OBJECTIVE: To explore the impact of nasopharynx and palatum durum on the pathogenesis and severity of OSAHS patients via CT scan, and to establish a foundation to select the suitable surgical procedures. METHOD: Thirty nine OSAHS patients diagnosed by PSG and 30 normal adults were included in this study. Successive CT scanning were undertaken from roof of nasopharynx to glottis and then the CT scan slices were reconstructed in sagittal plane through Efilm software. The parameters were measured in the midline of the nasopharynx,the longest section of the hard palate and then were analyzed by t test. RESULT: The subspinale-posterior nasal spine (A-PNS) of OSAHS patients were longer than those of normal adults. The posterior nasal spine-culminating point of nasopharynx (PNS-R) and posterior space of hard palate (PNS-B) of OSAHS patients were less than those of normal adults. A 95% confidence interval were calculated from the parameters of 30 normal adults. Among 39 OSAHS patients, the A-PNS in 6 patients were longer than the top limit of normal,the PNS-R in 10 patients and the PNS-B in 16 patients were less than the low limit of normal adults, 2 patients were seen the differences of both A-PNS and PNS, 5 were seen the differences of both PNS-R and PNS-B, and 1 were seen the differences of A-PNS and PNS-B. The AHI of 24 OSAHS patients with smaller nasopharynx and longer hard palate were larger than that of the other 15 OSAHS patients, meanwhile the SaO2 of the former patients were lower than the latter. CONCLUSION Though the narrow of the upper airway in OSAHS patients mainly attribute to the nasopharynx, the nasopharyngeal size and the length of hard palate are also involved in the pathogenesis and severity of OSAHS and should be considered when choosing the surgical procedures.
Adolescent ; Adult ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Nasopharynx ; diagnostic imaging ; Sleep Apnea, Obstructive ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

Objective:To investigate the differences in incidence of deep vein thrombosis (DVT) after closed fracture of lower extremity between patients with different blood types ABO.Methods:A retrospective study was conducted in the 1, 951 patients who had been admitted to Department of Orthopaedics Trauma, Honghui Hospital Affiliated to Xi'an Jiaotong University for lower extremity fractures from August 2014 to June 2018. They were 924 males and 1,027 females with a mean age of 63 (46, 78) years (range, from 16 to 102 years). Of them, 572 were type O, 564 type A, 609 type B and 206 type AB. Venous ultrasonography was performed on both lower extremities within 12 hours after admission. The incidences of DVT after fracture were compared between different blood types in all the patients, patients with proximal fracture of the knee, peri-knee fracture and distal fracture of the knee, and patients<60 years old and ≥60 years old.Results:The incidences of DVT were, respectively, 26.75% (153/572), 28.72% (162/564), 34.32% (209/609) and 29.61% (61/206) for patients with blood type O, type A, type B and type AB. The DVT incidence for type B was significantly higher than that for type O ( P< 0.008). The incidences of DVT were, respectively, 28.74% (98/341), 28.99% (100/345), 39.45% (144/365) and 30.97% (35/113) for blood type O, type A, type B and type AB in the patients with proximal fracture of the knee. The DVT incidence for blood type B was significantly higher than those for blood type O and blood type A ( P< 0.008). There were no significant differences in the DVT incidence between different blood types ABO in the patients with peri-knee fracture, distal fracture of the knee,<60 years old or ≥60 years old( P>0.05). The incidences of DVT were, respectively, 30.99% (97/313), 33.33% (108/324), 45.22% (156/345), 34.74% (33/95) for blood type O, type A, type B and type AB in the patients ≥60 years old. The DVT incidence for blood type B was significantly higher than those for blood type O and blood type A ( P< 0.008). Conclusions:The incidence of DVT varied with different blood types ABO after lower extremity fracture. The highest DVT incidence was found in patients with blood type B. The impact of blood type on the DVT incidence after lower extremity fracture was mainly observed in the patients with proximal fracture of the knee or an age of ≥ 60 years old.

Objective:To investigate the effects of preoperative nutritional status on postoperative functional prognosis in elderly patients with proximal humerus fracture.Methods:From January 2020 to December 2020, 103 elderly patients (≥65 years old) were treated for proximal humerus fractures by open reduction and internal fixation at Department of Traumatology, Honghui Hospital Affiliated to Xi'an Jiaotong University. Upon admission, according to the Geriatric Nutrition Risk Index (GNRI), they were assigned into a normal nutrition group (55 cases, with GNRI≥92) and a malnutrition group (48 cases, with GNRI<92). The baseline data, preoperative hemoglobin level, time from injury to operation, intraoperative blood transfusion, postoperative complications, 1-year mortality, and Neer shoulder functional scores at 3 months, 6 months and the last follow-up were compared between the 2 groups.Results:The 2 groups were comparable because there were no significant differences in gender, injury side, Neer fracture classification, injury cause, or American Society of Anesthesiologists (ASA) grading ( P>0.05). The age of the malnutrition group was significant older than that of the normal nutrition group ( P<0.05). All patients were followed up for 9 to 16 months (mean, 13.6 months) after surgery. In the normal nutrition group and the malnutrition group, respectively, the preoperative hemoglobin level was (10.24±0.68) g/dL and (8.94±0.89) g/dL, the time from injury to operation (3.9±1.3) d and (5.8±1.2) d, the rate of intraoperative blood transfusion 14.5%(8/55) and 60.4%(29/48), the rate of postoperative complications 20.0%(11/55) and 39.6%(19/48), the 1-year mortality 1.8%(1/55)、4.2%(2/48), and the Neer shoulder function score (46.7±8.8) points and (43.2±5.6) points at 3 months after operation, (67.6±6.2) points and (76.3±5.5) points at 6 months after operation, and (80.4±5.0) points and (76.3±5.5) points at the last follow-up. Comparisons of all the above items showed significant differences between the 2 groups (all P<0.05). Conclusions:Preoperative malnutrition in elderly patients with proximal humerus fracture has adverse effects on preoperative waiting time, intraoperative blood transfusion, complications and postoperative shoulder function. Therefore, perioperatively, attention should be paid to the nutritional status of elderly patients to reduce their stress responses to fracture, surgery and anesthesia, and to improve their postoperative function and quality of life.

Objective:To identify the risk factors for acute kidney injury (AKI) after non-cardiac surgery.Methods:Medical records of patients who underwent non-cardiac surgery with general anesthesia in our hospital from October 1, 2016 to March 31, 2021 were collected.AKI was diagnosed using the Kidney Disease Improving Global Outcomes definition of AKI.Multi-factor logistic regression analysis was used to screen the risk factors affecting AKI.Generalized linear regression was used to analyze the factors influencing the difference in serum creatinine before and after surgery.Results:A total of 2 214 patients were eventually enrolled, and the incidence of AKI was 5.15%.The results of multi-factor logistic regression analysis showed that preoperative hypertension, American Society of Anesthesiologists Physical Status classification ≥ Ⅲ, intraoperative bleeding >300 ml, emergency surgery, and grade IV surgery were independent risk factors for AKI after non-cardiac surgery ( P<0.05). The results of generalized line regression analysis showed that preoperative hyponatremia, intraoperative bleeding >300 ml, emergency surgery, and duration of anesthesia were positively correlated with increased difference in serum creatinine before and after surgery ( P<0.05). Conclusions:Preoperative hypertension, American Society of Anesthesiologists Physical Status classification ≥ Ⅲ, intraoperative bleeding >300 ml, emergency surgery and grade IV surgery are independent risk factors for AKI after non-cardiac surgery.

OBJECTIVETo investigate the clinical influence factors of oral-maxillofacial benign tumors.

METHODSWe conducted a case-control study with 113 cases newly diagnosed primary oral-maxillofacial benign tumors and 584 cases controls from a hospital in Fujian from September 2010 to January 2015. Epidemiological data were collected by in-person interviews using a standard questionnaire. The contents of the questionnaire included demography character, history of tobacco smoking and alcohol drinking, dietary habits, oral hygiene status, family history of cancer, etc. Unconditional logistic regression was used to research the relationship between the factors and oral-maxillofacial benign tumors.

RESULTSMultivariable analysis showed that risk factors of oral-maxillofacial benign tumors included: cigarette smoking index above 1 000, passive smoking before the age of 18, age of wearing bad prosthesis between 33 to 55 years old and high blood pressure; the corresponding OR (95% CI) values were 14.63 (3.88-55.13), 2.34 (1.19-4.62), 2.35 (1.17-4.73), 3.46 (1.71-7.00), respectively; Protective factors included: regularly intake of meat above 1 time/day, fruits, health care products and vitamin tablets, brushing teeth above 1 time per day and oral examination above 5 years/time, the corresponding OR (95% CI) values were 0.22 (0.07-0.70), 0.18 (0.08-0.41), 0.32 (0.11-0.88), 0.22 (0.07-0.73), 0.28 (0.16-0.48), 0.28 (0.13-0.60), respectively.

CONCLUSIONAbstinence from tobacco smoking, reduce passive smoking before the age of 18, regularly intake of meat, fruits, health care products and vitamin tablets, and oral examination at regular time might have impact on the incidence of oral-maxillofacial benign tumors to a certain extent.

Alcohol Drinking ; Case-Control Studies ; Demography ; Diet ; Humans ; Incidence ; Logistic Models ; Mouth Neoplasms ; epidemiology ; Oral Hygiene ; Risk Factors ; Smoking ; Surveys and Questionnaires ; Tobacco Smoke Pollution

OBJECTIVETo investigate the association between oral hygiene, chronic diseases, and oral squamous cell carcinoma.

METHODSWe performed a case-control study with 414 cases and 870 controls in Fujian during September 2010 to January 2015. Patients were newly diagnosed oral squamous cell carcinoma cases according to the pathologic diagnoses, control subjects were enrolled from community population. Epidemiological data were collected by in-person interviews using a standard questionnaire. The contents of the questionnaire included demography character, history of tobacco smoking and alcohol drinking, dietary habits, oral hygiene status, family history of cancer, etc. Using unconditional logistic regression analysis to estimate adjusted odds ratios (OR) and corresponding 95% confidence intervals (CI) for oral hygiene and chronic diseases. We also stratified by sex, smoking and drinking to explore possible difference in association between subgroups.

RESULTSThe multivariate logistic regression analysis indicated that number of teeth (20-27 and < 20), bad prosthesis, recurrent oral ulceration were the risk factors of oral squamous cell carcinoma, the adjusted OR (95% CI) values were 2.01 (1.49-2.73), 3.51 (2.39-5.15), 2.33 (1.79-3.04), 3.96 (2.11-7.44), respectively; brushing tooth once per bay, brushing tooth more than once per day, regular oral health examination at least 5 years per time were the protective factors of oral squamous cell carcinoma, the adjusted OR (95% CI) values were 0.24 (0.13-0.43), 0.13 (0.07-0.24), 0.37 (0.26-0.53), respectively. The stratification analysis indicated that recurrent oral ulceration could increase the risk of oral squamous cell carcinoma for non-smokers and non-drinking, the adjusted OR (95% CI) value was 5.21 (2.42-11.18) and 4.71 (2.37-9.36); and a risky effect of hypertension on risk of oral squamous cell carcinoma was observed for non-smokers and non-drinking, the adjusted OR (95% CI) values were 1.70 (1.10-2.61) and 1.58 (1.07-2.34).

CONCLUSIONSOral hygiene and chronic diseases could affect the incidence of oral squamous cell carcinoma.

Alcohol Drinking ; Carcinoma, Squamous Cell ; epidemiology ; Case-Control Studies ; Chronic Disease ; epidemiology ; Diet ; Humans ; Incidence ; Mouth Neoplasms ; epidemiology ; Odds Ratio ; Oral Hygiene ; Risk Factors ; Smoking ; Surveys and Questionnaires

Objective: To investigate the effects between fish, seafood and pickled food intakes on oral squamous cell carcinoma (OSCC). Methods: A case-control study was carried out in Fujian area during September 2010 to December 2016, in which 604 newly diagnosed primary OSCC cases confirmed by pathological diagnosis were collected from hospital and 1 343 control subjects were enrolled from community and healthy hospital population. Demographic data, history of smoking drinking and tea drinking, oral hygiene status and dietary behaviors (fish, seafood and pickled food intakes) were collected by in-person interviews using a standard questionnaire.Using unconditional logistic regression to estimate adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) to assess the effects of fish, seafood and pickled food intakes on OSCC. Analysis stratified by smoking, alcohol drinking and bad prosthesis to explore the possible difference in association between subgroups. Multiplicative interactions and additive interactions between fish and bad prosthesis, seafood and alcohol drinking, pickled food and bad prosthesis were assessed by unconditional logistic regression, relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S). Results: The average age of case group and control group were separately (58.69±13.92) years old and (59.27±11.37) years old (χ²=4.75, P=0.191). The people whose fish and seafood intakes ≥3 times/week had the lower risk of OSCC, the adjusted OR (95%CI) values were 0.63 (0.52-0.77) and 0.51 (0.41-0.64); The stratified analysis indicated that the people having bad prosthesis had the lower risk of OSCC if they eating fish ≥3 times/week, and the adjusted OR (95%CI) values was 0.53 (0.39-0.71); the people having bad prosthesis had the higher risk of OSCC if they eating pickled food ≥3 times/week, the adjusted OR (95%CI) values was 1.37 (1.02-1.88). Regularly eating seafood can decrease the risk of OSCC for non-smokers, smokers, non-drinkers, drinkers, people without bad prosthesis and had bad prosthesis, the adjusted OR (95%CI) values were 0.49 (0.36-0.68), 0.52 (0.37-0.73), 0.41 (0.31-0.55), 0.77 (0.51-0.96), 0.49 (0.36-0.67), 0.59 (0.42-0.83). Crossover analysis showed fish and bad prosthesis exist multiplication interaction relationship (adjusted OR=0.66, 95%CI: 0.44-0.97) and additional interaction relationship (RERI=-0.81, 95%CI:-1.43--0.19; AP=-0.76, 95%CI:-1.35--0.17; S=0.08, 95%CI: 0.01-0.98); pickled food and bad prosthesis exist multiplication interaction relationship (adjusted OR=1.63, 95%CI: 1.06-2.51) and addition interaction relationship (RERI=0.65, 95%CI:0.08-1.22; AP=0.36, 95%CI:0.10-0.62; S=5.19, 95%CI:1.32-54.49). Conclusion Reducing the consumption of pickled food, quitting smoking and limiting alcohol consumption, and regularly eating fish and seafood can prevent the occurrence of OSCC.

Objective: To evaluate the influence of oral hygiene on risk of oral cancer in non-smoking and non-drinking women. Methods: From September 2010 to February 2016, 242 non-smoking and non-drinking female patients with pathologically confirmed oral cancer were recruited in a hospital of Fuzhou, and another 856 non-smoking and non-drinking healthy women from health examination center in the same hospital were selected as control group. Five oral hygiene related variables including the frequency of teeth brushing, number of teeth lost, poor prosthesis, regular dental visits and recurrent dental ulceration were used to develop oral hygiene index model. Unconditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95%CI). The area under the receiver operating characteristic curve (AUROC) was used to evaluate the predictability of the oral hygiene index model. Multivariate logistic regression model was used to analyze the association between oral hygiene index and the incidence of oral cancer. Results: Teeth brushing <2 twice daily, teeth lost ≥5, poor prosthesis, no regular dental visits, recurrent dental ulceration were risk factors for the incidence of oral cancer in non-smoking and non-drinking women, the corresponding OR (95%CI) were 1.50 (1.08-2.09), 1.81 (1.15-2.85), 1.51 (1.03-2.23), 1.73 (1.15-2.59), 7.30 (4.00-13.30), respectively. The AUROC of the oral hygiene index model was 0.705 9, indicating a high predictability. Multivariate logistic regression showed that the oral hygiene index was associated with risk of oral cancer. The higher the score, the higher risk was observed. The corresponding OR (95%CI) of oral hygiene index scores (score 1, score 2, score 3, score 4-5) were 2.51 (0.84-7.53), 4.68 (1.59-13.71), 6.47 (2.18-19.25), 15.29 (5.08-45.99), respectively. Conclusion Oral hygiene could influence the incidence of oral cancer in non-smoking and non-drinking women, and oral hygiene index has a certain significance in assessing the combined effects of oral hygiene.

Objective: To explore the relationship between selenium and the risk for oral cancer. Methods: We performed a case-control study in 325 cases of newly diagnosed primary oral cancer from the First Affiliated Hospital of Fujian Medical University and 650 controls from the same hospital and community. Unconditional logistic regression and stratification analyses were used to explore the association between selenium and oral cancer. Adjusted OR and corresponding 95%CI were calculated. The analyses on multiple interactions between selenium and smoking or drinking status, and fruit or fish intake frequencies were conducted. Results: The level of serum selenium was 112.42 (80.98-145.06) μg/L in the case group, which was lower than 164.85 (144.44-188.53) μg/L in control group, the difference was statistical significant (P<0.01). There was a negative correlation between serum selenium level and the risk for oral cancer regardless of smoking and drinking status, and fruits and fish intake frequencies (P<0.05). There were multiple interactions between serum selenium level and smoking or drinking status, and fruit and fish intakes. Conclusions The high level of serum selenium is a protective factor for the incidence of oral cancer, and serum selenium has multiple interactions with smoking or drinking status, and fruit and fish intakes. Therefore, reducing tobacco use and alcohol consumption and increasing the intakes of fruit and fish can reduce the risk for oral cancer to some extent.

Objective: To explore the association of TBX5 polymorphisms and environmental exposure index with susceptibility to oral cancer. Methods: A case-control study was conducted to collect 300 oral cancer patients hospitalized in the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University from September 2010 to December 2016. A total of 445 non-tumor patients were selected as the control group. Questionnaires were used to collect the information of all subjects and 5 ml peripheral blood was collected to detect single nucleotide polymorphisms (SNPs) of the rs10492336 locus of TBX5 gene. According to the environmental exposure index score, subjects were divided into two groups, low risk group (0-2.31) and high risk group (2.32-11.76). To analyze the association of TBX5 gene rs10492336 SNPs, environmental exposure index and oral cancer and its interactions. Results: The age of all subjects in the case group and control group were (56.19±13.10) years and (54.56±12.48) years old. Compared with CC genotype, the OR (95%CI) values of the co-dominant genetic model AC genotype and the dominant genetic model AC+AA genotype were 0.69 (0.49-0.98) and 0.70 (0.51-0.97), respectively. Compared with the low risk group, the OR (95%CI) risk of oral cancer in the high risk group was 3.72 (2.55-5.43). The results of gene-environment interaction analysis showed that compared with the group with CC genotype and high risk of environmental exposure index, the OR (95%CI) value of oral cancer in the group with AC+AA genotype and low risk of environmental exposure index was 0.18(0.10-0.31). Furthermore there was a multiplicative interaction between rs10492336 SNPs and environmental exposure index (β=-0.405, P<0.001). Conclusion This study suggests that the TBX5 gene rs10492336 SNPs and environmental exposure index were associated with oral cancer. And there was a multiplication interaction between rs10492336 SNPs and environmental exposure index.