Objective To evaluate the impact of sleep-disordered breathing(SDB)on the quality of life(QOL)in children with SDB and investigate the value of tonsillectomy and adenoidectomy in improving their QOL.Methods Questionnaire of disease-specific quality of life for children with obstructive sleep apnea with 18 items(OSA-18)was used to evaluate QOL in 168 children with SDB within four weeks before and six to 12 months after surgical operation,and correlation between OSA-18 scores to apnea hypopnea index(AHI)and minimum oxygen saturation(MiO2)in 62 of them was evaluated with polysomnography(PSG),with 50 healthy children without snoring as controls.Results Overall scores of OSA-18 in children of SDB group before surgical operation were significantly higher than those in children of control group(t=15.12,P＜0.01).and QOL was seriously affected in 30.4 percent of the children with SDB.Scores of OSA-18 correlated to AHI and MiO2 before surgical operation.QOL was improved significantly in 73.8 percent of children with SDB after tonsillectomy and adenoidectomy.Conclusions SDB has obvious impact on pediatric QOL,which can be improved by tonsillectomy and adenoidectomy.There exists significant correlation between OSA-18 scores and objective indicators of PSG,and the former can be used as clinical diagnosis for SDB in children and as quantitative evaluation for the effectiveness of intervention.

Objective To investigate whether scores of epworth sleepiness scale (ESS) assessing daytime sleepiness were associated with sleep apnea syndrome(SAS)combined with cerebral vascular disease and ESS could be used to predict cerebral vascular disease occurrence.Methods A group of 62 SAS combined with transient ischemic attack(TIA), a group of 53 SAS with combined hypertension and the other group of 61 SAS combined without other diseases were monitored by polysomnography(PSG), daytime sleepiness of these SAS patients were assessed by ESS at the same time. Results Compared to SAS combined without other diseases, those SAS combined with TIA and hypertension patients had significant higher scores of ESS,apnea/hypopnea index (AHI) and micro-arousal index(MAI)(all P

Objective To investigate the survival status of liver cirrhosis patients without upper gastrointestinal hemorrhage after transjugular intrahepatic portosystemic shunt (TIPS).Methods From 2004 to 2013,15 liver cirrhosis patients without upper gastrointestinal hemorrhage volunteered received TIPS treatment were followed up to find out the difficulty and the success rate of TIPS procedure,the incidence of hepatic encephalopathy,upper gastrointestinal hemorrhage and improving of hypersplenism.Results The success rate of operation was 100％.The average of operation time was 60 minutes.During follow-up,no stent angulation occurred,no gastrointestinal hemorrhage happened and no one died in all 15 patients after TIPS operation.There were four patients with hepatic encephalopathy in eight weeks after operation.The anemia of four patients improved compared with that before operation.Conclusions TIPS is a safe and effective threapy in the prevention of gastrointestinal hemorrhage in the patients with liver cirrhosis accompanied with severe gastroesophageal varices.It may become the primary prophylaxis for liver cirrhosis patients without upper gastrointestinal hemorrhage.

OBJECTIVE: To investigate the effect and potential mechanisms about apoptosis induction and migration suppression of photodynamic therapy with a new photosensitizer, 9-hydroxypheophorbide-α (9-HPbD), and diode laser on HN-3 human laryngeal squamous cancer cells. METHOD: The attached HN-3 cancer cells were photosesitized with 0.29 μg/ml and 0.59 μg/ml 9-HPbD for 6 h and irradiated by 664 nm diode laser for 15 min at an energy density of 2.0 J/cm for activating 9-HPbD. Wound healing assay and photographing was respectively performed immediately after laser irradiation. Photographing focusing on the same location was repeated 12 h, 24 h and 36 h after PDT and cells migration distance counted respectively. H2DCFDA staining was used to assess accumulation of reactive oxygen series (ROS) 1 h after PDT. MTT assay, Hoechst33342/PI double staining, western blotting were respectively performed to assess cellular viability, apoptosis and the expression of Enos, p-c-Jun, EGFR. RESULT: Phototoxicity and apoptosis on HN-3 cells induced by 9-HPbD-PDT was exhibited in a dose-related manner. Neither 9-HPbD alone nor laser alone was cytotoxic to HN-3 cells. Generation of ROS was initiated immediately after PDT. The apoptotic cells, marked with condensed/fragmented blue or pink nuclei, and up-regulated expression of eNOS, p-c-Jun were subsequently induced 24 h after PDT. Coupled with a down-regulated expression of EGFR, a photosensitizer dose-ralated cell migration suppression was initiated by PDT. After pretreatment of GSH or ascorbic acid, a kind of antioxidant, the efficacy of PDT-induced apoptosis and migration suppression was partially inhibited. CONCLUSION Activation of p-c-Jun, eNOS and down-regulated expression of EGFR may respectively involve in the apoptosis induction and cell migration suppression after 9-HPbD-PDT. Generation of ROS may play an important role in the course of apoptosis induction and migration suppression of HN-3 cells initiated by 9-HPbD-PDT.
Apoptosis ; Carcinoma, Squamous Cell ; pathology ; Cell Line, Tumor ; drug effects ; Cell Movement ; Cell Survival ; Chlorophyll ; analogs & derivatives ; pharmacology ; Head and Neck Neoplasms ; pathology ; Humans ; Laryngeal Neoplasms ; pathology ; Lasers ; Photochemotherapy ; Photosensitizing Agents ; pharmacology ; Squamous Cell Carcinoma of Head and Neck

Objective:To evaluate the effect of different water-improving methods on dental fluorosis of children aged 8 to 12 in drinking-water-borne fluorosis areas in Xi'an City, and provide basis for making fine prevention and control measures.Methods:In 2018, 50 drinking-water-borne fluorosis villages in Xi'an City with water improvement time from 2011 to 2013 were selected as survey sites. The condition and the way of water improvement were surveyed, water fluoride content was determined and the prevalence of dental fluorosis in children aged 8 to 12 was examined, and the rates of dental fluorosis were compared before and after the water improvement in the 50 villages.Results:The water-improving projects were in normal operation in 50 villages. The medians of water fluoride content were 0.31, 0.88 and 1.14 mg/L in villages with municipal water supply, low fluorine well and defluoridation treatment water supply (the villages of different water-improvement methods were 12, 24 and 14, respectively), the differences were statistically significant ( H = 75.54, P < 0.01). The qualification rates of water fluoride in villages with different water-improvement methods were 100.00% (12/12), 79.17% (19/24) and 57.14% (8/14), and the difference was statistically significant (χ 2 = 6.95, P < 0.05). The detection rate of dental fluorosis was 43.17% (218/505) in the 11 villages with excessive water fluoride content, and the detection rate was 20.77% (331/1 594) in the 39 villages with qualified water fluoride content, the difference was statistically significant (χ 2 = 99.66, P < 0.01). After water improvement, the total detection rate of dental fluorosis (26.16%, 549/2 099) in the 50 villages was lower than that before water improvement (41.66%, 959/2 302), the difference was statistically significant (χ 2 = 117.17, P < 0.01). The detection rates of dental fluorosis were reduced after the water improvement in villages with municipal water supply and low fluorine well, the differences were statistically significant (χ 2 = 74.37, 69.36, P < 0.01). The detection rate was declined after water improvement in villages with defluoridation treatment water supply, but the difference was not significant (χ 2 = 0.78, P > 0.05). There was a statistically significant difference in the detection rate of dental fluorosis among children in villages with different water-improvement methods (χ 2 = 72.79, P < 0.01). The detection rate of dental fluorosis in villages with defluoridation treatment water supply [39.53% (200/506)] was higher than that in villages with municipal water supply [17.97% (133/740)] and low fluorine well [25.32% (216/853)], the differences were statistically significant ( P < 0.017); the detection rate of dental fluorosis in villages with municipal water supply was lower than that in villages with low fluorine well ( P < 0.017). Conclusions:The dental fluorosis of children's has been effectively controlled in the villages after water improvement in Xi'an City. The fluoride content in the water and the detection rate of dental fluorosis in children in some endemic areas are still high. It is necessary to further improve the water quality or consolidate the improvement effect as soon as possible.

Objective To assess the effects of defluoridation on prevalence of children's dental fluorosis in Xi'an City and study related influencing factors.Methods In 2017,the survey results of 2013 were collected from the previous investigation of drinking water type fluorosis in Xi'an Center for Disease Control and Prevention,and villages from drinking water type fluorosis areas were divided into five groups:0.0-,0.2-,0.5-,1.0-,and ≥ 1.5 mg/L,according to the fluoride concentrations of water.Four villages were randomly selected from each group,a total of 20 villages were selected as the investigation sites.A cross-sectional analytical study was conducted in the 20 villages,the fluoride in drinking water,the dental fluorosis of children aged 8-12 years and fluoride content in urine were detected,and the survey results were compared with those of 2013.Children were divided into five groups according to urinary fluoride contents as:0.0-(control),0.4-,0.8-,1.2-,and ≥ 1.6 mg/L,and the logistic regression model was used to evaluate the risk of dental fluorosis.Results There were no significant differences in water fluoride content between 2013 and 2017 (P ＞ 0.05).The rates of dental fluorosis among the study population in 2013 and 2017 were 25.35％ (200/789) and 20.58％ (164/797),and the difference was significant (x2 =5.11,P＜0.05).The prevalence rate and severity of dental fluorosis in 2013 [3.52％ (9/256),13.28％ (17/128),31.62％ (43/136),37.82％(45/119),57.33％(86/150)] and 2017[4.02％(10/249),11.82％(13/110),18.05％(24/133),29.13％(37/127),44.94％ (80/178)] were significantly increased with increase of water fluoride concentration (x2 =168.02,117.83,P ＜ 0.01).The prevalence rate of dental fluorosis was higher than 30％ in the three groups with water fluoride content 0.5-,1.0-and ≥ 1.5 mg/L in 2013,and the prevalence rates were decreased in these groups in 2017.The prevalence rate of dental fluorosis was lower than 30％ in the groups with water-fluorine content of 0.5-,1.0-＜1.5 mg/L,while the rate of dental fluorosis in the group with water-fluorine content of higher than 1.5 mg/L was still over 40％.The geometric mean of urinary fluoride of children in 2013 and 2017 were 1.02,0.67 rg/L,and the difference was significant (t =10.24,P ＜ 0.01).There were significant differences in children urinary fluoride between water fluoride groups in 2013 and 2017 (F =85.36,151.14,P ＜ 0.01).The risk of dental fluorosis increased with increase of urinary fluoride content,the odds ratio (OR) values were 5.26,7.83 and 13.28 in the three groups with the urinary fluoride 0.8-,1.2-,≥1.6 mg/L in 2013;the OR values in 2017 were 5.18,7.65 and 13.36,the differences were statistically significant (P ＜ 0.05).Conclusions The situation of water fluoride and dental fluorosis are not optimistic after defluoridation of drinking water.It is necessary to reinforce the measures of water defluoridation,and carry out classified management in endemic fluorosis areas.

Objective:To assess the implementation of control measures and dental fluorosis of children in drinking-water-borne endemic fluorosis areas in Xi'an City, and to evaluate the implementation effects of the prevention and control measures.Methods:All drinking-water-borne endemic fluorosis villages in Xi'an were selected as the investigation sites. The progress and running condition of all water-improved projects were investigated, fluoride concentration in all the water-improved projects and tap water were tested. "Standard Test Method for Drinking Water" (GB/T 5750.5-2006) was used to test the water fluoride. A cross-sectional analytical study was conducted on school children aged 8 - 12 years old, the dental fluorosis was determined according to "Diagnosis of Dental Fluorosis" (WS/T 208-2011).Results:There were 273 drinking-water-borne endemic fluorosis villages, the rate of water improved villages was 91.58% (250/273), and all of the water-improved projects were operating normally (100.00%, 196/196). The rate of water-improved projects with qualified water fluoride was 88.27% (173/196), 237 villages had fluoride safe drinking water and the qualified rate was 86.81% (237/273). The median of water fluoride in the 250 villages with water-improved projects was 0.78 mg/L, the median was 0.83 mg/L in the 23 villages without water-improved projects, and the difference was not significant ( Z = 1.475, P > 0.05) . The overall prevalence of dental fluorosis among children aged 8 - 12 years old was 19.86% (1 960/9 871), and the dental fluorosis index was 0.39. The prevalence of dental fluorosis in the villages with qualified water fluoride was 16.13% (1 377/8 539), and the rate was 43.77% (583/1 332) in the villages with unqualified water fluoride, and the difference was significant (χ 2 = 553.283, P < 0.01). The prevalence of dental fluorosis in children with water fluoride content of 0.00 - 1.20, 1.21 - 1.50, and ≥1.51 mg/L was 16.13% (1 377/8 539), 41.20% (281/682), 46.46% (302/650), and the difference was significant (χ 2 = 559.011, P < 0.01), the severity of the disease was positively correlated with water fluorine concentration ( r = 0.273, P < 0.01). The epidemic situation in 202 villages was effectively controlled and 71 villages did not reach the control standard. Conclusions:The progress of water-improved projects and the rate of qualified water fluoride are not optimistic in Xi'an, the dental fluorosis of children is still higher than the government standard in the high fluoride drinking-water areas. The measures for water improving defluorination and disease surveillance should be strengthened.

Craniopharyngiomas develop from remnant epithelial cells of Rathke's pouch in the sella/parasella region with low histological grade. Clinical manifestations are related to visual impairment, increased intracranial pressure, and hypothalamic/pituitary deficiencies, including vision loss, headache, nausea, growth retardation, and hypogonadism. Despite benign epithelial tumors, craniopharyngiomas are adjacent to critical brain structures including hypothalamus, pituitary stalk, chiasma opticum and have recurrence tendency. Treatment-related complications including hypothalamic/pituitary deficiencies, diabetes insipidus, and hypothalamic obesity are major risk factors for reduced quality of survival and throw out a great challenge to the surgical treatment and the postoperative management. Clinical features of one case craniopharyngiomas with manifestation of severe hypopituitarism are described with the aim of exploring effective therapies.

Objective To investigate the effects of mild hypothermia on post-resuscitation neurological outcome after ventricular fibrillation (VF) in rabbits.Methods Forty-five adult New Zealand rabbits were induced VF by direct current of electricity.The rabbits were randomly(random number) divided into following groups:normothermic resuscitation group (NR),mild hypothermia prearrest group (HP),mild hypothermia resuscitation 30 min group (HRe30),mild hypothermia resuscitation 90 min group (HRe90),normothermic sham group (NS),and hypothermia sham group (HS).The rabbits of NR group were observed for 600 min in room temperature after restoration of spontaneous circulation (ROSC).The mild hypothermia was induced by surface cooling,and maintained for 600 min after the aimed low temperature reached.The arterial blood samples were collected for determining neuron-specific enolase (NSE) and thioredoxin (Trx) and the mean arterial pressure (MAP),left ventricular end-diastolic pressure (LVEDP) and left ventricular pressure raise and fall rate (±dp/dtmax) were observed at 15 min before CA,and 30 min,60 min,120 min,360 min and 600 min after ROSC.After the animals were sacrificed at 600 min after ROSC,the whole brain of animals was harvested and observed under light microscope to calculate the apoptotic index of the hippocampal CA1 neurons by using TUNEL method.One-way ANOVA was used to determine the statistical significance between two groups,a two-tailed value of P＜0.05 was considered statistically significant.Results (1) Hemodynamically compared with normal temperature groups,HR was lower in hypothermia groups.Compared with NR,HRe30,and HRe90 group,LVEDP was higher in HP group at 30 min after ROSC(3.4±0.8 vs.4.6±1.0,4.1±0.5,4.3±0.2,F=9.85,P=0.019).In Hp group,the level of +dp/dtmax was higher than that in NR,HRe30 and HRe90 groups at 30 min and 120 min after ROSC.In HP group,the level of-dp/dtmax was higher than that of NR group at 30 min,60 min,120 min,360 min and 600 min after ROSC.(2) Serologically compared with HP,HRe30 and HRe90 group,NSE levels were higher in NR group at 60 min,120 min and 360 min after ROSC.Compared with NR,HRe30,and HRe90 group,Trx levels in NR group were lower at 60 min,120 min,360 min and 600 min after ROSC.Compared with HP group,Trx levels in HRe30 and HRe90 groups were higher at 60 min,120 min,360 min and 600 min after ROSC.(3) Pathologically compared with NR group,histopathological changes in hippocampus CA1 area were milder found in HP,HRe30 and HRe90 groups.AI (％) was lower in HP,HRe30 and HRe90 groups than that in NR group[(62.25±10.43)％ vs.(20.61±5.02)％,(25.08±3.92)％,(30.33±7.15)％,P=0.001].Concusions This study shows that hypothermia should be initiated as soon as possible,and especially early intra-arrest cooling appears to be significantly better than post-ROSC cooling and normothermia.

Objective: To evaluate the dynamic prevalence of dental fluorosis of children and levels of fluoride in drinking water after improvement of water in Xi an City, to provide scientific basis for water fluoridation improvement. Methods: A total of 35 fluorosis endemic villages were selected as fixed monitor sites in 2014-2018, the ways of water improvement were surveyed, water fluorine content were detected and the prevalence of dental fluorosis in children aged 8 to 12 years were examined. Results: Rates of excess fluoride in drinking water from 2014 to 2018 were 22.86%, 14.29%,11.43%, 11.43% and 8.57%, the difference were significant(χ2=16.44, P<0.01).The dental fluorosis detection rates of children aged 8 to 12 years were 20.89%,18.22%,17.46%,18.13% and 16.76% in 2014-2018 which showed a obvious descending trend by year(χ2=10.02, P<0.01). The detection rate of dental fluorosis in children aged 8 and 9 years showed a decreasing trend by year(χ2=6.53, 4.54, P<0.05).The difference of total rate of dental fluorisis,rate of mild cases rate of moderate-to-severe cases were statistically between the villages without qualified water and the villages with normal fluorine water(χ2=179.22, 167.93,10.35, P<0.01). The rate of detection in the villages with the water fluorine exceed standard in 2014-2018 showed a declining trend year by year(χ2=28.50, P<0.01). The detection rate were significant different across water improvement methods(χ2=197.76, P<0.01). Detection rate of dental fluorosis decreased from 2014 to 2018 in the areas with municipal water supply showed a decreasing after year(χ2=12.16, P<0.01). Conclusion The improvement of municipal water supply shows significant effects on water fluorosis control, the detection rate of water fluoride and children s dental fluorosis in some villages with the other ways of water improvement are still higher than expected, the continuously monitor of fluoride content in water and dental fluorosis in children should be strengthened.