Adult ; Female ; Humans ; Male ; Middle Aged ; Pharynx ; metabolism ; Receptors, Leptin ; metabolism ; Sleep Apnea, Obstructive ; metabolism

OBJECTIVETo reseach the correlations between cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) expressions and angiogenesis in pharyngeal tissue of patients with obstructive sleep apnea hypopnea syndrome (OSAHS).

METHODSBiopsies were obtained by uvulopalatopharyngoplasty from 40 patients with mild to severe OSAHS. Control specimens of palatopharyngeal and palatoglossal arch mucosa were retreved from 6 patients with chronic tonsillitis and proved have no related disorders. HE was used to observe the changes of pharyngeal tissue, immunohistochemical staining with antibodies against COX-2, VEGF, microvessel density (MVD) (marked with CD34).

RESULTSCOX-2 and VEGF mainly expressed at pavement-epithelium and glandular epithelium of pharyngeal tissue, and stronger COX-2 and VEGF expression was found in midrange and severe OSAHS than mild and control group (P < 0.01), so as MVD. COX-2 expression was correlated positively with VEGF expression, and had significant correlation with MVD. VEGF expression had the same correlation with MVD. These three targets had considerable relation with apnea hypopnea index (AHI) and lowest O2 saturation at night.

CONCLUSIONThere was angiogenesis which had important relationship with hypoxia degree in patients of OSAHS, and COX-2 and VEGF play a crucial role in its development.

Adult ; Cyclooxygenase 2 ; genetics ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Neovascularization, Pathologic ; Pharynx ; blood supply ; metabolism ; Sleep Apnea, Obstructive ; metabolism ; physiopathology ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

OBJECTIVE: To study the expression of substance P (SP) in human sudden erethistic death, and to seek objective morphological supports to diagnose sudden erethistic death for forensic medicine. METHODS: The expression of SP was detected with immunohistochemical technique on 15 human laryngopharynx and gastrointestine of sudden erethistic death, and 20 sudden death of heart attack as control. The images of SP were analyzed by image analyzer, and the positive indexes (PI) were calculated. RESULTS: SP expression in the experimental groups was significantly stronger than that in the control one (P < 0.001). CONCLUSION SP expression can offer an objective morphological reference support for forensic diagnosing sudden erethistic death.
Adolescent ; Adult ; Anaphylaxis/pathology* ; Autopsy ; Child ; Death, Sudden ; Death, Sudden, Cardiac/pathology* ; Female ; Gastric Mucosa/metabolism* ; Humans ; Immunohistochemistry ; Intestinal Mucosa/metabolism* ; Male ; Middle Aged ; Mucous Membrane/metabolism* ; Pharynx/metabolism* ; Substance P/metabolism* ; Young Adult

OBJECTIVE: To study the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and insulin resistance (IR), then evaluate the effectiveness of the improved Uvulopalatopharyngoplasty (MUPPP) and continuous positive airway pressure (CPAP) on IR. METHOD: Fourteen patients of OSAHS were treated by MUPPP, and sixteen patients of OSAHS were treated by CPAP. All index of the nocturnal polysomnography, fasting plasma insulin, fasting plasma glucose, insulin and blood sugar of 2 hours after meal were analyzed before and after therapy, and 10 patients of OSAHS were untreated by MUPPP or CPAP. The other 33 cases of non-OSAHS were selected as control group. According to the model of HOMA and the formula of LiGuangwei,insulin resistance index and insulin sensitivity index were calculated, respectively. RESULT: There were significant differences between OSAHS group before treatment and control group, before and after treatment, after treatment and untreated group (P < 0.01 or P < 0.05). There was very significant correlation between IAI and LSaO2 (r = 0.633),and there was significantly negative correlation between IAI and AHI (r = -0.654). CONCLUSION OSAHS is an important risk factor for the development of insulin resistance. It shows that OSAHS may develop IR of the patients and the treatment of MUPPP and CPAP can improve insulin sensitivity.
Adult ; Blood Glucose ; metabolism ; Continuous Positive Airway Pressure ; Female ; Humans ; Insulin ; blood ; Insulin Resistance ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; Palate ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; metabolism ; physiopathology ; surgery ; therapy ; Uvula ; surgery

OBJECTIVE: To observe the effects of different maintain doses of Dexmedetomidine on plasma cortisol and glucose during anesthesia recovery period in patients undergoing uvulopalatopharyngoplasty under sevoflurane inhalation anesthesia. METHOD: In this prospective, randomized, double-blind study, 120 ASA I and II patients undergoing selective uvulopalatopharyngoplasty under general anesthesia were included. The patients were randomly allocated to three groups (n = 40): Dexmedetomidine low maintain dose group (D1), Dexmedetomidine high maintain dose group (group D2) and control group (group C). The Dexmedetomidine groups and control group were given Dexmedetomidine 1 microg/kg and normal saline in 20 ml within 15 min just before induction of anesthesia. Then Dexmedetomidine were maintained at 0.2 microg x kg(-1) x h(-1) and 0.7 microg x kg(-1) x h(-1) in group D1 and group D2 and were withdrawed 5 min before the end of operation, the same maintained speed of normal saline was given in group C. BIS value was maintained at 40-60 by adjusting the inhaled concentration of sevoflurane. Anesthetic was withdrawed 10 min before the end of operation. Thus, plasma cortisol concentration and blood glucose was needed to be detected just before anesthesia (T0), tracheal extubation (T1), 5 min after extubation (T2) and 15 min after extubation (T3). Duration of operation and anesthesia, consumption of sevoflurane, emergence time, extubation time, the occurrence of dysphoria, bucking and hypoxemia (SpO2 < 90%) during extubation were recorded. RESULT: Compared with group C, MAP and HR at T1, plasma cortisol concentration and blood glucose at T1 - T3 were all significantly lower in group D1 and group D2 (P < 0.05), and so were the consumption of sevoflurane and the occurrence of dysphoria (P < 0.05). The emergence time and extubation time were significantly prolonged in group D2 compared with group D1 and group C (P < 0.05). There was no significant difference in the occurrence of bucking and hypoxemia in three groups (P > 0.05). CONCLUSION In the patients undergoing UPPP under sevoflurane inhalation anesthesia, Dexmedetomidine infused at 0.2 microg x kg(-1) x h(-1) maintains a stable hemodynamics without respiratory depression, alleviates stress response during extubation and reduces both the consumption of sevoflurane and the occurrence of dysphoria without prolonging emergence time and extubation time.
Adult ; Anesthesia Recovery Period ; Anesthesia, Inhalation ; Blood Glucose ; metabolism ; Dexmedetomidine ; administration & dosage ; Double-Blind Method ; Female ; Humans ; Hydrocortisone ; blood ; Hypnotics and Sedatives ; administration & dosage ; Male ; Methyl Ethers ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; Palate, Soft ; surgery ; Pharynx ; surgery ; Sevoflurane ; Uvula ; surgery

OBJECTIVE: To determine the value of treadmill exercise test in predicting patients with moderate OSAHS treated by uvulopalatopharyngoplasty (UPPP) and tone base reduction or oral appliance. METHOD: Sixty-six patients were treated by UPPP and tone base reduction or oral appliance. The data including PSG (AHI, SaO2) and treadmill exercise test (METs) was analysed. RESULT: The success rate (percentage of patients with at least 50% reduction in AHI) of UPPP and tone base reduction was 86.7%, and 84.8% in oral appliance. The difference (AHI, SaO2, METs or the success rate) between the groups of postoperation or oral appliance was nonsignificant (P > 0.05). CONCLUSION As to moderate OSAHS, the UPPP and tone base reduction or oral appliance may be one of the effective therapy. The data including PSG (AHI, SaO2) and METs may be very useful in predicting effectiveness of treatment to OSAHS.
Adult ; Aged ; Exercise Test ; Female ; Humans ; Male ; Middle Aged ; Palate ; surgery ; Pharynx ; surgery ; Polysomnography ; Predictive Value of Tests ; Sleep Apnea, Obstructive ; metabolism ; physiopathology ; surgery ; Treatment Outcome ; Uvula ; surgery ; Young Adult

2019-nCoV epidemic was firstly reported at late December of 2019 and has caused a global outbreak of COVID-19 now. Saliva, a biofluid largely generated from salivary glands in oral cavity, has been reported 2019-nCoV nucleic acid positive. Besides lungs, salivary glands and tongue are possibly another hosts of 2019-nCoV due to expression of ACE2. Close contact or short-range transmission of infectious saliva droplets is a primary mode for 2019-nCoV to disseminate as claimed by WHO, while long-distance saliva aerosol transmission is highly environment dependent within indoor space with aerosol-generating procedures such as dental practice. So far, no direct evidence has been found that 2019-nCoV is vital in air flow for long time. Therefore, to prevent formation of infectious saliva droplets, to thoroughly disinfect indoor air and to block acquisition of saliva droplets could slow down 2019-nCoV dissemination. This review summarizes diagnostic value of saliva for 2019-nCoV, possibly direct invasion into oral tissues, and close contact transmission of 2019-nCoV by saliva droplets, expecting to contribute to 2019-nCoV epidemic control.
Betacoronavirus ; isolation & purification ; pathogenicity ; Clinical Laboratory Techniques ; Coronavirus Infections ; diagnosis ; transmission ; Humans ; Mouth ; virology ; Pandemics ; Peptidyl-Dipeptidase A ; metabolism ; Pharynx ; virology ; Pneumonia, Viral ; diagnosis ; transmission ; SARS Virus ; isolation & purification ; pathogenicity ; Saliva ; virology

OBJECTIVES: An outbreak of acute febrile illness occurred in the Republic of Korea Air Force boot camp from May to July 2011. An epidemiological investigation of the causative agent, which was of a highly infective nature, was conducted. METHODS: Throat swabs were carried out and a multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) assay was performed to identify possible causative factors. RESULTS: The mean age of patients who had febrile illness during the study period was 20.24 years. The multiplex RT-PCR assay identified respiratory syncytial virus (RSV) as the causative agent. The main symptoms were sore throat (76.0%), sputum (72.8%), cough (72.1%), tonsillar hypertrophy (67.9%), and rhinorrhea (55.9%). The mean temperature was 38.75degreesC and the attack rate among the recruits was 15.7% (588 out of 3750 recruits), while the mean duration of fever was 2.3 days. The prognosis was generally favorable with supportive care but recurrent fever occurred in 10.1% of the patients within a month. CONCLUSIONS: This is the first epidemiological study of an RSV outbreak that developed in a healthy young adult group. In the event of an outbreak of an acute febrile illness of a highly infective nature in facilities used by a young adult group, RSV should be considered among the possible causative agents.
Adolescent ; Adult ; Antiviral Agents/therapeutic use ; Body Temperature ; Disease Outbreaks ; Humans ; Male ; Military Personnel ; Multiplex Polymerase Chain Reaction ; Oseltamivir/therapeutic use ; Pharynx/virology ; RNA, Viral/chemistry/genetics/metabolism ; Republic of Korea/epidemiology ; Respiratory Syncytial Virus Infections/drug therapy/*epidemiology/virology ; Respiratory Syncytial Viruses/*genetics/isolation & purification ; Sputum/virology ; Young Adult