Research on the patterns of upper airway obstructive levels by drug-induced sleep endoscopy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To identify the patterns of airway collapse in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) by dexmedetomidine induced sleep endoscopy.</p><p><b>METHODS</b>Forty-five obstructive sleep apnea patients diagnosed by polysomnography were given dexmedetomidine intravenously. Once the patient was sedated in dorsal position, the electronic nasopharyngoscope was inserted transnasally and positioned on five levels of the upper airway sequentially (velum, oropharyngeal lateral wall, tongue base, epiglottis and larynx) to observe and document the collapse. Each level should be observed no less than three apneas. The degree of airway narrowing was calculated by using the ImageTool. No obstruction was defined when the degree of airway narrowing <50%, and complete obstruction when ≥ 75%.</p><p><b>RESULTS</b>In 45 patients with OSAHS, 1 case showed no obstruction on any level, 6 cases demonstrated obstructions on single level only, and 38 cases demonstrated complete obstructions on multilevel, including 17 cases with complete obstructions on two levels, 15 cases complete obstructions on three levels, and 6 cases complete obstructions on four levels. The patterns of collapse found in the trial were: (1) circumferential stricture by velum collapse was found in 43 patients, and 41 cases showed complete obstructions; (2) the side wall of oropharynx all collapsed in a lateral configuration, and 32 cases showed complete obstructions on this level; (3) anteroposterior swallowing tongue base was common, 11 cases showed partial obstructions on level of tongue base, and 10 cases complete; (4) epiglottic collapses occurred in lateral configuration folding as V shape; in anteroposterior configuration, epiglottis met posterior wall of the pharynx due to swallowing tongue base; the server soften epiglottis obstructed the entrance of the larynx, while the mild soften epiglottis and the collapsed side wall of pharynx came into being obstructions in concentric configuration; (5) the arytenoid area and aryepiglottic fold mucosa inwardly covered the glottis when the obstruction occurred in the larynx.</p><p><b>CONCLUSIONS</b>The patterns of hypopharynx obstructions in OSAHS patients are multifarious. Lateral oropharyngeal wall, epiglottic and tone base collapse play an important role in the obstructions. The laryngeal obstruction can also be observed.</p>

Assessment of quality of life for laryngeal cancer patients after laryngectomy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#This study was designed to develop a rating scale of quality of life (QOL) which fits laryngeal cancer patients after laryngectomy.@*METHOD@#The item pool was developed on the definition of QOL from WHO and the principles and procedures of ddveloping a rating scale. Five methods had been used in the item selection including, such as subjective evaluation methods, discrete tendency, correlation coefficient method, stepwise regression analysis, and factor analysis. The survey was conducted in 126 laryngeal cancer patients after laryngectomy in order to assess the reliability and validity of the rating scale.@*RESULT@#(1) A rating scale of QOL which fits laryngeal cancer patients after laryngectomy including six domains and 27 items is was developed. (2) The split-half reliability coefficient of the scale is 0.802, and the Cronbach' α coefficient is 0.794. (3) It is inferred from the correlation analysis that there are strong correlation between items and their own domains; conversely there are weak correlation between items and other domains. Correlation coefficient is 0.731 between total score and self-rating score.@*CONCLUSION@#The reliability and validity of the rating scale is proved to work well.

Feasibility study for the dexmetomidine utend the drug induced sleep endoscopy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the application of the Dexmedetomidine utend drug induced sleep endoscopy.@*METHOD@#Forty-four OSAHS patients diagnosed by PSG randomly were divided into group A (Dexmedetomidine group) and group B (Propofol group), each group of 22 cases. Group A: pump the Dexmedetomidine (1 microg/kg) over 15 minutes. Once the patient reached a satisfactory level of sedation, the electronic nasopharyngoscope was introduced into the nasal cavity group B: the propofol (2 mg/kg) was intravenous injected, use the same exmination after the object patients falling asleep. If not, double the injection dose of the two group. Observe and record the patient vital signs, EEG and sleep time, and handle the complications.@*RESULT@#The study was successfully completed both in group A and B. Mean arterial pressure (MAP) in group B was lower than group A during the examination significantly (P < 0.05). The time falling to sleep in two groups were (13.4 +/- 2.5) min and (6.6 +/- 1.2) min, and the time in group A was much longer than that in group B. The lowest oxygen saturation during the examination in two groups were 0.835 +/- 0.096 and 0.691 +/- 0.095, and the difference was statistically significant. There was no incidence of adverse reactions in two groups.@*CONCLUSION@#Compared with propofol, Dexmedetomidine is a safer sleep-inducing drug, and it can be used for clinical sleep endoscopy.

The expression and clinical pathological significance of PDCD in laryngocarcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression and clinical pathological significance of PDCD4 in laryngocarcinoma tissue and its potential significance to clinic.@*METHOD@#Western-blotting and immunohistochemistry ana lyse to measure the protein expression of PDCD4 in 54 cases of laryngocarcinoma tissues (studying group) and their paraneoplastic normal tissues (control group). The correlations of PDCD4 with clinical pathological parameters were analyzed.@*RESULT@#PDCD4 protein was positively expressed in paraneoplastic normal tissue while which was lost or decreased in laryngocarcinoma tissue by Western blot and immunohistochemistry. Immunohistochemistry assay showed the location of PDCD4 protein in cells was different between the studying group and the control group. The expression level of PDCD4 was related to the pathological grades of the laryngocarcinoma. It's higher in the well-differentiated tumor group than that in the poorly differentiated ones. But the expressions of PDCD4 were no differences among other clinical parameters including sex, age, clinical classification, clinical stage and the cervical lymphonodus who had been metastases or not.@*CONCLUSION@#PDCD4 gene is anti-oncogene. It may play an important role in the pathogenesis and development of laryngeal carcinoma and it may be a new target of therapy for laryngo carcinoma.

Effect of H3R agonist, IMETIT on allergic rhinitis in guinea pigs / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the treatment of H3R agonist, IMETIT, on the allergic rhinitis(AR) ,and the influence to mRNA of Substance P(SP) and Substance P Receptor (SP-R) in AR model of guinea pigs.@*METHOD@#The severity of AR was assessed by allergic symptoms (sneezing, nasal rubbing and nose blocking). The changes in the nasal mucosa were studied by pathological methods. The expression of SP positive cell was detected by immunohistochemistry, and the expression of SP-R mRNA was detected by reverse transcriptive polymerase chain reaction (RT-PCR).@*RESULT@#Histamine H3R agonists, IMETIT can effectively improve the AR symptoms, sneezing, nasal itching, nasal congestion, reduce the pathological changes in the nasal mucosa, cut down the SP secretion and SP-R mRNA expression.@*CONCLUSION@#Histamine H3R agonist, IMETIT can effectively relieve the symptoms of AR in guinea pigs, which is related to reducing SP secretion and SP-R mRNA expression.

Expression and clinical significance of hypoxia-inducible factor-1alpha and angiopoietin-2 in laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expressions and clinical significance of Hypoxia-Inducible Factor-1alpha (HIF-1alpha) and angiopoietin-2 (Ang-2) proteins in laryngeal squamous cell carcinoma.@*METHOD@#Immunohistochemical technique was used to detect the expressions of HIF-1alpha and Ang-2 protein in 52 laryngeal squamous cell carcinoma and 10 normal tissues.@*RESULT@#The positive rates of HIF-1alpha and Ang-2 proteins were significantly higher in laryngeal squamous cell carcinoma than those in normal tissues (P 0.05). The level of Ang-2 expression was also correlated with TNM stage, lymph node metastasis and histological differentiation of laryngeal squamous cell carcinoma. But not related to the age and sex. There was positive correlations between both expressions of HIF-1alpha and Ang-2 proteins (r = 0. 333, P < 0.01).@*CONCLUSION@#High expressions of HIF-1alpha and Ang-2 proteins in laryngeal squamous cell carcinoma may play an important role in tumor growth, invasion and metastasis.

Analysis of the clinical significance of serum CA125 and CA199 levels and their correlation factors in patients with chronic nephropathy / 解放军医学杂志

Objective To analyze the clinical significance and correlation factors influencing the serum levels of CA125 and CA199 in patients with chronic nephropathy.Methods Clinical data of 649 hospitalized patients with chronic nephropathy from Jan.to Dec.in 2007 were retrospectively analyzed.The criteria of enrolment were: patients with chronic nephropathy aged below 70 years,tumor excluded by CT and ultrasound,and virus hepatitis and tuberculosis excluded by microbiological examinations.The serum levels of CA125,CA199,albumin,total cholesterol(TC),triglyceride(TG),24h urine protein and urine creatinine(Cr) were determined.The patients were divided into CA125/CA199 positive group and negative group according to the cutoff value of serum CA125 and CA199,and the clinical differences were analyzed by t or ?2 test.The correlation factors influencing the serum levels of CA125 and CA199 were analyzed by multiplicity.Results The ratio of female,nephrotic syndrome(NS),membranous nephropathy(MN) and hydrops of serous cavity were significantly higher in CA125/CA199 negative group than that in positive group(P