Automated Monitoring System for Suspended Photocatalytic Batch Reactions Based on Online Circulatory Spectrophotometry.

Employing an automated monitoring system (AMS) for data acquisition offers benefits, such as reducing the workload, in the kinetic study of suspended photocatalytic batch reactions. However, the current methods in this field tend to narrowly focus on the substrate and often overlook the optical characteristics of both the mixture and solid particles. To address this limitation, in this study, we propose a novel AMS based on online circulatory spectrophotometry (OCS) and incorporate debubbling, aeration, and segmented flow (DAS), named DAS-OCS-AMS. Initially, a debubbler is introduced to mitigate the issue of signal noise caused by bubbles (SNB). Subsequently, an aerated and segmented device is developed to address the issue of particle deposition on the inner wall of the pipeline (PDP) and on the windows of the flow cell (PDW). The proposed DAS-OCS-AMS is applied to monitor the kinetics of the photocatalytic degradation of Acid Orange Ⅱ by TiO2 (P25), and its results are compared with those obtained using the traditional OCS-AMS. The comparative analysis indicates that the proposed DAS-OCS-AMS effectively mitigates the influence of SNB, PDP, and PDW, yielding precise results both for the mixture and solid particles. The DAS-OCS-AMS provides a highly flexible universal framework for online circulatory automated monitoring and a robust hardware foundation for subsequent data processing research.

XPA A23G polymorphism and susceptibility to cancer: a meta-analysis.

Xeroderma pigmentosum group A (XPA) participates in modulating recognition of DNA damage during the DNA nucleotide excision repair process. The XPA A23G polymorphism has been investigated in case-control studies to evaluate the cancer risk attributed to the variant, but the results were conflicting. To clarify the effect of XPA A23G polymorphism in cancer risk, we conducted a meta-analysis that included 30 published case-control studies. Overall, no significant association of XPA A23G variant with cancer susceptibility was observed for any genetic model. However, significant association was observed for colorectal cancer (GG vs. AA: OR = 1.68, 95% CI = 1.15-2.44; dominant genetic model GG + AG vs. AA: OR = 1.54, 95% CI = 1.08-1.17), for breast cancer an increased but non-significant risk was found (GG vs. AA: OR = 1.27, 95% CI = 0.98-1.66; dominant genetic model GG + AG vs. AA: OR = 1.27, 95% CI = 0.99-1.63), and for head and neck cancer an increased risk was observed in recessive model (OR = 1.19, 95% CI = 1.02-1.38), whereas for lung cancer a significant reduced risk was observed (GG vs. AA: OR = 0.77, 95% CI = 0.66­0.90; dominant genetic model GG + AG vs. AA: OR = 0.76, 95% CI = 0.66-0.87), it's noting that in Asian population the inverse association was more apparent. In addition, in Asian population for esophageal cancer a significant decreased risk was also found in dominant genetic model (OR = 0.55; 95% CI = 0.43-0.70) and for head and neck cancer an increased risk was observed in dominant genetic model (OR = 1.51, 95% CI = 1.03-2.23). The meta-analysis suggested that the XPA A23G G allele is a low-penetrant risk factor for cancer development.

Suppression of survivin expression by short hairpin RNA induces apoptosis in human laryngeal carcinoma cells.

PURPOSE: The aim of this study was to evaluate the suppression effect of survivin shRNA on the expression of the survivin gene in the human laryngeal cancer cell line Hep-2. PROCEDURES: 60 cases of laryngeal squamous-cell carcinoma (LSCC) and 10 cases of normal laryngeal mucosa were examined using immunohistochemistry to determine whether the expression of survivin correlated with tumorigenesis. Three plasmid vectors of short hairpin RNA (shRNA) specific for survivin were designed and generated. Western blot and real-time PCR analysis of survivin expression in Hep-2 cells was performed 48 h after transfection. The growth curve was used to determine the cell proliferation. Propidium iodide (PI) single staining was applied to detect the cell cycle. The apoptosis of the cells was analyzed by flow cytometry with the FITC-annexin-V/PI double staining and PI single staining. RESULTS: 68.33% (41 out of 60) of tumors were positive for survivin expression and significantly associated with lymph node metastasis and advanced stage. In contrast, no expression of survivin in normal mucosa was detected. Transfection of Hep-2 cells with survivin shRNA significantly inhibited survivin expression at both the mRNA and the protein level in Hep-2 cells. Downregulation of survivin resulted in increasing the apoptosis index, but the results showed no obvious influence on cell cycle. CONCLUSIONS: This study demonstrates that survivin shRNA effectively inhibits survivin gene expression in Hep-2 cells leading to growth suppression and apoptotic induction in Hep-2 cells.

Aberrant methylation and expression of DAPk1 in human hypopharyngeal squamous cell carcinoma.

CONCLUSION: These findings indicate that in hypopharyngeal squamous cell carcinoma (HSCC), hypermethylation and down-regulation of death-associated protein kinase-1 (DAPk1) are common events, which are associated with a poor prognosis. OBJECTIVES: This study aimed to investigate the methylation and expression of DAPk1, a tumor suppressor gene, in HSCC, and explore its clinical significance. METHODS: The tumor and adjacent non-tumor tissues were collected from 53 patients with HSCC. The methylation status of DAPk1 was detected by methylation-specific polymerase chain reaction (MSP), and expression of DAPk1 was determined with real-time reverse transcriptase polymerase chain reaction (RT-PCR), immunohistochemistry, and Western blot at mRNA or protein levels. Correlations between the findings and patients' clinicopathological parameters were further evaluated. RESULTS: The methylation ratio of DAPk1 in tumor tissues (60.38%) was significantly higher than that in the adjacent non-tumor tissues (26.42%) (p = 0.001), while DAPk1 expression in the tumors was down-regulated markedly (real-time RT-PCR, p = 0.002; immunohistochemistry, p = 0.006; Western blot, p < 0.001). DAPk1 methylation was negatively correlated with its mRNA expression (p = 0.002, r = -0.521). Both hypermethylation and down-regulation of DAPk1 were closely related to lymph node metastasis (p = 0.001 and 0.001, respectively), advanced TNM stage (p = 0.009 and 0.019, respectively), and low survival rates (p = 0.031 and 0.045, respectively).

Chloroquine-enhanced efficacy of cisplatin in the treatment of hypopharyngeal carcinoma in xenograft mice.

Hypopharyngeal squamous cell carcinoma (HSCC) has the worst prognosis among head and neck cancers. Cisplatin (DDP)-based chemotherapy is an important part of multimodal treatments. However, resistance to DDP severely impairs the effectiveness of chemotherapy for HSCC. Chloroquine (CQ) has been reported to enhance the effectiveness of chemotherapy and radiotherapy in liver, pancreas, breast, prostate and colon tumors, but it is unclear whether CQ could increase the efficacy of DDP for treating HSCC. We inoculated BALB/c nude mice with a subcutaneous injection of human hypopharyngeal FaDu cells to generate our animal model. Mice were randomly divided into 4 groups and treated with vehicle control, CQ (60 mg/kg/day), DDP (5 mg/kg/6 days), or a combination of DDP and CQ. Tumor growth and survival of the mice were monitored. We found that CQ inhibited autophagy and increased DDP-induced apoptosis in the xenograft mouse model. CQ enhanced the efficacy of DDP, resulting in decreased tumor growth and prolonged survival of the mice. To test whether blocking autophagy enhanced the efficacy of DDP, FaDu cells were infected with lentiviral shRNA to Beclin-1 and inoculated into the flanks of nude mice. Inhibition of autophagy markedly enhanced the DDP-induced antitumor effect. Our study suggests that the addition of CQ to DDP-based chemotherapy could be a potential therapeutic strategy for treating HSCC, and the inhibition of autophagy may contribute to chemotherapy sensitization in HSCC.

[Substitution of esophagus with stomach or colon without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preserved].

OBJECTIVE: To study the feasibility and effect of substituting esophagus with stomach or colon without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preserved. METHODS: Twenty-four patients with cervical esophageal carcinoma were retrospectively reviewed. The esophagus was resected and substituted with 19 gastric pull-up and 5 colon interposition. Nineteen patients received radiotherapy postoperatively (dose 50 - 70 Gy). RESULTS: Twenty two patients were follow up over 3 years. The 3- and 5-year survival rates for T2 were 3 and 1, for T3, T4 8 and 3, respectively. The laryngeal function preservation rate was 77% (17/24) and the decannulation rate was 75% (12/16). The complication rate was 29%. CONCLUSION: Surgical resection of cervical esophageal carcinoma with removal of the extraesophageal invaded tissues while preserving the laryngeal function is possible. The continuity of the esophagus is restored by stomach transposition and colon interposition. Combined with radiotherapy, the survival rate and life quality of the patient might be improved.

[Surgical treatment of advanced laryngeal cancer with preservation of laryngeal function].

OBJECTIVE: To explore the surgical methods for advanced laryngeal cancer and long term effects of laryngectomy. METHODS: Two hundred and thirty-eight cases of laryngeal cancer at different stages, including 103 cases with supraglottic cancer, 118 cases with glottic cancer, 3 cases with subglottic cancer, and 14 cases with recurrent cancer, underwent different kinds of operation from 2000 to 2010. The TNM classifications were as follows: T3 168 cases, T4 70 cases. Stage III 145 cases, Stage IV 93 cases. N0 134 cases,N1 64 cases,N2 38 cases, and N3 2 cases. The effects of operation, especially with the preservation of laryngeal function, was analyzed. The disease-free survival rate was calculated by Kaplan-Meier methods. RESULTS: Partial laryngectomy was performed on 142 of the 238 cases (59.7%). Total laryngectomy was performed on 96 cases. In 142 patients who received partial laryngectomy with preservation of laryngeal function, the trachea cannula was extracted in 90 patients, with the decannulation rate as 63.4%. The nasal feeding tube was removed and peroral feeding was recovered in all patients. The patients undergoing partial laryngectomy succeeded in phonation. The 3 years and 5 years disease-free survival rates in all patients were 81.4% and 59.5%. The 3 years and 5 years disease-free survival rate of partial laryngectomy were 82.9% and 64.3%. The 3 years and 5 years disease-free survival rates in total laryngectomy were 79.2% and 52.4%. There was no significantly different between the two groups (χ(2) = 2.478, P = 0.115). CONCLUSION: For the advanced laryngeal cancer, it is possible to preserve the laryngeal function without compromising the remote survival rate by detailed pre-operational estimation, properly selected operation and skilled surgical practice.

HOGG1 Ser326Cys polymorphism and susceptibility to head and neck cancer: a meta-analysis.

PURPOSE: Several research groups have investigated the influence of the human 8-oxoguanine DNA glycosylase 1 (hOGG1) Ser326Cys polymorphism on head and neck cancer (HNC) susceptibility. However, the results remain inconclusive and controversial. We therefore conducted the present meta-analysis. METHODS: Relevant studies were identified through a search of PubMed databases until July 2011 and selected on the basis of established inclusion criteria for publications. RESULTS: A total of 8 case-control studies on the association of hOGG1 Ser326Cys polymorphism with HNC risk were included in the present meta-analysis. Overall significant associations were observed (G allele vs. C allele: OR=1.49, 95%CI=1.08-2.05, P<0.01 for heterogeneity; GG vs.CC: OR=2.30, 95%CI=1.05-5.05, P<0.01 for heterogeneity; CG vs. CC: OR=1.40, 95%CI=1.03-1.90, P<0.01 for heterogeneity; dominant model (GG+CG vs. CC): OR=1.52, 95%CI=1.06-2.16, P<0.01 for heterogeneity; recessive model (GG vs. CG+CC): OR=2.04, 95%CI=1.05-3.96, P=0.01 for heterogeneity) after excluding the studies that were not in agreement with HWE. On performance of a subgroup meta-analysis by ethnicity, significant associations were found (G allele vs. C allele: OR=1.40, 95%CI=1.001-1.95, P<0.01 for heterogeneity; GG vs.CC: OR=2.30, 95%CI=1.05-5.05, P<0.01 for heterogeneity; recessive model (GG vs. CG+CC): OR=2.04, 95%CI=1.05-3.96, P=0.01 for heterogeneity) in Caucasian populations after excluding one study not in agreement with HWE. CONCLUSIONS: Our results suggested that the G allele might be associated with an increased risk of HNC in Caucasian populations.

Altered expression of miR-21 and PTEN in human laryngeal and hypopharyngeal squamous cell carcinomas.

PURPOSE: The purpose of this study was to examine the expression of mir-21 and phosphatase and tensin homologue (PTEN) in laryngeal squamous cell carcinomas (LSCCs) and hypopharyngeal squamous cell carcinomas (HSCCs), and assess correlations between the two as well as with clinical characteristics of patients. METHODS: The expression of mir-21 in tumor and adjacent non-tumor tissues was investigated by real-time RT-PCR. Immunohistochemistry (IHC) was carried out to analyze PTEN protein levels. RESULTS: Mir-21 was up-regulated in LSCCs and HSCCs compared to adjacent non-tumor tissues (P < 0.05), and the up-regulated expression of mir-21 was associated with clinical stage (P = 0.001), T classification (P = 0.007), pathologic differentiation (P = 0.025), and lymph node positivity (P = 0.002). In contrast, PTEN IHC staining was notably weaker in tumor tissues than in matched non-tumor tissues (P < 0.05), and the down-regulated expression of PTEN was correlated with tumor staging (P = 0.025), the extent of tumor (P = 0.017), and lymph node positivity (P = 0.040). Furthermore, the level of mir-21 was reversely correlated with PTEN expression (P = 0.006). CONCLUSION: mir-21 and PTEN might play important roles in the progression of LSCC and HSCC, the two fcators demonstrating a negative correlation.

Identification of epidermal growth factor receptor (EGFR) exon 20 single nucleotide polymorphism in Chinese squamous cell carcinoma of head and neck (SCCHN).

CONCLUSION: The 78th single nucleotide polymorphism (SNP) in exon 20 of epidermal growth factor receptor (EGFR) might be a predictor of the clinical course of squamous cell carcinoma of the head and neck (SCCHN), and genetic predisposition could influence the progression of SCCHN in Chinese subjects. OBJECTIVE: To analyze the clinical significance of EGFR SNP in Chinese SCCHN patients. MATERIALS AND METHODS: Direct sequencing of exons 18-21 was used to analyze somatic mutations of EGFR. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to evaluate the expression level of EGFR. The chi-square test and Kaplan-Meier method were the main statistical methods used to analyze the correlation of the investigated variables and prognostic significance. RESULTS: In analyzing exons 18-21 of EGFR in 96 patients with SCCHN, only one SNP was found in the 78th site of exon 20 and it mostly existed in specimens coming from the hypopharynx. Further statistical analysis showed that among the clinical or histopathologic parameters, the 78th SNP had a close relationship with earlier stage and more localized primary carcinoma, while at present the analysis did not support the proposition that the SNP was an independent prognostic factor.

[Comprehensive treatment of 352 cases with hypopharyngeal cancer].

OBJECTIVE: To review the experience of different surgical construction methods and comprehensive treatments for hypopharyngeal cancer. METHODS: Three hundred and fifty-two cases (According to UICC 2002 criteria, stage I, 3; II, 31; III, 134; IV, 184) with hypopharyngeal cancer were retrospectively reviewed from 1999 to 2005 in the Department of Otorhinolaryngology of Qilu Hospital of Shandong University, including 321 males and 31 females. The median age was 58 years old, ranged from 26 to 82 years old. All the tumors originated from the pyriform sinus (272), posterior pharyngeal wall (61), postcricoid area (19). There were no distant metastasis. Two hundred and fourty-one cases were surgically treated with laryngeal functions preserved and 111 cases without laryngeal functions preserved. All the patients received modified neck dissection, including both unilateral (247 patients) and bilateral (105 patients). Pharyngoesophageal defect reconstruction methods in cases with laryngeal functions preserved were: direct suture in 137, pectoralis major musculocutaneous flap in 62, split graft in 2, pectoralis major musculocutaneous flap combined with the split graft in 5, stomach pulling-up in 12, colon interposition in 23 patients. While in cases without laryngeal functions preserved the methods includes: direct suture in 54, laryngotracheal flap in 54 patients, pectoralis major musculocutaneous flap in 7, laryngotracheal flap combined with pectoralis major musculocutaneous flap in 8, stomach pulling-up in 22, colon interposition in 3 patients. All patients received radiotherapy postoperatively (dose 55 - 75 Gy). RESULTS: The overall 3 and 5 year survival rates were 65.1% (229/352) and 53.6% (142/265), respectively. For stage I, the 5 year survival rate was 3/3, stage II, 80.6%(25/31), stage III, 65.0% (67/103), stage IV, 36.7% (47/128). The 3 and 5 year survival rates in functionally preserved group were 68.0% (164/241) and 59.7% (114/191), respectively, while in non-functionally preserved group were 58.6% (65/111) and 37.8% (28/74), respectively. The cervical lymph node metastasis was found in 239 sides. Pathologic findings showed that well, moderately and lower differentiated squamous cell carcinomas were 84, 163, 105 cases, respectively. Laryngeal functions (voice, respiration and deglutition) were completely restored in 169 patients and partially restored (voice and deglutition) in 72 patients. CONCLUSIONS: Combined surgery and radiotherapy are the best choice for hypopharyngeal cancer. The continuity of the pharyngoesophagus is restored and the laryngeal function is preserved as far as possible. The preservation of laryngeal function and the laryngeal and pharyngeal reconstruction are based on the premise that the tumor was excised completely.

Therapeutic influence on circulating and monocyte-derived dendritic cells in laryngeal squamous cell carcinoma patients.

CONCLUSION: Surgical resection of laryngeal squamous cell carcinoma (LSCC) could be associated with improved circulating myeloid dendritic cell (mDC) number and monocyte-derived dentritic cell (MoDC) function. Although adjunctive radiotherapy after surgery did not effect the normalization of mDC number, it may have an impact on MoDC function. OBJECTIVE: To investigate the effects of surgery and adjunctive radiotherapy on both circulating dendritic cells (DCs) and MoDCs of LSCC patients. SUBJECTS AND METHODS: Forty-six patients with LSCC and 15 age-matched healthy control subjects were enrolled in this study. Blood samples were taken before, during, and after conventional treatment from both patients who underwent surgery only (n=18) and those who had adjunctive radiotherapy after tumor removal (n=28). Three-color flow cytometry was used for determination of circulating DC subsets. Moreover, MoDCs were generated utilizing granulocyte macrophage colony-stimulating factor (GM-CSF) and interleukin-4 (IL-4), then the phenotype of MoDCs was measured by flow cytometry and the ability to stimulate autologous T cells was tested in a mixed leukocyte reaction (MLR). RESULTS: The preoperative mDC counts, MoDC surface molecular expression and stimulatory capacity were impaired in patients in comparison with controls. The number of mDCs and the expression of CD80, CD83, and HLA-DR on MoDCs were significantly increased as compared with those pretreatment in patients who underwent surgery only and in those who had surgery followed by adjunctive radiotherapy. However, the recovery of CD86 expression and allostimulatory activity was only observed in patients who underwent surgery alone.

[An experimental study of polypropylene combined with flap for trachea reconstruction].

OBJECTIVE: Canine model established for tracheal defect reconstruction, to investigate the outcome of tracheal reconstruction with combination of polypropylene and flap. METHODS: About 3.5 to 4 centimeter cervical trachea was resected and replaced with artificial trachea made from monofilament knitted polypropylene and surgical flap. Covered stent was implanted postoperatively. Survival period and quality of life were recorded, bronchofibroscopy, X-ray films and HE sections were performed. RESULTS: Six dogs survived well and another two died. The causes of death were respiratory failure in 1 and infection in another. Stenosis of anastomosis in 1 was recorded during survival period. The dogs started drinking and eating on the second postoperative day, no dyspnea was found. The animals were sacrificed at 2, 4, 8 weeks and 6 months after surgery. Soft tissue growth was found in polypropylene net 2 weeks after surgery and more at 4 weeks. The polypropylene net was covered completely with soft tissue at 8 weeks and 6 months postoperatively, the hardness and sustentation degree were enhanced following the growth and fibrosis of soft tissue. The squamous epithelium and columnar epithelium were observed healing well by HE staining method. CONCLUSIONS: One-stage operative artificial trachea made from monofilament knitted polypropylene which has good histocompatibility and surgical flap is the closer artificial trachea to native trachea. It has a promising prospect in clinical use.

Overexpression of CyclinD1 and underexpression of p16 correlate with lymph node metastases in laryngeal squamous cell carcinoma in Chinese patients.

BACKGROUND: CyclinD1 and p16 are involved in the regulation of G1 checkpoint and may play an important role in the tumorgenesis of laryngeal squamous cell carcinoma (LSCC). Previous studies have examined the level of expression of cyclinD1 or p16 in LSCC but no such information is available for their relation and their correlation with lymph node metastasis in Chinese patients. PATIENTS AND METHODS: A total of 58 patients underwent surgical resection of laryngeal tumours in the Department of Otolaryngology, Qilu Hospital Shandong University between January 2001 and December 2002. All pathologic specimens were available for immunohistochemical study using antibodies against cyclinD1 and p16. RESULTS: Compared with normal epithelium, expression of CyclinD1 in the LSCC was significantly higher (62.1% vs. 10.0%, P < 0.05), expression of p16 was significantly lower (48.3% vs. 90.0%, P < 0.05); CyclinD1 expression in LSCC was up-regulated in TNM classification (r (s) = 0.409, P < 0.05) as well as with cervical lymph node metastases (r (s) = 0.294, P < 0.05); p16 expression in LSCC was down-regulated with cervical lymph node metastases (r (s) = -0.275, P < 0.05); negative significant correlation between p16 immunostaining and CyclinD1 was observed in LSCC (r (s) = -0.331, P < 0.05). CONCLUSION: There was a negative correlation between CyclinD1 expression and p16 expression in LSCC. The over-expression of CyclinD1 and the under-expression of p16 may play a significant role in the incidence and development of LSCC and may be important indicators for cervical lymph node metastases in Chinese patients of LSCC.

[Diagnosis and surgical management of carotid body tumor as well as blood vessel prosthesis' role].

OBJECTIVE: To analyse the diagnostic and therapeutic aspects of carotid body tumor (CBT). METHODS: Seven patients with CBT had been hospitalized between 2003 and 2006. The clinical data was analyzed retrospectively. The preoperative evaluation included angiography in 7 patients. Most of them had an asymptomatic cervical lateral mass. Only one patient had the hoarseness and buckling and was given radiation therapy alone. Six of seven patients with carotid body tumour underwent surgery. Simple tumor excision was accomplished in 4. Carotid artery resection with the tumor was required in 2 patients and in the both, interposition of a 7 mm polytetrafluoroethylene graft was performed . During the resection, temporary carotid shunt was required in the two patients. RESULTS: All tumors by surgery were identified as carotid paragangliomas without evidence of malignancy. There was no mortality and no hemiplegia. After surgery, temporary cranial nerve dysfunction was noted in one case. In the follow-up period of 2 months to 2 years, no recurrent disease occurred. The patient's tumor who accepted radiotherapy was in the stable stage under the half year follow up, and the follow up would be further continued. CONCLUSIONS: With non-invasive investigation and arteriography it was possible to obtain an early and precise diagnosis. The surgical management was the major treatment of these tumors. The pattern of operation should be chosen according to the relation of tumor and carotid. The decision to perform simple tumor excision or additional arterial resection was based on diagnostic preoperative and after the arterial resection the polytetrafluoroethylene graft would be used for carotid reconstruction.

[Validity of high negative pressure drainage for chylous fistula after neck dissection: a report of eight cases].

BACKGROUND & OBJECTIVE: Chylous fistula, a severe complication after operation on neck, has close correlation with definite anatomical position and variation. Its treatment remains controversial. This study was to evaluate the validity of high negative pressure drainage for chylous fistula after neck dissection. METHODS: A treatment of high negative pressure (-30 to -50 kPa) drainage, fasting, and reasonable venous nutrition was applied to 8 patients with postoperative chylous fistula. RESULTS: Of the 8 patients, 7 recovered smoothly without severe complication, and pectoralis major muscle flap was adopted to cure the failed one. CONCLUSION: A treatment of high negative pressure drainage and reasonable diet is effective and safe for chylous fistula at early stage.

[Surgical treatment of postcricoid carcinoma].

OBJECTIVE: To explore the surgical techniques in surgical treatment of postcricoid carcinoma. METHODS: Twenty-one cases with postcricoid carcinoma were treated surgically. The TNM stage were as follows: T3NOM0 5 cases, T3N1M0 1 case, T3N2M0 2 cases, T4NOM0 7 cases, T4N1M0 4 cases, T4N2M0 1 case, T4N3M0 1 case. The laryngeal and pharyngeal functions were rebuilt by the remaining tissue when the lesions entirely removed. Ten cases were surgically treated with laryngeal functions preserved and 11 cases with total laryngectomy. Eight cases were received unilateral neck dissection, and 3 cases were received bilateral neck dissection. All the cases received postoperative radiotherapy. RESULTS: The follow-up interval varied from 60 to 276 months with average interval 96 months. Four cases died of cervical metastasis,3 died of local recurrence, 1 died of cardiopulmonary failure, 2 died of unknown reasons. The overall 3 and 5 year survival rates were 61.9% (13/21) and 52.4% (11/21), respectively. Among 10 cases having laryngeal functions partially restored (voice and deglutition), the postoperative complications included 5 cases of pharyngeal fistula, 3 hypopharyngeal stenosis and 1 severe aspiration. CONCLUSIONS: The preservative surgery is feasible for the selected cases with postcricoid carcinoma. The laryngeal function can be partially restored with lesions entirely removed. The patients can gain satisfied survival rate and quality of life.

[Surgical treatment of hypopharyngeal cancer with cervical esophageal invasion].

OBJECTIVE: To review the experience of different surgical construction methods for hypopharyngeal cancer with cervical esophageal invasion. METHODS: From 1989 to 2000,forty-eight patients with advanced hypopharyngeal cancer and cervical esophageal invasion were retrospectively reviewed, including 38 males and 10 females. The median age was 54. 3 years old, ranged from 26 to 71 years old. According to UICC 1997 criteria, all the tumors were T4 stage and originated from the pyriform sinus (33), posterior pharyngeal wall (14), postcricoid area (1), there were 28 patients in cN0, 15 in cN1, 5 in cN2 and no distant metastasis. Precise preoperative evaluation was performed with computed tomography scan, barium swallow perspective and biopsy. All the patients received modified neck dissection, including both unilateral (38 patients) and bilateral (10 patients). Pharyngoesophageal defect reconstruction methods were: laryngotracheal flap in 11 patients, pectoralis major musculocutaneous flap in 13, laryngotracheal flap combined with pectoralis major musculocutaneous flap in 6, pectoralis major musculocutaneous flap combined with the split graft in 10, stomach pulling-up in 3, colon interposition in 5 patients. Total laryngectomy was carried out in 8 patients. All patients received radiotherapy postoperatively (dose 55 - 75 Gy). RESULTS: The cervical lymph node metastasis was found in 20 patients. Pathologic findings showed that well, moderately and lower differentiated squamous cell carcinomas were 18, 24, 6 cases, respectively. The overall 3 and 5 year survival rates were 52.1% (25/48) and 27.3% (12/44), respectively. The 3 and 5 year survival rates in functionally preserved group were 65.2% (15/23) and 33.3% (7/21), while in non functionally preserved group were 40.0% (10/25) and 21.7% (5/23), respectively. Fifteen patients laryngeal functions (voice, respiration and deglutition) were completely restored and 8 patients partially restored (voice and deglutition). The decannulation rate was 65% (15/23). The complication included pharyngeal fistulas in 10 cases and splitting of chest wall in 1 cases. CONCLUSIONS: Combined therapy was the best choice for hypopharyngeal cancer with cervical esophageal invasion. The laryngeal function is preserved as far as possible. The continuity of the pharyngoesophagus was restored by pectoralis major musculocutaneous flap, laryngotracheal flap, or combined with the split graft. Stomach transposition or colon interposition was used while the defect of the esophagus was greater.

[Surgical management of primary cervical tracheal cancer].

OBJECTIVE: To review the experience of surgical treatment of primary cervical tracheal cancer. METHODS: Six patients with primary cervical tracheal cancer were treated surgically from January 1997 to April 1999. The trachea anastomosis, platysmamyocutaneous flap combiend with the facial flap of the sternohyoid muscle, sternocleidomastoid myoperiosteal flap and the pectoralis major muculocutaneous flap were applied to restore the defects of cervical trachea. By pathology, there were two squamous cell carcinomas, three adenoid cystic carcinomas, and one adenocarcinoma. RESULTS: Six cases were decannulated from 23 days to 3 months after operation. The length of follow-up was more than 3 years. Five cases have stable airway by fiberscope and good voice after decannulation and there is no recurrence. One case died of lung metastasis 2 years after operation. CONCLUSION: Trachea anastomosis is suited for small partial defect. The platysmamyocutaneous flap combined with the facial flap of the sternohyoid muscle, sternocleidomastoid myoperiosteal flap and the pectoralis major muculocutaneous flap are ideal transplant for cervical tracheal reconstruction.

[Surgical management of benign pharyngo-esophageal stenosis].

OBJECTIVE: To study the methods and outcome of surgical management for pharyngo-esophageal stenosis. METHODS: Twenty-seven patients with pharyngo-esophageal stenosis from January 1983 to June 2001 were reviewed. Among 27 cases, there were 12 cases accompanied with laryngeal stenosis and one case accompanied with tracheal stenosis. In terms of etiological factor, all patients were cataloged into two groups, i.e. 25 cases with chemo-causis and 2 cases with trauma. The repair methods included colon interposition in 20 patients, free jejunum transplantation in 6 patients and pectoralis major muculocutaneous flap in 1 patient. In total 12 cases of laryngeal stenosis, sternohyoid myofascial flap was applied in 8 cases, and sternohyoid myofascial flap and epiglottis were applied in 4 cases. RESULTS: Swallow function recovered in 25 cases and failed in 2 cases. Laryngeal function recovered totally in 10 patients and partially in 2 patients with laryngeal stenosis. The patient with tracheal stenosis recovered and decannulated. CONCLUSION: According to the foci of pharyngo-esophageal stenosis, the colon interposition, the free jejunum transplantation and the pectoralis major myocutaneous flap can be applied respectively to restore normal physiological function.