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Objective@#To investigate the diagnosis and management of laryngeal cleft.@*Method@#The clinical data of 13 cases of laryngeal cleft treated between 2007 and 2015 was analyzed retrospectively.@*Results@#The children with laryngeal cleft were classified according to the classification of Benjamin-Inglis, as type Ⅰ(11 cases), typeⅡ(1 case) and type Ⅲ(1 case). All patients were confirmed by microlaryngobronchoscopy under general anaesthetic. Eleven typeⅠ and 1 type Ⅱ clefts were managed conservatively, with which all type Ⅰ patients were successfully managed, while the type Ⅱ patient was resolved by surgical endoscopy. The type Ⅲ patient was treated by open repair but the results was poor.@*Conclusions@#Patients who suffered with choking on feeding or recurrent aspiration pneumonia, especially coexisted with other congenital malformation, needed detailed evaluation for laryngeal cleft, although which was a rare congenital abnormality. Electronic laryngoscope could be the first step to screen the cleft, while microlaryngobronchoscopy is the gold standard for diagnosis of laryngeal cleft. The majority of children with lower type clefts can be managed conservatively. Surgical endoscopy has high success rate when strictly following the indication. Type Ⅲ and Ⅳ clefts have high mortality for usually combining with severe complications and abnormalities.
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OBJECTIVE:To establish a method for determining the plasma concentration of paeoniflorin and phillyrin and phar-macokinetic study before and after intragastric administration of Qianliean granules. METHODS:LC-MS/MS method was adopted. The column was Waters C18 with mobile phase consisted of acetonitrile(A)-2 mmol/L ammonium acetate(containing 0.05% formic acid)(B)(0-9 min:15%A→50%A;9-11 min:50%A→90%A;11-17 min:90%A;17-19 min:90%A→15%A;19-20 min:15%A),at the flow rate of 0.6 ml/min;column temperature was 35 ℃ and the volume was 20 μl;quantitative ions were paeoniflorin m/z 525.2 → m/z 449.0,phillyrin m/z 552.3 → m/z 355.3. 7 SD male rats were docked to collect blood 0.5 ml from angular vein 0.25,0.5,0.75,1,1.5,2,3,4,6,8,10,12,24 h after administration Qianliean granule solution 1 g(medicinal materials)/kg to determine the blood concentration of drugs. DAS 2.1.1 software was employed to calculate pharmacokinetic parameters. RE-SULTS:The linear range of paeoniflorin and phillyri were 5.0-2500.0 μg/L(r=0.9979)and 2.0-2000.0 μg/L(r=0.9982),re-spectively;RSD of precision test was less than 5.5%(n=5);the method recovery were 96.0%-104.0% and 92.0%-107.0%,the extration recovery were 71.4%-83.5% and 81.5%-92.3% and RSD of stability test was less than 5.0%(n=3). The pharmacokinet-ic parameters of paeoniflorin and phillyrin were as follows as t1/2 of (2.206 ± 0.631) and (1.355 ± 0.317) h;cmax of (1504.069 ± 620.885) and (79.043 ± 15.568)μg/L;tmax of (1.000 ± 0.250) and (1.214 ± 0.267) h;AUC0-24 h of (4897.645 ± 2207.577) and (263.475±54.795)μg·h/L;CL of(5.025±2.773)and(76.253±13.986)L/(h·kg). CONCLUSIONS:The method is highly sensi-tive,exclusive,simple,accurate and reliable,and can be applied to study the pharmacokinetic characteristics of paeoniflorin and phillyrin in rats in vivo.
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OBJECTIVE:To study the influence of butylphthalide on the pharmacokinetics of aspirin in rats. METHODS:20 rats were randomly divided into control group(vegetable oil 0.4 ml/rat+aspirin 10 mg/kg)and trial group(butylphthalide 80 mg/kg+aspirin 10 mg/kg) intragastrically,once a day,for consecutive 10 days. Blood samples were collected before the last medication and 10,20,40,60,120,240,360,480,600 and 720 min after medication,0.2 ml each time. The blood concentration of drugs was determined by HPLC,and pharmacokinetics parameters were calculated by DAS 2.0 software. RESULTS:Main pharmacokinet-ic parameters of aspirin in control group vs. trial group were as follows as cmax of (28.68 ± 6.08) vs. (29.33 ± 4.25)μg/ml;t1/2 of (2.48±0.67)vs.(1.60±0.36)h;AUC0-720 min of(188.71±24.29)vs.(140.31±15.08)μg·h/ml;CL/F of(0.05±0.01)vs.(0.07± 0.01)L/(h·kg);there were significant differences in t1/2,AUC0-720 min and CL/F(P<0.05). CONCLUSIONS:Butylphthalide has no significant effect on the absorption and distribution of aspirin in rats,but can strengthen its metabolism and elimination.
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Objective To explore the changes of plasma orexin-A level before and after operation in obstructive sleep apnea-hypopnea syndrome(OSAHS) children and its effect on their behavior performance.Methods 120 cases OSAHS children performed tonsillectomy and / or adenoidectomy and 30 cases normal children as control group.According to the AHI index,the OSAHS group was divided into mild group (5 times/h ≤ AHI ＜ 20times/h,n=13),moderate group (20/h ≤ AHI ＜40/h,n=76),and severe group (AHI ≥ 40 times / h,n=31).And at the same time,according to the sensory integration ratings,OSAHS group was divided into normal group(n =30),mildly abnormal group (n =47),moderately abnormal group (n =28),severely abnormal group (n =15).Before operation and 6 months after operation,plasma orexin-A levels and children's sensory integration were measured.Results Plasma orexin-A level of the OSAHS group ((0.41 ± 0.06) μg/ml) was significantly higher compared with the control group((0.31±0.04) μg/ml) (P＜0.01).In orexin-A level of different AHI groups before and after operation(mild group:(0.33±0.02) μg/ml vs (0.28± 0.03) μg/ml,moderate group:(0.39±0.04) μg/ml vs (0.29±0.03) μg/ml,severe group:(0.49±0.04) μg/ml vs (0.32± 0.02) μg/ml),there had significant differences (P＜0.01).In OSAHS children,AHI index had positive correlation with preoperative plasma orexin-A level (r=0.803,P＜0.01).There was a significant negative correlation between sensory integration scores and plasma orexinA level(r=-0.812,P＜0.01).Conclusions Plasma orexin-A level of OSAHS children is closely related to the severity of OSAHS and the changes of their behavioral ability.And it may become a diagnostic plasma marker of OSAHS children.
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OBJECTIVE@#To investigate the clinical pathological features of children tracheobronchial foreign bodies and to improve diagnosis and treatment.@*METHOD@#A retrospective study 368 children cases with tracheobronchial foreign bodies in our hospital. Each patient was analyzed for age, sex, nature,complication and location of the foreign body, results of bronchoscopic removal and presence of foreign bodies in the airways. Among this cases, three of them coughed out the foreign body before operation; two of them failed to be operated for serious complication, others were conducted by rigid bronchoscopy and bronchoscopic removal with general anaesthesia.@*RESULT@#Three children of 368 coughed out the foreign body before operation; 4 children of them were dead for the long heartbeat respiratory arrest and deep coma; 2 children of them suffered form hypoxic ischemic encephalopathy and epilepsy; others were successfully taken out by operation.@*CONCLUSION@#For the diagnosis of children cases with tracheobronchial foreign bodies, it is very important to collect the detailed history of foreign body inhalation, physical examination and careful analysis on the findings from chest radiographs or CT scan.