Assessment of fluid and nutritional status using bioelectrical impedance methods in acute kidney injury patients requiring continuous renal replacement therapy / 中华肾脏病杂志

Objective To investigate the predictive value of nutritional and fluid status measured by bioelectrical impedance methods for the prognosis of acute kidney injury (AKI) patients undergoing continuous renal replacement therapy (CRRT). Methods Patients with severe AKI received CRRT in the First Affiliated Hospital of Nanjing Medical University from September 2016 to September 2018 were enrolled, and divided into death group and survival group according to 28-day survival. Cox regression was used to analyze the association between 28-day survival and lean tissue index (LTI), fat tissue index (FTI), the ratio of extracellular water (ECW) and body cell mass (BCM) (ECW/BCM), and overhydration (OH), respectively. Results A total of 156 patients were included, including 101 males and 55 females. The age was (62.7 ± 15.4) years, with sequential organ failure assessment (SOFA) score of 9.9±3.9. The 28-day mortality rate was 46.2％. The pre-CRRT OH values in the 28-day survival group and death group were 2.95(1.80, 5.50) L and 4.20(2.95, 5.70) L(P=0.016), and ECW/BCM values were 1.00(0.76, 1.18) and 1.07(0.88, 1.25) (P=0.033), respectively. Univariate Cox regression analysis showed that pre-CRRT high OH values (HR=1.08, 95％CI 1.00-1.17, P=0.040) and high ECW/BCM values (HR=3.02, 95％CI 1.46-6.22, P=0.003) were associated with 28-day death. The changes of OH values (HR=0.83, 95％CI 0.72-0.95, P=0.008) and ECW/BCM values (HR=6.79, 95％CI 1.72-26.82, P=0.006) between pre - CRRT and the 7th day after CRRT initiation were significantly associated with 28-day mortality in patients who survived 7 days after CRRT initiation. After adjusting for age, gender, and SOFA scores, multivariate Cox regression analysis showed that the high OH value (HR=1.16, 95％CI 1.06-1.27, P=0.002) and the high ECW/BCM value (HR=2.80, 95％CI 1.30-6.06, P=0.003) before CRRT, the change of OH value (HR=0.82, 95％CI 0.72-0.95, P=0.008) and ECW/BCM value (HR=2.79, 95％CI 1.30-5.98, P=0.009) between the 7th day after CRRT initiation and pre-CRRT, were independently associated with 28-day death, while LTI (HR=0.93, 95％CI 0.86-1.02, P=0.113) and FTI (HR=0.98, 95％ CI 0.92-1.04, P=0.475) before CRRT were uncorrelated with 28-day death. Conclusions In bioelectrical impedance analysis, the high OH value and high ECW/BCM value before CRRT are associated with 28-day mortality in patients with AKI, while the nutritional indicators LTI and FTI before CRRT are not significantly related. The correction of fluid overload by CRRT within 7 days may reduce the risk of 28-day mortality.

Comparison of simple canalith repositioning treatment and medication therapeutic alliance in the management of canalithiasis associated with benign paroxysmal positional vertigo of the horizontal semicircular canal / 临床耳鼻咽喉头颈外科杂志

Objective:To compare the therapeutic efficacy and the recurrence rate between the simple repositioning method and the reposition manoeuvre plus medication in the treatment of horizontal semicircular canal otolith benign paroxysmal positional vertigo (HSC-BPPV). Method:Sixty-two patients diagnosed with otolith HSC-BPPV by roll maneuver test were randomly divided into canalith repositioning group (32 patients) and reposition plus drug treatment group (30 patients). Patients in the canalith repositioning group were treated only with Barbecue reposition maneuver; patients in the reposition plus drug treatment group were treated firstly with Barbecue reposition maneuver and then were given Alprostadil, Cinepazide and Betahistine drug treatment. Both groups were evaluated after 7 days and 28 days treatment, and the recurrence rate was analyzed after 3 months. Result:After 7 days of the treatment , the recovery rate of the two groups was 62.5% and 73.3%, respectively. There's no significant difference between the two groups. However, the total effective power of the reposition plus drug treatment group was 96.7%, which was significantly higher than that of the canalith repositioning group (75.0%) (χ²=5.858, P<0.05). There were 8 patients in the canalith repositioning group showed changes of BBPV types after treatment, while only 1 patient in the reposition plus drug treatment group showed lesion changes. The difference was statistically significant (χ²=4.061, P<0.05). After 28 days of the treatment, the recovery rate and the total effective power of the two groups was 100%, respectively. There is no statistical difference in the total effective rate between the two groups. After 3 months follow-up, 2 patients in the canalith repositioning group (6.25%) and in the reposition plus drug treatment group (6.67%) showed BBPV recurrence, and no significant difference in the recurrence rate was found between the two groups (P>0.05). Conclusion:The repositioning maneuver is the preferred method for treating HSC BPPV. Canalith reposition maneuver plus medication has no obvious effect on the recovery rate and the recurrence rate, it only increases the effective rate and reduces the changes of the BBPV types.

Advances in the researches of lutein and alzheimer's disease / 中华预防医学杂志

Lutein, a kind of oxycarotenoid, can pass the blood brain barrier and preferentially accumulate in the human brain, which is the most abundant carotenoid in human brain. Evidence from multiple studies suggested that lutein was closely related to age-related cognitive decline and risk of Alzheimer's disease (AD) in human. Dietary, plasma and brain concentrations of lutein were negatively associated with age-related cognitive decline. Lutein concentrations in plasma and brain were significantly lower in AD patients than those of health control. In human brain, lutein was the sole carotenoid which consistently associated with a range of cognitive function measures. In elderly women, lutein supplement can improve the cognitive function. In this article, we systematically reviewed the literature on the role of lutein in age-related cognitive decline and alzheimer's disease and its possible mechanisms. It may prove some benefit information for the advanced research and prevention of AD.

The clinical research of aviatic nasal diseases with medical evaluation prevention and control intervention / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Exploring the clinical features of aviatic nasal diseases to provide references for medical evaluation, prevention and control measures in aircrew.@*METHOD@#To analysis and summary 605 cases with 503 pilots of nasal diseases in aircrew during 1966 to 2013.@*RESULT@#(1) There were 605 cases of aviatic nasal diseases, including 550 cases of general diseases and 55 cases of specific diseases. The general nasal diseases included 140 cases of anatomical abnormalities in nasal cavity type, 290 cases of inflammation in nasal cavity, 73 cases of allergy type, 47 cases of cyst and tumor type, and the specific nasal diseases were 55 cases of sinus barotrauma (SB). (2) The, constituent ratio of SB, which was happened in frontal sinus and /or maxillary sinus, was 95.55%. (3) The constituent ratio of cyst and tumor type in nasal cavity was easier causing to SB than anatomical abnormalities, inflammation, allergy disease in nasal cavity (P < 0.05). (4) The grounded constituent ratio of secondary SB was higher than anatomical abnormalities, inflammation, allergy, cyst and tumor disease in nasal cavity (P < 0.05). (5) The ways of hypobaric chamber tests were different for the kinds of aircrew. The qualified adjustment function of sinuses for barometric pressure was an essential condition for aircrew to continue flying. (6) The key point for the treatment of aviatic nasal diseases was to remove pathological change in nasal cavity and sinus and restore sinus ostium patency. The key point for the medical evaluation was to restore normal sinus pressure balance function.@*CONCLUSION@#The key point of medical evaluation about aviatic nasal diseases is to assess the sinus pressure balance function in hypobaric chamber tests. Normative treatment and medical evaluation can effectively avoid flight accidents and improve the attendance rate for aircrew.

Correlative study of the metabolic disorder of hippocampus and cerebral cortex and cognitive impairment in moderate to severe OSAHS patients / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To research the serum levels of BDNF, H2S and S-100β as metabolic product of hippocampus and cerebral cortex in moderate to severe obstructive sleep apnea hypopnea syndrome(OSAHS) patients before and after surgery, and to analyze their correlations with cognitive impairment.@*METHOD@#Forty-four randomly selected diagnosed OSAHS patients were divided into two groups according to Montreal Cognitive Assessment (MoCA), 19 cases in cognitively normal group and 25 cases in cognitive dysfunction group. Cases in cognitive dysfunction group underwent UPPP oriented surgery, and received 6 months follow-up, 21 cases were remained as treament group, 4 cases lost. 19 cases of healthy subjects were randomly selected as the normal control group. All groups were detected for the serum BDNF, H2S and S-100β levels to analyze the correlations between the biochemical indexes and sleep disorders indexes, hypoxia levels and cognitive function scores.@*RESULT@#(1) In the comparison between the treatment group and the normal control group regarding PSG monitoring results, the AHI, I + II, LA/HT and SLT90% indexes of OSAHS patients increased, and the III + IV phase, REM phase, MSaO2 and LSaO2 decreased. In the comparison between the cognitive dysfunction group and the cognitively normal group, the III + IV, REM and LSaO2 indexes of the cognitive dysfunction group decreased. (2) In the comparison between cognitive dysfunction group and cognitively normal group, and between the treatment group and the normal control group, BDNF and H2S levels increased and S-100β levels decreased, and the MoCA total scores, attention, memory/delayed recall scores decreased. (3) The correlation between biochemical indexes with PSG indexes was as follows. The serum BNDF and H2S levels were negatively correlated with AHI index. The serum BNDF and H2S levels were positively correlated with III + IV stage, REM stage and MSaO2 indexes. The S-100β level was positively correlated with AHI index, and S-100β levels were negatively correlated with III + IV stage, REM stage, MSaO2 and LSaO2 indexes. (4) The correlation between biochemical indexes and MoCA scores was as follows. The serum BNDF and H2S levels were positively correlated with MoCA total scores, attention, and memory/delayed recall scores. The serum S-100β levels were negatively correlated with MoCA total scores, attention and memory/ delayed recall scores. (5) The linear regression equation between MoCA total scores in cognitive dysfunction group of OSAHS patients and the serum BNDF, H2S and S-100β levels was as follows: Y(MoCA) = 40.131 + 0.22 X(BDNF) + 0.012 X(H2S)-0.647X(S-100β) (R2 = 0.461).@*CONCLUSION@#OSAHS patients with sleep disorder and nocturnal hypoxemia might suffer from cognitive dysfunction in which attention and memory predominates. Serum BNDF, H2S and S-100β levels, which could indirectly reflect the metabolic abnormalities degree of hippocampus and cerebral cortex, are sensitive indicators of early cognitive dysfunction in OSAHS patients.

Risk factors for methicillin-resistant Staphylococcus aureus infection of refractory wound / 中国感染控制杂志

Objective To explore the risk factors for methicillin-resistant Staphylococcus aureus (MRSA)infection of refractory wound,and provide reference for clinical prevention and control.Methods Clinical data of patients who were isolated Staphylococcus aureus (SA)from wound at the burn ward in a hospital from January 2006 to December 2013 were analyzed,patients were divided into four groups according to whether the isolated SA were MRSA and whether SA were from refractory wound or from non-refractory wound.Risk factors for MRSA infection of refractory wound were analyzed. Results A total of 112 isolates of SA were isolated from wound,statistical differences existed in the length of hospital stay,recent invasive operation,and recent antimicrobial use between patients in refractory wound MRSA group and refrac-tory wound methicillin-sensitive SA (MSSA)group (all P 30 days (OR 95% CI :1.14-30.69)and recent invasive operation (OR 95% CI :1.41 -17.84) were independent risk factors for refractory wound MRSA infection.There were statistically differences in previous MRSA infection,burn depth,recent operation and recent antimicrobial use between refractory wound MRSA group and non-refrac-tory wound MRSA group(all P <0.05);non-conditional logistic regression analysis revealed that recent antimicrobial use (OR 95% CI :2.080-26.800)was independent risk factor for the persistence of MRSA infection of refractory wound. Conclusion Shortening the length of hospital stay,reducing invasive operation,and using antimicrobial agents ra-tionally are helpful for the prevention and control of MRSA infection of refractory wound.

Characteristics and aeromedical evaluation of Meniere's disease in flight aircrew / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To find out the clinical characteristics of Meniere's disease in flight aircrew and discuss relevant principles of clinical aviation medicine, in order to summarize experience in medical evaluation of aircrew.@*METHOD@#Collect the data of 35 cases that were diagnosed with Meniere's disease from 1966 to 2011 in our hospital and analyze the clinical characteristics, diagnosis and flight conclusion of them.@*RESULT@#Among the 35 cases, 34 patients complained of vertigo. 27 patients complained of tinnitus and 21 patients complained of hearing loss. (1) 18 cases manifested typical symptoms of Meniere's disease (paroxysmal vertigo, fluctuating neurosensory hearing loss, tinnitus and ear fullness); (2) 7 patients showed the symptoms of vertigo and tinnitus, not complaining of significant hearing loss (after inspection. 4 of them proved the low-frequency hearing loss); (3) 7 patients only manifested as vertigo; (4) 2 patients manifested as tinnitus and hearing loss. 1 patients manifested only hearing loss. On the basis of the diagnostic criteria of Meniere's disease formulated hy Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery. 22 patients were diagnosed with definite Meniere's disease, 2 patients were diagnosed with probable Meniere's disease, 11 patients were diagnosed with possible Meniere's disease. For patients with definite Meniere's disease and probable Meniere's disease, the phases of the disease were: 11 cases of phase I, 7 case of phase II and 6 case of phase III. The flight conclusion of all the 35 patients was permanent grounding. The time from the attack of the disease to receiving the conclusion of permanent grounding fluctuated from three months to 11 years.@*CONCLUSION@#The diagnosis of Meniere's disease of flight aircrew must he cautious. For patients with atypical symptoms of Meniere's disease, the diagnosis should be made in the case of completely ruling out other possible diseases. Once be diagnosed, a patient should normally be flight unqualified. The flying waiver would he recommended only under exceptional circumstances. The criterion of waiver condition need to be further explored in the future.

Surgical treatment of burns for 47 pediatrics patients / 局解手术学杂志

Objective To investigate the characteristic of surgical treatment of burns in pediatrics patients. Methods From January 2006 to March 2012,47 pediatrics patients and 244 adult patients were received the surgical treatment in our hospital. The clinical data of two groups were analyzed retrospectively and compared. Results The female ratio in pediatric patients was higher than adult group,and almost patients received operation,especially plastic surgery and skin repair,with less surgeries of wound repair and infected surgeries. The preopera-tive physiological index between two groups was no significantly different. Conclusion On the premise of effective preoperative preparation, we could carry out surgical treatment of burns for pediatrics patients positively.

Comparative analysis on data of nasal sinus between helicopter and(strike) fighter pilots under physical examination for change to new-type aircraft / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To comparatively analyze the disease data of nasal sinus between helicopter and (strike) fighter pilots under flying qualification, and then to provide references for aeromedical support as a significant part of new logistics service union in army,@*METHOD@#The CT data of nasal sinus in 138 pilots who accepted physical examination for change to new-type aircraft, were collected included 46 cases of helicopter pilots and 92 cases of (strike)fighter pilots). The incidence of chronic sinusitis and cyst of nasal sinus were computed respectively in helicopter pilots and (strike)fighter pilots.@*RESULT@#(1) Fourteen cases suffered from chronic sinusitis (6 cases of maxillary sinusitis, 4 cases of ethmoiditis and 4 cases of maxillary sinusitis and ethmoiditis) in helicopter pilots whose incidence rate of chronic sinusitis was 30.4% (14/46). Of which, 3 cases of antracele were treated. Twelve cases suffered from chronic sinusitis (8 cases of maxillary sinusitis, 1 case of ethmoiditis, 3 cases of maxillary sinusitis and ethmoiditis) in (strike)fighter pilots whose incidence of chronic sinusitis was 13.0% (12/92). Of which, 1 case of antracele was treated. The incidence of chronic sinusitis was higher in helicopter pilots than (strike) fighters pilots (Chi2 = 6.07, P < 0.05). (2) Four cases suffered from unilateral mucosa cysts in maxillary sinus in helicopter pilots whose incidence of cyst of nasal sinus was 8.7% (4/46). Ten cases suffered from mucosa cysts in maxillary sinus (unilateral 8 cases and bilateral 2 cases) in (strike) fighters pilots whose incidence of cyst of nasal sinus was 10.87% (10/92). The difference of the incidence of cyst of nasal sinus was not statistically significant between the helicopter pilots and(strike)fighters pilots. The cysts of nasal sinus did not need treatment in 14 cases of this group data.@*CONCLUSION@#The incidence of symptomless chronic sinusitis and cyst of nasal sinus are high in pilots. It is related with repeatedly changes of atmosphere pressure during flying. But most chronic sinusitis and cyst of nasal sinus do not need treatment. The incidence of chronic sinusitis is higher in helicopter pilots than(strike)fighter pilots. It may be related with the environment of helicopter which have unclosed cockpit and load other aircrew.

Diagnosis, treatment and medical evaluation of head and neck tumors in aircrew / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To sum up the experiences of diagnosis, treatment and medical evaluation of head and neck tumors in aircrew.@*METHOD@#Sixty-seven cases of pilot patients with head and neck tumors in our hospital since September in 1979 to July in 2009 were retrospective analyzed in the study.@*RESULT@#Among 44 aircrew with benign head and neck tumors there were 37 cases continued their flying jobs and 7 cases were permanently grounded; whereas in 23 aircrew with malignant tumors there were 6 cases qualified for flight and 17 patients unqualified.@*CONCLUSION@#Benign or malignant of the head and neck neoplasm in the pilots are not the exclusive basis for their medical assessment. Tumor nature, location, efficacy of treatment and the impact on the function of their body should be considered as making the flight medical evaluation for the aircrew with head and neck tumors. Early diagnosis and treatment of head and neck tumors in aircrew are very important for reducing the rate of grounded.

Analysis of Distortion Product Otoacoustic Emission in Pilots Under Physical Examination for Modification to Equipment of High Performance Aircraft / 听力学及言语疾病杂志

Objective To evaluate the hearing function of pilots under physical examination for modification to equipment of high performance aircraft,using pure tone audiometry(PTA) and distortion product otoacoustic emission(DPOAE).Methods Analyzed were all the results of PTA and DPOAE of 75 pilots (150 ears) which accepted physical examination for modification to equipment of high performance aircraft in our department from March 2008 to February 2009.75 cases were divided into two groups according to their flight time.The difference between these two groups was studied.Results According to the Equipments of Physical Constitution for Flying Persons of Air force,PLA,all 75 pilots passed the ENT assessments as being qualified for flying.Of all 150 ears,abnormal DPOAEs were obviously higher than that of abnormal PTA tests.128 ears had normal PTA results.92 ears had normal DPOAE results.36 ears (27.6&) showed abnormal DPOAEs at one or more frequencies,especially at 1,3 and 4 kHz.22 ears had abnormal PTA results.20 ears had noticeable V or U shaped thresholds at 3 kHz and/or 4 kHz.The DPOAE amplitudes showed similar curves.The other two ears showed depressions at all frequencies,in both PTA and DPOAE tests.No statistically significant difference was found between the two groups in DPOAE.But statistical difference was found in DPOAE at 4 kHz compared with other frequencies.No statistically significant differences were found between the two groups in DPOAE amplitudes at 1,2,3 and 4 kHz.but at 6 and 8 kHz.Conclusion The application of DPOAE test helped find pilots who were on the early stage of noise-induced hearing loss.These pilots were the most important objects for us to follow up.

Preliminary study on diplopore puncture of tympanum and intratympanic administration for management of acute secretory otitis media / 临床耳鼻咽喉头颈外科杂志

Objective:To evaluate the therapeutical effects of diplopore puncture of tympanum and intratympanic administration(DPTIA) on patients with acute secretory otitis media(ASOM).Method:One hundred and forty -one cases with ASOM were divided into two groups randomly,with 69 cases(80 ears) in group A(experimental group) and 72 cases(84 ears) in group B(control group).Group A was treated with DPTIA combined with medication, group B was treated with haplopore puncture of tympanum combined with medication. All patients accepted 1 to 3 courses of treament,and were observed during the period of treatment and 3 months after treatment.Result:The factors (including gender, age, side of ailing ear, course of disease, air-bone gap in the pure tone average,and acoustic immitance type in ailing ear) which may impact the prognosis were matched in two groups prior treatment(P＞0.05). While there was a significant difference in the cure rate and the total effective rate respectively between two groups after treatment(P＜0.05).No adverse reaction or complication was seen.Conclusion:DPTIA is a safe, reliable and effective way to manage patients with ASOM.

Research on correlation between anesthesia and complications of nasal endoscopic surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To conclude the correlation between the alternatives of anesthesia--general and local anesthesia--and the complications of nasal endoscopic surgeries.@*METHOD@#Summing up the occurrence rates of the complications from 176 cases (321 sides) of patients with sinusitis(some were air crew); comparing and calculating these complications according to the ways of anesthesia which were adopted in the surgeries.@*RESULT@#The occurrence rates of the complications from nasal endoscopic surgeries were 6.9% (22/321) and rates of major complications were 1.6% (5/321). Rates of 1.9% (4/210) occurred after surgeries with local anesthesia, 16.2% (18/111) with general anesthesia, which indicated the striking differences between them (chi2 = 21.11, P 0.05). However, the incidences of various types of complications with local anesthesia were less than those with general anesthesia, which differed significantly within two groups (P < 0.05). No cases of obvious complications occurred to air crew.@*CONCLUSION@#The occurrence rates of complications of endoscopic surgeries with local anesthesia are lower than that of those with general anesthesia, which is worth promoting in ground crew and sing for reference to elevate rate of resuming flight in aircrew.

Preliminary study on diplopore puncture of tympanum and intratympanic administration for management of acute secretory otitis media / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the therapeutical effects of diplopore puncture of tympanum and intratympanic administration (DPTIA) on patients with acute secretory otitis media (ASOM).@*METHOD@#One hundred and forty-one cases with ASOM were divided into two groups randomly, with 69 cases (80 ears) in group A (experimental group) and 72 cases (84 ears) in group B (control group). Group A was treated with DPTIA combined with medication, group B was treated with haplopore puncture of tympanum combined with medication. All patients accepted 1 to 3 courses of treatment, and were observed during the period of treatment and 3 months after treatment.@*RESULT@#The factors (including gender, age, side of ailing ear, course of disease, air-bone gap in the pure tone average, and acoustic immittance type in ailing ear) which may impact the prognosis were matched in two groups prior treatment (P>0.05). While there was a significant difference in the cure rate and the total effective rate respectively between two groups after treatment (P<0.05). No adverse reaction or complication was seen.@*CONCLUSION@#DPTIA is a safe, reliable and effective way to manage patients with ASOM.

Diagnosis, treatment and medical evaluation of sinusitis and nasal polyp in aircrew / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To sum up the experiences of diagnosis, treatment and medical evaluation of sinusitis and nasal polyp in aircrew.@*METHOD@#Ninety three aircrew with sinusitis and nasal polyp were included in the study.@*RESULT@#There were 11 cases with acute sinusitis and 82 cases with chronic sinusitis and nasal polyp. Of the 82 cases, there were 46 cases in class I (including 39 cases with symptoms and signs on ground in Ia, 7 cases only with signs in Ib), 36 cases in class II (no symptoms on ground but with symptoms of secondary barotraumas in flight, including 14 cases with secondary barosinusitis in IIa, 13 cases with secondary barotrauma in IIb, 9 cases with secondary barosinusitis and barotrauma in IIc ). Of the 82 cases, there were 24 cases in 1 stage of type I, 38 cases in 2 stage of type I, 7 cases in 3 stage of type I, 2 cases in 1 stage of type II, 6 cases in 2 stage of type II, 3 cases in 3 stage of type II, 2 cases in type III. Eighty four cases continued their flying jobs and 9 cases were permanently grounded.@*CONCLUSION@#Flying safe can be endangered by sinusitis and nasal polyp alone or with its secondary barotraumas. Chronic sinusitis and nasal polyp complicated with barotraumas are important causation for medical grounding. The aircrew with sinusitis and nasal polyp will be allowed to continue their flying jobs only after getting well curative effect and normal gas pressures of ear and nasal sinus.

The impact of Angong Niuhuang Wan(安宫牛黄丸) on orexin-A,Leptin and neuropeptide Y in patients with obstructive sleep apnea-hypopnea syndrome / 中国中西医结合急救杂志

Objective To observe the impact of Angong Niuhuang Wan(安宫牛黄丸) on orexin-A,neuropeptide Y(NPY) and Leptin in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods Total 50 mild and moderate cases of OSAHS which were definitely diagnosed by the results of polysomnogram′s monitoring were selected and randomly divided into treatment group and control group(each n=25).The treatment group took one pill of Angong Niuhuang Wan everyday before sleep for 30 days,while the control group received no treatment.Then the levels of orexin-A,NPY and Leptin were tested by radio-immune assay and enzyme linked immunosorbent assay(ELISA) to compare the changes of 3 indexes before and after the treatment and compare the result differences between the two groups.Results Compared with the control group,after treatment,apnea hypopnea index(AHI) and arousal index of treatment group were obviously decreased((16.33?3.57) times/h vs.(22.23?9.98) times/h,(103.58?32.90) times/s vs.(127.89?42.78) times/s),the average pulse oximetric saturation(MSpO2) and the lowest pulse oximetric saturation(LSpO2) were significantly increased(0.950?0.032 vs.0.934?0.048,0.830?0.041 vs.0.826?0.127,P0.05).The correlative analyses indicated that the levels of orexinA,Leptin and NPY in the patients of OSAHS had positive correlations with AHI(r1=0.445,r2=0.480,r3=0.454) and awareness index(r1=0.613,r2=0.510,r3=0.479,P

The Application of Vestibular Functional Test in the Diagnosis and Evaluation of Flight Illusion in Pilots / 听力学及言语疾病杂志

0.05). ②Among 30 pilots with abnormal vestibular functions,19 were permanently grounded and 11 were permitted to return their flying station. 36 pilots returned to fly in 45 cases with normal vestibular functions. The permanently grounded rate had significant differences between the two groups with normal and abnormal vestibular functions. (P

Effect of obstructive sleep apnea/hypopnea syndrome (OSAHS) on the cognitive function of pilots / 解放军医学杂志

Objective To explore the effects of obstructive sleep apnea/hypopnea syndrome (OSAHS) on the cognitive function of pilots. Methods The cognitive function of 13 pilots diagnosed as severe OSAHS and 10 healthy pilots as control was evaluated using Epworth Sleepiness Scale (ESS), Flicker Fusion Frequency Indicator, Many Reaction Time Tester, Space Place Memory Span Tester, Attention Instrument and Guard Tester. The correlation analyses were also performed between the ESS, AHI, MinSaO2% with the results of each cognitive test in the OSAHS group. Results Compared with the healthy control subjects, the scores of ESS in OSAHS group were significantly higher (P

Diagnosis,treatment and medical evaluation of anatomical abnormalities in nasal cavity in aircrew / 解放军医学杂志

Objective To sum up the experiences of diagnosis,treatment and medical evaluation of the anatomical abnormalities in nasal cavity(AANC,including deviation of nasal septum and turbinate hypertrophy) in aircrew.Methods Case data of 91 pilots with CANC were analyzed.The classification and typing of AANC and secondary barotraumas associated with typing of AANC were studied.Results There were 50 cases of class I AANC(with symptoms or signs on ground),41 cases of class II(no symptoms or signs on ground but with symptoms of secondary barotraumas in flight,including IIa 10 cases:with symptoms of secondary barosinusitis,IIb 26 cases:with symptoms of secondary barotrauma of ear,IIc 5 cases:with symptoms of secondary barosinusitis and barotrauma of ear after flying).For the typing of AANC,there were 41 cases of nasal septum deviation,29 cases of inferior turbinate hypertrophy,8 cases of middle turbinate hypertrophy,and 13 cases of nasal septum deviation and turbinate hypertrophy.85 cases were still in a qualified position to continue their flying job,1 pilot was transferred from fighter to transport pilot,2 pilots were temporarily grounded,and 3 were permanently grounded.Conclusions AANC is very common in aircrew.AANC in aircrew is classified and typed according to the effect of gas pressure adjustment functions of ear and nasal sinus.The classification and typing are of important implication in clinical aviation medicine.Medical workers must unify the qualification criteria in selection for air candidates,and also in diagnosis,treatment,medical evaluation of disease in aircrew.This is an important measure to improve the health quality and ensure combat effectiveness for the air force.