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.

0.1 improved significantly, while the eyesights of the other patients improved slightly or not at all. In the 53 cases of mass diseases,45 cases (84.9 %) required complete removal whereas 8 cases required bulk removal. No cases of sunken eyeball was found. Snuffle was improved in all cases. Most symptoms disappeared and no optic nerve injury resulted after the tumors in the orbital apex were removed. CONCLUSION Selecting the proper operative approach is important to the uncovering of the operative area. The use of navigation systems and endoscope could increase the rate of complete removals,result in fewer injuries of vessels and nerves,and avoid facial incision.

Objective: To study the comprehensive utilization of Herba Ephedrae resources during the extraction process of ephedrin, that is the extracting of porphyrin compound.Methods: The process conditions for preparing sodium copper porphyrin were optimized by the two preparation processes and twice orthogonal tests. Results: Herba Ephedrae was powdered, steeped and boiled in alcohol, saponified, then extracted with xylene. The ephedrin was extracted from the upper layer of xylene extraction solution and sodium copper porphyrin was obtained from the lower layer by copper substituton, acidulation and alkalization. Conclusion: The optimum preparation process for producing sodium copper porphrin of Herba Ephedrae which is superior to porphyrin in the stability and colour is ascertained.

Objective: To investigate the effect of potassium channel opener nicorandil on myocardial ischemia-reperfusion injury (MIRI) in isolated rat's heart. Methods: Langendorff system was established for isolated heart reperfusion. A total of 44 rats were randomly divided into 4 groups: Normal control group, Ischemia-reperfusion (I-R) group, Adenosine/I-R (A/I-R) group, the I-R heart was treated by adenosine 100 μmo/L and Nicorandil/I-R (N/I-R) group, the I-R heart was treated by nicorandil 200 μmo/L.n=11 in each group. Left ventricular developed pressure (LVDP), the maximal rise/fall rate of left ventricular pressure (±dp/dtmax), reperfusion arrhythmia (RA) and myocardial infarction (MI) size were recorded; the expressions of left ventricular tissue acetaldehyde dehydrogenase 2 (ALDH2), Bcl-2 and Bax were examined and compared among different groups. Results:①Compared with I-R and A/I-R groups, N/I-R group had increased LVDP at 30 min and 45 min reperfusion, allP<0.05.②Compared with N/I-R and A/I-R groups, I-R group showed reduced ±dp/dtmax at 30 min and 45 min reperfusion, allP<0.05; while ±dp/dtmax in N/I-R group was higher than A/I-R group at 30 min and 45 min reperfusion, all P<0.05.③Compared with I-R group, both N/I-R and A/I-R groups presented reduced RA score, allP<0.01, RA score was similar between N/I-R group and A/I-R group,P=0.771.④compared with I-R group, both N/I-R and A/I-R groups had the smaller MI size,P<0.01 and N/I-R group showed the smaller MI size,P<0.05.⑤Compared with Normal control group, I-R group had decreased mitochondrial ALDH2 expression and increased Bcl-2, Bax expression; ALDH2 level was elevated in N/I-R group had reduced in A/I-R group; Bcl-2 and Bax levels were increased in both N/I-R and A/I-R groups. Compared with I-R group, both N/I-R and A/I-R groups had increased ratio of Bcl-2/Bax,P<0.05; the anti-apoptosis effect was similar between N/I-R group and A/I-R group,P>0.05. Conclusion: Nicorandil may reduce MIRI and protect myocardium in isolated rat's heart, the overall effect is better than adenosine. Nicorandil can up-regulate the expressions of mitochondrial ALDH2, Bcl-2 and down-regulate the expression of Bax.

Objective To expose the effect and its potential mechanism of vinpocetine (Vinp) on the restenosis of dia?betic grafted veins. Methods Thirty-six Sprague-Dawley rats were randomized into saline control group and Vinp treat?ment group. The autologous jugular vein to carotid artery transplantation was performed in diabetic model rats. Normal sa?line or Vinp were intraperitoneally injected. The rats were sacrificed at 0, 2 or 4 weeks after surgery, then the grafted veins were harvested. The pathological sections were used to detect the effect of Vinp on intimal hyperplasia. The protein expres?sion of proliferating cell nuclear antigen (PCNA) was detected by immunohistochemical method, and which was described by cell proliferation index. The phosphorylation of NF-κB was detected by Western blot assay. Results The treatment of Vinp on intimal hyperplasia in vivo was significant at two weeks after surgery (17.06±5.10)μm versus control group (39.79±7.84μm, P<0.01), (30.94±5.18)μm versus (63.67±18.09)μm at four weeks after surgery (P<0.01). Vinp treatment effectively reduced the protein expression of PCNA [2 weeks:(21.07±1.38)%vs. (28.13±1.35)%,P<0.01;4 weeks:(31.73±1.38)%vs. (63.67 ± 18.09)%, P<0.01]. The treatment of Vinp inhibited phosphorylation of NF-κB at two weeks (1.08 ± 0.42 vs. 0.84 ± 0.12, P < 0.01). Conclusion Vinpocetine can effectively attenuate intimal hyperplasia in diabetic grafted veins, which might be related to its effect on inhibiting phosphorylation of NF-κB as well as inflammation.

Objective To discuss high dose methylprednisolone therapy in infantile spasm.Methods Sixty-six children with infantile spasm of the Third Affiliated Hospital of Zhengzhou University from Nov 2002 to Nov 2012,adopted intravenous methylprednisolone with 20 mg/(kg· d) for 3 to 5 days continuously,then changed to oral prednisone with 1 ～ 2 mg/(kg.d),4 ～ 8 weeks after drug withdrawal.The total course of 8 ～ 12 weeks of clinical curative effect was retrospectively studied.Results (1) Of 66 cases,51 cases were effective,total effective rate was 77.2％ ;28 cases achieved complete response,complete response rate was 42.4％.(2) The onset age had no influence on curative effect (P ＞ 0.05).(3) The beginning ages of the patients to use methylprednisolone therapy had no effect on curative effect (P ＞0.05).(4) Course of curative effect:23 cases within 2 months,the effective rate was 91.3％,43 cases more than 2 months,the effective rate was 69.7％.Difference of effective rate between the two groups had statistical significance (x2 =3.958,P ＜ 0.05).(5) Etiology of curative effect:50 cases of symptomatic,the effective rate was 78.0％,16 cases of cryptogenic,the effective rate was 75.0％ ;compared two groups,the effective rates had no statistical significance(x2 =0.008 7,P ＞ 0.05).(6) Long-term follow-up of 41 cases,14 cases had complete remission (34.2％),29 cases was effective(70.7％),3 cases had a recurrence (10.3％).Conclusion Application of methylprednisolone in the treatment for infantile spasm is simple,the recent control is effective,and it has a less adverse effect.The curative effect is related to the course,the shorter the duration,the better curative effect;and the long-term effect is good,the recurrence rate is low,the method can be recommended in clinical application.

AIM: To study the pharmacokinetics of flavonoids in mice after ig administration of Xiexin Decoction (Radix et Rhizoma rhei, Rhizoma coptidis, Radix Scutellariae). METHODS: Mice were given a single ig dose of Xiexin Decoction 4.5, 9.0 or 18.0 g/kg. Flavonoids in plasma were analysed by HPLC and plasma concentration of baibalin was determined. Pharmacokinetic parameters were calculated from the plasma concentration-time data with the DAS software package. RESULTS: After ig administration of Xiexin Decoction in mice, baicalin, baicalein and another flavonoid were detected in plasma and baicalin concentration was the highest of the three kinds of flavonoids in plasma. After a single ig dose of Xiexin Decoction 4.5, 9.0 or 18.0 g/kg, the pharmacokinetic parameters of baicalin were as follows:T_ 1/2 =2.77、5.69、6.20 h,AUC_ 0-∞ =9.09、23.49、39.57 ?g?h/mL,CL= 12.52 、 6.962 、 11.50 L?h/kg,V_d= 50.11 、 79.56 、 102.95 L/kg,C_ max1 =1.89、3.32、4.79 ?g/mL(T_ p1 = 0.08 h ), C_ max2 =1.46、2.57、4.16 ?g/mL(T_ p2 =3 h), respectively. CONCLUSION: Three kinds of flavonoids can be absorbed after ig administration of Xiexin Decoction in mice, of which baicalin is the major component.

Objective: To obtain ephedrine with porphyrin copper sodium from Herba Ephedrae. Methods: Application of ethanol to obtain ephedrine and porphyrin copper sodium from ephedra. The spoinfy reaction of porphyrin will take place, the integral ephedrine will turn into free ephedrine (dissolved in ether), when the liquor of ethanol of ethanol of ephedra are heated with NaOH. Using dimethylponyle to extract, the liquor will into two phases, one's (including sponify porphyrin) is water phase, the other's (including free ephedrine) is ether phase. Results: The yield proportion of ephedrine is 0.72%, and porphyrin copper sodium is 1.8%.Conclusion: It is practicable to extract porphyrin copper sodium with ephedrine from Herba Ephedrae.

Clinical teaching is an important link in cultivating clinician,Heuristic teaching can stimulate students'activeness of learning,enlighten their thoughts,arouse their positivity and creativity,find out their inner potential,and increase teaching effect.Intractable case discussion is an important method of heuristic clinical teaching,which can help strengthening theory knowledge,exercising correct clinical thinking,creating scrupulous scientism and satisfactory medical ethics.

Objective To investigate the expressions of aquaporin 4 (AQP4) in the bacterial meningitis in rats and to explore the molecular mechanism for brain edema caused by bacterial meningitis.Methods Totally 40 of 3-week-old-Sprague-Dawley healthy rats,body weight 60-80 g,male or female,were divided into a normal control group(n =10),and infection groups:24 hours after injection(n =10),48 hours after injection(n =10),and 5 days after injection(n =10).The expressions of AQP4 in the brain were detected by immunohistochemistry and Western blot methods respectively after 24 hours,48 hours,5 days of inoculation.Results Mortality rate:no rats in the control group and the infection group after 24 hours were dead.Two rats in the infection group after 48 hours and 4 rats in the infection group after 5 days were dead because of serious sickness,with the mortality rates 20％ and 40％,respectively.AQP4 expression was slightly positive under light microscope,and the positive cells mainly surrounded glial cells and blood vessels,while neurons were not dyed.Immunohistochemical staining showed that AQP4 expression in the model group increased with the severity of edema;compared with the control group,the AQP4 expression in the brain tissues increased in different periods after rats were infected,and the differences between groups were statistically significant (F--91.84,P ＜ 0.01).Western blot analysis showed that after the brain received streptococcus pneumoniae injection,expression of AQP4 began to increase in 24 hours after streptococcal injection,and reached to the peak in 48 hours,but decreased in 5 days,but the expression still remained higher than that of the normal control group.Each group had statistically significant difference(F =14.23,P ＜ 0.01).Conclusions Expression of AQP4 in the models with bacterial meningitis may increase initially and decrease later.It suggests that AQP4 plays a protective role during the development of infectious brain edema.