[ABSTRACT]OBJECTIVETo compare the differences of aerodynamic characteristics of pharyngeal cavity between normal subjects and OSAHS patients, and to study the nasal obstruction in the pathogenesis of the OSAHS.METHODSA total of 60 normal subjects and 60 OSAHS patients were enrolled in this study. Numerical simulation was performed to calculate the airflow dynamic indexes of three sections of pharyngeal cavity. Correlation analysis of the nasal resistance and negative pressure were studied.RESULTSThe average pharyngeal negative pressure and airflow velocity in OSAHS patients were significantly increased than that in normal subjects. The total nasal airway resistance significantly correlated with the average negative pressure of pharyngeal cavity. CONCLUSIONAirflow dynamic indexes of OSAHS patients had significant different pharyngeal aerodynamic characteristics from normal subjects. The increased average negative pressure in pharynx might contribute to the severity of pharyngeal collapse for OSAHS patients. Higher total nasal resistance might play a role in the pathophysiological mechanisms of OSAHS.

Objective To explore the effect of gravitational traction on height change of degenerative disc of New Zealand white rabbit.Methods In order to create intervertebral disc degeneration models, the right front side of the annulus fibrosus of lumbar vertebrae of rabbits were damaged by 16-gauge needle. After confirming the success of modeling, 20 animal models were randomized into 2 groups, 15 of which received a routine gravitational traction using a model of our own design, 30 min per day, for 8 weeks, while the control group received no treatment at all. Radiographic exam were performed in the 2nd, 4th, 6th and 8th week, after intervention and the disc height index percent (DHI%). Results Compared to the baseline, DHI% increased significantly 2 and 4 weeks after gravitational traction (P<0.05), and there was no further effect as the traction continued. However, compared to the control group, an improvement of DHI% was found on all the time points in the gravitational traction group (P<0.001). Conclusion Gravitational traction may delay and inhibit intervertebral disc degeneration by increasing height of degenerated disc of New Zealand white rabbit.

[ABSTRACT]OBJECTIVETo compare the aerodynamic differences before and after nasal cavity ventilation expansion techniques in patients with OSAHS. METHODSA total of 30 adult patients with OSAHS were included in this study. Pre-operative upper airway CT of each subject was acquired. Each subject underwent surgery. Postoperative upper airway CT was obtained at least 3 months later. By means of CFD simulation method, numerical simulation was performed to calculate the airflow dynamic indexes of the upper airway. The pre-and post-operative aerodynamic characteristics were compared. RESULTSAfter operation, post-operative negative pressure nephogram of the nasal cavity indicated more smooth variation of pressure gradient, post-operative velocity nephogram of nasal cavity indicated slower airflow velocity. Proper values of flow field indicated the volume of nasal cavity increased significantly (t=4.025,P<0.01), the total nasal airway resistance decreased significantly (t=-2.065,P<0.01). The total negative pressure of the upper airway decreased significantly (t=-2.659,P<0.01) after operation. However, the proper values of flow field increased in 5 patients. CONCLUSIONNasal cavity ventilation expansion effectively increase the volumes of nasal cavity, improve the nasal ventilation, and reduce the air flow velocity of both nasal cavity and pharynx in OSAHS patients, those reduce the pharyngeal negative pressure and the pharyngeal collapse. However, for patients with its narrowest segment at the velopharyngeal level, operation cannot do anything or even aggravate the pharyngeal collapse. Operation should be performed individually.

[ABSTRACT]OBJECTIVETo evaluate the curative effect of endoscopic sinus surgery from the viewpoint of biomechanics analysis.METHODSWe select one case undergoing nasal endoscopic surgery for chronic sinusitis patients, after half year follow-up and collect preoperative and postoperative spiral CT data to build a numerical model of nasal cavity and paranasal sinuses with computer numerical simulation (CFD) research methods, to explore nasal airflow distribution and flow field characteristics of value changes before and after the operation. Patients undergo subjective assessments: nasal obstruction of VAS score, olfactory VAS score, SNOT-20, objective assessment: Lund Kennedy score, Lund Mackay score, saccharin test time and acquisition clinical efficacy data to verify the credibility of the analysis method is feasible and the results. RESULTSThe nasal resistance after endoscopic sinus surgery in nasal cavity and paranasal sinuses numerical simulation decreased, middle meatus of nose and nasal air flow velocity decreased, the pressure change slightly;nasal threshold region, middle turbinate head end section in maxillary sinus ostium section, after nearly sieve horizontal cross-section average velocity decreased, nasal airflow for the mucosa of the shear stress reduced. The volume of the nasal cavity and the area of the mucosa was increased, the volume ratio was decreased, the subjective and subjective assessment of the patients was improved, and the objective assessment was lighten.CONCLUSIONAerodynamic rules are presented through the calculation of numerical simulation of fluid mechanics which is invisible before. Better understanding of changes in the nasal airflow distribution and the changes of flow field characteristics can be useful to establish nasal endoscopic surgery in numerical analysis of offshore platform,which provides a new research tool for the understanding of the pathophysiology of chronic sinusitis by endoscopic sinus surgery.

HBsAg is one of the oldest diagnostic markers for HBV infection, and serum HBsAg level is associated with HBV cccDNA level in hepatocytes, HBV replication capability, and host immune response. In recent years, with the development of serum HBsAg quantification and the concept of functional cure, HBsAg quantification has been taken more and more seriously in the clinical diagnosis and treatment of HBV infection. This article analyzes the role of serum HBsAg quantification from the aspects of natural disease course of chronic hepatitis B, prediction of response to antiviral therapy, and prediction of drug withdrawal.

OBJECTIVE: To investigate the law of auditory remodeling by studying the Cortical Auditory Evoked Potential in a group of post-lingually deaf adults in the early stage of the cochlear implant use. METHOD: Ten post-lingually deaf adults implanted with PULSAR ci 100 of Medel device ranged from 19 to 52 years old with duration of deafness from 3 months to 23 years.were involved. Their P1-N1-P2 responses to /ba/ at around 60-70 dB SPi and open-set speech recognition scores of mono-syllabic words were recorded at 1. 3 and 6 months after the switch-on of cochlear implants. RESULT: Six out of 10 typical waveforms of Pl-N1-P2 were obtained. The other I were with atypical waveforms. The group with atypical waveform was characterized by long duration and early onset of deafness. There was no significant difference regarding either the amplitude or the latency of each peak at the 3 data collection time points. There was significant difference among the 3 data collection time points about the speech recognition scores with the highest score at the 6th month of switch on. There was no significant correlation between the peak of the CAEP and speech recognition score. CONCLUSION In the first 6 months of cochlear implant use in the post-lingually deaf adults, the duration and the onset age of deafness played important role in respect of the presence and waveform morphology of the CAEPs. It needs at least 6 months for the central auditory system to make use of the audio input from the cochlear implant.
Adult ; Cochlear Implantation ; Cochlear Implants ; Evoked Potentials, Auditory ; Female ; Hearing Loss, Sensorineural ; physiopathology ; rehabilitation ; Humans ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVE: Analyzing the prognostic factors in endoscopic surgery of juvenile nasopharyngeal angiofibromas (JNA). METHOD: Forty-seven records of JNA, treated with the endoscopic, from 2002 to 2008 were reviewed retrospectively. Previous surgery in other hospitals, sites involved, whether selective embolization was performed before surgery, feeding vessels, operative techniques and follow-up results were recorded. Evaluated factors include previous surgery for resection of JNA, vascular supply from carotid artery, surgery after selective embolization, involvement of cavernous bone in the root of pterygoid process, greater wing of sphenoid bone, interpterygoid fossa, infratemporal fossa and orbit. Chi-square test was used. RESULT: Operations were done under general anesthesia. The follow-up time was 12 to 87 month (median 35 month). During follow up, six patients presented recurrent lesions. Chi-square test showed that deep invasion of the cavernous bone in the root of pterygoid process was related to recurrence (P<0.05). There was no statistically significant difference between other factors and recurrence. Imaging examination showed that recurrent tumor was around the root of pterygoid process. CONCLUSION Deep invasion of the cavernous bone in the root of pterygoid process which was related to recurrence deserve close attention before and after endoscopic surgery.
Adolescent ; Adult ; Angiofibroma ; diagnosis ; pathology ; surgery ; Child ; Endoscopy ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; pathology ; surgery ; Prognosis ; Recurrence ; Retrospective Studies ; Treatment Outcome ; Young Adult

BACKGROUNDQuantitative dynamic contrast enhancement MR imaging (DCE-MRI), used to measure properties of tissue microvasculature and tumor angiogenesis, is a promising method for distinguishing benign and malignant tumors and characterizing tumor response to antiangiogenic treatment. The aim of this study was to assess the feasibility of quantitative parameters derived from clinically used DCE-MRI for distinguishing benign from malignant tumors in the sinonasal area, which may be potentially useful for prediction and monitoring of treatment response to chemoradiotherapy of sinonasal tumors.

METHODSOne hundred and forty-three patients with sinonasal tumors, including 78 malignant tumors and 65 benign tumors and tumor-like lesions, underwent clinically used DCE-MRI. Parametric maps were obtained for quantitative parameters including K(trans), kep and ve. Two radiologists reviewed these maps and measured K(trans), kep and ve in the tumor tissue. Data were analyzed using independent T-test or Mann-Whitney U test analysis and receiver operating characteristic curves.

RESULTSK(trans), kep and ve showed significant differences between benign and malignant tumors in the sinonasal area (P = 0.000 1). The accuracy of K(trans), kep and ve in differentiation between benign and malignant sinonasal tumors were 72.0%, 76.2% and 67.1%, respectively. There were significant differences in kep and ve between malignant epithelial sinonasal tumors and lymphomas (P < 0.05). Using a ve value of 0.213 as the threshold value differentiated malignant epithelial tumors from lymphomas with an accuracy of 78.3%, sensitivity of 88.2%, specificity of 68.0%, positive predictive value of 66.7%, and negative predictive value of 90.9%. However, no significant difference in K(trans) and kep was found between malignant epithelial and non-epithelial tumors in the sinonasal area (P > 0.05).

CONCLUSIONSIt is feasible that quantitative parameters of tumors can be derived from clinically used DCE-MRI in the sinonasal region. Preliminary findings suggest an increased value for quantitative DCE-MRI in the evaluation of sinonasal tumors in clinical practice.

Contrast Media ; Female ; Humans ; Image Enhancement ; methods ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Paranasal Sinus Neoplasms ; diagnosis