Xuezhong Li

University of Jinan (Jinan, China), Chi-nan-shih, Shandong Sheng, China

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Publications (6)0.9 Total impact

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    ABSTRACT: This study compares clinical characteristics and survival between patients with and without laryngeal function (LF) preservation during surgical treatment for hypopharyngeal carcinoma. We retrospectively reviewed 485 cases of hypopharyngeal carcinoma treated at a single institution for analysis. There were 337 cases with and 148 cases without LF preservation after surgery. Preservation of LF was complete in 237 patients and partial in 100 patients. There were significant statistical differences between the preservation group and the group without preservation in T-stage (P < 0.001), overall staging (P < 0.001), and tumor sites (P < 0.001) except the N-stage (P = 0.240). The patients with LF preservation had significantly better overall survival (log-rank, P = 0.005) and a lower risk of death than those without LF preservation (HR 0.62, 95 % CI 0.43-0.97), after multivariable adjustment. Treatment with surgery in combination with radiotherapy is still the favorable choice for patients with hypopharyngeal carcinoma. The maximal restoration of pharyngoesophageal continuity and function improves survival for patients whose tumors are excised completely for the preservation of LF and laryngeal and pharyngeal reconstruction.
    06/2014;
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    ABSTRACT: To investigate the effect and clinical value of multiple plane operations in treating severe OSAHS. 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. 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). 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.
    Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 07/2006; 20(11):502-4.
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    ABSTRACT: To explore the feasibility and the related surgical techniques of laryngeal function preservation in surgical treatment of posterior hypopharyngeal wall cancer. 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. 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. 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.
    Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 01/2006; 19(24):1109-11, 1115.
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    ABSTRACT: To explore the relationship between the expression of MDM2 and p27 in hypopharyngeal carcinoma and clinicopathological parameters and their clinical significance. The expression of MDM2 and p27 in 59 hypopharyngeal carcinoma were detected by S-P immunohistochemical technique. 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). 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.
    Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 12/2004; 18(12):716-8.
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    ABSTRACT: To seek for the best surgical approaches to the skull and near-skull base neoplasms. 161 patients with skull or near-skull base tumors were surgically treated. The surgical approaches were craniofacial approach in 6 cases, total maxillectomy or/with orbital exenteration in 5 cases, lateral rhinotomy in 7 cases, frontorbital approach in 1 cases, maxillary swing or extended maxillary swing approach in 21 cases, mandibular swing approach in 30 cases, cervical approach in 48 cases, postaurical large C incision approach in 19 cases, transparotid approach in 8 cases, transoral approach in 6 cases, temporofrontal approach in 8 cases, subtemporal preauricular approach in 2 cases. Of the 98 benign tumors cases, 2 recurred postoperatively. Of the 63 malignant tumors, 1 case had cerebrospinal fluid leakage and died of intracranial infection 1.5 months postoperatively. In the follow up period, the longest one survival was over 8 years, and 10 over 5 years, 19 over 3 years, 16 over 2 years, 16 over 1 year. Survival rates of 3 and 5 years were 59.18% and 38.46% respectively. According to the site, range and pathology of the skull base neoplasmas, surgical approaches were designed and selected rationally and the effects better.
    Lin chuang er bi yan hou ke za zhi = Journal of clinical otorhinolaryngology 01/2003; 16(12):656-8.
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    ABSTRACT: To study the surgical technique and results of laryngeal function preservation in treatment of hypopharyngeal carcinoma. A retrospective review of 305 patients with malignant neoplasms of the hypopharynx (279 males, 26 females, age ranging from 14 to 77 years) was performed from 1978 to 1996. In the 305 patients (stage I, n = 6; stage II, n = 12; stage III, n = 82; stage IV, n = 205), the sites of origin were pyriform sinus (n = 234), postcricoid (n = 21), posterior pharyngeal wall (n = 35) and superior hypopharynx (n = 15). Of the 305 patients, 206 (67.54%, stage I, n = 6; stage II, n = 12; stage III, n = 65; stage IV, n = 123) were surgically treated with laryngeal function preserved and 99 (32.46%, stage III, n = 17; stage IV, n = 82) had no laryngeal function preserved. All had 55-75 Gy radiotherapy according to their need. A total of 206 patients (67.54%) were surgically treated with laryngeal function preserved, totally (voice, respiration and deglutition) in 139 (67.5%) and partially (voice and deglutition) in 67 (32.5%). 99 patients (32.46%) had no laryngeal function preserved. The overall 5-year survival rate of the 305 patients was 44.8%, which segregated to 83% (stage I), 71% (stage II), 58% (stage III), and 36% (stage IV). The 5-year survival of the laryngeal function preserved group was 48% (n = 66), the rate of complications 28% (n = 58) and the rate of residual tumor 5.8% (n = 12), compared with the no laryngeal function preserved group 37% (n = 20), 31.3% (n = 31), and 6% (n = 6) (P > 0.05). Only a small proportion of patients (31/305, 10%) with hypopharyngeal carcinoma who require total laryngectomy and preservation of the laryngeal function is feasible for eradication of tumor and preservation of laryngeal function.
    Chinese medical journal 07/2002; 115(6):892-6. · 0.90 Impact Factor