Correlation of obstructive sleep apnea and silent brain infarction in elderly population / 国际脑血管病杂志

ObjectiveToinvestigatethecorrelationofobstructivesleepapnea(OSAS)andsilentbrain infarction (SBI) in elderly population. Methods A total of 1658 old subjects aged 60 in Beijing and Qingdao w ere screened. Polysomnography (PSG) w as used to conduct the diagnosis and grade of OSAS. MRI w as used to diagnose SBI. Results In al elderly subjects, the prevalences of OSAS and SBI w ere 32.1% and 22.4%. There w ere significant differences in the constituent ratio of the patients w ith hypertension and diabetes, as w el as apnea-hypopnea index (AHI), oxygen desaturation index (ODI), mean oxygen saturation and the low est oxygen saturation betw een the patients w ith OSAS of different severity and the control group. With the increased severity of OSAS, the incidence of SBI increased significantly. The incidences of patients w ith non-OSAS and mild, moderate and severe patients w ith OSAS w ere 13.2%, 30.5%, 43.5%, and 68.8%, respectively. There w as a significant difference betw een the 2 groups ( χ2 =13.365, P=0.004). Multivariable logistic regression analysis showed that hypertension (odds ratio [OR] 2.254, 95%confidence interval [CI] 1.325 to 8.347;P=0.002), diabetes melitus (OR 1.893, 95%CI1.471-8.432;P=0.003) and AHI ≥15 times/h (OR 3.106, 95%CI 1.583-12.571; P<0.001) were the independent risk factors for SBI in elderly population. Conclusions The incidence of OSAS w as higher in the elderly population aged over 60. The incidence of SBI in patients w ith OSAS w as significantly higher than that in patients w ith non-OSAS, and w ith the aggravation of OSAS, it show ed an increasing trend. Moderate to severe OSAS w as an independent risk factor for SBI in elderly population.

Hypertension intervention program organized by tertiary hospitals with community health centers / 中华全科医师杂志

Five hundred and nineteen patients with essential hypertension from 6 community health centers in Baoshan Distract of Shanghai were enrolled in the program,all patients received direct or indirect comprehensive interventions.These interventions were conducted by doctors from tertiary hospitals and community health serwice centers.Among these hyperpietic,462 patients were followed-up for 1 year.After interventions,the awareness rate of hypertension was significantly increased,unhealthy life styles were changed; blood pressure control rate and risk factors control rate were also increased; carotid-femoral artery pulse wave velocity and carotid-radial artery pulse wave velocity were decreased (P ＜ 0.01 or P ＜ 0.05).The results indicate that comprehensive interventions organized by tertiary hospitals with community health centers are effectivc in managcmcnt of hypcrtension.

The investigation for the neuropeptides of nasal septum in perennial allergic rhinitis patient / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of neuropeptides in the nasal septum of the perennial allergic rhinitis patients, and the mechanism of the alleviation effect of nasal septum rectification to allergic rhinitis.@*METHOD@#Forty-five patients with deviation of nasal septum (20 with allergic rhinitis and 25 without), who undergone nasal septum rectification in Changhai hospital during Jun to Dec, 2007, were included in this research. The levels of SP, VIP, CGRP of the nasal septum were determined by radioimmunoassay.@*RESULT@#In the normal controls, the SP, VIP and CGRP levels of the nasal septal cartilages were lower than that of the nasal septal bones (P0.05), and the CGRP level of the nasal septal cartilages was higher than that of the nasal septal bones (P0.05). There were no statistical significance between the CGRP levels of the nasal septal cartilages in the two groups (P>0.05), neither did that of the nasal septal bones in the two groups (P>0.05).@*CONCLUSION@#The SP level of the nasal septum in the perennial allergic rhinitis patients was higher than that in the normal controls, which was more obvious in the nasal septal cartilages. The VIP level of the nasal septum in the perennial allergic rhinitis patients was higher than that in the normal controls, which was more obvious in the nasal septal cartilages. There were no statistical significance between the CGRP levels of the nasal septum in the perennial allergic rhinitis patients and the normal controls.

The recovery study of excising the different range of dog's anterior commissure by semiconductor laser / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the effective method to treat the glottic carcinoma invading the anterior commissure, we observed the difference of three kinds of operation to the anterior commissure of dogs by semiconductor laser.@*METHOD@#Twelve dogs were divided into 3 groups at random, A: to cauterize to the thyroid cartilage's inner membrane of the anterior commissure, the right ventricular bands and vocal cord, the anterior and 1/3 of the left vocal cord; B: to cauterize part of the thyroid cartilage of the anterior commissure besides A; C: to open a window about 5 mm x 5 mm on the thyroid cartilage of the anterior commissure besides B. To take photos to observe the dogs' laryngeal wound with digital camera or electrolaryngoscope immediately, 1 week and 4 weeks, then to record the hoarseness, body weight and complications etc.@*RESULT@#All the dogs' laser surgery were completed successfully. To observe the gross specimen, it was identical between the extent of excising and the design preoperation. One week later, the neonatal membrane covered the wound incomplete. Edematization, inflammatory reaction, pseudomembrane and the hoarseness were not heavy too. No obvious complication in group A. The neonatal membrane covered the wound incomplete. Edema, inflammatory reaction, pseudomembrane and granulation can be seen in group B. Exudation was heavy in local, erosion and infected, the hoarseness was severe. No other obvious complications in C. Different extent of adhesion could be seen at the anterior commissure in group A, B and C after 4 weeks, the laryngeal web formed, and the length of vocal cord was shorter than before. The color and luster of anterior commissure membrane was normal basically, the inflammatory reaction was not heavy in A and B groups. The anterior commissural membrane appeared the dark red chronic inflammatory reaction; the window was closed by neonatal membrane completely and had no infection in group C. To observe the gross specimen: the wound of anterior commissure was covered by prosthetic epithelia completely in three groups. The window was closed by complete membrane at the anterior commissure. The No. 1- 3 dog's conditions of hoarseness in three groups after 4 weeks: slight in A group, little severe in B and C group. The change of weight was not obvious at the pre or postoperative in group A and B. No obvious complication happened in each group postoperation.@*CONCLUSION@#The three operative methods have satisfied effects,the recovery of wound can cure well finally and no severe complications happened. It is valuable in clinic.

Pathogens of Nosocomial Infection in Intensive Care Units and Related Drug-resistance Analysis / 中华医院感染学杂志

OBJECTIVE To estimate the distribution of pathogens of nosocomial infection in intensive care units,the sites where infections often taken place and the related antibiotic-resistance of bacteria.METHODS Various samples of bacteria from intensive care units have been examined by applying half-automatic analyzer ATB Expression,with bacteria inspecting cards and drug-sensitivity cards,all from Bio-Merieux,France.RESULTS Totally 153 strains of nosocomial pathogens have been found,where Acinebacter baumannii,fungi and Pseudomonas aeruginosa ranked top three,with rates of 32.0%,16.3%,and 15.0%,respectively.About 45.8% of pathogens were found in samples from the lower respiratory tract.Approximately 4.3% of A.baumannii showed drug-resistance to imipenem.However,more than 50.0% of A.baumannii presented its strong drug-resistance to rest of eight regular antibiotics.CONCLUSIONS A.baumannii is a dominating pathogen to cause nosocomial infection in intensive care units,and has shown strong multi-drug-resistance,which should incur high clinical attention.It comes to be crucial to highlight sanitization and sterilization operation,applying proper antibiotics in order to reduce appearance of bacteria with drug-resistance.