Rapid eye movement-related and none rapid eye movement-related classification in obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the value of a new measurement that divided obstructive sleep apnea-hypopnea syndrome (OSAHS) into rapid-eye-movement (REM) related and non-rapid-eye-movement (NREM) related subgroups.</p><p><b>METHODS</b>According to Siddiqui classification, 137 adult patients with OSHAS were diagnosed as REM-related OSAHS [REM apnea hypopnea index (AHI)/NREM AHI > 1] or NREM-related OSAHS (REM AHI/NREM AHI < 1). Polysomnographic data were compared and discussed.</p><p><b>RESULTS</b>(1) There were 72 cases defined as REM-related OSAHS (52.6%) and 65 cases defined as NREM-related OSAHS (47.4%). (2) In all cases, total AHI and NREM AHI in REM-related OSAHS were significantly lower than those in NREM-related OSAHS, while lowest arterial oxygen saturation (LSaO₂), REM LSaO₂ and NREM LSaO₂ were significantly higher than those in NREM-related OSAHS (t were -6.466, -7.638, 3.426, 2.472, 4.873 respectively, P < 0.05). No significance was found in sleep structure, REM AHI and REM LSaO₂ between REM-related and NREM-related OSAHS (P > 0.05). (3) Given the severity of OSHAS, the constituent ratio of REM-related OSAHS decreased (77.8%, 61.5%, 37.3%) from mild to severe OSAHS, while that of NREM-related OSAHS rose (22.7%, 38.5%, 62.7%; chi² = 16.996, P < 0.01). In mild and moderate groups, REM LSaO₂ of REM-related OSAHS was significantly lower than those in NREM-related OSAHS (t were -4.273 and -2.136, P < 0.05), while the differences of total AHI and LSaO₂, NREM LSaO₂ between these two types were not significant. In severe group, AHI in NREM-related OSAHS was significantly higher than that in REM-related OSAHS, while LSaO₂, REM LSaO₂ and NREM LSaO₂ was significantly lower than those in REM-related OASHS (t were -4.943, 2.574, 1.996, 3.571, P ≤ 0.05). (4) There was no significance in sleeping latency and efficiency between REM-related and NREM-related OSHAS.</p><p><b>CONCLUSIONS</b>REM-related OSHAS mainly exists in mild and moderate OSHAS, while NREM-related one mainly exists in severe OSHAS. NREM-related OSAHS may be more severe in AHI and hypoxia than REM-related one. Whenever obstructive apnea happened in REM or NREM period, its impacts on sleep structure, efficiency and latency have no difference.</p>

DJ-1 expression in laryngeal squamous cell carcinoma and its relationship with tumor recurrence and metastasis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To detect the expression of DJ-1 in laryngeal squamous cell carcinoma (LSCC) and to study the relationship between DJ-1 expression and clinical indexes of LSCC.</p><p><b>METHODS</b>The expressions of DJ-1 protein in 71 LSCC samples and 9 cases control samples from laryngeal mucosa tissues of non-LSCC patients were detected using streptavidin peroxidase immunohistochemistry staining and the relationships between DJ-1 protein expression and clinicopathologic characteristics were analyzed.</p><p><b>RESULTS</b>(1) The positive expression rate of DJ-1 protein in LSCC was 85.9%(61/71), which was significantly higher than the rate (55.5%, 5/9) in control laryngeal mucosa tissues (P < 0.05). (2) DJ-1 expression was related to tumor recurrence (P < 0.05), but not to sex, age, primary cancer position, T stage, clinical stage, lymph node metastasis and tumor differentiation. Tumor recurrence rate (53.3%) in the patients with higher expression of DJ-1 protein was higher than the rate (26.8%) in the patients with lower expression of DJ-1 protein (χ(2) = 5.164, P < 0.05). (3) With Kaplan-Meier curves and Cox regression analysis, the cumulative 5-year survival rates were correlated with DJ-1 expression levels in laryngeal cancer tissues or cervical lymph node metastasis (all P < 0.05), but not to sex, age, primary cancer position, T stage, clinical stage and tumor differentiation.</p><p><b>CONCLUSIONS</b>The expression of DJ-1 protein in LSCC is higher than that in control laryngeal mucous tissues. Overexpression of DJ-1 is associated with poor overall survival in LSCC patients.</p>

Analysis of relevant factors causing laryngeal stenosis after partial laryngectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical relevant factors causing laryngeal stenosis after partial laryngectomy.</p><p><b>METHODS</b>A retrospective study was carried out to review the history clinical data from 138 patients of partial laryngectomy in the First Affiliated Hospital of Sun Yat-Sen University between January 1994 to October 2004. The clinical relevant factors causing laryngeal stenosis were included as follows: age, sex, TNM stage, tumor site, extension of thyroid cartilage defect, extension of larynx parenchyma defect, reconstruction method, laryngeal dilator, duration of using antibiotics, postoperative radiotherapy, lung infection, gastroesophageal reflux, diabetes. Multivariate stepwise logistic regression model was used for the analysis.</p><p><b>RESULTS</b>Of 138 cases after partial laryngectomy, stenosis developed in 25 cases. The occurrence rate was 18.1%. In multivariate analysis, it was confirmed that the following factors correlated to laryngeal stenosis, i. e, extension of thyroid cartilage defect (chi2 = 4.323, P = 0.038), postoperative radiotherapy (chi2 = 6.002, P = 0.014), lung infection (chi2 = 4.220, P = 0.040), and gastroesophageal reflux (chi2 = 5.614, P = 0.018).</p><p><b>CONCLUSIONS</b>The clinical relevant factors causing laryngeal stenosis after partial laryngectomy were multiple. Statistical analysis showed that extension of thyroid cartilage defect, postoperative radiotherapy, lung infection and gastroesophageal reflux were the risk factors which may cause laryngeal stenosis.</p>