Chronic hepatitis C virus (HCV) infection is an important cause of hepatic fibrosis,liver cirrhosis,and hepatocellular carcinoma (HCC).Insulin resistance (IR) is one of the important pathological features of HCV infection.IR can accelerate the development of hepatic fibrosis,hepatic steatosis,and HCC and affect the efficacy of antiviral therapy.Therefore,HCV-related IR can be the target of pharmacotherapy during any stage of HCV infection.This article reviews the pathogenesis of IR in patients with hepatitis C,the interaction between them,and the impact of IR on antiviral therapy.

Humans ; Palate, Soft ; Pharynx ; Snoring ; Uvula

OBJECTIVE: To investigate the efficacy of Coblation-channelling for the tongue(CCT) treatment of tongue hypertrophy. METHOD: The 31 patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS) combining tongue hypertrophy staged as Friedman ll or N were performed CCT after nasal septum surgery, coblation channelling of bilateral inferior turbinate and coblation-assisted UPPP. While the vertical channelling in the base and the body of the tongue, the tilted one parallel side edge and posterior to the tongue were combined. The intraoperative and postoperative complications such as bleeding were observed. The 12 months postoperative follow-up were done by MRI of the tongue. RESULT: The retrolingual space were expanded postoperatively. The 2 bleedings occurred immediately after channellings in the tongue body, and they were stopped by local compression. No postoperative tongue paralysis, no tongue hematoma and abscess happened. The tongue sizes changed from preoperative III or IV degree to postoperative I to II degrees. One case received three CCT sessions. CONCLUSION CCT treatment tongue hypertrophy is a individually safe, effective and minimally invasive treatment.
Catheter Ablation ; methods ; Female ; Humans ; Hypertrophy ; complications ; surgery ; Macroglossia ; complications ; surgery ; Male ; Postoperative Hemorrhage ; etiology ; Postoperative Period ; Sleep Apnea, Obstructive ; etiology ; surgery ; Suction ; methods ; Tongue ; pathology

Objective:To explore therapeutic effect of noninvasive ventilator on advanced aged patients with acute de- compensated chronic heart failure.Methods:A total of 196 advanced aged patients with acute decompensated chron- ic heart failure hospitalized in our department were randomly and equally divided into routine treatment group and noninvasive ventilator group (received auxiliary treatment with noninvasive ventilator based on routine treatment group).Total effective rate,respiratory rate (RR),heart rate (HR),mean arterial pressure (MAP),partial pres- sure of oxygen in artery (PaO2 )and left ventricular ejection fraction (LVEF)were observed and compared between two groups before and after treatment. Results:Compared with routine treatment group, total effective rate (73.47% vs.90.82%)significantly rose in noninvasive ventilator group,P=0.007. There were no significant difference in above each indexes between two groups before treatment (P>0.05).Compared with before treat- ment,there were significant reductions in RR,HR and MAP,and significant rise in PaO2 and LVEF in both groups after treatment,P<0.05 or<0.01;compared with routine treatment group after treatment,there were significant reductions in RR [(27±6)times/min vs.(19±3)times/min],HR [(109±10)beats/min vs.(73±8)beats/min] and MAP [(110.5±9.0)mmHg vs.(81.6±8.0)mmHg],and significant rise in PaO2 [(77±8)mmHg vs.(98 ±9)mmHg]and LVEF [(41.9±5.4)% vs.(52.7±5.5)%]in noninvasive ventilator group,P<0.05 or<0.01. Conclusion:Noninvasive ventilator treatment based on routine therapy can effectively relieve symptoms of heart fail-ure,improve RR,HR,MAP,PaO2 ,LVEF and cardiac function in advanced aged patients with acute decompensat- ed chronic heart failure,which is worth extending.

OBJECTIVE To study the prevalence of atypical pathogens in patients with community acquired pneumonia(CAP) and the distribution of serotypes of Legionella pneumophilia.METHODS A prospective study was performed on 257 consecutive adult patients with CAP between Dec 2003 and Nov 2004.Antibodies of the paired serum samples to Mycoplasma pneumoniae,Chlamydia pneumoniae and Legionella pneumophilia serotypes 1 to 14 were detected.RESULTS The etiology of CAP was identified in 82(31.9%) patients.The distribution of causal agents was as follows:M.pneumoniae 63(24.5%),C.pneumoniae 17(6.6%),and L.pneumophilia 11(4.28%).Serotype 12 of L.pneumophilia was the predominant one,responsible for 21.8%(56/257).CONCLUSIONS Atypical pathogens especially M.pneumoniae have an important role in CAP;serotype 12 of L.pneumophilia is the predominant one in northern area of China.

AIM: To explore the delayed protection of heme oxygenase-1 (HO-1) in the exercise preconditioning (EP) from the myocardial relative ischemia reperfusion injury (rI/R). METHODS: 40 Wistar Rats were divided into 5 groups randomly: control group (CN), rI/R group (IR), EP+rI/R group (EI), HO-1 inductor hemin+rI/R group (HE) and HO-1 inhibitor ZnPP+EP+rI/R group (EZ). The following indexes were detected, including the HO-1activity in myocardium, the cardiac function parameter-pressure-rate product (heart rate × left ventricular developed pressure, PRP) and the content of MDA in coronary effluent. RESULTS: After myocardial rI/R, HO-1 activity increased significantly. Moreover, EP or HO-1 inductor could enhance this effect manifestly. Nevertheless, when the HO-1 inhibitor was administered before EP,HO-1 activity decreased. In addition, there was no distinct difference in the HO-1 activity between EI group and HE group. At the 30 min point of reperfusion, the PRP recovery rate of EI group was higher clearly than that of IR group. However, there was reverse effect between the EZ group and the EI group. The MDA in coronary effluent of EI group, EZ group and HE group were lower obviously than that of IR group and there was significant difference between EI group and EZ group. CONCLUSION: EP could protect the heart from the rI/R injury occurring 24 hours later, which might be performed through activating the HO-1.

Objective To discuss the clinical feature and the treatment of severe hand, foot and mouth disease (HFMD), and provide the basis for control of the disease. Methods The clinical data of 60 children with severe HFMD were retrospectively analyzed. Results All the 60 cases appeared fever and the erythra in hand, foot, mouth and gluteal region. Part of the children appeared jumping, body shaking, poor spirit and/or sleepiness. Some children appeared convulsion, and neurogenic pulmonary edema, pulmonary hemorrhage, cardiorespiratory failure happened in 2 critical severe cases. The children were given the comprehensive treatment including ribavirin, mannitol, human immunoglobulin and methylprednisolone. Forty-three cases were cured, 15 cases were improved, and 2 cases died. Conclusions Severe HFMD children usually appear critical condition. Early detection of critical signs and correct and effective clinical treatment can promote children's recovery and reduce the mortality rate.

Aim To study the protective effects of SEP on the hypertrophic myocardial cells induced with high glucose and high insulin and the mechanism. Methods The protein content was assayed with Lowrys meth-od;the cardiomyocytes area was measured by computer photograph analysis system;the expression of ANF and PPAR-α was determined by RT-PCR;APS was select-ed as control drug. Results Compared with conctrol group,the protein content,cardiomyocytes area and the expression of ANF and PPAR-α of high glucose and high insulin group were significantly increased. Com-pared with conctrol group,the SEP of different dosages were able to decrease the protein content, area, the expression of ANF mRNA and PPAR-α mRNA of cul-tured hypertrophic myocadial cells induced with high glucose and high insulin. Conclusion SEP can pre-vent cardiomyocyte hypertrophy induced by high glu-cose and high insulin, which is related to its inhibition on PPAR-α signaling path.

Objective To investigate the use of the endotracheal silicone stent with silver wire in repair of stricture of laryngotrachea. Methods A retrospective analysis was performed on nine cases with stricture of laryngotracheal stenosis that were treated with endotracheal silicone stent with silver wire that was then decannulated three months later. Results Endotracheal silicone stent with silver wire were successfully decannulated in all cases. The follow up ranging from 11 months to three years showed no stricture happened again. Conclusion Endotracheal silicone stent with silver wire can effectively and minimally invasively treat the stricture of laryngotrachea.

Objective To explore the value of ureteroscopy in the diagnosis and treatment of ureteral injury caused by laparoscopic hysterectomy . Methods Suspect ureteral injury occurred in 23 cases out of 578 laparoscopic hysterectomy from January 2010 to December 2015 in our hospital.Among them, 12 cases were testified by ureteroscopy .A double-J catheter was placed in for 3 months. Results All the 12 cases were followed up for 3-26 months (average, 19 months).The double-J catheter was removed at 3 months after surgery .The continuity of the affected side urinary tract was restored in 10 cases and hydronephrosis was not found by B ultrasound .Two cases were found ureteral obstruction and were given ureterovesical reimplantation at 3 months after surgery . Conclusions The ureteroscopy should be carried out as early as possible for patients with suspect ureteral injury after laparoscopic hysterectomy .Double-J catheter placement can avoid parts of patients converting to open surgery .