laryngeal stenosis significantly differed between the MFHPL- and AFVPL-treated groups (P = 0.025). No significant difference was detected in the 3- and 5-year overall- or tumor-free survival rates between two treatments. The Voice Handicap Index (VHI) and maximum phonation time (MPT) after surgery were 51.0±12.99 and 12.42±3.44 sec in the AFVPL-treated group; while in the MFHPL-treated patients they were 31.81±7.48 and 7.65±1.98 sec, respectively. Both differences in VHI (P = 0.012) and MPT (P = 0.024) were significant between two treatments. CONCLUSIONS: MFHPL was comparable to AFVPL with respect to postoperative complications, recurrence rate and survival rates, but possessed advantages over AFVPL in terms of the incidence of laryngeal stenosis and voice quality. Our study indicated that MFHPL has a potential value in clinical practice of treating stage T1b squamous cell carcinoma of the glottic larynx involving AVC.

[Effect of RNA interference mediated gene silencing of DJ-1 on proliferation of laryngeal carcinoma cell line Hep-2].

OBJECTIVE: To assess the effect of small interfering RNA (siRNA)-mediated gene silencing of DJ-1 on the proliferation of human laryngeal carcinoma cell line Hep-2. METHODS: Three siRNA sequences specific to DJ-1 gene were synthesized according to GenBank. Human laryngeal carcinoma cell line Hep-2 was cultured and divided into 4 groups: non-specific group (siRNA control) and 3 RNAi groups, transfected with specific DJ-1 siRNA (siRNA1, siRNA2, siRNA3). The mRNA and protein levels of DJ-1 were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot respectively. Cell apoptosis were analyzed by flow cytometry. The proliferation of Hep-2 cells was assessed by MTT assay. RESULTS: DJ-1 siRNA down-regulated the mRNA and protein levels of DJ-1 in Hep-2 cells. After transfection, the expression of DJ-1 mRNA and protein levels in Hep-2 cells of the DJ-1 siRNA1 group were significantly lower than those of non-specific siRNA control group. MTT assay showed that DJ-1 siRNA1 group inhibited proliferation of Hep-2 cells. Flow cytometry showed that apoptosis rate of the DJ-1 siRNA1 group (15.7%) was significantly higher than that of non-specific siRNA control group (4.5%) or untransfected group (3.5%), t = 4.736, P < 0.01. CONCLUSIONS: Specific siRNA targeting DJ-1 can effectively inhibit DJ-1 expression, resulting in the reduced proliferation and the enhanced apoptosis in Hep-2 cells.

[Effect of chemotherapy with cisplatin and rapamycin against Hep-2 cells in vitro].

OBJECTIVE: To evaluate the effect of combined use of rapamycin and cisplatin in the chemotherapy of Hep-2 cells in vitro. METHODS: The inhibitory effects of rapamycin and cisplatin, used alone or in combination, on the proliferation of Hep-2 cells were measured with MTT assay and median-effect plot analysis. The cell cycle changes after the treatment were analyzed using flow cytometry and Hoechst 33258 immunofluorescence staining. RESULTS: The IC50 of rapamycin and cisplatin for inducing growth arrest of Hep-2 cells was 11.03 nmol/L and 8.81 micromol/L, respectively. Rapamycin alone caused cell cycle arrest of the Hep-2 cells in G1 phase. Rapamycin and cisplatin showed synergistic effects in the chemotherapy of Hep-2 cells (q > 1.15, King's Formula), causing significantly increased apoptosis ratio and growth inhibition rate of Hep-2 cells. CONCLUSION: Combined use of rapamycin and cisplatin significantly improves the chemotherapeutic effect against Hep-2 cells.

[Transient receptor potential melastatin 7 channel protein in human head and neck carcinoma cells and role in cell proliferation].

OBJECTIVE: To detect the presence of ion channel protein and its role in cell growth and proliferation in human head and neck squamous carcinoma cells (SCC). METHODS: Human head and neck squamous carcinoma SCC-25 cell line was tested with transient receptor potential melastatin 7 (TRPM7) antibody using the method of immunocytochemistry. The role of TRPM7 in cell growth and proliferation was evaluated through its blockade by ion channel blockers and specific siRNA using lactate dehydrogenase (LDH) assay technique. RESULTS: Clear immunoreactivity against TRPM7 was detected in almost all SCC-25 cells tested, whereas no immunoreactivity was observed in negative control. The inhibitory effect of Gd3+, a non-specific ion channel blocker, on cell growth and proliferation was potent. Addition of 10 micromol/L Gd3+ (n = 16) and 100 micromol/L Gd3+ (n = 16) in the culture medium significantly inhibited the growth of SCC-25 cells, as compared with control cells growing in normal medium (t was 4.1414 and 6.2661, P was 0.0256 and 0.0082 respectively). However, the effect of 2-APB was striking. Cell proliferation was almost totally suppressed in the presence of 100 micromol/L 2-APB (t = 13.4493, P = 0.0008, n = 16) compared with cells growing in normal medium. Suppression of TRPM7 expression by siRNA also significantly inhibited the growth and proliferation of these cells (t = 4.3446, P = 0.0002, n = 32, compared with nontransfected cells),whereas cells transfected with negative control siRNA showed no difference in cell proliferation compared with nontransfected cells. CONCLUSIONS: All of those results strongly suggest the existence of TRPM7 channel in human head and neck squamous carcinoma cells. Ion channel blockers serve as a potent inhibitor of SCC-25 cell proliferation. The striking inhibitory effect of 2-APB on cell growth and proliferation may promise clinical workers an inspiring remedy for fighting against carcinoma.

[Postoperative diabetes insipidus after transsphenoidal resection of pituitary tumor].

OBJECTIVE: To study the prevention and treatment of postoperative diabetes insipidus after removal of pituitary tumor through transsphenoidal operation, to decrease the incidence of postoperative complications and improve the treatment of pituitary tumor. METHODS: The clinical data of 86 cases of transsphenoidal resection of pituitary tumor in recent 8 years were retrospectively reviewed, including 35 endoscopic operation and 51 microscopic operation. The incidence, prevention and treatment of diabetes insipidus were statistically analysed. RESULTS: There were 18 cases of postoperative diabetes insipidus in total of 86 operations, including 15 acute cases, 3 delayed cases. Twelve were temporary , which recovered within 1 week. After prompt treatment, 14 recovered within 1 week, 4 recovered within 2 weeks. No persistent diabetes insipidus was found. CONCLUSIONS: The key points to prevent postoperative diabetes insipidus lay in the improvement of operative skills, careful protection during operation and avoidance of unnecessary injury. In case of diabetes insipidus occurred, rational use of antidiuretics and correction of electrolyte balance were effective in the treatment of postoperative diabetes insipidus.

[Analysis of the risk factors causing tracheal stenosis after tracheotomy for mechanical ventilation in 560 patients].

OBJECTIVE: To investigate the risk factors causing tracheal stenosis after tracheotomy for mechanical ventilation. METHODS: A retrospective study was carried out to review the clinical data of 560 patients who had been tracheotomy for mechanical ventilation in the First Affiliated Hospital of Sun Yat-sen University from 1990 to 2006. The clinical relevant factors causing tracheal stenosis included age, sex, preoperative intubation, preoperative intubation time, postoperative mechanical ventilation duration, airway infection, multiple changes of intubation tube, cricothyroidotomy, previous tracheotomy, gastroesophageal reflux, diabetes, etc. Multivariate stepwise logistic regression model was used for the analysis. RESULTS: Fifty-four cases (9.6%) presented tracheal stenosis in 560 patients after tracheotomy. With multivariate analysis, it was confirmed that the following variable correlated to tracheal stenosis. i.e, preoperative intubation time (chi2 = 4.323, P = 0.038), postoperative mechanical ventilation duration (chi2 = 14.062, P = 0.000), airway infection (chi2 = 8.604, P = 0.004), diabetes (chi2 = 5.237, P = 0.014). The effect degree of these risk factors was as below, postoperative mechanical ventilation duration (OR = 10.818), airway infection (OR = 6.349), diabetes (OR = 3.019), intubation time preoperative (OR = 2.156). CONCLUSIONS: Among patients who received tracheotomy for mechanical ventilation, the clinical relevant factors causing tracheal stenosis were various. Statistical analysis showed that preoperative intubation time, postoperative mechanical ventilation duration, diabetes, airway infection were main risky factors which may cause tracheal stenosis.

[Analysis of relevant factors causing laryngeal stenosis after partial laryngectomy].

OBJECTIVE: To investigate the clinical relevant factors causing laryngeal stenosis after partial laryngectomy. METHODS: A retrospective study was carried out to review the history clinical data from 138 patients of partial laryngectomy in the First Affiliated Hospital of Sun Yat-Sen University between January 1994 to October 2004. The clinical relevant factors causing laryngeal stenosis were included as follows: age, sex, TNM stage, tumor site, extension of thyroid cartilage defect, extension of larynx parenchyma defect, reconstruction method, laryngeal dilator, duration of using antibiotics, postoperative radiotherapy, lung infection, gastroesophageal reflux, diabetes. Multivariate stepwise logistic regression model was used for the analysis. RESULTS: Of 138 cases after partial laryngectomy, stenosis developed in 25 cases. The occurrence rate was 18.1%. In multivariate analysis, it was confirmed that the following factors correlated to laryngeal stenosis, i. e, extension of thyroid cartilage defect (chi2 = 4.323, P = 0.038), postoperative radiotherapy (chi2 = 6.002, P = 0.014), lung infection (chi2 = 4.220, P = 0.040), and gastroesophageal reflux (chi2 = 5.614, P = 0.018). CONCLUSIONS: The clinical relevant factors causing laryngeal stenosis after partial laryngectomy were multiple. Statistical analysis showed that extension of thyroid cartilage defect, postoperative radiotherapy, lung infection and gastroesophageal reflux were the risk factors which may cause laryngeal stenosis.

[Inhibition of hydroxycamptothecin on laryngeal squamous carcinoma cell line].

BACKGROUND & OBJECTIVE: Hydroxycamptothecin(HCPT) has wide antitumor spectrum and high inhibition rate of tumor cell line and xenografts. Recently,no studies on the treatment of laryngeal squamous carcinoma with HCPT were reported. Hence,this study were designed to investigate the inhibition of O-HCPT [ring-opened form(O-HCPT)] and C-HCPT[ring-closed form(C-HCPT)] on laryngeal squamous carcinoma cell line(Hep-2 cell line)and its mechanism. METHODS: The cytotoxicity of O-HCPT and C-HCPT on Hep-2 cells was measured by MTT assay and cell cycle was detected using flow cytometry (FCM). The growth state of Hep-2 cell xenografts treated with 10 mg/kg HCPT (O-HCPT or C-HCPT) was observed. The doubling time and the tumor inhibition rate were calculated. RESULTS: The growth inhibition of O-HCPT and C-HCPT on Hep-2 cell depended on concentration. The IC(50) were 0.69 and 0.48 micromol/L, respectively. After treated with high concentration of HCPT, the cell cycle was arrested in S phase and then apoptosis were obviously induced. At the low concentration of HCPT, the cell cycle was slightly arrested in G(2)+M phase. Compared with control group, the xenografts of O-HCPT (10 mg/kg) treated group grew slowly and tumor doubling time prolonged. There was significant difference in the tumor volumes of two HCPT-treated group (P< 0.001) and the tumor inhibition rate was 77.0%. All mice in C-HCPT (10 mg/kg) treated group died of toxicity. CONCLUSION: The result showed that O-HCPT and C-HCPT had obvious cytotoxicity to laryngeal squamous carcinoma cells which mechanism was HCPT arrest cell cycle in S phase and induce cell apoptosis. O-HCPT has slight toxicity effect and can be used as chemotherapeutic agent for laryngeal squamous carcinoma, but C-HCPT had strong toxicity.

[Meta analysis of relationship between laryngeal tumor of chinese and human papillomavirus infection].

BACKGROUND & OBJECTIVE: Researches showed that the infection of human papillomavirus (HPV) was closely related to laryngeal tumor, but those results existed great differences because of different research methods. In this study Fisher's and Meta analysis were used to synthetically evaluate relationship between laryngeal benign and malignant tumors of Chinese and infection of different types of HPV. METHODS: A total of 123 references about relationship between laryngeal benign and malignant tumors of Chinese and infection of different types of HPV were collected from CBMdisc (Chinese Biomedical Literature Analysis and Retrieval System for Compact Disc). There were 11 references accorded with research criteria which were case-control study, and had detected HPV16 or HPV6/11 by polymerase chain reaction (PCR). Fisher and Meta analysis were used to quantitatively and qualitatively analyze these references synthetically. RESULTS: Mean detection rates of HPV16 in normal laryngeal tissue, laryngeal carcinoma (LC), laryngeal papilloma(LPa), laryngeal polyp (LPo) from all references were 10.8%,35.2%,27.5%,5.0%, respectively; and those of HPV6/11 were 8.7%, 18.6%, 61.6%, 21.9%, respectively. The infection of HPV16 in LC were significantly higher than those in LPa, and LPo (P< 0.005); the combined odds ratio (ORc) for HPV16 infection in LC was 2.8 (1.7-4.7) times that in LPa, and 12.7 (4.2-38.8) times that in LPo; mean positive rate of HPV16 in LC was 22.0% (12.2%-31.8%) higher than that in LPa, and 39.0% (19.4%-58.6%) higher than that in Lpo. The infection of HPV6/11 in LPa was significantly higher than that in LC (P< 0.005); OR(c) for HPV16 infection in LPa was 16.4 (5.6-48.1) times that LC; mean positive rate of HPV16 in LPa was 56.0% (34.4%-75.6%) higher than that in LC. There was no significant difference of HPV6/11 infection between LC and LPo (P >0.05). CONCLUSION: The infection of HPV16 may enhance risk of development of laryngeal carcinoma; and the infection of HPV6/11 may enhance risk of development of laryngeal papilloma.

[Oropharyngeal measure in patients with obstructive sleep apnea-hypopnea syndrome before and after uvulopalatopharyngoplasty].

OBJECTIVE: To explore the relationship between the extent of enlarged oropharynx and efficiency through measuring the anterior-posterior and transverse diameter of oropharynx of patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) before and after uvulopalatopharyngoplasty (UPPP). METHODS: Thirty eight patients with OSAHS were studied. The following indexes were measured before and after UPPP: width of uvula base, length of uvula, distance between uvula and posterior pharyngeal wall (DBUP), distance between anterior pillar (DBPP), apnea-hypopnea index (AHI), body mass index (BMI) and SaO2. RESULTS: The preoperative DBAP and DBPP were significantly less than those of normal adults (P < 0.05). DBUP, length of uvula and width of uvula base has no significant difference between preoperative patients and normal adults (P > 0.05). There was no significance difference in DBAP. DBPP and DBUP between postoperative patients and normal adults (P > 0.05). The preoperative AHI, IBM, minimal SaO2, mean SaO2, DBUP, DBPP, DBAP, length of uvula and width of uvula base has no significant difference between good responders and nonresponders (P > 0.1). CONCLUSIONS: Transverse diameter of OSAHS patients is shorter than that of normal adults but anterior-posterior diameter of OSAHS patients has no difference compared with normal adults. Transverse diameter could be enlarged by UPPP. Not only anatomical abnormality but also other factors will contribute to the effect of UPPP.

[Investigation and analysis of quality of life for patients after laryngectomy].

OBJECTIVE: To institute and test the quality of life for laryngectomy, and evaluate the feasibility of above questionnaire in patients after laryngectomy. METHODS: A questionnaire of quality of life for laryngectomy was instituted. An investigation was conducted in patients treated by partial (36, Group A) or total (45, Group B) laryngectomy for laryngeal cancer with above questionnaire. The feasibility, reliability and validity of the questionnaire was evaluated, the quality of life and the influencing factors in laryngectomy were also analyzed. RESULTS: The questionnaire of quality of life for laryngectomy consists of 22 items, covering six aspects. The questionnaire has a comparatively good reliability, and the criterion-related validity and content validity of the questionnaire is valid. The correlation coefficient of split-half method and Cronback's alpha of questionnaire were 0.842 and 0.889 respectively. The composite quality of life scores of group A were significant higher than those of group B ( P < 0.001). The differences in physical function, laryngeal function, psychological state, the ability of living independently were statistically significant (P < 0.001; P < 0.001; P < 0.01; P < 0.05) as well. Seven factors including operative modality, tumor stage, postoperative complication, coexisted disease, family incomes, voicing modality and wearing tracheo-cannula were related to postlaryngectomy quality of life. CONCLUSIONS: The questionnaire of quality of life for laryngectomy has speciality in laryngectomy and a comparatively good reliability and validity, and it is suitable for quality of life research in patients after laryngectomy.