BACKGROUND: Partial soft palate, uvula and the otiose soft tissue of lateral pharyngeal wall are resected in traditional uvulopalatopharyngoplasty. Although the syndrome can be improved, the complications, such as velopharyngeal insufficiency, cicatricial contration of pharyngeal cavity, can occur in some patients, furthermore, the prostecdtive efficacy is below the mark.OBJECTIVE: To investigate efficacy of the dilatation of oropharyngeal and nasopharyngealisthmus in uvulopalatopharyngoplasty treating obstructive sleep apnea hypopnea syndrome.DESIGN: A case-control observation.SETTING: The Affiliated Municipal Hospital of Medical College, Qingdao University.PARTICIPANTS: The patients who were hospitalized for snoring, apnea, breathing obstruction and somnolence were selected from the Sleep Respiratory Disorder Diagnosis and Treatment Center in the Affiliated Municipal Hospital of Medical College of Qingdao University from July 2001 to February 2006. We ascertained that the obstruction located at pharynx oralis, no hypertrophy of lingual root, and made a definite diagnosis of OSAHS by polysomnogram. The apnea hypopnca index (AHI) was ≥ 5 times per hour. Among 216 patients, there were 159 males and 57 females aged older than 25 years.METHODS: The patients were treated by modified UPPP which maintained the normal anatomic form of pharyngeal cavity, reserved the uvula, performed oblique straight incision along palatoglossal arch to soft palate, and avoided the incision of inverse U type. Palatoplasty and pharyngoplasty could extend the oropharyngeal isthmus and nasopharyngeal isthmus thoroughly.MAIN OUTCOME MEASURES: ① The survey of effect in the near future: Defined the pain without pain-killer as pain lightly, or as pain heavily inversely. If the lateral wall of oropharynx could remain the designed morphous, it was a good henosis; it was a bad henosis inversely. ② The survey of effect in a long term: According to the statement of the patients themselves. Estimated whether the patients had postoperative complications, such as backstreaming in nasal cavity, pharyngeal foreign body sensation, etc. Assessed if the patients had sleep apnea according to the observation of the family member and the monitoring of PSG. And ascertained whether the pharyngeal cavity had approached to normal structure by the examination of oropharynx.RESULTS: All 216 patients were involved in the final analysis. ① Of the 216 subjects, there were 156 patients who needed pain-killer (72%), and 60 Patients need not (26%). The lateral pharyngeal wall of 136 subjects was smooth (63%), and the other 80 were splited partly (37%). There were no complications such as breath holding, backstreaming in the nasal cavity. ② The survey of longdated postoperative effect: The 216 patients were followed up for 6 mouths.There was no deglutitive bucking, open rhinolalia. A total number of 84 patients (39%) had pharyngeal foreign body sensation. The syndrome of sleep apnea disappeared in 169 patients, and the other 47 patients still had the syndrome,but improved than before. In 203 patients (94%), the postoperative morphous of oral cavity were content, and the other 13 patients (6%) were not content. ③ The statistical significance of the preoperative and postoperative result of PSG monitoring of the 216 patients with OSAHS existed and the difference was significant [AI: 35.45±16.42, 12.75±9.62; HI:19.39±9.86, 17.43±10.15; AHI: 54.29±18.13, 28.31 ±16.23; the average low saturation of blood oxygen: (83.58±7.96) %,(85.53±8.18) %; the average saturation of blood oxygen: (91.98±3.29) %, (93.01±3.02) %, P ＜ 0.05].CONCLUSION: The modified uvulopalatopharyngoplasty indicates that this approach not only extend the nasopharynx cavity, but also avoids the postoperative complications. The patients have markedly improved symptoms.

Branchioma ; diagnosis ; Head and Neck Neoplasms ; diagnosis ; Humans ; Neck ; Rheumatoid Nodule ; diagnosis

Objective To explore the distributional differences of the gene frequencies of 22 short tandem repeats loci on Y Chromosome(Y?STRs) between offenders with Initiative?aggressive behavior and impulsive?aggressive behavior,and to probe into the genetic factors of initiative?aggressive behavior and im?pulsive?aggressive behavior. Methods Biological samples of 271 offenders with initiative?aggressive behav?ior and 271 offenders with impulsive?aggressive behavior were collected and PCR compound amplification was carried out with the aid of PowerPlex Y23 System. Then the PCR products were subjected to electrophoresis and gene detection with AB3500xL gene analysis system so as to calculate and compare the alleles and haplo?types of 22 Y?STRs gene frequency in the two groups. Results The distribution of allele frequency were sig?nificantly difference in locus DYS437(P=0.022) between two groups,not in the other 21 Y?STRs loci( all P>0.05) . Univarite analysis showed significant differences at allelle 14 in locus DYS437 between both groups ( initiative?aggressive behavior group:69. 37%;impulsive?aggressive behavior group:58. 67%; P=0. 009 ) . Conclusion Loci DYS437 may be associated with aggressive behavior. In the group of aggressive behavior, allelle 14 on locus DYS437 may be the susceptible factor of initiative?aggressive behavior and the resistant factor of impulsive?aggressive.

OBJECTIVETo assess the association of short tandem repeats (STRs) loci with aggressive behaviors of schizophrenia.

METHODSBlood samples from 123 schizophrenic patients with aggressive behaviors and 489 schizophrenic patients without aggressive behaviors were collected. DNA from all samples was amplified with a PowerPlex 21 system and separated by electrophoresis to determine the genotypes and allelic frequencies of 20 STR loci including D3S1368, D1S1656, D6S1043, D13S317, Penta E, D16S639, D18S51, D2S1338, CSF1PO, Penta D, TH01, vWA, D21S11, D7S820, D5S818, TPOX, D8S1179, D12S391, D19S433, and FGA.

RESULTSAll of the 20 STR loci have reached Hardy-Weinberg equilibrium in both groups. A significant difference was found in allelic and genotypic frequencies of loci Penta D between the two groups (alleles: P=0.042; genotypes: P=0.014) but not for the remaining 19 loci (P> 0.05). Univariate analysis also showed a significant difference for allele 10 and genotypes 10-12 of Penta D between the two groups (P=0.0027, P=0.0001), with the OR being 1.81 (95%CI: 1.22-2.67) and 4.33 (95%CI: 1.95-9.59), respectively.

CONCLUSIONPenta D may be associated with aggressive behaviors of schizophrenia. Allele 10 and genotypes 10-12 of Penta D may confer a risk for the disease.

Adolescent ; Adult ; Aged ; Aggression ; Gene Frequency ; Genotype ; Humans ; Microsatellite Repeats ; Middle Aged ; Schizophrenia ; genetics ; Young Adult

With the accelerated aging society in China, the incidence of biliary surgical diseases in the elderly has increased significantly. The clinical characteristics of these patients indicate that improving treatment outcomes and realizing healthy aging are worthy of attention. How to effectively improve the treatment effect of geriatric biliary surgical diseases has attracted widespread attention. This paper reviews and comments on the hotspots and difficulties of biliary surgery in older patients from six aspects: (1) higher morbidity associated with an aging society, (2) prevention and control of pre-operative risks, (3) extending the indications of laparoscopic surgery, (4) urgent standardization of minimally invasive surgery, (5) precise technological progress in hepatobiliary surgery, and (6) guarantee of peri-operative safety. It is of great significance to fully understand the focus of controversy, actively make use of its favorable factors, and effectively avoid its unfavorable factors, for further improving the therapeutic effects of geriatric biliary surgical diseases, and thus benefits the vast older patients with biliary surgical diseases. Accordingly, a historical record with the highest age of 93 years for laparoscopic transcystic common bile duct exploration has been created by us recently.
Humans ; Aged ; Aged, 80 and over ; Biliary Tract Surgical Procedures ; Gallstones ; Laparoscopy ; Treatment Outcome ; Aging ; Retrospective Studies