OBJECTIVE: To investigate the efficacy and related factors of nasal surgery combined with upper air way radiofrequency ablation(RFA) for treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) with chronic nasal blockage. METHOD: One hundred and three mild or moderate OSAHS patients with chronic nasal blockage were recruited, all cases had nasal surgery and upper airway RFA. All patients were evaluated by body mass index (BMI), Epworth sleep scale (ESS), snoring scale, and nocturnal polysomnography (PSG). Eighty-nine patients were reevaluated at least 6 months after surgery with the preoperative methods. RESULT: After operation, the apnea and hypopnea index (AHI) decreased from (18.67 +/- 9.48)/h to (9.22 +/- 7.18)/h; the lowest artery oxygen saturation (LSaO2) increased from (0.83 +/- 0.08) to (0.92 +/- 0.06); the Epworth sleep scale(ESS) decreased from (8.74 +/- 5.67) to (5.12 +/- 3.74); the snoring scale decreased from (7.16 +/- 2.85) to (3.56 +/- 2.26), the percentage of time with oxyhemoglobin saturation below 0.90 (CT90) decreased from (18.64 +/- 12.98) to (10.73 +/- 8.29). All of the differences were obvious (P<0.01). Success was defined as a postoperative apnea-hypopnea in dex < 10 events per hour and at least 50% less than the preoperative value. The surgical success rate was 75.3% (67/89). No major perioperative complications occurred. CONCLUSION Our findings suggest that nasal surgery combined with upper airway RFA can improve snoring and disease-specific quality of life in patients with anatomic na sal obstruction with mild or moderate OSAHS.
Adult ; Catheter Ablation ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; surgery ; Nasal Surgical Procedures ; Sleep Apnea, Obstructive ; surgery ; Snoring ; surgery ; Turbinates ; surgery

Objective To investigate the restrictive factors in the development of foreign medical education. Methods From the years 2011 to 2013, 350 foreign students conducted a questionnaire survey in Chongqing Medical University, and recovered 339 valid questionnaires. Results Only 33.0%(112/339) students thought that the teacher's English was fluent and 70.2% (238/339) needed to add Chinese class. Additionally, 69.6% (236/339) and 63.1% (214/339) students considered theoretical knowledge and practi-cal experience were not enough. 92.3%(313/339) students came from developing countries in Southeast Asia. 86.1%(292/339) foreign students considered that university management was insufficient. Conclusion The survey found the restrictive factors included students' demand for English and Chinese, lack of medical ex-pertise and practice, the problem of student sources and daily management difficulties and so on.

AIM:To explore the role of sphingosine 1-phosphate (S1P) in the dysfunction of vascular endo-thelial cells exposed to high glucose.METHODS: In human aortic endothelial cells cultured under high-glucose ( 22 mmol/L glucose) medium, nitric oxide ( NO) level, polymorphonuclear neutrophil-endothelial cell adhesion rate, protein level of intercellular adhesion molecule-1 ( ICAM-1) , migration of endothelial cells and Akt/endothelial nitric oxide syn-thase ( eNOS) pathway activation were observed after S1P, sphingosine kinase-1 inhibitor and/or Akt inhibitor treatments. RESULTS:S1P decreased NO level, increased polymorphonuclear neutrophil adhesive rate, enhanced ICAM-1 protein level, and inhibited migration of endothelial cells and activation of Akt/eNOS pathway in endothelial cells cultured under high-glucose condition.Sphingosine kinase-1 inhibitor, which reduced S1P content, significantly improved the above endo-thelial cell function indexes and restored the activation of Akt/eNOS pathway.CONCLUSION: S1P promoted high glu-cose-induced dysfunction of endothelial cells probably by inhibiting the activation of Akt/eNOS signal pathway.Targeting S1P is expected to become one of potential treatment strategies to reduce endothelial cell dysfunction.

Objective To evaluate the effect of prosthetic rehabilitation and analyze the exercise training program with myoelectric signal for upper limb stumps.Methods Twenty canes with 22 upper limb stumps were treated with exercise for strength training,muscle contraction and control training and the complication of stump were managed.The myoelectrlc signal of upper limb stumps were detected and the stumps were trained with electronic biofeedback software system,including basic signal of biofeedback training and visual biofeedback training.Then the myoelectric prostheses were assembled.Results After prosthetic rehabilitation and myoelectfic signal training,there Wan no significant atrophy of muscle of stumps,muscle strength and range of motion of these twenty limb stumps increased.The amputees could control muscle contraction and grasp,pinch,wrist rotation,elbow extension or flexion consciously.Twenty myoelectrie prostheses were assembled.Conclusion The prosthetic rehabilitation and myoelectric signal training of limb stump is important for assembling myoelectric prosthesis.

Objective To investigate the clinical efficacy and safety of temperature-controlled radiofrequency ablation(TCRF)for treatment of elderly patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods From March 2009 to June 2010,52 elderly patients with OSAHS confirmed by polysomnography(PSG)were treated with TCRF under local anesthesia.PSG monitoring was used preoperatively and 6 months postoperatively to determine the therapeutic effect.Apnea hyponea index (AHI),the lowest blood oxygen saturation(LSaO2),sleep apnea quality of life index(SAQLI)and the Epworth sleepiness scale(ESS)were assessed before and 6 months after operation.Results All these cases were reevaluated with PSG by the end of postoperative period lasted for 6 months.Thirteen cases were cured,18 cases were significantly improved,15 cases were improved,6 cases were not improved,with a total effective rate of 88.5％(46/52).No serious complications occurred.After operation,AHI decreased from (47.8 ± 13.7)times/h to(13.5 ± 7.3)times/h,LSaO2 increased from 0.677 ± 0.095 to 0.808 ± 0.056,SAQLI increased from(3.53 ± 0.43)scores to(5.01 ± 0.22)scores and ESS scores decreased from(14.93 ± 3.13)scores to(5.33 ± 2.52)scores,all above index had significant differences(P＜ 0.01).Conclusions TCRF for elderly patients with OSAHS is effective,and can improve their health-related quality of life.This treatment is convenient,simple,minimally invasive,repeatable,without serious complications,and can be especially suitable for surgical treatment of elderly patients with mild and moderate OSAHS.

OBJECTIVE: To investigate the effects of short-time continuous positive airway pressure treatment before the surgery on insulin sensitivity in patients with obstructive sleep apnea-hypopnea syndrome and type 2 diabetes who need the operation of uvulopalatopharyngoplasty. METHOD: Thirty cases of patients with moderate and severe obstructive sleep apnea-hypopnea syndrome and type 2 diabetes who need the operation of UPPP were included in this study. The apnea hypopnea index (AHI) and LSaO2 and the insulin sensitivity index (ISI) was evaluated by homeostasis model assessment (HOMA), after 7 days of effective CPAP treatment. Subsequently, the data of the PSG and the ISI were rechecked and compared to the data previously achieved. RESULT: After 7 days of effective CPAP treatment, the level of AHI and LSaO2 changed (P < 0.05). The level of ISI improved (P < 0.05), while the level of AHI was correlated with fasting blood insulin level (r = 0.6365, P < 0.05) and was inverse correlated with insulin sensitivity (r = - 0.6229, P < 0.05). There was an negative correlation between LSaO2 and fasting blood insulin level (r = -0.8889, P < 0.05), and there was a correlation between LSaO2 and insulin sensitivity (r = 0.9526, P < 0.05). CONCLUSION The 7 days of effective CPAP treatment could improve the hypoxia of patients, and it could enhance the ISI and could reduce the operation risk of UPPP.
Aged ; Continuous Positive Airway Pressure ; Diabetes Mellitus, Type 2 ; complications ; therapy ; Female ; Humans ; Insulin ; pharmacology ; Insulin Resistance ; Male ; Middle Aged ; Sleep Apnea, Obstructive ; complications ; therapy

Objective To observe the effects of rehabilitation exercises on limb function of patients with cervical spondylotic myelopathy (CSM) after artificial intervertebral disc replacement.Methods 42 CSM patients undergone anterior cervical decompression and Bryan disc prosthesis under microscope were randomly divided into the normal care group (n=20) and rehabilitation exercises group (n=22). All patients of two groups were assessed by JOA scale at 2nd week and 6th month after operation.Results The JOA scores of two groups at 6th month were all higher than that at 2nd week and scores of the rehabilitation exercises group were also higher than that of the normal care group ( P<0.01).Conclusion Rehabilitation exercises after artificial intervertebral disc replacement can improve spine cord function of CSM patient.

Objective To investigate the clinical manifestations, angiographic features and clinical significance of kinking of extracranial internal carotid artery (ICA). Methods The clinical and radiological data of 21 patients with kinking of extracranial ICA were retrospectively reviewed in our hospital from April 2003 to July 2007. Fisher exact test was performed. Results Of the 21 patients, 7 hod no clinical symptoms, the other 14 showed manifestations of cerebral iachemia with varying degree. One of the characteristic clinical manifestations that neck rotation or specific positions of head and neck might induce the occurrence of clinical symptoms was found in 5 cases. The whole-brain coverage DSA accurately showed the location of kinking of extracranial ICA and the degree of vascular stenosis. In patients with α < 66%, 80% > α≥ 66% and α≥ 80%, clinical symptoms were found in 3 out of 5,7 out of 10 and 4 out of 6 patients, respectively. Fisher exact test revealed that the positive rates of clinical symptoms in three groups had no significant difference (P > 0. 05). Conclusion Kinking of extracranial ICA is a frequent vascular morphologic variation, and it is also a kind of potential disease. The whole-brain coverage DSA is a relatively reliable method to detect this variation.

OBJECTIVETo investigate the guiding role of narrow-band imaging endoscopy in laryngeal malignant lesion biopsy.

METHODSFrom February 2013 to January 2014, 113 patients suspected of laryngeal malignant lesions after electronic nasopharyngolaryngoscope screening were included in the study. The patients were randomly divided into two groups, 58 cases in group A underwent laryngeal tumor biopsies in the white light mode and 55 cases in group B did in NBI mode. The patients were applied with corresponding surgery treatment according to the biopsy results. Postoperative pathologic examination result was as a gold standard for identifing the laryngeal diseases.

RESULTSThe positive rate of malignant lesions in group A (71.1%, 32/45) was significantly lower than that in group B (95.4%, 42/44) (χ² = 7.75, P < 0.05); the accurate rate of biopsy in group A (77.6%, 45/58) was significantly lower than that in group B (96.4%, 53/55, χ² = 7.09, P < 0.05) .

CONCLUSIONNarrow-band imaging endoscopy can obviously improve in the detection of laryngeal malignant lesion by biopsy.

Biopsy ; methods ; Endoscopy ; methods ; Humans ; Laryngeal Neoplasms ; diagnosis ; surgery ; Laryngoscopy ; Larynx, Artificial

OBJECTIVE: To explore the oncologic efficacy of transoral endoscopic CO2 laser surgery in early glottic carcinoma. METHOD: Retrospectively study 91 patients with glottic carcinoma (9 Tis, 45 pT1a, 25 pT1b, 12 pT2) treated in our department from October 1999 to August 2004. Surgical treatment included endoscopic CO2 laser cordectomies according to the classification of the European Laryngological Society in 2000. RESULT: According to the Kaplan-Meier method, the probability of remaining free of local recurrence 5 years after primary surgery alone was 100.00% for the Tis, 93.33% for the T1a, 84.00% for T1b and 75.00% for the T2 respectively, without statistical significance of various groups by the Log-Rank tests (P > 0.05). The probability of remaining free of local recurrence 5 years after primary surgery alone was 78.57% (6/28) of tumors offended the anterior commissure, versus 93.65% (4/63) with no involvement of anterior commissure, have statistical significance (P < 0.01). The 5 year overall survival and the disease free survival were 92.72% and 84.62% respectively. Perceptive evaluation was performed with the "GRBAS" evaluation system 6 month after laser operation. All patients in the group of type I and type II had an normal voice or mild dysphonia. The patients treated with type III, type IV and type V had a mild or moderate vocal disease. CONCLUSION According to the present series, endoscopic CO2 laser surgery is an effective treatment for early glottic cancer.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Lasers, Gas ; Male ; Microsurgery ; Middle Aged ; Retrospective Studies ; Vocal Cords