Pediatric sleep-disordered breathing, also known as obstructive sleep apnea and hypopnea syndrome (OSAHS) in children, is caused by obstruction of upper airway, characterized by repetitive pauses in breathing during sleep despite the effort to breathe, and usually leads to reduction in oxygen saturation. Due to the importance of sufficient oxygen in growth and development, many children patients suffer from abnormal secretion of growth hormone at night, and also their activity and resting of cerebral cortex during sleep. Therefore, they face great risks in keeping normal physical growth, forming mental behavior, building up learning ability and shaping personalities. It is a very important interdisciplinary subject, yet still much remains unclear about the disease. Oral medicine is one of the subjects that show increasing importance in prevention and treatment of OSAHS in children. On one hand, due to the special means of the field, such as cephalometric, it can diagnose and monitor the development of craniofacial structures, especially the upper airway. On the other hand, it can provide treatments which can both improve breath during sleep and consequent dental facial deformities. Most typical treatments include mandibular sagittal growth stimulation, transverse maxillary palatal expansion and maxillary protraction. Oral medicine provides additional treatment apart from traditional adenectomy and tonsilectomy to improve ventilation. It not only directly helps to improve deformities caused by sleep-disordered breathing in OSAHS children with indications, but also helps to avoid many of physical and mental complications, which will in turn benefit their life quality. Also, it may prospectively provide insights in treatment and prevention of OSAHS in adults.
Adult ; Cephalometry ; Child ; Humans ; Mandible ; Maxilla ; Palatal Expansion Technique ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive

The diseases of esophagus and stomach possess highest morbidity in China. For decades the interventional radiology has effectively solved a lot of clinical puzzles upon the lesions of esophagus and esophagogastric junction. Rapid development and extensive application offen induce the exaggeration of indication and improper choice of the proceduce, resulting in clinical disposal for various complications. Scientific attitude should be taken on the utilization of interventional method: possessing rich imaging and clinical knowledge; understanding the property of various interventional instruments; strictly grasping indications of arterial infusion chemotherapy, balloon catheter dilation and stent placement; perfectly mastering the operation technology; well controlling complications.

Objective To discuss the clinical characteristics of gastric stromal tumor (GST),as well as their diagnosis and treatment.Methods The clinical and pathological data of 18 patients with GST were retrospectively analyzed.Results The chief clinical manifestations included abdominal pain or discomfort,gastrointestinal bleeding and the abdominal mass.Only a rectum stromal tumor in 1 case diagnosed before operation.All the 18 patients were treated surgically,of all 17 cases were resected completely,1 case was rssected palliatively. The microscopic pathological morphology were exclusively fusiform cells,immunohistochemical analysis display positive reactivity for CD117 ( 16/18 ),CD34 ( 11/18 ),positive reactivity for CD117 and CD34 (15/18).Conclusion The confirmed diagnosis rate of preoperative-GIST is low and digestive tract symptoms have no specific.The diagnosis of GST mainly depends on pathologicl analysis.The size of the tumor is the important marker to the diagnosis of benign of malignant GST.At present,the operation is still the main method to treat GST.Appropriate treatment with Glivec can improve the prognoeis of patients with GST.

Obstructive sleep apnea hypopnea syndrome(OSAHS) has been the main research area of the Dental Therapy Center for Sleep Apnea,Peking University School and Hospital of Stomatology.The basic research in the center includs: epidemic survey of OSAHS and snoring in a Beijing population,setting up the cephalometrc and MRI standard of airway and surrounding structures for non-snoring Chinese,aetology exploring OSAHS from views of airway size,craniofacial form,neck circumference and genioglossus muscle activity.Clinically,different dental appliances were developed.The treatment effects of the oral appliances for OSAHS patients were evaluated quantitatively.Two and three dimension changes of the airway and surrounding structures,genioglossus muscle activity,as well as snoring loudness following mandible advancing and opening were studied.Besides,research was expended to OSAHS in children recently.Under the support of National Nature Science Foundation 7 PhD and 3 MS students have graduated.More than 60 papers were published domestically and abroad and two awards were received from the National Ministry of Education and Chinese Medical Association in the past 10 years.This paper is a review of the past and current situation of dental research on OSAHS in China.

Objective:To study the effect of surrounding tissues on the minimum cross-section area(minCSA) of upper airway in non-snoring males.Methods: Upper airway scanning by magnetic resonance imaging(MRI) was conducted in 83 non-snoring males aged 22 to 57 years. The correlation between the minCSA of upper airway and the linear, area and volume measurement items about the morphology of the surrounding tissues was analyzed. Results: The minCSA was in velopharynx or glossopharynx. In non-snoring males,the main relative factors to minCSA were transverse dimension/ transverse distance between mandible(r=0.700), transverse dimension/ pharyngeal wall thickness(r=0.680), and parapharyngeal fat volume(r=-0.290). The velopharynx was more prone to be affected by the surrounding tissues than the glossopharynx. The location of the parapharyngeal fat, the lateral pharyngeal wall and parapharyngeal fat volume had the most obvious influence on the velopharyngeal size in sequence. While the thickness of the lateral pharyngeal wall was the main factor which influenced the size of glossopharynx. Conclusion: The feature of surrounding tissues has certain influence on minCSA of upper airway in non-snoring males.

Objective To investigate the protective effects of melatonin and possible mechanisms on rats with alco-holic fatty liver (AFL). Methods All rats were randomly divided into 4 groups: normal group (n = 10), model group (n = 12) and melatonin groups (10 mg / kg, 20 mg / kg; n = 10, respectively). The model of rats’ alcoholic fatty liver was induced by intragastric influsion of ethanol for 8 weeks. The melatonin groups’ rats received melato-nin by intraperitoneal injection after intragastric infusion of ethanol. Histopathological changes were evaluated by hematoxylin and eosin staining. The expressions of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected by immunohistochemical methods. The detection of aspartate aminotransferase (AST) levels and alanine transarninase (ALT) levels and the total bilirubin ( TBIL) levels in serum were provided by routine laboratory methods using an autoanalyzer. The levels of malondialdehyde ( MDA) and activities of glutathione peroxidase ( GPx) were measured by spectrophotometry. Results Compared with the normal group, the liver cells of the mod-el group showed obvious steatosis and significant swelling. However, less degree and less extensive of steatosis and swelling were observed in the melatonin groups. Compared with the normal group, the levels of ALT, AST and TBIL in serum and the levels of MDA in liver homogenates were significantly increased in the model group (P <0. 01), and the activities of GPx were distinctly decreased in the model group(P < 0. 01). But in the melatonin groups, the levels of ALT, AST and TBIL in serum and the levels of MDA in liver homogenates were decreased (P< 0. 01), and the activities of GPx were increased (P < 0. 01). Additionally, melatonin lessened the expression of TNF-α and IL-6 in liver obviously (P < 0. 01). Conclusion Melatonin may inhibit the development of alcoholic fatty liver and its possible mechanism is the ability to resist oxidative stress and lessen the expression of TNF-α and IL-6 and other relevant factors in liver.

Objective To analyse the clinical manifestation of thoracostomach-airway fistula in order to improve the recognition.Methods The clinical information in 20 cases with thoracostomach-airway fistulas was analyzed retrospectively.Results The main clinical manifestations were choke after drinking or eating,inhalation pneumonia,fever,becoming thin ness,aridity,turbulence of water and electrolyte,et al.The stomach radiography showed thoracostomach-tracheal fistulas in six cases,thoracostomach-carina fistula in fwo cases,thoracostomach-left main bronchial fistulas in 10 cases and thoracostomach-right main bronchial fistula in two cases,vespectively.Conclusions Thoracostomach-airway fistula could be diagnosed according to the specific clinical significances and stomach radiography.

Objective To explore the technical feasibility and sensitivity of percutaneous transhepatic cholangiobiopsy in malignant obstructive jaundice, together with the guidance for clinical managements.. Methods 31 patients with obstructive jaundice after percutaneous transhepatic cholangiography and drainage were undesgone percutaneous transhepatic cholangiobiopsy. The technique was performed through an preexisted percutaneous transhepatic tract with a 8 Frerch sheath, multiple specimens were obtained after passing the forceps for the biopsy. The specimens were fixed with formalin, and then taken for histopathologic diagnosis. Results The histopathologic diagnosis was acquired in 30 of 31 patients(sensitivity, 96.8%). Conclusions Percutaneous transhepatic cholangiobiopsy is an accurate, safety and reliable way, easy to perform with a histopathologic diagnosis sensitivity rate of 96.8%.

Objective: To obtain the data about morphology of upper airway and surrounding tissues of non-snoring males from three age groups. Methods: Through questionnaires and clinic examinations, 83 non-snoring males (20-60 years) were selected from 453 volunteers and involved in the following research. There were 30 volunteers aged from 22 to 29 (mean 23.60?2.58 years), 31 volunteers aged from 36 to 45 (mean 40.10?2.64 years) and 22 volunteers aged from 46 to 57 (mean 49.55?3.45 years). Magnetic resonance imaging (MRI) of upper airway of each volunteer was acquired under strict posture-control conditions. The dimensions and cross-section area of nasopharynx, velopharynx, glossopharynx, hypopharynx and whole upper airway with its surrounding tissues were measured with MRI intrinsic software. Volumes of upper airway and surrounding tissues were also calculated. Results: There were 93 items about morphology of the upper airway and surrounding tissues of non-snoring males from the three age groups.With increase in age, some nasopharynx items showed increase tendency, while little change showed in velopharynx, glossopharynx and hypopharynx. Fat volume, tongue volume, anterior and posterior pharyngeal dimension showed age-related increase tendency, but fat deposition rate slowed down in elder age in non-snoring males, which supplies the reason why non-snoring males avoided becoming sleep apnea patients. Conclusion:We provide age-related reference data of upper airway and its surrounding tissues for further sleep and respiration research.

Objective To systemically evaluate the clinical therapeutic effect of combined traditional Chinese medicine (TCM) and western medicine for treatment of acute heart failure by Meta analysis. Methods The America National Library PubMed and China Biomedical Literature Data System (SinoMed), China National Knowledge Infrastructure (CNKI), VIP Data Resource, Wanfang Data Resource, Chinese TCM Database Retrieval System were searched from 1990 to May 2014 to identify the formally published randomized controlled trials (RCTs) in which the effects of combined TCM and western medicine (experiment group) or simple western medicine (control group) for treatment of patients with acute heart failure were reported. The Cochrane system 4.2.2 quality evaluation standard in Evaluation Handbook was applied to assess the methodological quality of literature. The Cochrane Collaboration's RevMan 5.2 software was used to seek the literatures consistent to the criteria of enrolling into the study for Meta analysis. Results There were 18 RCTs, and all together 1 374 cases were included in the data. The grade of methodological quality of the enrolled studies was of high migration. Meta analysis showed: compared with the control group, the clinical efficacy in experimental group was significantly higher [odds ratio (OR) = 5.04, 95% confidence interval (95%CI): 3.31 - 7.69, P < 0.000 01]; the level of type B natriuretic peptide (BNP) was significantly reduced [standardized mean difference (SMD) = -1.31, 95%CI: -1.78 to -0.83, P<0.000 01];left ventricular ejection fraction (LVEF) was significantly increased (SMD=0.79, 95%CI:0.52-1.07, P < 0.000 01); the therapeutic effect on TCM syndrome was significantly elevated [categorical variables: relative risk (RR) = 1.30, 95%CI: 1.06 - 1.59, P = 0.01; quantitative variables: mean difference (MD) = -1.67, 95%CI: -2.48 to-0.86, P<0.000 1] and cardiac diastolic function was significantly improved (SMD=0.64, 95%CI:0.05-1.24, P<0.05). Conclusions The clinical therapeutic effects of combined TCM and western medicine are significantly higher than those of simple western medicine for treatment of patients with acute heart failure. However, the low quality of the reports involved in this study limits the reliability of this conclusion.