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Objective: To explore the relationship of children adenoid and nasopharyngeal volume using upper airway model established with CT volume scanning and three-dimensional reconstruction technology, and to analyze the impact of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: Nasopharyngeal CT images of 109 children were collected. After reconstruction of all images, the size of adenoid (A/N value) and nasopharyngeal cavity volume were measured and calculated. The children were divided into normal group and hypertrophic group according to A/N value, also OSAHS group and non-OSAHS group according to whether had OSAHS or not. The indexes were compared between normal group and hypertrophic group. The correlation of A/N value and nasopharyngeal cavity volume in different genders and ages were analyzed, and the impact of OSAHS on the relationship of A/N value and nasopharyngeal cavity volume was observed. Results: Nasopharyngeal volume of hypertrophic group ([3 111.67±1304.73]mm3) was smaller than that of normal group ([4 960.55±2 036.14]mm3,P<0.01). A/N value of hypertrophic group (0.69±0.11) was greater than that of normal group (0.45±0.97, P<0.01). The nasopharyngeal volume was negatively correlated with A/N value in both genders (rmale=-0.43, rfemale=-0.42, both P<0.01). The correlation coefficient of A/N value and nasopharyngeal volume in children <5 years old (r=-0.43) was less than that in children aged 6-10 years old (r=-0.49), and of OSAHS group (r=-0.60) was higher than of non-OSAHS group (r=-0.33). Conclusion: Negative correlation of adenoid size and nasopharyngeal cavity volume exists, which is of age difference. Compared with non-OSAHS children, adenoid size is obviously correlated with nasopharyngeal cavity volume in children with OSAHS.
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Objective: To analyze the relationship of adenoid and upper airway morphology with obstructive sleep apnea hypopnea syndrome (OSAHS) in children, and to observe the efficacy of predicting OSAHS. Methods: Totally 109 children aged 1-10 years who received nasopharyngeal CT volume scanning were enrolled and divided into OSAHS group (n=20) and non-OSAHS group (n=89). After 3D reconstruction of all CT images, the shape and size of adenoid and the morphology of upper airway (including nasopharyngeal volume, nasal space, airway narrowest area, upper and lower diameter as well as left and right diameter) were evaluated. The shape and size of adenoid and the morphology of upper airway were compared between 2 groups, the relationships with OSAHS were analyzed, and the efficacy of combination of which for predicting OSAHS were evaluated. Results: Statistical differences of nasopharyngeal volume, nasal space, upper airway narrowest area, upper and lower diameters and left and right diameters (t=2.07, 4.55, 3.96, 3.62, 3.48, all P<0.05), also of adenoid hypertrophy and adenoid morphology (χ2=24.43, 12.94, both P<0.05) were found between 2 groups. Adenoid hypertrophy and OSAHS were more likely to occur in children with smaller nasal space, airway narrowest area and left and right diameter. Adenoid hypertrophy was a risk factor for OSAHS. The AUC, sensitivity, specificity and accuracy of combination of adenoid and upper airway morphology in prediction of OSAHS was 0.91, 90.00%, 79.78% and 81.65%, respectively. Conclusion: Adenoid hypertrophy is a risk factor of OSAHS. Combination of adenoid and upper airway morphology has good efficacy for predicting OSAHS in children.
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Objective To discuss the protective effect of creatine phosphate (CP)on isolated rat liver against cold preservation.Methods Isolated perfused rat liver model under simple cold preservation was established.The liver of the control group was perfused with pure University of Wisconsin (UW)solution. With UW solution as the base fluid,the liver of the low-dose group was perfused with 1 g/100 ml CP in UW solution;the liver of the middle-dose group was perfused with 2 g/100 ml CP in UW solution;the liver of the high-dose group was perfused with 3 g/100 ml CP in UW solution.The livers of each group were cold preserved in the corresponding perfusion fluid at 4 ℃.The content of alanine aminotransferase (ALT)and lactate dehydrogenase (LDH)in preservation solution in infrahepatic vena cava were determined.The content of malondialdehyde (MDA)and activity of myeloperoxidase (MPO)in liver tissues were detected.The apoptosis index (AI)of liver cells in liver tissues and positive expression rate of NF-κB in liver tissues were observed. Pathologic changes of liver tissues were observed under optical microscope.Results At 12 h after the cold preservation,the content of ALT and LDH in the rat livers of low-,middle-and high-dose groups were lower than those of the control group (all in P <0.05).At 18 h after the cold preservation,the content of MDA and MPO in the liver tissues of low-,middle-and high-dose groups were lower than those of the control group (all in P <0.05).At 12 h and 18 h after the cold preservation,AI and positive expression rate of NF-κB in liver cells in the rat livers of low-,middle-and high-dose groups were lower than those of the control group (all in P<0.05).At 24 h after the cold preservation,the content of ALT and MDA in preservation solution of the high-dose group was obviously higher than that of the control group as well as the low-and middle-dose groups (all in P <0.05).The results of pathological examination indicated that the injuries to the livers of the high-,middle-and low-dose groups were obviously lighter than that of the control group.There was no obvious difference among each dose group.Conclusions CP in UW solution may well protect the isolated rat liver against cold preservation,which is better than pure UW solution.
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Effective treatments of acute ischemic stroke include the specialist wards (stroke units) with multidisciplinary treatment team receiving treatment and intravenous thrombolytic therapy.However,only a few patients can receive these treatments.Telestroke can improve the thrombolytic rate of acute ischemic stroke on site in hospitals for lacking of specialists and enable stroke care maintained at a high level in rural areas.This article reviews telestroke in the treatment of acute ischemic stroke and the roles of nurses in telestroke.