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Objective@#To analyze the total fluids intake and sources of college students from Hebei in spring and summer, and to provide a scientific reference for appropriate fluids intake in different seasons.@*Methods@#Subjects were recruited in a university in Baoding, Hebei Province, and investigations were conducted in April and June 2021. The number of people who completed both spring and summer investigations was 80. Quantitative instruments and 7 day 24 h Fluid Intake Questionnaire were used to investigate the total drinking fluids, and it was recorded for 7 consecutive days in spring and summer respectively. The duplicate portion method was used to investigate the water from food. The total fluids intake and sources among subjects were analyzed in spring and summer.@*Results@#There was no statistical significance between the total drinking fluids and total fluids intake between spring and summer [1 141(715), 1 176(649)mL/d, (2 496±604)(2 458±554)mL/d] ( F=1.86, 0.59, P >0.05). Spring showed significantly higher water from food compared with summer [(1 318±274)(1 217±302)mL/d]( F=16.63, P <0.05). The proportions of total drinking fluids and water from food in spring were 46% and 54%, respectively, and both were 50% in summer, the differences were statistically significant ( F=12.97, 12.97, P <0.05). There were differences in total fluids intake,total drinking fluids and water from food of different genders in earch season ( t/Z =4.75, -3.63, 3.44; 4.80, -2.91, 4.01, P <0.05). There were differences in total water intake, total drinking fluids, the proportions of total drinking fluids and water from food of different BMI groups in each season ( F/H =8.08, 16.65, 3.03, 3.03; 7.11,17.97, 4.52, 4.52, P <0.05). In spring, only 13.8% of subjects achieved the recommended total drinking fluids of China, compared with 18.8% in summer. In spring and summer, the total fluids intake, total drinking fluids, the proportions of total drinking fluids in the group achieved the recommendation were all higher than those who did not reach the recommendation ( t/Z =6.64, -5.19, 5.79; 8.12, -5.97, 5.70, P <0.05).@*Conclusion@#Season is a factor that affects total fluids intake, and it should be taken into account when setting the recommendation on adequate water intake.
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Objective:To summarize the clinical data and imaging characteristics of patients with PHACES syndrome treated with oral Propranolol.Methods:The clinical data of 4 cases of PHACES syndrome treated with oral Propranolol in Children′s Hospital, Capital Institute of Pediatrics from October 2018 to October 2022 were retrospectively analyzed.Relevant studies reporting the treatment of PHACES with Propranolol were retrieved in PubMed, China National Knowledge Infrastructure (CNKI) and Wanfang Data.Results:Three cases of the 4 patients with PHACES syndrome treated with Propranolol obtained relieved symptoms of facial hemangioma, and 1 case died due to late treatment, complication of severe cardiovascular malformation, and treatment abandonment by parents.A total of 7 clinical studies on the use of Propranolol in the treatment of PHACES were retrieved, including 6 retrospective studies and 1 observational study.Most studies have shown that Propranolol is well tolerated in the treatment of PHACES syndrome, and most of cases have relieved facial hemangioma.The main factors affecting the prognosis are the degree of damage to middle and small arteries such at brain, aorta, chest and neck.Propranolol treatment can improve the prognosis.Conclusions:Oral Propranolol is currently the first-line treatment for PHACES syndrome, and most patients tolerate oral Propranolol well.
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Lower extremity chronic total occlusion (CTO) is the most severe manifestation of peripheral artery disease (PAD), with high amputation and mortality rates. As a minimal invasive reconstruction therapy, endovascular therapy (EVT) plays an important role in limb salvage for CTO in current clinical practice. The complexity of CTO lesions leads to a high risk for complications and a low success rate of EVT. Therefore, establishing a grading or scoring system to predict the success rate of revascularization strategy will be helpful in developing appropriate treatment strategies and assessing benefits and risks. This paper summarizes the most popular CTO scoring systems, such as PACSS grading, PARC grading, TAC grading, CTOP classification, Infrapop-CTO scoring, and J-BTK CTO scoring. PACSS grading and PARC grading are suitable for evaluating the severity of vascular calcification including iliofemoral segment, femoral-popliteal segment, and below-the-knee artery segment. TAC grading is suitable for grading calcification below the knee lesions; with low intervention success rate in a high calcification grading. CTOP classification was developed by analyzing the effect of morphological characteristics of proximal and distal fibrous caps of lower extremity CTO lesions on the outcome of EVT. The success rate of antegrade intervention is lower in type IV. The Infrapop-CTO score and J-BTK CTO score can predict successful anterograde crossing of infrapopliteal CTO lesions, with low intervention success rate in high score. Both scoring systems use three variables, namely, shape of proximal stump, calcification, and occlusion length.
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Objective:To explore the training methods to improve the cosmetic suture technique of junior surgeons.Methods:The training course of cosmetic suture techniques was carried out for junior residents such as plastic surgery professional graduate students and standardized training residents, through the study of the basic knowledge of cosmetic suture and the practical training of minimally invasive principles, to help them master cosmetic suture techniques systematically for the need of future clinical practice. Compared with the level of operation skills before and after cosmetic suture training in different groups (graduate students of plastic surgery and other majors, standardized training residents of plastic surgery and other majors), the residents' performance had been significantly improved. The incisions healing after half a year follow-up in cases they sutured were observed.Results:After cosmetic suture training, the suture skills of the students were significantly improved, and there was a significant correlation with the time of clinical practice. The incidence of incisions inflammation and postoperative scar formation in the cases sutured by the students with practice for 6 months was significantly lower than those for 1 month (6.42% vs 21.67%, 1.13% vs 5.56% respectively).Conclusions:The training of cosmetic suture techniques is very important to improve the professional ability of junior residents in plastic and cosmetic surgery, and it needs a long time practice to master the suture skills.
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This study introduces that we have established a clinical case database of scar prevention and treatment with medical histories, diagnosis and treatment ideas, and case expansion according to the scar diseases that professional postgraduates of plastic surgery need to master, and applied it to the practical teaching for plastic surgery postgraduates. Through the comprehensive evaluation from three aspects of mastering basic knowledge, applying knowledge and developing discipline, it's suggested that the professional postgraduates can better grasp the knowledge of scar prevention and treatments after learning from the clinical scar database, and the application of the teaching case database has further improved students' teaching and learning participations and innovative thinking abilities.
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Objective@#To investigate the effect of genioglossus (GG) activation at sleep onset on the outcome of velopharyngeal surgery in obstructive sleep apnea hypopnea syndrome (OSAHS) patients.@*Methods@#Thirty-five patients between April 2014 and February 2015 in Beijing Tongren Hospital with OSAHS underwent overnight polysomnography with synchronous genioglossus electromyography (GGEMG) using intraoral electrodes. The upper airway (UA) anatomy was evaluated by three-dimensional computer tomography (3D-CT) in OSAHS patients. Then, all of the patients received velopharyngeal surgery, including revised uvulopalatopharyngoplasty (UPPP) with uvula preservation or UPPP combined transpalatal advancement pharyngoplasty. All patients were followed-up using polysomnography 3-6 months after surgery. T-test or Wilcoxon test were used to compare the variables between groups, and Spearman correlation analysis was used to test the correlation between parameters.@*Results@#Thirty-five patients received velopharyngeal surgery. Twenty-two patients (62.86%) were responders, and 13 patients (37.14%) were non-responders. Responders had a higher mean GGEMG during sleep onset (15.31±3.74 vs. 9.92±2.93, t=4.504, P=0.001). The decreased AHI was significantly positively related to the sleep onset mean GGEMG (r=0.541, P=0.004) and the change in GGEMG (r=0.422, P=0.028). The decreased AHI was significantly negatively related to the minimal cross sectional airway area (mCSA,ρ=0.629,P=0.000) and the minimal lateral airway dimension (mLAT, ρ=0.484, P=0.009) at velopharynx.@*Conclusions@#The outcome of velopharyngeal surgery was affected by the mean GGEMG during sleep onset. We speculated that the patient with higher GGEMG at sleep onset and narrower velopharynx were more suitable candidates for velopharyngeal surgery.
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Objective To investigate the prokaryotic expression and immunoreactivity of BspE,a type Ⅳ secretion protein of Brucella,and the effect of recombinant protein BspE on cytokines.Methods According to the BspE gene of Brucella M5-90 published in GenBank,the gene fragments were synthesized by a company and then ligated into PUC57 vector for sequencing.The sequenced gene was cloned into a prokaryotic expression vector pET-28α and transformed.Induced expression was performed in E.coli DE3 competent cells.The obtained target protein was purified by a Ni-NTA affinity column,and its reactogenicity was analyzed by Western blotting.Mouse RAW264.7 cells were treated with 25 g/L BspE recombinant protein for 12,24,48 h,and the control group was treated with the same amount of BSA instead of BspE,and enzyme-linked immunosorbent assay (ELISA) was used to detect interleukin (IL)-1β level.Results The recombinant expresed plasmid of pET-28α-BspE was successfully obtained.The results of Western blotting showed a single band with a relative molecular mass of about 30.1 × 103,and the recombinant protein BspE had good reactogenicity,and IL-1β levels (ng/L)were significantly elevated by the recombinant protein BspE (12 h:43.27 ± 2.13 vs 30.24 ± 1.66,24 h:57.78 ± 3.44 vs 41.22 ± 1.22,48 h:72.52 ± 3.04 vs 46.77 ± 2.75,t =8.38,7.86,10.89,P ＜ 0.05).Conclusions BspE recombinant protein has better immunoreactivity and can increase the expression level of IL-1β in mouse macrophages.This study provides a scientific basis for the role of effector proteins in the pathogenesis of Brucella.
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Objective@#To explore the feasibility and effectiveness of transoral surgery (TOS) for the treatment of hypopharyngeal carcinoma by means of the radiofrequency coblation(RFC).@*Methods@#Twenty-two patients with hypopharyngeal carcinoma who were treated with TOS using RFC during the years of 2010-2016 were enrolled. Among these patients, 15 suffered from pyriform sinus carcinoma, 4 suffered from postcricoid carcinoma, and 3 suffered from posterior hypopharyngeal wall carcinoma. According to the AJCC 2002 guideline, the tumor stages were T1N0M0 for 3 patients, T2N0M0 for 9 patients, T1N1M0 for 1 patient, T1N2M0 for 1 patient, T2N1M0 for 4 patients, and T2N2M0 for 4 patients respectively. All patients with N+ underwent concurrent neck dissection; 2 patients underwent concurrent prophylactic tracheotomy; 17 underwent post-operative radiotherapy for 50-66 Gy. The follow-up time was 6-72 months with a median 35 months.Two patients were lost to follow-up.@*Results@#All patients except 2 underwent the TOS successfully, while the two patients were treated with open approach surgery due to unsure safe margin. Most patients returned to oral feeding within one week. Among the 18 patients with complete follow up data, 3 had the local recurrence of the tumor (16.7%) and one died due to local recurrence, multiple primary esophageal carcinoma, and distant metastasis 4 years after surgery (5.6%). According to the Kaplan-Meier method, the 5-years local control rate and survival rate were 57.8% and 67.5% respectively. All patients had no disorders in speech, swallowing and respiration during the follow up.@*Conclusions@#The RFC can be applied in TOS for the treatments of hypopharyngeal carcinoma with high cutting efficiency and better control of intraoperative hemorrhage, which is useful in lowering the operation difficulty. The oncologic results are comparable to the open surgery with satisfactory postoperative organ function preservation.
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AIM:To study the effects of extracellular potassium on the protein expression of wild-type HERG and its mutant L539fs/47.METHODS:Wild-type HERG (WT) or its mutant HERG-L539fs/47 (MT) were transfected into HEK293 cells for 36 h.The cells were incubated in different media containing 0.8, 4.3 or 10 mmol/L potassium.Af-ter 6 h of incubation, the protein expression of HERG was detected by flow cytometry.After 12 h of incubation, the locali-zation and quantity of the proteins were detected by laser confocal imaging and Western blot.RESULTS: Different from the retention of mutant protein in cytoplasm, wild-type HERG protein was mainly distributed in the cell membrane.The 2 proteins both increased with the changes of extracellular potassium.Flow cytometry showed that the fluorescence in the 2 groups both increased with the changes of extracellular potassium ( P<0.01 ) .The fluorescence in WT group was signifi-cantly higher than that in MT group (P<0.01).Western blot showed that mutant HERG protein included only one 60 kD band, different from the 135 kD and 155 kD bands in wild-type HERG, which were affected by the changes of extracellular potassium (P<0.05).CONCLUSION:The retention of HERG mutant L539fs/47 protein in the cytoplasm is more than wild-type HERG.Chronic high extracellular potassium keeps the stability of wild-type and mutant HERG proteins on the cell membrane.Chronic low potassium reduces the expression of HERG channel proteins in a time-dependent manner.
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Objective To observe the efficacy and safety of topical 2％ propranolol cream for strawberry hemangiomas in proliferative phase.Methods Sixty infants with strawberry hemangiomas in proliferative phase were included in this study.There were 18 males and 42 females aged 30 days to 12 months.The lesions were located in head and neck (n=30),trunk (n=19) and extremities (n =11).All the infants received the 2％ propranolol cream treatment three times per day.The infants were required a regular return visit every month.The changes of tumor size,texture and color were monitored and recorded.The adverse effects after medication were observed and managed accordingly.The short-term results were evaluated using a 4-grade system.Results All the infants were followed up for 12 months.Among 60 infants,the Ⅰ,Ⅱ,Ⅲ and Ⅳ grade curative effects were 2,17,33 and 8 cases,respectively.All the infants had no drug adverse reaction.Conclusions The effect of topical 2％ propranolol cream for strawberry hemangiomas in proliferative phase is reliable,with little side effects.It will be popularized in clinical application.
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OBJECTIVE@#To evaluate the function of tubomanometry (TMM) in forcasting the progonosis of acute otitis media with effusion (OME).@*METHOD@#We used the technique of TMM to quantify the degree of eustachian tube (ET) dysfunction in 65 patients with OME. The opening of the ET and the transportation of gas into the middle ear were registered by a pressure sensor in the occluded outer ear after applying the stimulus of a controlled gas bolus into the nasopharynx during swallowing. Three excess pressure values were tested subsequently (30, 40, and 50 mbar). If tube opening was registered, the time of opening in relation to pressure applied was measured. The TMM calculated the opening latency index or index R. An R value of 1 indicated late opening of the tube occurring after the initial stimulus and was interpreted as suboptimal. Inability to calculate the index R value indicated that the tube was unable to actively open at all. The TMM results, were weighted as follows: no R with 0 points, R > 1 with 1 point and R < 1 with 2 points for the measurements at 30, 40, and 50 mbar, respectively. The points of these three tests were added so the ET score (ETS) ranges from 0 (worst value) to 6 (best value). According to the medical history, the patients were divided into two groups, chronic OME group (defined as positive control group), 30 cases with 38 ears; and acute OME group, 35 cases with 46 ears. The healthy ears of all patients were defined as normal control group, 46 cases with 46 ears. The same regular treatments, including classic medical treatments and intratympanic dexamethasone injections, were used to acute OME group in the following 1-2 months. On the basis of therapeutic effect, acute OME group was subdivided into valid group (26 cases with 33 ears) and invalid group (9 cases with 13 ears).@*RESULT@#The ETS of normal control group was 5.11 ± 1.32 while it was 1.08 ± 1.32 in positive control group. It was found marked differences between the two groups (P < 0.01). The ETS of both valid and invalid subgroup of actue OME group were significantly lower than normal control group (P < 0.01), but in valid subgroup it was significantly higher than positive control group (P < 0.01), and no marked difference was found between the invalid subgroup and positive control group. After treatments, a significant improvement of the ETS was found in both valid and invalid subgroup (P < 0.05) there was no marked difference between valid subgroup and normal control group. But in invalid subgroup it was still significantly lower than normal cohtrol group (P < 0. 01).@*CONCLUSION@#TMM could forecast the prognosis of acute OME. Patients with acute OME suffered from ET dysfunction of varied degrees. Those with high ETS could be cured by classic medical treatments and intratympanic dexamethasone injections. But those with poor ETS could not be cured in short period, tube insertion should be considered. If ETS could not be improved by ventilation tube placement, more active treatment, for example, balloon Eustachian tuboplasty (BET), should be used to prevent transforming into chronic OME.
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Humans , Acute Disease , Ear, Middle , Eustachian Tube , Injection, Intratympanic , Manometry , Middle Ear Ventilation , Otitis Media with Effusion , Diagnosis , Pressure , PrognosisABSTRACT
Various surgical procedures are widely used for treating obstructive sleep apnea hypopnea syndrome (OSAHS) currently. The most prominent advantage of surgery is the excellent long-term adherence, which is just the main limitation for the first-line treatment of continuous positive airway pressure (CPAP). However, nearly all the surgical procedures used now usually could not cure this disease completely. The success rate of the uvulopalatopharyngoplasty, which is the most widely used procedure, can only reach to 40% - 50% in terms of AHI Therefore, there are some opinions that the surgery should not be applied for treating this disease. In fact, the outcomes of surgical treatments should not be only evaluated basing on some of the objective results. In this article, the clinical significance of surgery based on objective and subjective data, and the effects on long-term consequences, the combination of surgery with CPAP, and the possible prospects of surgical treatments for this disease will be discussed. This may help us to redefine the clinical efficacy of surgery for the treatment of OSAHS.
Subject(s)
Humans , Continuous Positive Airway Pressure , Palate , General Surgery , Pharynx , General Surgery , Sleep Apnea, Obstructive , General SurgeryABSTRACT
[ABSTRACT]OBJECTIVETo investigate the relationships between the characteristics of the upper airway anatomy, including the basis nasi, and the severity of obstructive sleep apnea hypopnea syndrome(OSAHS). METHODSFifty OSAHS patients and 40 normal subjects received three-dimensional CT scan and poly somnography(PSG). Variables between the two groups were compared. The association between the PSG parameters and the upper airway anatomic features were analyzed. RESULTSThere were significant differences in several CT variables between OSAHS patients and normal subjects(P<0.05), including the minimal lateral airway dimension and the minimal cross-sectional airway area of both velopharynx and glossopharynx, the minimal anterior-posterior airway dimension of velopharynx, and the airway width of basis nasi. The result of logistic regression analysis suggested that the minimal cross-sectional airway area of velopharynx and the airway width of basis nasi were significant predictors of the OSAHS(P<0.05, the values of the odds ratio were 0.978 and 0.589). The correlation analysis suggested that the airway width and the airway area of basis nasi both correlated significantly with several CT variables of pharynx(P<0.05), among these results, the correlation coefficents between these two variables and the mCSA of velopharynx were 0.536 and 0.425 respectively. CONCLUSIONNarrowed basis nasi and velopharynx might be important anatomical features in OSAHS patients. There are correlations between the characteristics of basis nasi and the anatomy of pharyngeal airway.
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Objective:To investigate the effects of TGF-β1 on T lymphocytes of BALB/c mice infected with Echinococcus granulosus( E.granulosus ) in vitro.Methods: The inhibitor group:the spleen cells of BALB/c mouse were co-cultured with E.granulosus and SB525334.The control group:the spleen cells of BALB/c mouse were co-cultured with E.granulosus and PBS.The blank group:the spleen cells of BALB/c mouse were co-cultured with RPMI-1640 medium and SB525334.The lymphocytes were collected at 48 h post-infection.The T lymphocyte subsets, the number of CD4+CD25+T cells, the number of NK cells, and the expression of NKG2D receptor were detected by flow cytometry.The NK cell activity was determined with the lactate dehydrogenase leakage assay(LDH).Results:The inhibition the TGF-β1 receptors resulted in the increase of in the number of CD4+T cells,the decrease in the number of CD8+T cells,the increase of in the ratio CD4+/CD8+T cells,the decrease of in the number of CD4+CD25+T cells,the increase in the expression of the NKG2D receptors,the increase in the lysis rate of Yac-1 cells by NK cells,and a positive cor-relation between the expression of activity receptor NKG2D and killing activity of NK, which were mediated by E.granulosus.Conclusion: The inhibition of TGF-β1 receptors can enhance the immune response of T lymphocytes against E.granulosus infection in vitro.
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<p><b>OBJECTIVE</b>To evaluate the predictive value of the position of the hyoid in surgical outcomes of velopharyngeal surgery for obstructive sleep apnea hypopnea syndrome (OSAHS).</p><p><b>METHODS</b>The polysomnography, CT, and anthropometry data were retrospectively reviewed from patients who underwent revised uvulopalatopharyngoplasty with uvula preservation (H-UPPP) simply or the combination of H-UPPP and transpalatal advance pharyngoplasty (TAP) for OSAHS from July 2008 to December 2011. OSAHS was diagnosed by polysomnography (PSG) in 128 patients who underwent H-UPPP or H-UPPP with TAP surgery for their sleep disorder. After surgical treatment, the patients were evaluated by PSG.</p><p><b>RESULTS</b>The 128 patients included were all male, the mean age of these patients was (39.6±8.5) years, ranged from 19 to 66 years. Seventy-seven patients were successfully treated and 51 did not respond to surgical treatment. The overall apnea hypopnea index (AHI) improved from (58.2±22.4) times/h preoperatively to (20.6±18.1) times/h postoperatively (t=14.9, P<0.001). The vertical distance from inferior margin of hyoid to the inferior mandibular margin (D-HM) was the only parameter that had a significant difference between responders [(14.6±7.7)mm] and non-responders [(19.4±8.0)mm] (t=3.452, P=0.001). D-HM, AHI and the lowest blood oxygen saturation were significant predictors of surgical outcomes (P<0.05). There was a significant correlation between the D-HM and the postoperative AHI (r=0.284, P=0.001). The D-HM of ≥23 mm could predict the postoperative AHI of >10 times/h a specificity of 95.2%.</p><p><b>CONCLUSION</b>The D-HM is a negative predictor of surgical outcomes, patients with a D-HM of ≥23 mm are inappropriate candidates for velopharyngeal surgery.</p>
Subject(s)
Adult , Humans , Male , Middle Aged , Anthropometry , Hyoid Bone , Mandible , Palate , Pharynx , Polysomnography , Postoperative Period , Retrospective Studies , Sleep Apnea, Obstructive , General Surgery , Treatment Outcome , UvulaABSTRACT
Objective To investigate the change of plasma ghrelin level and explore the related factors of ghrelin alteration in elderly hypertensive patients with psychological distress. Methods A total of 300 elders, who were screened with Hamilton Anxiety Scale (HAMA), Hamilton Rating Scale for Depression (HAMD), and the Symptom Checklist-90 (SCL-90) for psychological stress and somato-psychological manifestations respectively, were divided into hypertension group (n=148) and non-hypertension group (n=152). Their blood samples were collected to measure the plasma level of ghrelin and total cortisol on the same day. Results The incidences of anxiety and depression were 27.7% and 11.7%, respectively, in all the enrolled elders. However, the rates of psychological distress, particularly anxiety, were significantly higher in the hypertensive elders than in the non-hypertensive ones (43.2% vs. 12.5%). Anxiety was positively related to the cortisol level but negatively related to the plasma ghrelin level, and the latter two were negatively correlated with each other. Conclusion Chronic increase of plasma cortisol induced by long-term anxiety can lead to the reduction of ghrelin level, which then adversely affects blood pressure in elders with psychological distress. Therefore, ghrelin might be a selective antihypertensive medicine for hypertensive elders with anxiety.