Treating obstructive sleep apnea with nasal operation and revised uvulopalatopharyngoplasty / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Nasal operation and/or H-uvulopalatopharyngoplasty (UPPP) was performed for obstructive sleep apnea hypopnea syndrome (OSAHS) patients with both oral pharynx and nasal obstruction, results analyzed.</p><p><b>METHODS</b>Patients were divided into group A (46 cases) and group B (42 case) randomly. Nasal procedures were: septoplasty, radiofrequency reduction of inferior turbinate, adenoidectomy and functional endoscopic operation. Cases in group A had nasal operation first, while cases in group B first had UPPP. All patients had sleep study with polysomnography (PSG) 2 and 12 months after each operation. Those who failed to reach the criteria of being effective after first surgery (defined as a 25% reduction in baseline apnea hypopnea index (AHI) received second phase operation (nasal operation for group B and UPPP for group A). The response rates were compared between the two groups after each phase of operation.</p><p><b>RESULTS</b>In group A, the phase one operation were effective in 44.0% (11/25) for the mild degree OSAHS patients (defined as AHI < 20/h), according to the sleep study performed 2 months after surgery, and no recurrence after one-year. All moderate ones (defined as 20/h < AHI < 40/h) responded poorly to nasal operation. The overall response rate was 23.9% (11/46). Non-responses (35 cases) in group A underwent UPPP and the response rate to it was 85.7% (30/35) in one year. In group B, UPPP operation was effective in 63.6% (14/22) mild cases and 30.0% (6/20) moderate cases in 2 months but 4 cases had recurrence in one year. Twenty-two cases underwent the second phase operation of nose and the response rate was 86.4% (19/22) in one year. There was no statistical significance on the overall response rate between group A and B (89.1% vs 83.3%, P > 0.05). While there was statistical significance of response rate between those patients who had only one operation and those who had both surgeries (P < 0.05).</p><p><b>CONCLUSIONS</b>The combination of nasal procedures and UPPP is effective a for OSAHS patient with nasal diseases especially in mild and moderate cases.</p>

A cytogenetic and molecular genetic study on microdeletion of AZF region on Y chromosome / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To study the morphology of Y chromosome and microdeletion of the correlated specific azoospermia factor(AZF) region on Y chromosome in cases of azoospermia and to identify the genetic diagnosis made for male infertility patients.</p><p><b>METHODS</b>Peripheral blood samples were taken from two patients with azoospermia, and then were examined by use of G banding, C banding cytogenetic analysis and multiplex polymerase chain reaction (PCR) microdeletion analysis.</p><p><b>RESULTS</b>The karyotypes of the two cases were 45, X, -Y, -22, +der(Y)t(Y;22)(q11.2;q11.2) and 46, XY, del(Y)(q11.2) respectively. In 12 sequence-tagged sites(STS) of AZFa, AZFb, AZFd, AZFc, only one was detected in the first case and two were detected in the other case.</p><p><b>CONCLUSION</b>The cytogenetic analysis and the detection of AZF microdeletion on Y chromosome are essential to the final genetic diagnosis to be made for male infertility patients.</p>