Since Fujita first described uvulopalatopharyngoplasty(UPPP)in 1981,UPPP and its modified procedures have been widely used to treat obstructive sleep apnea and hyponea syndrome(OSAHS).However,despite of its wide application,the success rates was uncertain,ranging from 20% to 80%,with patients of varing Friedman stages.It is well known that the principle of UPPP is to remove the redundant tissue of palate,elongated uvula and hypertrophic tonsils in order to widen the anteroposterior space at the level of palate.But recently,surgeons have found that not only the collapse of soft palate but also the collapse of lateral wall at the palate level can contribute to the obstruction of upper airway at the level of palate.As a result,many surgeries which can widen the lateral velopharyneal space have sprung up in these years.This review focuses on the development of techniques that emphasize the enlargement of lateral velopharyneal space in patients with OSAHS.
Humans ; Larynx ; Palate ; anatomy & histology ; Palate, Soft ; Pharynx ; anatomy & histology ; Sleep Apnea, Obstructive ; therapy ; Uvula

Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Hyaluronic Acid ; metabolism ; Laryngeal Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Staging

Cardiomyopathy, Dilated ; genetics ; Humans ; Molecular Biology

Objective To investigate the levels and the abnormal incidences of apolipoprotein and other related indicators in health people in Hunan province,and to provide data for establishment of reference intervals in Hunan province.Methods The people with physical examination (n =341) were chosen from the Second Xiangya Hospital of Central South University during August 2014 ～ October 2014 (male,n =239;female,n =102) with age from 22 to 77 years old.All people were divided into 4 groups according to their age:group A aged from 22 to 42 (35.56 ± 5.39),group B aged from 43 to 48 (45.59 ± 1.59),group C aged from 49 to 55 (51.19 ± 1.81),and group D aged from 56 to 77 (63.08 ±5.84).The levels of apoAI,apoB,Lp (a),hypersensitive C-reactive protein (hs-CRP),and homocysteine (HCY) were detected with automatic biochemical analyzer,and were compared among different age groups and between male and female in each age group.Results Compared to male,the average levels of apoAI,and Lp (a) were significantly increased (P ＜0.05),and apoB,hs-CRP,and Hcy were significantly decreased (P ＜ 0.05) in the female.The levels of apoB,and hs-CRP were significantly different among 4 age groups (P ＜ 0.05).The abnormal rate in each index among 4 age groups was not significantly different (P ＞ 0.05).For groups A,B and D,the abnormal rate of Hcy was significant higher in male relative to female (P ＜ 0.05).Conclusions All the indices have significant difference between male and female (P ＜0.05).The levels of apoAI,Lp (a),hs-CRP,and Hcy do not change with the changed age.However,apoB has a certain relationship with age.The level and abnormal rate of Hcy are significantly higher in male relative to female.

ObjectiveTo screen the colonization of multidrug resistant organisms (MDROs) and determine their risk factors in intensive care unit (ICU), so as to provide the basis of prophylaxis and treatment of MDROs colonization.Methods A prospective single-center study was conducted in ICU of China-Japan Friendship Hospital from June 2008 to December 2014. The nostril and anal swabs for each patient who stayed in ICU over 24 hours were collected. Each specimen was cultured and tested for drug sensitivity. Clinical findings and relative risk factors were collected. The risk factors of MDROs colonization were analyzed with univariate analysis. The independent risk factor was selected from the risk factors withP< 0.05 with logistic regression analysis to analyze the related factors of MDROs colonization in ICU.Results 1 672 patients were enrolled. At ICU admission, MDROs colonization was present in 604 cases (36.12%), of whom 62 cases (3.71%) were found to be colonized with methicillin-resistantStaphylococcus aureus (MRSA), 529 (31.64%) were colonized with extended-spectrumβ-lactamase (ESBL) enterobacteria, 7 (0.42%) were colonized with multidrug resistantAcinetobacter baumannii (MDR-AB), and 6 (0.36%) were colonized with multidrug resistantPseudomonas aeruginosa (MDR-PA). ICU acquired MDROs colonization were 197/1 068 (18.45%), among whom 24 patients (1.44%) were colonized with MRSA, 118 (7.06%) were colonized with ESBL enterobacteria, 50 (2.99%) were colonized with MDR-AB, and 5 (0.30%) were colonized with MDR-PA. By multivariable analysis, prior administration of more than two kinds of antibiotics [odds ratio (OR) = 2.352, 95% confidence interval (95%CI)=1.847 - 4.464,P = 0.002], prior use of broad spectrum antibiotics within 3 months (OR = 2.862, 95%CI = 1.458-5.631,P = 0.014), duration of prior antibiotic administration (OR = 1.781, 95%CI = 1.152 - 3.413,P = 0.003) and hospitalization days prior to ICU admission> 9 days (OR = 1.766, 95%CI = 1.235 - 3.986,P = 0.021) were independent risk factors of MDROs colonization on admission to ICU.ConclusionsHigh prevalence of MDROs colonization in ICU patients was found in our hospital, and ESBL enterobacteria was the predominant bacteria. ICU acquired MDROs colonization is also worth considering, especially for MDR-AB. Identification of risk factors for MDROs colonization may help identify and screen patients with high risk, and it is also instructive in prophylaxis of MDROs colonization/infection and restriction of the use of broad spectrum antibiotics.

Objective:To investigate the changes and clinical significances of serum levels of granulocyte macrophage colony-stimulating factor (GM-CSF),interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels in patients with rheumatoid arthritis (RA).Methods:126 cases of patients with RA in our hospital from June 2013 to December 2016 were selected as RA group and divided into two subgroups as active RA group (69 cases) and remission RA group (57 cases) according to the severity of the disease.55 healthy cases who receive physical check in our hospital at same time were selected as the control group.The serum GM-CSF,IL-6 TNF-α levels were detected by enzyme linked immunosorbent assay (ELISA) and compared between different groups,the correlation of serum GM-CSF,IL-6 TNF-α levels with DAS28 were analyzed.Results:The serum GM-CSF,IL-6 TNF-α levels of RA group were significantly higher than those of the remission RA group and control group (P＜0.01),and the serum GM-CSF,IL-6 TNF-α levels of remission RA group were also significantly higher than those of the control group (P＜0.01).Positive correlation between serum GM-CSF,IL-6 and TNF-α levels were found(P＜.0.01).The level of DAS28 was significantly correlated with the levels of serum GM-CSF,IL-6 and TNF-α (r=0.473,0.584,0.675,all P＜0.01).Conclusion:The levels of serum GM-CSF,IL-6 and TNF-α were up-regulated in patients with RA and positively correlated with the activity of RA,which might be of important clinical significance in the early diagnosis,disease evaluation and prognosis of RA.

Objective To investigate the application effect of scene exercise training model of 6 emergency disease entities in the junior nurses training .Methods Thirty‐six newly employed nurses during 2010-2013 were performed the scene exercise train‐ing of six disease entities .Before and after training ,the the forms of questionnaire investigation ,written examination and implemen‐tation were adopted to survey and analyze the post competence ,training attitude ,theoretical knowledge ,operation skill ,single time for help and participating doctor′s satisfaction on the coordinate ability .Results After training ,the aspects of post competence , training attitude ,theoretical knowledge ,operation skills ,single time for help and participating doctor′s satisfaction on the coordinate ability in junior nurse were significantly improved ,the differences between before and after training had statistical significance (P<0 .01 or P<0 .05) .Conclusion Using the scene exercise training model of 6 emergency disease entities in junior nurses training has active significance for increasing the overall quality of junior nurses .

OBJECTIVE To investigate the time and dose relation of new urine bio markers in rat model of acute kidney injury induced by genta mycin (GM)to search for more sensitive,noninvasive and specific markers than traditional approaches to monitor nephrotoxicity.METHODS SD Rats were im treated with GM5,20,80 mg·kg -1 or saline once daily.Rats were randomly divided into 20 subgroups:treated for 1 ,3,7,14 d and 14 d followed with 28 d recovery period.Ten rats per group (5 rats per sex)were scarified at 24 h after the last dosing or the end of recovery period.Blood sa mples were col-lected for blood urea nitrogen (BUN)and creatinine(CRE)analysis.Urine was collected at each nec-ropsy for urine protein by dry che mistry method,for kidney injury molecule-1 (KIM-1 )analysis by ELISA, and for β2-microglobulin (β2-MG)analysis by ELISA.Kidneys were obtained for histological exa mination after HE stains.RESULTS Positive protein(3 +)was noted for several fe male animals treated for 7 or 14 d at 80 mg·kg -1 and the tendency of recovery were noted at the end of recovery period.Co mpared with those in saline control group treated for 7 d,the seru m BUN and CRE levels for fe males and the CRE level for males were significantly increased at 80 mg·kg -1 (P <0.05),and the BUN level showed the tendency of increase for males at 80 mg·kg -1 (P >0.05).When treated for 14 d,the seru m BUN and CRE levels for fe males and males at 80 mg·kg -1 and the seru m CRE level for fe males at 20 mg·kg -1 were significantly increased when compared with those in saline control group(P <0.05). The seru m BUN and CRE recovered to base line for all animals treated for 14 d followed by a 28 d recov-ery period.Histopathological observation of kidney tissues indicated that focal tubule dilatation was noted for animals treated for 3 d at 20 and 80 mg·kg -1 ,infla mmatory cell infiltration and focal tubule dilatation were noted at 20 mg·kg -1 and focal renal tubular epithelial cell degeneration,infla mmatory cell infiltra-tion,focal casts (lightly)were noted at 80 mg·kg -1 for animals treated for 7 or 14 d.For animals treated for 14 d followed by a 28 d recovery period,only basophilic tubules and renal casts were noted at 80 mg·kg -1 .New urine bio markers determination indicated that KIM-1 level was significantly increased at 20 and 80 mg·kg -1 for animals treated for 3,7 or 14 d when compared with that in saline control group (P<0.05).For animals treated for 14 d followed by a 28 d recovery period,the KIM-1 level was still significantly higher than saline control group for males and fe males at 80 mg·kg -1 and males at 20 mg·kg -1 (P <0.05 ),but there was evidence for reversal.The β2-MG level was significantly increased at 80 mg·kg -1 for animals treated for 3 d(P<0.05),at 20 or 80 mg·kg -1 for animals treated for 7 or 14 d(P<0.05 or P<0.01 ),when compared with that in the saline control group.For animals treated for 14 d followed by a 28 d recovery period,the β2-MG level was still significantly higher than saline control group for males and fe males at 80 mg·kg -1 and fe males at 20 mg·kg -1 (P <0.05),but there was also evidence for reversal.CONCLUSION Urine KIM-1 and β2-GM are more sensitive and specific markers for early diagnosis of kidney injury induced by GM when compared with the traditional approaches to monitor nephrotoxicity.

Objective To investigate the effect on free portal pressure (FPP), postoperative complications and rebleeding of devascularization procedure with intact portasystemic collateral shunts. Methods The clinical data of 121 patients with portal hypertension undergoing devascularization in our hospital from 1994 to 2004 were retrospectively analyzed. Patients were divided into two groups(96 cases and 25 cases) , respectively according to whether or not the portasystemic collateral shunts were reserved during operation. Results (1) Free portal pressure (FPP) decreased significantly after devascularization in both two groups [(47?8) cmH2O vs. (37?5) cmH2O, (41?7) cmH2O vs. (37?6) cmH2O; P

Objective To determine if nitric oxide(NO)is involved in the protective effect of propefolpretreatment(PP)against ischemia-reperfusion injury(I/R).Methods Eighteen male SD rats weighing 250-350 gwere randomly divided into 3 groups(n=6 each):A normal control;B I/R and C PP+I/R.The animals werekilled by a knock on the head.Hearts were immediately removed and passively perfused in a Langendorff apparatusat 37℃ with oxygenated(95% O_2,5% CO_2)Krebs-Hensleit(KH)solution at 90 cm H_20.In group B and C thehearts were subjected to 35 min global ischemia by suspension of perfusion followed by 120 min reperfusion.Ingroup C the hearts were perfused with KH solution containing 50 ?mol?L~(-1) propofol for 10 min followed by 10 minpropefol wash-out before I/R.At the end of reperfusion myocardial specimen was obtained from left ventricle andhomogenized for determination of the activities of total NOS(iNOS+cNOS)aand SOD and expression of iNOS andheme-oxygenase-1(HO-1)and content of NO,The relationship between the NO content and activity and/orexpression of these protein and enzyme were analyzed by correlation analysis.Myocardium was examined with lightand electron microscope.Results The myocardial NO content,tNOS activity and tSOD activity were significantlylower in group B than in group A and C and there was no significant difference in NO content,and activity of tNOSand tSOD between group A and C.The NO content was positively correlated with tNOS and negatively correlatedwith Mn-SOD aetivety and HO-1 expression.Microscopic examination showed severe cell injury or necrosis in groupB but little injury in group C.Conclusion Ischemia and reperfusion decrease activity of tNOS and SOD butincrease HO-1 expression resulting in decrease in NO content.Propofol pretreatment protects the heart from I/Rinjury through increase in NOS and antioxidases(Mn-SOD,HO-1).