OBJECTIVE To investigate the value of rigid bronchoscope combined with fiber bronchoscope application in children with airway obstruction.METHODS Retrospective analysis of 176 cases children with airway obstruction from January 1, 2006 to January1, 2016, all patients were diagnosised and treated in our hospital. RESULTS All children were acceptted rigid bronchoscopy combined with fiber bronchoscope under general anesthesia, then received the different thrapy according to the different causes. 104 patients with airway foreign body were all obtained satisfactory effect, 2 cases of children with bronchial foreign body(cap) inspection, failed to remove and contact thoracic surgery doctors to remove the foreign body by thoracotomy. 10 plastic bronchitis patients improved after treatment or cured. 7 cases of bronchial tuberculosis were cured after treatment. 4 patients with airway tumor after minimally invasive surgery, obtained good effect, 2 cases were turned to the other cancer hospital. 2 cases of patients with tracheal stenosis, the symptom is reduced after expansion. Bronchial granulation, tracheomalacia, bronchial softening, bronchial atresia patients improved after treatment. This group of all patients with pneumonia were cured after symptomatic treatment.CONCLUSION Rigid bronchoscopy and fiber bronchoscope are both useful for diagnosis and treatment of children with airway obstruction, both have its advantages and disadvantages, combined application can improve the accuracy of disease diagnosis and timely intervention on the patients.

AIM: The purpose of this study was to investigate the expression of myristoylated alanine-rich C kinase substrate (MARCKS) and p-MARCKS during cerebral ischemia. METHODS: The multi-cerebral infarction model was established by method of Kaneko. The stroke symptoms and signs scoring system were used to evaluate the animal model. Microscope and electronic microscope were used to watch the structure of rat brain. The expression of MARCKS and p-MARCKS was measured by Western blotting. The expression pattern of these proteins was further analyzed for their distribution at cellular level by immunohistochemistry staining of the tissues. RESULTS AND CONCLUSION: The expression of MARCKS and p-MARCKS protein in acute ischemic brain were elevated compared with the normal and control group (P

Objective To investigate the clinical application of the coblation in the treatment of the infant with sleep-disordered breathing. Methods The clinical data were reviewed from 161 infants, who had the cobtilaon tonsillectomy and/or adenoidectomy sugeries in our hospital from January , 2008 to June, 2012. Among the 161 SDB cases, there were 85 obstructive sleep apnea hypopnea syndrom cases and 76 primary snoring cases. After 12 months, the follow-up visit is cut off in January, 2013. Successful follow-ups had been done to 161 infant with SDB. And the clinical efficacy and the occurrence of the complications were investigated. Results the intra-operative blood loss was 10 mL or less. 2(1.24%) were delayed hemorrhage with less pain afteroperation. One year after the surgery, there were 141 cured (87.6%), 15 with apparent effects (9.3%), 3 with effective results (1.9%), 2 with no effect(1.2%)and the total effective rate is 98.8%. Conclusion It is minimally invasive, safe and effective to use coblation to remove tonsil and adenoid in the treatment of infants with sleep-disordered breathing.

OBJECTIVE To study the relationship between the level of high sensitive C-reactive protein (hs-CRP)and obstructive sleep apnea/hypopnea syndrome(OSAHS)in children. METHODS Between 2008 and 2009, 30 children who were diagnosed OSAHS, were enrolled in OSAHS group. Thirty children with a history of chronic tonsillitis made up chronic tonsillitis group. Thirty children(27 children were diagnosed accessory auricle and 3 children with laryngeal web)consisted of the control group. The three groups were matched by age, sex and BMI. Children in OSAHS group underwent overnight polysomnography monitoring in our medicine sleep center. Samples for plasma hs-CRP level were collected in the morning. RESULTS 1. The difference of plasma hs-CRP level among three groups was not significant (?2=0.179,P=0.914). 2. Plasma hs-CRP level did not correlated with AHI, BMI and lowest saturation of blood oxygen(rs=0.343, 0.104 and-0.062; P=0.064, 0.584, and 0.747, respectively). CONCLUSION Higher hs-CRP values were not observed in children with OSAHS. There are no correlation between hs-CRP and AHI, BMI and lowest saturation of blood oxygen.

Objective To explore the characteristics of auditory brainstem response(ABR) in children with otitis media with effusion(OME) before and after myringotomy with grommet insertion and the significance of ABR in diagnosing OME.Methods ABR were recorded in 50 cases(100 ears) before receiving myringotomy with grommet insertion for OME,30 cases(60 ears) underwent ABR monitoring after surgery again.For comparison,50 age-matched healthy children(100 ears) were also tested with ABR.Furthermore,30 cases were divided into two groups according to the viscidity of tympanic cavity secretion and the response threshold of wave Ⅴ were compared between the two groups.Results The response threshold of wave Ⅴand the peak latency of wave Ⅰwere normal in 13 percent of 50 cases(100 ears) before surgery.The rate of missed diagnosis was 13%.Among 50 cases,41% had normal response threshold for wave Ⅴ,52% had slight abnormal responses of thresholds of wave Ⅴ and 7% had medium response threshold of wave Ⅴ.The peak latency of wavs Ⅰwas normal in 19% OME children,but it prolonged in 72% OME children and absent in 9% OME children.The prolonged peak latencies(waves Ⅰ,Ⅲ andⅤ) and eleveted response thresholds of wave Ⅴ and shorted transmission time between waves(Ⅰ-Ⅲ andⅠ-Ⅴ) significant when compared to the control group.After surgery,the response thresholds of wave Ⅴand the peak latency of wave Ⅰwere normal in 46.7% children,the response threshold of wave Ⅴ were normal in 70.5% and slight abnormal in 29.5%.Occuring(elicit) rate of wave Ⅰwas 100% and peak latency of wave Ⅰwas normal in 50.2% chilren.The differrence of peak latencies(waves Ⅰ,Ⅲ andⅤ) and the response threshold of wave Ⅴ before surgery

OBJECTIVE This study was conducted to analyze the underlying bacterial pathogens of the tonsils and adenoids in children with sleep-disordered breathing(SDB).METHODS The core tissue from the tonsils and/or adenoids of 163 SDB children was cultured aerobically. Of the 163 cases, 120 children underwent adenoidectomy and tonsillectomy simultaneously(A+T), 39 children underwent adenoidectomy(A) and 4 tonsillectom(T) only. 124 children who underwent tonsillectomy were subdivided into two groups based on history(with or without a history of recurrent tonsillitis). 71 children with the history were enrolled in the 'recurrent tonsillitis group' and 53 children without the history were enrolled in 'non- recurrent tonsillitis group'.RESULTS Of the total 120 cases who underwent A+T, 114(95.00%) cases had same distribution of bacteria detected in both sides in the same patient. Besides this, 17 cases in whom mixed organisms were identified in both sites shared common pathogen. No significant difference in the detection rates of staphylococcus aureus and haemophilus influenzae were found when we compared seasons(Tonsil:χ2=8.538,P=0.201; Adenoid:χ2=5.427, P=0.490). No significant difference in the type and detection rate of essential bacteria was found when we compared between recurrent tonsillitis group and 'non-recurrent tonsillitis group' (χ2=3.028,P=0.387).CONCLUSION The bacterial isolates from the tonsils and adenoids are virtually identical in type and detection rate in the same SDB patient. The bacterial distribution of the tonsillar and adenoidal core is unaffected by the seasonal variation and history of recurrent tonsillitis.

Objective:To compare low temperature coblation assisted tonsillectomy with conventional dissec-tion tonsillectomy intraoperation and afteroperation. Method:Ninty-two pedia-patients were randomly divided into coblation-assisted tonsillectomy group and the control group. Arthrocare EVac 70 T&.A Wand was used for cobla-tion-assisted tonsillectomy, and the energy set was 7. Conventional dissection tonsillectomy was operated in control group. The operating time,bleeding,tonsillar fossae healing and return to normal diet and activities, intraoperative complications were recorded seperately. Postoperative pain of the pedia-patients was recorded daily using Wong Baker FACES pain scale for 10 days of afteroperation. Result: Coblation assisted group had a shorter operative time than the control group (10. 2min vs. 36. 5min, P<0. 001). The average amount of intraoperative bleeding of Coblation assisted group was(6. 83±3. 36) ml, while the control group was(30. 07±7. 04)ml. Pedia-patients of Coblation group had a better pain score on 1, 2, 3 days after operation than in control group, and there was no statistically significant difference on 4 to 10 days between the two groups. Coblation group ones returned to normal diet earlier than the control group, but both group required similar time returned to normal activities. There was one patient in control group, who required suturing to stop bleeding for active oropharyngeal bleeding on the 6th day after operation. Conclusion: Comparing with traditional dissection, Coblation assisted tonsillectomy is easy to perform with less intraoperative bleeding,shorter operation time,earlier return to normal diet, less pain on 1st to 3th day postoperatively.

Objective To evaluate the efficacy of eszopiclone for patients with acute insomnia and the impact of premedication with eszopiclone on sleep structure of patients with acute insomnia.Methods In an open-label,self-control trial was conducted at Changzheng Hospital Sleep Centers,and patients (n =32) with acute insomnia (12 men,20 women; mean age,36.2 years) were administered eszopiclone 3 mg for three consecutive nights.Sleep was monitored via polysomnography.The insomnia severity index (ISI),and mini-mental state examination (MMSE) were used to assess the degree of insomnia and impact of drugs on cognitive function during the day.Results Eszopiclone can shorten sleep latency ( before treatment:(52.92 ± 11.71 ) min,after treatment:(28.2 ± 10.11 ) min; t =-4.376,P ＜0.01 ),prolong total sleep time(before treatment:(365.22 ±30.13) min,after treatment:(429.18 ±26.93 ) min; t =4.102,P ＜ 0.01 ),decrease wake up times( before treatment:( 5.00 ± 1.92 ) times,after treatment:( 2.73 ± 0.91 )times; t =- 4.592,P ＜ 0.01 ),improve sleep efficiency ( before treatment:72.69％ ± 6.32％,after treatment:82.67％ ± 4.16％ ; t =3.371,P ＜ 0.01 ),reduce awake time ( before treatment:( 88.51 ±17.48) min,after treatment:(65.93 ±21.l0)min; t =-4.592,P ＜0.01 ),decrease light sleep ( NREM1 period) the percentage of time ( before treatment:12.54％ ± 2.10％,after treatment:7.30％ ± 2.90％ ;t=-3.155,P ＜ 0.01 ),and increase the percentage of slow wave sleep (before treatment:8.03％ ±5.37％,after treatment:9.31％ ±5.29％; t =4.228,P ＜0.01).No effect was observed on the percentage of NERM2 period (t =0.731,P ＞0.05) and REM period (t =-0.813,P ＞0.05).Eszopiclone can improve the quality of subjective assessment of sleep ( ISI score decreased,t =- 2.551,P ＜ 0.05) and has no significant effect on cognitive function on first the morning after patients taking the medication.Conclusion Eszopiclone can positively regulate the sleep structure in patients with acute insomnia and improve subjective assessment of sleep quality.It is safe and has no significant effect on cognitive function.

0.05). CONCLUSION Obesity was an influential factor of snoring. The PS and OSAHS have the same effect on children growth and their clinical features.

Objective To investigate the microRNAs expression profile in human colorectal cancer with or without liver metastasis and try to screen miRNA associated with liver metastasis in colorectal cancer. Methods Twenty five surgical resected colorectal cancer specimens were collected and frozen in liquid nitrogen. Three without liver metastasis and three with liver metastasis were selected, from which total RNAs were isolated. The expressions of miRNAs in these two types of specimens were detected by illumine microRNA microarray, and the difference of miRNA expression was screened. The biochip results were verified with real-time RT-PCR in all colorectal caner specimens. Results The miRNA expression was significantly different in colorectal cancer with liver metastasis and without liver metastasis. Compared with colorectal cancer without liver metastasis, 28 miRNA expressions was different in colorectal cancer with liver metastasis, 4 up regulated and 24 down regulated. The quantity of miR-139-3p expression in colorectal cancer with liver metastasis was 1.75±0.40, up regulated compared with that incolorectal cancer without liver metastasis(0. 69 ±0.58,P＜0.05). The quantity of miR-19a expression in liver metastasis was 0. 39±0. 20, downregulated compare with no liver metastasis( 1.38 ± 0.98, P＜0. 05). The result of miRNA biochip was consistent with that of RT-PCR. Conclusion The difference of miRNA expression might relate to liver metastasis of colorectal cancer. The specific miRNAs expression profile might provide new target for diagnosis and treatment of colorectal cancer with liver metastasis.