Objective To evaluate the analgesic efficiency and safety of patient-controlled intravenous analgesia ( PCIA) with both flurbiprofen and sufentanil after Han-uvulopalatopharyngoplasty ( H-UPPP) surgery. Methods Patients undergoing H-UPPP surgery ( n=60 ) were randomly divided into four groups with 15 cases in each group .They received PCIA after operation with a loading dose of 2 ml, lockout time of 15 minutes, background infusion rate of 2 ml/h and liquid volume of 100 ml.The PCIA formulation in each group was as follows:sufentanil 3.0 μg/h in group A;sufentanil 3.0 μg/h+flurbiprofen 4.0 mg/h in group B;sufentanil 2.0μg/h+flurbiprofen 4.0 mg/h in group C;sufentanil 1.0μg/h+flurbiprofen 4.0 mg/h in group D.The visual analogue scale (VAS) and Ramsay sedation scale were recorded at 2, 6, 12, 24, and 48 h after surgery (T1 -T5 time points).Patient pressing times and the adverse effects within 48 h after surgery were counted . Results The VAS scores of the group D were higher than those in the other three groups at T1 and T2 time points (P<0.05).The Ramsay scores of the group D were lower than those in the other three groups at T1 and T2 time points (P<0.05).The numbers of pressing times in the group D were more than those in the other three groups (P<0.05). Conclusion PCIA with both flurbiprofen 4.0 mg/h and sufentanil 2.0 μg/h is effective for postoperative analgesia after H-UPPP.

Objective:To study the effect of chemokines CCL20 and CCL22 combined with skin-induced Treg on survival time of grafted skin.Methods: Skin grafting mice were divided into four groups, three mice per group, namely Treg group, Treg+CCL20 group,Treg+CCL22 group and control group.C57BL/6 mice were used as donor and BALB/c as acceptor, and the Treg cells were isolated from the mice induced by skin allograft.After skin grafted,CCL20 and CCL22 were subcutaneous injection every day,which lasted for 10 day.Survival time of skin in each group were observed and recorded.The Treg colonzation experiments were performed as follows.We firstly isolated Treg with Magnetic cell sorting system( MACS) and then labled them with 99 Tcm.After that we intravenously injected them into the mice.3 hours later,the mice were sacrifced and the radioactivity of organs were detected by GC-2016γradioim-munoassay counter.Results:①After Treg treated the survival time of skin grafted in antigen-induced Treg group was signifiantly longer than control group,when treg were cooperated with CCL20 and CCL22,the skin grafted showed more longer survival time than Treg and control groups( P<0.001 ).②After injection of induced Treg, Treg in autologous and allogeneic skin grafts goups were mainly distributed in autologous and allogeneic skin,accounting for 60% and 98% respectively.When cooperated with CCL20 or CCL22,the Treg were mainly distributed in liver.Conclusion:Chemokines CCL20 and CCL22 synergistically improved the effects of skin antigen induced Treg on survival time of skin graft,which probably related with the Treg colonization into the liver.

Objective:To investigate the chemokine receptors expression on regulatory T cells induced by different antigens and chemotaxis of T cells conducted by CCL20 and CCL22.Methods:BALB/c mice were divided into different groups and inoculated with skin-antigen derived from C57BL/6 mice or BCG vaccine respectively.The changes of CCR4 and CCR6 expression on CD4+CD25-T cells and CD4+CD25+CD127-T cells were detected at 1st,2nd,3rd and 4th week using flow cytometer.The chemotactic effects of CCL20 and CCL22 on CD4+CD25-T cells and CD4+CD25+CD127-T cells subsets were assayed by chemotaxis assay.Results: ①In skin-antigen group,the average fluorescence intensity ( MFI) of CCR4 on CD4+CD25-T cells at 4 week was significantly stronger than that at 3 week (P<0.05).There were no significant changes of CCR4 expression in BCG group.②The MFI of CCR6 on CD4+CD25-T cells was strongest at 2 week in skin-antigen group (P<0.05) while in other groups at 4th week (P<0.05).Besides,the expression of CCR6 on CD4+CD25+CD127-T cells was stronger during the first two weeks than the later two weeks ( P<0.05) in skin-antigen group, while in BCG group,the MFI was stronger at 2nd and 4th week than 1st week (P<0.05).③The chemotactic index of CD4+CD25+CD127-T cells was highest at 4th week in BCG group (P<0.05) in CCL20 induced chemotaxis,while in other groups were higher at 2nd and 4th week(P<0.05).In CCL22 induced chemotaxis ,there were no significantly differences of chemotactic index of CD4+CD25+CD127-T cells between skin-antigen group and BCG group.Conclusion:①The expression of chemokine receptor on the surface of Treg was associated with antigenic properties.②CCL22 had a notable chemotactic effect on Treg at the early stage of post-induction, while CCL20 did that at the late stage of post-induction.

Objective To investigate the epidemiological and molecular virological characteristics in HBV-infected patients with copositive HBsAg and anti-HBs.Methods HBV serological markers were analyzed in 52 070 specimens.The epidemiological characteristics of HBsAg and anti-HBs simultaneously positive patients (the experimental group) and HBsAg positive and auti-HBs negative patients (the control group) were compared.The S protein of HBV coding region was amplified by semi-nested PCR and sequenced.The statistical differences between the two groups were compared in different gene regions,genotypes and different clinical diagnosis.Results HBsAg was positive in 20.40％ (10 621/52 070) of all specimens.In the patients with positive HBsAg,2.48％ (263/10 621) was positive anti-HBs.The prevalence of co-positive HBsAg and auti-HBs was higher in aged 0 to 9 years and greater than or equal to 80 years than that in other age,and the prevalence of positive HBsAg and negative anti-HBs was completely opposite.The mutation rate of S protein in the experimental group was significantly higher than that in the control group (1.52％ vs 0.81％,P ＜0.01) with the mutation in the major hydrophilic region (MHR) (1.68％ vs 0.57％,P ＜0.01).The mutation rates of S protein of HBV carriers,chronic hepatitis B (CHB) patients and patients with liver cirrhosis (LC) in the experimental group were significantly higher than those in the control group (1.47％ vs 0.65％,1.28％ vs 0.84％,2.21％ vs 0.44％,P ＜0.05,respectively),except for the patients with hepatocellular carcinoma (HCC) (1.97％ vs 2.21％,P ＞ 0.05).Conclusion Co-positive HBsAg and anti-HBs in HBV-infected patients was more common in HBsAg positive patients aged 0 to 9 years and greater than or equal to 80 years than the others.Coexistence of HBsAg and anti-HBs in HBV-infected patients may relate to immune escape caused by mutation of S protein (mainly MHR).The mutation rates of S protein in the two groups of patients,co-positive HBsAg and anti-HBs and the positive HBsAg combined with negative anti-HBs,were associated with the stage of liver disease.

OBJECTIVE: To observe the histopathologic and morphological changes of palatopharyngeal soft tissues in patients with different degrees of obstructive sleep apnea hypopnea syndrome (OSAHS) patients. METHOD: Thirty-eight male OSAHS patients were divided into 3 groups according to AHI, namely mild group (n = 10), moderate group (n = 13),and severe group (n = 15). The soft palate tissues with partial palatopharyngeal arch and palatoglossal arch tissues were obtained from surgery and processed with conventional paraffin embedding. The sections were stained by HE and observed under a light microscope. The histological quantitative changes of the specimens were measured by analyzing the constituent ratios of glandular tissue, fat tissue and interstitial elements. Statistical analysis was performed. RESULT: 1) Optical microscope showed that (100 times), as the aggravation of the OSAHS, the soft palate squamous epithelial cells are swollen and irregular, exhibiting hyperkeratosis, accompanied by liquefied degeneration of basal cell; The mucous membrane and submucosal connective tissue contain a certain number of lymphocytes infiltration. The mucosa and submucosal layer of loose connective tissue contain inflammatory cells and a lot of fat vacuoles can be observed; The soft palate mucous acini have inconsistent and irregular shape, among which there are a certain amount of fat cells infiltration. Some mucous acini are replaced by serous acini with dark stained cytoplasm; The palatoglossal muscle and palatopharyngeus muscle fibers can't be identified with disordered arrangement of structure, showing pleomorphic changes including swelling, atrophy and degeneration. Some of elastic fibers were disrupted and a lot of fat cells infiltration was observed. (2) The constituent ratios of the three kinds of tissues in soft palate from different degrees of OSAHS patients show that quantitative changes of glandular tissue and interstitial elements among the mild, moderate and severe OSAHS group patients exhibit statistically significant differences (P < 0.05). The constituent ratio of vascular components between mild and severe groups and that between moderate and severe groups exhibit statistically significant differences (P < 0.05). The constituent ratio changes of vascular components between mild and moderate groups show no statistically significant difference (P > 0.05). CONCLUSION With the rising of severity of OSAHS, the soft palate squamous epithelial cells are swollen and irregular, exhibiting hyperkeratosis. Between acinar cell we could see a certain amount of fat cells infiltration. Some mucous acini are replaced by serous acini. Muscle fibers of palatopharyngeal tissue have pleomorphic changes of swelling, atrophy and degeneration.
Adult ; Humans ; Male ; Middle Aged ; Palate, Soft ; pathology ; Pharyngeal Muscles ; pathology ; Sleep Apnea, Obstructive ; classification ; pathology

Objective To investigate the application value of local anesthesia with lidocaine carbonate and tetracaine in the prevention of tracheal intubation and extubation response in nasal endoscopy. Methods From January 2016 to March 2017, 90 patients scheduled for endoscopic sinus surgery were randomly divided into 3 groups,with 30 cases in each group.Before endotracheal intubation,1%tetracaine was used for endotracheal surface anesthesia,and air was filled into tracheal intubation airbag(group T). The intratracheal surface was sprayed with physiological saline and 1.73%lidocaine carbonate was filled into tracheal intubation airbag (group C).The 1%tetracaine was used for endotracheal surface anesthesia,and 1.73%lidocaine carbonate was filled into tracheal intubation airbag(group TC).The mean artery pressure(MAP)and heart race(HR)were recorded before induction(T1), immediately after intubation(T2),immediately after extubation(T3),and 5 min after extubation(T4).The scoring of cough during extubation was recorded.Sore throat scores were recorded by using Visual Analogue Scale(VAS)at 30 min,1 h,2 h,6 h and 24 h after extubation,respectively. Results The MAP and HR were less in the group T and TC than those in the group C at T 2(F=8.384,P=0.000;F=6.154,P=0.003), less in the group C and TC than in the group T at T 3(F=14.112, P=0.000; F=3.514,P=0.034).The cough scores were the lowest in the group TC(0.9 ±0.7), median in the group C(1.3 ±0.7), and the highest in the group T(1.7 ±0.5)(F=10.307, P=0.000).The VAS scores of pharyngalgia were the lowest in the group TC (2.1 ±0.8),median in the group C(3.0 ±1.2),and the highest in the group T(3.8 ±1.3)(F=17.961,P=0.000)at 30 min after surgery,and lower in the group TC(1.8 ±0.7)than in the group T(2.5 ±1.0)(F=5.058,P=0.008)at 1 h after surgery.Conclusion Local anesthesia combined with lidocaine carbonate and tetracaine can effectively reduce the cardiovascular response of endotracheal intubation and extubation and relieve the incidence of postoperative cough and sore throat.