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The testis, as one of the important reproductive organs in men, has two major functions of secreting androgens and producing sperm. Androgen and spermatogenesis are the key factors for the evaluation of the testicular function. The lack of androgen or the decline of spermatogenic function is both a symbolic manifestation and a "product" of testis aging. In order to gain a deeper insight into the relationship between testis aging and overall health, this article reviews the relevant literature based on the correlation of androgen deficiency with various systemic diseases and the belief in the impacts of testis aging on the health of the cardiovascular and nervous systems through different channels, the development and progression of metabolic diseases, orthopedic diseases, PCa, kidney disease, peptic ulcer and other diseases. All these suggest that adequate attention should be paid to the studies of male reproductive health and its impact on overall health, so as to provide some new ideas and evidence for clinical diagnosis and treatment of relevant conditions.

Based on the analysis of the total concentrations of 10 metals in the sediment core and total concentrations and chemical fractions of seven metals in the surface sediments of Qionghai Lake in Xichang City, Sichuan Province, the spatial-temporal characteristics of metal accumulation and pollution over the past century and the potential ecological risk of metals in surface sediments were studied. Before the 1970s, metal concentrations in the sediment core were stable. The total concentrations of Al, Fe, K, and Cr in the sediment core exhibited visible peaks in the 1970s, which were related to the enhanced input of fine-grained topsoil caused by increasing precipitation, lake reclamation, and deforestation. Since the 1990s, the total concentrations of Al, Fe, K, and Cr decreased with the reduced topsoil erosion, whereas the total concentrations of As, Cd, Cu, Pb, and Zn gradually increased or remained stable. The enrichment factor results showed that Cd, Pb, and Zn were the main contaminants, with Cd as the typical contaminant in the sediment core. The Cd contamination started in the 1960s and has remained at a moderate level since the 1990s. In the surface sediments, the total concentrations of Cd were higher in the northwest lake area, and no visible spatial concentration trends of the other metals were displayed. The bioavailable fractions of Cd, Pb, and Zn accounted for 95%, 63%, and 48% of the total metal concentrations on average. Among the bioavailable fractions, Cd was mainly in the acid-soluble fraction, and Pb and Zn were mainly in the reducible and oxidized fractions. The bioavailable fractions of the other metals were less than 27%. The results of total concentrations and bioavailable fractions of metals revealed that Pb and Zn in the surface sediments were slightly or moderately contaminated, and Cd was moderately contaminated on average. Cd contamination was at a severe level in the northwest lake area. The concentrations of anthropogenic Cd, Pb, and Zn in the surface sediments estimated from the total and bioavailable concentrations were comparable ( P >0.05), indicating that anthropogenic metals primarily existed in bioavailable fractions in the sediment. Integrating the assessment results from sediment quality guidelines, potential ecological risk index, and chemical forms of metals, Cd in surface sediments may pose a high ecological risk, whereas the other metals has a low ecological risk.

Objective: To examine the short-term curative effect with minimally invasive right infra-axillary thoracotomy for transaortic modified Morrow procedure. Methods: The clinical data of 60 patients who underwent video-assisted thoracoscopic transaortic modified Morrow procedure from August 2021 to August 2022 at Department of Cardiovascular Surgery, Zhejiang Provincial People's Hospital were retrospectively analyzed. There were 31 males and 29 females, with the age ( M (IQR)) of 54.0(22.3) years (range: 15 to 71 years). The echocardiography confirmed the diagnosis of moderate mitral regurgitation in 30 patients, and severe mitral regurgitation in 13 patients. Systolic anterior motion (SAM) was present preoperatively in 54 patients. All 60 patients underwent transaortic modified Morrow procedure through a right infra-axillary thoracotomy using femorofemoral cardiopulmonary bypass. Surgical procedures mainly included transverse aortic incision, exposure of left ventricular outflow tract (LVOT), septal myectomy, and correction of the abnormal mitral valve and subvalvular structures. Results: All 60 patients underwent the programmatic procedures successfully without conversion to full sternotomy. The cardiopulmonary bypass time was (142.0±32.1) minutes (range: 89 to 240 minutes), while the cross-clamp time was (95.0±23.5) minutes (range: 50 to 162 minutes). The patients had a postoperative peak LVOT gradient of 7.0 (5.0) mmHg (range: 0 to 38 mmHg) (1 mmHg=0.133 kPa). A total of 57 patients were extubated on the operating table. The drainage volume in the first 24 h was (175.9±57.0) ml (range: 60 to 327 ml). The length of intensive care unit stay was 21.0 (5.8)h (range: 8 to 120 h) and postoperative hospital stay was 8 (5) days (range: 5 to 19 days). The postoperative septal thickness was 11 (2) mm (range: 8 to 14 mm). All patients had no iatrogenic ventricular septal perforation or postoperative residual SAM. The patients were followed up for 4 (9) months (range: 1 to 15 months), and none of them needed cardiac surgery again due to valve dysfunction or increased peak LVOT gradient during follow-up. Conclusion: Using a video-assisted thoracoscopic transaortic modified Morrow procedure through a right infra-axillary minithoracotomy can provide good visualization of the LVOT and hypertrophic ventricular septum, ensure optimal exposure of the mitral valve in the presence of complex mitral subvalvular structures, so that allows satisfactory short-term surgical results.

Objective: To evaluate the indications, safety, feasibility, and surgical technique for patients with head and neck cancers undergoing transoral robotic retropharyngeal lymph node (RPLN) dissection. Methods: The current study enrolled 12 consecutive head and neck cancer patients (seven males and four females) who underwent transoral robotic RPLN dissection with the da Vinci surgical robotic system at the Sun Yat-sen University Cancer Center from May 2019 to July 2020. Seven patients were diagnosed as nasopharyngeal carcinoma with RPLN metastasis after initial treatments, 4 patients were diagnosed as thyroid carcinoma with RPLN metastasis after initial treatments, and one patient was diagnosed as oropharyngeal carcinoma with RPLN metastasis before initial treatments. The operation procedure and duration time, intraoperative blood loss volume and complications, nasogastric feeding tube dependence, tracheostomy dependence, postoperative complications, and hospitalization time were recorded and analyzed. Results: All patients were successfully treated by transoral robotic dissection of the metastatic RPLNs, none of which was converted to open surgery. RPLNs were completely resected in 10 patients, and partly resected in 2 patients (both were nasopharyngeal carcinoma patients). The mean number of RPLN dissected was 1.7. The operation duration time and intraoperative blood loss volume were (191.3±101.1) min and (150.0±86.6) ml, respectively. There was no severe intraoperative complication such as massive haemorrhage or adjacent organ injury during surgery. Nasogastric tube use was required in all patients with (17.1±10.6) days of dependence, while tracheotomy was performed in 8 patients with (11.6±10.7) days of dependence. The postoperative hospitalization stay was (8.5±5.7) days. Postoperative complications occurred in 4 patients, including 2 of retropharyngeal incision and 2 of dysphagia. During a follow-up of (6.5±5.1) months, disease-free progression was observed in all patients, 10 patients were disease-free survival and other 2 patients were survival with tumor burden. Conclusions: The transoral robotic RPLN dissection is safety and feasible. Compared with the traditional open surgical approach, it is less traumatic and safer, has fewer complications and good clinical application potentiality. The indications for transoral robotic RPLN dissection include thyroid carcinoma, oropharyngeal carcinoma, and some selected nasopharyngeal carcinoma and other head and neck cancers. Metastatic RPLNs from some nasopharyngeal carcinoma with incomplete capsule, unclear border and adhesion to the surrounding vessels are not suitable for transoral robotic RPLN dissection.

With the increasing awareness of men's health, more and more clinical studies are reported on the relationship of testicular microlithiasis (TM) with male infertility. TM is a relatively rare disease characterized by multiple microcalcifications (<3 mm) in the seminiferous tubules of the testis. This review summarizes the findings in the studies of the diagnosis, epidemiology, correlation with male fertility, treatment, and follow-up of TM in recent years. Many researches show that TM has a certain correlation with the decline of male fertility, which, however, is not identically agreed on at home and abroad. As for the treatment of TM complicated with male infertility, there is still a lack of effective and reliable drugs and strategies and a need for many basic and clinical studies.

The employment situation and advantages of interdisciplinary talents of English and acupuncture-moxibustion and tuina at home and abroad are analyzed. The employment rate and further education rate of interdisciplinary talents of English and acupunctue-moxibustion and tuina are higher than those of the normal undergraduates majoring in acupunctue-moxibustion and tuina . The interdisciplinary talents of English and acupuncture-moxibustion and tuina at home are characterized by solid professional foundation and good specialized English, and high comprehensive quality; and the interdisciplinary talents at abroad are characterized by solid professional foundation and good language ability. The interdisciplinary talents of English and acupuncture-moxibustion and tuina should grasp the advantages, cultivate international vision to adapt to international standards, improve the level of clinical practice, promote comprehensive ability, furthermore, improve the employment competitiveness and promote the internationalization of acupuncture- moxibustion and tuina .

With the continuous improvement of living conditions, increasing attention is being drawn to the genitourinary health of males, which has boomed the development of uroandrology in recent years. Refractory hemospermia, infertility, and perineal pain are commonly seen in some male patients, and mainly relied on medical imaging for diagnosis in the past, which, however, has a high pseudopositive rate and cannot give an etiological explanation. Patients with these diseases often adopt conservative treatments such as medication and physiotherapy, often with poor prognosis, and those suffering frequent recurrence used to be treated by transurethral resection, laparoscopic surgery or open surgery, which are now rarely employed due to their high rate of postoperative complications, slow recovery, and easy recurrence. In recent years, transurethral seminal vesiculoscopy has gained a wide application in the diagnosis and treatment of the above-mentioned uroandrological diseases and shown its advantages of high clinical effectiveness and low incidence of complications. The review updates on the indications, methods, skills and clinical application of transurethral seminal vesiculoscopy.

Objective: To present 15 cases of inflammatory myofibroblastic tumor (IMT) in genitor-urinary system, and analyze the characteristics, diagnosis and treatment of the disease. Methods: The diagnostic and therapeutic process of 15 confirmed cases admitted to Sun Yat-sen University Cancer Center between March 2009 and September 2017 were retrospectively analyzed. Of the total cases, 11 cases were diagnosed with cystic IMT with a maximum diameter of 1.0-4.5 cm, 8 cases underwent transurethral resection of bladder tumor(TURBT)and 4 of them underwent partial cystectomy after TURBT and 3 underwent partial cystectomy directly. Two cases were renal IMT with a maximum diameter of 4.0-9.0 cm, one underwent partial nephrectomy and the other accepted radical nephrectomy. One case who was diagnosed with prostatic IMT with a maximum diameter of 3.4 cm underwent transurethral resection of the prostate (TURP) and postoperative radiotherapy. One case who was diagnosed with perineal IMT with a maximum diameter of 2.1 cm underwent tumor resection. Results: The patients were followed up for 10-32 months with a median time of 27 months. No cases relapsed during the follow-up. Conclusion: Surgery is the preferred method for treating IMT in genitor-urinary system. Retrospective study shows a good prognosis in IMT patients, but a long-term follow-up is still required.

Acute pain is the main cause for patient visits to the emergency department. An important issue faced in emergency medical care is to resolve patient pain. Moreover, limb traumatic pain is noted in 58-66% of emergency trauma patients. This paper explored the effectiveness of using non-pharmacological complementary interventions, including body operation therapies that used trauma limb care and therapeutic touch and mind-body interventions, in order to strengthen the support system and create a healing environment. The experience described herein is hoped to facilitate the provision of multifaceted emergency care for patients with limb trauma pain in the emergency department in order to improve the comfort and return rate of patients.

The basic principle of polarization-differentiation elastic light scattering spectroscopy based techniques is that under the linear polarized light incidence, the singlely scattered light from the superficial biological tissue and diffusively scattered light from the deep tissue can be separated according to the difference of polarization characteristics. The novel point of the paper is to apply this method to the detection of particle suspension and, to realize the simultaneous measurement of its particle size and number density in its natural status. We design and build a coaxial cage optical system, and measure the backscatter signal at a specified angle from a polystyrene microsphere suspension. By controlling the polarization direction of incident light with a linear polarizer and adjusting the polarization direction of collected light with another linear polarizer, we obtain the parallel polarized elastic light scattering spectrum and cross polarized elastic light scattering spectrum. The difference between the two is the differential polarized elastic light scattering spectrum which include only the single scattering information of the particles. We thus compare this spectrum to the Mie scattering calculation and extract the particle size. We then also analyze the cross polarized elastic light scattering spectrum by applying the particle size already extracted. The analysis is based on the approximate expressions taking account of light diffusing, from which we are able to obtain the number density of the particle suspension. We compare our experimental outcomes with the manufacturer-provided values and further analyze the influence of the particle diameter standard deviation on the number density extraction, by which we finally verify the experimental method. The potential applications of the method include the on-line particle quality monitoring for particle manufacture as well as the fat and protein density detection of milk products.

Objective: To study the chemical constituents of Callicarpa nudiflora., Methods: The chemical constituents were isolated and purified by column chromatography on silica gel, ODS, Sephadex LH-20 and MPLC. Their structures were elucidated on the basis of physicochemical properties and special analysis., Results: Eleven compounds were isolated from the leaves of Callicarpa nudiflora, whose structures were elucidated as 2α,3α-dihydroxyurs-12-en-28-oic acid (1), isorhamnetin (2), 2α,3β,19α-trihydroxyurs-12-en-28-oic acid(3), 2α,3α,19α,23-tetrahydroxyurs-12-en-28-oic acid(4), 2α,3α,19α-trihyhydroxy-olean-12-en-28-O-α-D-glucopyranoside (5), benzyl-4'-hydroxy-benzoyl-3'-O-β-D-glucopyranoside(6) (3S,5R,6R,7E,9S)-megastigman-7-ene-3,5,6,9-tetrol(7), philonotisflavone(8), 1, 6-di-O-caffeoyl-β-D-glucopyranoside (9), luteolin-4'-O-(6"-E-caffeoyl)-β-D-glucopyranoside (10), and (6S, 9R)-roseoside(11)., Conclusion: All compounds are isolated from this plant for the first time.

This study is to establish the HPLC fingerprint and determine eight components of Callicarpa nudiflora, and provide a scientific basis for the identification and quality control. The Waters sunfire C18 column (4.6 mm x 250 mm, 5 µm) was used and the detection wavelength was 330 nm . The column temperature was 30 °C. The mobile phases were acetonitrile (A) and 0.1% formic acid (B) eluting in a gradient program at a flow rate of 1.0 mL · min(-1). The chromatographic fingerprint similarity evaluation system for tradition Chinese medicine(2012) was used for analysis. C. nudiflora from different samples were of high similarity in fingerprint and the separation of ten components was good. There was an obvious difference between other samples and C. nudiflora leaves. In quantitative analysis, the ten components showed good regression(R2 > 0 999 0) with linear ranges, and their recoveries were in the range of 96.0%-105.0%. The established qualitative and quantitative methods are highly specific, simple and accurate, which can be used for the identification and quality control of C. nudiflora.

Objective: To investigate the clinical results of external fixation and AO titanium elastic intramedullary nailing for treatment of tibia-fibula comminuted closed fractures., Methods: From June 2010 to June 2012,58 patients with tibia-fibula comminuted closed fractures were treated with external fixation and AO titanium elastic intramedullary nailing, including 31 males and 27 females with an average age of 38.5 years old ranging from 21 to 57 years old. According to the system of AO Classification, the fractures were classified as type B1 in 9 cases,type B2 in 7 cases, type B3 in 10 cases, type Cl in 14 cases, type C2 in 12 cases,and type C3 in 6 cases. According to the system of Winquist-Hanson,the fractures' comminuted were classified as grade 1 in 23 cases, grade 2 in 17 cases, grade 3 in 12 cases, and grade 4 in 6 cases. According to the system of Johner-Wruhs, clinical results were compared between different type and grade groups by the time of last followed-up., Results: All 58 patients were followed up with an average time of 6.8 months (ranged from 18 to 36 weeks). All fractures had clinical healing with an average time of 28 weeks (ranged from 24 to 32 weeks). The total rate of good to excellent results was 91.4%. The rate of good to excellent in the group of grade 1 was higher than that of other grades. The complication rates and fracture healing time would increase respectively with higher Winquist-Hanson's grade. The complication rates in the group of type C3 was higher than that of other types, but the rate of good to excellent was lower than that of other types. The complication rates in the group of type B1 was lower than that of other types,but the rate of good to excellent was higher than that of other types., Conclusion: Minimal invasiveusing AO titanium elastic intramedullary nailing combined with external fixation for treatment of tibia-fibula fractures especially for the multiple-segment,long spiral mild-to-moderate comminuted with hidden fracture can get satisfactory reduction and reliable fixation,it conformes to the principle of BO completely, protects the fracture end blood supply,reduces the external fixation time, has less skin soft tissue complications, postoperative function recovered satisfactorily.

To investigate the metabolic rate and metabolites of 9-dehydro-17-dehydro-andrographolide, which is the main active ingredient in Xiyanping injection, by using the in vitro rat liver microsome incubation system. 9-dehydro-17-dehydro-andrographolide was incubated together with liver microsome mixed with NADPH. Its metabolic rate was studied by determining its residual concentrations with the UHPLC-MS/MS method; Its metabolites were identified by the UPLC-TOF-MS(E) method. The results showed that 9-dehydro-17-dehydro-andrographolide was metabolized faster than rat liver microsomes mixed with coenzymes, with t½ and CL of (19.7 ± 0.5) min and (35.1 ± 0.8) mL x min(-1) x g(-1) (protein), respectively. Based on the high resolution mass spectrum data and information from literatures, altogether nine metabolites of 9-dehydro-17-dehydro-andrographolide were identified in the incubation system, particularly hydroxylated and dehydrogenized products. The results of identification would provide a basis for screening out more active andrographolide derivatives.

Objective: To evaluate the efficacy and safety of submucosal tunneling endoscopic resection (STER) in the treatment of middle and lower esophagus submucosal tumors (SMT) originating from muscularis propria (MP) layer., Methods: A total number of 33 esophagus submucosal tumor (SMT) originating from MP layer underwent tumor resection by STER after endoscopic ultrasonography (EUS) and CT examination at Endoscopy Center, Department of Gastroenterology, First Affiliated Hospital, Nanjing Medical University from March 2012 to March 2013. There were 17 males and 16 females with an age range of (50 ± 10) years. Their lesion size, lesion origin, pathology, operative duration and complication rate were analyzed., Results: Among them, the origins were of submucosal (n = 4, 12.1%), superficial muscularis propria layer (SMP) (n = 18, 54.6%), deep muscularis layer (DMP) (n = 10, 30.3%) and serosa (n = 1, 3.0%). There were single tumor (n = 30, 90.9%), double tumors (n = 2, 6.1%) and triple tumors (n = 1, 3.0%). Except for 1 case of non-resected hemangioma, 36 operative specimens were examined pathologically, including 30 leiomyomas tumors (83.3%), 5 stromal tumors (GIST) (13.9%) and 1 lipoma tumor (2.8%). Thirty-two lesions were successfully resected by STER with a complete resection rate of 97.0%. Average lesion size was (1.7 ± 1.0) cm and average operative duration (49 ± 26) min. A number of (7.8 ± 2.5) hemostatic clips were used to close the mucosal incision site. Subcutaneous emphysema occurred in 3 patients (9.1%) while puncture and pneumothorax developed in one case (3.0%). All of them recovered uneventfully through conservative treatments., Conclusions: As a new safe, efficacious and feasible treatment for middle and lower esophagus submucosal tumors, STER may completely resect SMT and provide accurate histopathological evaluations. And it is feasible to regain the mucosal integrity of GI tract and prevent the occurrences of leakage and secondary infections.

Objective: The aim of this study was to describe a new technique of combined hyoid bone and thyrohyoid membrane flap in laryngeal reconstruction after tumor resection, and to evaluate outcome., Methods: Six patients requiring an frontal partial laryngectomy for cancer were enrolled between September 2008 and August 2012., Results: Nasogastric feeding was initiated within 24 hours. The mean times to swallow batter, ability to drink water and removal of the nasogastric tube were 2.6, 5.5 and 6.3 days. All patients had good respiratory function. There were no deaths, and no reports of postoperative dyspnea or dysphagia. The vocal quality was satisfactory, slightly deeper and raspy, and the volume was weak when calling. The final follow-up assessment was in August 2012, and the overall mean follow-up period was 29.5months, range 14 to 47 months. Case two subsequently underwent total laryngectomy for recurrence in the paraglottic space, but there was no evidence of further tumor recurrence at the final assessment., Conclusions: The combined muscle-pedicle hyoid bone and thyrohyoid membrane flap is a reliable graft for one-stage repair of laryngotracheal defects, providing effective repair of the mucosa and cartilage support. Vocal quality, swallowing function and ventilation after the procedure were favorable.

Objective: To investigate the clinical effects of Endobutton device in the treatment of tibiofibular diastasis without ankle fracture., Methods: From January 2009 to January 2011, a total of 8 patients with tibiofibular diastasis without ankle fracture were treated with Endobutton device. There were 6 males and 2 females with an average age of 34 years (ranged, 25 to 44 years). All the patients with ankle injured history and ankle pain, swelling, ecchy-mosis were diagnosed by radiology and then operated with Endobutton device. The clinical effects were evaluated according to Baird-Jackson scoring system and radiological evaluated parameters comprised of tibiofibular overlap,total clear space and medial clear space., Results: All the patients were followed up, and the duration ranged from 6 to 24 months,with an average of 12 months. Radiographic results were detailed as follows: tibiofibular overlap averaged (3.83 +/- 0.37) mm in preoperative and (7.46 +/- 0.14) mm in postoperative; mean total clear space (7.90 +/- 0.22) mm in preoperative and (3.39 +/- 0.07) mm in postoperative; medial clear space averaged (5.08 +/- 0.34) mm in preoperative and (3.16 +/- 0.07) mm in postoperative. There was significant difference above data between preoperative and postoperative one. The lastest Baird-Jackson score results: 6 cases obtained an excellent result, 1 good and 1 fair. The main score was (94.63 +/- 3.66)., Conclusion: Endobutton device for the treatment of tibiofibular diastasis without ankle fracture has advantages such as simple and minimally invasive, no need of second operation for implant removal, recover the ankle function better and less complications, which should be popularized and applied to clinical widely.

Background and Objective: Lymphatic microvessels may play an important role in tumor metastasis. This study detected lymphatic microvessel density (LVD) in supraglottic laryngeal carcinoma to find its correlation to clinicopathologic characteristics, and to assess its prognostic significance in supraglottic laryngeal carcinoma., Methods: Clinical data of 51 supraglottic laryngeal carcinoma patients who underwent primary lesion resection were reviewed. Immunohistochemical staining was performed with podoplanin monoclonal antibody to recognize lymphatic microvessels. The correlations of LVD to clinicopathologic characteristics and prognosis were analyzed., Results: The mean LVD was 3.25+/-2.37, with a median of 3, in the 51 specimens of supraglottic laryngeal carcinoma. LVD was significantly higher in the patients with cervical lymph node metastasis than in those without (P=0.009). The overall 5-year survival rate was 54.9%. The 5-year survival rate was significantly lower in the patients with poorly differentiated tumor, stages T3-4 disease, lymph node metastasis, stages III-IV disease and high LVD than in their counterparts. Cox regression analysis revealed that LVD, T classification, and differentiation were independent factors for survival., Conclusion: LVD is related to lymph nodes status, and is an independent factor for prognosis of supraglottic laryngeal carcinoma.

Background and Objective: The prognosis of esthesioneuroblastoma (ENB) patients is poor. This study was to analyze prognostic factors and explore a rational treatment for ENB., Methods: Clinical data of 53 ENB patients, treated at Sun Yat-sen University Cancer Center from 1980 to 2003, were analyzed retrospectively. The correlation of prognostic factors to clinical features and treatment approaches were analyzed using the Kaplan-Meier method. Efficacy of different treatment modalities was compared., Results: The five-year overall survival (OS) was 41% of all ENB patients. The five-year OS of the surgery group, radiotherapy group, chemotherapy group, surgery combined with radiotherapy and (or) chemotherapy group, chemoradiotherapy were 42%, 38%, 0, 56%, 0, respectively, which were statistically significant (p<0.05). The five-year OS of Kadish stage A, B, C patients were 100%, 37%, 31%, respectively, which were statistically significant among these three subgroups which (p<0.05). The recurrence rate over the entire period was 51%. The five-year OS of the recurrence group and recurrence-free group were 42% and 48%, respectively, without significant differences (p>0.05)., Conclusions: ENB is a malignant tumor with high rates of locoregional recurrence and distant metastasis. Surgery-based multimodality is a relatively reasonable method. The prognosis of ENB is associated with the clinical stage and treatment modalities.

Background and Objective: The prognosis of advanced squamous cell carcinoma of the larynx is poor Prognostic factors of this disease vary in different studies. This study was to analyze the most important factors affecting the prognosis of the patients with advanced (stage III and IV) squamous cell carcinoma (SCC) of the larynx., Methods: Clinical data of 221 patients with advanced SCC of the larynx were retrospectively analyzed. Survival analysis was performed by the life table method; comparison among/between groups was performed using the log-rank test; and multivariate analysis was carried out using the Cox proportional hazard model., Results: The two- and five-year overall survival rates of the 221 patients were 76.9% and 51.1%; while the 2-and 5-year disease free survival rates were 60.0% and 43.0%. Patients in stage III had better prognosis than those in stage IV. Post-operative radiotherapy improved the survival rate in patients with positive surgical margins. There was no difference in the survival rate between patients underwent partial laryngectomy and those underwent total laryngectomy. Multivariate analyses indicated that age, anatomic type, post-surgical stage, surgical margin and radiotherapy influenced the disease free survival (p<0.05), whereas, age, post-surgical stage and surgical margin affected the overall survival (p<0.05)., Conclusions: The prognosis of patients with advanced SCC of the larynx receiving surgery is poor. Age, post-surgical stage and surgical margin are the most important factors affecting the overall survival.

Background & Objective: Rhabdomyosarcoma is a rare malignant tumor. This study aimed to summarize the clinical features of head and neck rhabdomyosarcoma., Methods: Clinical data of 24 patients with head and neck rhabdomyosarcom, treated in Cancer Center of Sun Yat-sun University from 1989 to 2005, were analyzed., Results: Of the 24 patients, 15 (62.5%) were younger than 25; 12 (50.0%) with tumors originated from nasosinus. All patients presented with localized mass: 14 (58.3%) had large masses (>/=4 cm) at their first visit; 13 (54.2%) had clinical lymph node metastasis (cN+), and 12 (50.0%) of them were confirmed by pathology (pN+); 2 (8.3%) had distant metastasis. Of the 24 patients, 3 were at stage I, 3 at stage II, 16 at stage III and 2 at stage IV. Bone erosion was indicated by CT in 16 (66.7%) patients. Fourteen patients received immunohistochemical examination: 10 (71.4%) were HHF-35-positive, 6 (42.8%) were Desmin-positive, 9 (64.3%) were Myolobin-positive, 9 (64.3%) were Vemintin-positive. Thirteen patients were treated with multi-disciplinary treatment. The 3-year survival rate was 42.8% for those having chemotherapy as part of the treatment., Conclusions: Head and neck rhabdomyosarcoma is usually seen in adolescents and mostly developed in the nasosinus. It usually manifests as a localized mass and has a high frequency of lymphatic metastasis and distant metastasis. Chemotherapy-dominant multidisciplinary treatment is recommended for this disease.

Background & Objective: Postoperative relapse in tongue squamous cell carcinoma patients with pathologically negative cervical lymph node might be related to micrometastases. This study was to detect the lymph node micrometastases in cN0 tongue cancer patients, and explore its clinical significance., Methods: A total of 523 cervical lymph nodes taken from 49 tongue cancer patients were examined by routine HE staining and immunohistochemistry (IHC) with anti-cytokeratin antibody (CK19) staining. The follow-up period ranged from 9 to 83 (mean 56) months., Results: Metastases were detected in 7 (1.3%) lymph nodes from 5 patients with HE staining, and in 34 (6.5%) lymph nodes from 19 patients with CK19 staining. Micrometastases were detected in 27 (5.2%) lymph nodes from 14 patients. The difference in detecting lymph node metastases between two methods was significant (P=0.001). HE staining upstaged 3 cases from cN0 to pN1, and 2 cases from cN0 to pN2b; IHC staining upstaged 3 cases from cN0 to pN1, and 16 cases from cN0 to pN2b. Lymph node micrometastases showed no correlation to sex, age, T stage, differentiation, and depth of primary tumor invasion (P>0.05). The 5-year survival rates of the patients with and without micrometastases were 78.5% and 86.7%, respectively (P>0.05)., Conclusions: CK19 staining could increase the detection rate of cervical lymph node metastases and the accuracy of pathologic stage in tongue cancer. The results of our study showed that the presence of lymph node micrometastasis has no correlation to the prognosis. A further study is needed.

Background & Objective: There is no satisfactory treatment for advanced maxillary sinus squamous carcinoma. The treatment strategy is controversial. This study aimed to explore a rational treatment for advanced maxillary sinus squamous carcinoma., Methods: Clinical data of 92 patients with stage T3-T4 maxillary sinus squamous cell carcinoma, treated in Cancer Center of Sun Yat-sen University from Jan.1978 to Dec.2001, were reviewed. Of the 92 patients, 21 received radiotherapy alone, 8 received surgery alone, 63 received multimodality therapy (51 received surgery combined with radiotherapy, and 12 received chemoradiotherapy)., Results: The 3-and 5-year survival rates were significantly lower in radiotherapy group and surgery group than in multimodality therapy group (19.0% and 25.0% vs. 46.0%, P<0.05; 9.5% and 12.5% vs. 33.3%, P<0.05). In multimodality therapy group, the 3-and 5-year survival rates were 33.3% and 23.8% for the patients who received radiotherapy followed by surgery, 52.9% and 47.1% for the patients who received surgery follow by radiotherapy, 53.8% and 30.8% for the patients who received pre-and postoperative radiotherapy, and 50.0% and 33.3% for the patients who received chemoradiotherapy. There were no significant differences in survival rate between these four subgroups (P>0.05)., Conclusions: The efficacy of multimodality therapy is better than that of single therapy strategy for advanced maxillary sinus squamous carcinoma. The best treatment pattern for advanced maxillary sinus squamous carcinoma needs further research.

Background & Objective: The treatment and prognosis of gingival carcinoma, a common oral carcinoma, have seldom been reported. This study was to explore appropriate therapies and analyze prognostic factors of gingival carcinoma., Methods: Clinical data of 116 gingival carcinoma patients, treated at Cancer Center of Sun Yat-sen University from 1992 to 2003, were analyzed. Survival analyses were performed for patients who received surgery, radiotherapy, or surgery combined with chemotherapy or/and radiotherapy. The patients had been followed up for more than 3 years., Results: One hundred patients received radical therapy. The overall 3-and 5-year survival rates were 52.7% and 41.8%. The 5-year survival rates were 50.3% in surgery alone group and 49.0% in combined treatment group, without significant difference. The 5-year survival rate of radiotherapy alone group was only 20.0%. For advanced gingival carcinoma, the recurrence rate was much lower in combined treatment group than in surgery alone group. Clinical stage and surgical margin status were predictors of survival., Conclusions: Surgery alone is appropriate for gingival carcinoma patients at an early stage; surgery combined with chemotherapy or/and radiotherapy is an adequate treatment for patients at advanced stages. Clinical stage and surgical margin status are important prognostic factors.

Background & Objective: Total or partial defects after one-stage reconstruction for advanced head and neck cancer is a challenging problem in head and neck surgery. Pectoralis major myocutaneous flap (PMMF) plays an irreplaceable role in head and neck reconstruction surgery. This study was to define operational indications for using PMMF in head and neck defect reconstruction, and summarize how to further increase the success rate., Methods: From Jan. 2004 to Jan. 2007, 22 patients who underwent head and neck defect reconstruction using PMMF were investigated. Of the 22 patients, 8 had cervical skin defect, 5 had tongue defect, 4 had oropharynx defect, 3 had base of tongue defect, and 2 had hypopharynx defect; 13 had the flap passed through the subclavicular tunnel to the head and neck area, and 9 had the flap transposed over clavicle to the neck. The reconstruction size ranged from 15 cm x 12 cm to 8 cm x 5 cm., Results: No patient died during operation, 1 had total flap necrosis, and 1 had partial flap necrosis. The success rate of reconstruction was 95.5%. Postoperative complications occurred in 2 (9.1%) patients: 1 had wound hematocele, and 1 had fistula at the base of the tongue., Conclusions: PMMF is a good donor for head and neck reconstruction, especially for resurfacing huge cervical skin defect. The approach of passing the vascular pedicle through a subclavicular tunnel will not only enhance the arc of rotation, but also help to prevent compression of the vascular pedicle.

Background & Objective: Dissecting the facial nerves safely is an important guarantee for the accomplishment of parotidectomy and reduction of postoperative complications. This study was to explore the application of helix water jet to parotidectomy., Methods: Clinical data of 43 patients with parotid tumors, who received operation with helix water jet from Feb. 2004 to Feb. 2005 at Cancer Center of Sun Yat-Sen University, were analyzed. Meanwhile, traditional techniques in parotidectomy was performed in 36 patients (control group). Duration of operation, postoperative drainage volume, postoperative hospitalization, and occurrence of postoperative complications, such as facial nerve dysfunction and salivary fistula, of the 2 groups were compared., Results: The postoperative drainage volume was significantly lower in water jet group than in control group [(9.89+/-3.74) mL vs. (12.15+/-2.11) mL, P<0.05]. There were no significant differences in duration of operation [(90.28+/-25.30) min vs. (76.32+/-20.74) min, P>0.05], postoperative hospitalization [(6.39+/-1.38) days vs. (6.45+/-1.05) days, P>0.05] between the two groups. Of the 43 patients in water jet group, 6 (14.0%) had grade II facial nerve dysfunction and 1 (2.3%) had grade III facial nerve dysfunction; of the 36 patients in control group, 5 (13.9%) had grade II facial nerve dysfunction, 2 (5.6%) had grade III facial nerve dysfunction, 1 (2.8%) had grade IV facial nerve dysfunction and 1 (2.8%) had salivary fistula. There was no permanent facial nerve dysfunction occurred in both groups. There was no significant difference in the occurrence of complications between the two groups. Nine patients who retained nervus auricularis magnus suffered from slight numbness symptom of auricular lobule., Conclusion: Use of helix water jet in parotid surgery is safe and confers some advantages over conventional methods of parotid dissection.

Objective: To investigate the antitumor effect of a benzoquinone ansamycin antibiotic, geldanamycin (GA), against HER2 /neu tyrosine kinase-overexpressing human breast cancer cell line SKBr3., Methods: To evaluate the antitumor activity of GA, the degradation of HER2 /neu tyrosine kinase in GA-treated SKBr3 cells was analyzed by Western blotting, their proliferation assessed using MTT assay, and the cell cycle distribution identified by flow cytometry. RT-PCR and Real-time PCR were employed to detect cyclin D1 mRNA expression and cell culture inserts model was used to evaluate the motility of the cells., Results: GA induced a dose- and time-dependent degradation of HER2 /neu tyrosine kinase and cell proliferation inhibition. GA treatment obviously decreased the survival rates of the cancer cells, leading also to a dose-dependent G(1) arrest. The antitumor effects of GA proved to be relevant with declined transcription of cyclin D1. The GA-treated cells also exhibited reduced motility., Conclusion: GA can efficiently destabilize HER2 /neu tyrosine kinase and inhibit the proliferation and motility of human breast cancer cell line SKBr3 overexpressing HER2 /neu tyrosine kinase.

Background & Objective: The early diagnosis of head and neck squamous cell carcinoma (HNSCC) is the key factor that affecting the treatment result. We performed surface-enhanced desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS) using a multi-layer artificial neural network (ANN) to develop and evaluate a proteomic diagnosis approach for HNSCC., Methods: Serum samples from 74 HNSCC patients and 146 healthy individuals were randomized into training set (148 samples) and test set (72 samples). At first, we detected the training set of samples using SELDI mass spectrometry and WCX2 (weak cation-exchange) chips. Using a multi-layer ANN with a back propagation algorithm, we identified a proteomic pattern that could discriminate cancer from control samples in the training set. The discovered pattern was then used to determine the accuracy of the classification system in the test set., Results: Four top-scored peaks, at m/z (mass/charge) ratio of 4 469 u, 5 924 u, 8 926 u, and 16 697 u, were finally selected as the potential biomarkers for detection of HNSCC with both sensitivity and specificity of 100.0% in the training set. The classifier predicted the HNSCC with sensitivity of 85.7%(18/21) and specificity of 96.1%(49/51) in the test set., Conclusion: SELDI profiling is a useful tool to accurately identify patients with HNSCC.

Background & Objective: The treatment pattern for cT1-2N0 squamous cell carcinoma (SCC) of the oral tongue is controversial; the postoperative recurrence rate of the disease is high and the salvage effect is poor. This study was to explore the postoperative recurrence-related factors of cT1-2N0 SCC of the oral tongue, to analyze their effects on the survival, and to seek more reasonable therapeutic modality., Methods: Clinical data of 125 patients with cT1-2N0 SCC of the oral tongue, treated in Cancer Center of Sun Yat-sen University from Jan. 1992 to Dec. 2000, were reviewed. Of the 125 patients, 58 were at stage T1, 67 were at stage T2; 17 (13.6%) were treated with local operation alone, 53 (42.4%) were treated with both local operation and selective neck dissection, and 55 (44.0%) were treated with operation and chemotherapy and/or radiotherapy. The correlations of disease duration, tumor growth pattern, clinical TNM stage, pathologic grade, occult cervical lymphatic metastasis, tumor invasion depth, treatment methods and neck management to tumor recurrence and prognosis were analyzed., Results: Forty-one (32.8%) patients had recurrence; the overall 5-year survival rate was 62.59%. The 5-year survival rate was significantly lower in recurrent group than in non-recurrent group (38.74% vs. 74.69%, log-rank=19.27, P<0.001). Disease duration (Chi(2) test, P=0.002), tumor growth pattern (Chi(2) test, P<0.001), neck management (Chi(2) test, P<0.001) and occult cervical lymphatic metastasis (Cox regression, P=0.001) were significantly related to the recurrence of cT1-2N0 SCC of the oral tongue. Tumor invasion depth (Cox regression, P=0.005) and the site of recurrent tumor (Cox regression, P<0.001) were significantly related to the prognosis of cT1-2N0 SCC of the oral tongue., Conclusion: Disease duration, tumor growth pattern, neck management, and occult cervical lymphatic metastasis are main recurrent factors of cT1-2N0 SCC of the oral tongue; tumor invasion depth and the site of recurrent tumor are important prognostic factors.

Objective: As newly, functional, diagnostic measure-18F-deoxyglucose single photo emission computed tomography (18F-FDG SPECT-CT) has well sensitivity and specialty , it was proved availability in differentiating benign and malignant tumor. In this study, it was compared the efficiency of detecting residual tumor of thyroid cancer between 18F-FDG SPECT-CT and CT-TWIN., Methods: During May 2004 to August 2004, 56 patients with thyroid disease were divided into two groups, one group was 32 cases suffered thyroid tumor, another was 24 cases suffered improper operation. All cases must take 18F-FDG SPECT-CT and CT-TWIN., Results: Forty eight cases had been performed operation, and 8 cases waited and watched because they didn't be found residual tumor by 18F-FDG SPECT-CT and CT-TWIN. The results in detecting thyroid tumor showed that the same rate of diagnostic correction of SPECT-CT was 87.5% (28/32), and the Youden index of SPECT-CT was 0.667, higher than that of CT which was 87.5% (28/32) and 0.633 respectively. When the results two methods were accordant, the rate of diagnostic correction was 100% (24/24), and Youden index was 1, and the result had statistic signification. The rate of diagnostic correction of SPECT-CT in detecting residual tumor was 84.6%, and its Youden index was 0.675. The rate of diagnostic correction of CT in detecting residual tumor was 75.0%, and its Youden index was 0.492; and the result had statistics signification by being compared two different measures., Conclusions: SPECT-CT and CT all had higher diagnostic efficacy, and they could promote the diagnostic efficacy when they have the same diagnosis in detecting thyroid tumor. The rate of detecting residual tumor of SPECT-CT was 81.3%, compared with that of CT the diagnostic efficacy has greater raise.

Background & Objective: Patients with thyroid cancer often come along with level VI lymph nodal metastasis. Neck dissection, which includes level VI, is routinely performed on cN1 patients, but whether cN0 patients need routine level VI neck dissection is uncertain. This study was to explore the rule of level VI lymph nodal metastasis in thyroid cancer and the significance of level VI neck dissection in surgical operation for thyroid cancer., Methods: Clinical data of 130 patients with thyroid cancer, who received level VI neck dissection from Jan. 1988 to Jan. 2000, were analyzed retrospectively., Results: Of the 130 patients, 97 had level VI lymph node metastasis, 14 (10.8%) had post-operative complications, including 4 cases of recurrent laryngeal nerve injury. Multivariate survival analysis indicated that level VI lymph nodal metastasis was correlated to the survival of thyroid cancer patients., Conclusions: Routine level VI neck dissection may be helpful to improve the survival of thyroid cancer patients. Meanwhile, complication could be decreased by improving surgical skills.

Background & Objective: T-lymphocyte subsets and NK cell are the major forms of cellular immunity. Study of these 2 types of cells may lead to the better understanding of the function of cellular immunity in the onset and development of carcinoma. To a certain degree, there may be cellular immunodeficiency existing in patients with hypopharyngeal squamous cell carcinoma. This study was to investigate the cellular immunity function in these patients., Methods: T-lymphocyte subsets and NK activity were determined by flow cytometry in 78 patients with hypopharyngeal squamous cell carcinoma. Blood samples of 20 non-tumor patients were used as control., Results: The levels of CD4 lymphocyte subsets, CD4/CD8 ratio, and NK activity were lower in carcinoma group than in control group, but CD8 lymphocyte level was higher in carcinoma group. The levels of CD4 lymphocyte subsets, CD4/CD8 ratio, and NK activity were lower in T3-4 group than in T1-2 group, and lower in N+ group than in N0 group. The levels of CD4 lymphocyte subsets and CD4/CD8 ratio were decreased in the carcinoma with moderate or low differentiation (P<0.05)., Conclusions: T-lymphocyte subsets and NK activity are inhibited, and the cellular immunology is suppressed in the patients with hypopharyngeal squamous cell carcinoma. Analyzing T-lymphocyte subsets and NK activity would be helpful to evaluate the cellular immunologic condition of these patients.

Background & Objective: Primary mucosal malignant melanoma of the nasal cavity, paranasal sinuses, and nasopharynx is rare and current research data of this disease are mainly from western populations. This study was to analyze the clinical characteristics of this disease and prognositic factors., Methods: From Jan. 1971 to Jul. 2005, 66 patients with primary nasal mucosal melanoma were treated in Cancer Center of Sun Yat-sen University, China. Demographics and baseline characteristics, treatments, recurrence, metastasis, and survival were documented in hospital records. All records of these patients were analyzed retrospectively. Kaplan-Meier method was used to calculate survival rate; Cox model was used to analyze prognostic factors., Results: Among 44 evaluable cases, 37 were originated from the nasal cavity, 5 from the paranasal sinuses, and 2 from the nasopharynx. Cervical lymphadenopathy at initial presentation occurred in 12 patients. Of the 31 patients received operation-dominated treatment, 8 received adjuvant radiotherapy, 13 received adjuvant chemotherapy, and 6 received adjuvant non-specific immunotherapy. The median time of follow-up was 29 months. Local recurrence, cervical lymphadenopathy, and distant metastasis occurred in 24, 10, and 11 patients, respectively, during follow-up. The median survival time was 24 months and the 5-year survival time was 25%. Clinical stage affected prognosis, whereas age, gender, site, primary tumor mass, and adjuvant therapy were not correlated to survival status., Conclusion: Nasal mucosal melanoma has high incidence of local recurrence and distant metastasis, especially cervical lymphadenopathy. Clinical stage affects the prognosis.

Objective: To investigate the therapeutic effects of insulin-sensitizing drugs, rosiglitazone and metformin, on nonalcoholic fatty liver disease (NAFLD)., Methods: Forty-four male SD rats were randomized into 4 groups: normal control group (n = 8, fed with normal food) and NAFLD rats (n = 36, fed with high-fat food). Eight weeks later 4 rats were randomly selected from the NAFLD group and were killed to undergo pathological examination of the liver. When the establishment of experimental model of NAFLD rats was confirmed the remaining 32 NAFLD rats were subdivided into 4 equal subgroups: NAFLD control group (to be fed continuously with high-fat food), rosiglitazone treatment group (fed with normal food and rosiglitazone 1.5 mg x kg(-1) x d(-1) by gastric perfusion), metformin treatment group (fed with normal food and metformin 150 mg x kg(-1) x d(-1) by gastric perfusion), and dietary treatment group (fed with normal food and normal saline by gastric perfusion). By the end of the 12th week, all rats were killed to isolate the samples of serum to test the levels of total cholesterol (TC), triglyceride (TG), alanine transaminase (ALT), aspartate transaminase (AST), and tumor necrosis factor-alpha (TNF-alpha). Samples of liver tissue were taken to undergo pathology to examine fatty degeneration and inflammatory cell infiltration and detection of the levels of TC and TG. In the liver the weights of body and liver were measured so as to calculate the liver index., Results: (1) The levels of serum TC, TG, ALT, and AST, liver TC and TG, and liver index of the NAFLD control group increased significantly, and the liver histology of the NAFLD control group expressed moderate to severe fatty degeneration. (2) The serum TC levels of the rosiglitazone and metformin groups were 2.49 mmol/L +/- 0.68 mmol/L and 2.49 mmol/L +/- 0.58 mmol/L, both significantly lower than that of the NAFLD control group (4.55 mmol/L +/- 1.58 mmol/L, both P < 0.001). The serum TG levels of the rosiglitazone and metformin groups were 0.61 mmol/L +/- 0.17 mmol/L and 0.63 mmol/L +/- 0.16 mmol/L respectively, both significantly lower than that of the NAFLD control group (0.85 mmol/L +/- 0.15 mmol/L, both P < 0.001). The serum level of ALT of the rosiglitazone and metformin groups were 38.3 U/L +/- 10.6 U/L and 43.3 U/L +/- 27.5 U/L respectively, both significantly lower than that of the NAFLD control group (110.6 U/L +/- 44.2 U/L, P < 0.001 and P < 0.05). The serum levels of AST of the rosiglitazone and metformin groups were 141.7 U/L +/- 14.3 U/L and 174.5 U/L +/- 57.9 U/L, both significantly lower than that of the NAFLD control group (251.8 U/L +/- 91.0 U/L, both P < 0.05). The liver TG levels of the rosiglitazone and metformin groups were 18.9 mg/g +/- 2.7 mg/g and 20.4 mg/g +/- 3.6 mg/g respectively, both significantly lower than that of the NAFLD control group (54.8 mg/g +/- 7.6 mg/g, both P < 0.05). The fatty degeneration grades of liver tissues of the rosiglitazone and metformin groups were grade: 0.8 +/- 0.3 and 1.0 +/- 0.2, both significantly lower than that of the NAFLD control group (grade 2.8 +/- 0.5, both P < 0.05). The hepatic inflammation scores of: the rosiglitazone and metformin groups were 0.8 +/- 0.2 and 1.0 +/- 0.3 respectively, both significantly lower than that of the NAFLD control group (1.8 +/- 0.4, both P < 0.05). The levels of abnormality in serum TC and TG, liver TG, and liver histology of the dietary treatment group were all alleviated in comparison with the NAFLD control group, but were somewhat severer than those of the rosiglitazone and metformin treatment groups. (3) The serum TNF-alpha levels of the rosiglitazone and metformin treatment groups were 124.6 pg/mL +/- 21.0 pg/mL, 154.9 pg/mL +/- 32.5 pg/mL respectively, both significantly lower than that of the NAFLD group (324.2 pg/mL +/- 34.2 pg/mL, P < 0.001 and P < 0.05). The liver TNF-alpha levels of the rosiglitazone and metformin treatment groups were 0.24 +/- 0.14 and 0.30 +/- 0.12 respectively, both significantly lower than that of the NAFLD group (0.85 +/- 0.12, both P < 0.001). The levels of FAS mRNA expression of the rosiglitazone and metformin treatment groups were 0.22 +/- 0.14 and 0.29 +/- 0.16 respectively, both significantly lower than that of the NAFLD group (0.68 +/- 0.23, P < 0.001 and P < 0.005)., Conclusion: The insulin-sensitizing drugs, rosiglitazone and metformin, are effective in the treatment of NAFLD.

Objective: To review and evaluate pathologic features and treatment of epithelial-myoepithelial., Methods: Retrospectively reviewed 14 cases' pathological and clinical materials of epithelial-myoepithelial carcinoma of salivary gland. Eight cases origine from parotid gland, 2 cases from hard palate, 3 cases from submandibular gland and 1 case from nasal cavity. Three cases were performed induction chemotherapy preoperation. One case had palliative radiotherapy. Thirteen cases were performed radical surgery and 6 cases had radiotherapy postoperation., Results: Tumor arisen mostly from parotid gland and neck lymph node metastasis rate was 14.28% (2/14). The survival rate was calculated with Kaplan-Meier method. The overall 3-, 5- and 10-year survival rate were 67.20%, 45.49% and 17.06%. Its histological characteristics were inner layer composed by adenoid cells and outer layer composed by myoepithelial cells. Immunohistochemical exam show cytokeratin, S-100 and actin reaction positive., Conclusions: Epithelial-myoepithelial carcinoma easily develops recurrence. It is sensitivity to radiotherapy and chemotherapy to some extent. It is suitable to adopt surgical treatment as primary modality combined with other therapies.

Objective: To study the rules of occurrence and development of TCM syndromes in patients of depression by analysing the population distribution and related factors of it., Methods: A clinical epidemiologic survey was carried out with the materials collected by the four-diagnostic method from patients of depression to gain the syndrome types of 397 patients through dynamic cluster analysis, factor analysis and TCM syndrome differentiation. The constitution of syndrome types in different population and the relation between TCM syndrome types and the clinical types differentiated by Western medicine of depression was analyzed., Results: Six syndrome types were found in 397 patients with depression. They were, ranging in occurrence order, the Gan-Qi stagnation with mental uneasiness type (108 cases, 27.2%); the Xin-Pi deficiency with dampness retention type (94 cases, 23.7%); the Xin-Gan Qi-stagnation with Phlegm retention type (76 cases, 19.1%); the Xin-Gan Qi stagnation with Jing-Luo disharmony type (57 cases, 14.3%); the Xin-Shen Qi stagnation with collateral obstruction type (34 cases, 8.6%); and the Xin-Gan Qi stagnation with Heat interfering mental type (28 cases, 7.1%). There were statistical significance (P < 0.01) in comparison of the syndrome types constitution among patients of different ages or different Western medicinal types (mild, with or without psychotic symptoms), but no significant difference was shown in that among patients of different sexes, with or without familial history of mental diseases, with monophasic or biphasic, initial or recurrent episode (P > 0.05)., Conclusion: The result obtained in this study is basically in accord with the cognitive rule of TCM theory, it provides a reliable base of syndrome differentiation for treatment.

Objective: To investigate the clinical characteristics of second primary tumor of tongue after nasopharyngeal carcinoma (NPC) radiotherapy and the prognostic factors of patients., Methods: Fifty-three cases with second primary tumor of tongue after NPC radiotherapy, presenting to Cancer Centre, Sun Yat-sen University from Jan. 1st 1975 to Dec. 31st 2000 were analyzed retrospectively with regard to mortality and survival rate (Kaplan-Meier method); A multivariate analysis was performed in these patients with Cox proportional hazard model., Results: Forty of 53 patients died. Among them,37 died of second primary tumor of tongue, 2 of recurrence of NPC, 1 of perioperative period. The overall 5-year and 10-year survival rate of 51 patients receiving therapy were 41.64% and 35.69% respectively. The subsites of tumor were: tip 0, margin 26 (49.06%), ventral lateral 8 (15.09%) and dorsal aspect 19 (35.85%). Eighteen cases had recurrence of second primary tumor of tongue (33.96%) ; Six (11.32%) cases had clinical lymph node metastasis from second primary tumor of tongue and 3 (5.66%) had pathological lymph node metastasis; The univariate analysis showed the major prognostic factors influencing survival of these patients were tumor size, clinical TNM stage at presentation; Using multivariate analysis, risk factors that independently influence survival were clinical and pathological stage and the interval between two tumors., Conclusions: The clinical and pathological stage and the interval between two tumors are the prognostic factors for second primary tumor of tongue after NPC radiotherapy.

Background & Objective: Dendritic cells (DCs) are the most important antigen-presenting cells, and can synthesize and secrete S100 protein. This study was designed to investigate the expression of S100-labeled DCs in glottic squamous cell carcinoma, and analyze its correlation to the prognosis., Methods: The expression of S100-labeled DCs in peritumoral tissues of 111 specimens of gllotic squamous cell carcinoma was detected by immunohistochemistry; 17 specimens of normal tissues were used as control. The correlation of S100-labeled DCs expression to prognosis of the 111 patients was evaluated., Results: The positive rates of S100-labeled DCs were 51.35% (57/111) in peritumoral tissues of gllotic squamous cell carcinoma, and 0 in normal tissues. The 5-year survival rate was significantly higher in S100-positive group than in S100-negative group (72.31% vs. 53.91%, P=0.030)., Conclusions: The glottic squamous cell carcinoma patients with obvious infiltration of S100-labeled DCs may achieve good prognosis.

Background & Objective: Dendritic cells (DCs) are the most important antigen-presenting cells. CD1a, a marker of immature DCs, plays a role in tumorigenesis. This study was designed to explore the correlation of CD1a(+) DCs to pathologic degree, T stage, local recurrence, and prognosis of glottic squamous cell carcinoma., Methods: Clinical and follow-up data of 111 patients with glottic squamous cell carcinoma were analyzed retrospectively. The expression of CD1a(+) DCs in the 111 specimens of glottic squamous cell carcinoma and 17 specimens of non-tumor tissue was detected by immunohistochemistry. Correlations of CD1a(+) DCs to pathologic degree, T stage, local recurrence, and prognosis of glottic squamous cell carcinoma were analyzed., Results: Positive rates of CD1a(+) DCs were 59.46% in glottic squamous cell carcinoma tissues, and 0 in non-tumor tissues; it was significantly higher in well-differentiated group than in moderately-and poorly-differentiated group [71.43% (55/77) vs. 28.57% (11/34), P<0.05], higher in T1-T2 group than in T3-T4 group [67.16% (45/67) vs. 47.73% (21/44), P<0.05], and higher in non-recurrence group than in local recurrence group [65.06% (54/83) vs. 42.86% (12/28), P<0.05]., Conclusions: The lower pathologic degree and higher T stage of glottic squamous cell carcinoma, the lower expression of CD1a(+) DCs. The positive rate of CD1a(+) DCs is low in recurrent glottic tumor. High expression of CD1a(+) DCs may indicate better prognosis of glottic squamous cell carcinoma.

Objective: This study was designed to explore the optimal management option for cervical metastases in tongue squamous cell carcinoma (SCC) with clinically N0 neck in order to avoid excessive or inadequate treatment in clinical practice., Methods: Clinical data of 327 cases of tongue SCC with cN0 neck were retrospectively analyzed. Neck control rates affected by different pathoclinical parameters were compared. Prognosis analysis and death analysis were also performed., Results: Overall 3-year survival was 69.7% (228/327), 3-year survival of neck recurrent group and non-recurrent group was 39.1% (25/64) and 77.2% (203/263), and 51.5% (51/99) of the death related to neck failure. Overall neck control rate was 80.4% (263/327); neck control rate of wait and watch group, level I neck dissection, level I + II neck dissection, supraomohyoid neck dissection, radical neck dissection, functional neck dissection, was 67.5% (27/40), 72.7% (24/33), 60.0% (15/25), 84.9% (45/55), 86.8% (131/151), 84.0% (21/25), respectively. Treatment modality and cervical lymph node involvement were independent factors for neck control., Conclusions: Neck control is a key for prognosis of tongue SCC with cN0 neck. Supraomohyoid neck dissection is the first choice in management of cervical metastases in tongue SCC with cN0 neck, during which the suspected involved lymph nodes should be sent for frozen section to determine whether comprehensive neck dissection required. Multimodal metastasis and/or capsular spread are the indications for postoperative irradiation.

Background & Objectives: At present head and neck surgeons from many countries have different opinions on management of well-differentiated thyroid cancer (WDTC). We will discuss WDTC invading trachea surgical treatment and its clinical significance., Methods: Retrospectively reviewed clinical data of 15 cases WDTC invading trachea, According to WDTC invading extent and grade, there were 3 kinds of surgical approaches: 1) end to end anastomosis; 2) tissue flap reconstruction; 3)larynx-tracheal dissociation., Results: 15 cases underwent radical resection and reconstruct the defect of tracheal or larynx-tracheal dissociation. 2 cases received directly suture, 5 cases received sternocleidomastoid muscle flap reconstruction, 2 cases received pectorlis major muscle flap reconstruction, 2 cases received platysma flap reconstruction, 2 cases received free forearm flap with muticore titanium-board reconstruction, 2 cases received larynx-tracheal dissociation with larynx block out and tracheal fistula. 10 cases (10/15, 66.7%) received decannulation postoperation. Patients who were success fully decannulated could recover phonation and maintain airway breath. In the 5 patients who couldn't decannulate, underwent sternocleidomastoid muscle flap reconstruction, 1 underwent free forearm flap with muticore titanium-board reconstruction, 1 underwent pectorlis major muscle flap reconstruction, 2 underwent larynx-tracheal dissociation, but all of them could hardly utter voice by compress tracheostoma and needed permanent tracheostoma due to collapse of trachea. The recurrence rate of our group is 33.33%, 5 years survival rate is 88.89%., Conclusions: WDTC with trachea invading easily cause dyspnea or emptysis influencing on 5 years survival rate. We should take more actively surgical approach to resect all the tumor and involved organ, thus improve survival rate and reduce recurrence postoperation.

To study the effect of curcumin on signaling pathway of signal transducers and activators of transcription (STAT5) in primary newly-diagnosed chronic myelocytic leukemia (CML) cells, and to explore the clinical significance of curcumin in the treatment of primary CML cells, the cells were randomly divided into 3 groups: normal control group, CML cells group, and curcumin group; the cellular proliferation was assayed by MTT test; the expression of cellular STAT5 mRNA in CML cells was detected by RT-PCR; the activation of STAT5 in CML cell was detected by electrophoretic mobility shift assay (EMSA). The results showed that the cellular proliferation of curcumin group (OD value 0.640 +/- 0.073) was decreased, as compared with that of the CML cells group (OD value 0.856 +/- 0.083, P <0.01). The expression levels of STAT5 mRNA in CML cells group (integral ratio of OD 1.782 +/- 0.156) were significantly greater than that in the normal control group (integral ratio of OD 0.289 +/- 0.025, P <0.01). The expression of STAT5 mRNA in curcumin group (integral ratio of OD 1.398 +/- 0.126) was significantly decreased as compared with that in the CML cells group (P <0.01). The activation of STAT5 was significantly increased in CML cells group (gray value 5323.375 +/- 515.640) as compared with that in the normal control group (gray value 2943.000 +/- 273.377, P <0.01). The activation of STAT5 of curcumin group (gray value 4331.750 +/- 398.035) was significantly decreased as compared with that of CML cells group (P <0.01). It is concluded that the cellular proliferation and the expression of STAT5 mRNA are increased in the primary CML cells. The activation of STAT5 in primary CML cells is markedly enhanced. STAT5 signaling pathway may be involved in the proliferation of primary CML cells. Curcumin can inhibit the cellular proliferation and the expression of STAT5 mRNA, and down-regulate the activation of STAT5 in primary CML cells. Curcumin may be used in treatment of leukemia.

Objective: To analyze the reasons for re-operation and living condition of thyroid carcinoma patients who received second operation, and to formulate indications for selecting re-operation candidates and operation types., Methods: One hundred and eleven thyroid carcinoma patients were retrospectively summarized. All patients received re-operation after thyroidectomy from 1986 to 1997. The post operative follow-up data were analyzed statistically., Results: Pathological results confirmed there were 67.6% (75/111) cases with residual tumor. The incidence rate of post-operative complications was 2.7%, including 0.9% (1/111) recurrent laryngeal nerve injury. The sensitivity of residual carcinoma detection by CT scan before operations was 80.0% (28/35), with the positive predictive value of 87.5% (28/32). The recurrence rate within 3 years was 11.7% (13/111), with a local control rate of 88.3% (98/111). The recurrence rate within 5 years was 14.4% (16/111), with a local control rate of 85.6% (95/111). Life table was adopted to calculate living rates. The accumulated 5-year and 10-year living rates of re-operated thyroid carcinoma patients were 95.0% and 93.2% respectively. Analysis of Cox Regression showed that carcinoma recurrence influenced survival conditions significantly., Conclusions: The residual rate of re-operated patients with thyroid carcinoma was relatively higher, so a cautious re-operation was necessary. CT scan has a relatively higher positive predictive rate in detecting residual carcinoma, so it is necessary for screening right candidates for re-operation. Recurrence was the main factor that influenced patients' survival. So making proper indications, according to which to select patients who need re-operations will decrease the incidence of unnecessary operations.

Objective: To study the possible pathway of the effect of musk on brain disorder, distributing into the brain through blood brain barrier., Methods: We used the musk ketone (muscone), a main composition of musk, to inject through the tail vein of the rats into the blood and took the brain and other organs at different times to make samples. Then gas chromatography was used to measure the distribution of muscone in the brain and other organs., Results: Muscone could pass through the normal rat's blood brain barrier into the brain and soon reached the highest peak and remained in higher concentration, and more slowly metabolized as compared with other organs., Conclusion: Musk distributing into the brain through blood brain barrier provides the basis for its effect in treating brain disorders. Chromatography is an effective method to study the active composition of Chinese herbal medicine distributing through the blood brain barrier into the brain.

In order to explore the underlying mechanism of high effects and low toxicity of trichostatin A (TSA), the effect of TSA on growth inhibition, histone acetylation level and apoptosis in HL-60 cells and normal human peripheral blood mononuclear cells (NPBMNC) were examined using MTT method, immunocytochemistry technology, and Annexin-V-FITC/PI double staining flow cytometry. The results showed that TSA inhibited growth of HL-60 in time- and dose-dependent manners, and the IC(50) of 36 hours was 100 ng/ml. The apoptosis induction effect of TSA in HL-60 cells was also time- and dose-dependent. Besides, the dose of TSA showing significant apoptotic cytotoxicity in HL-60 cells did not demonstrate apparent apoptosis induction in NPBMNC within definite dose and time range. The histone acetylation level in HL-60 cells and NPBMNC both showed remarkable increase (P < 0.05) after incubated with 100 ng/ml TSA for 4 hours without statistical difference between them is detected (P > 0.05). It is concluded that TSA shows effects of definite and significant growth inhibition and apoptosis induction on HL-60 cells in time- and dose-dependent manners. TSA is able to selectively induce apoptosis in HL-60 cells with low toxicity in NPBMNC at the same time. The mechanism of this selectivity can not be ascribed to the differential regulation of histone acetylation level between HL-60 cells and NPBMNC.

Objective: To study the diagnosis and treatment of a second primary malignant tumor induced by previous radiotherapy., Methods: From March 1970 to March 1997, 108 nasopharyngeal cancer (NPC) patients who developed a second primary malignant tumor induced by radiotherapy were treated. There were squamous carcinoma 43 (39.8%), sarcoma 26 (24.1%), malignant fibrous histiocytoma 14 (13.0%), adenoid cystic carcinoma 12 (11.1%), thyroid papillary adenocarcinoma 8 (7.4%) and malignant melanoma 5 (4.6%). Fifty patients underwent operation, 32 received radiotherapy, 18 received chemotherapy and 8 received operation combined with chemotherapy., Results: The 3- and 5-year tumor-free survival rates were 64.0% and 36.0% in the operation group. They were 34.4% and 18.8% in the radiotherapy group., Conclusion: Surgery, if not contra-indicated, is the first choice for the second primary malignant tumor induced by radiotherapy. Aggressive treatment for these patients is, hence, indicated clinically.

Background & Objective: There were many treatment strategies for inferior postcricoid carcinoma; however, the total survival rates were not so good till now. This study was designed to investigate the effective method for treatment of inferior postcricoid carcinoma., Methods: Thirty-nine cases of inferior postcricoid carcinoma from 1970 to 1997 in Department of Head and Neck, Cancer Center, Sun Yat-sen University were surveyed. The treatment modalities were classified into two groups: simple radiotherapy and multimodality (surgery operation plus postoperational radiotherapy). The 3-year and 5-year survival rates of the two groups were analyzed. The different local lymph nodes metastasis was explored at the same time., Results: Both the 3-year and 5-year survival rates of the simple radiotherapy group (35.2% and 17.6%) were lower than another group (59.1% and 45.5%) with significant difference (P< 0.05). Of 39 follow-up patients, 18 were found with neck lymph node metastasis. Contralateral or (and) bilateral lymph node metastasis were found in 72.7%(13/18) of the patients with neck lymph node metastasis., Conclusion: Multimodality is an effective method for inferior postcricoid carcinoma. It will increase the survival rate of the inferior postcricoid carcinoma by paying more attention to contralateral or (and) bilateral lymph node metastasis and dealing with it actively.

Background & Objective: At present, whether neck dissection should be employed in squamous cell carcinoma (SCC) of the tongue with clinically node negative neck(cN0) is still controversial. This study was designed to explore the regularity of cervical lymph node metastasis in SCC of the mobile part of the tongue, and to discuss the theories and principles of employment of selective neck dissection in cN0 cases., Methods: A retrospective research was performed on clinical data of 214 cases of SCC of the tongue treated with surgery from 1991 to 1997. Distribution of cervical lymph node metastasis of cN0 pN(+)= (pathologically node positive) and cN(+) (clinically node positive) pN(+)= cases were analyzed; the survival rates of different groups were compared; the factors that impact the survival of SCC of the tongue were screened out by Cox regression analysis., Results: Cervical lymph node metastases were found in 69 cases. The metastatic rate was 32.2%. Metastases occurred in level I, II, III, IV, V of the ipsilateral neck were 22.3%, 33.5%, 22.3%, 4.6%, 1.0%, in level I,II,III, IV,V of the contralateral neck were 6.6%, 3.6%, 3.0%, 2.0%, 0.5%, respectively. The 5-year survival rates of the pN(+)= group and the pN0 group were 47% and 83%, respectively(P< 0.001). T stage and N stage were independent factors that impact the long-term outcome of SCC of the tongue., Conclusion: Level I,II,III of the ipsilateral neck tend to be involved when cervical lymph node metastases occur. Selective neck dissection can be used to treat the cervical metastasis in cN0 cases, as well as to evaluate the cervical lymph node status in order to determine whether comprehensive neck dissection should be employed.

Background & Objective: There was little report on the rule of lymph node metastasis in the cancer of mouth floor. The aim of this study was to investigate the rule of lymph node metastasis and investigate the reasonable treatment., Methods: A total of 79 cases with squamous carcinoma of mouth floor were included into this study retrospectively. The distributive difference of clinical and pathological positive lymph node was compared. The recurrent rate of the patients who were performed with radical neck dissection and supra-half-neck dissection in clinical positive lymph node group were compared with the recurrent rate of the patients who were preformed with radical neck dissection, supra-half-neck dissection, submandibular triangle dissection, and clinical observational group., Results: Clinical and pathological positive lymph node was found mainly in II region (61.8% and 40.0%, respectively), secondly in I and/or III region, and rarely in IV, V, and VI region. In clinical positive lymph node group, the recurrent rate of the patients who performed with radical cervical neck dissection was lower than supra-half-neck dissection, but without statistical significance (chi 2 = 3.403, P = 0.065). In clinical cervical negative lymph node group, the recurrent rates of the patients performed with supra-half-neck, submandibular triangle dissection, and in clinical observational group were 11.1% (1/9), 40.0% (2/5), and 23.5% (4/17), without statistical significance (chi 2 = 1.554, P = 0.46)., Conclusion: Lymph node metastasis of cancer of floor of mouth mainly distributes in I, II, III region; The patients with negative cervical lymph node should be performed lymph node dissection in I, II, III region (supra-half-neck).