Objective To evaluate the efficacy of tonsils and adenoid ablation by plasma-mediated temperature-controlled radiofrequency for obstructive sleep apnea hypopnea syndrome (OSAHS) in children. Methods From August 2005 to May 2007,43 cases with OSAHS received tonsillectomy and adenoid radical resection with Evac70 tool bit using a plasma-mediated temperature-controlled system. The clinical data of the patients were reviewed. Results The mean operation time was 16 minutes,ranged from 10 to 20 minutes. During the operation,the patients had a mean of 3 ml hemorrhage (1 to 10 ml). Compared with the preoperative examination,the patients showed significantly lowered AHI [(14.6?4.6) times/h vs (4.2?2.7) times/h,t=8.563,P=0.000] and OAI [(6.9?3.5) times/h vs (3.3?1.4) times/h,t=5.443,P=0.000] and increased minimum blood oxygen saturation [(85.7?4.4)% vs (99.7?0.2)%,t=-6.687,P=0.000]. Conclusions The ablation of the tonsil and adenoid using plasma-mediated temperature-controlled radiofrequency is effective and safe for children with OSAHS.

Objectives To approach the effect of the disturbance of lipid metabolism, fatty infiltration in oropharyngeal tissues on the patient with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods 19 obese patients of OSAHS, 15 nonobese patients of OSAHS and 9 healthy people (as control) were selected. Among the three groups, The related clinical index and size and the weight of uvula were measured. The fatty weight of uvula was analyzed by biochemical methods. The uvular tissue sections were evaluated by light microscope (LM) and transmission electron microscope (TEM). Results 1 Both the obese and nonobese groups, the TC, TC/HDL, size and weight and the adipose tissue in uvula were obviously different compared with control group( P

Objective:To evaluate the therapeutic methods of sensorineural hearing loss with iron deficiency anemia and their effects. Method:Sixty-eight Wistar rats were randomly divided into 3 groups: Group A (iron deficiency group A) 24 rats, group B (iron deficiency group B) 24 rats and group C (control group) 20 rats. Group A and B were fed with iron deficiency diet for 6 weeks. By analyzing ABR and DPOAE, hearing loss was detected in group A and B. Then,group A was given iron supplementation diet and hyperbaric oxygen therapies. and group B was given iron supplementation diet only. Result:The auditory thresholds and period latencies (PL) of I waves of ABR and DPOAE amplitude in 2 kHz and 3kHz within group A and B were significantly different before and after treatment (P＜0.05). But the effects of treatment between these two groups had not significant differences (P＞0.05). Conclusion: It suggested that good results can be obtained by early iron supplementation in iron deficiency hearing loss cases. Hyperbaric Oxygen therapy may not be necessary.

OBJECTIVE: To compare the effect of the medical and surgical treatment of pediatric chronic rhinosinusitis (CRS). METHOD: Seventy-two cases of pediatric CRS were randomly divided into medical group (35 cases) and surgical group (37 cases). The patients in medical group received a 12-week course of clarithromycin, alkaline nasal douche and intranasal mometasone furoate. The patients in surgical group underwent adenoidectomy or (and) tonsillectomy or ESS. All patients underwent pre- and post-treatment assessments of visual analogue score (VAS) and nasal endoscopy. The assessments of CT were arranged before starting the treatment and post-treatment in 12-month. RESULT: Both groups of pediatric CRS significantly improved in VAS and endoscopic parameters of CRS in all stages. There were no significant difference between two groups in 1-month (P > 0.05). The surgical group demonstrated greater change than medical group in 3-month, 6-month and 12-month (P < 0.01). In surgical group, 37 cases underwent three different styles of operation: adenoidectomy (n = 19), adenoidectomy and tonsillectomy (n = 10) and ESS (n = 8). VAS and endoscopic parameters were not significantly different among three groups in all stages except in 1-month. CONCLUSION The results of this study warrant further that both medical and surgical treatment of pediatric CRS significantly improve in VAS and endoscopic parameters of CRS. The mainstay of management is medical treatment. Long-term, low-dose macrolide is an effective therapy and a valid alternative in pediatric CRS. Surgical intervention is necessary for cases that do not respond to prolonged course medical treatment. Adenoidectomy or (and) tonsillectomy seems to be a recommended surgical procedure for children with adenoid or (and) tonsil hypertrophy.
Adenoidectomy ; Adolescent ; Child ; Chronic Disease ; Clarithromycin ; therapeutic use ; Female ; Humans ; Male ; Mometasone Furoate ; Pregnadienediols ; therapeutic use ; Sinusitis ; drug therapy ; surgery ; Tonsillectomy ; Treatment Outcome

Objective:To study the clinical effects of modified surgical method with H-uvulopalatopharyngoplasty(H-UPPP)and traditional surgical method in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)in children.Methods:The clini-cal data of 364 pediatric patients with OSAHS were retrospectively analyzed.The patients were divided into 2 groups and treated by low-temperature plasma knife radio frequency ablation for bilateral tonsil removal combined with H-UPPP(group A,n=204)and low-temperature plasma knife radio frequency ablation only(group B,n=160)respectively.The operative time,intraoperative bleed-ing,postoperative secondary bleeding,VAS of pain following operation,postoperative traumatic white film shedding time,OAH1,LSaO2,ESS scores and complications of the 2 groups were compared.Results:In group A the operative time,intraoperative bleed-ing,VAS,OAHI and ESS scores were lower than those in group B(P＜0.05),wile postoperative traumatic white film detachment time and LSaO2 were higher(P＜0.05).No statistically significant difference in terms of the number of cases of postoperative seconda-ry bleeding and complications was observed between the 2 groups(P＞0.05).Conclusion:The combination of low-temperature plas-ma radio frequency ablation and H-UPPP for the treatment of OSAHS may provide clear intraoperative view,and may improve the treatment effects.

Background Occupational stress is an important public health problem in the military. At present, there are few studies about occupational stress of officers and soldiers of the armed forces in China, especially the effects of plateau related environmental factors on occupational stress. Objective To understand current status and identify influencing factors of occupational stress among officers and soldiers stationed in plateaus, and provide a scientific basis for managing occupational stress. Methods In April 2023, stratified cluster sampling was used to recruit troops by deployed altitudes ranging from 500 to 3000 m into two strata of low altitude (＜2500 m) and high altitude (≥2500 m) based on the medical definition of plateau. Two regimental units were randomly selected from each stratum respectively, and one battalion unit was randomly selected from each regimental unit with all the officers and soldiers. Four selected battalion units were surveyed with a total of 2284 officers and soldiers. We designed a general questionnaire to collect their basic information, and distributed effort-reward imbalance questionnaires to evaluate occupational stress. We used logistic regression to identify potential influencing factors of occupational stress. Results Positive occupational stress was reported in 508 plateau-stationed officers and soldiers, with a prevalence rate of 22.2%. The total effort-reward imbalance score and the dimensional scores of effort, reward, and overcommitment in M (P₂₅, P₇₅) were 0.9 (0.7, 1.0), 16.0 (13.0, 19.0), 36.0 (33.0, 39.0), and 18.0 (15.0, 19.0), respectively. There were significant differences in the positive rate of occupational stress by gender, age, military service length, marital status, only child or not, physical fitness condition, reporting underlying diseases or not, exercise frequency before conscription, psychological changes after entering the plateaus, and having altitude sickness or not (P <0.05). The results of logistic regression showed that being female (OR=1.532, 95%CI: 1.061, 2.213), only child (OR=1.281, 95%CI: 1.038, 1.581), and with underlying diseases (OR=1.950, 95%CI: 1.340, 2.839) were associated with a higher risk of occupational stress. While setting 0 to <3 years of military service as the control group, the risk of occupational stress was higher in subgroups of 3 to 9 years (OR=1.380, 95%CI: 1.113, 1.710) and ≥9 years (OR=2.141, 95%CI: 1.461, 3.137). The participants reporting nervousness or fear (OR=1.728, 95%CI: 1.133, 2.635) and agitation or euphoria (OR=1.380, 95%CI: 1.113, 1.710) had a higher risk of reporting occupational stress than those with no psychological changes after entering the plateaus. Meanwhile, those who had regular exercise (OR=0.670, 95%CI: 0.492, 0.913) before enlistment, good physical fitness condition (OR=0.572, 95%CI: 0.426, 0.767) and excellent physical fitness condition (OR=0.502, 95%CI: 0.366, 0.688) had a lower risk of occupational stress. Conclusion Officers and soldiers in plateaus generally report a high rate of occupational stress. Female, military service length ≥3 years, being only child, with underlying diseases, nervousness/ fear or agitation/ euphoria after entering plateaus are risk factors for elevated occupational stress in this group; while good or excellent physical fitness condition and frequent exercise before enlistment are protective factors for occupational stress. Therefore, it is necessary to pay attention to the occupational stress problems in officers and soldiers stationed in plateaus and provide targeted intervention measures.

OBJECTIVE: To investigate the change of serum leptin levels in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after surgery. METHOD: The cases were divided into effective (n=44) and non-effective (n=13) groups according to PSG. The effective cases were divided into decreased (> or = 5%, n=25) and non-decreased(<5%, n=19) BMI. The level of serum leptin was detected by radioimmunoassay. RESULT: The level of serum leptin after treatment (9.1 +/- 2.6 microg/L) was as high as before treatment (9.3 +/- 2.3 microg/L) in 13 non-effective cases. The level of serum leptin after treatment (7.15 +/- 1.23 microg/L) was significantly decreased than before treatment (12.79 +/- 2.98 microg/L) in 25 cases of decreased BMI (> or = 5%). The level of serum leptin after treatment (7.15 +/- 1.23 microg/L) was significantly decreased than before treatment (12.79 +/- 2.98 microg/L) in 19 cases of non-decreased BMI (<5%). Leptin level of all cases showed a positive correlation with AHI (P < 0.01). CONCLUSION The level of serum leptin in patients with OSAHS are increased. The serum leptin level of effective patients with OSAHS after treatment was significantly decreased. The level of serum leptin reflects the degree of AHI in patients with OSAHS.
Adult ; Aged ; Humans ; Intraoperative Period ; Leptin ; blood ; Middle Aged ; Sleep Apnea, Obstructive ; blood ; surgery