Child ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; physiopathology ; surgery ; Tonsillectomy ; methods

Child ; Child, Preschool ; Epilepsy ; complications ; diagnosis ; surgery ; Female ; Humans ; Male ; Sleep Apnea, Obstructive ; complications ; diagnosis ; surgery

Objective To explore the methodology of reconstruction of a three-dimensional model of lid/cheek junction through continuous paraffin sections and stained lid/cheek junction three-dimensional visualization,and to further explore the feasibility and reliability to provide anatomical basis for clinical teaching of plastic and reconstructive surgery.Methods The full size of lid/cheek junction was cut from the specimens,the size of 25 mm× 15 mm× 10 mm,and then embedded in paraffin,and sectioned in thickness of 15 μm for 200 slices;the experimental HE staining and Masson staining were conducted,Sony camera photos using Adobe Photoshop CS 5.1 image processing software for image registration and 3D-Docter software image segmentation were used to give different colors for establishment of complete three-dimensional model.Results Histologically the LOT of the fascia area,the existence of reconstruction and the LOT model were confirmed.It showed the histological characteristics:the Masson stain displayed red,blue and white tissues in color;fascia tissue staining infered intertexture of elastic fibers and collagen fibers in LOT.LOT was the bottom edge of the triangle toward the orbital base with length of 26 mm,31 mm in high,0.8 mm in thick,and area of approximately 4.03 cm2 in size.Layers of skin,orbicularis oculi muscle,orbicularis retaining ligament,middle temporal fascia,periosteum and LOT were visible in the 3D model.By the three-dimensional model of lid/cheek junction,adjacent relationship could be rotated to any angle.Conclusions This initial establishment of a three-dimensional model of the lid/cheek junction confirms that the histological characteristics of lid/cheek junction and the feasibility of the fine structure of soft tissue within the three-dimensional model can be used as a new method for further research.

OBJECTIVETo observe the effect of magnesium sulfate, Nifedipine Tablet (NT) combined Salvia Injection (SI) on endothelin-1 (ET-1), nitric oxide (NO), thromboxane A2(TXA2), prostacyclin I2(PG2), and hemorheology of preeclampsia patients.

METHODSTotally 704 preeclampsia patients were randomly assigned to the treatment group and the control group, 352 cases in each group. All patients were treated with magnesium sulfate combined NT (on the first day: slow intravenous injection of magnesium sulfate 5 g + intravenous dripping of magnesium sulfate injection 10 g + oral administration of NT 30 mg; on the second and third day, intravenous dripping of magnesium sulfate injection 10 g + oral administration of NT 30 mg), while those in the treatment group were dripped with SI additionally at 20 mL per day for 3 consecutive days. Before and after treatment plasma levels of endothelin-1 (ET-1), nitric oxide (NO), TXA2, PGi2, and hemorheology indicators [such as high blood viscosity (HBV), low blood viscosity (LBV), plasma viscosity (PV), erythrocyte rigidity index (ERI), fibrinogen (FIB)] of two groups were detected.

RESULTSCompared with the same group before treatment, serum levels of ET-1, TXA2, HBV, LBV, PV, ERI, and FIB decreased in the two groups after treatment (P <0. 05), but levels of NO and PG2 increased (P <0. 05). Compared with the control group in the same period, levels of ET-1, TXA2, HBV, LBV, PV, ERI, and FIB decreased in the treatment group after treatment (P <0. 05), but levels of NO and PGI2 increased (P <0. 05).

CONCLUSIONMagnesium sulfate, NT combined SI could effectively regulate the balance of ET-1/NO and TXA2/PGI2, and improve hemorheology of preeclampsia patients.

Drug Therapy, Combination ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Endothelin-1 ; metabolism ; Epoprostenol ; metabolism ; Female ; Hemorheology ; Humans ; Injections ; Magnesium Sulfate ; administration & dosage ; pharmacology ; therapeutic use ; Nifedipine ; administration & dosage ; pharmacology ; therapeutic use ; Nitric Oxide ; metabolism ; Pre-Eclampsia ; drug therapy ; Pregnancy ; Salvia ; Tablets ; Thromboxane A2 ; metabolism

Objective To investigate the association between ten single nucleotide polymorphism (SNP) in the peroxisome proliferator-aetivated receptor (PPAR) α/δ/γ and essential hypertension (EH).Methods Participants were recruited within the framework of a cohort populations survey from the PMMJS (Prevention of Multiple Metabolic Disorders and MS in Jiangsu Province) which was conducted in the urban community of Jiangsu province from 1999 to 2007.Eight handred and twenty subjects (551 non-hypertensive subjects,269 hypertensive subjects) were randomly selected but were not related to each other.Ten SN P ( rs 135539,rs1800206,rs4253778 of PPAR αt; rs2016520,rs9794 of PPARδ ; rs10865710,rs1805192,rs4684847,rs709158 and rs3856806 of PPARγ ) were selected from the HapMap database.x2 test was used to determine whether the whole population was in H-W genetic equilibrium.SHEsis software was used to examine the relations of SNP and linkage equilibrium.Logistic regression model was used to examine the association between ten SNP in the PPAR and EH.Results Difference on the distribution of four SNP genotypes including rs1800206,rs9794,rsl0865710 and rs4684847 between high blood pressure and non-high blood pressure group,high systolic blood pressure(SBP) and normal SBP group,high diastolic blood pressure(DBP) and normal DBP group was significant (P＜0.05).After adjusting factors as age,sex,body mass index,fasting plasma glucose,high density lipoprotein cholesterol-C,high-fat diet and compared with wildtype gene carriers,the OR(95％ CI) of objects with rs1800206 V allele appeared in high blood pressure,high SBP and high DBP were 0.60 (0A1-0.89),0.57 (0.37-0.88) and 0.61 (0.39-0.96),respectively.The OR(95％CI) of objects with G allele of rs9794 were 0.63 (0.46-0.87),0.51 (0.36-0.73) and 0.68(0.47-1.01).The OR (95％CI) of objects with G allele of rs10865710 were 1.62 (1.19-2.20),1.59(1.14-2.22) and 1.53 ( 1.07-2.18),respectively.While the OR (95％ CI) of objects with rs4684847 T allele were 1.42 ( 1.04-1.94),1.38 (1.03-1.92) and 1.37 ( 1.00-1.88),respectively.Conclusion The four SNPs including rs1800206 of PPARα,rs9794 of PPARδ and rs4684847,rs10865710 of PPARγ influenced high blood pressure,high SBP and high DBP to different degrees.

OBJECTIVETo explore the diagnostic value of pulse transit time (PTT) in children with sleep disordered breathing(SDB).

METHODSForty eight randomly selected snorers (2 - 13 years) with SDB were examined by PSG and PTT in the same time. Data obtained were analyzed by different technicians respectively. Statistics and analysis of the data were performed.

RESULTSApnea hypopnea index (AHI), obstructive apnea index (OAI), the lowest oxygen and micro-arousal index were obtained by PSG and PTT. The results was described as M [25 percentile; 75 percentile]: 4.9[1.3;10.1], 4.6[1.5;11.8]; 1.2[0.7;4.9], 1.3[0.6;5.0]; 0.93[0.85;0.95], 0.93[0.84;0.95]; 14.5[12.6;16.4], 26.0[17.4;30.6]. The difference of AHI, OAI, and the lowest oxygen were not significant (P > 0.05), while the PTT arousal index detection rate was higher than PSG (Z = -5.19, P < 0.01). There was no significant difference in the diagnosis of obstructive sleep apnea-hypopnea syndrome (OSAHS) and determination of degree of patient's condition (P > 0.05). PTT could identify upper airway resistance syndrome in children without OASHS.

CONCLUSIONSBoth methods can be used to diagnose SDB. However, PTT is easy to use and suitable for the diagnosis of SDB in children, especially for UARS.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Polysomnography ; Pulse ; Sleep Apnea Syndromes ; diagnosis ; physiopathology

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Leukemia, Prolymphocytic, B-Cell ; diagnosis ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo analyse the clinical features of children with obstructive sleep apnea-hypopnea syndrome (OSAHS), accompanying with risk factors.

METHODSThe clinic data of 19 patients treated in the Department of Otorhinolaryngology of Guangzhou Children's Hospital between January 2005 to January 2008 were investigated retrospectively. Among them, 5 were < 2 years old, 6 with craniofacial deformity: small mandible and (or) mandibular retrusion (5 cases), transverse facial cleft (1 case), Down's syndrome (2 cases), cerebral palsy (2 cases), chronic bronchitis (3 cases) and mucopolysaccharidoses (1 case). Nineteen patients with symptoms of snoring, mouth breathing, were diagnosed as OSAHS by polysomnography (PSG) and treated by tonsillectomy and (or) adenoidectomy in hospital. All patients were closely followed-up.

RESULTSFourteen patients underwent PSG 6 months to 1 year after operation, 11 patients recovered, the median [percentiles 25; percentiles 75] apnea-hypopnea index (AHI) decreased from the pre-operative 22.5 [16.5; 24.3] times/h to 2.0 [1.5; 4.3] times/h, and the lowest oxygen saturation (LSaO(2)) before operation was 0.63, and was higher than 0.92 after operation, 1 case accompanying with chronic bronchitis, the pulmonary hypertension was improved after operation. One case with Down's syndrome was not significantly improved, preoperative AHI and LSaO(2) was 22.4 times/h and 0.67, and after operation was 14.2 and 0.84; 2 cases accepted adenoidectomy only, snoring, mouth breathing reappeared 3 months after operation, pre-operative PSG results showed AHI 24.6 times/h and 26.6 times/h, LSaO(2) was 0.69 and 0.73, after operation the AHI was 10.6 times/h and 8.5 times/h, LSaO(2) was 0.90 and 0.88, the symptoms disappeared after adenotonsillectomy. Five cases did not have PSG because they lived far away in the other cities, their pre-operative PSG showed AHI 16.4 to 26.2 times/h, LSaO(2) was 0.65 to 0.76. One year after operation, these patients were followed-up by telephone, 4 children were significantly improved, 1 case with mandibular symptoms showed no improvement.

CONCLUSIONSFor OSAHS children accompanying with risk factors, if they have adenoid and tonsil hypertrophy, adenotonsillectomy is the major treatment. Because of the existence of risk factors, perioperative risk increased, even the failure of operation. so these patients must be comprehensively assessed before operation. Satisfied results can be achieved by close observation after operation and management of complications as soon as possible.

Adenoidectomy ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Risk Factors ; Sleep Apnea, Obstructive ; complications ; surgery ; Tonsillectomy

OBJECTIVETo explore the prognostic impact of bone marrow involvement (BMI) and therapy in diffuse large B cell lymphoma (DLBCL).

METHODSThe clinical characteristics and prognosis of 83 DLBCL patients with or without BMI were retrospectively analyzed. The treatment outcome of standard CHOP regimen (CHOP group), intensive-dose regimen (intensive-dose group) and rituximab combined therapy (rituximab group) were compared.

RESULTSThe adverse prognostic factors including LDH elevation, ECOG score > or =2, higher IPI and aaIPI score, B symptom, hepatomegaly, splenomegaly, hemoglobin <110 g/L, platelet <100 x 10(9)/L and serum albumin <35 g/L were more prevalent in DLBCL patients with BMI than in those without BMI. Multivariate analysis showed that BMI was an independent prognostic factor of DLBCL. The 3-year OS and PFS rates in rituximab group were 78.1% and 64.3%, respectively, being statistically higher than that in CHOP group (23.6% and 21.8% respectively, P = 0.000 for both) and in intensive-dose group (33.3% and 25.7% respectively, P = 0.002 and 0.001, respectively). But no difference between the latter two groups (P = 0.411 and 0.694, respectively). For the patients with BMI, the 3-years OS and PFS in rituximab group (57.1% and 57.1%) were statistically higher than that in CHOP group (13.9% and 14.1%) and intensive-dose group (29.5% and 16.8%) (P = 0.029 and 0.012 respectively), respectively and also no difference in the latter two groups (P = 0.226 and 0.376 respectively). In the rituximab group, the 3-years OS and PFS were 86.7% and 67.3% respectively in patients without BMI, being higher than that in patients with BMI (57.1% and 57.1%), but the difference was not statistically significant (P = 0.645 and 0.965 respectively).

CONCLUSIONBMI is a negative independent prognostic factors of DLBCL patients. The rituximab combined chemotherapy can significantly improve the therapeutic effect of the DLBCL, and relieve the negative impact of BMI.

Adolescent ; Adult ; Aged ; Antibodies, Monoclonal, Murine-Derived ; administration & dosage ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Bone Marrow ; pathology ; Child ; Child, Preschool ; Cyclophosphamide ; administration & dosage ; therapeutic use ; Doxorubicin ; administration & dosage ; therapeutic use ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Prednisone ; administration & dosage ; therapeutic use ; Prognosis ; Retrospective Studies ; Rituximab ; Treatment Outcome ; Vincristine ; administration & dosage ; therapeutic use ; Young Adult

OBJECTIVETo present the efficacy of minimally invasive technology of coblation in the treatment of infant epiglottic cyst.

METHODSThe clinical data of 30 infants with epiglottic cyst treated between January 2008 and January 2011 were reviewed retrospectively. All infants with epiglottic cyst were treated with the ArthroCare ENT Coblator II Surgery System after being checked completely.

RESULTSAll 30 patients were successfully operated. The blood loss was less than 2 ml during the surgery. The infants recovered without any complications and were discharged from hospital in 10 days after surgery. The clinical symptoms improved significantly or disappeared. No patients showed recurrence during followed-up over 6 months.

CONCLUSIONThe advantage of the minimally invasive technology of coblation in infant epiglottic cyst was less bleeding, little injury and postoperative organization reaction.

Catheter Ablation ; Cysts ; surgery ; Epiglottis ; surgery ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Minimally Invasive Surgical Procedures ; Retrospective Studies ; Treatment Outcome