Objective:To explore the way of diminishing perioperative mortality of patient with obstructive sleep apnea syndrome(OSAS).Methods:The death reason of a patient with OSAS was analyzed and relevant articles were reviewed.Results:Asphyxia death mostly took place during anesthesia induction and convalescence as patients experienced general anesthesia for descending uranostaphyloplasty(uppp).Conclusion:The risk of anesthesia for the patient with OSAS must be fully recognized.Sedation amnesia and slow induction in pernasal intubation was an effective way for the operation.

Objective:To assess the appliance value of combined sternohyoid muscle flap in laryngeal funtion reconstruction after partial laryngectomy.Methods:46 patients who underwent partial laryngectomy were reviewed.The laryngeal function was reconstructed using combined sternohyoid muscle flap.Results:All the patients rehabilitated deglutition in 10 to 14 days after surgery.Postoperative decannulation rate is 97.83%.functions of respiration,deglutition and phonation are good.5-year survival rate was 86.96%(40/46).Conclusion:Combined sternohyoid muscle flap is a ideal material for laryngeal fuctional reconstruction after partial laryngectomy.

OBJECTIVE To evaluate the efficacyand safety of intratympanic injection of steroids in the treatment of sudden hearing loss with diabetes.METHODS PubMed, Medline, CNKI, CBM, VIP, and Wanfang databases were searched by electronic retrieval to collect documents meeting the inclusion criteria and extract data.Meta-analysis was performed using RevMan 5.3.RESULTS There were 9 articles included in the literature search,a total number of 587 ears, of which 294 ears accepted intratympanic injection of steroids as the experimental group. Another 293 ears was control group,of which 217 ears accepted systemic steroids and 76 ears accepted non-hormone therapy.Meta analysis results showed that the clinical effect of experimental group was more remarkable than that of the control group (Z=3.65, P<0.05;Z=3.70,P<0.05). The influence on blood sugar in experimental group was smaller than that of the control group (χ2=7.471,P<0.05). Other complications of intratympanic steroid injection were self-healing after tympanic membrane perforation, transient dizziness and so on.CONCLUSION There was a significant effect on patients with sudden hearing loss and diabetes through intratympanic steroid injection. It has little effect on blood glucose and slight complications, which is a priority in clinical practice.

Objective To investigate whether exosome-derived microRNA of nasopharyngeal carcinoma suppresses apoptosis of tumor associated macrophage (TAM).Methods Target microRNAs and genes were determined by bioinformatics methods.Isolated exosomes were used to detect miR-20a expression by qRT-PCR.Furthermore,apoptosis index and proteins involved in apoptotic pathways were detected after miR-20a mimic and inhibitor transfection into macrophages.Results miR-20a expression was upregulated in isolated exosomes.miR-20a target gene was BCL2L11.MiR-20a overexpression could inhibit apoptosis of macrophages,meanwhile,apoptotic pathways related proteins Bim,caspase-9 and caspase-3 were significantly suppressed by miR-20a mimic(P＜0.05).Condusion miR-20a can suppress activation of Bim-caspase-9-casepase-3 and resulting in apoptotic inhibition of macrophages.