Objective To explore the related factors of atherosclerosis in senile obstructive sleep apnea hypopnea syndrome (OSAHS) patients.Methods From May 2012 to January 2014,129 elderly hypertension and type 2 diabetes patients were recruited.According to the presence or absence of OSAHS,they were divided into OSAHS (n =60) and non-OSAHS (n =69) groups.And 30 physical examination subjects were selected as control group.The parameters of age,gender,height,weight,high sensitivity C-reactive protein (Hs-CRP),homocysteine (Hcy),triglyceride (TG),total cholesterol (TC),high density lipoprotein-cholesterol (HDL-C),low density lipoprotein-cholesterol (LDL-C) and intimate-media thickness of carotid artery (CIMT) were measured with ultrasonography.And their levels were compared among OSAHS,non-OSAHS and normal control groups.And the correlations were analyzed between CIMT and Hs-CRP,Hcy,TG,TC,HDL-C,LDL-C,age and body mass index (BMI).Results The levels of Hs-CRP[(3.40 ± 0.91) mg/L,(2.57 ± 1.01) mg/L],Hcy [(16.50 ± 2.89) μmol/L,(11.20 ± 2.32) μmol/L],CIMT[(1.06 ±0.14) mm,(0.93 ±0.13) mm],TG[(2.52 ± 1.40) mmol/L,(2.51 ±2.02) mmol/L],TC[(5.74 ± 1.16) mmol/L,(5.49 ± 1.09) mmol/L] and LDL-C[(3.15 ±0.47) mmol/L,(3.05 ±0.70) mmol/L] in both OSAHS and non-OSAHS groups were higher than those in normal control group [Hs-CRP:(2.06 ± 1.22) mg/L,Hcy:(6.04 ± 1.85) μmol/L,CIMT:(0.65 ± 0.07) mm,TG:(0.99±0.24) mmol/L,TC:(3.63 ±0.71) mmol/L and LDL-C:(2.47 ±0.27) mmol/L] (OSHAS group vs.control group,t =5.88,18.15,15.62,5.91,9.17,7.47,non-OSAHS group vs.control group,t=2.20,10.73,11.51,4.09,8.56,4.45,all P＜0.05).The levels of Hs-CRP,Hcy,CIMT and plaque score were higher in OSAHS group than those in non-OSAHS group [(1.92 ± 1.03) vs.(1.35 ± 0.97) points] (OSHAS group vs.non-OSAHS group,t =4.84,11.72,5.54,3.91,all P ＜0.05).CIMT or carotid artery plaque were related with age,BMI,TG,TC,LDL-C,Hs-CRP and Hcy in OSAHS group.Conclusions OSAHS may elevate the level of inflammatory factors and cause atherosclerosis.And the changes of CIMT,Hs-CRP and Hcy are parallel.Hcy also has important clinical significance in the progression of atherosclerosis.

[Objective]To examine the safety and efficacy of closing-opening wedege osteotomy for angular kyphosis.Seven patients with angular kyphotic deformity of the thoracic or thoracolumbar spine were treated by closing-opening wedge osteotomy using a single posterior approach.[Method]Seven patients with angular kyphosis were treated.The apex level of kyphosiswas T5 in one patient,T11 in one,and T12 in five.There was old fracture in five patients,congenital deformity in one,and neurofibromatosis in one.The first 30?~35? of kyphosis were corrected using the closing wedge technique with the hinge of the anterior longitudinal ligament after veretebrectomy and circumspinal decompression of the spinal cord.Then the hinge was moved posteriorly to the spinal cord and the remainder of the requisit angle of osteotomy was corrected using the opening-wedge technique(closing-opening wedge osteotomy).Spinal curvature was stabilized using posterior instrumentation and graft.[Result]Localized kyphosis was reduced from and average of 67? to 18? at 2.2 to 7.5 years ' follow-up.Sagittal alignment from T1 to the sacrum became more physiologic than before.There were no neurologic complications.Bony fusion was achieved in all patients,and there was no correction loss.[Conclusion]Satisfactory correction is safely performed by closing-opening wedged osteotomy with a direct visuzlization of the circumferentiall decompressed spinal cord.Although the performance is technically laborious,it offers good correction without jeopardizing the integrity of the spinal cord.