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In recent years, artificial intelligence has been employed to empower synthetic biology, demonstrating great potential in the simulation and prediction of protein structures as well as the design and optimization of regulatory elements and metabolic networks. Integrating artificial intelligence into the teaching of Synthetic Biology is in line with the development trends of synthetic biology and can promote the cultivation of interdisciplinary high-level talents and collaborative innovation. This paper expounds the idea of integrating artificial intelligence into the teaching of Synthetic Biology from establishing interdisciplinary course contents and teaching methods, simultaneously considering the fundamentals and application of artificial intelligence in synthetic biology, cultivating independent learning and innovative practice abilities, and enhancing the ethics education related to artificial intelligence. Furthermore, a system integrating artificial intelligence with the teaching contents of Synthetic Biology is designed, which focuses on supplementing fundamentals of artificial intelligence and incorporating artificial intelligence into the classroom and experimental teaching contents of Synthetic Biology. Moreover, with the course of Synthetic Biology in Jiangnan University as an example, this paper presents the pathway of integrating artificial intelligence into the teaching of this course under the background of discipline crossing. Finally, the teaching effects are expected.

Objective: To evaluate the immunogenicity and protective effect of a multicomponent recombinant protein vaccine EPRHP014 constructed independently and provide a scientific basis for developing new tuberculosis (TB) vaccine and effective prevention and control of TB. Methods: Three full-length Mycobacterium ( M. ) tuberculosis protein antigens (EsxH, Rv2628, and HspX) and two epitope-predicted and optimized epitope-dominant protein antigens (nPPE18 and nPstS1) were selected, from which five protein antigens were used to construct a protein antigen composition EPRHP014, including a fusion expression multi-component protein antigen (EPRHP014f) and a multi-component mixed protein antigen (EPRHP014m) formed with the five single protein using clone, purification, and purification respectively. Multicomponent protein vaccines EPRHP014f and EPRHP014m were prepared with aluminum adjuvant, and the BCG vaccine was used as a control. ELISA detected the titer of serum-specific antibodies, the secretion of various cytokines was detected by ELISpot and Luminex, and immune protection was observed by the M. tuberculosis growth inhibition test in vitro. The results were statistically analyzed by t -test or rank sum test, and P <0.05 was considered a statistically significant difference. Results: Mice Immunized with EPRHP014m and EPRHP014f could produce highly effective IgG antibodies and their subtypes IgG1 and IgG2a, and the antibody titers were similar to those of mice immunized with BCG, with no statistical significance ( P >0.05). The number of spot-forming cells (SFC) secreting IFN-γ and IL-4 induced by EPRHP014f group was significantly higher than those by EPRHP014m group and BCG group ( P <0.05), but there was no significant difference in the number of SFC for IFN-γ and IL-4 induced between EPRHP014m group and BCG group ( P >0.05). The secretion levels of GM-CSF and IL-12p70 induced by the EPRHP014m group were higher than those of the BCG group ( P <0.05), but there was no significant difference in the levels of IL-6 and IL-10 induced between EPRHP014m group and BCG group ( P >0.05). There was no significant difference in the secretions of IL-6, IL-10, IL-12, and GM-CSF between the EPRHP014f and BCG groups ( P >0.05). EPRHP014m group, EPRHP014f group, and BCG group had obvious antibacterial effects in vitro, and the difference was insignificant ( P >0.05). Conclusion: Both EPRHP014f and EPRHP014m can induce strong humoral and cellular immune responses in mice after immunization, and have a strong ability to inhibit the growth of M. tuberculosis in vitro, indicating that the antigen composition EPRHP014 has good potential in the development and application of TB vaccine.

Objective: To investigate the clinical effects of expanded flaps in reconstructing scar contracture deformities in the face and neck after extensive burns. Methods: A retrospective observational study was conducted. From May 2016 to September 2022, 17 patients with scar contracture deformities in the face and neck after extensive burns were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital, including 13 males and 4 females, aged 23 to 55 years, with 3 patients having degree Ⅱ cervical contracture, 14 patients having degree Ⅲ cervical contracture, and 12 patients having facial scar contracture deformity. In the first stage, 34 rectangular skin and soft tissue expanders (hereinafter referred to as expanders) with rated capacity of 100-600 mL were inserted into the face, chest, shoulder, and abdomen, and then the normal saline was injected for expansion. In the second stage, the scar tissue was removed and the contracture was released to correct the deformity. Two expanded facial flaps were transplanted in local fashion, 17 expanded flaps were transplanted in pedicled fashion, and 15 expanded flaps were freely transplanted to repair the secondary wounds after release, with artery pressurization was performed in 7 flaps. Indocyanine green fluorescence imaging was used to evaluate the arterial blood perfusion and venous return of the flaps during transplantation. The incision area of 32 flaps except 2 facial flaps was 10 cm×8 cm-36 cm×16 cm. The wounds of 31 flap donor sites were closed by direct suture, and the wound of 1 flap donor site was repaired by autologous split-thickness scalp transplantation. The skin condition of inserted place, expansion time, and total amount of normal saline injection of expanders, complications of skin and soft tissue expansion surgery, and survival of flap after the second stage surgery were observed and recorded. The long-term face and neck reconstruction effect and recovery of flap donor area were followed up. At the last follow-up, the 5-level Likert scale was used to evaluate the efficacy satisfaction of patients. Results: Of the 34 expander inserted places in 17 patients, 22 places were superficial scar skin after deep partial-thickness burns, 8 places were superficial scar skin after multiple skin donations, and 4 places were normal skin. After 4 to 15 months of expansion, the total normal saline injection volume was 238 to 2 000 mL, with no complications occurred. After the second stage surgery, the distal part of 2 pedicled flaps was partially necrotic, and the necrotic wounds were healed after flap dressing and free transplantation of contralateral expanded triangular flaps, respectively; the other flaps survived completely. During 6 to 18 months of follow-up, except for 2 expanded paraumbilical flaps and 1 expanded groin flap, which were bloated and improved by flap thinning, the appearance and texture of the other flaps were good, and all the flap donor sites recovered well. At the last follow-up, the face and neck scar contracture deformities were significantly improved in all patients, and the satisfaction of curative effect of patient was very satisfactory in 8 patients and relatively satisfactory in 9 patients. Conclusions: The expanded flaps of chest, abdomen, and other parts, combined with local advance, pedicled, and free transplantation, can effectively reconstruct scar contracture deformities in the face and neck after extensive burns, restore the function of operative area and improve the appearance simultaneously, with high degree of patient satisfaction, which is worthy of promotion in clinic.

This study constructed a nano-drug delivery system, A3@GMH, by co-delivering the stapled anoplin peptide(Ano-3, A3) with the light-harvesting material graphene oxide(GO), and evaluated its oncolytic immunotherapy effect on triple-negative breast cancer(TNBC). A3@GMH was prepared using an emulsion template method and its physicochemical properties were characterized. The in vivo and in vitro photothermal conversion abilities of A3@GMH were investigated using an infrared thermal imager. The oncoly-tic activity of A3@GMH against TNBC 4T1 cells was evaluated through cell counting kit-8(CCK-8), lactate dehydrogenase(LDH) release, live/dead cell staining, and super-resolution microscopy. The targeting properties of A3@GMH on 4T1 cells were assessed using a high-content imaging system and flow cytometry. In vitro and in vivo studies were conducted to investigate the antitumor mechanism of A3@GMH in combination with photothermal therapy(PTT) through inducing immunogenic cell death(ICD) in 4T1 cells. The results showed that the prepared A3@GMH exhibited distinct mesoporous and coated structures with an average particle size of(308.9±7.5) nm and a surface potential of(-6.79±0.58) mV. The encapsulation efficiency and drug loading of A3 were 23.9%±0.6% and 20.5%±0.5%, respectively. A3@GMH demonstrated excellent photothermal conversion ability and biological safety. A3@GMH actively mediated oncolytic features such as 4T1 cell lysis and LDH release, as well as ICD effects, and showed enhanced in vitro antitumor activity when combined with PTT. In vivo, A3@GMH efficiently induced ICD effects with two rounds of PTT, activated the host&apos;s antitumor immune response, and effectively suppressed tumor growth in 4T1 tumor-bearing mice, achieving an 88.9% tumor inhibition rate with no apparent toxic side effects. This study suggests that the combination of stapled anoplin peptide and PTT significantly enhances the oncolytic immunotherapy for TNBC and provides a basis for the innovative application of anti-tumor peptides derived from TCM in TNBC treatment.

Novel drug discovery from the active ingredients of traditional Chinese medicine is the most distinctive feature and advantageous field of China, which has provided an unprecedented opportunity. However, there are still problems such as unclear functional substance basis, action targets and mechanism, which greatly hinder the clinical transformation of active ingredients in traditional Chinese medicine. Based on the analysis of the current status and progress of innovative drug research and development in China, this paper aimed to explore the prospect and difficulties of the development of natural active ingredients from traditional Chinese medicine, and to explore the efficient discovery of trace active ingredients in traditional Chinese medicine, and obtain drug candidates with novel chemical structure, unique target/mechanism and independent intellectual property rights, in order to provide a new strategy and a new model for the development of natural medicine with Chinese characteristics.

Objective: Pelvic high-resolution magnetic resonance imaging (MRI) has now become a standard method for evaluating the efficacy of neoadjuvant treatment for locally advanced rectal cancer (LARC). However, this traditional morphological qualitative assessment method based on T2-weighted imaging (T2WI) is not effective in predicting pathological complete remission (pCR). The purpose of this study is to investigate whether combining the magnetic resonance tumor regression grade (mrTRG) with apparent diffusion coefficient (ADC) can improve diagnostic value for pCR after preoperative neoadjuvant chemoradiotherapy (nCRT) of LARC. Methods: This was a diagnostic study. Clinicopathological data of 134 LARC patients who received nCRT and radical surgery in the First Affiliated Hospital of Kunming Medical University from January 2017 to December 2019 were retrospectively analyzed. All the patients underwent MRI which included T2WI and DWI sequences before and 8 weeks after nCRT. Two radiologists independently drew ROIs on T2WI and DWI to estimate mrTRG stage and calculate the mean ADC value. Receiver operating characteristics (ROC) method was applied to evaluate the predict value of mrTRG combined with mean ADC value for pCR. Results: Of 134 LARC patients, 85 were male and 49 were female with median age of 58 (28-82) years. After nCRT, MRI suggested 21 patients (15.7%) had clinical complete remission (cCR), e.g. mrTRG stage 1-2. Postoperative pathology revealed 31 (23.1%) patients had pCR. The evaluations of mrTRG and ADC value by the two readers were highly consistent, and the intra-group correlation coefficients were 0.83 (95% CI: 0.703-0.881) and 0.96 (95% CI: 0.989-0.996), respectively. There was a negative correlation between mrTRG and pCR ( r(s) =-0.505, P <0.01), and a positive correlation between mean ADC value and pCR ( r(s) =0.693, P <0.01). The ROC curve showed that mrTRG alone had a medium predictive value for pCR, with an area under the curve (AUC) of 0.832 (95% CI: 0.743-0.921); the mean ADC value had a higher predictive value for pCR, with AUC of 0.906 (95% CI: 0.869-0.962). The predictive value of the combined model of mrTRG and ADC value for pCR was significantly better than that of mrTRG alone ( P =0.015), and the AUC was 0.908 (95% CI: 0.849-0.968). Conclusion: Both mrTRG and mean ADC value can be non-invasive methods to predict the efficacy of nCRT for LARC. Combining the mean ADC value with mrTRG can result in better pCR prediction.

Objective: To construct a knowledge, attitude and practice evaluation system of nursing humanistic care, and to provide reference for improving nursing humanistic construction. Methods: Based on literature analysis, the draft evaluation system was sorted out, and two rounds of Delphi expert consultation were conducted on 28 experts, and the items were modified according to the consultation opinions. Results: The enthusiasm coefficients of the two rounds of consultation were 100% and 96.4%, the authority coefficients were 0.888 and 0.870, and the coordination coefficients were 0.342 and 0.467, respectively, which were statistically significant ( P <0.05) . The final evaluation system of humanistic care for clinical nursing staff includes 3 first-level indicators and 63 second-level indicators. Conclusion: The humanistic care evaluation system constructed in this study is scientific and practical and can be used as a scientific evaluation tool for the humanistic care ability of clinical nurses.

Objective: To investigate mental workload among nurses from tertiary hospitals in Shandong Province, and analyze various factors related to mental workload. Methods: From May to July 2019, a cluster sampling method was used to select 8255 nurses from 20 third class a general hospitals in 16 cities of Shandong Province as the research objects, and 8159 valid questionnaires were collected. The general information and psychological load of nurses were investigated by general information questionnaire and task load index scale. The measurement data were expressed in percentage (%) ; the nurses' psychological load scores were in accordance with normal distribution, and the differences between groups were compared by t-test or ANOVA; the related influencing factors of nurses' psychological load were analyzed by multiple stepwise regression analysis. Results: The average scores of mental workload among nurses was 77.83 (SD=12.88) . Time demands and physical demands were the two highest rated dimensions of mental workload. the average scores were 90.77 (SD=12.47) and 79.92 (SD=15.23) . Multiple stepwise regression analysis showed that Satisfaction with income, monthly average night shift and professional titles were the significant predictors of mental workload ( R (2)=0.08) . Conclusion: Nurses with higher psychological load, lower income satisfaction, higher number of night shifts per month and lower title have higher psychological load.

Objectives: The effects of hormone replacement therapy on the survival rate of female lung cancer patients are still controversial. The Meta-analysis aims to systematically evaluate the effect of hormone replacement therapy on the survival rate of female lung cancer patients., Methods: Retrospective studies regarding the effect of hormone replacement therapy on female lung cancer patients' survival rate were searched from the database of Embase, Cochrane, Pubmed, CNKI, Wanfang, and Weipu. The Meta-analysis was conducted with Stata 12.0 software. I 2 test was used to analyze the heterogeneity among included studies. The analysis was conducted by randomized model. Egger's test and Begg's test were used to assess the publication bias., Results: Five retrospective studies were included, involving 2 582 female patients with lung cancer. There were 1 054 cases of female lung cancer with hormone replacement therapy and 1 528 cases of female lung cancer without hormone replacement therapy. No publication bias was observed among these studies. The sensitivity analysis result showed that the overall results were stable. Meta-analysis showed that compared with patients without hormone replacement therapy, patients with hormone replacement therapy had an increased survival time for 5 years (ES=0.346; 95% CI 0.216 to 0.476; P <0.001)., Conclusions: Hormone replacement therapy improves 5-year survival in female lung cancer patients. Female lung cancer patients with menopausal syndrome can use hormone replacement therapy properly under their doctors' suggestion.

Objective: To explore the clinical effects of fiberoptic bronchoscopy airway lavage (FBAL) in the treatment of extremely severe burn patients with severe inhalation injury. Methods: From January 2015 to January 2019, 47 extremely severe burn patients with severe inhalation injury who were hospitalized in Tongren Hospital of Wuhan University & Wuhan Third Hospital, meeting the inclusion criteria, were recruited in this retrospective cohort study. According to whether or not they were treated with FBAL, the patients were divided into fiberoptic bronchoscopy group (23 cases, 19 males and 4 females) and routine group (24 cases, 20 males and 4 females), with the age of (44±11) and (49±9) years, and the admission time of 4 (3, 4) h and 4 (3, 5) h respectively. The patients in routine group were given routine comprehensive treatment, and the patients in fiberoptic bronchoscopy group were treated with FBAL on the basis of routine comprehensive treatment. The pH value, arterial partial pressure of oxygen (PaO(2)), arterial partial pressure of carbon dioxide (PaCO(2)), arterial oxygen saturation (SaO(2)), oxygenation index, white blood cell count (WBC), neutrophils, blood lactic acid, and procalcitonin (PCT) at admission and on post injury day (PID) 3, 5, 7, and 10, the time of mechanical ventilation, the day of intensive care unit (ICU) stay, the incidence of complications and death within PID 28 were compared between the two study groups. The occurrences of bronchospasm and asphyxia of patients in fiberoptic bronchoscopy group were monitored. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, Bonferroni correction, chi-square test, and Fisher's exact probability test. Results: (1) At admission, the values of pH, PaO(2), PaCO(2), SaO(2), and oxygenation index of patients in the two groups were similar ( Z =-0.118, -0.320, -0.362, -2.416, -0.234, P >0.05). On PID 3, 5, 7, and 10, the values of pH, PaO(2), SaO(2), and oxygenation index of patients in fiberoptic bronchoscopy group were significantly higher than those of routine group ( Z (3 d)=-4.711, -4.161, -5.525, -2.661; Z (5 d)=-3.489, -4.678, -5.875, -3.599; Z (7 d)=-5.104, -4.619, -5.876, -4.844; Z (10 d)=-4.026, -5.698, -5.877, -4.716; P <0.05 or P <0.01). The PaCO(2) values of patients in fiberoptic bronchoscopy group were significantly lower than those of routine group ( Z =-2.895, -3.162, -3.407, -2.831, P <0.05 or P <0.01). (2) At admission and on PID 3, 5, and 7, the values of WBC, blood lactic acid, and PCT of patients in the two groups were similar ( Z =-0.830, -0.915, -0.458, -0.648, -1.714, -1.479; -0.330, -0.128, -1.766, -0.494, -1.396, -1.522, P >0.05). On PID 10, the values of WBC, blood lactic acid, and PCT of patients in fiberoptic bronchoscopy group were significantly lower than those of routine group ( Z =-3.502, -2.630, -2.662, P <0.05 or P <0.01). At admission, the value of neutrophils of patients in fiberoptic bronchoscopy group was 0.887 (0.862, 0.912), which was similar to 0.887 (0.856, 0.897) in routine group ( Z =-0.404, P >0.05). On PID 3, 5, 7, and 10, the values of neutrophils of patients in fiberoptic bronchoscopy group were respectively 0.848 (0.802, 0.867), 0.831 (0.815, 0.849), 0.798 (0.771, 0.849), 0.796 (0.751, 0.869), which were significantly lower than those of routine group [0.882 (0.820, 0.906), 0.871 (0.835, 0.903), 0.845 (0.819, 0.905), 0.881 (0.819, 0.916), Z =-2.756, -2.810, -2.618, -3.033, P <0.05]. (3) The time of mechanical ventilation and the days of ICU stay of patients were shorter in fiberoptic bronchoscopy group than those in routine group ( Z =-2.199, t =2.368, P <0.05). Within PID 28, the number of patients with complications was significantly less in fiberoptic bronchoscopy group than in routine group ( χ (2)=5.436, P <0.05), while the incidence of death within PID 28 in fiberoptic bronchoscopy group was similar to that of routine group ( P >0.05). The airway lavage procedures of patients in fiberoptic bronchoscopy group went well with no bronchospasm or asphyxia occurred. Conclusions: FBAL is effective in treating extremely severe burn patients combined with severe inhalation injury. It can improve the oxygenation status of the lung, reduce the systemic inflammatory reaction of patients, shorten the time of mechanical ventilation and ICU stay, and reduce the incidence of complications.

Objective To investigate the effect and mechanism of Trillium saponins on the invasion and migration of HuH-7 cells regulated by human β-defensin 2 (HBD-2). Methods HuH-7 cells were treated with 0.5, 1.0, 2.0, 4.0 mg/L Trillium saponins. Cell proliferation was detected by MTT assay. Transwell TM chamber was used to measure cell invasion and migration. The levels of matrix metalloproteinase-2 (MMP2), HBD-2 and matrix metalloproteinase-9 (MMP9) were detected by Western blot analysis. HBD-2 small interfering RNA (siRNA) was transfected into HuH-7 cells. The interference effect of Trillium saponins treatment was verified by real-time quantitative PCR and Western blot analysis, and Transwell TM assay was used to detect cell invasion and migration. Results Except that 0.5 mg/L Trillium saponins had no effect on the proliferation of HuH-7 cells, the proliferation of HuH-7 cells was inhibited by all other doses of Trillium saponins. (0.5, 1.0) mg/L of Trillium saponins down-regulated the levels of MMP2 and MMP9 proteins, increased the level of HBD-2 protein and inhibited cell invasion, migration. HBD-2 siRNA transfection significantly reduced the level of HBD-2 in HuH-7 cells. Down-regulation of HBD-2 increased the invasive, migratory ability and increased the levels of MMP2 and MMP9 proteins in HuH-7 cells treated with Trillium saponins. Conclusion Trillium saponins can inhibit the invasion and migration of HuH-7 cells by promoting the expression of HBD-2.

Objective: To investigate an occupational hazardous gas poisoning incident caused by gas leakage in the process of hazardous waste treatment. Methods: An investigation was conducted on a case of occupational acute hazardous gas poisoning caused by waste treatment gas leakage in Shandong province in December 2017. Meanwhile, the clinical data of 5 cases of poisoning patients were analyzed, and the accident related poison test report and other relevant data were analyzed. Results: The incident was caused by the toxic waste did not do labeling work, the workers' protection measures were not in place, the illegal operation and the blind rescue, resulting in a total of 5 people died on the spot, 12 people were hospitalized with poisoning. Among them, 5 patients admitted to our hospital showed varying degrees of damage to the nervous system and respiratory system. After active treatment, they all got better and were discharged. Conclusion: The poisoning is mainly caused by hydrogen sulfide dichloromethane hydrogen cyanide gas leakage serious production liability accident, clinical main performance for the nervous system circulatory system respiratory system and other system damage.

Objective: To investigate a poisonous mushroom poisoning incident and analyze its clinical data. Methods: Investigate a poisonous mushroom poisoning incident in a place in Shandong in July 2018, at the same time, the clinical data of 2 cases of mushroom poisoning were analyzed and summarized. Results: The incident was caused by a poisoning incident caused by residents eating poisonous mushrooms. The poisonous mushroom in this incident was identified as a scaled white goose cream. Two patients with poisoning developed gastrointestinal symptoms such as nausea and vomiting, abdominal pain and diarrhea, and liver damage occurred later. After active rescue and treatment, one patient was discharged from hospital, and the other patient developed acute pulmonary embolism during the treatment. He was discharged after interventional thrombolysis and follow-up treatment. Conclusion: After investigation, the incident was caused by the ingestion of poisonous mushrooms mainly based on the scalloped white goose cream. After active treatment, they were cured and discharged.

Objectives: To evaluate the application of 43-plex SNP typing system in forensic science., Methods: The typing of 43 SNP loci in 123 unrelated Han individuals from East China was detected by MALDI-TOF-MS. The application value of 43-plex SNP typing system was assessed according to the forensic parameters of population genetics., Results: All the 43 SNP loci of 123 individuals showed no significant departure from Hardy-Weinberg equilibrium （ P >0.05）. Excepted rs1355366, rs2270529, rs10776839 and rs938283, there were 39 SNP loci had minor allele frequencies （MAF）, which were greater than 0.25. Among the 25 loci MAFs, 24 ranged from 0.4 to 0.5, while 3 were close to 0.4. The DP, CDP, PIC, Ho, PE trio and PE duo of the 43 SNP loci were 0.290 1-0.654 4, 1-9.8×10⁻¹¹, 0.170 8-0.500 0, 0.155 7-0.593 5, 0.085 4-0.250 0 and 0.014 6-0.125 0, respectively. The CPE trio and CPE duo were 0.999 986 and 0.992 436 1, respectively., Conclusions: The 43-plex SNP typing system in present study shows a high polymorphism, which can be an effective supplement and verification for traditional STR genetic markers. It also can be used with other commercial kits for the forensic paternity testing and individual identification., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Forensic Medicine.)

Objective: To explore the mental health status for new nurse during the standardization training period and provide scientific basis for managers to formulate corresponding measures. Methods: Using eysenck personality questionnaire (EPQ) and symptom self-assessment scale (SCL-90) , understanding social support scale (PSSS) , trait coping style questionnaire (TCSQ) and other standardized psychological assessment tools and self designed general situation questionnaire, 141 nurses in our hospital before rotary department and 1 year later accepted the questionnaire survey while the control group accepted the same questionnaire. Results: Compared with before rotary department and the control group, the forced, anxiety and interpersonal sensitivity factor increased significantly in SCL-90 for rotary nurse and the differences were significant statistical significance ( P <0.05) ; Pearson correlation analysis showed rotary nurse SCL-90 forcing factor scores and EPQ-E dimension scores, TCSQ negative coping scores were positively correlated ( P <0.05; r 1 =0.537; r 2 =0.407; r 3 =0.701) , and were negatively correlated with EPQ-E dimension scores, PSSS scores and TCSQ active responding score ( P <0.05; r 1 =-0.621; r 2 =-0.671; r 3 =-0.312) ; Anxiety was positively correlated with EPQ-N, PSSS scores and TCSQ negative responding score ( P <0.05; r 1 =0.607; r 2 =0.409; r 3 =0.764) , was negatively correlated with EPQ-E dimension scores, PSSS scores and TCSQ positive responding score ( P <0.05; r 1 =-0.569; r 2 =-0.723; r 3 = -0.418) ; Interpersonal sensitivity factor score was positively correlated with EPQ-N, P dimension scores and TCSQ negative coping scores ( P <0.05; r 1 =0.611; r 2 =0.687; r 3 =0.773) , was negatively correlated with EPQ-E dimension scores, PSSS scores and TCSQ active responding score ( P <0.05; r 1 =-0.506; r 2 =-0.693; r 3 =-0.307) . Conclusion: Rotary nurse mental health status was significantly lower than non-rotary nurse.Insufficient social support, negative coping style and instability personality characteristics are the main risk factors to affect the rotation nurses mental health.

Objective: To compare the differentiation, inducing effects of human placenta mesenchymal stem cells (hPMSCs) on IL-10(+) T cells derived from cord blood and peripheral blood, and investigate the effect of IFN-γ on the induction., Methods: The hPMSCs were isolated from human placenta and cultured. The expression of programmed death ligand 1 (PD-L1) in hPMSCs was detected by reverse transcriptase PCR and flow cytometry (FCM), respectively. Mononuclear cells were isolated from cord blood and peripheral blood of healthy donors by Ficoll density gradient centrifugation, and T cells were purified by sheep red blood cells. Then hPMSCs, pretreated with PD-L1 mAb or IFN-γ, were co-cultured with phytohaemagglutinin (PHA)-activated T cells. Percentages of CD4(+)IL-10(+) and CD8(+)IL-10(+) T cells in cord blood and peripheral blood T cells were analyzed by FCM., Results: hPMSCs could induce the differentiation of CD4(+)IL-10(+) and CD8(+)IL-10(+) T cells from cord blood or peripheral blood T cells, and the number of IL-10(+) T cells in the peripheral blood T cells was significantly higher than that in the cord blood T cells. Pretreatment with IFN-γ markedly enhanced the differentiation, inducing ability of hPMSCs. PD-L1 was highly expressed in hPMSCs, and the expression was also significantly promoted by IFN-γ. After the expression of PD-L1 was blocked in hPMSCs, the percentages of CD4(+)IL-10(+) and CD8(+)IL-10(+) T cells obviously decreased in cord blood and peripheral blood T cells., Conclusion: The ability of hPMSCs to induce the differentiation of IL-10(+) T cells from peripheral blood T cells was apparently stronger than that in cord blood T cells. IFN-γ could up-regulate the number of IL-10(+)T cells differentiated from cord blood and peripheral blood T cells in the present of hPMSCs by enhancing the expression of PD-L1 in hPMSCs.

Objective: To study the expression of nNOS and ultrastructural changes in the penile tissue of rats with prolactinoma-induced erectile dysfunction (ED)., Methods: We established the model of prolactinoma in 20 male Westar rats by peritoneal injection of diethylstilbestrol (DES) and treated the control rats with normal saline (n = 10) or sterilized arachis oil (n = 10). After 8 weeks, we performed the apomorphine test and measured the weight of the pituitary gland and the levels of serum prolactin (PRL) and testosterone (T) to confirm the successful construction of the prolactinoma-induced ED model. Then we determined the expression of nNOS in the penile tissue by immunohistochemistry and examined the ultrastructural changes of the penile cavernosum under the transmission electron microscope., Results: The prolactinoma-induced ED model was successfully established in 15 rats. The weight of the pituitary gland was significantly increased in the rats treated with DES as compared with the normal saline and sterilized arachis oil controls ([46.7 ± 15.5] vs [11.7 ± 2.4] and [12.4 ± 2.3] mg, both P < 0.05). The level of serum PRL was markedly higher while that of T remarkably lower in the former than in the latter two groups ([1,744.9 ± 304.5] vs [11.5 ± 2.4] and [10.6 ± 1.9] ng/ml, both P < 0.0l; [1.54 ± 0.46] vs [3.11 ± 1.08] and [3.04 ± 1.11] ng/ml, both P < 0.05). The rate of penile erection was significantly reduced in the prolactinoma-induced ED model rats in comparison with the normal saline and arachis oil controls (16.7% vs 100% and 87.5%, both P < 0.05), and so was the expression of nNOS in the penile tissue (0.024 ± 0.011 vs 0.066 ± 0.019 and 0.058 ± 0.021, both P < 0.05). Transmission electron microscopy manifested significant ultrastructural changes in the endothelial and smooth muscle cells of the cavernous tissue in the prolactinoma-induced ED models., Conclusion: The ultrastructural changes of the penile cavernous tissue and the reduced expression of nNOS in penile tissue may be the most important mechanisms of prolactinoma-induced ED in rats.

Objective: To investigate the relationship between B7-H3 expression and the number of CD8(+) T cell infiltration in primary hepatocellular carcinoma (HCC) tissues., Methods: The level of B7-H3 expression and the number of CD8(+) T cell infiltration in primary HCC were determined using immunohistochemical staining, and then the correlation between them was analyzed statistically., Results: The immunohistochemical staining showed that the high expression of B7-H3 was found in 26 cases (41.3%), and the low expression in 37 cases (58.7%) of the 63 primary HCC. Fifty-seven cases (90.5%) were positive for B7-H3 expression in HCC tissues, and normal hepatocellular tissues hardly expressed B7-H3 molecules. The number of infiltrating CD8(+) T cells in B7-H3 high expression group was less than that in B7-H3 low expression group. B7-H3 expression was negatively correlated with the number of infiltrating CD8(+) T cells in HCC tissues. Moreover, both B7-H3 expression and CD8(+)T cell infiltration were related with clinical stage, local lymph node metastasis and distant metastasis in HCC patients., Conclusion: B7-H3 molecules were highly expressed and negatively correlated with CD8(+) T cell infiltration in primary HCC tissues.

Objective: To detect the expression and clinical significance of co-stimulatory molecule B7-H3 in sera and tissues of patients with hepatocellular carcinoma (HCC)., Methods: We collected 63 samples of sera and liver tissue from HCC patients, 5 adjacent normal tissues of hepatic hemangioma as controls, and the other 50 sera samples of healthy people in the same time. The expression of soluble B7-H3 (sB7-H3) in sera from HCC patients and healthy people was detected by ELISA. Immunohistochemistry was performed to analyze the expression of B7-H3 on normal liver and HCC tissues., Results: The level of sB7-H3 from HCC patients was significantly higher than that from healthy people [(4143.47±976.27) pg/mL vs (2076.18±605.42) pg/mL, P<0.05]; and sB7-H3 level was related to clinical stage, distant metastasis and the positive expression of B7-H3 in HCC tissues (P<0.05), while there was no significant difference between its expression and the other clinical pathological parameters, such as the patients' age, gender, histological type, lymphatic metastasis and size of tumor. Furthermore, a positive correlation was found between the level of sB7-H3 and CA19-9 in HCC patients (P<0.05), but it was not associated with AFP and CEA., Conclusion: The level of sB7-H3 in HCC patients was significantly higher than that in healthy people, and B7-H3 expression was correlated with clinical pathological indexes, which implicated that detecting the expression of sB7- H3 might be helpful for the diagnosis of primary HCC.

Objective: To investigate the expressions of programmed death ligand 1 (PD-L1) and PD-L2 in human placenta-derived mesenchymal stem cells (hPMSCs) and their mediated immunoregulation on the secretion of IL-17 of peripheral blood T cells., Methods: hPMSCs were isolated from mature human placenta by the method of enzyme digestion. The cells were cultured and expanded in vitro, and after the third passage, they were used in phenotyping and differentiation experiments. The expressions of PD-L1 and PD-L2 were detected by RT-PCR, laser-scanning confocal microscopy (LSCM) and flow cytometry. Specific siRNAs were transfected into hPMSCs via cathodolyte liposome transfection method to silence the expressions of PD-L1 and PD-L2. T cells were sorted from healthy peripheral blood by gradient centrifugation. IL-17 secretion of T cells activated by PMA was detected by intracellular staining after the expressions of PD-L1 and PD-L2 were silenced., Results: Besides PD-L1, hPMSCs also highly expressed PD-L2, which could be silenced effectively by specific siRNA. Intracellular staining showed that hPMSCs up-regulated the secretion of IL-17, which was further up-regulated after PD-L1 or/and PD-L2 had been silenced and there were overlapping roles of PD-L1 and PD-L2 in inhibiting IL-17 secretion by T cells., Conclusion: PD-L1 and PD-L2 expressed on hPMSCs could inhibit the hPMSCs-mediated up-regulation on the expression of IL-17 secreted by peripheral blood T cells.

This paper studied the residue of chlorpyrifos and its degradation dynamics in Chinese chive (Allium tuberosum) plant and soil after irrigating different concentrations of this pesticide into A. tuberosum root zone under plastic greenhouse and open-field cultivated conditions. The chlorpyrifos in A. tuberosum plant had a faster degradation rate than that in soil, with an average half-life of the pesticide being 3.41 and 7.40 days in the plant and soil, respectively. Under the conditions of plastic greenhouse and open-field cultivation, the degradation rate of chlorpyrifos in A. tuberosum plant had less difference, with the average half-life of chlorpyrifos being 3.37 and 3.44 days, respectively. 21 days after irrigating into root zone, the chlorpyrifos (0.021-0.102 mg x kg(-1)) in A. tuberosum plant did not exceed the maximum residue limit (< or = 0.01 mg x kg(-1), GB 2763-2005). A few chlorpyrifos residue was found in the new growth parts of A. tuberosum, but the residue concentration was obviously lower than that in the first harvested plant after irrigating this pesticide. The chlorpyrifos residue in soil had significant effects on the residue of the pesticide in A. tuberosum plant.

Objective: To analyze the mutation and abnormal expression of the FHIT gene in human hypopharyngeal carcinoma., Method: Matched normal and cancerous tissues from 24 patients with hypopharyngeal squamous cell carcinoma were obtained immediately after surgery. Total RNA was extracted, the FHIT gene was detected by nested RT-PCR and DNA sequencing technology., Result: Normal sized FHIT transcript was detected in 23 of the 24 cases of normal matched tissues. Aberrant FHIT transcripts were found in 9/24 (37.5%) cases in hypopharyngeal carcinoma. Aberrant FHIT transcripts rate of well-differentiated, moderately differentiated and poorly differentiated squamous cell carcinoma, was 28.6% (2/7), 50.0% (4/8) and 33.3% (3/9), respectively. There the carcinoma with FHIT aberrant transcripts was neither corresponding to histological grade (P>0.05) nor to lymphatic metastasis. The sequence analyses of the two aberrant cDNAs revealed absence of exon 8 and exon 7-9. All initial deletion were in conjunction of exons., Conclusion: High deletion rate of the FHIT gene in Chinese hypopharyngeal squamous cell carcinoma suggested the FHIT gene, a candidate tumor suppressor gene at 3p14.2, plays an important role in the tumor carcinogenesis, development and progression of the tumor, and thus may become a new prognostic marker in hypopharyngeal carcinoma.

Objective: To investigate the expression of urokinase-type plasminogen activator (uPA) and its receptor (uPAR) in squamous cell carcinoma of hypopharynx and reveal the correlation of the major clinicopathological parameters and prognosis., Method: Samples of 48 hypopharyngeal carcinoma and 10 normal hypopharyngeal tissue were detected by immunohistochemistry method (SP method) for urokinase-type plasminogen activator (uPA) and its receptor (uPAR). The correlation between the expression of urokinase-type plasminogen activator and its receptor and the major clinicopathological parameters of hypopharyngeal carcinoma were analyzed by rank sum test and Spearman correlation analysis. Overall survival were analyzed according to Kaplan-Meier and log-rank statistics, the prognostic relevance of uPA and uPAR and conventional prognostic factors were analyzed by Cox analysis., Result: In 48 hypopharyngeal carcinoma specimens, positive expression rates of uPA and uPAR were 77.1% and 68.75% respectively, which were significantly higher than in normal tissues (P < 0.01). The uPA and uPAR positive expression was correlated with pathological grading, lymph node metastases and growth mode of hypopharyngeal carcinoma. The positive expression rate for uPA and uPAR in patients with lower pathological grading, lymph node metastases and invasion growth mode were significantly higher than in patients with higher pathological grading, non-lymph node metastases and non-invasion growth mode. Patients were followed-up postoperatively. The positive expression of uPA and uPAR were correlated with prognosis (P < 0.05 and P < 0.01). According to Log-rank statistics, patients with positive expression of uPA and uPAR had a significantly shorter survival time than those with negative expression of uPA and uPAR. Multivariate Cox analysis revealed that three independent prognostic factors for overall survival time were clinical stage, invasion growth mode and uPAR expression., Conclusion: The positive expression of uPA and uPAR in hypopharyngeal carcinoma were significantly higher than in normal tissues. uPAR is a new independent and strong biologically prognostic factors, which positive expression may be a powerful aid in evaluating metastatic potential and High-Risk patients in early stage of hypopharynx carcinoma ryngeal carcinoma.

Objective: To assess the sensory restoration after the greater auricular nerve is implanted into the flap to repair the buccal defect in rabbits., Methods: Fifteen Japanese white rabbits, weighing 2.0-2.5 kg, were randomly divided into the experimental group (nerve implanted), the control group (nerve unimplanted), and the normal group (without any treatment). In the experimental and the control group, circular defects (2.0 cm x 2.0 cm) were constructed in the left cheek of the rabbits. Then, the cervical flaps (4.5 cm x 2.5 cm) were transferred and the great auricular nerve was implanted into the defects in the experimental group, and the flaps without any nerve were implanted into the defects in the control group. The subjects in the normal group were given no treatment. After 6 months, the nerve discharge, the HE staining, and the immunohistochemical method were used to assess the regeneration of the nerve fibers., Results: The nerve discharge and the percentage of the different kinds of the nerve fibers in the experimental group (124.2 +/- 33.8 roots) were not statistically different from those in the normal group (138.4+/-20.4 roots, P>0.05), but significantly different from those in the control group (18.8+/-5.6 roots, P<0.05). In the center of the flap in the experimental group, the receptive field of the nerve fibers was identical to the implanting approach of the greater auricular nerve. The HE staining and the immunohistochemical staining showed that the density of the regenerated fibers in the center of the flap in the experimental group reached the normal level. There was no regenerated fibers in the control group., Conclusion: The great auricular nerve implanted into the cervical flaps has a good effect on reconstruction of the buccal defect in rabbits.

Objective: To explore the feasibility,surgical techniques and the clinical curative effect of preservation of laryngeal function in surgical treatment of T3 supraglottic laryngeal carcinoma (SLC)., Method: A retrospective review of 70 cases with T3 SLC that we treated from 1994 to 2003 were accomplished. All of the cases were treated with partial laryngectomy. Among them, 42 cases underwent supraglottic horizontal partial laryngectomy, 19 supraglottic horizontovertical laryngectomy, 8 supracricoid partial laryngectomy and 1 near total laryngectomy. All patients were received postoperation radiotherapy with the dosage for 50-60 Gy., Result: The 3 year and 5 year-survival rates were 79.2% and 68.4%, respectively. Out of the 70 cases, 60 cases were decannulated with a decannulation rate of 85.7%. The normal diet was resumed in all patients, no buckling and dysphagia obviously. All patients had their successful phonation, no one failure for laryngotracheal atresia., Conclusion: It is feasibility to preservative laryngeal function in surgical treatment of T3 SLC, if surgeons master indications correctly, use many kinds restorative procedure expertly and improve surgical skill.

Objective: To investigate the effect and clinical value of multiple plane operations in treating severe OSAHS., Method: The clinical data of 28 patients with severe OSAHS were retrospectively analyzed. All the patients were performed two planes of operations or more as below: submucous nasal septum resection, nasal sinus endoscopy, adenoidectomy, uvulopalatopharyngoplasty (UPPP), tongue base incision, hyoid suspension, tongue base Coblation etc. Operations were finished in the same term or by stages. All patients underwent polysomnography(PSG) examination before operation, and 6-month and 1-year after surgical treatment separately., Result: No severe complication occurred, the 6-month, 1-year responders are 100% and 89.29% respectively. Both AHI and LSaO2 changed obviously (P < 0.01)., Conclusion: Most OSAHS have multi-level obstructions in upper airway caliber, such as nasal, nasopharyngeal, velo-pharyngeal and tongue-pharyngeal obstruction. Multiple plane operations which based on idiographic obstruction sites can improve curative effect. Operation project should be established according to the conditions of upper airway and patients' intention.

Objective: To investigate the expression of fragile histidine triad gene protein (Fhit) and the possible relationship between Fhit and biological behaviors of hypopharyngeal carcinoma., Method: The expression of Fhit protein in 66 cases with hypopharyngeal carcinoma were detected by rabbit antibody to human FHIT gene protein with SP immunohistochemical method. The relationship between historical grade and lymphatic metastasis were analysed., Result: (1) The positive expression rate of Fhit was 42.42% (28/66) in hypopharyngeal carcinoma, and 83.33% (55/66) in normal hypopharyngeal tissue, respectively. There was a significant difference in the expression of Fhit between the cancer tissue and normal tissue (P < 0.01). (2) The positive expression of Fhit in well, moderate, poor differentiated hypopharyngeal carcinoma were 65.38% (17/26), 38.10% (8/21) and 26.32% (5/19), respectively. There are significant statistic difference among them each other (P < 0.01). (3) The positive expression of Fhit was 75.00% (12/16) in the group without lymph node metastasis, and 36.00% (18/50) with lymph node metastasis., Conclusion: The expression of Fhit in hypopharyngeal squamous cell carcinoma lower than normal tissue. The expression of Fhit significantly associated with historical grade and lymphatic metastasis in hypopharyngeal squamous cell carcinoma. It suggested that the expression of Fhit decreased may plays an important role in the development and progression of the tumor, and thus may become a new prognostic marker in hypopharyngeal carcinoma.

Objective: To explore the feasibility and the related surgical techniques of laryngeal function preservation in surgical treatment of posterior hypopharyngeal wall cancer., Method: Thirty-five cases with posterior hypopharyngeal wall cancer were treated surgically. The methods of removing tumor and repairing surgical defects were depended on the extension of lesions. The laryngeal and pharyngeal function were rebuild by normal tissue preserved with lesions entirely removed. Twenty-seven cases were surgically treated with laryngeal functions preserved and eight cases total laryngectomy. The most of the cases received postoperative radiotherapy., Result: The overall 3 and 5-year survival rates were 45.7% and 28.6%, respectively. 45.7% patients having laryngeal functions (voice, respiration and deglutition) completely restored and 31.4% partially restored(voice and deglutition). Among the died patients, nine cases died from cervical lymph node metastasis, ten cases died from local recurrence, twa cases died from lung metastasis, one cases died from cervical massive haemorrhage, twa cases died from hear disease and one died from ambiguous reason., Conclusion: The preservative surgery is feasible for the selected posterior hypopharyngeal wall cancer cases. Choosing and following what is optimum from multiple feasible surgical methods is a prerequisite for improving the quality of life of the cases.

Objective: To assess the value of urinary uric acid excretion and urinary uric acid/creatinine ratio as the marker of obstructive sleep apnea-hypopnea syndrome (OSAHS) before and after Uvulopalatopharyngoplasty (UPPP)., Method: Twenty three cases diagnosed as OSAHS by polysomnography (PSG) were treated as trial group, 12 cases excluded from OSAHS by PSG were taken as control group,and 15 patients of the trial group were treated by UPPP and were taken as before UPPP therapy group and after UPPP therapy group. The makers above were compared in these groups., Result: The overnight change in urinary uric acid/creatinine ratio in trial group is 0.46+/-0.25, and after UPPP therapy group (0.13+/-0.2) significantly lower than before UPPP therapy group (0.49 +/-0.32), P < 0.01., Conclusion: The urinary uric acid excretion and overnight change in urinary uric acid/creatinine are good markers to determine the effects of UPPP on OSAHS.

Objective: To assess the role of soluble intercellular adhesion molecule-1 (sICAM-1) in etiology of nasal polyps., Method: Twenty-nine patients with nasal polyps and 20 healthy control cases were chosen. Their serum sICAM-1 was determined by a sandwich enzyme-linked immunosorbent assay (ELISA). All patients were treated by glucocorticoid, serum sICAM-1 was determined post-treatment again., Result: (1) Serum levels of sICAM-1 in patients with nasal polyps were higher than that of control group: (2) Serum levels of sICAM-1 in patients were reduced after glucocorticoid treatment, the decrease of sICAM-1 was more apparent in evident-effect group than in effect group; (3) There was a close correlation between the decrease of polyp-size scores and the decrease of serum sICAM-1., Conclusion: The elevated expressions of sICAM-1 in patients with nasal polyps indicate its important role in eosinophil recruitment, which was considered as a representative hallmark for nasal polyps. The sICAM-1 is down-regulated by systemic and topical glucocorticoid treatment and the decrease of sICAM-1 is correlated with clinical effect. To take these lines of evidence together, anti-adhesion therapy may be effective for nasal polyps, serum sICAM-1 levels may be use to monitor the effect of steroid therapy in nasal polyps.

Objective: To explore the application of the temporalis myofacial flap(TMF) in the reconstruction of craniofacial oncologic defects., Method: Ten cases with craniofacial neoplasms were treated surgically using TMF to reconstruct oncologic defects. TMF during 2000-2003. was used to reconstruct cranial base in 3 cases, oropharynx in 5 cases and orbital defects in 2 cases. TMF was designed according to size and locus of defect. The sizes of the flaps ranged from 3 cm x 4 cm to 8 cm x 10 cm., Result: During follow-up of 8 to 50 months, there were no cases of flap loss, no cranial infection or cerebrospinal fluid leak in cranial base reconstructions, no speech or swallowing disturbance in oropharyx reconstruction. All patients were satisfied with appearance with orbital reconstruction., Conclusion: TMF is a useful and reliable flap for reconstruct the craniofacial oncologic defects.

Objective: To investigate the application and long-term results of epiglottic in reconstruction of the traumatic laryngotracheal stenosis., Methods: From January 1988 to February 2002, 42 patients with traumatic laryngotracheal stenosis were treated, including 33 laryngeal stenosis and 9 laryngotracheal stenosis. The following surgical treatment were performed: (1) lowered epiglottic and bi-pedicled sternohyoid myofascial flap and (2) lowered epiglottic and bi-pedicled sternohyoid myofascial flap and sternocleidomastoideus clavicle membrane flap., Results: Thirty-seven patients (88.1%) were successfully extubated 10 to 75 days after operation. Feeding tube lasted from 9 to 24 days, all the patients rehabilitated deglutition after surgery. The time of using stent was 9 to 19 days in 25 cases. All patients were followed up 1 year to 3 years and 4 months. The function of larynx recovered completely in 37 extubated patients and partially in 5 cannulated patients., Conclusion: Epiglottic has the advantages of easy gain, high anti-infection and survival rate, and stable structure. A combination of epiglottic and the bi-pedicled sternohyoid myofascial flap plus sternocleidomastoideus clavicle membrane flap can repair large laryngeal and tracheal defects.

Objective: To explore the relationship between the expression of MDM2 and p27 in hypopharyngeal carcinoma and clinicopathological parameters and their clinical significance., Method: The expression of MDM2 and p27 in 59 hypopharyngeal carcinoma were detected by S-P immunohistochemical technique., Result: The high-expression rates of MDM2 and p27 were 66.1% and 33.9%, respectively, and the low-expression rates of them were 33.9% and 66.1%, respectively. The expression of MDM2 was unrelated to p27 (P > 0.05). The lymph node metastasis in high-expression group of MDM2 was significantly higher than that in low-expression group (P < 0.01). The expression rate of p27 was significantly different among the four T groups and degree of differentiation, respectively (P < 0.05). The survival rate was significantly higher in high-expression rate group of MDM2 than that in low-expression rate group (P < 0.01), while the survival rate was significantly lower in high-expression rate group of p27 than that in low-expression rate group (P < 0.05)., Conclusion: The expression of MDM2 and p27 may be involved in carcinogenesis and progression in hypopharyngeal carcinoma. Combined detecting of MDM2 and p27 may predict its prognosis better in hypopharyngeal carcinoma.

Objective: To detect whether there still have PM2.5 compound contamination on the condition of dedust equipment through the study., Methods: Both qualitative and quantitative analysis on the multiple contaminants and the particle radius of the sample were done by using chemical and electron microscope, electron spectrum, GC-MS, etc., Result: The ingredient of the compound contamination: H2O 22%, organics 34.75%, inorganics 43.75%. Main inorganics were Cu, C, Pb, Al, and most of their radius < or = 1.1 microm. There were over 140 kinds of organics, mainly the hydroxybenzene and PAHs. Besides heavy metals such as Pb, As, inorganics also included arsenic acid and phosphoric acid., Conclusion: On the existing condition of existing dedust equipment, the compound contamination in aerosol of metallurgical plant were multiple kinds of heavy metals, acidic oxide and tens of kinds of organic contaminations (hydroxybenzene and PAHs), and their radius < or = 1.1 microm.

Objective: To observe the long-term effects of clinical treatment for laryngeal carcinoma recurrence and cervical metastasis, and discuss the operative therapy method for laryngeal carcinoma recurrence and cervical metastasis., Method: Retrospective analysis the 70 patients with laryngeal carcinoma recurrence and cervical metastasis who was cured in our hospital from 1990 to 1998, including 31 local recurrence, 15 stomal recurrence and 24 cervical lymph node metastasis., Result: Sixty-four cases were observed over 3 years and 41 cases were studied over 5 years. Twenty-eight patients who received the second-time operation survived over 5 years. In 31 patients with local recurrence, 19 patients received total laryngectomy and 15 patients of them are now living, but 12 patients who did not accept surgical therapy were died in 1-3 years separately; 9 patients with stomal recurrence received the second-time operation and 5 of them lived 5 years longer, however, the 6 patients with stomal recurrence who did not accept the second-time operation all died in 18 months; In 24 patients with cervical lymph node metastasis, 15 patients received the neck dissection and 8 of them are now alive, but the rest patients who did not accept the operation died in 2 years., Conclusion: Regular re-examination and systemic clinical follow-up studying are very important for early detection and early treatment in laryngeal carcinoma recurrence and cervical metastasis; Second-time surgical operation is an effective therapeutic method for laryngeal carcinoma recurrence and cervical metastasis; Radiotherapy and chemotherapy play a limited role in clinical therapy for laryngeal carcinoma recurrence and cervical metastasis.

Objective: To explore the surgery way for T1, T2 glottic carcinoma., Method: Small partial laryngectomy were performed to 112 patients with T1, T2 (T1 N0 M0, T2 N0 M0) glottic carcinoma. The surgery method, effect and treatment advantage was summarized and compared with laser therapy and radiotherapy, the dynamic follow-up of arytaenoidea cartilage movement, glottidis rimae conformation and voice change was analyzed. The preoperative and postoperative voice quality was compared with the software of Dr. speech system for windows., Result: All incisions were healed one stage in 6 or 7 days, the mean time in hospital is 9.76 days; all patients took food with mouth after 2 or 3 days, all trachea cannula was removed successfully during in hospital, the mean time with cannula is 7.32 days and the rate of removing cannula 100%. Arytaenoidea cartilago movement of 47 cases 1 week after surgery weakened and gradually improved, glottidis rimae conformation is close to be normal after 2 months. There is no significant difference of Shimmer and NNE between preoperative and postoperative 1 week (P > 0.05), but there is a significant difference between preoperative and postoperative 2 months, half a year, and also is between postoperative 1 week and 2 months, half a year (P < 0.01). All 76 cases survive during 3 years' follow-up, 35 of 36 cases in 5 years' follow-up survive (1 case died without definite cause), and there is 2 cases for recurrence., Conclusion: Small partial laryngectomy can provide large operative view, resect the tumor completely, make diet and speech recover in shorter time and improve the voice quality, so the surgery is available.

Objective: To study the expression of inducible nitric oxide synthase(iNOS) mRNA in laryngeal carcinoma and hypopharyngeal carcinoma and its clinical significance., Method: The tissue samples (laryngeal carcinoma, 40; hypopharyngeal carcinoma, 12; adjacent tissue, 50; laryngeal papilloma, 10; amyloidosis of larynx, 2; and normal laryngeal mucosa, 7) were examined by reverse transcription-polymerase chain reaction(RT-PCR)., Result: 1. The target gene of iNOS were detected in 41 of 52 tumor tissues, 10 of 50 adjacent tissues, 5 of 12 benign tumor tissues and 0 of 7 normal tissues. The difference was significant (P < 0.0001, P < 0.005, P < 0.0001); 2. No significant difference was found among the expression of iNOSmRNA in different primary locations, there was significant statistical difference between the early clinical stages (T1-T2) and the advanced stages (T3-T4); 3. The poorly differentiated tumor cell showed a higher iNOSmRNA expression than that in moderate differentiated tumor cell (P < 0.05) and the iNOSmRNA expression in the lymph node metastasis group was higher than the non-metastasis group (P < 0.05)., Conclusion: It suggests that iNOS gene expression occurs in human laryngeal carcinoma and hypopharyngeal carcinoma, it might involve in the development of head and neck neoplasms in gene level by generating NO.

Objective: To study effective treatment of stomal recurrence., Method: Thirty-one patients with stomal recurrence underwent surgical management. Twelve of them considered to have the probability of metastasis to regional lymphnodes underwent modified radical neck dissection. Twenty-five cases(I and II type) received complete tumor excision, but for III and IV type, only 50% (3/6) of the patients gained complete tumor excision. The surgical defects were repaired by pectoralis major myocutaneous flap in all the patients., Result: In 13 cases of type I, 7 cases had followed up for 3 years, 4 cases died, while in 12 cases of type II, 8 cases had followed up for 3 years, 5 cases died. Survival remains poor for III or IV type. Most of them died within 3 years after operation. The complication rate of pharyngeal fistula and pneumatothorax was 12.9% and 9.7%, respectively., Conclusion: The overall prognosis of stomal recurrence is dismal. A proper surgical treatment in some cases will prolong the lifetime and improve their quality of life.

Objective: To explore the methods of surgery and evaluate the long-term results of preservative surgery for T3 glottic cancer., Method: Seventy-five cases with T3 glottic cancer were treated surgically from 1989 to 1999. The lesions were removed entirely, the epiglottis, bi-pedicled myoperichondral flap, platysma myocutaneous flap, sternohyoid myofascial flap, platysma myofascial flap, thyroid perichondral flap were utilized to restore the defects of larynx and reconstruct the laryngeal functions., Result: The 3- and 5-year survival rates were 83.2% and 73.6% in all cases, 82.7% had all laryngeal functions (voice, respiration and deglutition) restored and 17.3% partially restored(voice and deglutition)., Conclusion: Preservative surgery can be carried out for T3 glottic cancer with the lesions entirely removed. Choosing and following what is optimum from multiple feasible surgical methods is a prerequisite for better laryngeal functions.

Objective: To observe the appliance value of uni-pedicled sternohyoid myofascial flap in laryngeal function reconstruction after partial laryngectomy., Method: Forty patients who underwent partial laryngectomy from 1981 to 1999 were summarized(male 36 cases, female 4 cases). Among them 19 were supraglottic carcinomas (T2N0 6, T2N2 1, T3N0 2, T3N1 1, T3N2 2, T4N0 4, T4N1 1, T4N2 2), 19 cases were glottic carcinomas(T2N0 6, T3N0 11, T3N2 2), 2 cases were subglottic carcinomas(T2N0 1, T3N0 1). The choice of surgical procedure was decided on the pathologic conditions of the larynx, the laryngeal function was reconstructed using uni-pedicled sternohyoid myofascial flap., Result: Thirty-three cases were decannulated and recovered with laryngeal functions. The decannulation rate was 82.50%. All the patients rehabilitated deglutition in 10 to 20 days after surgery. None presented complication of aspiration. The 3-year survival rate was 86.58% and 5-year survival rate was 72.49%., Conclusion: The uni-pedicled sternohyoid myofascial flaps are appropriate for reconstruction of surgical defect in laryngeal carcinomas.

Objective: To investigate clinical prognosis and the one-stage methods of reconstruction for advanced thyroid carcinoma while larynx and cervical trachea involved., Method: One-stage resection and laryngotracheal reconstruction were performed in 18 advanced thyroid carcinomas. Among them, total laryngectomy were performed in 3 cases and partial laryngectomy in the other 4 larynx-involved cases. Cervical trachea involvement were found in all 18 cases. Besides 8 shave-off of tumor, area of trachea invaded by carcinoma were removed in other 10 cases. The methods applied for the tracheal reconstruction were 1 simple suture, 3 tracheal anastomosis, 2 pedicled sternocleidomastoid myoperiosteous flap, 3 insular myocutaneous pectoralis major flap and 1 cervical flap., Result: One patient died of cancer reoccurrence while in the hospitalization. Except for 3 cases with total laryngectomy, larynx preservation were done in 14 cases and tracheal cannula were pulled out in 8, blocked in 2 and kept carrying in 4 cases., Conclusion: One stage reconstruction of larynx and cervical trachea involved by advanced thyroid carcinoma is feasible and practical. Curative rate, survival time and life quality all can be improved.

Objective: To explore the surgical methods for laryngeal cancer and long-term effects of larygectomy., Methods: 625 cases of laryngeal cancer at different stages, including 182 cases of supraglottic cancer, 429 cases of glottic cancer, and 14 cases of subglottic cancer, underwent operation of different kinds from 1979 to 1999. Radiotherapy was given to those with poorly differentiated squamous carcinoma or with metastasis of cervical lymph nodes postoperatively. The effects of operation, especially that on the preservation of laryngeal function was analyzed., Results: Partial laryngectomy was performed on 521 of the 625 cases (83.4%) and 203 of the 305 cases at stages III and IV (66.6%). The decannulation rate was 84.07% in the cases undergoing partial laryngectomy. The nasal feeding tube was removed and peroral feeding was recovered in all patients. All cases undergoing partial laryngectomy succeeded in phonation. The overall 3-year survival rate was 89.63% and the overall 5-year survival rate was 77.36%. For the cases with laryngeal cancer at stages III and IV, the 3-year survival rate among those undergoing partial laryngectomy was 84.9%, not significantly different from that among those cases undergoing total laryngectomy (87.7%, P > 0.05); the 5-year survival rate was 66.6% among those undergoing partial laryngectomy and was 69.7% among those undergoing totals laryngectomy (P > 0.05)., Conclusion: The rate of partial laryngectomy is rather high in this group. It is possible to preserve the laryngeal function without compromising the remote survival rate. The prerequisite for the preservation of laryngeal function is to master and choose the proper renovation methods.

Objective: To observe the application value of epiglottis in laryngeal reconstruction after partial laryngectomy., Methods: The data of 168 patients, 25 with supraglottic carcinoma (T1N0 2, T2N0 10, T2N1 1, T2N2 1, T3N0 7, T3N2 1, T4N0 2, and T4N2 1), 140 with glottic carcinoma (T1N0 36, T1N1 1, T2N0 52, T2N1 1, T2N2 1, T3N0 40, T3N2 2, T4N0 6, and T4N2 1), and 3 with subglottic carcinoma (T3N0 1, and T4N0 2), who underwent partial laryngectomy from 1982 to 1999 were summarized. The choice of surgical procedure was decided on the pathology of the larynx. Epiglottis was used in larynx reconstruction., Results: Out of the 168 cases, 135 cases were decannulated with a decannulation rate of 80.36%, regained deglutation, recovered all laryngeal functions, and resumed normal diet. None presented complication of accidental aspiration. The 3-year and 5-year survival rates were 89.48% and 74.14% respectively., Conclusion: Epiglottis has many advantages in laryngeal reconstruction.

Objective: To assess the possible relation between the MspI polymorphism of Cytochrome P4501A1(CYP1A1) gene and the susceptibility to laryngeal cancer., Methods: The genotypes of CYP1A1 MspI site were detected using the methods of polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) in 62 cases of laryngeal squamous carcinoma and 56 healthy controls. Genetic risk of CYP1A1 genotypes was analyzed by smoking index (SI, cigarettes smoked per day x years of smoking)., Results: Three genotypes of CYP1A1 MspI were classified into the predominant homozygotes (A), heterozygotes (B) and the rare homozygotes (C). The frequency of heterozygote B (58.1%) and genotype C (14.5%) in the patients with laryngeal cancer were higher than that of the controls (39.3%, 7.1%, P < 0.05), while their odds ratios were 2.89 (95% confidence interval, CI: 1.31-6.37) and 3.97 (95% CI: 1.10-14.28), respectively. The odds ratios of genotype C was 9 (95% CI: 1.60-50.74) in the high dose cigarette smoking group, but was 4.5 (95% CI: 0.64-31.61) in the low dose cigarette smoking group., Conclusions: With the carcinogenesis and development of laryngeal cancer, the polymorphism of CYP1A1 gene and smoking exposure together may play an important role. The individuals with genotype C are at especially high risk of laryngeal cancer, which grows with increasing cigarette consumption.

Objective: To explore new methods of preservative surgery for T4 glottic cancer and to evaluate their long term results., Methods: 22 cases with T4 glottic cancer were treated surgically from 1982 to 1998. The lesions and involved cartilage and extrinsic laryngeal tissues were removed entirely, the sternohyoid myofascial flap, platysma myocutaneous flap, platysma myofascial flap, thyroid perichondral flap and hypopharyngeal mucosa flap were utilized to restore the defects of larynx, while the epiglottis or lamina of cricoid cartilage were reserved for laryngeal function restruction., Results: The 3- and 5-year survival rates were 86.4% and 75.0% in all cases. 68.2% had laryngeal functions(voice, respiration and deglutition) restored and 31.8% partially restored(voice and deglutition)., Conclusion: Despite the fact that the T4 glottic cancer usually involved with cartilage and extrinsic laryngeal tissues, preservative surgery can be carried out for the carefully selected cases with the lesions entirely removed.

Objective: To study the feasibility, surgical technique and results of laryngeal function preservation in surgical treatment for medial wall pyriform sinus cancer., Methods: From 1992 to 1999, 31 patients with medial wall pyriform sinus cancer including stage I 1, II 4, III 14 and IV 12 lesions were treated. Partial resection of pyriform sinus and partial laryngectomy were performed, then, the remains of epiglottis and uni-pedicled sternohyoid myofascial flap were used to restore the defects of larynx. At last, the remaining hypopharyngeal mucosa was sutured to cover the wound of hypopharynx and for artificial rebuild-up. All patients received postoperative radiotherapy., Results: The 3- and 5-year survival rates were 62.1% and 43.6% respectively, with 77.4% patients having laryngeal functions (voice, respiration and deglutition) completely restored and 32.6% partially restored (voice and deglutition)., Conclusion: Conservative surgery so introduced is feasible for selected medial wall pyriform sinus cancer patients with the lesion completely resected.

Objective: To review the experience of different surgical procedures and corresponding one-stage construction methods for cervical esophageal carcinoma., Methods: 1. Thirty-three patients with cervical esophageal carcinoma were retrospectively reviewed, including 31 males and 2 females. According to UICC 1997 criteria and pathologic findings showing squamous cell carcinomas, there were 2 patients in T1N0, 4 in T2N0, 1 in T2N1, 6 in T3N0, 6 in T3N1, 7 in T4N0 and 7 in T4N1 categoris. 2. Removal of cervical esophagus was conducted in 13 patients. The type of cervical esophageal reconstruction included direct suturing, pectoralis major musculo-cutaneous flap or combined with the split graft, laryngotracheal flap and colon interposition. Total esophagectomy without thoracotomy was carried out in 20 patients. Reconstruction of the esophagus consisted of 17 stomach pulling-up and 3 colon interposition. Twenty-four patients received radiotherapy postoperatively(dose 50-70 Gy)., Results: The resectability of cervical esophageal carcinoma was 100%. The overall follow-up was from 4 months to 10 years. Two and one patient in T1, 2 survived 3 and 5 years, respectively. Three and five-year survival rates for T3, 4 were 7/16 and 3/8, respectively. Twenty-six patients had laryngeal function preserved and acquired good speech. The decannulation rate was 80% (20/25). The incidence of complication was 33.3%, including pharyngeal fistulas in 6 cases, cervical stomal fistulas in 2, cervical stomal stenosis in 2 and splitting of abdominal wall in 2., Conclusion: Surgical resection of cervical esophageal carcinoma and resolvation of the extraesophageal invasion is possible. The continuity of the esophagus is restored by pectoralis major muculocutaneous flap, laryngotracheal flap, stomach transposition and colon interposition. Combined with radiotherapy, the resectability and survival rate of the cervical esophageal carcinoma can be improved.

Objective: To improve the curative effects of laryngotracheal stenosis., Method: Seventy patients treated for laryngotracheal stenosis on the different pathologic condition of the larynx and trachea were retrospectively reviewed. Different operative reconstruction methods were used accordingly., Result: Among 70 patients, 65 (92.9) patients succeed in decannulation. The average course of usage of stent was 14.8 days, the average course from operation to decannulation was 82.0 days., Conclusion: The choice of surgical procedure must be decided on the pathologic conditions of the larynx and trachea. Eliminating the defect of the mucosa and reconstructing a wide enough airway was the key to improve the curative effect.

Objective: To investigate the relationship between polymorphism of N-acetyltransferase (NAT2) gene and genetic susceptibility to laryngeal carcinoma., Methods: A case-control study on 62 laryngeal carcinoma patients and 56 controls was conducted. NAT2 alleles were differentiated by polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) methods using originally created PCR primers and genomic DNA extracted from peripheral white blood cells. Genetic risk for NAT2 genotype was analyzed by smoking index (SI, cigarettes smoked per day x years of smoking)., Results: The frequency of NAT2 slow genotype was 80.6% in patients with laryngeal carcinoma and 60.7% in the controls, the difference of which was statistically significant (chi(2) = 5.70, P = 0.017). The odds ratios were 2.70 (95% CI 1.19 approximately 6.11). Among the individuals with NAT2 slow genotype at high level of cigarette smoking, there was a significantly higher risk of 5.64 (95% CI 1.77 approximately 17.92), while those at low level were considered the reference group (OR 1.38, 95% CI 0.42 approximately 4.52)., Conclusion: NAT2 slow genotype increases the risk of susceptibility to laryngeal carcinoma. The combined effect of NAT2 slow genotype and exposure to smoking is observed during the development of laryngeal cancer.