Various surgical procedures are widely used for treating obstructive sleep apnea hypopnea syndrome (OSAHS) currently. The most prominent advantage of surgery is the excellent long-term adherence, which is just the main limitation for the first-line treatment of continuous positive airway pressure (CPAP). However, nearly all the surgical procedures used now usually could not cure this disease completely. The success rate of the uvulopalatopharyngoplasty, which is the most widely used procedure, can only reach to 40% - 50% in terms of AHI Therefore, there are some opinions that the surgery should not be applied for treating this disease. In fact, the outcomes of surgical treatments should not be only evaluated basing on some of the objective results. In this article, the clinical significance of surgery based on objective and subjective data, and the effects on long-term consequences, the combination of surgery with CPAP, and the possible prospects of surgical treatments for this disease will be discussed. This may help us to redefine the clinical efficacy of surgery for the treatment of OSAHS.
Continuous Positive Airway Pressure ; Humans ; Palate ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery

Neoadjuvant therapy has been gradually applied to the treatment of colorectal liver metastasis in recent years. Many clinic researches indicate neoadjuvent chemotherapy, neoadjuvent radiotherapy and neoadjuvent chemoradiotherapy can improve surgical reaction rate and radical rate of colorectal liver metastasis,and can shrink the primary tumor and metastasis, improve the resection rate and sphincter preservation rate, and reduce the recurrence rate of locally advanced lower rectal cancer. Neoadjuvent therapy has great clinical practical value in the multi-modality treatment for colorectal metastasis.

Objective To investigate whether host collateral vessels play a role in the cardiac repair induced by intracoronary injection of bone marrow mononuclear cell (BMMNCs) in a swine myocardial infarction (MI) model. Methods MI was induced in swine models by ligation of left anterior descending artery. Two weeks later, twenty animals with Rentrop score=0 (R0) or Rentrop score=1 (R1) received either intracoronary PBS or BM-MNCs (2?10~8 cells) infusion. Results At 6 weeks after MI, Rentrop score was significantly increased in the R1+BMT group. Ejection fraction and fractional shortening evaluated by echocardiography were increased in both R0+BMT and R1+BMT groups and the greatest improvements were seen in the R1+BMT group. Consistent with the changes in cardiac function and Rentrop score, the greatest degree of angiogenesis and cell count of engrafted BM-MNCs occurred in the R1+BMT group 6 weeks post MI. Conclusion The existence of intrinsic collateral vessels contributes to the beneficial effects for cardiac repair post MI by intracoronary BM-MNCs transplantation.

70%(59 male and 22 female,mean age 61?11 years)were enrolled in the study,IVUS was done in 55 cases before and after percutaneous coronary intervention(PCI)with 24 patients from the SFCT group and 31 patients from the conventional percutaneous coronary angioplasty(POBA).Quantitative coronary angiography(QCA)measurements included minimal lumen diameter(MLD),reference lumen diameter(RLD)and diameter stenosis(DS);IVUS measurements include external elastic membrane area(EEMA),minimal lumen area(MLA),and area stenosis(AS),style of endomembrane tear and dissection.Results All the target lesions were successfully dilated in both groups without serious complications.Mean dilated pressure was lower in the SFCT group than that in the POBA group(871.4 kPa vs 1 013.2 kPa P

Objective To study ultrastructure changes of myocardium and morphic change of cardiomyocyte apoptosis in mice with viral myocarditis(VMC).Methods Our experiment established animal model of VMC by the way of coxsackie virus B3(CVB3) inoculation,then we studied the changes and apoptosis of cardiomyocyte by ways of microscope and electron microscope.Results The myocardial changes and inflammatory cell infiltration were found by ways of microscope and electron microscope from 5 days after virus inoculation in experimental mice,the peak changes were at 7-9 days,and were almost recoverd at 35 days.Apoptotic changes and apoptotic bodies were found by eletron microscope at 7-9 days after virus inoculation in mice with VMC.Conclusions VMC can be caused in mice after CVB3 inoculation,abnormal cardiomyocyte apoptosis can be found in VMC.

50 as group B.All patients were examined by CAG.Plaque morphology was assessed by IVUS in 14 of group A and 38 of group B before intervention.Plaque external elastic membrane,minimal lumen area,plaque area,plaque burden,lipid pool area,thickness of fibrous cap and rupture were measured by IVUS.Results Heavy smoking,excess drinking and positive family history were more frequent in group A than those in group B,while hypertension and diabetes mellitus were more common in group B.The percentage multi-vessel lesions and collateral circulation were higher in group B.IVUS results showed that vulnerable and ruptured lesions were found in most of two groups.The severity of plaque burden is milder in group A.However,they had a bigger lipid core and a thinner fibrous cap.Group B showed a more severe stenosis and bigger plaque area.Conclusion Plaque vulnerability and rupture are the most common cause substrate of AMI.There are different risk factors and different coronary artery characteristics in AMI with different ages,which suggests that different emphases should be taken in preventing AMI in patients with different ages.

Objective:To study the effect and clinical significance of tumor necrosis factor-?(TNF-?) in viral myocarditis(VMC).Methods:Animal model was established by serum TNF-? in VMC mice was assayed by the way of ELISA.In addition,VMC mice were treated by TNF-? mAb and rTNF-?,death rate andmyocardial change of intervention group were compared with control group.Results:Serum TNF-? in VMC mice increased apparently.Inflammatory cell infiltration and myocardial necrosis had ralations with TNF-? in VMC.Inflammatory cell infiltration and myocardial necrosis in the mice of exogenous TNF-? intervention group were more serious than simple VMC group apparently,death rate of mice was also higher than simple VMC group.Inflammatory cell infiltration and myocardial necrosis in the mice of TNF-? mAb intervention group were milder than simple VMC group apparently,death rate of mice was also lower.Conclusion:TNF-? take part in the immunoreaction and pathogenesis of VMC,it has important significance to the therapy of VMC.

Objective To investigate the effect of purified single clonally mesenchymal cells (SCMSCs) on cardiac function in rat models and also try to find out wheter SCMSCs serve as a better source for transplantation than UMSCs, BM-MNCs and PB-MNCs. Methods SCMSCs were isolated, cultured, purified, cloned and expanded. UMSCs were isolated primarily by their tight adherence to the culture dishes. BM-MNCs and PB-MNCs were prepared by Ficoll-Hypaque gradient centrifugation. All cell characters were verified by fluorescence- activated cell sorter (FACS). A total of 5?10~6 PB-MNCs, BM-MNCs, UMSCs, and SCMSCs were transplanted into the ischemic zone immediately after MI. The cardiac function was evaluated by hemodynamic technique 1 month after the transplantation. The vessel density and cell differentiation were determined by histological techniques. Results SCMSCs expressed over 99% of the mesenchymal cell surface protein and none of the hematopoietic stem cell surface protein. Hemodynamics showed that transplantation of snMSC led to the greatest improvement in cardiac function, compared with PB-MNCs, BM-MNCs, and UMSCs transplantation. In consistence with cardiac function recovery, SCMSCs transplantation resulted in the greatest angiogenesis in the ischemic wall, and the greatest number of transplanted SCMSCs expressed these cardiomyocyte proteins, or vascular endothelial cell marker, in comparison with the other heterogeneous cells. Conclusion Transplantation of single clonally purified non-hematopoietic mesenchymal stem cells from human bone marrow showed the greatest imporvement in cardiac function compared to UMSC, BM-MNC, and PB-MNC in this study.

Objective To evaluate the safety and efficacy of homemade patent ductus arteriosus (PDA) closure device for patients with very large PDA. Methods A total of 15 patients (12 females) with very large PDA, underwent transcatheter occlusion with homemade PDA devices. The median age was 21?8 (16-46) years old. The median diameter of the PDA at its narrowest point was 16?3 (13-22) mm. Aortic angiography and measurement of pulmonary pressure were performed before and after the closure of PDA. Repeat echocardiography was performed on each patient at one week, one month and six months after the procedure. Results Fifteen patients underwent transcatheter closure using a device of 23?4 (18-32)mm in diameter, and all of them showed a trace to small shunt by aortic angiography 30 minutes after the procedure. Thirteen patients was successfully occluded with a peak systolic pulmonary pressure decreased from 113?21 mm?Hg to 70?29 mm?Hg (P

OBJECTIVE: To evaluate the function of tubomanometry (TMM) in forcasting the progonosis of acute otitis media with effusion (OME). METHOD: We used the technique of TMM to quantify the degree of eustachian tube (ET) dysfunction in 65 patients with OME. The opening of the ET and the transportation of gas into the middle ear were registered by a pressure sensor in the occluded outer ear after applying the stimulus of a controlled gas bolus into the nasopharynx during swallowing. Three excess pressure values were tested subsequently (30, 40, and 50 mbar). If tube opening was registered, the time of opening in relation to pressure applied was measured. The TMM calculated the opening latency index or index R. An R value of < 1 indicated early opening of the tube at the start of application of the stimulus, which was considered optimal. A value > 1 indicated late opening of the tube occurring after the initial stimulus and was interpreted as suboptimal. Inability to calculate the index R value indicated that the tube was unable to actively open at all. The TMM results, were weighted as follows: no R with 0 points, R > 1 with 1 point and R < 1 with 2 points for the measurements at 30, 40, and 50 mbar, respectively. The points of these three tests were added so the ET score (ETS) ranges from 0 (worst value) to 6 (best value). According to the medical history, the patients were divided into two groups, chronic OME group (defined as positive control group), 30 cases with 38 ears; and acute OME group, 35 cases with 46 ears. The healthy ears of all patients were defined as normal control group, 46 cases with 46 ears. The same regular treatments, including classic medical treatments and intratympanic dexamethasone injections, were used to acute OME group in the following 1-2 months. On the basis of therapeutic effect, acute OME group was subdivided into valid group (26 cases with 33 ears) and invalid group (9 cases with 13 ears). RESULT: The ETS of normal control group was 5.11 ± 1.32 while it was 1.08 ± 1.32 in positive control group. It was found marked differences between the two groups (P < 0.01). The ETS of both valid and invalid subgroup of actue OME group were significantly lower than normal control group (P < 0.01), but in valid subgroup it was significantly higher than positive control group (P < 0.01), and no marked difference was found between the invalid subgroup and positive control group. After treatments, a significant improvement of the ETS was found in both valid and invalid subgroup (P < 0.05) there was no marked difference between valid subgroup and normal control group. But in invalid subgroup it was still significantly lower than normal cohtrol group (P < 0. 01). CONCLUSION TMM could forecast the prognosis of acute OME. Patients with acute OME suffered from ET dysfunction of varied degrees. Those with high ETS could be cured by classic medical treatments and intratympanic dexamethasone injections. But those with poor ETS could not be cured in short period, tube insertion should be considered. If ETS could not be improved by ventilation tube placement, more active treatment, for example, balloon Eustachian tuboplasty (BET), should be used to prevent transforming into chronic OME.
Acute Disease ; Ear, Middle ; Eustachian Tube ; physiopathology ; Humans ; Injection, Intratympanic ; Manometry ; Middle Ear Ventilation ; Otitis Media with Effusion ; diagnosis ; Pressure ; Prognosis