Objective To investigate the influences of Bi-level positive airway pressure(BiPAP)to night-time hy- poxemia and change of sleep structure in the patients with overlap syndrome(OS).Methods 25 patients with OS,19 with primary snoring(PS)were monitored and diagnosed by nocturnal polysomnography(PSG)for parameters of sleep efficiency(SE)and sleep architecture.The data of patients with OS were rechecked after 2-month's BiPAP treatment. Results In OS group,the level of FEV1%,FEV1/FVC,SaO2 A,SaO2 L,SE,REM and S3+4 were significantly lower than those in PS(P

OBJECTIVETo explore the incidence, degree, and pattern of rib cartilage calcification in congenital microtia patients, in order to provide reference for harvesting the rib cartilage, sculpturing cartilage framework.

METHODSFrom Jun. 2013 to Nov. 2014, 383 patients (age range, 6-45 years) underwent CT scans of the chest. 11 patients with bony diseases or traumatic history were excluded. The remaining 372 patients were divided by age into four groups as 6-15, 16-25, 26-35, 36-45 years old. Twenty patients (10 male and 10 female) were selected by the order of patient identification number in each age group, thus selecting a total of 80 patients (40 male and 40 female). Retrospective study of CT scans of the chest in 80 patients and the incidence, degree, and pattern of cartilage calcification of the sixth to eighth ribs were noted. A chi-square test is conducted to test whether there are significant difference between the variables through the SPSS 19.0 software.

RESULTSOverall, 40.4% (194/480) cartilage was calcified; female patients (47.50%, 114/240) showed higher frequency of calcification than male patients (33.33%, 80/240, P = 0. 025). Calcification rates of all age groups are 1.7% (2/120), 46.7% (56/ 120), 49.2% (59/120), 64.2% (77/120). Calcification rate of 6-15 years group is lowest in all groups (P < 0.05) while other three groups have no statistical significance (P > 0.05). Calcification rates of the sixth and sevent rib cartilage were higher than those of the eighth rib cartilage in all age groups except 6-15 years group, who had a similar rate of all three ribs. Calcification rate of all three rib cartilage was significantly increased with age. Calcification rates of the amle's rib cartilage and the female's in all age groups are 3.3% (2/60) and 0.0% (0/60) (6-15 years): 33.3% (20/60) and 60.0% (36/60) (16-25 years): 40.0% (24/60) and 58.3% (35/60) (26-35 years), 56.7% (34/60) and 71.2% (43/60) (36-45 years). In 6-15 years group calcification rates of male and female had a similar rate, while female's rates were higher than male's rates in other three groups. Male and females mainly had the granular type of calcification [70.0% (56/80), 63.2% (72/114)].

CONCLUSIONSFemales who are over 16 years old should pay more attention to the possibility of middle-severe calcification before harvesting rib cartilage. These patients should take CT examination if necessary. In addition, the patients who had previous operation, or traumatic history, rib deformity, or spine deformity should select the CT examination.

Adolescent ; Adult ; Age Factors ; Calcinosis ; diagnostic imaging ; epidemiology ; Cartilage Diseases ; diagnostic imaging ; epidemiology ; Child ; Congenital Microtia ; Costal Cartilage ; diagnostic imaging ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Retrospective Studies ; Sex Factors ; Tomography, X-Ray Computed

AIM: To investigate the role of fluoxetine in the hippocampal synaptic plasticity in chronic unpre-dictable mild stress (CUMS) depression rats and its effect on mTOR and autophagy signaling pathways.METHODS:Male Sprague-Dawley rats (n =60) were randomly divided into normal control group, CUMS group and fluoxetine group. The CUMS rat model was established through CUMS combined with solitary raising, and fluoxetine (20 mg? kg -1? d -1 ) was administered via intragastric gavage.The changes of body weight, the ratio of sugar intake and the results of the behav-ioral test were recorded to identify the modeling.Moreover, the expression of synaptic plasticity-related proteins glial fibril-lary acidic protein (GFAP) and synaptophysin (SYP), apoptosis-related proteins Bcl-2 and caspase-3, mTOR signaling proteins mTOR and 4EBP1, and autophagy-related proteins beclin 1 and LC3 were examined by RT-PCR and Western blot. RESULTS: Compared with control group, the body weight, sucrose intake, and total distance and intermediate residence time in the open field test were significantly decreased in CUMS group.The results of RT-PCR and Western blotting showed that the mRNA and protein levels of SYP and GFAP in CUMS group were significantly down-regulated compared with con-trol group.The expression of Bcl-2 in CUMS group was downregulated, while the protein level of cleaved caspase-3 in-creased.Decreased phosphorylation levels of mTOR and its downstream target molecule 4EBP1 were observed in CUMS group.Besides, the autophagy-related proteins beclin 1 and LC3 were significantly upregulated at mRNA and protein lev-els.All these results(upregulation or downregulation) were attenuated by the treatment with fluoxetine, and the difference was statistically significant.CONCLUSION: Fluoxetine might improve hippocampal synaptic plasticity and alleviate symp-toms of depression by supressing apoptosis/autophagy signaling pathways and upregulating mTOR signaling pathway.

Objective To investigate resident iodine nutrition level in waterborne high iodine areas and prevalence of high iodine goiter in Shanxi Province.Methods In 2014,in Shanxi Province,in all the 10 high iodine counties (cities,districts),the jurisdiction area of each county (city,district) was divided into two blocks,high iodine and not high iodine districts,and in high iodine area of each county (city,area) according to their sub-area positions of east,south,west,north and center,a township was randomly selected (if the number of high iodine area in iodine excessive township ≤5,all townships were selected);four administrative villages in each monitoring township were randomly selected;in each administrative village,the edible salt samples of 15 randomly selected households were collected for detection of iodine content.Five counties (cities,districts) were selected from the province's 10 high iodine counties (cities,districts),water iodine content of 3 counties (cities,districts) was 150-300 μg/L,and 2 were ＞ 300 μg/L,one administrative village was selected from each county (city,area),household drinking water samples were collected to detect iodine content;and 100 elementary school children aged 8-10 were selected from the village where the monitoring stations located in for thyroid volume ultrasound measurement,and 30 of them were randomly selected for urinary iodine content detection.Results ① In the 10 high iodine counties (cities,districts),1 680 households salt samples were detected,and the rate of no iodine salt samples was 89.2％(1 499/1 680).② Fourteen water samples were collected in 5 counties (cities,districts),and the water iodine content was 155.7-467.3 μg/L.③ In the five high iodine counties (cities,districts),197 urine samples were collected from children aged 8 to 10.The median of urinary iodine was 466.5 μg/L;the median urinary iodine was 650.1 μg/L in water iodine≥300 μg/L children group which was significantly higher than that of the group with 150-300 μg/L water iodine content 332.5 μg/L (Z =-6.164,P ＜ 0.05);urinary iodine level of children and the water iodine of the corresponding village was positively correlated (r =0.543,P ＜ 0.05).④ In the five high iodine counties (cities,districts),543 children aged 8-10 were measured with their thyroid volume,the thyroid goiter rate was 6.8％(37/543);the goiter rate of water iodine ≥300 μg/L children group was [9.0％(28/311)] which was significantly higher than that in the iodine content of drinking water 150-300 μg/L group [3.9％(9/232),x2 =5.494,P ＜ 0.05].Conclusion The measurement of stopping iodized salt supply in high iodine areas in Shanxi Province is well implemented,iodine nutrition level and thyroid goiter rate in those areas are still too high,high iodine intervention measures can be focused on changing of the drinking water.

Objective To investigate the nutritional status of iodine among residents and the goiter disease of children in high water iodine areas in Shanxi Province,and to provide a scientific basis for establishment of longlasting control strategies and measures.Methods In 2012,according to the historical monitoring data,in the 10 high water iodine counties (citys,districts),one town was selected based on its location (east,west,south,north and middle) in each county (citie,district).In county (city,district) with 5 townships or less,all townships were selected.Four villages were selected in each township and fifteen residents in each village were selected to test salt iodine level.In five high water iodine counties (city,district),one or two high water iodine villages were selected,water samples were collected and the iodine content was measured; one hundred students aged 8-10 years old were chosen to examine their thyroid size.Thirty children were chosen from above students to collect their urine samples and to determine the iodine content.Results In 10 high water iodine counties (citys,districts),1 680 salt samples were tested.The rate of non-iodized salt was 85.2％ (1 432/1 680); in six villages of five high water iodine counties (citys,districts),the median of urinary iodine of 256 children aged 8 to 10 was 487.2 μg/L; in three villages which had improved the quality of water,the median of urinary iodine was 271.0 μg/L; other three villages which had not improved the quality of water,the median of urinary iodine was 692.6 μg/L.In those villages which had not improved the quality of water,urinary iodine of children ≥300 μg/L accounted for 85.8％ (139/162); in those villages which had improved the quality of water,high urinary iodine of children accounted for 41.5％ (39/94),and the difference was statistically significant (x2 =53.06,P ＜ 0.05).The thyroid was investigated among 591 children aged 8-10 years old,and the goiter rate was 6.6％(39/591).In those villages which had improved the quality of water,the goiter rate of children was 3.8％ (11/291),but in villages which had not improved the quality of water,the goiter rate of children was 9.3％ (28/300),and the difference was statistically significant (x2 =6.52,P ＜ 0.05).Conclusion The iodine nutrition level of residents in high water iodine areas in Shanxi is excessive,children's goiter disease has not been effectively controlled; water improvement to reduce iodine is the basic way to control the disease of high iodine.

Objective: To summarize the current progress of clinical therapy for concha-type microtia. Methods: The domestic and overseas literature about the treatment of concha-type microtia was reviewed and the contents of operative timing, operation selection, and complications were analyzed. Results: The unified therapeutic schedule of the concha-type microtia has not yet been determined due to its complicated various therapeutic methods and unknown etiology. The operation methods commonly used in clinic are partial ear reconstruction with autologous costal cartilage framework and free composite tissue transplantation. The timing of the partial ear reconstruction depends on the development of costal cartilage and children's psychological healthy. The timing of free composite tissue transplantation depends on the severity. It is recommended to perform the operation at about 10 years old for mild patients. For moderate patients, ear cartilage stretching should be performed at 1-2 years old and free composite tissue transplantation would be performed at about 10 years old. The complications of partial ear reconstruction with autologous costal cartilage framework for concha-type microtia mainly include framework exposure, deformation, infection, cartilage absorption, and skin necrosis. The complications of free composite tissue transplantation have not been reported. Conclusion: Etiology and elaborated classifications with individualized treatment are the future research directions.

Objective: To explore the anthropometric changes of the auricle after auricular cartilage unfolding in moderate concha-type microtia patients, so as to provide the basis to help evaluate surgical timing and prognostic. Methods: A total of 33 children with moderate concha-type microtia, who were treated with auricular cartilage unfolding between October 2016 and September 2018 and met the inclusive criteria, were included in the study. There were 24 boys and 9 girls with an average age of 1.4 years (range, 1-3 years). Sixteen cases were left ears and 17 cases were right ears. The follow-up time was 12-23 months (mean, 17.5 months). The affected auricular detailed structures were observed and quantitatively analyzed before operation and at immediate after operation. The width, length, and perimeter of auricle before operation and at immediate after operation and at last follow-up were noted with three dimensional-scanning technology. The normal auricle was noted as control. Results: There were (7.5±1.0) and (11.3±0.8) structures of the affected auricle at pre- and post-operation, respectively, showing significant difference between pre- and post-operation ( t=23.279, P=0.000). The length, width, and perimeter of the affected auricle constantly increased after operation, and there were significant differences between pre-operation and immediately after operation and between immediately after operation and last follow-up ( P<0.05). The differences of length, width, and perimeter of the affected auricle between immediately after operation and last follow-up were (3.13±1.44), (2.44±0.92), and (8.50±3.76) mm, respectively. And the differences of length, width, and perimeter of the normal auricle between pre-operation and last follow-up were (3.16±1.54), (2.35±0.86), and (9.79±4.60) mm, respectively. There was no significant difference in the differences of length, width, and perimeter between the affected auricle and the normal auricle ( P>0.05). Conclusion: The auricular cartilage unfolding in treatment of the moderate concha-type microtia can receive more ear structures and increase auricle sizes, which make it possible for free composite tissue transplantation. In addition, the affected and the contralateral normal auricles have a very similar growth rate and it offers the theoretical foundation for the early treatment for moderate concha-type microtia.

Domestic and overseas studies onthe prominent eartreatment were reviewed and analyzed.Current progress of clinical therapy for prominent ear was summarized.The uniform clinical diagnosis and therapy of prominent earhave not been determined, due to its complicated and various therapeutic methods and unclear etiology. Reported therapies mainly include: (1)surgical therapy, which attains satisfactory therapeutic effect by adopting improved approaches, i. e. the combination of operations or the innovative methods based on Mustarde′s, Sterstrom′s and Converse′s surgical methods. (2)Non-surgical therapy, including ear splinting or molding, and laser-assisted cartilage reshaping(LACR). The non-surgical therapyisa hot research field, and is going to bepopularizedin the future.Research of etiology and non-surgical treatments may be helpful to provide abetter therapy strategy for prominent ear.

Objective: To preliminarily investigate morghological changes of rabbits reshaping ear cartilage assisted by microdissection needle and explore feasibility of new therapy for ear deformity. Methods: The bilateral ears of 5 male New Zealand rabbits (aged, 5-6 months) were fixed maintaining the curvature and randomly divided into 2 groups (5 ears in each group). The ears were stimulated by microdissection needle in experimental group and were not treated with stimulation in control group. The skin reaction in the experimental group was observed immediately and at 4 weeks after stimulation. Then, the fixtures were removed at 4 weeks, and the shapes of the ears were observed. The cartilages were harvested from the ears to examined morphological changes after HE staining, and measured the chondrocyte layer thickness. Results: All rabbits survived until the end of the experiment. The skin has healed completely after 4 weeks in experimental group. After removing fixtures, the ears in the two groups all maintained certain forms momentarily; while 24 hours later, the ears in the control group mostly recovered original form, and the ears in the experimental group still maintained certain molding form until 8 weeks. HE staining showed there were smooth cartilage and uniform distribution of cells in the control group; the matrix staining was basically consistent; and the skin was normal appearance with epidermis, dermis, and cartilage of normal aspect. But the proliferation of chondrocyte with more layers of cells were observed in the experimental group. In addition, there were degeneration and injury of cartilage cells and connective tissue with necrotic cells and inflammatory cells at needle insertion sites. The chondrocyte layer thickness was (385.714±2.027) μm in the control group and (1 594.732±1.872) μm in the experimental group, there was significant difference between the two groups ( t=-759.059, P=0.000). Conclusion: Rabbit ear cartilage can be effectively reshaped by microdissection needle. Proliferation of chondrocyte and changes in matrix can be found during the reshaping process.

Objective: To summarize the current progress of laser-assisted cartilage reshaping (LACR) for prominent ear. Methods: The domestic and abroad article concerning the LACR in treatment of prominent ear was reviewed and analyzed. Results: As a new technique, there were three types of LACR therapies that been used for prominent ear. LACR with the 1 064 nm Nd/YAG laser is painful and the penetration depth of the 1 064 nm Nd/YAG laser is greater than that of the 1540 nm Er/Glass laser which is caused more tissue injury. LACR with the 1 540 nm Er/Glass laser has high absorption by the ear cartilage and produce less injury to the surrounding tissue. Use of the CO 2 laser permitted cartilage reshaping combined with both vaporization and incisions, which complicates the technique, although, with low recurrence rate and definite effect. Insisting on wearing ear mold is the key to get satisfactory effectiveness for postoperative patients. The complications of LACR for prominent ear, such as the dermatitis, perforation of the skin, hematoma, or infection, should be noticed. Conclusion: Application of LACR for prominent ear just has a short period of time, limited number of cases, and few relevant literature reports. Its effectiveness needs to be further studied and clarified.