Allergic rhinitis is a kind of nasal mucosal chronic noninfectious inflammatory disease, which is caused by an imbalance in the body cytokine network,a number of intracellular signaling pathways being actived. Many studies have shown that mitogen-activated protein kinase (MAPK) involved in the activation process of allergic rhinitis. p38 mitogen-activated protein kinase (MAPK), as one kind of that, plays a key role in the process of inflammatory cells proliferation and differentiation, as well as production of inflammatory cytokines, and involved in airway inflammatory mechanisms of chronic airway disease. In vitro experiments have confirmed that p38 MAPK inhibitors have anti-inflammatory effect by blocking the downstream related response.
Cell Differentiation ; Cell Proliferation ; Cytokines ; Humans ; Inflammation ; MAP Kinase Signaling System ; Rhinitis, Allergic ; metabolism ; p38 Mitogen-Activated Protein Kinases ; metabolism

Objective To explore the possibility and effectiveness of minimally invasive osteotomy and cable osteosynthesis for the treatment of adolescent eubitus varus. Methods Eleven cases of adolescent cubitus varns(2 cases complicated with internal rotation of 10°)were treated with minimally invasive supracondylar wedged osteotomy to preserve the integrity of the contralateral codex and periosteum.Two screws were inserted above and below the fracture line.They were fixed with cable after the greenstick fracture and internal rotation were adjusted.Plastic bandage was applied for 1 week postoperatively before rehabilitation. Results Bone fractures healed in the 11 cases in 36.3 days averagely,without infection or nerve palsy.Before operation,the mean angles of varus,flexion and extension were 35°±5°,125°±10°and 10°±5°respectively.After a mean follow-up of 33.5 months,the mean valgus angle of the elbow was improved to 8°±2°(t=16.632,P<0.05),flexion to 130°±8°and extension to 8°±3°(P>0.05).Internal rotation deformity was also ameliorated in the 2 cases. Conclusion It is practical and effective to treat adolescent eubitus varus with minimally invasive osteotomy and cable osteosynthesis,for it can lead to stable fixation,short healing time,and does not affect the flexion and extension of the elbow joint.

BACKGROUND: Partial soft palate, uvula and the otiose soft tissue of lateral pharyngeal wall are resected in traditional uvulopalatopharyngoplasty. Although the syndrome can be improved, the complications, such as velopharyngeal insufficiency, cicatricial contration of pharyngeal cavity, can occur in some patients, furthermore, the prostecdtive efficacy is below the mark.OBJECTIVE: To investigate efficacy of the dilatation of oropharyngeal and nasopharyngealisthmus in uvulopalatopharyngoplasty treating obstructive sleep apnea hypopnea syndrome.DESIGN: A case-control observation.SETTING: The Affiliated Municipal Hospital of Medical College, Qingdao University.PARTICIPANTS: The patients who were hospitalized for snoring, apnea, breathing obstruction and somnolence were selected from the Sleep Respiratory Disorder Diagnosis and Treatment Center in the Affiliated Municipal Hospital of Medical College of Qingdao University from July 2001 to February 2006. We ascertained that the obstruction located at pharynx oralis, no hypertrophy of lingual root, and made a definite diagnosis of OSAHS by polysomnogram. The apnea hypopnca index (AHI) was ≥ 5 times per hour. Among 216 patients, there were 159 males and 57 females aged older than 25 years.METHODS: The patients were treated by modified UPPP which maintained the normal anatomic form of pharyngeal cavity, reserved the uvula, performed oblique straight incision along palatoglossal arch to soft palate, and avoided the incision of inverse U type. Palatoplasty and pharyngoplasty could extend the oropharyngeal isthmus and nasopharyngeal isthmus thoroughly.MAIN OUTCOME MEASURES: ① The survey of effect in the near future: Defined the pain without pain-killer as pain lightly, or as pain heavily inversely. If the lateral wall of oropharynx could remain the designed morphous, it was a good henosis; it was a bad henosis inversely. ② The survey of effect in a long term: According to the statement of the patients themselves. Estimated whether the patients had postoperative complications, such as backstreaming in nasal cavity, pharyngeal foreign body sensation, etc. Assessed if the patients had sleep apnea according to the observation of the family member and the monitoring of PSG. And ascertained whether the pharyngeal cavity had approached to normal structure by the examination of oropharynx.RESULTS: All 216 patients were involved in the final analysis. ① Of the 216 subjects, there were 156 patients who needed pain-killer (72%), and 60 Patients need not (26%). The lateral pharyngeal wall of 136 subjects was smooth (63%), and the other 80 were splited partly (37%). There were no complications such as breath holding, backstreaming in the nasal cavity. ② The survey of longdated postoperative effect: The 216 patients were followed up for 6 mouths.There was no deglutitive bucking, open rhinolalia. A total number of 84 patients (39%) had pharyngeal foreign body sensation. The syndrome of sleep apnea disappeared in 169 patients, and the other 47 patients still had the syndrome,but improved than before. In 203 patients (94%), the postoperative morphous of oral cavity were content, and the other 13 patients (6%) were not content. ③ The statistical significance of the preoperative and postoperative result of PSG monitoring of the 216 patients with OSAHS existed and the difference was significant [AI: 35.45±16.42, 12.75±9.62; HI:19.39±9.86, 17.43±10.15; AHI: 54.29±18.13, 28.31 ±16.23; the average low saturation of blood oxygen: (83.58±7.96) %,(85.53±8.18) %; the average saturation of blood oxygen: (91.98±3.29) %, (93.01±3.02) %, P ＜ 0.05].CONCLUSION: The modified uvulopalatopharyngoplasty indicates that this approach not only extend the nasopharynx cavity, but also avoids the postoperative complications. The patients have markedly improved symptoms.

Objective To explore the role of compound nerve conduit, made of nerve growth factors (NGF) encapsuled by biodegradable core-shell nanofibers through coaxial electrospinning, in regeneration of injured sciatic nerves in rats. Methods The compound nerve conduits were developed from the core-shell structured biodegradable nanofibers with P(LLA-CL) as a shell and BSA/NGF or BSA as a core through coaxial electrospinning. Seventy-two Sprague-Dawley rats were randomly divided into 4 even groups. The middle segments (10 mm) of the sciatic nerve were excised and the defects were repaired with sciatic nerve autograft (group A), with P(LLA-CL) conduit (group B), with PLLA-CL conduit and one injection of NGF (group C), and with P(LLA-CL)/NGF controlled-release conduit (group D), respectively. Morphologic and functional evaluations of nerve regeneration were done by gross observation, sciatic function index, neural electrophysiological examination, resumption rates of triceps weight, histological and ultrastructural observa-tion respectively in 1, 2, 3 months after the operation. Results Three months after the operation, although partial biodegradation and small cracks could be observed, conduits remained intact in outline. Based on the functional and histological observations, nerve regeneration, nerve fibers arrangement, myelination and nerve function reconstruction in the P(LLA-CL)/NGF controlled-release conduit (group D) were similar to those in nerve autograft (group A) and significantly superior to those in groups B and C (P<0.05). Conclusion As the P(LLA-CL)/NGF-controlled release conduit has favorable mechanical properties and biocompatibility, it can effectively promote regeneration of the sciatic nerve in rats.

OBJECTIVETo study the high risk factors of the third level of lymphatic metastasis in breast cancer patients to guide clinical practice.

METHODSThe clinical data of 746 breast cancer patients (all female, aged from 33 to 80 years with a median of 46 years) received radical or modified mastectomy between 2001 and 2011 was analyzed retrospectively. Eleven individual variables were selected to investigate high risk factors of the third level of lymphatic metastasis in different conditions.

RESULTSAxillary nodes metastasis status (OR = 4.541, 95%CI:3.569-5.776), tumor site (OR = 1.437, 95%CI:1.029-2.007), external nodes involved (OR = 3.809, 95%CI:1.683-8.618) and estrogen receptor (OR = 0.740, 95%CI:0.569-0.964) were high risk factors of the third level of lymphatic metastasis. Further analysis found that it is prone to happen a metastasis, especially when the tumor with a size over 5 cm and located at the lateral quadrant. Negative estrogen receptor was a risk factor of the third level lymphatic metastasis along with the tumor stage.

CONCLUSIONFor preoperative tumor biopsy shows Negative estrogen receptor of tumor stage T3 and over stage T3 when considering suspicious lymph node metastasis or external tissues metastasis intraoperatively should take in account into third level axillary lymph node dissection actively.

Adult ; Aged ; Aged, 80 and over ; Axilla ; pathology ; Breast Neoplasms ; pathology ; surgery ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Mastectomy ; methods ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors