Objective To investigate the changes of uvulopalatopharyngoplasty on the auditory function in adult patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS).The possible mechanism of hypoxemia was analyzed,and hypercapnia might affect auditory function and the effect of operation to hearing was improved.Methods A total of 82 adult patients who were made a diagnosis by polysomnography (PSG) with severe OSAHS had been diagnosed by pure tone audiometry,tympa-nometry,auditory brainstem responses (ABR),and otoacoustic emissions (OAE) before and 6 months after surgical treatments.The control group included 43 non-snoring healthy people through the same line of the above test.Results (1)Among 82 patients who underwent uvulopalatopharyngoplasty,symptoms were resolved in 51 patients,significantly improved in 24 patients,and somewhat improved in7 patients at 6 months followed-up,yielding a total effective rate of 100％.(2)There were no significant differences in hearing threshold across 250 to 4 000 Hz on pure tone audiometry between OSAHS and control groups (P ＞ 0.05),although hearing thresholds at high frequencies showed significant differences (P ＜ 0.05).(3)The latencies of ABR waves Ⅰ and Ⅴ in the OSAHS group were significantly longer than control group (P ＜ 0.05).The interpeak lantency intervals of wave Ⅲ ～ Ⅴ in patients with OSAHS were longer than that in the control group (P ＜ 0.05).No significant difference was showed before and after surgery (P ＞ 0.05).(4)Distortion product otoacoustic emission (DPOAE) detection rate and amplitudes at all frequencies were poorer in OSAHS group before surgery compared with the control group (P ＜ 0.05),and significant changes were found after surgical treatments (P ＜ 0.05).Conclusions OSAHS can impair auditory function,probably from chronic hypoxia,which can be improved by surgical treatment in adult patients with severe OSAHS.

Objective To analyze the related factors,and discuss the causes and prevention measures of pharyngocutaneous fistula caused by total laryngectomy.Methods The complete chnical data of 118 patients underwent laryngeal ancer surgery were analyzed retrospectively.Analyzed the relationship between pharyngocutaneous fistula and the factors of sex,age,pre-operative nutrition states,preoperative radiotherapy,prior tracheotomy,neck dissection,tumor position,clinical stage of tumor,patho-staging,post-operative infection comobidity with analysis of single factor.Results Among the 118 cases of laryngeal carcinoma,17 cases were pharyngocutaneous fistula after operation,the incidence was 14.4％ (17/118).According to the statistical analysis results,the predominant influencing factors in the causation of pharyngocutaneous fistula were:pre-operative nutrition states,pre-operative radiotherapy,clinical stage of tumor and post-operative infection.Concusion Pharyngocutaneous fistula after total laryngectomy is related to many factors,avoiding the above mentioned factors can reduce the rate of fistula and improve the life quality.

Objective To compare the efficacies between nasal packing and no nasal packing after endoscopic sinus surgery for chronic sinusitis,and explore the feasibility of no nasal packing after endoscopic sinus surgery.Methods Eighty-two type 1 or type 2 chronic sinusitis patients who received endoscopic sinus surgery under general anesthesia were divided into no nasal packing group (44 cases,75 sides) and nasal packing group (38 cases,65 sides) by random digits table method.The patients in 2 groups were taken preoperative anti-inflammatory and regulation blood pressure treatment.The volume of bleeding,postoperative pain (visual analogue score,VAS),degree of mucosal edema,efficacy and postoperative complications between 2 groups were compared.Results There were no statistical difference in volume of bleeding and efficacy between 2 groups (P ＞ 0.05).The postoperative VAS in no nasal packing group was significantly lower than that in nasal packing group [(2.46 ± 0.54) scores vs.(5.49 ± 1.26) scores],there was statistical difference (P＜ 0.01).There was no statistical difference in mucosal edema score postoperative 1 week and 6 months between 2 groups (P ＞ 0.05),but the mucosal edema score postoperative 1 month in no nasal packing group was significantly lower than that in nasal packing group [(1.32 ±0.63) scores vs.(3.52 ±0.72) scores],there was statistical difference (P ＜ 0.01).Postoperative comphcations in nasal packing group were significantly more than those in no packing group.Conclusion No nasal packing can be performed for type 1 or type 2 chronic sinusitis patients who has no significant bleeding after endoscopic sinus surgery under general anesthesia,it is actually beneficial of relieving distress of the patient and reducing postoperative complications.

ive] To isolate the active constituents with analgesic and antemetic actions from Rhizo-ma Alpiniae Officinarum. [Methods] Polyamide and silica gel column chromatography was used to isolate and extract the analgesic and antemetic constituents. The structure of compounds was identified by ultra violet spectroscopy, infrared spectroscopy, mass spectroscopy and nuclear magnetic resonance spectrosco-py. [ Results ] Galangin and kaempferide are identified as the analgesic and antemetic constituents. [Conclusion] Galangin can be used as the quality control for Rhizoma Alpiniae Officinarum.

Objective To investigate the correlation between MR imaging and pathological features of nucleus pulposus degeneration in the lumbar disc, and to provide a reliable evidence to evaluate the nucleus pulposus degeneration by MR imaging relative signal intensity. Methods From January 2001 to December 2001, 91 patients who underwent operative treatment for lumbar disc diseases were recruited for the study, while 4 lumbar fracture patients with no previous low back pain and 2 fresh brain-injury cadavers were recruited for contrast study. Before operation, the relative signal intensity was measured in MRI T2WI images. All 117 specimens were dyed with HE and Alcian blue CEC. The water content was also detected. The correlation between MRI relative signal intensity and chondroitin sulfate index, water content was analyzed with SPSS 10.0 software, the correlation between chondroitin sulfate index and water content was analyzed as well. Results There was significant difference between the above mentioned two groups when MRI relative signal intensity, chondroitin sulfate index and water content was compared. Whereas there was no significant statistical difference when keratin sulfate index was compared between the two groups. MRI relative signal intensity positively correlated with water content and chondroitin sulfate index, and the chondroitin sulfate index positively correlated with water content. Conclusion The MRI relative signal intensity reflects not only the water content, but also the pathological characteristics of nucleus pulposus degeneration. The quantitative classification of relative signal intensity in MRI is a method to identify the grades of nucleus pulposus degeneration.

To simplify the preparation of neuraminidase in screening influenza neuraminidase inhibitors,the neuraminidase gene of H5N1 influenza A virus was optimized for high expression in mammalian cells and cloned into pcDNA4/TO vector. The recombinant plasmids were transfected into T-REx 293 cells to establish stable cell lines,in which the expression of neuraminidase was induced by tetracycline. Unlike from virions,the preparation of neuraminidase became conveniently and safely from these stable cell lines,which would facilitate developing high throughput assay to screen neuraminidase inhibitors. More than 3000 natural extracts and herbal components were screened in the study. Baicalin and baicalein were found to inhibit oseltamivir-sensitive and oseltamivir-resistant neuraminidase at similar level,furthermore,their anti-influenza activity was confirmed by plaque assay and virus inhibition assay.

Objective To discuss the clinical value and nursing of the three-endoscope in the treatment of eholedoeholithiasis. Methods 45 eases of choledocholithiasis patients who were treated with LCDE (three-endoscope) were named as the research group.56 patients who received traditional open ab-dominal surgery were set as the control group. The average hospitalization time and satisfaction degree with nursing were compared, t test and χ2 test were adopted. Results The average hospitalization time was shorter and satisfaction degree with nursing was higher in the research group than those in the control group. Conclusions The treatment of choledochohthiasis with three-endoscope is safe and feasible, es-pecially when combined with antibiotics lavage and stone dissolution through naso-biliary duct.The opera-tion can widen the surgical indication,reduce the risk of surgery with little damage,clear stones completely, reduce postoperative complicatioas,make patients recover faster, shorten the hospital stay and achieve the same or better treatment results when compared to the traditional open abdominal surgery.

The need for an efficacious HIV/AIDS vaccine remains the highest priority of the world HIV/AIDS agenda. The generation of an efficacious HIV/AIDS vaccine proves an enormous scientific challenge. This article reviews the neutralizing antibody problem, elusive immune protection, immunogen design, pre-existing anti-vector immunity and design of phase 3 vaccine trials and the challenges and opportunities in development of HIV/AIDS vaccine are discussed.

Objective To observe the MRI characteristics in subacute combined degeneration (SCD)of the spinal cord.Methods The data of 1 9 SCD patients were retrospectively analyzed by the clinical characteristics and MR images.Results Among the 1 9 pa-tients of SCD,1 6 cases showed abnormal findings.Most of intramedullary lesions located in posterior column of thoracic and cervical spinal cord,and only one case located in cerebellar cortex and medulla oblongata.Lesions were involved in muti-segmental spinal cord,and mainly located in the dorsal or lateral spinal cord,and only two cases located in the anterior spinal cord.Different segmental spinal cord lesions had a different morphological characteristics with no enhancement.After treatments with vitamin B1 2 ,the lesions diminished and even disappeared in 2 cases.Conclusion MRI has important value in the diagnosis and treatment monitor of the SCD.

Objective To detect different animal erythrocyte hemolysins titer,and compare the application of these hemolysins in immunological experimental teaching,for selecting the better method of preparing high titer hemolysin for experimental teaching of medical immunology.Methods A total of 40 experiment rabbits were divided into 4 groups in this study,and immunized by sheep red blood cell(SRBC) and porcine red blood cell(PRBC) through different immunization procedures to prepare the hemolysin,detect and compare these 4 groups hemolysins titer by the complement hemolysis test.Results Rabbit Anti-SRBC in the group A was 1∶4 800,rabbit Anti-PRBC in the group B was 1∶1 200,rabbit Anti-SRBC in the group C was 1∶1 000,rabbit Anti-PRBC in the group D was 1∶200.Conclusion The hemolysin titer of the rabbit Anti-PRBC was lower than that of the rabbit Anti-SRBC by the same immunization procedures,and the immunization procedure by intradermal multi-point and auricular vein injection is the better method of preparing high titer hemolysin,so PRBC could replace SRBC as antigen,and immunize the rabbits for preparing hemolysin,which could be used in experimental teaching of medical immunology.