BACKGROUND: At present, common therapies of obstructive sleep apnea syndrome (OSAS) are uvulo-palato-pharyngoplasty and nasal continuous positive airway pressure (N-CPAP). The effective rate of surgical treatment was 50% and the prostecdtive efficacy is decreased gradually. As to treatment with breathing machine, some of the patients can not adapt to it.OBJECTIVE: To investigate the effects of auricular acupoint pressing therapy on clinical indexes of patients with OSAS and its clinical effect,and analyze the possible mechanism.DESIGN: Randomized control observation.SETTING: Department of Acupuncture and Department of Respiration,Second Hospital of Hebei Medical University.PARTICIPANTS: Forty-five outpatients with OSAS between April 2001 and April 2004, who were diagnosed as OSAS in the room of sleep-monitoring of Department of Respiration, were selected from the Clinic of Respiration, Second Hospital of Hebei Medical University, including 44 males and one female. All subjects were randomly divided into treatment group (n=30) and control group (n=15).METHODS: ①Patients in the treatment group were treated by auricular acupoint pressing therapy, acupoint-locating: shenmen, sympathesis, subcortex, heart, lung, spleen, kidney, anterior ear lobe. Each acupoint was pressed about 10-20 times with 3-5 times every day and 10 days as onecourse. Patients in the control group were treated with placebo and orally took 100 mg of Vitamin C three times a day. Patients in both groups were detected by 7hour nocturnal polysomnography before treatment and 10 days after the treatment, and the curative effects were evaluated.②Criteria of the curative effects on clinical symptoms: Effective: clinical symptoms such as dizzy,somnolence, oppressed chest and obstructing etc. were significantly ameliorated with nocturnal times decreased from 4-5 times to once or none and awake times decreased from 4-5 to once or none. Valid: clinical symptoms were improved. Invalid: no amelioration was found in clinicalsymptoms.MAIN OUTCOME MEASURES: Changes of clinical symptoms before and after the treatment and hypopnea index (HI), apnea index (AI), apnea hypopnea index (AHI), minimum blood oxygen saturation as well as the longest apnea time detected by polysomnography were observed.RESULTS: A total of 45 patients with OSAS were involved in the analysis of results, and no one withdrew from the study.①The clinical symptoms in auricular acupoint treatment group were significantly ameliorated than control group. In the treatment group, 17 patients were effective (56.7%), 12 patients were valid and one patient was invalid. The clinical symptoms in the control group were not improved before and after the treatment, and there were significant differences between the treatment group and control group (P ＜ 0.05). ②Comparison in each inspecting indexes by polysomnogram: those in the auricular pressing therapy group were remarkably different from those in the control group after treatment (P ＜ 0.001). There was no significant difference in all indexes of the control group between and after the treatment (P ＞ 0.05).③The differences in AI, HI, AHI, minimum blood oxygen saturation as well as the longest apnea time of the auricular pressing treatment group after the treatment were markedly different from those before treatment [(65.25±7.44), (53.69±10.80) times/hour; (72.40±7.92), (59.22±10.55) times/hour; (9.46±2.6), (6.5±2.9) times/hour; (73.3±4.8)%,(77.67±3.78)%; (90.16±33), (45.33±24.69) s,P ＜ 0.001]. Among them, the maximum decrease of AI was 19.3 times/hour, the maximum decrease of AHI was 17.8 times/hour, the maximum decrease of HI was 12.9 times/hour and the maximum increase of blood oxygen saturation was 7% CONCLUSION: Auricular acupoint pressing therapy, in the treatment of OSAS, can significantly ameliorate the AI, HI; AHI, minimum blood oxygen saturation as well as the longest apnea time with better curative effects.

Objective To explore the technique of massive facial scar revision. Methods All 12 patients in the group were treated with expanded deltopectoral skin flap. In the primary surgery, expander was implanted underneath deltopectoral flap region through an incision inferior to the clavi-cle. The skin perforators of transverse cervical artery and thoracoacromial artery were ligated during surgery, and the internal thoracic artery was carefully preserved. After the deltopectoral skin flap was fully expanded, the second surgery was performed and the facial scar was released and the normal ana-tomic position of eyes, nose and month was restored. The deltopectoral skin flap was planed according to the size of the defect. The excised facial scar was converted to the flap pedicle and a hinge-like con-nection was formed. The flap was delayed and three weeks after the second surgery, the pedicle was divided. The flap from the pedicle was applied for the mental region scar revision. Results Unilateral or bilateral dehopectoral skin flaps were employed for the repair of extensive facial scar in 12 patients. Satisfactory results were achieved in all these patients. Conclusion Expanded deltopectoral skin flap is a good technique for the repair of extensive facial scar.