Objective To explore the value of microarousal in the diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods 120 snorers were monitored by standard polysomnography(PSG). The overnight PSG recordings were also performed 1 year after operation in 24 patients, who had filled in the Epworth Sleep Score(ESS) before and after treatment, to evaluate the improvement of daytime sleepiness. Results After operation, obstructive sleep apnea of the 24 patients disappeared, their ODI 4 decreased from (52?26)/h to (10?8)/h, microarousal decreased from (28?16)/h to (14?6)/h, and the subjective and objective daytime sleepiness was improved. Conclusion The EEG changes of microarousal with at least 3 seconds in OSAHS patients can be recorded by computerized EEG analysis. Microarousal can serve as an index for daytime sleepiness, and be complementary to AHI in the diagnosis and treatment of OSAHS.

The purpose of this study was to assess the diagnostic value of main frequency of transient evoked otoacoustic emissions for Meniere's disease. The click- evoked transient otoacoustic emissions(TEOAE) in normal subjects and in patients with Meniere' s disease were examined using ILO 88 otodynamic analyzer system to observe the main frequency distrbution. The main frequeencies ranged from 1.2 to 1.6 kHz in normal ears, and from 0.8 to 1. 1 kHz in Meniere' s ears. The main frequency range of normal ears was obviously higher than that in Meniere's ears. After application of glycerol, the main frequencies in some Meniere's ears were shifted from relative low frequency range to relative high frequency range. TEOAE appeared in some Meniere's ears in which TEOAEs could not be evoked before application of glycerol. The results suggest that the TEOAE can be used in the diagnosis of Meniere's disease.

ObjectiveTo observe the effect of the doctor-led telephone interview on the state of anxiety for outpatients with epilepsy.Methods100 outpatients with epilepsy and state of anxiety were divided into two groups: intervention group (doctor-led telephone interview) and control group (outpatient face-to-face visit in the epileptic clinic), 50 cases in each group. Doctor-let semi-structured telephone interview was performed in the intervention group, while routine face-to-face interview in outpatient was performed in the control group for 6 months. Self-rating Anxiety Scale (SAS) was used to assess the anxiety state before and 6 months after intervention. The state of anxiety and the patients' contents in the two groups were analyzed.ResultsThe scores of SAS in two group decreased 6 months after intervention and the intervention group was better than the control group.ConclusionThe doctor-led telephone interview can improve the state of anxiety for the patients with epilepsy.

Objective: To study the effect of lipopolysaccharides(LPS) on nitric oxide(NO) production in synoviocytes and inhibition of genistein on it.Methods: LPS or LPS+genistein stimulated synoviocytes in vitro .NO in culture medium was determined by Griess method.Results: LPS dose and time dependently induced NO production in synoviocytes; Genistein (6.25 50 ?mol/L) dose dependently inhibited the production of NO induced by lipopolysaccharide.Conclusion:The effect of LPS on NO production can be dose dependently inhibited by genistein,this may be mediated by tyrosine kinase(PTK).

Objective To observe the action of H_2O_2 on the hair cells in the organ of Corti of rats.Methods The culture technology of Corti in neonatal rat in vitro was used to establish the model of studying the injury of inner and outer hair cells caused by exogenous H_2O_2. 24 neonatal SD rats of 1～ 5 days were selected and divided into 4 groups with 6 in each group.There were 12 ears in each group:①serum-free medium;②0.05 mmol/L H_2O_2;③0.1 mmol/L H_2O_2;④0.5 mmol/L H_2O_2.Forty-eight hours after the tissues cultivation, the tissue was stained by AO and PI.The ratio of apoptotic cells in different groups was studied.Results Apoptosis cells were detected in groups of different concentration of H_2O_2.Outer hair cell were the main target attacked by H_2O_2.But not at apoptotic Sertoli cells.The loss of hair cells on the bottom,middle and parietal turn of basilar membranes varied as the injury to the bottom turn was more severe.The results suggest OFR could cause apoptosis of hair cells,and cochlea damage was dose-dependent in this way.Conclusion Under the conditions of this experiment,exogenous H_2O_2 can cause the apoptosis of hair cells of the organ of Corti in rats,but not related to apoptotic Sertoli cells.

Objective To investigate the clinical,histopathological and dermoscopic features as well as treatment and prognosis of cicatricial alopecia.Methods Clinical data on 53 patients with cicatricial alopecia were retrospectively collected and studied.Pathological and dermoscopic characteristics,as well as treatment modality and prognosis of cicatricial alopecia were analyzed.Results Cicatricial alopecia was characterized by alopecia,disappearance of follicular ostia,and absence or decrease in the number of polisebaceous gland units.Pathologically,focal liquefactive degeneration of basal cells,follicular keratotic plugs,arborising telangiectasia together with a positive immunofluorescence test were usually suggestive of discoid lupus erythematosus,interface dermatitis suggestive of lichen planopilaris,inflammation and mild disruption of elastic fibers suggestive of classic pseudopelade of Brocq.Mucin deposition between hair follicles and sinking of follicular ostia were pathological and dermoscopic characteristics of alopecia mucinosa.Pustules could be visible in both folliculitis decalvans and dissecting cellulitis/folliculitis,with tufted hairs usually seen in the former,and sinus formation in the later.Lymphocytic disorders were treated with immunosuppressors,and neutrophile disorders with antibiotics and retinoids.Conclusions Histopathological examination plays a determinant role in the diagnosis of cicatricial alopecia,which can cause irreducible damage to hair follicles,and require long term treatment.Early diagnosis and appropriate use of drugs may control the development of cicatricial alopecia,and reduce the occurrence of permanent hair loss.

ObjectiveTo assess the relationship of filaggrin expression with atopic diathesis and disease severity in patients with alopecia areata (AA).MethodsThirty-seven patients with AA aged (26.3 ± 10.6) years were enrolled in this study.Atopic diseases were noted in 8 of these patients.Clinical data and laboratory test resuhs were reviewed.Immunohistochemical staining was performed to quantify the expression of filaggrin protein in scalp biopsy specimens from all of the 37 patients with AA and from 10 human controls,and fluorescence-based semiquantitative reverse transcription-PCR to detect the expression of filaggrin mRNA in scalp biopsy specimens from 22 patients with AA and 13 healthy controls.Data were statistically analyzed by Mann Whitney U test,chi-square test,and Spearman's rank correlation test.ResultsThe expressions of filaggrin protein and mRNA were significantly lower in patients with AA than in the controls(P ＜ 0.05 or 0.01 ),and the decrease seemed more obvious in patients with large areas of lesions,long duration of disease,and nail abnormalities,but the degree of decrease was unrelated to the complication with atopic diseases.No significant differences were observed in sex ratio,age at onset,disease duration,area of hair loss,the prevalence of family history or incidence of nail abnormalities and increase in serum IgE and eosinophils,between patients with atopic diseases and those without.ConclusionsThe expressions of filaggrin protein and mRNA are decreased in patients with AA,suggesting that filaggrin may participate in the development of AA and is correlated with the severity of AA.

Objective To detect the expressions of apoptosis-related factors and inflammatory cytokines in superficial and deep layers of as well as anagen hair follicles in lesions of early alopecia areata (AA).Methods Scalp biopsy samples were collected from 25 patients with early AA and 15 healthy human controls.Fluorescence-based quantitative PCR was performed to detect mRNA expressions of apoptosis-related genes p53,caspase 3,Fas,survivin and bcl-2,as well as those of inflammatory cytokines interleukin (IL)-4,IL-10,IL-12 and interferon (IFN)-γ.An immunohistochemical assay was conducted to measure the expression of p53 protein in anagen hair follicles.Results Compared with control skin samples,anagen hair follicles in AA lesions showed significantly increased mRNA expression levels (expressed as 2-△△Ct) of pro-apoptotic factors caspase 3,p53 and Fas (6.78,8.01,9.74,respectively,all P ＜ 0.05),but decreased mRNA expression levels of antiapoptotic factors bcl-2 and survivin (0.08 and 0.03 respectively,both P ＜ 0.01),and similar mRNA expression levels of inflammatory cytokines.There was a significant increase in mRNA expression levels of Th1 cytokines IFN-γ and IL-12 (2.75 vs.1.00,P ＜ 0.05; 85.67 vs.1.00,P ＜ 0.01),but a significant decrease in the expression level of the Th2 cytokine IL-10 (0.002 vs.1.000,P ＜ 0.01) in superficial layers of AA lesions compared with those of normal control skin.The degree of changes in mRNA expression levels of IL-10 and IL-12 was significantly higher in superficial layers than in deep layers of AA lesions (P＜0.01 and 0.05 respectively).The immunohistochemical assay showed that the number of p53-positive cells per 100 cells in anagen hair follicles of AA lesions was higher than that in those of control skin (t =23.79,P ＜ 0.01).Conclusions Anagen hair follicles in AA lesions exhibit high expressions of pro-apoptosis factors,but low expressions of antiapoptotic factors,suggesting that apoptotic factors play a role in the occurrence of AA.

Objective To compare the clinical effects of three-dimensional (3D) and two-dimensional (2D) laparoscopic surgeries for rectal cancer (RC) after neoadjuvant chemoradiation therapy (nCRT).Methods The retrospective cohort study was conducted.The clinicopathological data of 126 patients with RC who received laparoscopic surgery after nCRT in the Liaoning Cancer Hospital from January 2013 to January 2014 were collected.Of 126 patients,63 undergoing 3D laparoscopic surgery and 63 undergoing 2D laparoscopic surgery were respectively allocated into the 3D and 2D groups.Surgery was performed by the same doctors' team.Patients received surgery at 6-8 weeks after nCRT,and surgery followed the principle of total mesorectal excision.Observation indicators:(1) intra-and post-operative situations;(2) postoperative pathological examination;(3)follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect local tumor recurrence and patients' survival up to January 2017.Patients received reexaminations once every 3 months within 1 year postoperatively and once every 6 months after 2-3 years postoperatively.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed using the t test.Comparisons of count data were analyzed using the chi-square test.Comparison of ordinal data was done by the nonparametric test.Survival curve was drawn using the Kaplan-Meier method.Survival was analyzed using the Logrank test.Results (1) Intra-and post-operative situations:all the patients underwent successful laparoscopic surgery for RC,without conversion to open surgery and perioperative death.Operation time,volume of intraoperative blood loss,time to anal exsufflation and number of patients with postoperative urinary dysfunction were (125±10)minutes,(54±23)mL,(44±5)hours,0 in the 3D group and (137±12)minutes,(62±20)mL,(46±5) hours,5 in the 2D group,respectively,with statistically significant differences between the 2 groups (t=5.777,2.038,2.575,x2 =7.138,P＜0.05).Number of patients with preserving anus,number of lymph node dissected,number of patients with anastomotic fistula and duration of hospital stay were 60,14.9±2.1,2,(9.5±0.8)days in the 3D group and 58,14.3± 1.7,4,(9.9±2.0)days in the 2D group,respectively,with no statistically significant difference between the 2 groups (x2 =0.133,t=1.606,x2 =0.175,t =1.329,P＞0.05).Two and 4 patients with anastomotic leakage in the 3D and 2D groups received defunctioning stoma,and finally anastomotic leakage healed,without anastomotic stenosis.Of 5 patients with urinary dysfunction in the 2D group,4 received indwelling catheter for 3 weeks and then can micturate autonomously after indwelling catheter removal,1 received indwelling catheter for 3 months and then can micturate autonomously after indwelling catheter removal,without suprapubic cystostomy.(2) Postoperative pathological examination:0 and 4 patients in the 3D and 2D groups had positive circumferential margin,with a statistically significant difference (x2=5.676,P＜0.05).One and 2 patients in the 3D and 2D groups had positive distal margin,with no statistically significant difference (x2 =1.606,P＞0.05).Number of patients with stage Ⅱ and Ⅲ of postoperative pathological staging were 30,33 in the 3D group and 32,31 in the 2D group,respectively,with no statistically significant difference between the 2 groups (x2=0.127,P＞0.05).(3) Follow-up and survival situations:126 patients were followed up for 36.0-48.0months,with a median time of 39.5 months.During the follow-up,0 and 3 patients in the 3D and 2D groups were complicated with local tumor recurrence,with a statistically significant difference between the 2 groups (x2 =4.232,P＜0.05).One-and 3-year overall survival rates were 98.4％,82.5％ in the 3D group and 96.8％,79.4％ in the 2D group,respectively,with no statistically significant difference between the 2 groups (x2 =0.206,P＞0.05).One-and 3-year disease-free survival rates were 92.7％,77.8％ in the 3D group and 90.5％,73.0％in the 2D group,respectively,with no statistically significant difference between the 2 groups (x2=0.421,P＞0.05).Conclusion Compared with 2D laparoscopic surgery,3D laparoscopic surgery for RC after nCRT is safe and feasible,it can also shorten operation time,reduce intraoperative bleeding,alleviate the influence of intestinal peristalsis function,protect pelvic nerves better and improve operation quality.

Objective To investigate the cognitive function and psychological mental state of patients with juvenile myoclonic epilepsy (JME), and the related risk factors. Methods From September, 2011 to Febrary, 2014, 21 patients with JME and 18 healthy controls matched with age, sex and educational level were assessed with Montreal Cognitive Assessment (MoCA), and Revised Chinese Wechsler Adult Intel-ligence Scale (WAIS-RC) and Symptom Checklist-90 (SCL-90). The risk factors were analyzed with Logistic regression analysis. Results There was no significant difference in the score of MoCA between two groups (t=―1.544, P=0.131). The scores of verbal intelligence quo-tient (VIQ), performance intelligence quotient (PIQ) and full intelligence quotient (FIQ) in WAIS-RC were significantly lower in the patient group than in the control group (t>4.119, P<0.001). The scores of interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, par-anoid ideation and psychoticism in SCL-90 were significantly higher in the patient group than in the control group (t>2.480, P<0.05). Logis-tic regression analysis showed that VIQ significantly decreased in patients taking valproic acid (B=―3.064, OR=0.047, 95% CI=0.002~0.920, P=0.044). Conclusion VIQ, PIQ and FIQ decreased in patients with JME. Furthermore, different levels of dysfunction were found in interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism. Taking valproic acid was the risk factor of cognitive decline.