The primary etiopathology of pediatric OSAHS includes tonsil or adenoid hypertrophy. Severe OSAHS contributes to or aggravates thoracic deformity, which is rarely reported. In the current report, This children sleep snoring more than 4 years, increasing with thoracic severe depression during sleep 2 days. Clinical examination indicated tonsil and adenoid hypertrophy, and polysomnography revealed OSAHS . The symptoms of OSAHS and severe inhalation-related sternum depression disappeared rapidly after tonsillectomy. Our findings indicated that OSAHS were the major causes underlying funnel chest in children. The rarity of the incidence may result in missed diagnosis or misdiagnosis. Polysomnography was recommended for the child diagnosed with funnel chest accompanied by upper airway stenosis.
Adenoids ; pathology ; Child ; Funnel Chest ; diagnosis ; Humans ; Hypertrophy ; Palatine Tonsil ; pathology ; Polysomnography ; Sleep Apnea, Obstructive ; diagnosis ; Snoring ; Tonsillectomy

Obstructive sleep apnea hypopnea syndrome (OSAHS) is characterized by repeated episodes of upper airway obstruction that results in brief periods of breathing cessation (apnea) or a marked reduction in airflow (hypopnea) during sleep. Asthma is a chronic inflammatory disease of the airways characterized by revesible air-flow obstruction and bronchial hyperresponsiveness. This article reviewed related reseaches progress of relationship between the obstructive sleep apnea hypopnea syndrom and asthma in the vascular endothelial growth factor, systemic inflammation, leptin, obesity, gastroesophageal reflux disease and upper airway diseases, excessive daytime sleepiness and asthma control.
Asthma ; Humans ; Inflammation ; Obesity ; Respiration ; Sleep Apnea, Obstructive ; Vascular Endothelial Growth Factor A

Objective To understand the status quo of AIDS discrimination among Xinjiang medical college students and its influence factors .Methods By using the stratified cluster sampling method ,583 students in a Xinjiang medical college were conduc‐ted the AIDS related questionnaire investigation .Results If medical undergraduate students found that the schoolmates carried HIV ,18 .01% of college students would not directly contact with them ,45 .97% of medical college students would not give sympa‐thy and concern ,31 .22% of students would not keep normal communication with them ,53 .17% of medical college students thought that they should drop out of school to go home ,32 .76% of medical college students would not keep a secret to the outside world ;40 .99% of the medical college students would advise them to restrain their own behaviors ,24 .87% of medical college students would choose to report it to the teacher or leader .By the multivariate analysis of covariance ,gender ,nationality ,family monthly in‐come ,origin of students ,AIDS related knowledge ,etc .were the factors affecting the level of AIDS discrimination .Conclusion The medical college students have a certain degree of discrimination to the AIDS patients ,learning the AIDS related knowledge should be strengthened for reducing the fear psychology on AIDS ,thus to eliminate the discrimination towards AIDS .

Objective To summarize the experience of operation on gastric carcinoma combined with severe pulmonary dysfunction and reduce the incidence of postoperative fatality and complications.Methods According to FVC,MVV,FEV1 from high to low grouping,and interfere with ambroxol hydrochloride,doxofylline,budesonide,terbutaline,ipratropium bromide,tiotropium bromide to 20 patients who suffered gastric carcinoma combined with severe pulmonary dysfunction before and after operation,and interfere with different anesthesia methods.Results Postoperative complications occurred in 20 patients within one month,Hydrothorax in 2 cases,pulmonary infection in 2 cases,respiratory failure in 2 cases,acute pulmonary edema in 1 cases,acute pulmonary embolism in 1 case.After active treatment,19 patients cured,1 case died due to acute pulmonary edema.Conclusion The complications rate and risks are high in the gastric carcinoma patients combined with severe pulmonary dysfunction,and strict preoperative and postoperative managements are key to the operation.

BACKGROUND:Intervertebral disc degeneration is the pathological basis of degenerative spinal diseases. Studies on the influentialfactors of intervertebral disc degeneration contribute to the prevention and treatment of degenerative spinal disease.
OBJECTIVE:To observe the growth and proliferation of nucleus pulposus cels isolated by trypsin plus type II colagenase digestion in complete medium with different glucose concentrations, exploring the optimal glucose concentration for growth of nucleus pulposus cels.
METHODS:Nucleus pulposus cels isolated and cultured by trypsin plus type II colagenase digestion method were observed under an inverted microscope, and thecelnumber was counted. Morphology of nucleus pulposus cels was observed afterhematoxylin-eosinstaining and toluidine blue staining. Colagen type II immunoreactivity was detected by immunohistochemical staining combined with immunofluorescent staining.Nucleus pulposuscels were incubated in complete medium containing various glucose concentrations (0, 6.25, 12.5, 17.5, and 25 mmol/L) for 24 hours, and then cel proliferation and apoptosis were determined.
RESULTS AND CONCLUSION:The stained nucleus pulposus cels showed polygonal and short spindle, with one or two nuclei. Celularpseudopod appeared gradualy and then became slim with increased passage numbers. The isolated and cultured nucleus pulposus cels positively expressed colagen type II and aggrecanProliferative activity of nucleus pulposus cels cultured in medium with 17.5 mmol/L glucose was significantly higher than that in medium with 0 and 25 mmol/L glucose (P< 0.05 orP< 0.01). There wasno significant differencein cel apoptosis between these groups except for 0 mmol/L glucose (P<0.05). These results confirm that a large number of nucleus pulposus celscan beharvested by trypsin plustype II colagenase digestion and the optimal glucose concentration is 17.5 mmol/L.

ObjectiveTo evaluate morphometric changes of brain in patients with alcohol addiction by voxel-based morphometry. MethodsFifteen patients with alcohol addiction and 15 health controls were recruited and underwent fluid attenuated inversion recovery (FLAIR) and 3D fast spoiled gradient echo (FSPGR) T1 -weighted sequences on a 3.0 T MRI system. 3D FSPGR T1 structure images were normalized,segmented and smoothed, and then underwent voxel-based morphometry. An ANCOVA was applied with age,body mass index ( BMI ), and education years as covariates because of exact sex match.A statistical threshold of P ＜ 0. 01 (uncorrected) and more than continuous 50 voxels were determined as significant.ResultsRegional results showed there was a significant reduction of gray matter volume in left middle frontal gyrus, superior frontal gyrus, precuneus, gyrus rectus, right medial superior frontal gyrus and orbital gyrus in patients with alcohol addiction compared with health controls, and the regional reduction of white matter volume in patients with alcohol addiction mainly located in the white matter of bilateral superior frontal gyrus. Global brain volume analysis showed there was a significant smaller volume in white matter [ (675. 14 ± 70. 62) ml]and brain parenchyma [ ( 1578. 81 ± 199. 05 ) ml]for patient group than that in white matter [ ( 841.33 :± 177. 35 ) ml]and brain parenchyma [ ( 1722. 13 ± 117.62) ml]for control group (t ＝ 11.37,5. 764, respectively, P ＜0. 05 ), but there was no difference in the gray matter volume between patient group [(903.67 ±1±9.87) ml]and control group [(880.79 ±1±7.10) ml](t ＝0.177, P＞0. 05 ). ConclusionsRegional gray and white matter atrophy can be the initial changes in patients with alcohol addiction and the frontal region is a relative specific damaged brain region.VBM has a potential value for the detection of subtle brain atrophy in patients with alcohol addiction.

Objective: We examined the cause、level of pathology、onset of symptoms、time taken to treatment and outcome of 14 patients with cauda equina syndrome(CES) to determine how these factors influenced the eventual outcome.Methods:14 patients with CES treated at our hospital between 1991 and 1997 underwent laminectomy followed by bilateral decompression.The mean time of followup was 35 months(range 22～48months).Logistical regression analysis was used to manage the data.Results:Out of 14 patients,11 had satisfactory recovery at 2 years postdecompression;3 patients were left with some residual dysfunction.Conclusion:There was a clear correlation between delayed decompression and the poor overall outcome,as well as the presence of perineal anaesthesia and significant sphicter dysfuncation.

Objective To summarise the experience of surgical treatment of invasive pulmonary fungal infection in patients with hematologic malignancies.Methods From Jan.2000 to Dec.2012,78 hematologic patients with invasive pulmonary fungal infections,including 49 males and 29 females with average age of 29.6 years,underwent surgical treatment.Preoperatively,all patients with 1 to 3 courses of chemotherapy had received average 4 weeks antifungal treatment.There were 58 cases received conventional open thoracic surgery and 20 cases received VATS including lobectomy,segmentectomy,wedgectomy.Results The procedures were successful,the average operation time w as(125.3 ± 35.7) min and intraoperative blood loss was(253.1 ± 42.8) nl.There were no severe postoperative complications.The main complications were excessive effusion (10.2％) and persistence airleak (7.7％).The hospital days was(7.8 ± 2.5) days,no reoperation and death case in 30 days after operation.The follow-up was from 6 to 24 months,38 cases(48.7％) received prophylaetic antifungal treatment,no ease with fungi spread and recurrence.Conclusion The surgical treatment is safe and useful for the hematologic patients with invasive pulmonary fungal infections,when internal medicine conservative treatment is invalid.

Objective To explore the significance of mediastinum drainage tube in prevention and treatment of intrathoracic anastomotic leak after esophagectomy. Methods The morbidity and prognosis of intrathoracic anas-tomotic leak after esophagectomy in 180 patients with esophageal or cardia carcinoma (group A) who used mediasti-num drainage tube in operation from 2006 to 2008 was studied retrospectively,and were compare with 154 patients (group B) without mediastinum drainage tube from 2004 to 2006. Results The morbidity of intrathoracic anasto-motic leak after esophagectomy was 1.67% (3/180) in group A,and 4.55% (7/154) in group B,but no difference between them(χ2=1.4807, P>0.05) were found. Compared to group B, the final diagnosis of anastomotic leak in group A was early [(6.7±0.6) vs (10.0±2.1) days after operation (t=2.62, P<0.05)] and the duration of fe-ver was short [(5.3±1.5)vs (43.0±20.9) hours (t=4.39, P<0.01)]. The prognosis of 3 cases in group A was well, who all recovered without operation and had shorten hospital days than group B [(23.7±5.9)d vs (45.3± 5.0)d,t=4.86,P<0.01)]. In 7 cases of group B,there were 5 cases underwent second operation,but only 3 cases recovered, the case fatality rate was 2.60% (4/154), higher than in group A (0, Fisher, P<0.05). Conclusions Although the mediastinum drainage tube used or not used in esophagectomy is unrelated with the occurrence of anas-tomotic leak, and the significance to use it is that it can help to discover anastomotic leak early, and control mediasti-num infection effectively without reoperation,and improve patients' prognosis.