The purpose is to report a case of chordoma, which orignated from sphenoid sinus and encroach on sella, metasella and clivus. We comprehensively analyzed the CT and MRI information and diffrentiated the illness from the commonly encountered diseases of sphenoid sinus and sellato improve the accuracy before surgery.
Chordoma ; pathology ; Humans ; Male ; Middle Aged ; Paranasal Sinus Neoplasms ; pathology ; Sphenoid Sinus ; pathology

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; instrumentation ; Sleep Initiation and Maintenance Disorders ; diagnosis

OBJECTIVE: Observed the using of coblation during the maxillary sinus operation, to investigate the superiority of its clinical application. METHOD: Selecting 46 patients with the maxillary sinus lesions of sinusitis, nasal polyps and nasal inverted papilloma as research objects, the control group used high speed cutting drill, the research group used coblation separately for functional endoscopic sinus surgery. Six months postoperative follow-up, observeing the subjective symptoms and objective examination. RESULT: Subjective symptoms and objective examination scores of two groups of patients improved significantly. Compared with the control group, the operation time, bleeding volume and postoperative examination time are reduced in the study group of patients. Endoscopic examinations of the study group are better than the control group. CONCLUSION Using coblation for the maxillary sinus operation, treatment are more thorough, more minimally invasive, shorten operation time, reduce bleeding and recheck time after surgery, is worthy of clinical use.
Endoscopy ; Humans ; Maxillary Sinus ; surgery ; Nasal Polyps ; surgery ; Nasal Surgical Procedures ; methods ; Papilloma, Inverted ; surgery ; Postoperative Period ; Sinusitis ; surgery

OBJECTIVE: To investigate the result of child-type micro-sensitive mattress sleep monitor on obstructive sleep apnea-hypopnea syndrome in children. METHOD: The PSG and child-type micro-sensitive mattress sleep monitor were synchronously performed on 58 cases of children with OSAHS. The breathing and sleep metrics were compared. RESULT: By PSG monitoring, 41 cases were diagnosed as mild OSAHS, 14 cases were moderate and 3 cases were severe. The results of mattress system monitoring showed mild OSAHS in 37 cases, 16 cases of moderate and severe OSAHS in 5 cases. Seven patients diagnosed as mild OSAHS monitored by PSG were classified as moderate by mattress system monitoring; three cases diagnosed as mild OSAHS by mattress system monitoring system were diagnosed as moderate by PSG. Among 14 cases of children diagnosed as moderate by PSG, three cases were diagnosed as mild by mattress system monitor and two cases as severe. Children diagnosed as severe by PSG got the same result by mattress system monitor. Two kinds of sleep monitoring methods were compared and there were no statistically significant difference in AHI (t = 2.316, P > 0.05), deep and shallow sleep constituent ratio (t = 2.280, t = 2.388, PF > 0.05). while there was significant difference in REM period Sleep constituent ratio (t = 3.135, P < 0.01). CONCLUSION Child-type micro-sensitive mattress is in good agreement with the PSG for diagnosing OSAHS in children, which can be used as a monitoring method in clinical work.
Child ; Child, Preschool ; Female ; Humans ; Male ; Polysomnography ; instrumentation ; methods ; Sleep Apnea, Obstructive ; diagnosis

Objective To investigate the clinical effect of active immunotherapy combined with endometrial local injury in women with recurrent spontaneous abortion( RSA) caused by negative-blocking antibodies.Methods 112 patients diagnosed RSA with negative -blocking antibodies were randomly divided into the treatment group (62 patients) and control group (50 patients).The patients in treatment group were treated by active immunotherapy combined with endometrial local injury.The patients in the control group were treated by active immunotherapy.The pregnancy outcomes were observed.Results The rate of pregnancy was 93.54%in treatment group,and 80.00%in the control group.The success pregnancy rate in the treatment group was significant higher than that in the control group (χ2 =4.65,P<0.05).The rate of abortion was 3.44% in the treatment group and 12.50% in the control group.It was significant lower than the control group(χ2 =4.90,P<0.05).After active immunotherapy,the pregnan-cy rate was 90.58%in positive-blocking antibodies group and 77.77%in negative-blocking antibodies group.The success pregnancy rate in positive-blocking antibodies group was significant higher than that in negative-blocking antibodies group (χ2 =4.27,P<0.05).The abortion rate in positive-blocking antibodies group was 2.60% and 19.05%in negative-blocking antibodies group.It was significant lower than that in negative-blocking antibodies group (χ2 =6.14,P<0.05).Conclusion It can significantly improve pregnant outcome and reduce the abortion rate with active immunotherapy combined with endometrial local injury in women with recurrent spontaneous abortion ( RSA) caused by negative-blocking antibodies.

OBJECTIVE: To investigate the sleep monitoring feature of the MSMS in elderly patients with OSAHS. METHOD: One hundred and ninety patients diagnosed with OSAHS were divided into elderly group and non elderly group according to age, then the results of MSMS were analyzed. RESULT: Majority elderly patients were with mild to moderate OSAHS. The nocturnal mean blood oxygen and the lowest oxygen were higher than non elderly group, coupled with higher percentage of the total oxygen saturation < 90% monitoring time (TS90). There was no significant difference in sleep structure between two groups, but the total sleep time of elderly group is lower than the non elderly group, the difference is statistically significant. CONCLUSION The elderly patients with OSAHS were less severe in nature, but the nocturnal hypoxia last longer in the elderly group. There is no significant difference in the sleep structure between the two groups. But the total sleep time decrease in elderly group. With smaller interference, the MSMS is closer to the natural sleep stustus of the subjects.
Aged ; Humans ; Hypoxia ; diagnosis ; Oxygen ; physiology ; Polysomnography ; Sleep ; Sleep Apnea, Obstructive ; diagnosis

OBJECTIVE: To investigate the efficacy and feasibility of coblation treatment of partial tonsillectomy in children with obstructive sleep apnea-hypopnea syndrome (OSAHS). METHOD: The clinical datum of 91 children with OSAHS were retrospective analysis during the period from January 2009 to November 2009. All subjects, the main obstructive lesions were hypertrophy of tonsils and adenoids ,and which without recurrent pharyngodynia and tonsillitis, were applied with coblation treatment of partial tonsillectomy and adenoid ablation. RESULT: Intraoperative blood loss was about 1-2 ml in all subjects,no primary and delayed hemorrhage happened and postoperative pain happened. All subjects were followed-up for 12 months to 22 months, symptoms of snoring and mouth breathing disappeared. No tonsil regeneration and repeated inflammatory episode was found. CONCLUSION Coblation treatment of partial tonsillectomy in children with OSAHS is micro-invasive, safe and effective, which is suitable for children of different age groups with hypertrophy of tonsils.
Catheter Ablation ; methods ; Child ; Child, Preschool ; Female ; Humans ; Male ; Retrospective Studies ; Sleep Apnea, Obstructive ; surgery ; Tonsillectomy ; methods

OBJECTIVE: To investigate the therapeutic efficacy of coblation-assisting uvulopalatopharyngoplasty (CAUPPP) combining with coblation-channeling of the tongue (CCT) for patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS). METHOD: A retrospective analysis was made on patients with severe OSAHS treated by CAUPPP combining with CCT. The adult with severe OSAHS were involved in the study and the apnea-hypopnea index (AHI) were beyond 40/h and lowest arterial oxygen saturation (LSaO2) were under or equal to 80%. Surgical approach: The UPPP was performed to decrease the size of soft palate with coblation and coblation-channeling in the soft palate and decrease the size of tongue by CCT. All patients were followed up for 6 to 12 months and underwent polysomnography (PSG). RESULT: Subjective symptoms of patients improved more significantly than that of preoperation. The function of soft palate is normal without significant nasopharyngeal regurgitation. Compared with the preoperative data, AHI values were significantly decreased (P<0.01) and the lowest oxygen saturations increased significantly (P<0.01) and the effective rate was 91.7%. CONCLUSION There are usually multiple obstruction levels in patients with severe OSAHS and the traditional surgical treatment is not ideal. This study demonstrated that with the assistance of coblation, combining CAUPPP with CCT for patients with severe OSAHS is an effective surgical method. It has less blood loss, minimally invasive, retained the normal function of the soft palate, etc., should be widely applied.
Adult ; Aged ; Catheter Ablation ; Female ; Humans ; Male ; Middle Aged ; Palate ; surgery ; Palate, Soft ; surgery ; Pharynx ; surgery ; Retrospective Studies ; Sleep Apnea, Obstructive ; surgery ; Tongue ; surgery ; Uvula ; surgery

OBJECTIVE: To explore the long-term efficacy of allogeneic hematopoietic stem cell transplantation (alloHSCT) in patients with Mucopolysaccharidosis (MPS), which has rarely been reported in China. METHODS: A 18-month-old boy and a 23-month-old girl undergoing alloHSCT for MPS VI and MPS IH Shanghai Children's Medical Center on March 30, 2006 and September 6, 2006 were selected as the study subjects. A busulfan-based myeloablative regimen was used as the conditioning regimen. Peripheral stem cells were respectively collected from a human leucocyte antigen (HLA) matched sibling carrier donor and a HLA 9/10 matched unrelated donor. Both patients were followed up for more than 15 years. The functions of internal organs before and after the transplantation were compared, and child 1 was also compared with his untreated brother and healthy brother. RESULTS: Both children have achieved full donor chimerism after the transplantation, and their enzymatic activities have remained stable. The enzymatic activity of the child 1 was slightly lower than normal but similar to that of his carrier donor, whilst that of the child 2 was normal. Both children have attended schools with good academic performance. Compared with his untreated brother, the respiratory function and hearing of child 1 have significantly improved. However, his orthopedic and cardiac disorders have still remained and required medical intervention. For child 2, her obstructive pulmonary disease was resolved and cognitive development was well preserved after the HSCT. Her heart disease has become stabilized and even improved with time, though her corneal clouding and skeletal malformation still required surgery. CONCLUSION MPS patients can sustain long-term and stable enzymatic activities after successful alloHSCT. Compared with untreated patients, their health can be significantly improved, along with considerably prolonged survival, though the long-term efficacy of HSCT for different organs may vary to a certain extent.
Humans ; Child ; Male ; Female ; Infant ; Child, Preschool ; Graft vs Host Disease/etiology* ; China ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Mucopolysaccharidoses/etiology* ; Busulfan ; Treatment Outcome

Anti-tumor necrosis factor (T N F) - α monoclonal antibody is a first-line treatment for inflammatory bowel disease, and its therapeutic response has attracted more and more attention. Although therapeutic drug monitoring and antidrug antibody monitoring have been widely used in clinic, however, there are no laboratory indicators that can predict the therapeutic response to anti-TNF-α before the drug treatment, so as to provide a guidance of selecting therapeutic drug. Studies have shown that some baseline biomarkers can predict the therapeutic response to anti-TNF-α. This article reviewed the progress of research on biomarkers in predicting efficacy of anti-TNF-α monoclonal antibody in treatment of inflammatory bowel disease.