0.05]. CONCLUSIONS: The currents of voltage-gated potassium channel was inhibited by chronic hypoxic. The inhibitory effect of cGMP on currents of voltage-gated potassium channel in PASMCs from both normal and chronic hypoxic rats may be probably through the phosphorylation of voltage-gated potassium channel.

Objective To evaluate the short-term effect of drug-coated balloon (DCB) with paclitaxel in treating in-stent restenosis (ISR) of femoral popliteal artery.Methods A total of 18 patients with femoral popliteal artery ISR,who were admitted to authors' hospital during the period from June 2016 to December 2016 to receive paclitaxel DCB treatment,were enrolled in this study.The patients included 15 males and 3 females,with a mean age of (72.7±9.8) years old.According to Fontaine classification,grade Ⅱ B was seen in 9 patients,grade Ⅲ in 8 patients,and grade Ⅳ in one patient.Preoperative CT angiography showed that ISR could be confirmed in 3 patients and complete occlusion of the stent in 15 patients.After the diseased artery was re-opened,pre-dilatation with common balloon was conducted,which was followed by dilatation with paclitaxel DCB;remedial stent implantation was carried out when the restrictive dissection was observed or if the residual stenosis was beyond 50％.Angiography was performed immediately after the procedure to check the vascular patency.On the third day afterthe treatment,the ankle-brachial index (ABI) of diseased lower extremity was determined to assess the improvement of ischemia.Three month after the treatment,the patients were followed up to detemine the incidence of restenosis,the clinically-driven target lesion revascularization (TLR) rate,and the occurrence of serious clinical events within 3 months.Results Successful re-opening of the diseased artery was achieved in all 18 patients,the technical success rate was 100％.At 3 months after the treatment,the restenosis rate and TLR rate were 10％ (1/10) and 6.67％ (1/15) respectively.No procedure-related complications occurred in all patients.Conclusion For the treatment of femoral popliteal artery ISR,the use of paclitaxel DCB is safe and effective.

Objective To demonstrate the effect of comprehensive treatment under nasal endoscopy for epistaxis. Methods The bleeding sites of 92 patients were defined by nasal endoscopic examination. Epistaxis was cured by single pole or bipolar coagulation, combined with micro packing and systemic treatment. The bleeding sites and effect were studied retrospectively. Results The hemorrhagic foci were found in the following sites: 60.87%(56/92) in Little area, 13.04%(12/92) in the middle and back of nasal septum, 10.87% (10/92) in olfactory sulcus, 8.70% (8/92) in middle turbinate , 3.26% (3/92) at the top of inferior meatus, 2.17% (2/92) at the top of nasal cavity, 1.09% (1/92) at unknown part at the back of nasal cavity. Epistaxis was successfully controlled by once nasal endoscopic examation and hemostasis in 86 of 92 patients. While in 5 of 92 patients, epistaxis was cured by twice nasal endoscopic examation and hemostasis. Endoscopicligation of the sphenopalatineartery was performed in 1 patient with unknown posteriorepistaxis. In 92 patients,15 cases were given micro packing combined with systemic treatment. All the patients were cured and were followed up for 3 months without recurrence and the cure rate was 100.00%. Conclusions The major bleeding site is Little area. Single pole or bipolar coagulation, combined with micro packing and systemic treatment under nasal endoscope is effective for epistaxis and worth of clinic application extensively.

Objective To investigate nutrition status and dyspnea in the patients with chronic obstructive pulmonary disease (COPD) between GOLD Ⅱ and GoLD Ⅲ, and test the evaluative validity of disease status by GOLD classification of COPD. Methods Thirty patients with clinically stable COPD were recruited, including 15 patients of GOLD Ⅱ of COPD and 15 patients of GOLD Ⅲ of COPD. Body mass index (BMI), triceps skin-fold thickness (TSF), serum albumin (Alb), and partial pressure of oxygen in arterial blood (PaO2) were measured in each patient. Dyspnea was assessed by the Borg Scale (BS). Exercise stress test was taken by incremental exercise test. Results BMI was significantly lower in the patients of GOLD Ⅲ than that in the patients of GOLD Ⅱ[(19±5 ) kg/m2 vs (23±3) kg/m2,p < 0.05]. TSF was significantly reduced in the patients of GOLD Ⅲ than that in the patients of GOLD Ⅱ[ (8±3) mm vs(13±5) mm, P < 0.01]. Alia in the patients of GOLD Ⅲ was significantly decreased than that in the patients of GOLD Ⅱ [(32±7) g/L vs (36±6) g/L, P <0.05]. The difference of PaO2 between the patients of GOLD Ⅲ and the patients of GOLD Ⅱ was significant [(72±9) nun Hg (1 mm Hg = 0.133 kPa ) vs (78±8) nun Hg, P < 0.01], and the significant difference of BS was found between the patients of GOLD Ⅲ and the patients of GOLD Ⅱ( 5.0±2.0) grades vs (3.0±1.0) grades, P <0.05 ]. In addition, 12 patients in the patients of GOLD Ⅱ took the exercise stress test and 8 patients were found anaerobic threshold (AT), 5 patients in the patients of GOLD Ⅲ took the exercise stress teat and no AT was found. Conclusions The parameters of BMI, TSF, Alb and PaO2 are significantly reduced in the patients of GOLD Ⅲ than those in the patients of GOLD Ⅱ. In the patients of GOLD Ⅲ, BS is higher than that in the patients of GOLD Ⅱ and AT is difficult to obtain, suggesting more severe in degree of impairment. GOLD classification of COPD reflects the disease stares and prognosis in the patients with COPD, as a valuable parameter in clinical practice.

OBJECTIVE To study the best surgical technique for treatment of chronic hypertrophic rhinitis(HR).METHODS Eighty six cases with HR were divided randomly into 3 groups.Thirty cases were treated by transnasal endoscopic submucous inferior turbinate resection(group A),26 cases by partial inferior turbinectomy(group B)and 30 cases by bipolar radiofrequency ablation(group C).The epithelium of the inferior turbinate of the every case in 3 groups was examined with histomorphology and ultrastructure techniques at 6 months after operation. The efficacy and the features of in the 3 groups were compared.The MTR was determined in the patients of the 3 groups.The histomorphology and ultrastructure of the inferior turbinate were observed at 6 months after operation.RESULTS All the cases with HR in 3 groups were followed up for 3 to 6 months after operation.Effective rates of group A,group B and group C were 100 %,100 % and 96.3 % respectively, while there was no significant difference among the three groups.Compared to the group B,surgical techniques applied in Group A and group C have more advantages because ultrastructure of inferior turbinate mucosal cilia and nasal mucociliary transport function were nearly normal at 3 to 6 months after operation. The advantages include operating easily,wound healing up fast.MTR between pre-and post-operation was significant difference in group B.Epithelial tissue remained intact in group A and group C,while epithelial tissue in group B was instead of fiber tissue at 6 months after operation.The ultrastructure of inferior turbinate mucosal cilia in group A and group C remained intact at 6 months after operation.CONCLUSION The transnasal endoscopic submucous inferior turbinate resection and bipolar radiofrequency ablation for treatment of chronic hypertrophy rhinitis are effective. Submucous minimally invasive surgery of the inferior turbinate deserves to be recommended.

[ABSTRACT]OBJECTIVETo investigate the morbidity rate and the epidemiological characteristics of snoring among the elderly in Yangpu District of Shanghai City.METHODSOne thousand six hundred and thirty persons(≥60 years) were investigated through questionnaires in Yangpu District of Shanghai City by a method of cluster sampling.The prevalence and risk factors of snoring were estimated. The relationship between snoring and the common clinical complications was observed by correlation factor analysis.RESULTS1630 questionnaires were provided, among which 1489 questionnaires(91.35%) were effective for evaluation.Of 1489 subjects, 213(14.3%) subjects had habitual snoring. Multivariate analysis revealed that obesity as a significant risk factor of snoring. The prevalence rate of snoring in the elderly with hypertension and poor quality of sleep was higher than that in the normal elderly.CONCLUSIONThe prevalence of snoring in the elder persons (≥60 years) in Yangpu District of Shanghai City is high. Obesity is a significant risk factor of snoring. The main clinical presentations of snoring in the elderly are atypical by the performance of poor sleep quality and the complication of hypertension.

Objective To explore the therapeutic effect of Han-uvulopalatopharyngoplasty (H-UPPP) combined with coblation on treatment of type Ⅱ mild and moderate obstructive sleep apnea hypopnea syndrome (OSAHS).Methods According to the measuring parameters analyzed and clinical characteristics of velopharyngeal,68 patients were divided into 3 groups:group A (28 patients,treated by H-UPPP combined with coblation of tonsillectomy),group B (22 patients,treated by H-UPPP combined with drilling of tonsil) and group C (18 patients,treated by velopharyngeal multi-points drilling).After operation for 6 months,the pafor tients in 3 groups were detected by the polysomnography (PSG),Epworth sleepiness scale,and the parameters of velopharyngeal were compared.Results After operation for 6 months,the heal,excellence,efficiency and inefficiency patients in group A were 6,10,7,5 cases,in group B were 3,8,7,4 cases,in group C were 2,7,5,4 cases,there was no significant difference (P ＞0.05).After operation for 6 months,the apnea hyponea index (AHI) and the scores of ESS in group A,B,C were significantly lower than those before operation [(10.1 ± 2.3) times/h vs.(21.2 ± 2.5) times/h,(6.4 ± 1.0)scores vs.(16.2 ± 1.0) scores,(6.9 ± 1.3) times/h vs.(16.0 ± 1.4) times/h,(5.4 ± 1.3) scores vs.(14.5 ±1.5) scores,(7.7 ± 1.8) times/h vs.(16.0 ± 2.1) times/h,(4.1 ± 1.0) scores vs.(12.3 ± 1.9) scores],thelevel of LSaO2 was significantly higher (0.885 ±0.035 vs.0.737 ±0.030,0.871 ±0.046 vs.0.763 ±0.033,0.901 ±0.029 vs.0.820 ±0.034),there was significant difference (P ＜0.01),but there was no significant difference among 3 groups (P ＞ 0.05).After operation for 6 months,the pharyngomaxillary space,distance between uvula and posterior wall of pharynx,distance between anterior pillars in group A,B,C were significantly increased compared with those before operation [(24.6 ± 0.9) mm vs.(12.3 ± 1.2)mm,(11.6 ±1.2) mm vs.(5.4 ± 0.6) mm,(34.9 ± 1.2) mm vs.(28.3 ± 1.0) mm,(24.0 ± 0.8) mm vs.(14.3 ± 1.0) mm,(11.8 ± 0.8) mm vs.(6.3 ± 0.4) mm,(38.3 ± 0.8) mm vs.(31.9 ± 1.9) mm,(23.6 ± 1.4) mm vs.(19.9 ±1.1) mm,(7.3 ± 0.5) mm vs.(6.8 ± 0.6) mm,(38.5 ± 0.8) mm vs.(35.2 ± 1.0) mm],the length of soft palate was decreased [(31.9±0.9) mm vs.(38.3 ±0.9) mm,(25.6 ± 1.0) mm vs.(35.6 ± 1.2) mm,(29.9 ± 1.3) mm vs.(34.9 ±0.9) mtm],there was significant difference (P ＜0.01),but there was no significant difference among 3 groups (P ＞ 0.05).Conclusions H-UPPP combined with coblation on treatment of type Ⅱ mild and moderate OSAHS is effective and safe.According to the clinical characteristics of the patients to select suitable method is the key to get a satisfactory curative effect.

Objective To summarize the experience in prevention and treatment of iatrogenic bile duct injury Methods Clinical data of 112 cases with iatrogenic bile duct injury in ten hospitals of Songhua river drainage area from January 1978 to January 2003 were analyzed retrospectively Results The main cause of iatrogenic bile duct injury was wrong identifying the anatomy of the Calot′s triangle before cholecystectomy accounting for 55 4% (62/112) Diagnosis depended on clinical features, celiac puncture and imaging examination Ultrasonography was among the most sensitive diagnostic means (diagnostic rate=97 5%) Six types of injury were identified according to their locations and type Ⅲ damage was most common in clinical practice (92/112) The curative rate in this group was 95 5% (107/112) Eighty seven cases (77 7%) underwent Roux en Y choledochojejunostomy, with cure rate of 94 3%(82/87) Conclusion Iatrogenic bile duct injury prevention lies in identifing the topography of extrahepatic bile ducts Roux en Y choledochojejunostomy is usually the therapy of choice

To reduce recurrence in the patients with bladder cancer after tumor removal through open surgery or transurethral resection, a form of gelatin-adriamycin sustained drug release system was developed and its release kinetics both in vitro and in vivo, its efficacy in inhibiting BIU-87 bladder tumor cell growth in vitro and its safety in vivo were studied. The results showed that this system controlled adriamycin release over a period of 21 days in vitro and significantly inhibited BIU-87 cell growth. When this system was injected into rabbit bladder, it sustained adriamycin release for 12 days and the released drug could diffuse 1 cm around the injection point. No major complications were observed except minor acute nonspecific cystitis that could be tolerated well by the animals. This study suggests the possibility of applying this system locally in treating bladder cancer.

To reduce recurrence in the patients with bladder cancer after tumor removal through open surgery or transurethral resection, a form of gelatin-adriamycin sustained drug release system was developed and its release kinetics both in vitro and in vivo, its efficacy in inhibiting BIU-87 bladder tumor cell growth in vitro and its safety in vivo were studied. The results showed that this system controlled adriamycin release over a period of 21 days in vitro and significantly inhibited BIU-87 cell growth. When this system was injected into rabbit bladder, it sustained adriamycin release for 12 days and the released drug could diffuse 1 cm around the injection point. No major complications were observed except minor acute nonspecific cystitis that could be tolerated well by the animals. This study suggests the possibility of applying this system locally in treating bladder cancer.