Objective To improre typieal proeedure of UPPP,increase clinical effects and deerease complioations caused by the operation.Methods Twenty eight patients with obstructive sleep apnea syndrome who had been confirmed by PSG in our hospital from 2003 to 2005 were involved in this study.1)improving stripping method:the fat and tonsil were removed by electric knife.2)improving molding method:the muscle of uvula was maitained,but the fat was removed;mucous and the tissue under it were double-layer sutured.3) the data before and 6 months after UPPP were analyzed by questionnaire and polysomnography(PSG)detection.Result No fissuration occurred.The distance between soft palate and posterior wall was 3?0.6 before operation and it was 6?0.8 6 months after operation.The effect is 100% based on the questionnaire investigation and PSG detection.Conclusions 1)Hemostasis of electric knife was reliable;2)Double-layer suture of mucous and the tissue under it can avoid hemorrhage and insure molding of pharyngeal cavity;3)The results of the uvula preservation can improve the effect of the UPPP by increasing the nasopharyngeal and oropharyngeal cavity,and avoiding velopalatal insufficiency.

OBJECTIVE: To study the pathological changes of genioglossus with transmission electron microscope (TEM) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) dominated by lingual region obstruction, and to explore the role of tongue organizations in the pathogenesis and its clinical significance. METHOD: Thirty-eight cases of genioglossus were collected from the patients received UPPP and partial glossectomy (3060 severe group 15 cases), 6 adult patients without oropharyneal and hypopharyneal obstructive disease received tongue tumor resection or trauma debridement surgery were collected as control group. The features of morphological changes in genioglossus were observed by TEM. RESULT: Under the TEM, in the control group,the muscle fibers of the genioglossus organization arranges regular, mitochondrial shape between muscle was regular; The below 3 kinds of variations existed simultaneously in all genioglossus specimens of all the OSAHS patients. In the mild group, myofibrillar atrophied, arranged sloppily, the gap was increased, localized filaments were edema, connective tissue between muscle bundles was proliferated, mitochondria were swelling, some were spherical, crests were still clear; In the moderate group, myofibrillar obviously atrophied with different diametric sizes and disorderliness, the Z lines were shortened or distorted, part of the myofibrillar ruptured, dissolved or disappeared, the connective tissues between muscle bundles were obviously proliferated, mitochondria were swellen, vacuolar degeneration, crests were vague, shorten and irregulatio; In the severe group, a large number of myofibrillar were fractured, dissolved, disorganized, integrated condensate lumpy, spotty or flake arranged, Z-lines were distorted or disappeared. Mitochondria were sizes, showed vacuolar degeneration, crests were disappeared, some changes were flocculent, mitochondria accumulation phenomenon was visible in some samples. Moreover, with the AHI increased, the occurence ratio of mild changes was decreased while severe changes occurence ratio increased. CONCLUSION The changes of genioglossus and mitochondrial in OSAHS patients is a continuous, progressive process, moverover, with the aggravation of OSAHS, genioglossus histopathological changes had gradually worsening tendency.
Adult ; Glossectomy ; Humans ; Mitochondria ; Muscle, Skeletal ; pathology ; ultrastructure ; Sleep Apnea, Obstructive ; complications ; Tongue ; pathology

The external stimuli and other reasons may result in hyperplasia and abnormal angle of the upper corner of the thyroid cartilage. The upper corner of the thyroid cartilage has anatomical variations. To oppression stimulate carotid artery, cervical sympathetic dry section and so on, could causing pharyngeal foreign body sensation and sore throat. By surgical removal of the thyroid cartilage hyperplasia upper corner, postoperative symptoms would be resolved.
Humans ; Hyperplasia ; Male ; Middle Aged ; Thyroid Cartilage ; pathology

Objective The purpose of this study was to determine the relationship between Bcl-2 and p53 gene protein expression and radiation sensitivity according to the biologic character of laryngeal carcinoma.Methods Using monoclonal antibody for Bcl-2 and p53 gene protein,70 cases of laryngeal carcinoma were stained by immunohistochemical DACO CSA System method.Bcl-2 and p53 gene protein expression were divided into 3 levels:intense,moderate and negative expression.The relationship between expression intensity and radiation sensitivity was tested with Cramer method.Results There was relationship between each gene protein expression and radiation sensitivity.The relationship between cooperative expression and radiation sensitivity was higher than that of individual expression.Conclusion There was significant relationship between Bcl-2 and p53 gene protein coocperative expression and radiation sensitivity.The Bcl-2 and p53 gene protein cooperative expression can be consult criteria in predicting prognosis of radiation therapy of laryngeal carcinoma and instructing clinic therpy.

Objective: To investigate the clinical features and pathogenic genes of a family with osteosclerosis. Methods: Six patients and six family members from a family in Jiangsu were tested for biochemical parameters, bone metabolic markers, bone mineral density, thoracolumbar anterior lateral slices, skull positive lateral radiographs, and pelvic plain films. Meanwhile, Sanger sequencing was performed to detect gene mutations of the proband and five other family members with high bone mass. The conformation of the mutational low-density lipoprotein receptor-related protein 5 (LRP5) protein was predicted by SWISS-MODEL. Results: Four adult patients (one male and three females) were tall, with mandibular enlargement and kyphosis in the center of the lower jaw, and none of the four had fractures. Their X ray examination revealed that the skull and long bone cortex was thickened, while the sella and mandible was enlarged. In addition, the absolute values of bone mineral density at each site of all patients were significantly higher as compared with the standard age- and sex-matched adults or adolescent mean reference values, with Z scores of L2-4, femoral neck and total hip being (6.31±4.03) SD, (6.56±2.36) SD, and (7.19±2.03) SD, respectively. The results of genetic sequencing revealed that all six patients carried a heterozygous mutation (c.331G>T; D111Y) in exon 2 of LRP5 gene, while other family members showed wild type (c.331G>G; D111D). Functional prediction indicated that this mutation was located at the amino acid terminal of exon 2 of LRP5 gene, which encodes the first β-helix-generating region of LRP5 protein. Conclusion The D111Y mutation in LRP5 gene leads to a clinical phenotype characterized by benign increased bone mineral density without increasing the risk of fracture. This mutation may further affect the downstream Wnt signaling pathway by altering the spatial structure of LRP5 protein, thereby promoting maturation and differentiation of osteoblasts and resulting in osteosclerosis.

OBJECTIVETo explore the optimal surgical approach for Siewert II and III adenocarcinoma of esophagogastric junction (AEG).

METHODSClinical data of 135 patients with Siewert II and III AEG treated in our hospital from August 2007 to August 2012 were analyzed retrospectively. Of 135 patients, 57 received transthoracic path for the stomach and proximal gastrectomy, second station lymph node resection (transthoracic group), and 78 cases received transabdominal hiatal approach (transabdominal group). The intraoperative lymph node harvested, postoperative complications and 5-year survival rate were compared between the two groups.

RESULTSThere were no significant differences in the residual tumor positive margin and anastomotic leakage rate between the two groups (both P>0.05). Compared with transthoracic group, transabdominal group had more lymph node dissected (11.1±0.2 vs. 10.4±0.3, P=0.033], less postoperative cardiac [2.6% (2/78) vs. 19.3% (11/57), P<0.01] and pulmonary [7.7% (6/78) vs. 21.1% (12/57), P<0.05] morbidity, and short postoperative hospital stay [(13.4±0.1) d vs. (16.4±0.3) d, P<0.01]. A total of 128 cases were followed up for median 38 months (6 to 72 months). The 5-year survival rate in transthoracic group and transabdominal group was 29.8% and 34.6% respectively, without significant difference (P>0.05).

CONCLUSIONFor the treatment of patients with Siewert II and III AEG, transabdominal hiatal approach can remove more lymph nodes, reduce postoperative cardiopulmonary morbidity and shorten hospital stay.

Adenocarcinoma ; surgery ; Esophageal Neoplasms ; surgery ; Esophagogastric Junction ; pathology ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Postoperative Complications ; Retrospective Studies ; Stomach Neoplasms ; surgery ; Survival Rate

OBJECTIVE: To investigate clinical efficacy of dual plate internal fixation triceps through approach for the treatment of type C3 fracture of distal radius. METHODS: Totally 21 patients with type C3 fracture of distal radius were retrospectively analyzed from December 2011 to June 2017. Among them, including 13 males and 8 females, aged from 15 to 68 years old with an average of (40.7±3.4) years old. The time from injury to operation ranged from 3 to days with an average of (5.0±1.2)days. Fracture healing and postoperative complications were observed, Mayo elbow joint performance score(MEPS) was used to evaluate recovery of elbow joint function, VAS score was used to evaluate relieve degree of pain at 3 months after operation. RESULTS: All patients were followed up for 8 to 24 months with an average of (14.0±2.6) months. The time of fracture healing ranged from 2.5 to 4.0 months with an average of(3.0±1.2) months without complications. Postoperative MEPS score at 3 months was 91.0±2.3, and 15 patients got excellent results, 4 good, and 2 moderate; VAS score was 1.95±0.34 at 3 months after operation. CONCLUSIONS Dual plate internal fixation triceps through approach for the treatment of type C3 fracture of distal radius could provide satisfactory surgical field exposure, facilitate for reduction and internal fixation of joint fracture, could obtain good elbow joint function and is beneficial for early functional exercise.
Adolescent ; Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Radius ; Radius Fractures ; diagnosis ; Retrospective Studies ; Treatment Outcome ; Young Adult

Brown adipose tissue (BAT) increases energy consumption by directly dissipating stored energy in the form of heat through the role of uncoupling protein (UCP1). Recent studies have found that brown adipocytes may also regulate metabolism through autocrine, paracrine, and endocrine mechanisms. A growing body of evidences have shown that the BAT has a close relationship with bone metabolism, in which BAT secretes a variety of factors to regulate bone metabolism, while bone also secretes a variety of bioactive substances to control BAT function. In addition, BAT may indirectly participate in bone metabolism through muscle-mediated regulation or SNS activity and improvement of body metabolism, thus forming a BAT-skeletal axis. In this paper, we try to explain the relationship between brown adipose tissue and bone, and to discuss their interactive mechanisms.

Objective: To study the clinic and pathological features of leukoplakia of the larynx, and reduce canceration rate. Method: Seventy-four postoperative patients of leukoplakia of the larynx were followed up for four years by telephone or clinic service. Result: None of eighteen cases of pure leukoplakia was recurrence. Fifty-six ca-ses were leukoplakia with epithelial dysplasia histologically. Seven out of fifty-six postoperative cases occurred hoarseness; three out of fifty-six postoperative cases recured, and accepted twice or more operations successively; three out of fifty-six postoperative cases occurred canceration. Conclusion:Operation is the main means for the treatment of leukoplakia of the larynx, and the effect is comparatively well. The patients with histological epitheli-al dysplasia should be pay great attention because of their higher canceration rate, and enlarged operation ranges appropriately with the patient consent could effectually prevent recurrence or canceration during the early lesions. Close observation is important for these patients.

Objective To prepare serum calibrators for CRP measurement.Methods Fresh serum without infectious diseases , hemolysis, lipemia and choloplania were collected and divided into 3 groups, low, medium, and high, according to the CRP concentration.Each serum pool was mixed , filtered, sterilized and aliquoted.The materials were tested for homogeneity and stability.The values of the CRP was assigned by particle enhanced immunonephelpmetry , and calibrated with international reference materials.The expanded uncertainty was evaluated.Results The materials were tested to be homogeneous (Ubb﹤Ur, P>0.05) with Ubb values being 0, 0.125, 0, Ur values being 0.046, 0.213, 0.785, and F values being 0.803, 1.686, 0.966 in CL, CM, CH groups respectively.Stability study, where F values are 0.609, 0.259, and 1.557 at 22-25℃, 1.217, 4.583, and 0.893 at 2-8℃(P>0.05), showed that the materials were stable for at least 3 days at 22-25 ℃or 30 days at 2-8 ℃, respectively.The certified values of the 3 levels materials for CRP were ( 2.64 ±0.14 ) , ( 31.17 ±0.63 ) , ( 73.85 ±1.74 ) mg/L, respectively.Conclusion The calibrators prepared for serum CRP measurement were homogeneous , stable and accurately assigned and can be used to calibrate the CRP measure system.