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

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.

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.

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 relationship between serum fibrinogen,uric acid and the severity of coronary heart disease(CHD).Methods 156 patients with or without coronary heart disease were divided into CHD group and control group.All subjects were examined by cronary artery angiography.The severity of coronary artery stenosis was evaluated and graded with Leaman coronary scoring system.With the multiple analysis method,the relationships were studied between serum fibrinogen,uric acid and the severity of coronary heart disease.Results With multiple logistic regression,smoking,age,fibrinogen,triglyceride and low-density lipoprotein were independently associated with the severity of coronary heart disease.Gender,uric acid and other variables did not have significant independently association with the severity of coronary heart disease.With stepwise multiple regression analysis,age,fibrinogen,total cholesterol,lipoprotein(a)and low density cholesterol showed significant independent association with the severity of coronary heart disease,but uric acid and other variables did not.Conclusion Fibrinogen was related to the severity of coronary heart disease independently,but uric acid was not independently associated with the severity of coronary heart disease.

Objective To explore the clinical characteristics of coronary heart disease (CHD) companied by type-2 diabetes mellitus (DM) and features of their coronary angiographies. Methods The data of clinical characteristics and coronary angiography results of 108 CHD cases with T2DM and 103 CHD cases without T2DM were compared and analyzed. Results Compared with the cases of CHD without diabetes mellitus, the cases of CHD with T2DM exhibited significantly increased incidence rates of hypertension and dyslipidemia. The body mass index and serum uric acid level also increased obviously. The main manifestation of dyslipidemia of CHD patients with T2DM was the higher levels of triglycerides and lower level of serum high-density lipoprotein cholesterol. And the severe coronary artery disease and lower left ventricular ejection fraction were often found in CHD patients with T2DM Conclusion CHD patients with type-2 DM tend to have multiple cardiovascular-risk factors, and often have multi-branches lesion and more severe lesions.To treat cardiovascular risk factors actively is very important to prevent the CHD and improve its prognosis.

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 evaluate the polysomnology results along with mandibular titrated advancement using oral appliance to treat obstructive sleep apnea and hyponea syndrome(OSAHS).Methods: Several electronic databases (PubMed, Embase, Cochrane Library, CNKI, VIP, and Wanfang) were systematically searched up to September 2015.There was no restriction of language or source of information.All randomized clinical trials (RCT) and before-after trials (BAT) comparing at least two different mandibular advancements were included.Two independent reviewers selected the studies, extracted data and evaluated risk of bias by quality assessment.Data were pooled using a fixed-effects model, and the summary effect measure was calculated by risk ratio (RR) and 95%CI.Meta-analysis was performed using RevMan 5.3 software.Results: Two RCTs and five BATs were included in the review.Among the five BATs, two of them were randomized, while the other three were not.Outcomes including apnea hypopnea index (AHI), oxygen desaturation index (ODI), success rate (reduction of AHI or ODI >50%), normalization rate (AHI or ODI<10/h) were assessed in this review.Based on the trial design and quality assessment, four studies were included for meta-analysis.No significant difference in the success rate was found between the group with 50% of the maximal mandibular advancement (MMA) and the group with 75% of MMA [I2=0%, RR=0.93, with 95%CI (0.80, 1.09)].No significant dif-ference in the normalization rate was found between the 50% of MMA and 75% of MMA groups [I2=45%, RR=0.85, with 95%CI (0.68, 1.06)].Subgroup analysis displayed that the severity of OSAHS before treatment was a potential factor affecting the normalization rate.Conclusion: Based on current available evidence, the success rate and normalization rate for treating OSAHS in the patients with 75% MMA were not found to be significantly higher than those with 50% MMA.Due to small simple size in this meta-analysis, the results of the present study should be interpreted with caution.Further prospective studies are needed to strengthen the evidence.

Objective To improve the understanding of pelvic lipomatosis.Methods The clinical features of eight patients(males,aged 26-64years) with pelvic lipomatosis who were admitted to Peking Union Medical College Hospital from 1983 to November 2006 were reviewed.The clinical and pathologic features,treatment and prognosis were analyzed.The course of disease before admission was(95?82)months,The period of follow-up was(15?32)months,five cases under went upper tract urinary diversion,one case had urinary tract diversion and received steroids,one case received steroids treatment only.Results Four cases had cystitis glandularis,frequency and urgency of micturition were observed in three cases.Dysuria in three cases,hematuria in three cases,and hypertension in five cases were recorded during the course of disease.Renal insufficiency was observed in all of eight cases(Mean Ccr was 76?18mL/min).All cases had abnormal features in their image investigation,which indicated excessive pelvic fat directly or indirectly.Six cases had upper tract distention.Four cases underwent pelvic tissue biopsy.The result of biopsy was fat-vessel tissue.Their symptoms,not renal function,were relieved after treatment.Conclusion The symptoms of pelvic lipomatosis are atypical,they had renal insufficiency,and their diagnosis mainly depends on image investigation and pathologic examination.

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%.