Endoscopic resection of type D trigeminal schwannoma through nasal sinus approach / 中华外科杂志

Objective: To examine the feasibility and surgical approach of removing type D trigeminal schwannoma through nasal cavity and nasal sinus under endoscope. Methods: Eleven patients with trigeminal schwannoma who were treated in the Department of Otorhinolaryngology, Qilu Hospital of Shandong University from December 2014 to August 2021 were analyzed retrospectively in this study. There were 7 males and 4 females, aged (47.5±13.5) years (range: 12 to 64 years). The neoplasm involved the pterygopalatine fossa, infratemporal fossa, ethmoidal sinus, sphenoid sinus, cavernous sinus, and middle cranial fossa. The size of tumors were between 1.6 cm×2.0 cm×2.0 cm and 5.7 cm×6.0 cm×6.0 cm. Under general anesthesia, the tumors were resected through the transpterygoid approach in 4 cases, through the prelacrimal recess approach in 4 cases, through the extended prelacrimal recess approach in 2 cases, and through the endoscopic medial maxillectomy approach in 1 case. The nasal endoscopy and imaging examination were conducted to detect whether neoplasm recurred or not, and the main clinical symptoms during follow-up. Results: All the surgical procedures were performed under endonasal endoscope, including Gross total resection in 10 patients. The tumor of a 12-year-old patient was not resected completely due to huge tumor size and limited operation space. One patient was accompanied by two other schwannomas located in the occipital region and the ipsilateral parotid gland region originating from the zygomatic branch of the facial nerve, both of which were removed concurrently. After tumor resection, the dura mater of middle cranial fossa was directly exposed in the nasal sinus in 2 cases, including 1 case accompanied by cerebrospinal fluid leakage which was reconstructed by a free mucosal flap obtained from the middle turbinate, the other case was packed by the autologous fat to protect the dura mater. The operation time was (M(IQR)) 180 (160) minutes (range: 120 to 485 minutes). No complications and deaths were observed. No recurrence was observed in the 10 patients with total tumor resection during a 58 (68) months' (range: 10 to 90 months) follow-up. No obvious change was observed in the facial appearance of all patients during the follow-up. Conclusion: Type D trigeminal schwannoma involving pterygopalatine fossa and infratemporal fossa can be removed safely through purely endoscopic endonasal approach by selecting the appropriate approach according to the size and involvement of the tumor.

Clinical effect of different maintenance doses of caffeine citrate in the treatment of preterm infants requiring assisted ventilation: a pilot multicenter study / 中国当代儿科杂志

OBJECTIVES@#To explore the optimal maintenance dose of caffeine citrate for preterm infants requiring assisted ventilation and caffeine citrate treatment.@*METHODS@#A retrospective analysis was performed on the medical data of 566 preterm infants (gestational age ≤34 weeks) who were treated and required assisted ventilation and caffeine citrate treatment in the neonatal intensive care unit of 30 tertiary hospitals in Jiangsu Province of China between January 1 and December 31, 2019. The 405 preterm infants receiving high-dose (10 mg/kg per day) caffeine citrate after a loading dose of 20 mg/kg within 24 hours after birth were enrolled as the high-dose group. The 161 preterm infants receiving low-dose (5 mg/kg per day) caffeine citrate were enrolled as the low-dose group.@*RESULTS@#Compared with the low-dose group, the high-dose group had significant reductions in the need for high-concentration oxygen during assisted ventilation (P=0.044), the duration of oxygen inhalation after weaning from noninvasive ventilation (P<0.01), total oxygen inhalation time during hospitalization (P<0.01), the proportion of preterm infants requiring noninvasive ventilation again (P<0.01), the rate of use of pulmonary surfactant and budesonide (P<0.05), and the incidence rates of apnea and bronchopulmonary dysplasia (P<0.01), but the high-dose group had a significantly increased incidence rate of feeding intolerance (P=0.032). There were no significant differences between the two groups in the body weight change, the incidence rates of retinopathy of prematurity, intraventricular hemorrhage or necrotizing enterocolitis, the mortality rate, and the duration of caffeine use (P>0.05).@*CONCLUSIONS@#This pilot multicenter study shows that the high maintenance dose (10 mg/kg per day) is generally beneficial to preterm infants in China and does not increase the incidence rate of common adverse reactions. For the risk of feeding intolerance, further research is needed to eliminate the interference of confounding factors as far as possible.

Baicalein Mediated FAK Protein Regulates PI3K/Akt Signaling Pathway to Inhibit Proliferation and Migration of Gastric Cancer HGC-27 Cells / 中国实验方剂学杂志

ObjectiveTo study the possible molecular mechanism of baicalein （BAI）-mediated focal adhesion kinase （FAK） in the regulation of phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway to inhibit the proliferation and migration of gastric cancer HGC-27 cells. MethodThe gastric epithelial GES-1 cells and gastric cancer HGC-27 cells were respectively treated with BAI （0， 5， 15， 25， and 50 μmol·L-1） for 48 h， and then methyl thiazolyl tetrazolium （MTT） assay was adopted to detect effect of BAI on cell proliferation. Western blot （WB） was employed to detect the expression of FAK and the proteins related to epithelial-mesenchymal transition （EMT） and PI3K signaling pathway after intervention with different concentrations of BAI. The HGC-27 cells stably overexpressing FAK were constructed with lentivirus-mediated transfection technique， and the transfection of FAK was detected through WB and green fluorescent protein （GFP）. The cells were divided into empty vector （NC） group， BAI group， FAK overexpression group， and BAI-treated FAK overexpression group， and cell proliferation activity was detected by MTT assay. The colony formation and cell migration were observed via colony formation assay and Transwell migration assay， respectively. The expression of proteins involved in EMT and PI3K signaling pathways were detected by Western blot. ResultCompared with the NC group， BAI （15， 25 and 50 μmol·L-1） inhibited the proliferation of HGC-27 cells in a dose-dependent manner （P<0.05， P<0.01） while did not affect that of GES-1 cells. BAI （5， 15 and 25 μmol·L-1） down-regulated the expression level of p-FAK （P<0.05， P<0.01）. Compared with NC group， FAK overexpression group showed up-regulated expression level of FAK in HGC-27 cells. The HGC-27 cells in both NC group and FAK overexpression group had green fluorescence. Compared with NC group， BAI inhibited the growth， colony formation， and migration， while FAK overexpression promoted those of HGC-27 cells. The treatment of FAK overexpression group with BAI inhibited the enhancement of cell proliferation and migration （P<0.05）. WB showed that compared with NC group， BAI （15， 25 μmol·L-1） significantly up-regulated the expression of E-cadherin protein and down-regulated that of Vimentin， Snail， p-PI3K， and p-Akt protein in HGC-27 cells （P<0.05， P<0.01）. Compared with NC group， FAK overexpression group showed down-regulated expression of E-cadherin， up-regulated expression of p-FAK， Vimentin， and Snail， and increased ratios of p-FAK/FAK， p-PI3K/PI3K and p-Akt/Akt （P<0.05）. This phenomenon would be reversed after BAI treatment. ConclusionBAI can affect the proliferation and migration of gastric cancer HGC-27 cells by mediating FAK to regulate PI3K/Akt signaling pathway.

Compound Kushen injection induces immediate hypersensitivity reaction through promoting the production of platelet-activating factor via de novo pathway / 中国药理学与毒理学杂志

OBJECTIVE Compound Kushen injection (CKI) is a bis-herbal formulation extracted from Kushen (Radix Sophorae Flavescentis) and Baituling (Rhizoma Heterosmilacis Japonicae). Clinically, it is used as the adjuvant treat?ment of cancer. However, with the increased application, the cases of immediate hypersensitivity reactions (IHRs) also gradually rise. In this study, we investigated the underlying mechanism(s) and active constituent(s) for CKI-induced IHRs in experimental models. METHODS T helper 2 (Th2) immunity-amplified mice were prepared by aluminum adjuvant. Anaphylactic shock was detected by measuring rectal thermometry in propranolol pretreated mice. For evaluating micro?vascular permeability, Evans blue extravasation assay was used. Platelet-activating factor (PAF), serum total IgE (tIgE) and mouse mast cell protease 1 (MMCP1) were measured by ELISA. RESULTS The obtained results showed that CKI did not elevate serum tIgE and MMCP1 after consecutive immunization for five weeks, but could induce Evans blue extravasation (local) and cause obvious hypothermia (systemic) after a single injection. Further study showed that alka?loids in Kushen, especially matrine, were responsible for CKI-induced IHRs. Mechanism study showed that various PAF receptor antagonists could significantly counter CKI-induced IHRs locally or systemically. In cell system, CKI was able to promote PAF production in a non-cell-selective manner. In cell lysate, the effect of CKI on PAF production became stron?ger and could be abolished by blocking de novo pathway. CONCLUSION In conclusion, our study identifies, for the first time, that CKI is a PAF inducer. It causes non-immunologic IHRs, rather than IgE-dependent IHRs, by promoting PAF production through de novo pathway. Alkaloids in Kushen, especially matrine, are the prime culprits for IHRs. Our find?ings may provide a potential approach for preventing and treating CKI-induced IHRs.

Effect of serotonin 1A receptor agonist on pathological aggressive behaviors and brain-derived and glial cell-derived neurotrophic factors in prefrontal cortex and hippocampus of puberty rats / 第二军医大学学报

Objective To explore the effect of serotonin 1A (5-HT1A) receptor agonist 8-OH-DPAT on pathological aggressive behavior, brain-derived neurotrophic factor (BDNF) and glial cell-derived neurotrophic factor (GDNF) in prefrontal cortex and hippocampus in pubertal rats. Methods Forty-two 21-day-old male SD rats were randomly divided into 6 groups:model group, normal group, model+8-OH-DPAT group, model+normal saline (NS) group, normal+8-OH-DPAT group and normal+NS group, with 7 rats in each group. The rats in the model, model+8-OH-DPAT and model+NS groups were given a series of early chronic stresses to establish the pathological aggressive animal model, and the other 3 groups were fed normally. Then the rats in the model+8-OH-DPAT and normal+8-OH-DPAT groups were injected intraperitoneally with 8-OH-DPAT (0.5 mg/kg), while the rats in the model+NS and normal groups were administered with 2 mL of NS. We determined the aggressive behaviors of the rats through resident-intruder test and detected the protein expressions of BDNF and GDNF in prefrontal cortex and hippocampus by Western blotting. Results (1) Compared with the normal group, the latency in the first attack in the model group was significantly shorter (P0.05). (2) The protein expressions of BDNF and GDNF in the prefrontal cortex and hippocampus in the model group were significantly lower than those in the normal group (P<0.01), but they were significantly decreased in the model+NS group compared with the normal+NS group (P<0.05, P<0.01) and were significantly increased in the model+8-OH-DPAT group compared with the model+NS group (P<0.05, P<0.01). Conclusion The expressions of BDNF and GDNF in the prefrontal cortex and hippocampus may be related to the pathological aggressive behaviors induced by early chronic stress in puberty rats. 5-HT1A receptor agonist can reduce the pathological aggressive behaviors induced by early chronic stress and increase the expressions of BDNF and GDNF in prefrontal cortex and hippocampus in puberty rats.

Investigation and Analysis on Public Cognition Status for Adverse Drug Reaction in Guangdong Province / 中国药房

OBJECTIVE:To understand the public cognitive status about the adverse drug reaction(ADR),and provide refer-ence for improving the ADR reporting system. METHODS:Field to fill out and recycling questionnaire on the spot were conducted to investigate the cognition of ADR about 1 379 people from the Pearl River Delta,Eastern,Western and Northern region of Guangdong Province,and analyze related influential factors. RESULTS:Totally 1 500 questionnaires were sent out and 1 379 were effective with effective rate of 91.9%. Among the respondents,931(67.5%)could correctly answer the question of ADR concept, the correct rate showed lowest in the people lived in Northern region and with no less than 40 years old and low education;only 36.1% could correctly know the cause of ADR;only 388 (28.1%) knew the individuals can report ADR;723 (52.4%) thought hospital should be held responsible for ADR;once the ADR appeared,62.2% of respondents would choose to report to the hospi-tal. The main causes of discourage individual report of ADR were due to less know about where,how and which relevant depart-ments could report,and the report way was not convenient and the procedures were cumbersome. CONCLUSIONS:The public awareness of the ADR concept is not high and the enthusiasm of report is relatively low. Therefore,the propaganda of public aware-ness of ADR should be strengthened to encourage the public to participate in the ADR report actively,and broaden the channels of ADR personal report.

Forskolin inhibits spontaneous contraction of gastric antral smooth muscle in rats / 生理学报

The aim of the present study was to investigate the effects of cyclic adenosine monophosphate (cAMP) on rat gastric antral circular smooth muscle function. Forskolin, a direct activator of adenylyl cyclase (AC), was used to observe the influences of cAMP. Multi-channel physiological recorder was used to record spontaneous contraction activity of gastric antral circular muscle from Wistar rats. And ELISA method was used to detect the change of cAMP production in perfusate. The results showed that forskolin concentration-dependently suppressed the amplitude and frequency of the spontaneous contraction of the gastric antral muscle, and lowered the baseline of contraction movement significantly. Forskolin concentration-dependently increased the production of cAMP in the perfusate, which showed a significant negative correlation with the contraction amplitude of gastric antral ring muscle. The inhibitory effect of forskolin on spontaneous contraction activity of rat gastric antral circular muscle could be blocked by cAMP-dependent protein kinase (PKA) inhibitor H-89. These results suggest forskolin increases cAMP production and then activates PKA pathway, resulting in the inhibition of the spontaneous contraction activity of rat gastric antral circular smooth muscle.

Transnasal endoscopic repair of cerebrospinal fluid rhinorrhea / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To present the surgical technique and clinical effect of transnasal endoscopic repair of cerebrospinal fluid (CSF) rhinorrhea.</p><p><b>METHODS</b>From 1996 to 2010, 54 patients with CSF rhinorrhea were treated with intranasal endoscopic surgery, including 25 patients with traumatic CSF rhinorrhea, 17 patients with spontaneous CSF rhinorrhea, and 12 patients with iatrogenic CSF rhinorrhea. The temporalis muscle, temporalis fascial, middle turbinate mucosa, nasal septum mucosa, inferior turbinate mucosa, fascia lata, leg muscle, abdominal fat, uncinate process mucosa and sinus mucosa were used to repair the fistulae.</p><p><b>RESULTS</b>Forty-nine patients were successfully treated after the first operation, 1 after the second attempt, 1 after the third attempt, and 1 was successfully treated at the second operation in other hospital, 1 stopped therapy after an unsuccessful repairing. One patient recurred within one and a half years after operation and stopped therapy. Seven patients developed complications after the operation (high fever in 4, high fever and transient mild coma in 1, epilepsy in 1, pneumocephalus in 1) and were cured afterwards.</p><p><b>CONCLUSIONS</b>Transnasal endoscopic surgery is safe, effective and microinvasive treatment for patients with CSF rhinorrhea, it is the first choice for repairing of CSF rhinorrhea for its high successful rate. Accurate leakage site identification, selection of suitable approach and repairing method are critical to the success of operation.</p>

Safety and efficacy of three-dimensional conformal radiotherapy combined with temozolomide in treatment of diffuse brainstem gliomas / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the safety and efficacy of three-dimensional conformal radiotherapy in combination with temozolomide in treatment of patients with diffuse brainstem glioma.</p><p><b>METHODS</b>Twelve patients with MRI-confirmed diffuse brainstem glioma received 54 Gy three-dimensional conformal radiotherapy for 6 weeks with 1.8 Gy per fraction, 5 times per week. All of the patients were given daily oral temozolomide 75 mg/m(2) during radiotherapy. Four weeks after radiotherapy, all of the patients received 6 cycles of temozolomide, each cycle lasted 5 days with 28 days interval between each two cycles. 150 mg/m(2) of temozolomide was given for the first cycle for five days, followed by 200 mg/m(2) of the drug for the rest of the cycles if no significant drug-related toxicities were observed. Magnetic resonance imaging and laboratory tests were performed to evaluate the efficacy and adverse reactions.</p><p><b>RESULTS</b>In the 12 patients, CR was 1 case (8.3%), PR 6 cases (50.0%), SD 2 cases (16.7%), and PD 3 cases (25.0%). The overall clinical benefit rate was 75.0%. Progression-free survival rate was 75.0% (9/12) at 6 months and 50.0% (6/12) at 1 year. The one-year overall survival rate was 75.0%. There were no severe temozolomide-related toxicities.</p><p><b>CONCLUSIONS</b>Concurrent temozolomide with three-dimensional conformal radiotherapy and followed by 6 cycles of temozolomide chemotherapy for diffuse brainstem gliomas have a better clinical efficacy, good tolerance and with no severe toxicities.</p>

Knowledge and attitude of clinicians to pediatric obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the knowledge and attitude of clinicians in the departments of pediatrics and otolaryngology to pediatric obstructive sleep apnea hypopnea syndrome (OSAHS), since in China, the clinicians in these two departments had closest relationship with the diagnosis and treatment of OSAHS in children.</p><p><b>METHODS</b>A validated questionnaire from USA which was the obstructive sleep apnea knowledge and attitudes questionnaire in children (OSAKA-KIDS) was used and permission by original author. The questionnaire was mailed to ENT doctors and pediatricians in 43 public hospitals in Shandong province.</p><p><b>RESULTS</b>OSA-KIDS in Chinese version was re-tested by 30 physicians, r = 0.92. Totally, 391 valid questionnaires (87.7%) were returned. Average of correct rate (x(-) ± s) in 18 knowledge items was 64.1% ± 19.1%. Cronbach's α coefficient was 0.76. There was no difference between ENT doctors and pediatrics in total knowledge score. However, there was significant difference in below 2 questions: ENT doctors had more correction in answer "nearly 2% of children have OSAHS" and pediatrics had more correction in answer "pediatric OSAHS may be associated with pulmonary hypertension". Only 24.3% clinicians correctly know the degree of snoring (mild to severe) was not correlated with the severity of obstructive apnea in children. Only 16.1% could correctly answer the question about cardio-respiratory monitor could not reliably detect both central and obstructive apnea in infant. Cronbach's α coefficient was 0.72 in 5 items which was about importance of disease and self-evaluation in confidence. While more than 90% clinicians stated that "As a clinical disorder OSAHS is important or very, extremely important". However, among them, only about 36% felt confident in identifying or managing children with OSAHS. Total knowledge score about OSAHS was not different by gender or specialty (P > 0.05), but more knowledge was associated with more positive attitudes overall (P < 0.05) and more elder in age or longer years in practice (r = 0.384, P < 0.0001).</p><p><b>CONCLUSIONS</b>It should be paid more effort to elevate the knowledge and attitude about pediatric OSAHS in pediatricians and otolaryngologists.</p>

An analysis of the cause and countermeasure of death of patients with severe obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To discuss the causes and countermeasures of death of severe obstructive sleep apnea hypopnea syndrome (OSAHS) patients undergoing tests or treatment.</p><p><b>METHODS</b>A retrospective study of the data of six patients with severe OSAHS who died undergoing tests or treatment in 6 hospitals was conducted.</p><p><b>RESULTS</b>Among the 6 patients, overly fat were found in 2 cases, hypertension in 2 cases, cardiac diseases in 2 cases, abnormal pulmonary function or chest X-ray in 2 cases, diabetes in 2 cases, while 2 cases had no above positive finding. Three patients did not have polysomnography (PSG). One patient died during PSG test. Two patients' apnea hypopnea index (AHI) were 56 times/h and 82 times/h respectively. The causes of death were as follows, two patients died of airway obstruction and unsuccessful tracheal intubation before uvulopalatopharyngoplasty (UPPP) operation. One died of encephaledema in long-term coma due to airway obstruction, long time poor oxygenation and unsuccessful tracheal intubation with muscle relaxants before hemostasis procedure for treating postoperative hemorrhage. One patient whose preoperative pulmonary function showed increased airway resistance died of cardiac and respiratory arrest after tracheal extubation when UPPP surgery finished. One who was found to have potential cardiac and pulmonary disorder died of cardiac arrest when doctors were replacing his tracheal intubation with a cannula, before the tube replacing procedure the patient was conscious. One who had hypertension, coronary heart disease, diabetes mellitus and adiposis suffering from respiratory acidosis with his electrocardiogram showing a level-three heart function died of cardiac arrest with repeated apnea during PSG monitoring.</p><p><b>CONCLUSIONS</b>OSAHS patients with severe complications should be treated extremely carefully. The indication of surgery should be strictly observed. OSAHS patients can not undergo surgery until their cardiopulmonary functions and general conditions are improved.</p>

Obstructive sleep apnea hypopnea syndrome: surgical complications and strategy for avoidance / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the surgical complications in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and discuss the risk factors and preliminary strategies for prevention of complications.</p><p><b>METHODS</b>From September 1998 to March 2007, 653 OSAHS patients confirmed by polysomnography were treated by different surgical approaches according to their obstructive sites, which included uvulopalatopharyngoplasty (UPPP) in 586 cases, nasal surgery in 104 cases/times, hyoid suspension surgery in 53 cases/times, respectively or at the same time. Local anesthesia was used in 294 cases and general anesthesia in 359 cases. Two hundreds and seventeen cases were treated by continuous positive airway pressure (CPAP) 3 to 7 days pre-operation and 2 to 3 days post-operation.</p><p><b>RESULTS</b>Perioperative complications were found in 57 OSAHS cases (93 times), the incidence of peri-operative complications was 8.7% (57/653), including respiratory problems in 19 cases/times and 1 death occurred during inducing stage in general anesthesia. Profuse bleeding was encountered in 9 cases/times during operation and primary and secondary bleeding in 27 cases/times, cardiopathy and hypertension crisis in 31 cases/times and cerebral stroke and hemiplegia in 1 case, reactive somnolence in 3 cases/times and reactive hyperglycemia in 3 cases/times. Data were analyzed by the multivariate logistic regression model. The results showed that the complications were significantly reduced after CPAP treatment during peri-operative stage and increased accompanied with patients' hypertension, choice of general anesthesia, BMI and AHI. All patients were followed-up more than 1 year. After UPPP, 23.9% cases (140/586) had sensation of foreign body in pharynx and alleviated in 6 to 12 months. Scar tissues in oropharynx in 7 cases, nasopharyngeal stenosis in 1 case, atrophy rhinitides and atrophy pharyngitis in 3 cases, nasopharyngeal un-closure and long-term nasopharyngeal reflex in 3 cases. Conclusions Peri-operative complications are more common in obese and severe OSAHS patients, especially when they accompanied with hypertension. The corresponding strategies should be taken to reduce complications in OSAHS surgery, which include controlling the hypertension effectively, performing CPAP treatment actively, cooperating with interdisciplinary doctors, monitoring closely after operation. It is important to reduce surgical sequelae through improving surgical skills and not enlarging the surgical scale blindly.</p>

Diagnosis and surgical management of carotid body tumor as well as blood vessel prosthesis' role / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyse the diagnostic and therapeutic aspects of carotid body tumor (CBT).</p><p><b>METHODS</b>Seven patients with CBT had been hospitalized between 2003 and 2006. The clinical data was analyzed retrospectively. The preoperative evaluation included angiography in 7 patients. Most of them had an asymptomatic cervical lateral mass. Only one patient had the hoarseness and buckling and was given radiation therapy alone. Six of seven patients with carotid body tumour underwent surgery. Simple tumor excision was accomplished in 4. Carotid artery resection with the tumor was required in 2 patients and in the both, interposition of a 7 mm polytetrafluoroethylene graft was performed . During the resection, temporary carotid shunt was required in the two patients.</p><p><b>RESULTS</b>All tumors by surgery were identified as carotid paragangliomas without evidence of malignancy. There was no mortality and no hemiplegia. After surgery, temporary cranial nerve dysfunction was noted in one case. In the follow-up period of 2 months to 2 years, no recurrent disease occurred. The patient's tumor who accepted radiotherapy was in the stable stage under the half year follow up, and the follow up would be further continued.</p><p><b>CONCLUSIONS</b>With non-invasive investigation and arteriography it was possible to obtain an early and precise diagnosis. The surgical management was the major treatment of these tumors. The pattern of operation should be chosen according to the relation of tumor and carotid. The decision to perform simple tumor excision or additional arterial resection was based on diagnostic preoperative and after the arterial resection the polytetrafluoroethylene graft would be used for carotid reconstruction.</p>

Serum excitatory amino acids concentrations in patients with amnestic mild cognitive impairment or Alzheimer's disease / 中华神经科杂志

Objective To figure out changes of serum excitatory amino acids (EAAs) levels in patients with amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD).Methods The levels of serum EAAs was assessed in 34 cognitively normal control subjects,30 patients with aMCI,and 32 patients with AD using high performance liquid chromatography (HPLC).Results ①Higher serum concentrations of glutamate((39.6?22.1) ?mol/L),alanine((282.5?71.3) ?mol/L) were found in the aMCI patients (P=0.044,P=0.007),and higher serum concentrations of glutamate ((42.2?21.8) ?mol/L),glycine ((464.2?142.6) ?moL/L) were found in the AD patients than in the control subjects (P=0.010,P=0.010).②No statistically significant difference of EAAs level between the aMCI and AD groups was found.③A close and positive correlation between the serum concentrations of glutamate, aspartate and the mini-mental status examination scores were found in AD patients:the 2 amino acid levels were higher in patients with mild dementia((42.1?21.3),(55.0?29.0) ?mol/L) than those with moderate or severe dementia ((25.4?9.2) ?mol/L,P=0.023;(34.6?11.1) ?mol/L,P=0.036). Conclusion EAAs,correlating with the severity of the condition,play a significant role in AD,while aMCI patients also have disturbance of metabolism of EAAs,indicating that it has similar pathogenesis to AD.

Primary evaluation of the indications of uvulopalatopharyngoplasty / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the indications of uvulopalatopharyngoplasty (UPPP) and clinical staging for oropharyngeal narrow in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).</p><p><b>METHOD</b>Sixty-six OSAHS patients were retrospectively analyzed, the data of physical examination and clinical staging for oropharyngeal narrow were built based on body mass index (BMI), palate-tongue position, tonsil sizes and hypertrophy degree in lateral side of oropharynx. The patients who had palatine-tongue position in degree 1 to 2 (no significant tongue enlargement) were defined as stage I (32 cases). The patients who had palatine-tongue position in degree 3 to 4 (tongue enlargement) were defined as stage II (34 cases). Among them, the patients with tonsil sizes 0 to 1 were stage I a (5 cases) and stage IIa (10 cases), another group with tonsil size 2 to 4 were stage I b (27 cases) and stage II b (24 cases), respectively. The indications of UPPP were evaluated according to the results of polysomnography (PSG) before and after operation.</p><p><b>RESULTS</b>PSG in 1 to 2 years after operation showed: the surgical efficiency of UPPP had not any difference (P > 0.05) among different groups with the severity of OSAHS(labeled in preoperational AHI and LSaO2). Surgical results was better in patients with BMI < 30 kg/m2 (P = 0.023). Success of operation was defined as postoperational AHI <20/h and reduced more than 50% compared to preoperational AHI and symptoms alleviated significantly. Successful rates of UPPP in stage I b (70.4%, 19/27 cases) were statistically higher than that of other groups (I a:0%; I b:70. 4%; II a:20.0%; II b: 16.7%).</p><p><b>CONCLUSIONS</b>Clinical staging system for oropharyngeal narrow is based on palate-tongue position and tonsil size. It is helpful to choose the surgical indications of UPPP for patients with OSAHS. It is the best UPPP indication for stage I b patients who had no tongue enlargement (palatine-tongue position 1 to 2) and accompanied with enlargement of tonsil size (in degree 2 to 4) and their sleep breathing disorder could be alleviated through UPPP.</p>

Quality of life survey in children with obstructive sleep apnea hypopnea syndrome before and after operation / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the influence of OSAHS in quality of life (QOL) for children and its changes before and after surgery.</p><p><b>METHODS</b>Pediatric OSAHS disease-specific quality of life survey (OSA-18) and polysomnography (PSG) were used to analysis in 54 cases within 4 weeks before surgery. They were treated by tonsillectomy in 8 cases and adenoid tonsillectomy in 32 cases, adenoidectomy alone in 14 cases and were followed up in 12 to 18 months post-operation.</p><p><b>RESULTS</b>The impact of pediatric OSAHS on QOL was severe in 61.11% patients. There were significant statistically correlation between OSA-18 and AHI, LSaO2 before surgery. After surgery, the total scores of QOL were improved in 75.92% cases in general. The domains of sleep disturbance in 88.89% cases, caregiver concerns in 74.07% and physical suffering in 70.37% were significantly improved, respectively.</p><p><b>CONCLUSIONS</b>Pediatric OSAHS had severely influenced in quality of life of children. There are significant correlations between the survey in quality of life of pediatric OSAHS (OSA-18) and the objective data in PSG. OSA-18 can be a valuable measure in clinical diagnosis and treatment follow-up.</p>

Purification and immobilization of chondroitinase from Aeromonas sobria YH 311 / 生物工程学报

Chondroitinase has been used as an important tool in the study of the structure, function and distribution of glycosaminoglycans for many years. Recently, the enzyme has been reported to be a potential enzyme for chemonucleolysis, an established treatment for intervertebral disc protrasion. In this paper, a chondroitinase had been purified from the culture supernatant of Aeromonas sobria YH311 using a simple purification procedure of ammonium sulfate precipitation, QAE-Sephadex A50 ion exchange chromatography and Sephadex G-150 gel filtration. The immobilization of purified chondroitinase using sodium alginate or cellulose as carriers has also been studied. The chondroitinase obtained from Aeromonas sobria YH311 was purified 55-fold to 95.3% pure, the specific activity of the purified enzyme was 31.86u/mg and the yield was 37%. The molecular weight of chondroitinase from Aeromonas sobria YH311 was determined by SDS-PAGE to be 80kD, which was almost the same as those chondroitinase AC from Arthrobacter aurescens, Aeromonas liquefaciens and Flavobacterium heparinum. But its isoelectric point was 4.3 - 4.6, which was far lower than the microbial chondroitinase AC. After the immobilization on sodium alginate or cellulose, the properties of chondroitinase changed greatly. The optimum temperature and pH of the free enzyme were 50 degrees C and 7.0 respectively, and about 10% activity remained after heat treatment at 80 degrees C for 20 minutes, and 47% activity remained after two weeks storage at 4 degrees C. The chondroitinase immobilized on sodium alginate had the optimum temperature and pH of 40 degrees C and 7.0 respectively, about 50% activity remained after 80 degrees C heat treatment for 120 minutes and 50% remained after 30 days storage at 4 degrees C. The chondroitinase immobilized on cellulose had the optimum temperature and pH of 70 degrees C and 6.0 respectively, and more than 70% activity remained after heat treatment at 80 degrees C and 30 days storage at 4 degrees C. The yield of the immobilization was very low, with 18.56% for alginate and 18.86% for cellulose.