Objective To explore the curative effect of endoscopic simple maxillary ostium enlargement in the treatment of non-invasive mycosis of maxillary sinus. Methods Clinical data of 16 cases of noninvasive mycosis of maxillary sinus were analyzed retrospectively. Results The operation time was 30～120 minutes, with a mean of 60 minutes. No operative complications occurred. The hospital stay was 5～7 days, with a mean of 6 days. Histopathological examination found hyphae and spores in 16 cases, and a positive culture of Aspergillus was observed in 9 cases. Postoperative follow-up for 3～24 months (mean, 18 months) in 16 cases revealed free of symptoms in 14 cases, in which the endoscopic examination showed unobstructed ostium and normal sinusal mucosa, and recurrence in 2 cases, who underwent repeated enlargement of ostium and were re-followed for 6 and 13 months, respectively, without recurrence. Conclusions Nasal endoscopic simple maxillary ostium enlargement in the treatment of non-invasive mycosis of maxillary sinus is a radical and minimally invasive technique, but particular attention must be directed to managing the maxillary ostium.

Objective To investigate advantages of sep to plasty under nasal endoscope. Methods Septoplasty was carried out under nasal endoscope in 50 cases, including 6 cases of upper or posterior n asal septum deviation. Results The operation was completed on one session in all the 50 cases, with the deviated nasal septum being entirely c orrected. The operation time was 30~72 min (mean, 48 min). Follow-up surveys for 6~9 months (mean, 7.1 months) indicated a complete cure in 45 cases (90%) and a n improvement in 5 cases (10%). No septal hematoma, abscess, perforation, nasal cavity adhesion, or bridge collapse were encountered. Conclusions Nasal endoscopic septoplasty has advantages of short operation time, few bl ood loss, mild pain, little complications, and the possibility of nasal sinus co -operation. This technique may fully replace the traditional submucous resection .

Objective To investigate the curative effect of tube placement and drug irrigation in the auditory tube under nasoscope in the treatment of secretory otitis media(SOM). Methods Under the visualization of a 30? nasoscope,an epidural guiding tube was placed through the pharyngeal opening of the auditory tube into the tympanic cavity for drug irrigation in 50 cases of secretory otitis media(50 ears).Results Follow-up observations for 6~24 months showed 26 cases of cure(52%),19 cases of improvement(38%),and 5 cases of no effect(10%),the total effective rate being 90%. Conclusions This procedure has advantages of simplicity of performance,unaffected drum membrane,high safety,no pain,and satisfactory outcomes,being an effective treatment option for improving the function of the auditory tube and hearing ability in patients with secretory otitis media.

OBJECTIVE: To investigate the correlation between tongue body MRI measurements and the lingual region obstruction in patients with obstructive sleep apnea hypopnea syndrome (obstructive sleep apnea hypopnea syndrome, OSAHS), and the relationship of two diagnosis methods in positioning obstructive level, in order to improve the preoperative diagnostic accuracy of obstructive level in OSAHS patients . METHOD: Fifty-nine patients with OSAHS definited by the AG200 sleep apnea monitoring and obstruction plane positioning system was included. They all underwent tongue MRI scan, after three-dimensional reconstruction, the tongue body length to diameter, relative thickness, basal diameter, wide around central about wide diameter and tongue body volume were measured. The lower blocking (mainly composed of lingual region) constituent ratio P established by AG200 was correlated with tongue parameters measured by MRI. At the same time, To analysis of differences of P in patients with different degree of OSAHS. RESULT: Among these patients with OSAHS in different degree, the coefficient correlation between tongue parameters(tongue length, relative thickness, basal diameter, wide middle diameter, tongue body volume) and lower blocking constitute ratio P werer LP = 0.051,rHP = 0.069, r1 = 0.215, r2 = 0.147, rVP = 0.259, respectively. lower obstruction of form than the differences had statistical significance. The measured tongue parameters and value P(the lower blocking constituent ratio) were negatively correlated, which demonstrated that exclusing of the larynx and hypopharynx airway obstruction, the lower airway obstruction detected by AG200 was related with tongue parameters measured by MRI, and was strongestly related with the tongue body volume. CONCLUSION The volume of tongue and AG had correlation in judgement of lower blocking. In OSAHS patients the lower blocking constituent ratio varies between the defferent severity groups of the disease, the combina tion of the two method can be used to predict the obstructive plane in OSAHS patients with upper airway obstruction, and provide the basis for the individual treatment of patients with OSAHS.
Airway Obstruction ; complications ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Sleep ; Sleep Apnea, Obstructive ; diagnosis ; Tongue ; pathology

AIM:To study the effect of hypertensive arteriosclerosis on cerebral blood flow autoregulation (CBFA), and to introduce a new method to measure the lower limit. METHODS:The blood velocities and blood pressure was recorded simultaneously and the curves of CBFA were analyzed and classified into classical and non-classical pattern. The lower limit were determined by clinical closing pressure (CCP) and the curve CBFA. RESULTS:When the blood pressure was decreasing, the classical and non-classical pattern of the cerebral blood flow autoregulation were 25% and 75% respectively in normal SD rats, while they were 40.55% and 54.45% respectively in renovascular hypertensive rats (RHR). However, when the blood pressure was elevating, the classical and non-classical pattern were 76.47% and 23.53% respectively in SD rats, while they were all classical in RHR. Furthermore, in SD and RHR ras, the lower limits measured by CCP were well in accordance with that measured by CBFA. CONCLUSION:Hypertensive arteriosclerosis could influence the limits and the patterns of cerebral blood flow autoregulation. The lower limit of CBFA can be measured and analyzed by CCP.

Objective To investigate the influence of tethered cord syndrome (TCS) on the up-per urinary tract and its etiology. Methods Forty patients with TCS diagnosed by spinal MRI were enrolled in this study. There were 21 males and 19 females with mean age of 23 years old. The course of disease ranged from 1 to 40 years. Urinalysis, mid-stream urine culture, serum creatinine(SCr), urinary system ultrasound, IVU, eystography and urodynamic study were carried out on all patients. Results Urinary tract infection was found in 17 patients and increased level of SCr was found in 6 pa-tients (251.64±98.5μmol/L). Of the 29 patients who underwent urinary system ultrasound examina-tion, 12 cases had hydronephroais and dilated upper ureter. Of the 30 patients who underwent IVU, 10(33.3%) had ureterectasia and hydronephrosis, 22 cases had bladder turriform or Christmas tree like deformity with diverticulum and trabeculum. Of the 22 patients accepted cystography, 17 cases had vesieoureteral reflux on 27 sides. Post-void residual (PVR) was evaluated in 35 patients and found increased in 31 cases. Cystometry had been done in 33 patients. The mean value of maximal detrusor pressure (Pdetmax) during filling phase was 41.2±20.9 cm H2O. The detrusor compliance was 22.35±18.8 ml/cm H2O. During voiding phase, detrusor-sphincter dyssynergia(DSD)was observed in 16 patients, detrusor areflexia was observed in 16 patients and detrusor underactivity was observed in 13 patients. Resting urethral pressure profilemetry was measured in 16 patients. Maximal urethral closure pressure (MUCP) was 76.1±33.1 cm H2O. The upper urinary tract deterioration was de-fined as increased SCr, hydronephrosis or vesicoureteral reflux. There were 20 patients diagnosed as upper urinary tract deterioration. The compliance of the upper urinary tract deteriorating group and the no-deteriorating group was 9.4±7.8 vs 19.3±15.8 ml/cm H2O, Pdetmax was 43.1±21.2 vs 24.0±11.9 cm H2O, PVR 189.0±138.0 vs 47.8±36.8 ml, MUCP 86.2±32.4 vs 46.8 5±20.8 cm H2O, incidence of damaged detrusor 100.0% vs 69.2% and DSD 65.0% vs 23.1%, respectively. There were significant differences between the 2 groups(P<0.05). And when comparing the VUR group with no VUR group, the incidence of urinary tract infection was 94.1%(16/17) vs 20.0%(1/ 5) (P=0.003). And when comparing urinary tract infection group with no infection group, the inci-dence of upper urinary tract deterioration was 88.2% (15/17) vs 21.7%(5/23)(P=0.000). Condn-sion Low compliance bladder, high Pdetmax during filling phase, increased PVR, high MUCP, damage of detrusor contractive function and DSD are the risk factors for upper urinary tract deteriora-tion in the TCS patients.

Objective 　To establish a new practical method to assess the cerebral blood flow autoregulation. Methods　We assessed the flow velociey of middle cerebral artery with transcranial Doppler and recorded invasively the blood presure simultaneonsly. Then on the basis of critical closing pressure (CCP), the lower limit of cerebral blood flow autoregulation and the blood flow resistance of arterioles were calculated.The data compared with the results generated by routine method. Results　The lower limit of autoregulation working out by CCP was 70.88±24.05 mmHg, which was similar to the result measured by routine method. The lower limit of autoregulation and the arteriole resistance in RHR were significantly higher than those of normal controls, and highly relate to arterial blood pressure significantly, especially pulse pressure. Conclusions　The physiology and pathology of cerebral blood flow can be evaluated conveniently and accurately by assessment of the lower limit of autoregulation and arterioles resistance with CCP.

Objective To explore the application value of single-door laminoplasty via Y type nano-bone plate in treating multilevel cervical spondylotic myelopathy (MCSM) and analyze the short-term efficacy.Methods From January 2013 to December 2016,79 cases of MCSM were treated with single-door laminoplasty via Y type nano-bone plate to evaluate the improvement of post-operative neurological function by the Japanese Orthopaedic Association (JOA) evaluation system.We also measured cervical curvature of cervical X-ray and C5 sagittal diameter of the spinal canal before operation and 6 months after operation to understand the maintenance and enlargement of the spinal canal.The improvement degree of spinal cord compression was evaluated by preoperative and postoperative cervical MRI.Osseous healing on the open door side and the door shaft side was observed with the aid of three-dimensional spiral CT.Results Follow-up ranged from 6 to 36 months,with an average of (20.4±7.9)months.Preoperative JOA score was (8.6 ± 1.3) points and JOA score 6 months after operation was (14.3 ± 1.5)points (P ＜ 0.05).JOA improvement rate was (68.6 ± 15.8)％;postoperative follow-up X-ray and threedimensional spiral CT showed that the spinal canal had satisfying enlargement,the door shaft side all had osseous healing,the open door side osseous healing was not obvious,and there was no lamina collapse or reclosing.Sagittal diameter of theC spinal canal was (8.9±l.1)mm before operation and (15.1±l.1)mm 6 months after operation (P＜0.05).The spinal canal enlargement rate was (70.8±22.3)％,cervical curvature was (14.8± 7.0)°preoperatively and (15.1±6.7)°postoperatively with no significant difference (P＞0.05).Conclusion EOLP via Y type nano-bone plate is safe and efficacious in treating MCSM.It not only provides a good immediate fixation,but also provides the possibility for the open door side lateral osseous fusion.

0.02 kgf was considered as signifieant.All patients were studied within the first week of presentation with stroke, and underwent every day follow-up within the first month.Results Nine htmdred and fourteen patients were recruited into the study during 1-year period. WECSFP without lesion in brain stem was present in 4.4% of patients within the first week of stroke presentation.The patients with WECSFP had less JFS than the patients without WECSFP(P

Objective To investigate the potential application of human transforming growth factor-beta-1 (hTGF-β1) gene mediated by type 2 recombinant adeno-associated virus (rAAV2) vector inducing chondrogenic differentiation of canine mesenchymal stem cells (MSCs) in vitro. Methods Canine MSCs from bone marrow were isolated and cultured in vitro by density gradient centrifngation and adherence screening methods. The morphology of MSCs was observed by inverted phase contrast microscope and Giemsa stain. Flow eytometry was used to detect surface antigens of MSCs, The third generation of MSCs were transfected by rAAV2-hTGF-β1 with or without MOI of 1 ×105 v.g./cell or 5×105 v.g./cell. The expression of hTGF-β1 was detected by Western blot after 10 days, and TGF-β1 synthesis was determined by ELISA at 3, 6 and 9 day, respectively. After 2 weeks of culturing, mRNA expressions of type Ⅱ collagen and aggrecan were determined by RT-PCR and the collagen Ⅱ protein was detected by immunocytochemistry. Results The MSCs appeared to be morphologically spindle-shaped and showed active capability of proliferation both in primary and passage generations. Flow cytometry analysis indicated that MSCs were universally positive for CD29, CD44 and CD105, but negative for CD34 and CD45. TGF-β1 expression can be observed by Western blot after 10 days in two transfection groups, MOI of 5 × 105 group and MOI of 1× 105 group. With the extension of time, the contents of hTGF-β1 increased in the two groups detected by ELISA, while there was a significant difference between them two (P < 0.01). After 2 weeks of transfection of MSCs by rAAV2-hTGF-β1, the expression of collagen Ⅱ and Aggreacan mRNAs were positive. It also showed positive of collagen Ⅱ detected by immunocytochemistry. Conclusion Canine MSCs show chondrogenesis differentiation after induction by Type 2 rAAV mediated transfer of TGF-β1 gene. The process is a potential application for cartilage tissue engineering.