OBJECTIVE: To discuss the method and effect of exercising larynx and genioglossus to treat obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: Fifty-four patients who were diagnosed as OSAHS and exercised larynx and genioglossus were defined as treatment group. We took Epworth sleep scale, check patient's PSG, and took computer tomography (320CT) before treatment, 6 months and 12 months later. We made a record of AHI, LSaO2, BMI, the shortest sagittal diameter and transverse diameter. Compared with 30 patients who had taken UPPP surgery (control group 1) and the 21 patients without any treatment (control group 2) at the same time. SPSS 10.0 was used to analyze the data. RESULT: According to Chinese OSAHS construction in 2009, 6 months and 12 months later, the effective rates of treatment group were 31.48% and 44.44%, among which the effective rates in mild and moderate patients of treatment group were 44.74% and 63.16%. Before treatment the mark of Epworth sleep scale was 7.67, 6 month and 12 month later the marks were 3.54 and 3.25. AHI were up to 15.45 after 6 months and 13. 60 after 12 months from 22. 84 at the beginning. LSaO2 were up to 81.18% after 6 months and 81.93% after 12 months from 74.05% at the beginning. The effective rate of control group 1 was 66.67%, and was much higher than the treatment group 6 months later (P < 0.05). But there was no statistics difference of effective rate between treatment group and control group 1 (36.67%) after 12 months (P > 0.05). The effective rates of treatment group were much higher than control group 2 (P < 0.01). After 12 months, the sagittal wall compliance of retropalatal area was lower (P < 0.01). There was no significant change of BMI in every group. CONCLUSION Exercising larynx and genioglossus is one kind of non-invasive and effective method without payment to treat part of OSAHS patients, especially the patients who is old, without surgical condition, and especially mild and moderate OSAHS patient that do not want to take surgery and CPAP treatment. Besides, exercising larynx and genioglossus can be considered as remedial treatment of OSAHS to surgery and other therapy.
Adult ; Aged ; Exercise Therapy ; Female ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; Pharynx ; Sleep Apnea, Obstructive ; therapy ; Young Adult

ObjectiveTo investigate the application value of Toshiba 320-row dynamic volumetric CT angiography in the diagnosis of venous erectile dysfunction (VED).

METHODSWe enrolled in this study 33 patients diagnosed with ED by audiovisual sexual stimulation screening in the outpatient department. Penile erection was induced in the patients by injection of 2 mg phentolamine plus 30 mg papaverine into the corpus cavernosum, followed by that of contrast agent of iobitridol through the vein and corpus cavernosum successively. Then 320-row dynamic volumetric CT angiography was performed and the images of the corpus cavernosum in the arterial and venous phases were collected and processed.

RESULTSDifferent degrees of abnormal venous drainage were observed in 29 of the patients, including 7 cases (24.1%) of back deep venous leakage, 6 cases (20.7%) of foot venous leakage, 3 cases (10.3%) of dorsal superficial venous leakage, 1 case (3.5%) of intervertebral venous leakage, 2 cases (6.9%) of cavernous venous leakage, and 10 cases (34.5%) of mixed venous leakage. Ten of the patients underwent surgery, dorsal deep penile vein ligation in 2 cases, dorsal deep vein embedding plus foot vein ligation in 4, and foot vein ligation in the other 4. Eight of the patients were followed up for 3－12 months post-operatively, during which 2 achieved obvious erectile improvement, while the other 6 gained normal penile erection.

CONCLUSIONSToshiba 320-row dynamic volumetric CT angiography is a reliable method for the diagnosis of VED, which displays the precise location of venous leakage for clinical treatment, with the advantages of clearer images, lower doses of contrast agent and radiation, and faster examination than X-ray penile angiography.

Adult ; Arteries ; diagnostic imaging ; Computed Tomography Angiography ; Contrast Media ; Drug Combinations ; Erectile Dysfunction ; diagnostic imaging ; Humans ; Injections ; Iohexol ; analogs & derivatives ; Ligation ; Male ; Middle Aged ; Papaverine ; administration & dosage ; Penile Erection ; Penis ; diagnostic imaging ; physiopathology ; Phentolamine ; administration & dosage ; Veins ; diagnostic imaging ; surgery

OBJECTIVE: To discuss the expression and correlation of COX2 and LMP1 in NPC. METHOD: Fifty-three nasopharyngeal biopsy specimens of NPC patients who had been diagnosed definitely with pathology in our department from 2000 to 2005, and 8 nasopharyngeal biopsy specimens of chronic nasopharyngitis patients were collected. The expression of COX2, LMP1 were detected with streptavidin peroxidase immunohistochemistry staining. All the datas were analyzed with SPSS 12.0. RESULT: The positive expression rate of COX2 was 71.70% (38/53), and that of LMP1 was 66.04% (35/53) of Nasopharyngeal carcinoma tissue. The higher expression rate was detected in neck lymph nodes metastasis group of nasopharyngeal carcinoma (P<0.05). While the expression rate of COX2, LMP1 was no significant relation with age, gender, clinical stage and pathological classification (P>0.05). The expression of COX2 and LMP1 showed positive correlation (gamma = 0.797, P<0.01). CONCLUSION COX2 and LMP1 were highly expressed in nasopharyngeal carcinoma cells. The expressions of COX2 and LMP1 was significantly associated with neck lymph nodes metastasis, and was none-significant relation with age, gender, clinical stage and pathological classification. The expression of LMP1 showed a significant positive correlation with that of COX2. LMP1 could enhance NPC neck lymph nodes metastasis by up-regulating the expression of COX2.
Carcinoma, Squamous Cell ; metabolism ; pathology ; Cyclooxygenase 2 ; metabolism ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Nasal Mucosa ; metabolism ; pathology ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Neoplasm Staging ; Viral Matrix Proteins ; metabolism

OBJECTIVETo compare the stability of subaxial cervical anterior transpedicular screw(ATPS) fixation and three traditional fixations for three-column injury.

METHODSSix specimens of cervical spine were prepared. After measurememt of the range of motion(ROM) in intact state, the specimens were made into three-column injury models. The models were reconstructed with an anterior cervical cage, and stabilized by ATPS, anterior plate(AP), anterior plate + lateral mass screw(AP+LMS) and posterior transpedicular screw(PTPS). The ROM of the models in the four states were measured, and the results of data were compared after standardization.

RESULTSThe normalized ROM of ATPS state in flexion-extension, lateral bending, axial rotation were(77.17±4.75)%, (82.00±2.61)%, (83.17±2.23)%, which were significant small than those in intact state(<0.05). The normalized ROM of AP state in flexion-extension, lateral bending, axial rotation were(119.67±7.42)%, (116.33±7.53)%, (112.67±5.99)% , which were significant larger than those in intact state(<0.05). The normalized ROM of AP in all directions were significant larger than those of ATPS(<0.05). There was no significant difference between normalized ROM of PTPS state and those of ATPS state in flexion-extension and lateral bending(>0.05). The normalized ROM of PTPS state in axial rotation was(6.83±2.48)% and was significant larger than that of ATPS state(=0.009). The normalized ROM of AP+LMS state in flexion-extension was(68.50±2.43)%, which was significant smaller than that of ATPS state(=0.003). There was no significant difference between the normalized ROM of AP+LMS state and those of ATPS state in lateral bending and axial rotation(>0.05).

CONCLUSIONSSubaxial cervical three-column injury model reconstruction by ATPS can provide the adequate primary stability, of which biomechanics property is superior compared to AP and PTPS, and is similar to that of AP+LMS. It can be applied to the patients with no need to decompression and reduction through posterior approach.

OBJECTIVETo assess the effect of percutaneous endoscopic lumbar discectomy (PELD) combined with epidural injection for prolapsed lumbar disc herniation(PLDH).

METHODSIn this prospective randomized controlled study, the clinical data of 126 patients who had undergone a PELD because of a single-level PLDH from March 2014 to June 2015 were analyzed. There were 67 males and 59 females, ranging in age from 17 to 75 years old with an average of(41.0±13.5) years old, 9 cases were L₃,₄, 76 cases were L₄,₅ and 41 cases were L₅S₁. According to the random number table, the patients were randomized into two groups, with 63 patients in each group. Patients in group 1 were injected normal saline after PLED, patients in group 2 were subjected to an epidural injection of Diprospan, Lidocaine and Mecobalamine after PLED. All the patients were followed up from 6 to 20 months with the mean of 12.4 months. Complications, the postoperative hospital stay, the period of return to work, visual analogue scale (VAS) and Japanese Orthopedic Association (JOA) score were compared between two groups, and clinical outcomes were evaluated according to modified MacNab criteria.

RESULTSAll the operations were successful, and no complications were found. The mean postoperative hospital stay and the period of return to work in group 1 were (4.61±1.25) days and (4.31±0.47) weeks, respectively, and in group 2 were (2.53±0.69) days and (3.14±0.52) weeks, there was significant differences between two groups(=0.000). Postoperative VAS and JOA scores in two groups were obviously improved (=0.000). At 1 day, 1 week, 1 month after operation, VAS, JOA scores in group 2 were better than that of group 1(=0.000), and after 6 months, there was no significant difference between two groups(>0.05). According to the modified MacNab criteria, 39 cases got excellent results, 21 good, 3 fair in group 1, and which in group 2 were 41, 20, 2, respectively, there was no significant difference between two groups(=0.087).

CONCLUSIONSPELD is an mini-invasive technique for PLDH, it can fleetly reduce pain and improve function. And combination with epidural injection has the advantages of pain releasing and function improving in the short-term postoperative period, and it can decrease postoperative hospital stay and time of returning to work, and it is a safe and effective method.

Objective: To analyze the causes of local necrosis and hemodynamics after pedicle peroneal perforator flap and try to find out prevention strategies. Methods: Retrospective 17 tissue defect cases admitted by Plastic and Reconstructive Surgery of Ningbo First Hospital, which treated by pedicle perforator flap with kinds of complications. 3 of 17 were naked the perforators to reduce reverse pressure. Patients involved 12 male, 5 female, ages from 22 to 46, with defected area from 5.0 cm×11.0 cm to 8.0 cm×14.0 cm, located in lateral ankle. Results: 3 to 5 days postoperative 12 cases with distal local necrosis, all of which were designed interregional, one with performator naked, turned back after drainage and wound dressing, 3 cases were gradually swelling and purple postoperative, two of them were perforator naked. 1 weeks later, the distal skin of flap necrosis and were gradually turning black scab appeared.With scab cutting and fascia survived, no bony tissues exposure, after 0.5% povidone iodine wet dressing regularly, endothelial cells crawled to cover. 2 cases with larger ranger of swelling and purple, not be better even pedicale releasing was conducted, 2 weeks later most part of the flap necrosis and the distal turned black eschar. After debridement and skin grafting, wounds healed later.All patients were followed up for 3 months with no flap transplantation required. Conclusions Coaxial homology, within 2 choke vessel areas, perforator skeletonization, kick out the small saphenous vein, might be the ways to reduce the complication of the cross area designing trans pedicled peroneal perforator flap.

Carcinoma, Verrucous ; diagnosis ; Humans ; Skull Base ; pathology

Objective: To explore the association between thyroid hormones and visceral fat area(VFA) in the patients with type 2 diabetes. Methods: A total of 729 patients with type 2 diabetes, who joined National Metabolic Management Center(MMC) through Ningbo First Hospital from March, 2018 to July, 2019, were enrolled in this study. Blood tests were taken to assess their thyroid hormones and biochemical indexes. VFA and subcutaneous fat area(SFA) were obtained through bioelectrical impedance analysis. Statistics were later analyzed by Spearman correlation analysis and multivariate linear regression. Results: Spearman correlation analysis showed that VFA were positively correlated with T₃、FT₃(r=0.225 and 0.211, P<0.01), and VFA were inversely correlated with FT₄(r=-0.112, P<0.01). No correlation was found between VFA and either of T₄ or TSH(P>0.05). Multivariate linear regression analysis indicated that VFA was independently correlated with FT₄ and FT₃(P<0.01). An increment of 1 pmol/L in FT₄ was associated with 1.759 cm² increase in VFA, and increment of 1 pmol/L in FT₃ was associated with 3.256 cm² decrease in VFA. Conclusion VFA in patients with type 2 diabetes are correlated with FT₃ and FT₄.

Objective To observe the effect of home nursing based upon protocol nursing theory on liq-uid intake compliance improvement of patients undergoing hemedialysis. Methods Forty-eight HD patients of hquid intake un-compliance were randomized into the observation group and the control group with 24 cases in each group. The control group received routine nursing, the observation group was given home care instruc-tion based upon protocol nursing theory for 1 month. The two groups both received follow-up for 3 months and their liquid intake comphance were evaluated before and after intervention. The relationship between family sup-port and relative increase of body weight during hemodialysis was also evaluated. Results The IDGW relative magnitude was lower, the compliance of liquid intake was higher, the level of family support was higher in the observation group than those of the control group. There was negative correlation between the family support and the IDGW relative magnitude the IDGW relative magnitude, family support, comphance of liquid intake. Conclusions Home care nursing based upon nursing theory facilitate patients to get effect family support, increase the compliance of hquid intake and make IDGW within desirable range.

In this experimental study, the AC impedance of isolated gastrocnemius was measured with an impendance analyzer of Agilent 4294A, and the effect of simulated weightlessness on the dielectric properties of the cells in isolated rat sural muscle was investigated by analyzing the dielectric numerical characters with the use of dielectric spectroscopy, the Cole-Cole plots, the spectrum of loss factor and loss tangent, as well as the spectrum of conductivity imaginary part. The results demonstrated that 10 weeks' simulated weightlessness caused some changes; for example, both permittivity at low frequency (epsilonL) and permittivity increment (deltaepsilon) were reduced, and conductivity at high frequency (kappa(h)) was also reduced; at the same time, conductivity increment (deltakappa) was reduced, too. The first characteristic frequency (f(C1)) decreased, while the second characteristic frequency(f(C2)) increased. All of the peak of loss factor, the peak of loss tangent, and the maximum of conductivity imaginary part were reduced. These data indicated that the reduction of dielectric properties of skeletal muscles was induced by weightlessness.
Animals ; Electric Impedance ; Electrophysiology ; In Vitro Techniques ; Male ; Muscle, Skeletal ; pathology ; physiology ; Rats ; Rats, Sprague-Dawley ; Weightlessness Simulation