Objective To evaluate the value of 128-slice CT on locating the obstruction site of the upper airway in obstructive sleep apnea hypopnea syndrome (OSAHS)patients by three-dimensional reconstruction technology.Methods There were 52 patients with OSAHS diagnosed by the PSG and 32 cases of healthy volunteers in our hospital.All objects were performed 128-slice CT scan of the upper airway during awake state,and those patients’upper airways were scaned on Muller test.The airway volume of the ret-ropalatal region,retroglottal region and epiglottal region,and the total length of upper airway were measured,and statistical analysis of the each index was obtained.Results During awake state,compared with the control group,the length of upper airway in OSAHS patients increased significantly(P <0.001).Compared with the awake state,OSAHS patients’airway volume of the retropalatal region, retroglottal region and the total airway volume on the Muller test were reduced significantly(P <0.001).OSAHS patients’upper air-way length was correlated negatively to the average MSaO 2 (r=-0.33,P <0.05).Conclusion The three-dimensional reconstruc-tion of upper airway on 128-slice CT can evaluate the position and degree of the obstruction site in OSAHS patients’upper airway better,which has important significance to guide clinical treatment.

Objective To discuss the clinical diagnostic and guiding treatment value of changed positions of hyoid bonein the upper airway of patients with obstructive sleep apnea hypopnea syndrome. Methods 128-slice computed tomography was performed for 52 patients with severe OSAHS and 32normal healthy people to measure thehyoid bone in the upper airway in sober state and Muller maneuver. The correlationsbetweenthese indexes were analyzed under linear relation. Results (1)In comparison of the Muller maneuver with sober state , chinnodules and palatal plane to the hyoid in the OSAHS group were statistically higher than the healthy controlgroup (P < 0.001). (2)The distance of hyoid to chinnodules in the OSAHS group was significantlylonger and greater than that of the healthy control group (P < 0.001).(3)The distance of palatal plane to the hyoid was positively correlated with AHI , while thedistances of palatal plane andchinnodules to the hyoidwere both negatively correlated with MSaO2. Conclusion The changes ofhyoid positionare indicative for the clinical diagnosis and is helpful for the guidance of clinical treatment of OSAHS.

OBJECTIVE: To discuss the soft palate, hard palate and mandibule for the pathogenesis and clinical treatment of patients who have obstructive sleep apnea hypopnea syndrome. METHOD: There were 52 patients with OSAHS diagnosed by the PSG and 32 cases of normal healthy volunteers in our hospital. All objects were given 128 slice spiral CT scan of the upper airway. We measured the related indexes of the soft palate, hard palate and mandible, then analysed statistical differences between them and did Pearson correlation analysis with apnea hypoventilation index (AHI), average blood oxygen saturation (MSaO2) in PSG. RESULT: Compared with the control group, the soft palate length [(37.93 ± 5.20)mm VS (33.52 ± 4.25)mm] and the distance between mandible with cervical vertebra [(75.00 ± 7.10)mm VS (69.93 ± 5.58)mm] increased significantly, but the distance of trailing edge of hard palate to inferior margin of slope significantly reduced [(42.57 ± 4.52)mm VS (45.80 ± 2.94)mm, P < 0.01] in patients with OSAHS. Each measurement associated with AHI and MSaO2 had no significant correlation (P > 0.05). CONCLUSION The soft palate, hard palate and mandibular are some of the important risk factors of OSAHS, and they also have reference value for the choice of clinical treatment operation. Preoperative CT examination can offer help in the treatment of OSAHS.
Case-Control Studies ; Humans ; Mandible ; anatomy & histology ; Oximetry ; Palate, Hard ; anatomy & histology ; Palate, Soft ; anatomy & histology ; Sleep Apnea, Obstructive ; diagnosis ; Tomography, Spiral Computed

Objective:To observe the clinical effect of omeprazole based triple therapy in the treatment of children with peptic ulcer.Methods:From September 2016 to September 2018, 86 children with peptic ulcer in the People's Hospital of Qingyuan County were selected in this study.By using the random number table method, they were divided into two groups, with 43 cases in each group.The control group received ranitidine based triple therapy treatment, the observation group was given omeprazole based triple therapy treatment.The treatment course of the two groups was 30 d. The eradication rate, clinical effect, gastrointestinal hormone level and adverse reactions of helicobacter pylori were compared between the two groups.Results:The eradication rate and total effective rate of helicobacter pylori in the observation group were 97.67%(42/43) and 95.35%(41/43), respectively, which were higher than those in the control group[81.40%(34/43) and 79.07%(34/43)], the differences were statistically significant (χ 2=6.081, 5.108, all P<0.05). After treatment, the levels of gastrin and motilin in the observation group were (75.29±8.31)μmol/L, (164.88±15.05)ng/L, respectively, which were lower than those in the control group [(81.07±8.96)μmol/L, (204.15±17.67)ng/L], the differences were statistically significant( t=3.102, 11.095, all P<0.05). The somatostatin level of the observation group was (22.67±3.95)ng/L, which was higher than that of the control group [(18.31±3.31)ng/L], and the difference was statistically significant( t=5.548, P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(χ 2=0.938, P>0.05). Conclusion:Omeprazole based triple therapy is safe and effective in the treatment of children with peptic ulcer, which is helpful to eradicate helicobacter pylori, reduce gastrin, motilin levels and improve the level of somatostatin.

母体胚胎亮氨酸拉链激酶（maternal embryo leucine zipper kinase ,MELK）在多数恶性肿瘤中高表达，其通过与各种类 型蛋白相互作用和使其磷酸化后调节靶蛋白的生物活性，影响细胞周期调控和细胞增殖、凋亡、侵袭与转移等，促进癌细胞增殖 和肿瘤形成，因此，MELK功能失调成为癌细胞逃避人体正常免疫监视的重要机制。深入了解MELK在肿瘤中的表达和作用机 制，为完善肿瘤诊断分子标志物体系、肿瘤靶向治疗方案具有一定的临床意义。本文就MELK的生物学功能、对恶性肿瘤的治疗 情况及其作为候选靶向分子的潜质进行综述。

Objective:To evaluate the characteristics of carotid plaque and the immediate outcomes after carotid artery stenting (CAS) in diabetic and non-diabetic patients by optical coherence tomography (OCT).Methods:Patients underwent CAS and OCT before and after operation in the Department of Neurology, Jinling Hospital from January 2014 to March 2019 were enrolled retrospectively. The clinical features, the characteristics of carotid plaque on OCT and the immediate outcomes after CAS were compared between diabetic group and non-diabetic group. The risk factors of stent malapposition were analyzed.Results:A total of 46 patients were enrolled. Their age was 64.02±8.32 years and 41 were males (89.1%). There were 20 patients (43.5%) in the diabetes group and 26 (56.5%) in the non-diabetes group. The proportions of atherosclerotic plaque with thin fibrous cap (40.0% vs. 7.7%; χ2=5.166, P=0.023), plaque rupture (55.0% vs. 23.1%; χ2=4.945, P=0.026) and macrophage infiltration (60.0% vs. 30.8%; χ2=3.930, P=0.047) in the diabetic group were significantly higher than those in the non-diabetic group. Multivariate logistic regression analysis showed that older age (odds ratio [ OR] 1.208, 95% confidence interval [ CI] 1.033-1.413; P=0.018), coronary heart disease ( OR 15.953, 95% CI 1.142-222.952; P=0.040), alcohol consumption ( OR 6.192, 95% CI 1.098-34.923; P=0.039) and lower systolic blood pressure ( OR 0.944, 95% CI 0.894-0.997; P=0.037) were independently associated with stent malaposition. Conclusion:Compared with the non-diabetic patients, carotid plaque in diabetic patients may be more unstable. Older age, coronary heart disease, alcohol consumption and lower systolic blood pressure were associated with stent malaposition after carotid stenting. OCT can reveal the characteristics of carotid plaque and the immediate outcomes after CAS, which can provide strong evidence for treatment decision.

Objective To explore the application effects of clinical nursing pathway on recovery of upper-extremity functions during different stages after surgery of breast tumor. Methods A total of 120 patients who received the surgery of breast tumor in our hospital from January 2012 to December 2013 were selected as research subjects. They were randomly assigned to a research group and a regular group according to the method of random number table, with 60 in each. The regular group was given clinical regular nursing for the recovery of upper-extremity functions after the surgery, and the research group was given clinical nursing pathway for the recovery of upper-extremity functions after the surgery. Nursing effects were observed between the two groups. Results Arms bending forward and arms bending inward as well as abduction and rotation in the research group were significantly better than those in the regular group, and the differences were statistically significant (P<0.05). Satisfaction rate on clinical nursing in the research group was 93.3%, higher than that of 75.0%in the regular group(P<0.05). Life quality score in the research group was(56.1±5.9), significantly higher than that of(43.8±6.3)in the regular group, and the difference was statistically significant(P<0.05). Conclusion Clinical nursing pathway is feasible clinically for the recovery of upper-extremity functions during different stages after the surgery of breast tumor. It promotes the recovery of upper-extremity functions, as well as en-hances satisfaction rate on clinical nursing and life quality, which is worthy of clinical application.

Objective:To explore the application value of CT pulmonary function imaging in patients with Coronavirus Disease 2019 (COVID-19) in the convalescent phase.Methods:The COVID-19 patients who were clinically cured and discharged from Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were prospectively collected from January to April 2020. Clinical pulmonary function tests (PFTs) and CT pulmonary function imaging were performed 3 months after discharge. The Philips IntelliSpace Portal image post-processing workstation was used to obtain the paired inspiratory-expiratory CT quantitative indexes of the whole lung, left lung, right lung and five lobes. The patients were divided into two groups according to whether residual lesions remain in inspiratory CT images: non-residual lesion group and residual lesion group. The chi-square test was used to compare the differences in the PFT results between groups; the Mann-Whitney U test was used to compare the differences in PFT indexes [forced expiratory volume in the first second as percentage of predicted value (FEV 1%), FEV 1/forced vital capacity (FEV 1/FVC), total lung capacity as percentage of predicted value (TLC%), FVC%] and the differences in quantitative CT indexes [lung volume (LV), mean lung density (MLD), volume change in inspiratory phase and expiratory phase (?LV)] between groups. Multiple linear regression was used to analyze the relationship between CT pulmonary function imaging and PFT indexes of convalescent COVID-19 patients. Results:Of the 90 patients with COVID-19, 35 were males and 55 were females; 45 were included in the non-residual lesion group and 45 were included in the residual lesion group. Fifty-three patients had clinical pulmonary dysfunction 3 months after discharge, including 22 patients in the non-residual lesion group and 31 patients in the residual lesion group. In patients with residual disease, left lower lobe and right lower lobe LV, left lower lobe and right lower lobe ?LV in the inspiratory and expiratory phase were smaller than those without residual disease; whole lung, left lung, right lung, left upper lobe, left lower lobe and right lower lobe MLD in the inspiratory phase and left lower lobe and right lower lobe MLD in the expiratory phase were greater than those without residual disease ( P<0.05). Since there was no significant difference in FEV 1/FVC and FVC% between residual and non-residual lesion groups ( P>0.05), FEV 1/FVC and FVC% of two groups were combined. Multiple linear regression analysis showed FEV 1/FVC=91.765-0.016×LV in-right middle lobe+0.014×MLD ex-left lower lobe ( R2=0.200, P<0.001), FVC%=-184.122-0.358×MLD in-right lung-0.024×?LV left upper lobe ( R2=0.261, P<0.001). There was significant difference in TLC% between residual and non-residual lesion groups ( P<0.05), so multiple linear regression analysis was performed both in the two groups. In the non-residual lesion group, TLC%=80.645+0.031×LV ex-right lower lobe ( R2=0.132, P<0.001); In the residual lesion group, TLC%=-110.237-0.163×MLD in-right upper lobe-0.098×MLD ex-left upper lobe -0.025×LV ex-right lower lobe ( R2=0.473, P<0.001). Conclusion:CT pulmonary function imaging can quantitatively analyze the whole lung, unilateral lung and lobulated lung, thus reflecting the regional pulmonary function, providing more valuable diagnostic information for the assessment of pulmonary function in convalescent patients with COVID-19.

Objective:To investigate the clinical characteristics of Epstein-Barr(EB)virus associated gastroenteritis, aiming to improve the diagnosis and treatment.Methods:The clinical data of 8 patients diagnosed as EB virus associated gastroenteritis in Department of Gastroenterology, Beijing Children′s Hospital were retrospectively analyzed from January 2017 to December 2021 including the clinical data, laboratory examination, endoscopic and imaging findings, medications and clinical prognosis.Results:There were eight cases with the male: female ratio 6: 2, the average age 7.46 years, and history 20 d to 3 years.Main clinical manifestations were abdominal pain(7/8), diarrhea(4/8), bloody stools(3/8), fever(2/8), hematemesis(1/8), with the high load of serum EB virus DNA in 4 cases.The endoscopic features were rough mucosa, edema, erosion, boundary clear shallow ulcer.The EB virus-encoded small RNA(EBER)was positive in situ hybridization(8/8).The frequently affected sites were upper gastrointestinal tract(3/8), small intestine(2/8)and colon(4/8).The common complications were sepsis(3/8)and mild malnutrition(3/8).All patients became better by the enteral nutrition and antiviral therapy.Conclusion:The EB virus associated gastroenteritis is rare with the serious complications, the non-specific clinical manifestations.The clinical doctors should improve the understanding of this disease in order to improve the diagnosis and therapy.Clinicians should pay more attention to the test of EB virus in serum and membrane, then carry out the accurate treatment.

Objective:To investigate the clinical features and risk factors of the extraintestinal manifestations(EIM)in children with ulcerative colitis(UC).Methods:A retrospective case-control study was conducted.The clinical data of 99 children with UC diagnosed in Department of Gastroenterology, Beijing Children′s Hospital, Capital Medical University from January 2016 to December 2021 were analyzed.According to whether the patients had EIM or not, they were divided into EIM-positive group and EIM-negative group.Rank sum test, χ2test or Fisher′s exact test were used to compare the variables between the 2 groups, including the clinical features, laboratory examination results and treatments.The Logistic regression was used to analyze the risk factors of EIM in children with UC. Results:A total of 99 children with UC were enrolled, including 57 males and 42 females; the age of onset was 10.3(6.4, 12.6)years, and the course of disease was 4.2(1.6, 10.1)months.The patients were mainly characterized by extensive disease(E3)and pancolitis(E4)(69/99, 69.7%), moderate to severe activity(63/99, 63.6%)and moderate to severe inflammation of colonic mucosa(89/99, 89.9%). There were 77 patients(77.8%)in the EIM-negative group and 22 patients(22.2%)in the EIM-positive group, of which 5 patients had two types of EIMs; the most common EIMs were oral ulcers(9 cases), joint lesions(7 cases), and skin lesions(6 cases). Compared with the EIM-negative group, those in the EIM-positive group, such as the E4 type(77.3% vs 44.2%, χ2=7.513, P=0.006), moderate to severe activity(81.8% vs 58.4%, χ2=4.041, P=0.044), pediatric ulcerative colitis activity index score[47.5(35.0, 57.5)score vs 35.0(25.0, 50.0)score, Z=-2.260, P=0.024], the proportion of C-reactive protein≥8mg/L at diagnosis(54.5% vs 19.5%, χ2=10.607, P=0.001), erythrocyte sedimentation rate[30.0(13.8, 47.8)mm/h vs 10.0(4.0, 19.5)mm/h, Z=-3.918, P<0.001], the proportion of glucocorticoid treatment within one year after diagnosis(77.3% vs 49.4%, χ2=5.403, P=0.020)and the proportion of biological agents treatment(45.5% vs 23.4%, χ2=4.112, P=0.043)were significantly higher; the E3 type were significantly lower than those in the EIM-negative group(0 vs 23.4%, χ2=4.813, P=0.028), and the differences were statistically significant.Multivariate Logistic regression analysis showed that erythrocyte sedimentation rate at diagnosis was an independent risk factor of EIM in children with UC( OR=1.063, 95% CI: 1.025~1.103, P=0.001). Conclusion:The UC patients with EIM had more extensive lesions, more severe disease activity, significantly increased inflammatory indicators, and more commom glucocorticoid and biologic therapy.Increased erythrocyte sedimentation rate was an high risk factor of EIM in children with UC.