Noninvasive continuous positive airway pressure (CPAP) for the ventilation treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS) is the first-line treatment method. This article aims to describe the effect of surgical operation especially for the UPPP in the individualized comprehensive treatment of OSAHS and the importance of surgical technique. Lower compliance is the bottleneck of CPAP therapy in clinical application, for the OSAHS patients with treatment failure in CPAP or those cannot accept CPAP therapy, when with no other ideal instrument therapeutics, accurate diagnosis of position in airway obstruction with an adequate surgical operation is the treatment,of choice. Surgical operation is particularly important either as a fore-lying means to improve the CPAP treatment compliance or as an independence treatment method of OSAHS. The pharyngeal cavity is the most common obstructive plane in patients with OSAHS. The operation of traditional UPPP aiming at the expansion of pharyngeal cavity is the classics surgery to solve obstruction in this plane, the lower operation effective rate is the main reason of restriction in its development. How to improve the effective rate of surgical treatment of OSAHS is our surgical goal. The effective rate of surgical operation treatment in OSAHS rely on the following sides: to follow the OSAHS individualized comprehensive treatment principle, reasonable choice of surgical operation indication, the precise localization diagnosis of upper airway obstruction, adequate surgical operation and skilled surgical techniques.
Airway Obstruction ; Continuous Positive Airway Pressure ; Humans ; Palate ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Treatment Failure

Objective To observe the effect of high-dose vitamin C on MMP2 expression and invasive ability in PANC-1. Methods Transwell invasion assay was used to compare the invasive ability of PANC-1 cells in different concentrations of vitamin C treated groups. RT-PCR and Western blot were used to detect and compare the levels of MMP2 mRNA and protein expression in each group. Results Compared with the 0mM vitamin C treated group, the mRNA expression of MMP2 was significantly decreased in 1.0,5.0,10. 0mM group(0. 510 ±0. 004 vs 0. 792 ±0. 006, 0. 391 ±0. 007 vs 0. 792 ±0. 006, 0. 282 ±0. 008vs 0. 792 ± 0. 006, P ＜ 0. 05 ). Compared with the 0mM vitamin C treated group, the protein expression of MMP2 was significantly decreased in 1.0,5.0,10. 0mM group(0. 519 ±0. 004 vs 0. 761 ±0. 014,0. 310 ±0. 007 vs 0. 761 ±0. 014,0. 297 ±0. 008 vs 0. 761 ±0. 014, P ＜0. 05). Compared with the 0mM vitamin C treated group, the invaded cell number was significantly decreased in 1.0,5.0,10. 0mM groups ( 452 ± 22 vs653 ± 28,340 ± 32 vs 653 ± 28,409 ± 33 vs 653 ± 28, P ＜ 0. 05 ). Conclusion High-dose vitamin C can decrease the expression of MMP2 in PANC-1 cells, and weaken its invasive ability.

Objective:In order to prevent misdiagnosis and degrade death rate, we explored the early diagnosis and correct treatment methods of traumatic pseudoaneurysm of internal carotid artery in sphenoid sinus,. Method: The clinic data of 6 cases who had traumatic pseudoaneurysm of internal carotid artery in sphenoid sinus and were admited in our hospital were analyzed retrospectively. Large numbers of literature about the disease were re-viewed. Some early diagnosis methods and optimal treatment schemes were proposed. Result: All patients had a history of cranium trauma and recurrent attacks nasal hemorrhage. There are two patients with a complication of sight loss in single eye. In the six cases, one case was treated with unilateral common carotid artery ligation, three cases were treated with aneurysm and internal carotid artery embolism by using sacculus proprius which is able to shedding , one case was treated with internal carotid artery embolism by using tiny circlip ring . These five pa-tients were crued with no severe complication. One patient death of hemorrhea. His nasal cavity was tamponaded repeatly because repeat nasal hemorrhage. However, he had never treated with internal carotid artery embolism. Conclusion:The patients who have traumatic pseudoaneurysm of internal carotid artery usually die of unmanageable hemorrhea. The patients may be cured if they could obtain an early diagnosis and correct treatment.

This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) by using dynamic 3-Dimensional (3-D) CT imaging. A total of 41 male patients who presented with 2 of the following symptoms, i.e., daytime sleepiness and fatigue, frequent snoring, and apnea with witness, were diagnosed as having OSAHS. They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller's maneuver. The soft palate length (SPL), the minimal cross-sectional area of the retropalatal region (mXSA-RP), and the vertical distance from the hard palate to the upper posterior part of the hyoid (hhL) were compared between the two breathing states. These parameters, together with hard palate length (HPL), were also compared between mild/moderate and severe OSAHS groups. Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index (AHI) and the lowest saturation of blood oxygen (LSaO(2))] was examined. The results showed that 31 patients had severe OSAHS, and 10 mild/moderate OSAHS. All the patients had airway obstruction at soft palate level. mXSA-RP was significantly decreased and SPL remarkably increased during Muller's maneuver as compared with the quiet breathing state. There were no significant differences in these airway parameters (except the position of the hyoid bone) between severe and mild/moderate OSAHS groups. And no significant correlation between these airway parameters and the severity of OSAHS was found. The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group. The patients in group with body mass index (BMI)≥26 had higher collapse ratio of mXSA-RP, greater neck circumference and smaller mXSA-RP in the Muller's maneuver than those in group with BMI<26 (P<0.05 for all). It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients. All the OSAHS patients had airway obstruction of various degrees at soft palate level. But no correlation was observed between the airway change at soft palate level and the severity of OSAHS. The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI<26.

We analyze the epidemiology,clinical features,and outcome of the patients with Creutzfeldt-Jakob diseases (CJD) in Guizhou Province from 2010 to 2015.The epidemiology,clinical characteristics and follow-up data of CJD suspected patients obtained from Guizhou CJD surveillance network were analyzed.The testing results of cerebrospinal fluid (CFS) and blood from the patients were also collected and analyzed.Results showed that a total of 11 CJD cases was found from 23 reported CJD suspected patients in Guizhou from 2010 to 2015,including 8 probable sporadic CJD(sCJD) cases,2 possible sCJD cases and 1 genetic CJD(gCJD) case.In 11 cases,rapidly progressive dementia was the major initial symptom,following by mental symptoms,extrapyramidal symptoms,signs and cerebellum cortical blindness.Clinical symptoms of progressive dementia were the main symptoms,following by visual or cerebellar dysfunction,myoclonus,cone system/extrapyramidal dysfunction,and akinetic mutism.Most of cases were abnormal in MRI (45.45％) and 14-3-3 protein detection in CSF(70％).The 14-3-3 blood samples of prion gene 129 amino acids (PRNP)polymorphisms were M/M type,excepting for 1 case gCJD confirmed diagnosis cases with D178N mutation in PRNP gene.Eleven CJD cases did not show season and regional clusterings and vocational tendency.The majority of the cases were male,the median age was 65,and mainly were the Han nationality.For all cases of CJD reported during that year for follow-up,the lost-tofollow-up rate was 27％,and the majority of cases died within one year.The sCJD cases were the majority in CJD cases of Guizhou Province,2010-2015.The epidemiological characteristics were similar to the national monitoring cases in the same period.

Objective: To investigate the association of poor vision with time spent in outdoor activity among students from primary and middle schools, as well as from universities in Guangzhou, so as to provide targeted scientific basis for prevention and control of low vision. Methods: According to the requirements of National Monitoring of Common Diseases and Health Risk Factors among Students Manual, a total of 2 908 students were selected in 1 urban area and 1 suburban county for monitoring and investigation in Guangzhou. Results: The poor vision rate was 69.2% among students in Guangzhou, with girls (74.4%) > boys (64.2%), suburban country (76.3%) > urban areas (54.1%), university (95.0%) > vocational high school (82.5%) > regular high school (81.1%) > junior high school (73.4%) > primary school (45.6%). With the exception of primary students, the severe poor vision has the largest proportion in each age group. The proportion of spending less than 1 or 2 h for outdoor activities per day: girls>boys, suburban country > urban area, university and regular high school are higher. The poor vision rate of students who spent <2 h(72.3%) for outdoor activities daily was higher than those spent ≥2 h(65.6%). Compared with students who spent ≥2 h/d for outdoor activities, those spent < 2 h/d were at 1.24 times risk of being low vision(OR=1.24, 95%CI=1.04-1.48), controlling for the available confounders. Conclusion Poor vision rate of students in Guangzhou is high, occurring mainly with severe impairment and in younger age, the daily outdoor activity time is low. Girls, students from suburban country and junior high school should be considered as the emphasis for prevention and control of low vision.

Objective:To investigate the safety and efficacy of drug-eluting stents(DES)in patients with acute coronary syndrome(ACS)complicated with diabetes and multivessel disease.Methods:A total of 80 patients with ACS who received XIENCE V Everolimus stent implantation in the heart center of the 82nd army hospital from January 2017 to October 2018 were retrospectively enrolled and analyzed.Patients were divided into the diabetic group(35 cases)and the non-diabetic group(45 cases)according to whether they were complicated with diabetes or mltivessel lesions.Stent implantation status within 12 months after PCI were compared between the groups.Results:(1)All stents were successfully implanted in the two groups.After coronary angiography re-examination within 12 months, there were no significant differences in the rate of stent restenosis(0.0% vs 2.2%), non-fatal myocardial infarction(2.9% vs.2.2%), or MACEs(2.9% vs.4.4%)between the diabetic and non-diabetic groups(all P>0.05). No patients died from cardiogenic causes in the two groups.(2)During the follow-up period, one patient was hospitalized for acute myocardial infarction in the diabetic group and one case died of an ascending aorta rupture. Conclusions:The safety and efficacy of XIENCE V DES in patients with diabetes and multivessel lesions are good, and the incidence of MACEs is low.

Objective: To describe the prevalence and relationship between moderate to vigorous physical activity(MVPA), screen time (ST) and depressive symptoms among middle school students in Guangzhou, and to provide a reference for adolescent depression prevention and control. Methods: Using stratified cluster random sampling method, a total of 2 140 students were selected from one urban area and one suburban country for MVPA, ST and depressive symptoms investigation. Logistic regression was used to analyze relations among MVPA, ST and their combined patterns for depressive symptoms. Results: A total of 89.72% students failed to meet the MVPA recommendations, girls (95.52%) were higher than boys(84.38%). Totally 67.38% of the students failed to meet the ST recommendations, boys (69.75%) were higher than girls(64.81%). The prevalence of depressive symptoms was 27.01%, girls (31.58%) higher than boys(22.80%). MVPA, ST failure compliance rate and depression symptoms detection rate of vocational high school and ordinary high school were higher than junior high school ( χ 2=6.40,121.71,27.37, P ＜ 0.05 ). Logistic regression analysis showed that the OR for depressive symptoms was 1.19 ( P =0.35) in students whose MVPA time achieving 1 h<7 d in the last week, and was 1.93 ( P <0.01) in students with the ST>2 h/d independently, no significant interactions were observed. Students with both MVPA time 1 h<7 d in the last week and the ST>2 h/d were more likely to report depressive symptoms( OR=2.03, P <0.05). Conclusion Insufficient MVPA, prolonged ST and high prevalence of depressive symptoms are observed among middle school students in Guangzhou. Students with both insufficient MVPA and prolonged ST are more likely to suffer from depressive symptoms. Specific psychological care and health education regarding physical activity and screen behavior should be implemented to students with different characteristics, as well as their parents for depressive symptom prevention.

Objective: To investigate the general situation of scoliosis and influencing factors among middle school students in Guangzhou, so as to provide evidence for behavioral intervention measures. Methods: By stratified cluster random sampling method, 2 121 students from 8 middle schools of Guangzhou were selected to conduct questionnaire survey and physical examination. Results: The detection rate of scoliosis among middle school students in Guangzhou was 8.20%, girls (9.50%)＞boys (7.00%), urban area (10.45%)＞suburb area (4.77%), senior high school (10.08%)＞junior school (6.39%) ( P ＜0.05). Among the most of the 174 positive students were found to have large thoracic curve, right lateral bending, being girls with medium scoliosis. Multivariate Logistic regression analysis showed that students in urban area ( OR=2.56, 95%CI =1.71-3.82), with mobile electronic devices usage time≥3 h/d( OR=1.59, 95%CI =1.12-2.27), prolonged near vision work ≥1 h ( OR=1.40, 95%CI =1.00-1.95), outdoor activity time＜2 h/d( OR=1.82, 95%CI =1.24-2.67) had a higher detection rate of scoliosis ( P <0.05). Conclusion The detection rate of scoliosis among middle school students in Guangzhou is much higher, which might be related to district, mobile electronic devices usage, prolonged near vision work and insufficient outdoor activity. Health education regarding spinal knowledge should be strengthened.

OBJECTIVE: To evaluate the utilization of functional neck dissection for treatment of recurrent branchial cleft anomalies. METHOD: Fifteen patients with recurrent branchial cleft anomalies (fistula and cyst) undergoing functional neck dissection were retrospectively analyzed. RESULT: Complications included 2 incisions secondary healing, 1 postoperative choking persisting for 1 months and 1 Horner's syndrome. There was no recurrence after a follow up from 2 months to 6 years,except 2 cases were lost to follow-up. CONCLUSION Functional neck dissection is an effective and safe surgical management for recurrent second and third branchial cleft anomalies(fistula and cyst).
Adolescent ; Adult ; Branchial Region ; abnormalities ; surgery ; Child ; Female ; Humans ; Male ; Neck ; surgery ; Neck Dissection ; methods ; Recurrence ; Retrospective Studies ; Young Adult