RESUMEN

Objective To evaluate the safety and effectiveness of excessive dynamic airway collapse(EDAC)treated by laser.Methods 13 patients with EDAC confirmed by bronchoscopy from January 2018 to August 2022 were selected and divided into a simple EDAC group(6 cases)and an EDAC combined with tracheobronchomalacia(TBM)group(7 cases)based on whether they were combined with TBM.All patients underwent laser tracheobronchoplasty under bronchoscope.Symptoms,airway collapse,oxygenation index,modified version of British Medical Research Council dyspnoea scale(mMRC)and 6 min walking test before and after treatment were compared to evaluate the therapeutic effect.Results 13 patients underwent 17 times of laser tracheobronchoplasty with laser power of 8～15 W,and 4 patients underwent 2 times of laser tracheobronchoplasty.After treatment,the clinical symptoms of cough,sputum,shortness of breath and dyspnea were improved in all patients.1 week post-treatment,the EDAC group showed a significant improvement in airway lumen stenosis,with a significant statistical difference(P<0.05),1 month post-treatment,enhancements were observed in airway stenosis,oxygenation index,FEV1%,6-minute walk test,and mMRC,which remained stable over a 6 month follow-up.In the EDAC + TBM group,significant enhancements in airway stenosis,oxygenation index,and mMRC were noted 1 week post-treatment,with statistical significance(P<0.05).Between 8 d～6 months post-treatment,some patients exhibited a recurrence of airway stenosis,necessitating comprehensive interventions like balloon dilation,cryotherapy,and stent insertion.Local necrosis and granuloma occurred in some patients after laser therapy,and no serious complications associated with laser intervention were found in all patients.Conclusion Laser tracheobronchoplasty is a safe and effective technique for the treatment of EDAC.For patients with EDAC alone,the therapeutic effect is good,but for patients with EDAC combined with TBM,the long-term effect is not good.

RESUMEN

AIMS: To investigate the efficacy and safety of minimally invasive bronchoscopic interventions for patients with tracheobronchial mucoepidermoid carcinoma (MEC). METHODS: Patients with tracheobronchial MEC were included in this retrospective study, and the clinical features, histologic grading, treatments, and cumulative survival rates were calculated. Patients were categorized into child (n = 16) and adult (n = 19) group according to their ages. Histologic grading, treatments, and survival status were compared between the two groups. RESULTS: In pathology, high-grade MEC counts for 6.77% and 42.10% in the child and adult group, respectively. As tumor growth pattern was concerned, 93.33% and 21.05% tumors in the child and adult group present intratracheal type. Multiple bronchoscopic interventions were conducted, including rigid bronchoscopy, argon plasma coagulation (APC), dioxide carbon cryotherapy, and electric loop. Tumors could be removed by multiple bronchoscopic interventions. Bronchoscopy-associated complications were rare, including an oral mucosa injury and a glottis edema. In the child group, one patient underwent left upper lung lobectomy. In the adult group, lobectomy and/or chemotherapy and/or radiotherapy were conducted in seven patients. The 5-year survival rate was 100% and 68.90% in the child and the adult group, respectively. CONCLUSIONS: Almost all children have low-grade and intratracheal MEC; 2/5 adults have invasive high-grade MEC. Multiple bronchoscopic interventions are effective in erasing low-grade intratracheal MEC without severe complications. For high-grade invasive MEC, aggressive and comprehensive therapy should be considered.

Asunto(s)

Carcinoma Mucoepidermoide , Adulto , Coagulación con Plasma de Argón , Broncoscopía , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/cirugía , Niño , Humanos , Estudios Retrospectivos

RESUMEN

Accumulating evidence shows that human papillomavirus (HPV) may play a significant role in head and neck squamous cell carcinomas (HNSCC) initiation and development, however, the detailed mechanism remains unclear. It is possible that the malicious transformation of infected cells by HPV E6 and E7might contribute to development of HPV positive HNSCC. In order to give a full description of HPV positive HNSCC, this review will focus on HPV infection epidemiology, carcinogenesis mechanism and feasibility of HPV vaccine in cancer prevention/treatment.

RESUMEN

Simultaneous distillation-extractor was used for extracting the volatile substances in Phellodendron chinense Schneid.41 Volatile components were identified by gas chromatography/mass spectrometry (GC/MS) method. Of them the main components are ketones(16.38%),aldehydes(13.94%),alcohols(8.27%),phenols(50.38%),esters(3.02%),acids(2.18%).The content of the 41 identified compounds makes up 97.50% of the total volatile substances detected