Objective To explore the changes of plasma orexin-A level before and after operation in obstructive sleep apnea-hypopnea syndrome(OSAHS) children and its effect on their behavior performance.Methods 120 cases OSAHS children performed tonsillectomy and / or adenoidectomy and 30 cases normal children as control group.According to the AHI index,the OSAHS group was divided into mild group (5 times/h ≤ AHI ＜ 20times/h,n=13),moderate group (20/h ≤ AHI ＜40/h,n=76),and severe group (AHI ≥ 40 times / h,n=31).And at the same time,according to the sensory integration ratings,OSAHS group was divided into normal group(n =30),mildly abnormal group (n =47),moderately abnormal group (n =28),severely abnormal group (n =15).Before operation and 6 months after operation,plasma orexin-A levels and children's sensory integration were measured.Results Plasma orexin-A level of the OSAHS group ((0.41 ± 0.06) μg/ml) was significantly higher compared with the control group((0.31±0.04) μg/ml) (P＜0.01).In orexin-A level of different AHI groups before and after operation(mild group:(0.33±0.02) μg/ml vs (0.28± 0.03) μg/ml,moderate group:(0.39±0.04) μg/ml vs (0.29±0.03) μg/ml,severe group:(0.49±0.04) μg/ml vs (0.32± 0.02) μg/ml),there had significant differences (P＜0.01).In OSAHS children,AHI index had positive correlation with preoperative plasma orexin-A level (r=0.803,P＜0.01).There was a significant negative correlation between sensory integration scores and plasma orexinA level(r=-0.812,P＜0.01).Conclusions Plasma orexin-A level of OSAHS children is closely related to the severity of OSAHS and the changes of their behavioral ability.And it may become a diagnostic plasma marker of OSAHS children.

Objective: To analyze the causes and management plan of pediatric spontaneous tonsillar haemorrhage(STH). Methods: According to the criteria of STH difined by Griffies, patients with STH from December 2013 to January 2016 were included in this retrospective study. Results: A total of 11 patients were reviewed. The etiological diagnosis included 3 pediatric Epstein-Barr virus associated infectious mononucleosis(EBV-IM), 3 suspected pediatric EBV-IM to 3 acute suppurative tonsillitis, 1 acute viral tonsillitis and 1 hemophilia A. The management strategies included antiviral, antibacteria, transfusion, surgical examination followed with bipolar coagulation hemostasis under general anesthesia. No patient treated with tosillectomy. Conclusions STH is now a rare condition, the causes of which in child are more or less different from adult.This emergency can be treated in time if a detailed management plan for pediatric STH is formulated.