游离空肠移植术重建颈部食管、下咽并发症分析

目的探讨游离空肠移植下咽及颈部食管重建术中常见并发症及其防治措施。方法选用10条比格犬(Beagle)行游离空肠移植下咽及颈部食管重建术,术中以空肠血管与甲状腺前动脉及颈外静脉行端-侧、端-端吻合,空肠移植颈部下咽、食管重建,观察并发症发生情况。结果术后6条实验犬手术成功,存活4w以上并能够正常饮食,术后移植空肠血供良好;4条犬出现并发症而死亡。结论游离空肠移植技术可以重建颈部组织缺损的修复,术前准备充足、术中操作细腻、术后观察及护理及时可以减少并发症,提高手术成功率,是颈部缺损修复最为理想的方法。     

游离空肠移植术重建下咽及颈部食管动物实验研究

目的:探讨游离空肠移植术重建下咽及颈部食管的临床应用。方法:选用10条比格犬(Beagle)行游离空肠移植下咽颈部食管重建术,术中以空肠血管与甲状腺前动脉及颈外静脉行端-侧、端-端吻合,空肠移植颈部食管重建。结果:6条实验犬手术成功,存活4周以上并能够正常饮食,术后移植空肠血供良好。结论:游离空肠移植技术可以重建颈部组织缺损,且并发症少,符合正常生理要求,比格犬的特殊的实验价值在游离空肠移植术中有重要的临床意义。     

半胱氨酸蛋白酶-8蛋白在下咽癌组织中的表达及临床意义

目的探讨Caspase-8在下咽癌组织中的表达及其与各临床、病理因素的关系。方法采用流式细胞术检测41例下咽癌组织和41例相应癌旁组织中的Caspase-8的表达,并以15例非下咽癌患者咽部正常黏膜组织作对照。并分析下咽癌组织中Caspase-8表达与临床病理因素的关系。结果(1)下咽癌组织中Caspase-8蛋白的表达量及阳性表达率均明显低于癌旁组织及正常咽黏膜组织(P<0.05),癌旁组织及正常咽黏膜组织的表达差异无统计学意义(P>0.05)。(2)Caspase-8蛋白的表达与下咽癌组织中的淋巴结转移、临床分期、分化程度呈相关性(P<0.05);与肿瘤大小、吸烟量、年龄和性别无相关性(P>0.05)。结论Caspase-8蛋白的低表达可促进下咽癌的发生、发展,其蛋白检测可作为判断下咽癌分化、浸润、转移、分期的重要指标。     

Malignant tumours of the cervical oesophagus

Forty-seven patients with malignancy of the cervical oesophagus are described and compared with a group of 647 patients with hypopharyngeal malignancy. There was a higher proportion of non-squamous malignancy in cervical oesophageal cancer compared with hypopharyngeal cancer. Cervical oesophageal malignancy tended to present earlier with significantly lower T stage and neck node metastases were relatively unusual at presentation. Patients with cervical oesophageal malignancy were frequently incurable at the time they are first seen and 21 had palliative treatment only, 26 patients had curative treatment, 12 underwent radical radiotherapy and 14 had surgery. Cervical oesophageal malignancy had a significantly worse prognosis than hypopharyngeal malignancy with an 18% 3 year survival compared with a 33% 3 year survival (χ²₁=7.1089, P <0.01). Those patients with oesophageal malignancy who were treated fared considerably better than the whole group with 30% being alive at 3 years (χ²₁=10.5185, P <0.01).     

Differential expression profiling of head and neck squamous cell carcinoma (HNSCC)

Head and neck squamous cell carcinoma (HNSCC) is the fifth most common cancer in men with an incidence of about 780000 new cases per year worldwide and a poor rate of survival. There is a need for a better understanding of HNSCC, for the development of rational targeted interventions and to define new prognostic or diagnostic markers. To address these needs, we performed a large-scale differential display comparison of hypopharyngeal HNSCCs against histologically normal tissue from the same patients. We have identified 70 genes that exhibit a striking difference in expression between tumours and normal tissues. There is only a limited overlap with other HNSCC gene expression studies that have used other techniques and more heterogeneous tumour samples. Our results provide new insights into the understanding of HNSCC. At the genome level, a series of differentially expressed genes cluster at 12p12-13 and 1q21, two hotspots of genome disruption. The known genes share functional relationships in keratinocyte differentiation, angiogenesis, immunology, detoxification, and cell surface receptors. Of particular interest are the 13 'unknown' genes that exist only in EST, theoretical cDNA and protein databases, or as chromosomal locations. The differentially expressed genes that we have identified are potential new markers and therapeutic targets.     

The Distended Fetal Hypopharynx: A Sensitive and Novel Sign for the Prenatal Diagnosis of Esophageal Atresia

Background/Purpose

Although advances have been made in the prenatal diagnosis of esophageal atresia (EA), most neonates are not identified until after birth. The distended hypopharynx (DHP) has been suggested as a novel prenatal sign for EA. We assess its diagnostic accuracy and predictive value on ultrasound (US) and magnetic resonance imaging (MRI), both alone and in combination with the esophageal pouch (EP) and secondary signs of EA (polyhydramnios and a small or absent fetal stomach).

麻醉喉镜在喉咽部异物取出术中的应用

目的 探讨麻醉喉镜在特殊人群(指：咽反射敏感、颈部粗短、张口困难、舌体肥厚、舌系带较短、患者年龄较小的人群。)中喉咽部异物诊断和取出的作用。方法 通过对过去1a特殊人群中难以诊断或取出的36例喉咽异物诊断和取出的成功经验进行回顾性研究分析。结果 在麻醉喉镜下36例难取下咽异物均成功取出。结论 在特殊人群中麻醉喉镜可作为下咽异物诊断和取出的一种有效方法，该方法使用简便，成功率高。     

纤维喉镜在隐蔽性下咽部异物诊治中的应用

目的探讨纤维喉镜在隐蔽性下咽部异物诊治中的应用。方法自2001年3月～2006年8月对112例有明确下咽部异物史,但常规间接喉镜检查未发现异物的患者,采用电视纤维喉镜检查。结果发现111例有异物,并全部用纤维喉镜活检钳成功取出异物,1例发现梨状窝有肉芽组织,后经颈部CT扫描发现右侧声门旁间隙异物,行颈前径路切开取出鱼刺。结论纤维喉镜具有检查全面、观察清晰、定位准确、钳取方便的优点,可以有效地减少隐蔽性下咽部异物的漏诊。