Objective To investigate the causes and therapy of complications of microvascular decompression (MVD) for hemifacial spasm (HFS). Method Totally 255 cases of HFS underwent MVD in our hospital from December 2000 to March 2000. Among the cases,207 patients were followed up for more than 1 year,the occurrence and recovery of their postoperative complications were reviewed in this study. Results In this series,no patient died;cerebrospinal fluid leakage was detected in 15 patients (7.2%) in one week after the operation;facial palsy occurred in 48 cases (23.2%);hearing deficit was shown in 20 patients (9.7%);and tinnitus was found in 12 cases (5.8%). The patients were followed up for 1 to 7.3 years with a mean of (4.2?2.7) years,during the period,none of the cases had cerebrospinal fluid leakage or intracerebral infection,and the cases who had facial palsy and tinnitus recovered completely;only 10 patients remained hearing deficit (including unilateral deaf in 6) during the follow-up.Conclusion Cerebrospinal fluid leakage,facial palsy,hearing deficit,tinnitus are the major complications of MVD,among which cerebrospinal fluid leakage,facial palsy,and tinnitus can be improved after treatments,but hearing deficit is non-reversible.

Objective To explore the curative effect of microsurgery via posterior approach through the sigmoid sinus in the treatment of secondary trigeminal neuralgia. Methods Clinical data of 37 cases of trigeminal neuralgia secondary to cerebellopontine angle (CPA) tumor from October 2000 to July 2006 were studied, including 18 cases of cholesteatoma, 8 cases of meningoma, 6 cases of acoustic neuroma, and 5 cases of trigeminal schwannoma. All tumors were removed with microsurgery through a posterior approach by way of the sigmoid sinus. Results A total resection was achieved in 23 cases, a subtotal resection in 10 cases, and a partial resection in 4 cases. Symptoms of neuralgia disappeared in 35 cases (including 32 cases of immediate relief and 3 cases of relief 2 months after operation). There was no improvement in 2 cases. Conclusions Microsurgery via posterior approach through the sigmoid sinus in the treatment of secondary trigeminal neuralgia is safe and effective.

Background:Single-balloon enteroscopy(SBE)is a new method for the examination of small intestine,its clinical value in suspected small intestinal diseases need to be further studied. Aims:To evaluate the diagnostic and therapeutic value of SBE in suspected small intestinal diseases. Methods:A total of 73 suspected small intestinal diseases patients who had undergone 81 SBE examinations from July 2011 to October 2013 at Chengdu Military General Hospital were retrospectively examined,indications,diagnostic and therapeutic value of SBE in suspected small intestinal diseases were analyzed. Results:Of all the 81 examinations,33(40. 7% )were obscure gastrointestinal bleeding,29(35. 8% ) incomplete intestinal obstruction,and 19(23. 5% )chronic abdominal pain or diarrhea. The intubation depth was 230 cm for the oral approach,and 100 cm for the anal approach. The diagnostic yield of SBE was 67. 9% ,the main lesions were small intestinal ulcer,small intestinal inflammation,small intestinal tumor,small intestinal polyp. A total of 8 patients underwent endoscopic therapy,of whom 5 underwent endoscopic hemostatic therapy and 3 underwent resection of polyp. No serious complications were found. Conclusions:SBE is a safe and reliable diagnostic and therapeutic method for suspected small intestinal diseases,and its main indications are obscure gastrointestinal bleeding and incomplete intestinal obstruction.

Aim: To search for novel modulators of glycogen metabolism through structural modifications of natural pentacyclic triterpenes. Methods: A series of N-heterocyclic derivatives were synthesized by fusing indole, qui-noxaline and pyrazine rings with A-ring of oleanolic and ursolic acids. The compounds were biologically evaluated for their inhibitory activity against rabbit muscle glycogen phosphorylase. Results and Conclusion: Twelve heter-ocyclic triterpene derivatives were synthesized and their structures were confirmed by IR, ~1H NMR, ~(13)C NMR and MS. Except for compound 12, all of the compounds exhibited glycogen phosphorylase inhibitory activity with IC_(50) values in the range of 14-252 μmol/L Among this series of compounds, compound 15 showed the best potency with IC_(50), of 14 μmol/L

Objective To investigate effectiveness of anthropometric parameters and body composition analysis for the screening and prediction of metabolic syndrome and explore the best indicator for predicting metabolic syndrome in the elderly. Method A cross-sectional study of 763 (406 men and 357 women) elderly people who participated in the annual health check-up was conducted. Clinical data of all participants were obtained including anthropometric parameters, body composition, lipid profiles, fasting blood glucose, and high sensitivity C-reactive protein. Receiver operating characteristic (ROC) curve was used to determine the optimal cutoff points for waist circumference, waist-to-hip ratio, waist-to-height ratio, percent body fat and fat mass index in relation to the area under the curve (AUC), sensitivity and specificity in the screening and prediction of metabolic syndrome. Result In total subjects, compared with non-metabolic syndrome group,the ROC curve analysis showed that parameters including waist circumference, waist-to-height ratio, waist-to-hip ratio, percent body fat and fat mass index had a significant potential for predicting metabolic syndrome (P<0.001). It was determined that waist circumference of 87.5 cm and 77.5 cm, waist-to-hip ratio of 0.89 and 0.87, waist-to-height ratio of 0.51 and 0.52, percent body fat of 24.1%and 31.7%and fat mass index of 5.00 kg/m2 and 7.80 kg/m2 were the optimal cutoff points for screening and predicting the presence of metabolic syndrome among men and women with a sensitivity of 81.3%,78.8%,87.5%, 51.3%and 83.8%(in men) and 85.1%,79.8%,71.3%, 70.2%and 80.9%(in women) and a specificity of 57.7%,62.6%,50.0%, 75.5%and 51.8%(in men) and 38.0%,53.2%,55.1%, 50.6%and 52.5% (in women),respectively. The area under the ROC curve (AUC) was 0.728, 0.755, 0.716, 0.671 and 0.725 in men and 0.652, 0.707, 0.658, 0.619 and 0.675 in women,respectively. Waist-to-hip ratio showed the highest AUC in all the parameters in men and women. Conclusion Anthropometric parameters and body composition analysis play important roles in the screening and prediction of metabolic syndrome, and waist-to-hip ratio seems to be the best parameter in the screening and prediction of metabolic syndrome in the elderly.

BACKGROUND:Propagation phase contrast tomography can greatly improve the spatial resolution of chondrocytes and microvessels depending on the high colimation and high coherence performance of hard X-ray. OBJECTIVE: To detect the alteration of angioarchitecture after spinal cord injury in rats using propagation phase contrast tomography. METHODS: Eight male Sprague-Dawley rats were divided into two groups: in experimental group, an acute spinal cord injury model was induced in rats by the modified Alen’s method; in sham control group, rats were subjected to laminectomy. At 1 day after operation, normal and injured spinal cord segments were taken and treated with formaldehyde-methyl salicylate sequentialy for 48 hours. The segments were scanned by propagation phase contrast tomography in BL13W1 beamline experimental station of Shanghai Synchrotron Radiation Facility, China. Harvested data were analyzed by VGStudio Max 2.1 software for three-dimensional reconstruction and microvasculature quantitative analysis. RESULTS AND CONCLUSION:The propagation phase contrast tomography successfuly simulated the morphology of angioarchitecture folowing spinal cord injury. After acute spinal cord contusion, the destruction of nerve tissues was accompanied by severe microvasculature damage. Intramedulary tissue damage and loss of blood supply was spread from the central zone to the ends. Three-dimensional microvascular quantitative data showed that after spinal cord contusion, the number of microvessels and vascular perfusion volume drasticaly reduced (P < 0.01). These findings indicate that the propagation phase contrast tomography without angiography has potential as a new ultra high-resolution visualization technique for three-dimensional microvessel imaging and quantitative analysis.

Objective To analyze the clinical effect of a bifurcated ball frame designed for undergraduate research to assist hand-knee position,avoid physical exertion and increase comfort.Methods Randomized controlled trials consisted of 260 occipital (posterior) primiparous women born during labor,and were randomly divided into the observation group and the control group with 130 cases each.The observing group's mothers were on the yoga ball on the device.The angle and height of the frame and the ball plate were adjusted according to the maternal body type,so that the yoga ball at the chest and the cross could effectively support the maternal weight loss knee burden,and both sides of the small abdominal yoga ball could be effectively posted.After the adjustment was completed,the maternal relaxes and gently shakes the body in one direction so that the small yoga ball on the ventral side forms a continuous soothing push.The control group leaned forward on both knees (with protective gear) and supported themselves with both hands or both fists,swaying the pelvis or crawling forward.Comparing the two groups of vaginal delivery rate,maternal postural maintenance time,maternal dehvery experience,and effective correction rate of occipital position.Results The time of postoperative maintenance in the observation group was (49.51 ±10.62) minutes,and that of the control group was (18.31 ± 9.72) minutes.The difference between the two groups was statistically significant (t=6.69,P ＜0.05).The effective correction of abnormal fetal position rate,spontaneous delivery rate and comfort rate were 82.30％ (107/130),77.69％ (101/130),and 99.23％ (129/130),respectively in the observation group,and 27.69％ (36/130),33.85％ (44/130),3.84％ (5/130),respectively in the control group,the differences between the two groups were statistically significant (x2 =4.06,4.15,5.61,all P ＜0.05).Conclusions The undergraduate design of this sort of ball delivery group has a significant effect on the extraversion of the assisted position to the fetal position.

Objective To explore the causes of persistent abnormal muscle response (AMR) after microvascular decompression (MVD) for hemifacial spasm (HFS) and the clinical outcomes of these patients.Methods MVD was performed under intraoperative electrophysiological monitoring of AMR in 372 HFS patients in 2014.Before MVD,the characteristic AMR of HFS was recorded in 326 patients.The patients were divided into two groups based on whether AMR disappeared or persisted following MVD;21 patients showed persistent AMR after successful MVD while AMR disappeared after decompression in the other 305 patients.The clinical features,treatment efficacy and postoperative complications were compared between these two groups.Results Gender,side of depression and mean age between the two groups showed no significant differences (P＞0.05).The immediate postoperative cure rate of the AMR disappeared group (88.9％) was significantly higher than that in the AMR persisted group (28.6％,P＜0.05).The follow-up cure rate showed no significant difference between the two groups (P＞0.05),and the postoperative and follow-up complications showed no significant differences (P＞0.05).Conclusion The long duration of HFS patients may be responsible for persistent AMR after successful decompression,and it is more likely for these patients to get delayed cured;their long-term outcomes showed no difference as compared with those in patients with disappeared AMR after MVD.

Objective:To investigate the pathogenesis, clinical signs and diagnosing procedures of relapsing polychondritis(RP) in children with airway involvement.Methods:The medical history, clinical symptoms, physical examination, electronic laryngoscopy and imaging findings of six patients were retrospectively analyzed. The patients diagnosed as relapsing polychondritis with involving the airway from January 2018 to December 2021 were in our hospital. The clinical features of the 6 cases were summarized.Results:All 6 patients were male, ranging in age from 8 years 1 month to 14 years 1 month, with a median age of 12.04 years. Stridor and dyspnea were observed in all patients, with hoarseness in 2 patients and frequently nocturnal dyspnea during sleep in 2 patients. Initially, all children were diagnosed as laryngitis or laryngotracheitis, and were treated symptomatically with glucocorticoids and aerosol inhalation. Immunosuppressants and targeted therapy with biologics were given after patients diagnosed as RP. All patients were ultimately required tracheostomy. The time from the onset of airway symptoms to tracheostomy ranged from 1 month to 27 months. Two children had a history of endotracheal intubation prior to tracheostomy. All 6 patients underwent electronic laryngoscopy, revealing involvement of the laryngeal and subglottic mucosa and cartilage structures, which showed gradual improvement with medical therapy. Computed tomography (CT) of the trachea with three-dimensional reconstruction was performed in all patients, demonstrating moderate to severe subglottic stenosis. Two patients exhibited complete airway obstruction at the C4-C6 cervical level. Three children underwent suspension laryngoscopy under general anesthesia and endotracheal mucosal biopsy.Of the 6 children, 3 presented with nasal tip collapse or saddle nose, 2 had auricular cartilage changed, and 1 had scleralinvolvement. One patient underwent PET-CT scanning, which revealed tracheal collapse, diffuse increase in FDG(Flurodeoxyglucose)metabolism with increased FDG uptake in the nasal alar regions. All children were followed up for 2-3 years, 1 child died, while the remaining five continued to receive medical treatment.Conclusions:Relapsing polychondritis with airway involvement has an insidious onset and is difficult to diagnose. The airway stenosisresulting from RP is always severe and necessitating tracheotomy to maintain airway patency in the majority of cases.The treatment coursef or RP is prolonged, requiring long-term tracheostomy tube placement.

OBJECTIVE To investigate the therapeutic effect of autologous costal cartilage transplantation with anterior/posterior split of cricoid cartilage on laryngotracheal stenosis in children.METHODS A retrospective analysis of 12 cases of laryngotracheal stenosis in children treated with anterior/posterior split of cricoid cartilage combined with T-tube implantation in Beijing Children's Hospital Affiliated to Capital Medical University in recent years.There were 5 males and 7 females,aged from 2 years and 6 months to 16 years and 9 months,with an average age of 8 years and 9 months.There were 2 cases of grade Ⅱ stenosis,9 cases of grade Ⅲ stenosis and 1 case of grade Ⅳ stenosis.All cases underwent tracheotomy before operation.The course of disease ranged from 4 months to 6 years,with an average of 3 years.RESULTS Of the 12 patients,10(83.3％)were cured,and the tracheotomy cannula was successfully removed to restore normal breathing and pronunciation function.There were 2 cases of extubation failure,including 1 case of grade Ⅲ stenosis and 1 case of grade Ⅳ stenosis.CONCLUSION The etiology of laryngotracheal stenosis in children is complex and difficult to treat.Anterior/posterior split costal cartilage transplantation combined with T-tube implantation through internal/external cervical approach can achieve good therapeutic effect in the treatment of laryngotracheal stenosis in children.