Objective To explore the clinical effect of temperature-controlled radiofrequency ablation of tonsil in the treatment of children obstructive sleep apnea hypopnea syndrome(OSAHS).Methods From January 2003 to January 2006,30 patients,confirmed OSAHS by polysomnography(PSG),aging from 3 to 10 years(mean:5.8 years)were treated by temperature-controlled radiofrequency ablation of tonsil,in which 21 cases with adenoidal hypertrophy were treated with adenoidectomy,and 3 of the 21 cases with secretory otitis media received auripuncture.Results Six months after the operation,the symptom of snoring and mouth breathing in all patients disappeared,tonsillar hypertrophy was kept in Ⅰ or Ⅱ grade,no pharynx stenosis was detected,and hearing was recovered to normal.After 1 year,20 cases were monitored with PSG,of which 10 cases were cured,8 cases showed apparent efficacy and 2 cases showed efficacy.Conclusions The temperature-controlled radiofrequency ablation of tonsil is an effective and safe technique in the treatment of children OSAHS.

BACKGROUND:Artificial tissue-engineered bone combined with acel ular bone matrix has been shown to be favorable for bone repair. OBJECTIVE:To explore the safety and biocompatibility of the stromal vascular fraction of the adipose tissue combined with the acel ular bone matrix-chitosan scaffold in the repair of rabbit radial defects. METHODS:A total of 38 New Zealand rabbits were selected, 3 rabbits were used to extract stromal vascular fraction of adipose tissue, 3 used to prepare acel ular bone matrix and 32 divided into experimental and control groups. Models of rabbit radial defects were established using Brownlow method. The rabbits in the experimental group were treated with the SVF of adipose tissue combined with the acel ular bone matrix-chitosan scaffold, while those controls received no treatment. General situation, gross observation, X-ray examination, histological observation and Lane-Sandhu scores were performed at 2 and 4 months postoperatively. RESULTS AND CONCLUSION:No infections occurred in both two groups at 2 and 4 months postoperatively, but the activity level and degree of healing in the experimental group were significantly better than those in the control group. In the experimental group, there were high-density shadows at 2 months postoperatively and the X-ray image of the bone defect site was the same as that of the normal one at 4 months, while bone nonunion occurred in the control group. The bone tissues in the experimental group grew significantly better than that in the control group at 2 and 4 months postoperatively, and the Lane-Sandhu histological scores in the experimental group were significantly higher than those in the control group at 2 and 4 months postoperatively (P<0.05). These results indicate that the stromal vascular fraction combined with the acel ular bone matrix-chitosan scaffold exhibits safety and biocompatibility in the repair of rabbit radical defects.

The teaching for medical advanced students is a routine and important task in teaching hospital.To increase the teaching quality,we should emphasize professional theory learning,increase clinical skill training,strengthen medical records writing training and enhance emotional exchange.

Objective To observe the application of elastic bandage in cerebral palsy with knee hyperextension. Methods 20 spastic diplegia children were radomly divided into control group and experimental group with 10 cases in each group. Both of them received conventional rehabilitation, including exercise therapy, occupational therapy and speech therapy. The experimental group worn elastic bandages additionally when orthostatic walk preparing and walking training. The knee range of motion (ROM), D and E zones of Gross Motor Function Measure (GMFM) were evaluated before and 3 months after treatment. Results The ROM decreased, and the score of GMFM increased after treatment in both groups (P<0.01), especially in the experimental group (P<0.01). Conclusion The elastic bandage can improve the knee function and the gross motor function of cerebral palsy children with knee hyperextension.

OBJECTIVETo explore a simple and reliable method for intraperitoneal injection through a paravertebral approach in rabbits.

METHODSSixty New Zealand rabbits were randomized into conventional group and modified groups to receive intraperitoneal injections through conventional and paravertebral approaches, respectively. In the conventional group, the injection site was on the abdominal wall 3~4 cm lateral from the umbilicus bilaterally, while that in the modified group was located dorsally at L5/L6 level 3-4 cm lateral from the midline. Abdominal CT scan was performed in the post-injection rabbits, which were sacrificed after 24 h for abdominal dissection.

RESULTSSuccess with a single puncture was achieved in 13 out of the 20 rabbits in the conventional group, and the rest required at least two punctures, with a mean rank sum of 23.50. With the modified approach, a single attempt was successful in all the 40 rabbits, with a mean rank sum of 34.0, showing a significant difference between the two groups (P<0.01). The success rates of a single injection differed significantly between the two groups (P<0.01). CT scan and abdominal dissection showed that the injection site with the modified approach was far away from the vital organs and large vessels with less peritoneal hyperemia and exudation.

CONCLUSIONParavertebral intraperitoneal paracentesis is a convenient and reliable method for intraperitoneal injection in rabbits.

Animals ; Injections, Intraperitoneal ; methods ; Rabbits

OBJECTIVETo observe the pathological changes of axonal injury in a rat model of experimental allergic encephalomyelitis (EAE).

METHODSWith HE, luxol fast blue and Bielschowsky staining, the expression of APP, MBP, SMI-32 and MBP in the brain and spinal cord of EAE rats using double-labeling indirect immunofluorescence.

RESULTSExtensive cuffing lesions of inflammatory cell infiltrations were found in the brain and spinal cord of the rats, accompanied by multiple lesions of demyelination, axonal disarrangement with vesicular loss. SMI-32 staining identified numerous nonphosphorylated neurofilament, indicating the presence of axonal injury. Axonal oval bodies formed by APP accumulation were found in the white matters of the spinal cord 14 days after EAE, suggesting that neuraxial damage occurred in the early stage of EAE which was not synchronous with myelin loss.

CONCLUSIONDifferent levels of inflammation occur in different stages of EAE, and inflammatory cell infiltration is the most obvious at the peak of EAE. Axonal injury occurs in the early stage of EAE and progresses over the entire disease course.

Animals ; Axons ; pathology ; Brain ; pathology ; Encephalomyelitis, Autoimmune, Experimental ; pathology ; Female ; Rats ; Rats, Wistar ; Spinal Cord ; pathology

Objective To evaluate the clinical application value of multi-slice helical CT volumetric (VH) scanning in lumber spine. Methods One thousand of patients with back and leg pain who underwent CT examinations were selected as subjects. We simulated the traditional protocol of single-slice(SS) discrete scanning for L3/4, L4/5, and LS/S1 intervertebral discs. The VH scanning mode was performed with 120 kV, 210 mAs,pitch of 1.5 and coverage of 97. 5 mm. The simulated SS scanning mode was performed with 120 kV, 240 mAs and coverage of 45.0 mm. The diagnostic outcomes and the radiation doses were compared between the two scanning modes. Two groups doctors observed ten terms, including the osseous spinal stenosis,narrowed intervertebral space and so on in two scanning modes respectively. Then consistency analysis of the data was carried out. Results The VH scanning mode showed far more features than the SS mode. The detection rates of the VH mode in the osseous spinal stenosis, narrowed intervertebral space,herniated nucleus pulposus, narrowed lateral recess, vertebral lesion, hypertrophy of L5 transverse process,abnormal direction of facet, facet degeneration, lumbar spondyloschisis, and paraspinal soft tissue were 11.8% (n =118), 38. 5% (n =385), 9. 3% (n =93), 46. 8% (n =468), 31.4% (n =314), 5.7% (n =57), 25.4% (n = 254), 49. 7% (n = 497), 9.9% (n = 99), and 0. 6% (n = 6) respectively, while the detection rates of the SS mode in ten terms were 5.6% (n = 56), 0, 0. 6% (n = 6), 27. 9% (n = 279),22.4% (n =224), 1.2% (n = 12), 16.7% (n = 167), 37.2% (n =372), 0.5% (n =5), and 0.2%(n = 2) respectively. The difference between the two groups had statistically significance (average P <0.05), except the paraspinal soft tissue abnormal (P > 0.05). The detection rates of the VH mode were higher than the SS mode in the osseous spinal stenosis, narrowed intervertebral space, herniated nucleus pulposus, lumbar spondyloschisis, being 6.2% (n = 62) , 38. 5% (n = 385) , 8.7% (n = 87), and 9.4%(n =94), respectively. In addition, VH mode only partially showed the articular facets, narrowed lateral recess, hypertrophy of L.5 transverse process, and paraspinal soft tissue. We could not acquire the imaging slices paralleling to intervertebral discs in SS mode in 467 patients (46.7%) with lumbosacral angle greater than 35°. The radiation dose of VH mode (164.9 mGy/em) was slightly higher than SS mode (147.0 mGy/cm) Conclusion MSCT VH scanning mode can significantly improve the diagnostic rate of lumbar spine diseases compared with SS mode, and was not restricted by the lumbosacral angle with slightly increasing radiation dosage.

OBJECTIVETo examine cerebral pathologies in cerebral amyloid angiopathy in a rat model of Alzheimer's disease.

METHODSRat models of Alzheimer's disease was established by stereotactic Aβ1-42 fiber injection in the bilateral hippocampus. The cognitive function of the rats was evaluated with water maze test. HE staining, Congo red staining and double-labeling indirect immunofluorescence were used to examine the dynamic distribution of Aβ fiber deposit in the brain.

RESULTSThe model rats showed significant differences from the control rats in the escape latency and the times of crossing platform in waster maze test. HE staining revealed a decreased number and degeneration of the granular cells with increased glial cells in the model rats. Congo Red staining showed that the Aβ fiber was deposited gradually in the small vessels in the brain parenchyma to cause thickening, stenosis or occlusion of the small vessels. Immunofluorescence staining detected Aβ fiber migration from the parenchyma to the walls of the small arteries in the rat models.

CONCLUSIONCerebral amyloid angiopathy is a major pathological feature in Alzheimer's disease.

Alzheimer Disease ; pathology ; Amyloid beta-Peptides ; chemistry ; Animals ; Brain ; pathology ; Cerebral Amyloid Angiopathy ; pathology ; Disease Models, Animal ; Rats ; Staining and Labeling

OBJECTIVETo investigate the correlation of apolipoprotein AI (ApoAI), ApoB, ApoB/ApoAI and the severity of brain white matter lesions (WML).

METHODSA total of 648 patients with WML confirmed by brain magnetic resonance imaging (MRI) were divided into mild WML group (=386) and moderate to severe WML group (=262) according to evaluations with the Fazekas scale. The demographic data, blood biochemical parameters and the levels of ApoAI, ApoB and ApoB/AI ratio were compared between the two groups to identify the risk factors of moderate to severe WML.

RESULTSUnivariate analysis showed that age, gender, hypertension, diabetes, coronary heart disease, previous stroke, homocysteine, HDL-C, ApoAI, and ApoB/AI ratio all differed significantly between the two groups ( < 0.05), but ApoB levels were similar between them ( > 0.05). Multivariate logistic regression analysis revealed that with ApoAI and ApoB/AI ratio as the continuous variables, after adjustment for the compounding factors, ApoB/AI ratio was an independent risk factor (OR=11.456, 95% : 3.622-36.229, < 0.001) and ApoAI was an independent protective factor for moderate to severe WML (OR=0.068, 95% : 0.018-0.262, < 0.001). With the upper quartiles of ApoAI level (1.38 g/L) and ApoB/AI ratio (0.58) as their respective cutoff values, patients with a high ApoAI level and a low ApoB/AI ratio were found to have the lowest incidence of moderate to severe WML ( < 0.001).

CONCLUSIONSAn increased ApoB/AI ratio is an independent risk factor and an increased ApoAI level is an independent protective factor for moderate to severe WML.