OBJECTIVE To investigate the therapeutic effect of modified uvulopaoatopharyngoplasty(UPPP)on obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS Sixty eight cases of OSAHS were treated with modified UPPP.During operations,the uvula was preserved,the fat tissues of space veli palatine were dissected,palatoplasty and pharyngoplasty were performed.All the patients were followed up for over 6 months.Polysomnography(PSG)was monitored again one year after operation.RESULTS The symptoms of dyspnea,snoring,sleepiness were disappeared or improved obviously after 6 months.The effective rate was 95.6% at one year after operation.CONCLUSION The modified UPPP not only extends the oropharyngeal cavity,but also avoids postoperative complications and improve the effectiveness of UPPP.

Objective To investigate the characteristics of stem cells marked with bromode oxyuridine (Brdu) and telomerase reverse transcriptase (TERT) in lung tissue, as well as its effects on pulmonary development and injury-repair. Methods A model of hyperoxia in neonatal rats was established by exposed to 95% O2 for 7 days. Before executing rats, Brdu was injected peritoneally, then Brdu and TERT positive cells were detected by immunohistochemistry. Results (1)The positive staining cells of Brdu with large nuclear located in septa and submucose of series bronchia, scattering in epithelium of bronchia, and the number of positive cells were less. The positive staining cells of TERT located in the septa and alveolar walls of peripulmonary tissue and the number of which was less than that of Brdu. (2)The positive cells of SPC located in septa and alveolar walls. Staining with Brdu and TERT, small number of positive cells was observed. (3) In hyperoxia and normal oxygen group, integral of expression of Brdu, TRET and SPC had no differences. But integral of expression of Brdu in whatever hyperoxia (1. 61?0. 83) or normal oxygen group (1. 43?0. 85) were higher than TRET and SPC (P

Objective To study the effect of dexamethasone on KGF expression in lungs of neonatal rats after hyperoxic exposure. Methods A randomized controlled study was designed in 48 Sprague-Dawley neonatal rats of 3 days old and divided into hyperoxia group, hyperoxia + dexamethasone and control groups for 7days. Histologic examination of the lung tissues were studied and radical alveoli count (RAC) were determined after HE staining. KGF expression was detected by immunohistochemistry. Results (1)The lungs of the rats in the hyperoxia group showed thinner walls of alveoli, simple alveolar structure, fewer and larger alveoli, expanded and shrinked alveoli. While those rats in the dexamethasone group showed more severe changes and some destroyed septa and walls of alveoli which lead to structure turbulence of the pulmonary tissue. The RAC in the hyperoxia and dexamethasone group was siginificanly lower than that in the control group (9.50?1.05, 10.03?3.26 vs 13.00?1.79, P

Objective To analyze the effect of circulatory failure on ventilation therapy of respiratory failure after resuscitation in neonates with severe asphyxia. Methods Three hundred and eighty-two neonates with mechanical ventilation following severe asphyxia were retrospectively analyzed. Two groups were divided according to the efficacy of mechanical ventilation: effective and noneffective. Results The non-effective rate was 24.1% at 1 hour after ventilation (19.4% in full term babies,34.5% in preterm babies). The degree of asphyxia in noneffective group was significantly more severe than the effective group. The incidence of persistent pulmonary hypertension of the newborns(PPHN),exsanguine shock,cardiogenic shock,DIC and cardiac failure was 84.3%、51.0%、80 4%、49.0% and 54.9% respectively in term babies,while the incidence of exsanguine shock,cardiogenic shock,DIC and cardiac failure was 65.9%、68.3%、75.0% and 58.5% respectively in preterms babies. All of them were significantly higher than the effective group. After treatment of the circulation problems,the blood gas turned to normal in 94.1% term babies and 92.7% of preterms. No difference was shown in the recovery rate in both groups. Conclusion The circulatory failure is a main cause of non-effective mechanical ventilation in asphyxia neonates. To correct the pathophysiologic changes of the circulation in time can effectively improve the prognosis.

Objective To explore the clinical, radiological features and gene mutation of GALC gene in one child with globoid cell leukodystrophy (Krabbe disease). Methods The clinical and radiological data of a patient diagnosed with Krabbe disease through next-generation sequencing were retrospectively analyzed. Sanger sequencing was used to confirm the results. Results The patient was late infantile form with main manifestations of progressive psychomotor regression and convulsion. Brain MRI showed symmetric long T1 and long T2 signal changes in the white matter next to lateral ventricle angle, posterior limb of internal capsule, and the ministry of corpus callosum. The patient was found to have compound heterozygous mutations of c.1832T>C in exon 15 and c.979T>G in exon 9, which resulted in amino acid changes of p.L611S and p.F327V, respectively. Sanger sequencing results showed that the two heterozygous mutations were correspondingly inherited from his mother and father. Conclusions Next-generation sequencing technology is a useful tool for the detection of GALC gene mutation, which is valuable for definite diagnosis and differential diagnosis of Krabbe disease in clinical practice.

Objective To put forward the prevention advice on foreign body suction,and to discuss the effica-cy,safety and application experience of flexible bronchoscopy in the diagnosis and treatment of tracheobronchial foreign bodies in children. Methods The treatment experience of 38 cases for airway foreign body removal with flexible bron-choscopy and granulation tissue proliferation in Argon plasma coagulation ( APC ) ( argon knife ) combining carbon dioxide( CO2 ) cryotherapy in Bayi Children′s Hospital Affiliated to General Hospital of Beijing Military Command from January 2013 to December 2014 were reviewed,and the clinical data including age,gender,treatment time for inhaled foreign body,clinical and X-ray manifestations,location of the foreign body,treatment with bronchoscopy with APC and cryotherapy,complications and outcomes were analyzed. Results There were 38 cases of patients including 31 male (81. 6%) and 7 female(18. 4%),aged from 10 months to 14 years old,with mean age 28. 5 months;among them there were 30 cases with definite history of foreign body,accounting for 78. 9%;the most common clinical symptom was cough among the cases,accounting for 84. 3%;X ray showed 15 cases with ipsilateral lung atelectasis,accounting for 39. 5%, emphysema in 17 cases,accounting for 44. 7%,pneumonia change in 6 cases,accounting for 15. 8%,there were 11 ca-ses who had lung computerized tomography examination when coming to the hospital,and only 1 case could be seen to have foreign body shadow;microscopic examination found that inhaled foreign body in the right bronchus accounted for 57. 9%,and peanut was the main foreign body inhalation in this group;only 4 cases(10. 5%) had definite diagnosis and foreign body removal within 24 h after foreign body aspiration,moreover,34 cases(89. 5%) with foreign body aspi-ration got the diagnosis and treatment after 24 h;crying was the primary inducement for inhaled foreign body. All the 38 cases of children with inhaled foreign body experienced removal under flexible bronchoscopy. There were 19 cases (50. 0%) who had granulation tissue proliferation around the foreign body,among which 5 cases of foreign body was wrapped by the proliferation of granulation tissue,with APC dealing with the granulation tissue of foreign body surface to remove foreign body after exposure,then giving CO2 cryotherapy. Nevertheless,there were 9 cases of foreign body who had granulation tissue but was not wrapped,receiving CO2 cryotherapy directly after the foreign body removal. One case of this group had bradycardia during the surgery,and 2 cases had postoperative bleeding,but there was no death cases with foreign bodies removal. Conclusions Education is the key to prevent foreign body aspiration in infants under 3 years old. Flexible bronchoscopy is safe to remove foreign bodies from the respiratory tract and has fewer complications, so it is one of the alternative methods in diagnosis and treatment of foreign body inhalation.

Objective To explore the operating methods,the effectiveness and safety for 2 cases of tracheal in-tubation related severe subglottic stenosis under laryngeal mask by using bronchoscopy in the diagnosis and interven-tional treatment. Methods Two male patients ( age at 4 and 11 months) both had difficulty breathing and weaning failure after endotracheal intubation,who were diagnosed with severe subglottic stenosis through CT and bronchoscopy examination. All parents signed their consent after being fully informed of treatment risks. Two cases were treated under bronchoscopic holmium laser combined with argon plasma coagulation and freezing treatment by using the laryngeal mask. The clinical data, complications and postoperative outcome and follow-up were analyzed. Results Two cases were operated successfully,the subglottic granulation tissue of 1 case was completely removed,2 cases of patients had subglottic narrow annular completely removed, and there was no problem for 4. 0 mm bronchoscope to get through,postoperative tracheal catheter was successfully extracted,dyspnea was significantly improved. Two cases imme-diately showed well open after treatment,7 d,30 d and 90 d through endoscopic examination. During the operation,oxy-gen saturation decreased and heart rate increased fast or slowed down,but after operation and oxygen got resumed,they immediately recovered,and there were no abnormal hemodynamic changes during and after operation. The two cases were still under follow-up. Conclusions The laryngeal mask holmium laser,argon plasma coagulation and cryotherapy can be used to remove acquired granulation tissue hyperplasia caused by subglottic stenosis,which is safe and effective, and the short-term effect was remarkable. Long-term effect still needs to be further assessed through follow-up.

Objective To investigate the clinical outcome and treatment characteristics of viral encephalitis with bilateral thalamic damage so as to improve its prognosis.Methods Twelve cases of viral encephalitis with bilateral thalamic damage were collected during September 2012 to June 2013 by head MRI.These cases were retrospectively studied with the data of medical history,physical examination,laboratory and brain function monitoring and treatment.The relationship between treatment and prognosis was studied during 2 years of follow-up.Results All patients began with the rapid onset,accompanied by fever,coma,and convulsions.Delirium and involuntary movement occurred during the recovery period.Six cases(50.0％) received ventilator assisted ventilation.In the acute phase,electroencephalogram (EEG) showed diffuse slow wave and 4 cases(33.3％) had status epilepticus on EEG.Ten cases discharged from hospital had long-term oral anti epileptic drugs,which lasted 6 months in 3 cases,1 year in 4 cases,and 2 years in 3 cases for maintaining EEG stability.Head MRI indicated white matter demyelination besides the gray matter damage within the thalamus.All 12 patients underwent methylprednisolone impact treatment and 6 cases had effective reversal within 1 week of onset with better tolerance,and the other 6 cases received treatment in subacute stage and 5 of them accelerated recovery and 1 case had sense improvement,but died after giving up therapy.After 3 months courses,8 cases(66.7％) got gross motor and swallowing function recovered to normal,and 3 cases had left unilateral limb movement disorder.After 2 years of follow-up,11 cases had normal motor,intelligence returned to normal in 9 cases,and 2 cases had mild mental retardation.Conclusions Viral encephalitis complicated with bilateral thalamic damage is characterized by acute onset,serious manifestations,idiopathic progress;in the subacute stage it is most likely to develop white matter demyelination.The key to control the disease is to block the inflammatory immune response quickly,and give patients large dose methylprednisolone treatment can effectively curb the progress of the disease.In the sub acute phase,it can promote the recovery,safe and effective.The long-term prognosis will be good with the reasonable treatment at early stage of the disease.

OBJECTIVETo summarize the experiences of using cardiopulmonary bypass for patients with serious airway obstructive lesions.METHODS From Sept. 2013 to Jan. 2015, 3 cases with serious airway obstructive lesions underwent operation safely with the assistance of cardiopulmonary bypass.RESULTSAll of 3 cases were successfully managed by tracheotomy under cardiopulmonary bypass without hemodynamic disturbance and coagulation dysfunction.CONCLUSIONSevere airway obstructive lesion could be relieved successfully under the cardiopulmonary bypass. Complications can be avoided effectively by shortening the time of cardiopulmonary bypass.

Objective To investigate the copy number variants of a developmental delay patient by applying single nucleotide polymorphisms array technique and to analyze the relationship between the clinical manifestation and copy number variants.Methods Single nucleotide polymorphisms array was used to detect genomic copy number variants in a child with development delay and her phenotypic normal parents.Results The patient had a 7. 9-Mb deletion at 8p23.3-p23.1 and a 27.4-Mb duplication at 8p23.1-p11.23, which were conifrmed as pathogenic copy number variants after comparative analysis with database.Conclusions Single nucleotide polymorphisms array could serve as a useful method to diagnose developmental delay patients and analyze pathogenesis.