One new glycoside naphthopyranone from the Yiling cave-derived Metarhizium anisopliae NHC-M3-2 / 药学学报

Seven compounds were isolated from fermentation extract of cave-derived Metarhizium anisopliae NHC-M3-2 by silica gel, semi-preparative HPLC and other chromatographic methods. Their structures were elucidated by UV, IR, MS and NMR methods as 2,3-dehydroindigotide G (1), (-)-regiolone (2), naphtho-γ-pyrone (3), indigotide G (4), indigotide B (5) destruxin A (6) and destruxin B (7). Compound 1 is a new glycoside naphthopyranone compound. The anti-hepatitis B virus (HBV) activity of these compounds was evaluated. The EC50 and CC50 of compound 3 against HBV were 4.5 μmol·L-1 and 92.3 μmol·L-1, respectively. This is the first report of the antiviral activity of compound 3.

Effects of brucea javanica oil emulsion on proliferation, apoptosis and autophagy of esophageal squamous cell carcinoma TE-1 cells and its possible mechanism / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：探讨鸦胆子油乳剂（BJOE）对食管鳞状细胞癌TE-1细胞增殖、凋亡和自噬的影响及其可能的机制。方法：按干预措施的不同，将TE-1细胞分为对照组、RAPA（自噬激动剂）组、740Y-P（PI3K激活剂）组、BJOE组、BJOE+RAPA组和BJOE+740Y-P组。采用FCM、克隆形成、Transwell实验检测细胞凋亡、增殖、迁移和侵袭能力，qPCR法检测细胞中PI3K、Akt、mTOR、LC3Ⅰ、LC3Ⅱ、p62、Beclin 1、caspase-3的mRNA表达，WB法检测PI3K、Akt、mTOR及其磷酸化、LC3Ⅱ/Ⅰ、p62、Beclin 1、caspase-3的蛋白表达。结果: 与对照组比较，RAPA组和BJOE组细胞凋亡率均显著升高（均P<0.01），细胞克隆形成率、迁移和侵袭能力均显著降低（均P<0.01），细胞中PI3K、Akt、mTOR的mRNA和蛋白磷酸化水平均显著降低（均P<0.05），p62的mRNA和蛋白水平显著降低（均P<0.01），LC3Ⅱ/Ⅰ、Beclin 1和caspase-3的mRNA和蛋白水平显著升高（均P<0.05），740Y-P组的结果则相反（均P<0.05）；与RAPA组或740Y-P组比较，BJOE+RAPA组或BJOE+740Y-P组细胞凋亡率显著升高（均P<0.01），克隆形成率、细胞侵袭和迁移能力显著降低（均P<0.01），PI3K、Akt、mTOR的mRNA和蛋白磷酸化水平均显著降低（均P<0.05），p62的mRNA和蛋白水平均显著降低（均P<0.05），LC3Ⅱ/Ⅰ、Beclin 1和caspase-3 mRNA和蛋白水平显著升高（均P<0.05）。结论: BJOE显著抑制TE-1细胞增殖、迁移、侵袭并促进细胞凋亡与自噬，其机制可能与抑制PI3K/Akt/mTOR信号通路的激活有关。

Research on anti-tumor natural product diosgenin / 中国中药杂志

Diosgenin is widely distributed in many plants, such as Polygonatum sibiricum, Paris polyphylla, Dioscorea oppositifolia, Trigonella foenum-graecum, Costus speciosus, Tacca chantrieri, which has good anti-tumor activity and preferable effects on preventing atherosclerosis, protecting the heart, treating diabetes, etc. This review combed through the anti-tumor mechanisms of diosgenin encompassing lung, breast, gallbladder, liver, oral cavity, stomach, bladder, bone marrow, etc. Besides, it was discovered that diosgenin mainly exerts its effect by inhibiting tumor cell migration, suppressing tumor cell proliferation and growth, and inducing cell apoptosis. However, problems like low yield and bioavailability frequently exist in natural diosgenin. This review introduced methods such as structural modification, dosage form optimization and combination medication to improve the yield and anti-tumor activity of diosgenin. Via the summary of this paper, it is expected to provide theoretical basis for the rational exploitation and utilization of diosgenin.

Study on chemical constituents from fruiting bodies of Ganoderma calidophilum / 中国中药杂志

Chemical constituents were isolated and purified from fruiting bodies of Ganoderma calidophilum by various column chromatographic techniques, and their chemical structures were identified through combined analysis of physicochemical properties and spectral data. As a result, 11 compounds were isolated and identified as(24E)-lanosta-8,24-dien-3,11-dione-26-al(1), ganoderone A(2), 3-oxo-15α-acetoxy-lanosta-7,9(11), 24-trien-26-oleic acid(3),(23E)-27-nor-lanosta-8,23-diene-3,7,25-trione(4), ganodecanone B(5), ganoderic aldehyde A(6), 11β-hydroxy-lucidadiol(7), 3,4-dihydroxyacetophenone(8), methyl gentiate(9), ganoleucin C(10), ganotheaecolumol H(11). Among them, compound 1 is a new triterpenoid. The cytotoxic activities of all of the compounds against tumor cell lines were evaluated. The results showed that compounds 1, 3, 4 and 6 showed cytotoxic activity against BEL-7402, with IC_(50) values of 26.55, 11.35, 23.23, 18.66 μmol·L~(-1); compounds 1 and 3-6 showed cytotoxic activity against K562, with IC_(50) values of 5.79, 22.16, 12.16, 35.32, and 5.59 μmol·L~(-1), and compound 4 showed cytotoxic activity against A549, with IC_(50) value of 42.50 μmol·L~(-1).

Evaluation of the teaching environment among the primary and secondary schools in China / 中国学校卫生

Objective@#To evaluate the current status of the primary and secondary schools’ teaching environment in China and associated factors,and to provide the support for making differentiated interventional stategies.@*Methods@#Data regarding to information of the primary and secondary schools was obtained by random inspection from the National Health and Family Planning Commission in 2018. Chi-square test was used to compare differences of qualified rates between groups. Spearman correlation analyses was applied to examine the correlations among population density, per capita GDP and qualified rates.@*Results@#Among the total of 37 531 schools, the overall qualified rate of teaching environmental sanitation of primary and secondary schools in 2018 was 59.1%. The qualifying rate in urban areas (60.3%) was higher than that of rural areas (59.4%) and towns (56.7%). Primary schools (59.8%) had higher qualifying rates than junior high schools (58.2%) and senior high schools (51.8%). In terms of each evaluation item, the qualifying rates of school furniture equipment including desks and chairs were the lowest, while the qualifying rates of dormitory ventilation ranked highest. Large variations among provinces were observed for the qualifying rates for school furniture equipment, as well as blackboard illumination. Those provinces with higher per capita GDP and higher population density had higher the qualifying rates for school furniture equipment.@*Conclusion@#The overall qualifying rate of Chinese primary and secondary schools’ teaching environment is low. Among all the evaluation measures, qualifying rates of dormitory ventilation are relatively good, while school furniture equipment needs to be improved. Notably, strengthened and targeted management should be applied to improve schools’ teaching environment in new era.

In Vitro and In Vivo Evaluation of Antitumor Activity of Ligustrum robustum, A Chinese Herbal Tea / 中国结合医学杂志

OBJECTIVE@#To examine the effect of the aqueous extract of Ligustrum robustum on tumor growth in vitro and in vivo and explore the possible molecular mechanisms.@*METHODS@#In in vitro study, cell viabilities of human cervical carcinoma cells (HeLa), human breast cancer cells (MCF-7), human prostate cancer cells (PC-3), human hepatoma cells (7721) and human colon carcinoma cells (SW480) were evaluated with cell counting kit-8. For L. robustum-treated Hela cells, early or late apoptosis were evaluated by annexin V/PI staining. Mitochondrial membrane potential was measured by staining cells with JC-1. Apoptosis was monitored by nuclear morphology based on chromatin condensation and fragmentation by 4',6-diamidino-2-phenylinole (DAPI) staining. Caspase-3 and -8 activity levels were measured by a colorimetric assay. In vivo, to evaluate the possible mechanism of L. robustum-mediated antitumor effect, nude mouse xenograft study was also conducted.@*RESULTS@#In in vitro study, L. robustum was found to be toxic to HeLa, MCF-7, PC-3, 7721, SW480, with an half maximal inhibitory concentration value of 2-5 mg/mL (P<0.05). Moreover, externalization of phosphatidylserine, loss of mitochondrial membrane potential, DNA fragmentation and activation of caspase-3 and -8 were detected in L. robustum-treated Hela cells. Using a nude mouse model bearing Hela xenografts, we found that L. robustum reduced tumor volume and tumor weight (P<0.05), but had no effect on body weight and histological damage of important organs. Intraperitoneal injection of L. robustum caused a significant reduction in serum aspartate transaminase and alanine transaminase levels (P<0.05). Furthermore, cleaved caspase-3-positive and terminal nucleotidyl transferase-mediated nick end labeling (TUNEL)-positive cells were observed in L. robustum-treated tumor tissues.@*CONCLUSIONS@#L. robustum inhibits tumor cell growth both in vitro and in vivo by inducing apoptosis in a caspase-dependent way without apparent hepatic toxicity and histological damage, which may offer partial scientific support for the ethnopharmacological claims of L. robustum as a herbal tea for its antitumor activity.

Identification of chemical constituents in Sinopodophylli Fructus by HPLC-DAD-ESI-IT-TOF-MSn / 中国中药杂志

This experiment was performed to analyze and identify the chemical constituents of Sinopodophylli Fructus by HPLC-DAD-ESI-IT-TOF-MSn. The analysis was performed on an Agilent Zorbax SB-C₁₈ (4.6 mm×250 mm, 5 μm) column.The mobile phase consisted of 0.1% formic acid was used for gradient at a flow rate of 1.0 mL·min⁻¹. Electrospray ionization ion trap time-of-flight multistage mass spectrometry was applied for qualitative analysis under positive and negative ion modes. The results indicated that 54 compounds consisted of 18 lignans and 36 flavonoids from Xiaoyelian had been detected by their HRMS data, the information of literature and reference substance. Among them, 27 compounds were reported in Sinopodophylli Fructus for the first time. In conclusion, an HPLC-DAD-ESI-IT-TOF-MSn method was established to qualitative analysis of Xiaoyelian in this study, which will provide the evidence for evaluating the quality of Xiaoyelian herbs, clarifying the mechanism, and guiding the development of pharmacological active ingredients.

A new sesquiterpene from Chinese agarwood induced by artificial holing / 中国中药杂志

In order to study the chemical constituents of n-butanol fraction of ethanol extract from Chinese agarwood induced by artificial holing, various chromatographic techniques were carried out to isolate compounds, and the structures of compounds were determined through a combined analysis of physicochemical properties and spectroscopic evidence. Seven compounds were obtained and identified as selina-3,11-dien-9,15-diol (1), aquilarone D (2), 5α,6β,7α,8β-tetrahydroxy-2-[2-(2-hydroxyphenyl)ethyl]-5,6,7,8-tetrahydrochromone (3), 6,7-dimethoxy-2-[2-(4-methoxyphenyl)ethyl]chromone (4), syringin (5), methyl (Z)-p-coumarate (6), and 4'-methoxycinnamic acid (7), among which compound 1 was a new compound and compounds 5-7 were isolated from agarwood for the first time. The bioactivity assay results concluded that compounds 6 and 7 showed certain nematicidal activity against Panagrellus redivivus, and compounds 4, 6 and 7 exhibited cytotoxicity against BEL-7402, SGC-7901 and A549 carcinoma cell lines.

Pars plana vitrectomy and Baerveldt glaucoma implant in the treatment of refractory glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the clinical efficacy of pars plana vitrectomy and Baerveldt glaucoma implant(PPV-BGI) in the treatment of refractory glaucoma.METHODS:One hundred twenty-nine refractory glaucoma patient's clinical data from March 2013 to December 2015 that underwent PPV-BGI were retrospectively reviewed.Among them,63 eyes were neovascular glaucoma (NVG) and 69 eyes were other types of glaucoma (non-NVG).The changes of intraocular pressure(lOP),surgical results,visual acuity (VA),the number of glaucoma medications,complications,and the success rate of surgery were analyzed.RESULTS:Cumulative success rates for the NVG group and non-NVG group were 46.0％ and 81.2％,respectively,within 1a after surgeries,the difference was significantly (P＜ 0.05).Preoperative lOP was 30.4 ± 10.2mmHg in the non-NVG group and 40.1±10.4mmHg in the NVG group,and lOP was reduced to 14.9±4.1mmHg in the non-NVG group and 17.8±4.9mmHg in the NVG,and the difference was significantly (P＜0.05).Number of glaucoma medications decreased from 2.7 ± 1.2 in the non-NVG group and 2.9 ± 1.4 in the NVG group preoperatively to 0.51 ±0.96 in the non-NVG group and 0.96±1.18 in the NVG group,and the difference was significantly (P＜0.05).Improvement in VA of in the NVG group and non-NVG group were observed in 14 eyes of 13 patients and 38 eyes and 37 patients respectively,and the difference was significantly (P＜0.05).The postoperative complications of 1d and 1a follow-up in NVG group was significantly higher than non-NVG group (P＜0.05).CONCLUSION:PPV-BGI is a viable surgical option for eyes with refractory glaucoma,but visual outcomes are frequently poor because of ocular comorbidities,especially in eyes with NVG.

Visual quality after femtosecond laser-assisted deep anterior lamellar keratoplasty with big-bubble method for the treatment of keratoconus / 眼科新进展

Objective To observe the visual outcomes of big-bubble deep anterior lamellar keratoplasty (DALK) for the treatment of keratoconus using a femtosecond laser.Methods A total of 30 patients (50 affected eyes) with keratoconus were enrolled in the study by the self control observation method.All the patients were treated with femtosecond laser assisted DALK by large bubble method,and the curative effect was observed.Results All the 30 patients underwent the surgery successfully.In the early time after the surgery,the corneal grafts were transparent,the corneal physiological thickness was restored,and the grafts fitted the implant bed elastic layer well.The uncorrected visual acuity and the best corrected visual acuity on day 7,1 month,6 months and 1 year after surgery were higher than those before surgery (all P ＜ 0.05),but there was no significant difference between above time points (all P ＞ 0.05).The corneal curvature and corneal astigmatism were significantly decreased after surgery,the thickness of the thinnest cornea was significantly increased after surgery (all P ＜0.05),but there was no significant difference between the different time points after surgery (all P ＞ 0.05).The endothelial cell density before surgery and 1 year after surgery was (2989.34 ±294.52) · mm-2 and (2821.19 ±325.51) · mm-2,while loss rate of endothelial cell was (5.62 ± 0.56)％,but there was no significant difference between different time points after surgery (all P ＞ 0.05).There were no complications during the surgery,but wound dehiscence occurred in 1 eye,loose suture in 1 eye,and stromal rejection in 1 eye,and there was no other complication after surgery.Conclusion It is safe and effective of femtosecond-laser assisted DALK by a big-bubble method to treat keratoconus,and it is a good choice for patients with advanced keratoconus.

Identification of chemical constituents in Scrophulariae Radix by HPLC-IT-TOF-MS / 中国中药杂志

This experiment was performed to establish a qualitative analysis on chemical constituents of Scrophulariae Radix by HPLC-ESI-IT-TOF-MS．The analysis was conducted on a C₁₈ column (Kromasil 100-5, 4.6 mm×250 mm, 5 μm) with 0.1% formic acid-acetonitrile as the mobile phase for gradient elution; ESI ion source was used for mass spectra, and data were collected innegative and positive modes. The results showed that 64 compounds from Scrophulariae Radix had been identified by analyzing negative ion mass data including element composition and by comparing with data from literature. Two new compounds (4-hydroxy-6-O-methylcatalpol and acetylangoroside C) and seventeen known compounds were detected from Scrophulariae Radix for the first time. Seventeen known compounds included twelve iridoid glycosides, three phenylpropanoid glycosides and two other kind compounds. This study will provide chemical basis for elucidation of the effective substance in the Scrophulariae Radix.

Significance of metronomic therapy against Helicobacter pylori for the prevention and treatment of emetogenic chemotherapy of gastric cancer / 中国肿瘤临床

Objective:To investigate the significance of metronomic therapy against Helicobacter pylori (HP) in the prevention of delayed emesis caused by chemotherapy of gastric cancer compared with the routine therapy. Methods:HP infection was confirmed by carbon 14 breath test in 69 patients. Combined chemotherapy was employed for the first time in the patients, who were divided into groups A and B. Metronomic therapy was administered to group A (n=33). Briefly, triplex medication against Helicobacter bacil i triplex was oral y ad-ministered:20 mg of omeprazole and 0.5 g of amoxicillin twice daily, with 200 mg of tinidazole once daily. Oral administration in group A was performed for 14 days from the start of chemotherapy. Simultaneously, 5-HT3 antagonists were applied. By contrast, group B (n=36) was treated with the oral triplex medication against Helicobacter bacilli:20 mg of omeprazole and 1 g of amoxicillin twice daily, with 400 mg of tinidazole once daily. Oral administration in group B was performed for 7 days from the beginning of chemotherapy with simultaneous application of 5-HT3 antagonists. Both groups were simultaneously treated with the 5-HT3 antagonist granisetron at 3 mg once daily during the administration of anti-HP therapy. HP infection was evaluated by immunohistochemistry before and after treatment. Results:The total effective rate for emesis in group A was 84.85%, which was significantly higher than that in group B (55.56%). Among the patients in group A, 15.15%demonstrated delayed emesis, compared with 44.44%of the patients in group B;the number of individuals was significantly lower in group A than in group B. The average number of chemotherapy cycles in group A was significantly higher than that in group B at 3.1 cycles;the difference between groups was statistically significant (P<0.05). In addition, the HP infection in group B was significantly lower than that in group A (P<0.05). Conclusion:Compared with one week of treatment with the conventional dose, two weeks of low-dose metronomic therapy against HP during chemotherapy can significantly reduce chemotherapy induced delayed emesis and can significantly reduce the degree of HP infection in patients with gastric cancer with HP infection.

Graded ethanol precipitation method on physicochemical properties and antioxidant activities of polysaccharides extracted from Astragalus Radix / 中国中药杂志

Astragalus polysaccharide has been widely used in food and medicinal industry owing to its health-promoting properties. In order to characterize better the relationship among molecular weight, structure-activity and activities, a simple method was used different concentration of ethanol including 30% (PW30), 50% (PW50), 70% (PW70), 75% (PW75), 80% (PW80) and 90% (PW90) to precipitate Astragalus polysaccharides into different molecular weight. As a result, PW90 showed smooth surface and the strongest antioxidant activity among these six fractions (P < 0.05). In conclusion, graded ethanol precipitation was a simple method to separate Astragalus polysaccharides into different molecular weight with different antioxidant activity fractions.

Regularity of drugs compatibility of anti-hepatoma traditional Chinese medicine ancient prescriptions and risk evaluation of anti-hepatoma new drug research and development / 中国中药杂志

Traditional Chinese ancient prescriptions have been used for treatment of liver cancer for a long history and the scientific and rational compatibility is a great wealth for modern research and development (R&D) of new drugs. The research and development of new drugs are often accompanied with a large investment, a long cycle and a high risk, especially for the anti-tumor drugs R&D which are facing more risks and lower successful rate. In this research, the regularity of compatibility of drugs was analyzed from 124 anti-hepatoma ancient prescriptions by computer program. The results can offer help to the R&D of anti-hepatoma new drugs and reduce the risk of drug screening. In addition, we surveyed 22 companies in this field from six provinces such as Beijing, Shanghai, Tianjin and so on and obtained 240 risk assessment questionaires. Then we used qualitative analysis method to interpret the greatest impacts for the risks in the process of R&D, production and sales of anti-hepatoma new drugs. The study provides a basis for anti-liver cancer drugs R&D researchers, who can take effective measures to reduce the R&D risks and improve successful rate.

Dynamic monitoring risk of anti-hepatoma new drug development / 中国中药杂志

Risk monitoring of new Chinese patent anti-hepatoma drugs is tracking recognized risks and residual risks, identifying emerging risk and ensure the implementation of the plan, estimating the process of reducing effectiveness. The paper is mainly through understanding the status of Chinese patent anti-hepatoma drugs, the content, characteristic and analysis method of dynamic risk monitoring, and then select the risk control indicators, collect risk information. Finally, puts forward the thought of anti-hepatoma drugs listed evaluation in our country, and try to establish the model of dynamic risk management of anti-hepatoma drugs.

Phytochemistry, Pharmacology, Toxicology, and Structure-Cytotoxicity Relationship of Paridis Rhizome Saponin / 中草药·英文版

The rhizomes of Paris polyphylla var. yunnanensis and P. polyphylla var. chinensis are used as traditional herbal medicines in many parts of China. The Paridis Rhizome saponin (PRS), as the active ingredient, has played an important role in hemostasis, antibacterial action, and inflammation counteraction, bearing some analogy to Gongxuening and Yunnanbaiyao in efficacy. Modern pharmacological experiments have proved that PRS possesses two main sapogenins: diosgenin and pennogenin, which could provide a lot of clinical treatment effects (anti-oxidation, anti-inflammation, anti-apoptosis, anti-metastasis, and immunostimulant, etc.). In the past, several main steroid saponins have been studied in a number of randomized controlled trials for their effects and mechanisms mainly on antitumor performance. The extensive results have demonstrated that PRS was an effective group of active components to antitumor clinical trials. In this article, we reviewed the reported phytochemical, pharmacological, and toxicological properties of PRS and compared the structure-cytotoxicity relationship of PRS in antitumor effects. © 2013 Tianjin Press of Chinese Herbal Medicines.

Comparison of two preparation methods of liver whole-organ decellularized matrix / 解放军医学杂志

Objective To compare the two different decellularization methods for preparation of liver whole-organ decellularized matrix for providing an experimental basis for screening more effective method. Methods Liver whole-organ decellularized matrix was prepared by two different decellularization methods using sodium dodecylsulfate (SDS) and Triton X-100+SDS (Tx+SDS) as main detergent respectively. The three-dimensional shape, vascular structure, histological results and immunofluorescence images were observed, and the contents of residual DNA, collagen and growth factors (HGF, bFGF) were determined by ELISA. Results Liver whole-organ decellularized matrix was successfully prepared by both methods, as the cellular and nuclear components were removed successfully and the extracellular matrix (ECM) protein was preserved. The Tx+SDS method preserved the vascular structure of the liver, and the SDS method resulted in damage to the vascular structure. Compared with SDS method, the Tx+SDS method preserved more ECM protein, including almost 100% of collagen, and 58.5% of HGF and 42.5% of bFGF. Conclusion The liver whole-organ decellularized matrix could be well prepared by Tx+SDS method, and it may provide an effective scaffold for the study of tissue engineered liver and regenerative medicine.

Protective effects of astragalus extract against intermittent hypoxia-induced hippocampal neurons impairment in rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intermittent hypoxia is the main pathophysiological cause of the obstructive sleep apnea syndrome. Astragalus shows improvement of spatial learning and memory abilities under intermittent hypoxia. Our study aimed to investigate the protective effect of astragalus against intermittent hypoxia induced-hippocampal neurons impairment in rats and lay the theoretical foundation for the sleep apnea improvement in cognitive function by astragalus.</p><p><b>METHODS</b>Male Wistar rats were divided into 4 groups: blank control group, normoxia group, intermittent hypoxia group and astragalus treated intermittent hypoxia group. After 6-week treatment, apoptosis of neurons was evaluated by terminal deoxynucleotidyl-transferase-mediated dUTP nick end-labeling (TUNEL) assay. Furthermore, the expression of HIF-1a was detected by real-time reverse transcription polymerase chain reaction (RT-PCR) at the mRNA level as well as by immunohistochemistry (IHC) and Western blotting at the protein level.</p><p><b>RESULTS</b>HPLC analysis indicated that astragaloside IV, astragaloside II and astragaloside I were the main compounds in astragals extract. Astragalus extract reduced the apoptosis of hippocampal neurons (P < 0.05) and decreased the expression of HIF-1a at both the mRNA and protein levels in hippocampus compared with non-treated groups (P < 0.05).</p><p><b>CONCLUSION</b>Astragalus protects against intermittent hypoxia-induced hippocampal neurons impairment in rats.</p>

Chemical composition and pharmacological activities of astragali radix / 中国中药杂志

Astragali Radix, as a tonic with a long history, is one of the most common traditional Chinese medicines. Recently, chemical composition and pharmacological activities of Astragali Radix have been widely reported. Polysaccharide, triterpenes and flavonoids are regarded to its effective components. Pharmacological experiments and clinical reports show that Astragali Radix has good effects on immune-regulation, anti-tumor, anti-virus, diabetes, anti-aging and so on. Therefore, it shows a good prospect to make good use of its effective components.

Combination of transpalatal advancement pharyngoplasty and uvulopalatopharyngoplasty for obstructive sleep apnea / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>Investigate the response of the patients with obstructive sleep apnea hypopnea syndrome (OSAHS) patients to combination of transpalatal advancement pharyngoplasty and uvulopalatopharyngoplasty.</p><p><b>METHODS</b>Thirty two patients with OSAHS, age ranged from 27 to 54, mean value (x +/- s) 39.1 +/- 7.8, male, body mass index (BMI) ranged from 22.9 to 36. 7 kg/m2, mean value (29.0 +/- 3.6) kg/m2, preoperative apnea and hypopnea index (AHI) was 11.7/h to 113.7/h, mean value (61.8 +/- 21.9)/h, the lowest blood oxygen saturation was 0.10 to 0.85, mean value 0.64 +/- 0. 13. With preoperative endoscopic technique, bony nasopharynx cavity narrowing were present, 14 patients had concomitant tonge-base obstruction. Cephalometric result, SNA ranged from 72.9 degrees to 87.0 degrees, mean value (80.7 +/- 4.1) degrees; SNB 69.50 to 85.0 degrees, mean value (76.8 +/- 4.5) degrees; PAS 0.5 cm to 2.1 cm, mean value (1.2 +/- 0.5) cm; MP-H: ranged from 1.2 cm to 3.5 cm, mean value (2.2 +/- 0.7) cm; PNS ranged from 2.4 cm to 3.5 cm, mean value (2.8 +/- 0.4) cm. All the patients had H-UPPP and concomitant transpalatal advancement pharyngoplasty. Fourteen patients with tonge-base obstruction had chin advancement. Results Six months after the operations, the patients were evaluated the response to the operations using Epworth sleep scale, OSAHS filtration questionnaire scale and polysomnography (PSG). There were 27 patients with the decrease percent of AHI reaching or more than 25% and 22 patients with the decrease percent of AHI reaching or more than 50% including 8 patients with AHI less than 5. The other 5 patients were ineffective. After operation, the Epworth sleep scale decreased from (9.2 +/- 4.5) to (4.7 +/- 2. 8) and OSAHS filtration questionnaire scale decreased form (56.0 +/- 15.3) to (17.5 +/- 11.5). Both of the differences were obvious (P < 0.01).</p><p><b>CONCLUSIONS</b>Combination of transpalatal advancement pharyngoplasty and H-UPPP can improve the efficacity and in some patients with pure retropalatal airway narrowing, the cure rate can be improved.</p>