Objective:To investigate the relationship between the Palatopharyngeal Arch Staging System（PASS） and the severity of Obstructive Sleep Apnea（OSA）, as well as the patterns of airway collapse, while further assessing its clinical applicability. Methods:A total of 98 patients diagnosed with OSA at the Department of Otorhinolaryngology Head and Neck Surgery, Shenzhen University Affiliated Shenzhen Hospital, were recruited for this study. Data collected included basic demographic information, oropharyngeal laryngoscopy videos, results from awake laryngoscopy Muller tests, and indicators from sleep respiratory monitoring. The distribution of each PASS stage among patients with varying severities of OSA was compared. Additionally, both objective and subjective sleep indicators along with occurrences of airway collapse in OSA patients across different PASS stages were analyzed. Results:In total, 98 patients participated in this study. Statistically significant differences were observed in neck circumference, weight, Body Mass Index（BMI）, tongue position, and PASS stage when comparing mild-to-moderate OSA patients to those with severe OSA（P<0.05）. Furthermore, there were statistically significant variations in Apnea-Hypopnea Index（AHI）, minimum blood oxygen saturation levels, average blood oxygen saturation levels, oxygen desaturation index values, and total oxygen desaturation indices among OSA patients categorized by different PASS stages. Multiple comparisons revealed statistically significant differences in AHI as well as minimum and average blood oxygen saturation levels between patients at PASS 1 versus those at PASS 3（P<0.05）. Additionally, notable differences regarding oropharyngeal collapse rates among OSA patients across various PASS stages were identified; specifically between those at PASS stage 1 and those at PASS stage 3. Conclusion:The proportion of PASS stages for OSA varies across different severity levels. The severity of OSA and the degree of airway collapse in patients with varying PASS stages also exhibit significant differences. Patients classified as PASS 3 demonstrate a more severe form of OSA compared to those at PASS 1, with stage 3 being more susceptible to oropharyngeal collapse than its stage 1 counterpart. This assessment system is anticipated to address the current limitations in evaluating the lateral pharyngeal wall within the oropharynx.
Humans ; Sleep Apnea, Obstructive/pathology* ; Male ; Severity of Illness Index ; Female ; Middle Aged ; Polysomnography ; Adult ; Pharynx/physiopathology* ; Aged

Objective:To investigate the value of routine echocardiography and two-dimensional speckle tracking echocardiography in evaluating the left ventricular function of patients with gestational diabetes mellitus (GDM) prenatal and postpartum.Methods:Twenty-two patients with clinically confirmed GDM in Xiamen Zhongshan Hospital from October 2019 to December 2020 were chosed as the case group, and 22 healthy pregnant women were chosed as the control group. Routine echocardiography and two-dimensional speckle tracking echocardiography were performed in the third trimester and about 3 months postpartum. Routine echocardiographic parameters and longitudinal strain (LS), circumfirential strain (CS) were obtained. The correlation between global longitudinal strain(GLS) and other cardiac function parameters was analyzed. The relationship between clinical parameters of pregnant women and GLS was analyzed by multiple linear regression.Results:In comparison with the control group, the interventricular septal diameter at disatole, left ventricular posterior wall diameter at diastole, Tei index were increased, e′ was decreased in GDM group(all P<0.05); the GLS, each layer LS of GDM group were lower than the control group(all P<0.05), the GLS, each layer LS and torsion parameters were improved at 3 months postpartum(all P<0.05). There was a negative correlation between GLS and Tei( r=-0.224, P=0.036). GLS and HbA 1c was linearly correlated with the regression equation: GLS=-27.458+ 1.534×HbA 1c( R2=0.115). Conclusions:The left heart function of pregnant women with GDM in the third trimester are significantly impaired, but the cardiac function recovers to a certain extent about 3 months after delivery. Two-dimentional speckle-tracking echocardiography is a more accurate and sensitive technique to evaluate the early damage of cardiac function in pregnant women with GDM.

Adventitia ; Atherosclerosis/genetics* ; Cell Communication ; Humans ; Hyperhomocysteinemia/genetics* ; Sequence Analysis, RNA

With the development of imaging technology, high-resolution magnetic resonance vascular wall imaging technology has been gradually applied to the risk assessment of intracranial aneurysms rupture. It has provided more comprehensive information for clinicians to assess the stability of intracranial aneurysms. This article summarizes the indicators used for assessing the risk of intracranial aneurysms rupture in recent years with high-resolution magnetic resonance vascular wall imaging.

Objective:To explore the value of enhancement rate of aneurysm wall by high-resolution magnetic resonance vessel wall imaging (HR-VWI) in assessing the risk of intracranial aneurysm rupture.Methods:Seventy patients with 80 intracranial aneurysms, admitted to our hospital from January 2016 to December 2019, were chosen in our study; morphological parameters (shape, neck width, height, diameter) of the intracranial aneurysms, and signal intensity and enhancement rate of aneurysm wall were collected from HR-VWI. These patients were divided into a high-risk rupture group (PHASES scores>3) and a low-risk rupture group (PHASES scores≤3) according to PHASES scores. Univariate analysis was used to compare the differences of clinical data (age, gender, blood pressure, blood lipids, and smoking history) and aneurysm imaging data between the two groups of patients. Multivariable Logistic regression was used to determine the independent influencing factors for aneurysm rupture, and receiver-operating characteristic (ROC) curve of enhancement rate of aneurysm wall in predicting aneurysm rupture was drew to determine the best diagnostic value.Results:Univariate analysis showed that the percentages of patients with hypertension, multiple aneurysms and irregular aneurysm morphology, aneurysm height, aneurysm diameter and aneurysm wall enhancement rate were significantly different between the high-risk rupture group and low-risk rupture group ( P<0.05). Multivariate Logistic regression analysis showed that aneurysm diameter ( OR=1.647, 95%CI: 1.177-2.306, P=0.004) and aneurysm wall enhancement rate ( OR=5.317, 95%CI: 1.527-18.512, P=0.009) were independent influencing factors for rupture of intracranial aneurysms. The area of ROC curve was 0.735, the optimal cut-off value was 0.583; the sensitivity of predicting rupture of intracranial aneurysms was 72.7% and the specificity was 70.2%. Conclusion:The aneurysm wall enhancement rate is significantly correlated with risk of aneurysm rupture; when the PHASES scores>3 and aneurysm wall enhancement rate>58.3%, clinical intervention should be vigilant.

Objective To analyze the impact of detrusor underactivity (DU) on the outcomes of transurethral resection of prostate (TURP) in patients with benign prostatic obstruction (BPO).Methods A retrospective study was conducted in 157 BPO patients who underwent TURP from January 2013 to December 2016.Their ages ranged from 48 to 86 years with a mean age of 70 years.All patients underwent urodynamic study before surgery,bladder contraction index(BCI) ranged from 49.3 to 208.6,with a mean of 120.1.The patients were divided into two groups according to BCI.DU group (BCI ＜ 100) consisted of 47 patients,non-DU group (BCI ≥ 100) 110patients.Before surgery,there were no significant differences in International Prostate Symptom Score (IPSS),storage and voiding symptom scores of IPSS (IPSS-S,IPSS-V),quality of life (QOL),maximum free flow rate (fQmax),post-voided residual urine volume (PVR) between the two groups[(21.5 ±7.0)vs.(21.5 ±6.2),(9.5 ±3.6)vs.(9.8 ±3.5),(12.0 ± 4.9)vs.(11.8±4.2),(5.1 ±0.8)vs.(5.3 ±0.7),(6.5±3.5)ml/s vs.(7.6±5.0)ml/s,(137.4± 146.2)ml vs.(105.2 ± 135.9)ml] (P ＞ 0.05 for each).The outcomes of TURP were assessed by the above mentioned parameters at 3 months postoperatively;IPSS、IPSS-S、IPSS-V were regarded as successful if they improved more than 50％,QOL was successful if it was improved more than 3,fQmax successful if it was improved 5ml/s.The change and successful improvement rates of the above mentioned parameters were compared between DU and non-DU group.Through receiver operating characteristic curve(ROC) analysis,patients were categorized into mild DU and severe DU group and compared the successful improvement rates between the two groups.Results Both DU group and non-DU group improved significantly in IPSS,IPSS-S,IPSS-V,QOL,fQmax,PVR at 3 months postoperatively (P ＜ 0.05)and the two groups differed significantly in those parameters [(8.6 ± 7.3) vs.(4.4 ±4.5),(5.0 ± 3.5) vs.(3.6 ±2.8),(3.6 ±5.1)vs.(0.9 ± 2.3),(2.3 ±1.5) vs.(1.5 ± 1.0),(11.5 ±6.9) ml/s vs.(16.3 ± 6.9) ml/s,(48.4 ± 65.6) ml vs.(23.6 ± 25.6) ml] (P ＜ 0.05 for each).In regard to the successful improvement rates of IPSS,IPSS-S,IPSS-V,QOL,fQ DU group was less successful than non-DU group [70.2％ (33/47)vs.90.9％ (100/110),51.1％ (24/47)vs.73.6％ (81/110),74.5％ (35/47)vs.93.6％ (103/110),59.6％ (28/47)vs.83.6％ (92/110),42.6％ (20/47)vs.81.8％ (90/110),P ＜0.05 for each].Youden index was maximum when BCI equaled to 82.There were significant differences in the successful improvement rates of IPSS and IPSS-V between mild DU (82 ≤ BCI ＜ 100) and severe DU (BCI ＜ 82) group [82.8％ (24/29) vs.50.0％ (9/18),86.2％ (25/29) vs.55.6％ (10/18),P ＜ 0.05 for each),no significant differences in IPSS-S and fQmax [58.6％ (17/29) vs.38.9％ (7/18),48.3％ (14/29) vs.33.3％ (6/18),P ＞ 0.05 for each].Conclusions Benign prostatic obstruction patients with DU can achieve improvement in both subjective and objective parameters after TURP,but patients without DU can get more improvement.BPO patients with severe DU patients show a worse improvement of the voiding symptom.Surgeons should have adequate communication with the patients and inform them of appropriate expectations.

Acute gangrenous cholecystitis is a histologic diagnosis,mostly diagnosed by intraoperative or postoperative pathology.In China,as the aging population increases,the incidence of the disease increases steadily.AGC is still an indication of surgical treatment for acute cholecystitis(AC),but the diagnosis and treatment of AGC remains a challenge for clinical surgeons.However,preoperative clinical data such as age, gender,hypertension,diabetes,coronary heart disease,cholelithiasis disease history,laboratory examination and radiographic results are helpful in early diagnosis and reasonable surgical timing selection.

Objective Toinvestigatetheclinicalvalueofhumanneutrophillipocalin(HNL)detectioninthedifferentialdiagnosis of bacterial and viral infections of elderly patients with acute respiratory infection .Methods 142 elderly patients with respiratory infection were divided the bacteria group (96 cases) and the virus group (46 cases) according to their infections ,42 healthy people in the corresponding period were enrolled as the control group .Enzyme-linked immunosorbent assay and highly sensitive dry chemi-cal particles enhanced immune turbidity assay were employed to detect their blood HNL and C-reactive protein(CRP) ,respectively , and virus-specific antibodies detection were performed simultaneously .Results Compared the blood HNL ,CRP levels and their positive rates of patients in bacteria group with those in the virus group ,control group ,respectively ,differences showed statistically significant(P<0 .01) ,while the differences of indicators listed above between the virus group and control group had no statistically significant(P>0 .05) .Antibiotic treatment before and 24 ,48 and 72 hours after ,the concentrations of HNL were (216 .8 ± 64 .1) , (192 .0 ± 41 .2) ,(158 .0 ± 54 .5) and (87 .0 ± 12 .4)μg/L ,respectively ,while those of CRP were (50 .9 ± 40 .9) ,(46 .2 ± 18 .3) , (39 .6 ± 9 .6) and (12 .6 ± 9 .8) mg/L ,respectively .Sensitivity ,specificity ,positive predictive value and negative predictive value of HNL detection were 90 .6% ,90 .9% ,91 .5% and 89 .9% ,respectively ,which were higher than those of CRP (88 .5% ,85 .2% , 86 .7% and 87 .2% ,respectively) ,with statistically significant difference(P<0 .05) .Conclusion NHL detection possesses impor-tant significance in differential diagnosis between bacterial and viral infections of elderly patients with acute respiratory infection .

BACKGROUND: The osteoarthritis (OA) is attributed to Gubi of TCM,which is mainly caused by liver and kidney deficiency, deficiency and damage of both qi and blood and wind-cold-damp pathogen. Kidney-deficiency with coagulating-coldness syndrome is very common.OBJECTIVE: To explore the clinical effect of the treatment of OA by invigorating the kidney, dispelling the cold and activating collaterals.DESIGN: Randomized controlled clinical study.SETTING: Department of Traditional Chinese Medicine, Dongguan Shilong People's Hospital of Guangdong Province.PARTICIPANTS: Eighty-eight inpatients and outpatients who were most possible to benefit from the experiment were selected as the subjects from the Department of Rheumatism and the Clinic of Orthopedics from June 2005 to July 2006. All subjects were randomized into the experimental group (n=44) including 21 males and 23 females, whose ages ranged 42-70 years, and their average age was (62±8) years and the average course of diseases was (34±18) months, and the control group (n=44), including 24 males and 20 females, whose ages ranged 40-69 years, and their average age was (61±7) years and the average course of diseases was (34±16)months.METHODS: Patients in the experimental group were treated with Bushen Quhan Tongluo herbs by orally taken or externally washing. The prescription of Bushen Quhan Tongluo: Hutaorou (12 g), Buguzhi (12 g), Chaoduzhong (12 g), Shudi (15 g), Dahuixiang (9 g), Luoshiteng (15 g),Zhichuanwu (9 g), Sanqi (6 g), Wugong (3 g), Jixieteng (15 g). The prescription for external washing: Tuogucao (40 g), Danggui (15 g), Sumu (15 g),Shengdahuang (15 g), Shengnanxing (10 g), Ruxiang (10 g), Meyao (10 g),Bingpian (3 g). (Orally taken: The medicine shall be taken with water of 37 ℃ one dose a day. External washing: The medicine that dissolved in 500 mL of 100 ℃ boiled water was adopted to wash both knees while the temperature down to 35 ℃ one dose upon a time and twice a day). Patients in the control group were given sulfated glucosamine (Weiguli Capsule.Each capsule contains 314 mg of sulfated glucosamine crystal, which is equal to 250 mg of sulfated glucosamine) two capsules a time and 3 times a day as well as piroxicam (Yantong Xikang Pill) once a day and 20 mg each time. Patients in both groups were administrated for 12 weeks. Referring to the Western Ontario and McMaster Universities (WOMAC) OA index and the clinical effect criterion of OA, the curative effect was compared between the two groups.MAIN OUTCOME MEASURES: WOMAC pain score, stiffness score,physiological function score, total score and the clinical effect.RESULTS: A total of 88 patients were involved in the analysis of results.joint stiffness index, physiological function index and the total index after the treatment in both the experimental group and the control group than those before the treatment (The experimental group: 4.95±2.46,11.39±4. 10;0.70±0.88,1.57± 1.42; 13.16±5.71,31.16± 10.08; 18.82±7.96,44.11 ± 13.29;Control group: 6.64±1.81,11.59±3.07 ;0.68±0.86,1.52±1.34; 14.25±3.99,pain index in the experimental group after the treatment was lower than that in thecontrol group, and the difference was remarkable (P ＜ 0.05),The total effective rate was 95.5% in the control group and it was 93.2% in the experimental group, and there was no marked difference between the epigastric discomfort in the control group, while there was no haematemesis, hemafecia or aggregation due to continuous administration. No adverse effect was found in the experimental group.CONCLUSION: Satisfying effect can be achieved in the treatment of OA of cold coagulation due to kidney deficiency by invigorating the kidney,dispelling the cold and activating the collaterals, moreover, the effect of relieving pain is especially excellent.

OBJECTIVETo explore the preventive effect of lanthanum chloride on enteral bacterial translocation in scalded rats.

METHODSNinety Sprague-Dawley (SD) rats were employed in the study and randomly divided into three groups, i.e. normal control (A), burn control (B) and treatment (C) groups. Plasmid PUC19 labelled by JM109 was transfected to Escherichia coli (E. coli), so that restriction endonuclease finger - print image spectrum analysis could be applied to the tracing and quantification of the translocation of E. coli from intestine to mesenteric lymph nodes (MLNs) and blood. The intestinal tissue contents of endotoxin (ET), nitric oxide (NO), nitric oxide synthase (NOS), malondialdehyde (MDA) and superoxide dismutase (SOD) were determined.

RESULTSIt was identified that the bacteria in MLNs and blood exhibited the same gene map with those from gastric gavage in B and C groups. But the bacterial quantity in MLNs in C group on 3 postburn day (PBD) was much lower than that in B group (P < 0.05). The intestinal MDA content in C group on 1 and 3 PBDs was obviously higher than that in B group (P < 0.05).

CONCLUSIONBacteria (E. coli) could be translocated from gut to MLNs and blood, which could be evidently alleviated by lanthanum chloride by means of its bactericidal property, inhibition of NOS activity, so that NO production decreased, and its ability to increase SOD activity leading to less production of MDA.

Animals ; Burns ; drug therapy ; microbiology ; Endotoxins ; blood ; metabolism ; Escherichia coli ; drug effects ; growth & development ; metabolism ; Escherichia coli Infections ; blood ; microbiology ; prevention & control ; Female ; Intestines ; drug effects ; metabolism ; microbiology ; Lanthanum ; pharmacology ; Lymph Nodes ; drug effects ; microbiology ; Male ; Malondialdehyde ; blood ; metabolism ; Mesentery ; drug effects ; microbiology ; Nitric Oxide ; blood ; metabolism ; Nitric Oxide Synthase ; blood ; metabolism ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; blood ; metabolism