Objective:To explore the feasibility and clinical efficacy of stratified suture of lateral pharyngeal wall(SSLPW) combined with soft palate radiofrequency coblation in the treatment of the patients with severe obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:The clinical data of 21 severe OSAHS patients underwent lateral pharyngoplasty(LP) combined with soft palate radiofrequency coblation (LP group) and 39 severe OSAHS patients underwent SSLPW combined with soft palate radiofrequency coblation (SSLPW group) were selected.The apnea hypopnea index(AHI),lowest SaO2(LSaO2),Epworth sleepiness scale(ESS) scores,and related postoperative complications of the patients in two groups were analyzed before and after operation.The successful rates of operation of the patients in two were compared.Results:In LP group,1 patient was cured (5%),19 patients were improved markedly (90%),1 patient was effective (5%),and no patient was invalid;the successful rate was 95.2%(20/21).In SSLPW group,2 patients were cured (5.1%),33 patients were improved markedly (84.6%),4 patients were effective (10.3%),and no patients was invalid;the successful rate was 89.7%(35/39);there was no statistical difference in the successful rate of operation of the patients between two groups (P>0.05).There was statistically significant improvement of the subjective symptoms.All the patients returned to normal subjective swallowing functions without nasal pharyngeal reflux and dysphagia in one month follow-up after operation.Compared with before operation,the AHI and ESS scores of the patients in two groups after operation were decreased(P<0.05);the LSaO2 scores were increased(P<0.05).Conclusion:The AHI,LSaO2 and ESS scores are significantly improved in the OSAHS patients after treated with SSLPW combined with soft palate radiofrequency coblation.The method is a valid option for the severe OSAHS patients.

Objective To evaluate the effectiveness of web-based mental health services.Methods Web-based mental health services were established in our hospital to offer continuing medical education on mental health and psychological assessments.The access of clinicians to psychiatric knowledge and consultation from psychiatry department was evaluated.Results A total of 803 medical staff took the continuing medical education,and 643 passed the examination.Five hundred and twenty-eight online psychological assessments were completed.The qualification rate of psychiatric examination was 83.3％ vs.31.7％ in educated and non-educated clinicians (x2=32.77,P＜0.01).The common consultation from psychiatry department of the educated group involved anxiety,depression/mania and delirium,of which anxiety and medically unexplained symptoms were comparatively higher while delirium was lower than the non-educated group (x2 values were 4.80,4.59 and 5.16,respectively; all P＜0.05).More use of online psychological assessments was found in the educated group (33.8％ vs.7.6％) before asking for a consultation from psychiatry department (x2=30.04,P＜0.01).Conclusions Online mental health continuing education and psychological assessment could improve psychiatric knowledge and recognition of anxiety and depression in clinicians.

[ABSTRACT]OBJECTIVETo estimate different dimensions of maxillary sinus measured on cone-beam computerized tomography (cone-beam CT), and determine the differences in side and gender.METHODScone-beam CT image data from 200 normal adults was selected and analyzed by Invivo Dental software. The craniocaudal diameter, anteroposterior diameter, width and volume of maxillary sinus were measured as well as the thickness of the orbital floor. Statistical analysis was performed with SPSS 11.5.RESULTSThere were no statistically significant differences in the craniocaudal diameter, anteroposterior diameter, width and volume of maxillary sinus between sides (P>0.05, respectively). Significant differences were noted in the craniocaudal diameter and volume of bilateral maxillary sinus and the width of right maxillary sinus based on gender (P<0.05, respectively). There were no significant differences in the width of left maxillary sinus, the anteroposterior diameter of bilateral maxillary sinus and the osseous thickness of the orbital floor (P>0.05, respectively).CONCLUSIONOur findings indicate that cone-beam CT can be used to measure different dimensions of maxillary sinus and provide imaging anatomical data for clinical treatment.

A comparative observation about histological and histochemical study were made onthe preservating methods of local ischemic kidney of dogs.The methods of this exp-eriment were divided into five groups:A.Local hypothermia;B.Hypothermic perfu-sion solution 500ml,4℃,containing Procaine 450 mg and Heparin 100 mg,infusedinto renal artery;C.Hypothermic perfusion solution 500ml,4℃,containing 20% Ma-nniton 32ml,25% MgSO_4 0.36 ml,Heparin 100 ml,infused into renal artery;D.Localhypothermia and heparin 30 mg injected into the same vessel.E.Local room tem-perature.The specimens were taken from the kidneys of the experimental dogs atvarious period after treated with every method.The results were as follows;A,D and E group presented irreversible histological changes within 4 hoursaftertreatment.Four hours later,the reaction of SDH,ATPase,AlPase werenegative.It suggested that the kidney damage was serious,as well as expressed thatthe effect of these preservating methods for ischemic kidney are not satisfactory.In B group,the histological and histochemical alteration is very light and almostreversible,during 60 days after treatment.In C group,hypothermic perfusionsolution containing Mannitol,MgSO_4 etc either during experiment or follow observa-tion for 60 days,no histological and histochemical alterations were found.It indica-ted that this method is an ideal perservating technique for ischemic kidney.

Parkinson′s disease (PD) is a common neurodegenerative disorder, which has a highly effective pharmacological symptomatic treatment. Levodopa is the most effective drug available for the symptomatic treatment of PD and is the gold standard with which other therapies must be compared. There are significant individual differences in clinical features, disease course, and response to pharmacological treatment in PD patients, not only attributed to disease process and environmental factors, but also genetic factors. Pharmacogenomics, also known as personalized medicine, is the study of how genetic variations in a person′s genome affect their response to drug therapies, which contribute to apply the patient with the best treatment plan, including the timing of dosing, the dose administered, and the most appropriate drugs. Pharmacogenomics accounts for 60%-90% variability in drug pharmacokinetics and pharmacodynamics. Major determinants of the pharmacogenomic outcome include pathogenic, mechanistic, metabolic, transporter and pleiotropic genes. This article will summarize the impact of polymorphisms in genes encoding dopamine signaling pathway on drug response, and the impact of genetic polymorphisms on complications and prognosis associated with dopaminergic drug therapy.

Objective:To investigate the safety and feasibility of the occipital condyle screw and evaluate the safepath parameters for the occipital condyle screw.Methods:Data of 64 patients with upper cervical computed tomographic angiograms from September 2016 to September 2018 were retrospectively collected. Excluded occipito-cervical injury, tumor, and vertebral artery course variation. Mimics software was used to reconstruct the occiput, atlas and vertebral artery. Three candidate entry points were placed for each occipital condyle, the midpoint of posterior of occipital condyle as middle entry point, and the medial and lateral entry points were located 3 mm medial and lateral to the middle entry point. The vertebral artery-occipital bone distance (VOD) of each entry point were measured on sagittal plane, and the minimum feasible value was determined to be 4mm. After that 3.5 mm diameter virtual screw was inserted into each candidate entry point with VOD>4 mm, each screw with maximum and minimum cranial angulation was combined with appropriate medial angulation to get the maximum screw length. Then, the screw placement parameters were measured by 3-Matic, and the safe range of cranial angulation and the success rate of screw placement were calculated.Results:The VOD of medial and middle entry point were 8.07±2.13 mm and 7.70±2.19 mm respectively, and the feasibility rate of screw placement of those entry point were 97.7% and 96.1%, respectively. There were significant differences inVOD and feasibility rate of screw placement between medial and middle entry point. The VOD of lateral entry point was 5.63±1.66 mm, and the feasibility rate was only 78.9%, which was significantly lower than that of medial and middle entry point. The lateral entry point could obtain a larger medial angulation, which was supplemented by a longer screw length. The medial angulation and length of screw gradually decreased with the inward movement of the entry point. There were significant differences in medial angulation and screw length among groups. The safe range of cranial angulation of medial, middle and lateral entry points were 8.17°±2.55°, 12.58°±4.23° and 12.09°±3.83°, respectively, and the difference were statistically significant. Among the screw entry point that could accommodate screw fixation, the maximum screw placement success rate can be obtained by adding 5° cranial angulation to the lateral and middle entry point, which were 98.02% and 98.37%, respectively,while 100% success rate of screw placement could be obtained at the medial entry point at 3° cranial angulation.Conclusion:In the selection of the entry point in the horizontal direction, middle and medial entry points have higher success rate of screw placement and wider safe range of cranial angulation because of less affection of horizontal segment of the vertebral artery. However, the screw length of medial entry point is much shorter than middle and lateral entry point. As a result, the middle entry point may be an optimal entry point for the occipital condyle screw.

Inorganic arsenic (iAs) is a toxic metalloid found ubiquitously in the environment. In humans, exposure to iAs can result in toxicity and cause toxicological manifestations. Arsenic trioxide (As2O3) has been used in the treatment for acute promyelocytic leukemia. The kidney is the critical target organ of trivalent inorganic As (iAsIII) toxicity. We examine if oral administration of astaxanthin (AST) has protective effects on nephrotoxicity and oxidative stress induced by As2O3 exposure (via intraperitoneal injection) in rats. Markers of renal function, histopathological changes, Na+-K+ ATPase, sulfydryl, oxidative stress, and As accumulation in kidneys were evaluated as indicators of As2O3 exposure. AST showed a significant protective effect against As2O3-induced nephrotoxicity. These results suggest that the mechanisms of action, by which AST reduces nephrotoxicity, may include antioxidant protection against oxidative injury and reduction of As accumulation. These findings might be of therapeutic benefit in humans or animals suffering from exposure to iAsIII from natural sources or cancer therapy.
Adenosine Triphosphatases ; Administration, Oral ; Animals ; Arsenic ; Humans ; Kidney ; Leukemia, Promyelocytic, Acute ; Oxidative Stress ; Rats ; Rats, Wistar*

Pyroptosis is a novel mode for programmed cell death discovered and confirmed in recent years. The Gasdermins (GSDMs) family is a key effector molecule mediating pyroptosis. As an important cause of extensive inflammatory damage and side effects of conventional chemotherapy drugs, anomalous pyroptosis has also been associated with hearing loss, tumor, and disorders of the immune system. The GSDME protein, encoded by the GSDME ( DFNA5) gene, belongs to the GSDMs family and is a key factor mediating pyroptosis. Gain-of-function variants of the GSDME gene can lead to GSDME-related hearing loss, which shows an autosomal dominant inheritance. This article has reviewed the role of GSDME-mediated pyroptosis in the pathogenesis of GSDME-related hearing loss, with an aim to provide insights into the treatment of GSDME-related hearing loss.

Pyrrolizidine alkaloids(PAs)are among the most hepatotoxic natural compounds that are widely distributed throughout the world.Most PAs are metabolically activated to trigger toxicity.Exposure to herbal medicine containing PAs and food supplements contaminated by PAs is considered to be one of the two main causes of hepatic sinusoidal obstruction syndrome(HSOS),which is a rare hepatic vascular disease with a high mortality rate.PAs-induced HSOS cases have been reported worldwide.However,there is no clinically effective therapy for PAs-induced HSOS,which is partially because the toxic mechanism is not fully understood.This review focuses on updating the information on the metabolism and the molecular mechanisms of PAs hepatotoxicity,including oxidative stress,apoptosis,and dysfunction of bile acid metabolism,and their interactions.

BACKGROUND:Changes in skeletal muscle mass have been indicated in studies addressing the effects of low-frequency pulsed magnetic fields on the structure and morphology of the skeletal muscle,but no relevant studies have been conducted on the morphologic changes that occur after chronic exposure to the low-frequency pulsed magnetic field. OBJECTIVE:To observe the effects of chronic exposure to low-frequency pulsed magnetic fields on the maximal voluntary contraction and morphologic indicators of the quadriceps muscle of the leg,thereby providing a reference of muscle morphologic changes for the use of this technique as a strategy for muscle function improvement. METHODS:Seventy healthy subjects were recruited and randomly divided into a test group that received magnetic field stimulation and a control group that underwent sham treatment,with 35 subjects in each group,and the total duration of the trial was 4 weeks.The test group underwent low-frequency pulsed magnetic stimulation for 15 minutes every 48 hours,while the control group underwent sham treatment,with the same intervention interval and duration as the test group.After 4 weeks of intervention,changes in the maximum voluntary contraction value of the quadriceps muscle in different groups were observed,and B-mode ultrasonography was utilized as a means of assessment to observe changes in muscle thickness,muscle cross-sectional area,and pinnation angle indexes. RESULTS AND CONCLUSION:After 4 weeks of chronic exposure to low-frequency pulsed magnetic fields,68 subjects completed the test.The maximum voluntary contraction value of the quadriceps muscle in the test group increased significantly(P=0.000),and the increment was significantly higher than that of the control group(P=0.008).Three indexes related to muscle morphology in the test group were significantly higher than the pre-test values(P=0.000),while in the control group,muscle thickness showed a significant reduction(P=0.020),there was no significant change in the pinnation angle,but a significant increase in the cross-sectional area(P=0.000).Intergroup comparisons revealed that the three indicators related to muscle morphology,including muscle thickness(P=0.012),pinnation angle(P=0.003),and cross-sectional area(P=0.049),were significantly higher in the test group than in the control group.The above data confirmed that the maximum voluntary contraction of the quadriceps muscle was significantly increased in healthy adults after 4 weeks of chronic exposure to the low-frequency pulsed magnetic field,and significant increases in the three muscle morphometric indices of muscle thickness,cross-sectional area,and pinnation angle were observed in the test group,providing a basis of muscle tissue morphology for the use of this technique as an exercise alternative and medical treatment strategy for muscle improvement.