Study on the time-point distribution characteristics of the occurrence of laryngopharyngeal reflux / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the characteristics of the time-point distribution of the occurrence of laryngopharyngeal reflux (LPR) by 24-hour multichannel intraluminal impedance-pH monitoring (24 h MII-pH) and to provide guidance for the development of individualized anti-reflux strategies for LPR patients. Methods: We conducted a retrospective analysis of 24 h MII-pH data from 408 patients [339 males and 69 females, aged 23-84 (55.08±11.08) years] attending the Department of Otorhinolaryngology Head and Neck Surgery at the Sixth Medical Center of the PLA General Hospital from January 2013 to March 2020. The number of gas acid/weak-acid reflux, mixed gas-liquid acid/weak-acid reflux, liquid acid/weak-acid reflux and alkaline reflux events at different time points were recorded and statistically analyzed through SPSS 26.0 software. Results: A total of 408 patients were included. Based on the 24 h MII-pH, the total positive rate of LPR was 77.45% (316/408). The type of positive gaseous weak-acid reflux was significantly higher than the remaining types of LPR (χ2=297.12,P<0.001). Except the gaseous weak-acid reflux, the occurrence of the remaining types of LPR showed a tendency to increase after meals, especially after dinner. Liquid acid reflux events occurred mainly between after dinner and the following morning, and 47.11% (57/121) of them occurred within 3 h after dinner. There was a significant positive association between Reflux Symptom Index scores and gaseous weak-acid reflux(r=0.127,P<0.01), liquid acid reflux(r=0.205,P<0.01) and liquid weak-acid reflux(r=0.103,P<0.05)events. Conclusions: With the exception of gaseous weak-acid reflux events, the occurrence of the remaining types of LPR events has a tendency to increase after meals, especially after dinner. Gaseous weak-acid reflux events accounts for the largest proportion of all types of LPR events, but the pathogenic mechanisms of gaseous weak-acid reflux are needed to further investigate.

Comparison of clinical characteristics of patients with different types of laryngopharyngeal reflux disease / 中华耳鼻咽喉头颈外科杂志

Objective: To compare the clinical characteristics of patients with different type of laryngopharyngeal reflux disease in order to study the effect of non-acid reflux on laryngopharyngeal reflux disease. Methods: From January 2015 to January 2020, 349 inpatients or outpatients suspected of having laryngopharyngeal reflux underwent 24-hour multichannel intraluminal impedance pH monitoring (MII-pH). There were 303 male and 46 female patients, with an average age of 56.03 years old ranged from 25 to 81 years old. The reflux symptom index (RSI)and reflux findings score(RFS)were recorded before MII-pH monitoring. The number of acid reflux events and non-acid reflux events in hypopharynx were counted. It was defined mainly acid reflux type when the ratio of acid reflux to all reflux events was greater than 50%, mainly non-acid reflux type when the ratio of non-acid reflux to all reflux events was greater than 50%. The clinical characteristics of patients with different type of reflux were compared. SPSS 19.0 software was used for statistical analysis, and multiple independent samples were compared between groups. The quantitative data were analyzed by multivariate analysis of variance, and the counting data were analyzed by chi-square test, the difference was statistically significant when P<0.05. Results: The 24-hour MII-pH showed that there were 90 patients with no reflux events, 51 patients with mainly acid reflux type, 198 patients with mainly non-acid reflux type and 10 patients with equal acid reflux events and non-acid reflux events. Statistics showed that the RSI(10.72±4.40), RFS(7.70±2.73) and the average number of reflux events(0) in the group without reflux events were significantly lower than those in patients with mainly acid reflux type (RSI 13.16±6.62,RFS 10.08±3.03,average number of reflux events 5.33±3.15,P<0.05) and mainly non-acid reflux type(RSI 13.25±5.54,RFS 8.81±2.54,average number of reflux events 7.93±5.26, P<0.05). There was no significant difference in RSI between the mainly non-acid reflux type group and the mainly acid reflux type group, but the RFS of the mainly non-acid reflux type group was significantly lower than that of the mainly acid reflux type group. The average number of reflux events in the mainly non-acid reflux group was significantly higher than that in the mainly acid reflux type group (P<0.05). Conclusion: The results show that non-acid reflux plays a certain role in laryngopharyngeal reflux disease, but the effect of acid reflux is greater.

Effect of parthenolide on proliferation and migration of MCF-7 breast cancer cells by targeting the c-myc G-quadruplex / 药学学报

This research investigated the effect of parthenolide on the proliferation and migration of human breast cancer cells and explored the molecular mechanism of that effect. Surface plasmon resonance and fluorescence resonance energy transfer melting were used to detect the binding and stabilizing ability of PTL and G-quadruplex. MTT assays were used to determine the effect of PTL on the proliferation of MCF-7 breast cancer cells. A wound healing assay was performed to detect the migration of MCF-7. The results indicate that PTL shows good binding and stabilizing activities with c-myc G-quadruplex with a KD = 13.1 μmol·L-1. PTL inhibited the proliferation of MCF-7 cells with an IC50 of 21.3 μmol·L-1 (24 h), 14.5 μmol·L-1 (48 h) and 9.1 μmol·L-1 (72 h). PTL inhibited MCF-7 breast cancer cell proliferation and migration and down-regulated the transcription and expression level of c-myc by targeting G-quadruplex.

Köebner Phenomenon Induced by Striae Distensae in a Vitiligo Patient

No abstract available.

Surface electromyographic study on swallowing in normal adults / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the characteristics of surface electromyography (sEMG) during swallowing in normal adults.</p><p><b>METHODS</b>The sEMG during swallowing was carried out in 126 normal adults. There were 66 males and 60 females with their age ranged from 18 to 65 years. The recording electrodes were placed on the skin above the superior thyroid notch and the duration and amplitude of muscle activities during every deglutition were recorded. Swallowing styles were dry swallow, 20 ml water swallow and 40 ml water swallow.</p><p><b>RESULTS</b>The durations of sEMG at dry swallow, 20 ml water swallow and 40 ml water swallow were (1.133 ± 0.209)s (x¯ ± s), (1.097 ± 0.208)s, and (1.510 ± 0.432)s, while the amplitudes were (0.332 ± 0.115)mV, (0.308 ± 0.095)mV, and (0.399 ± 0.139)mV in normal male group. The durations of sEMG at dry swallow, 20 ml water swallow and 40 ml water swallow were (1.118 ± 0.170)s, (1.085 ± 0.209)s, and (1.765 ± 0.463)s, while the amplitudes were (0.292 ± 0.100)mV, (0.261 ± 0.113)mV, and (0.342 ± 0.129)mV in normal female group. The amplitudes of sEMG in male were higher than those in female (P < 0.05) and the durations had no statistically significant difference between male and female (P > 0.05) in all swallow styles except that the duration of 40 ml water swallow in female was longer than that in male (P < 0.05). In all volunteers, the durations of sEMG at 40 ml water swallow were longer than those at dry swallow and 20 ml water swallow, and there was no statistically significant difference between dry swallow and 20 ml water swallow. The amplitude of sEMG at 40 ml water swallow was higher than that at dry swallow. The amplitude of sEMG in dry swallow was higher than that at 20 ml water swallow. There was no statistically significant difference in durations and amplitudes of sEMG among four different age groups of male. In the female groups, there was no statistically significant difference in durations and amplitudes of sEMG among four different age groups except that the duration at 40 ml water swallow was longer in younger group (<30 years old) than in older groups.</p><p><b>CONCLUSIONS</b>Surface EMG of swallowing is a simple and noninvasive method for evaluating the swallowing function. The sEMG data of swallowing in normal adults obtained in this study may be used to provide reference for screening swallowing function in adults in the future.</p>

Study on the consistency of reflux score evaluated by three different level of throat physicians / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The consistency of reflux finding score (RFS) was studied by three different level of throat physicians.</p><p><b>METHODS</b>One hundred and ten laryngeal photos were chosen to assess the RFS test-retest reliability on two separate occasions at least more than one week.</p><p><b>RESULTS</b>The mean total RFS scores for doctor A were 9.05 ± 2.54, doctor B were 8.80 ± 2.20, doctor C were 8.98 ± 2.21 at the initial screening, and 9.20 ± 2.47, 9.03 ± 2.14 and 8.91 ± 2.30 respectively at the repeat evaluation. The test-retest reliability of total RFS scores of three doctors were 0.860, 0.800 and 0.837 respectively, P all <0.001. The test-retest reliability of each item scores for doctor A were from 0.662 to 1.000, doctor B were from 0.486 to 1.000 and doctor C were from 0.613 to 1.000. There were no differences in the total RFS scores comparing among each evaluation of the three doctors (χ(2) = 1.553, P = 0.907). Total RFS scores more than 7 were considered as abnormal. The interobsever consistency was as follows: A with B was 83.6% (κ = 0.617, P = 0.000), A with C was 85.5% (κ = 0.644, P = 0.000),B with C was 89.1% (κ = 0.720, P = 0.000). The intraobserver consistency was 91.8% (κ = 0.807, P = 0.000), 81.8% (κ = 0.534, P = 0.000), 90.9% (κ = 0.741, P = 0.000) respectively.</p><p><b>CONCLUSIONS</b>The result of this study shows that the assessment of RFS is not influenced by different educational backgrounds and clinical experience.RFS can be applied widely in China.</p>

Relationship between obstructive sleep apnea-hypopnea syndrome and hypertension / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and hypertension.</p><p><b>METHODS</b>There were 1149 middle aged patients who were suspected to have OSAHS underwent polysomnography (PSG) from Jan, 1999 to June, 2011. The age of the patients ranged from 45 to 65 years. The patients were divided into 10 groups according to sleep apnea hypopnea index (AHI), group 1: AHI < 5; group 2: 5 ≤ AHI < 15; group 3: 15 ≤ AHI < 30; group 4: 30 ≤ AHI < 40; group 5: 40 ≤ AHI < 50; group 6: 50 ≤ AHI < 60; group 7: 60 ≤ AHI < 70; group 8: 70 ≤ AHI < 80; group 9: 80 ≤ AHI < 90; group 10: AHI ≥ 90. The incidence of hypertension in each group was tested using crosstabs method. The correlation between AHI, lowest oxygen saturation (LSaO2), age, body mass index (BMI) and hypertension were analyzed.</p><p><b>RESULTS</b>Among 1149 suspected OSAHS patients, 1004 were diagnosed as OSAHS by PSG. There were positive correlation between AHI and diastolic, systolic blood pressure (r were 0.239 and 0.305, respectively, P < 0.01). AHI was independent risk factor of hypertension (P < 0.001). No statistically significant difference in the incidence of hypertension was found among group 1 and group 2, 3, group 4 and group 5, group 6 to group 10 (χ(2) were 3.821, 0.005 and 1.325, P > 0.05, respectively). There was significant difference in the incidence of hypertension among group 4 and group 1, 2, 3, group 5 and group 6 (χ(2) were 2.615 and 4.300, P < 0.05, respectively). There were two cutoff points at the AHI of 30 and 50.</p><p><b>CONCLUSION</b>With OSAHS exacerbations, the incidence of hypertension was significantly increased.</p>

Habituation of seasickness in adult during a long voyage / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the habituation of seasickness in non marine subjects during a long voyage.</p><p><b>METHODS</b>A crew of 106 staffs of the Hospital Ship Ark Peace was included in this study. There were 59 male and 47 female with an age ranged from 23 to 53 years (mean 37.2 years). They all took part in the Mission Harmony 2011 for medical service in four countries around the Caribbean Sea. Questionnaires and visual analogue scales (VAS) were used to investigate the prevalence and degree of the seasickness in different periods.</p><p><b>RESULTS</b>The prevalence of seasickness was 72.64% in the initial period of voyage. The prevalence and degree of seasickness in female and in staff with motion sickness history were higher and more severe than that in male and in staff without motion sickness history(P < 0.05). After two weeks, the prevalence and degree of seasickness decreased, which meant habituation of seasickness occurred. With the voyage going longer, the prevalence and degree of seasickness were further decreased, but the severe sea condition make the prevalence and degree of seasickness worse. The rate of habituation of seasickness was 62.33%, and the habituation rate of seasickness in male (76.92%) was higher than that in female (47.37%) (χ(2) = 7.161, P = 0.007).</p><p><b>CONCLUSIONS</b>The habituation of the seasickness occurred after two weeks in a long voyage. Male are easier to get habituation of seasickness than female. The severe sea condition influences the prevalence and degree of seasickness.</p>

Measurement of objective parameters associated with pharyngeal swallowing function in Chinese adults / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To obtain a series of objective criteria associated with pharyngeal swallowing function using dynamic swallow study in Chinese adults.</p><p><b>METHODS</b>Dynamic videofluoroscopic swallow studies were performed on 80 normal adult volunteers. There were 40 males and 40 females aged from 20 to 60 years old. Measurement software Avidemux 2.5 and Image J were used to measure the objective parameters which were closely related to the pharyngeal swallowing function in the swallowing process, such as maximum displacement of the hyoid bone (HmaxD), pharyngeal transit time (PTT), pharyngeal constriction ratio(PCR), and maximum opening of the esophageal entrance (EEmax).</p><p><b>RESULTS</b>In the 80 adults, the HmaxD, PTT, PCR, and EEmax were (1.91 ± 0.48) cm (x(-) ± s), (0.82 ± 0.15) s, 94.9% ± 3.41%, and (0.91 ± 0.05) cm respectively. The HmaxD of the male (2.04 ± 0.46) cm was significantly larger than that of the female (1.78 ± 0.47) cm (t = 2.44, P = 0.017), but the PTT, PCR, and EEmax had no significant difference between different gender and age groups (P > 0.05).</p><p><b>CONCLUSIONS</b>Objective parameters of the HmaxD, PTT, PCR, and EEmax during swallowing are obtained in Chinese adults. These data are important for assessment of the swallow function and these data provide a foundation for further research on assessment of swallowing function in Chinese.</p>

Chinese version of the reflux symptom index was evaluated for reliability and validity / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To discuss the Chinese version of reflux symptom index (RSI) scale's reliability, validity and clinical value.</p><p><b>METHODS</b>Using the Chinese version of RSI scale on the ENT outpatients. There are one hundred and seven patients, included thirty-five patients with common throat (non-suspected) and seventy-two patients with clinically suspected throat reflux. 107 patients are to complete the two scales before and after one week. Thirteen patients with common throat(non-suspected) diseases and forty-one with suspected throat reflux also received RSI testing. Among the thirty-four confirmed acid reflux disease patients, thirty patients received pharmaceutical treatments and self-performed post-RSI testing after three months.</p><p><b>RESULTS</b>The RSI Scale internal reliability consistency included the test-retest reliability (0.750 - 0.971), discriminant validity and construct validity. RSI total targeting percentage of 66.7%, targeting percentage is 80.8%, discriminant validity using 2 independent samples Wilcoxon test, RSI total score compared to Z = -3.266, P = 0.001. The before and after treatment self-control chi-square test (P < 0.05), difference was statistically significant.</p><p><b>CONCLUSIONS</b>RSI Simplified Chinese version has good reliability and validity, and can be used for laryngopharyngeal reflux disease (LPRD) diagnostic screening along with the efficacy for the treatment of patients with appropriate LPRD aids.</p>

Morphology of cricopharyngeal muscle under suspension laryngeal endoscope / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the morphologic features of cricopharyngeal muscle (CPM) under suspension laryngeal endoscope.</p><p><b>METHODS</b>This prospective study was conducted on a series of 100 consecutive patients who undergone endoscopic microlaryngeal surgery with intubation general anesthesia. The suspension laryngoscope was introduced down to postcricoid area approaching esophageal inlet. By lifting the larynx with the laryngoscope, the mucosa-covered cricopharyngeal muscle was easily identified as the mound of tissue just at the posterior pharyngeal wall. The image of cricopharyngeal muscle under the laryngoscope was saved.</p><p><b>RESULTS</b>In 94 out of 100 patients, CPM could be visualized with laryngoscope. In the other 6 patients, both CPM and glottic could not be exposed because of cervical vertebra stiffness and obesity. According to the image of CPM under the laryngoscope, the shape of the CPM was divided into three types. It was named for flat type in which there was no mound of tissue visible at the posterior pharyngeal wall and esophageal cavity could be visible completely, semi-bar type in which there was a bar at the posterior pharyngeal wall and partial esophageal cavity could be visible and full-bar type in which the bar contact esophageal anterior wall and esophageal cavity could not be visible. There were 14(14.9%) patients as flat type, 59(62.8%) as semi-bar type and 21(22.3%) as full-bar type. No significant difference was found between adults group and the aged (≥ 65 years old) group (χ(2) = 1.224, P = 0.747) and reflux associated group and non-reflux associated group respectively (χ(2) = 5.252, P = 0.072).</p><p><b>CONCLUSIONS</b>The CPM could be well exposed in most of the patients with suspension laryngeal endoscope. It provides anatomy basis for endoscopic cricopharyngeal myotomy.</p>

Effects of laparoscopic radical resection of mid-low rectal cancer on sexual and urinary functions of male patients / 中华消化外科杂志

Objective To evaluate the effects of laparoscopic radical resection of mid-low rectal cancer on sexual and urinary functions of male patients. Methods The clinical data of 150 patients with mid-low rectal cancer who were admitted to the PLA General Hospital from May 2006 to March 2009 were retrospectively analyzed. Sixty-eight patients were allocated to laparoscopic group and 82 to open group. The incidences of erectile and ejaculatory dysfunction and the short- and long-term urinary dysfunction of patients in the 2 groups were compared seperately at 6 and 12 months after the operation. All data were analyzed using the chi-square test. Results The incidences of erectile and ejaculation dysfunction at 6 months after operation, incidence of ejaculation dysfunction at 12 months after operation, and long-term urinary dysfunction were 15% (10/68), 16% (11/68), 10% (7/68) and 0 in the laparoscopic group, and 22% (18/82), 23% (19/82), 21% (17/82) and 2% (2/82) in the open group, respectively, no significant difference between the two groups was found (x2 = 1. 285, 1. 137, 3. 013, 1.681, P>0. 05). The incidences of erectile dysfunction at 12 months after operation and short-term urinary dysfunction were 7% (5/68) and 4% (3/68) in the laparoscopic group, and 17% (14/82) and 20% (16/82) in the open group, respectively, a significant difference between the two groups was observed (x = 4. 565, 5.930, P <0.05). Conclusion Laparoscopic radical resection of mid-low rectal cancer can reduce the injury of pelvic autonomic nerve and improve the life quality of patients.

Electronic laryngoscope for transnasal esophageal examination / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the value of electronic laryngoscope for transnasal esophagoscopy.</p><p><b>METHODS</b>The electronic laryngoscope was used for transnasal esophagoscopy in 50 patients from June 2009 to June 2011 in our department. There were 32 males and 18 females with their age ranged from 16-88 years (mean 53.8 years). Before esophagoscopy, 1% ephedrine-dicaine mixture was sprayed into the nasal and pharyngeal cavities for topical anesthesia. The esophagoscopy was used for screening examination in the patients with reflux, globus sensation, dysphagia, head and neck cancer, suspected foreign body, and vocal cord paralysis, etc.</p><p><b>RESULTS</b>The transnasal esophagoscopy with electronic laryngoscope was performed successfully in all the patients. Mild nausea and vomiting occurred in 4 patients, but no patient required to stop the examination. Of the 50 patients, 38 patients (76%) had normal findings and 12 patients (24%) had positive findings of the esophagus. Esophageal cancer was diagnosed in one patient, esophageal foreign body in 2 patients, esophageal injury in one patient, candidal esophagitis in 3 patients, esophagitis in 3 patients, and achalasia of the cardia in 2 patients.</p><p><b>CONCLUSIONS</b>The electronic laryngoscope for transnasal esophagoscopy is an alternative to conventional esophagoscopy, which is useful for screening the esophagus in the patients with reflux, globus, dysphagia, head and neck cancer, and suspected foreign body, etc.</p>

Reliability and validity of the simplified Chinese version of Epworth sleepiness scale / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the reliability and validity of the simplified Chinese version of Epworth sleepiness scale(ESS).</p><p><b>METHODS</b>Five hundred and eighty-five patients with suspected obstructive sleep apnea hypopnea syndrome (OSAHS) and 103 OSAHS patients who underwent operations were included in this study. The ESS was filled before polysomnography (PSG) monitoring under the direction of professional technicians. The patients who underwent operations did both PSG and ESS tests more than 6 months after operation. Fifty-one patients who underwent PSG at our hospital from July to August, 2010 were chosen to assess the ESS test-retest reliability on two separate occasions at least more than one week.</p><p><b>RESULTS</b>The total Cronbach's Alpha of ESS was 0.814. The test-retest reliability of ESS total scores was 0.679 and for each item was from 0.473 to 0.698(P < 0.01). Split-half reliability was 0.817 (P < 0.01). In the analysis of discriminant validity with apnea hypopnea index (AHI), the ESS total scores and each item's scores had significant differences in severity in OSAHS patients and simple snoring patients (P < 0.05), and this was also true in different degrees of lowest saturation of arterial oxygen (LSaO(2)) patients and normal LSaO(2) patients (P < 0.05). The factor analysis of construct validity showed that 4 factors were extracted. The cumulative proportion was 74.270%. The loading was higher than 0.4 among every item. The correlation coefficiency of overall ESS scores and each item's scores was relatively high except the last item. The ESS had low consistency with clinical diagnosis(κ = 0.099, P < 0.01) and the predictive validity was not good (r = 0.138, P < 0.01).As for 103 patients who had operations, the initial assessment of total ESS scores were 15.0[10;20] (M[P(25); P(75)]), and improved to 4[1;6] after operation. The patients who got effective results had significant difference in the total ESS scores before and after operation (Z = -7.528, P < 0.01), so was the patients who got ineffective results (Z = -4.382, P < 0.01) .</p><p><b>CONCLUSIONS</b>The simplified Chinese version of ESS had a good reliability and validity. It can be used to evaluate the chance of dozing in the daytime.</p>

Design of standard voice sample text for subjective auditory perceptual evaluation of voice disorders / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To design a speech voice sample text with all phonemes in Mandarin for subjective auditory perceptual evaluation of voice disorders.</p><p><b>METHODS</b>The principles for design of a speech voice sample text are: The short text should include the 21 initials and 39 finals, this may cover all the phonemes in Mandarin. Also, the short text should have some meanings.</p><p><b>RESULTS</b>A short text was made out. It had 155 Chinese words, and included 21 initials and 38 finals (the final, ê, was not included because it was rarely used in Mandarin). Also, the text covered 17 light tones and one "Erhua". The constituent ratios of the initials and finals presented in this short text were statistically similar as those in Mandarin according to the method of similarity of the sample and population (r = 0.742, P < 0.001 and r = 0.844, P < 0.001, respectively). The constituent ratios of the tones presented in this short text were statistically not similar as those in Mandarin (r = 0.731, P > 0.05).</p><p><b>CONCLUSIONS</b>A speech voice sample text with all phonemes in Mandarin was made out. The constituent ratios of the initials and finals presented in this short text are similar as those in Mandarin. Its value for subjective auditory perceptual evaluation of voice disorders need further study.</p>

Value of Epworth sleepiness scale in assessment the degree of sleep disordered breathing / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the value of Epworth sleepiness scale in assessment of obstructive sleep apnea hypopnea syndrome (OSAHS) severity.</p><p><b>METHODS</b>The polysomnography (PSG) data of 620 suspected OSAHS patients from Jan. 2000 to Dec. 2003 were retrospectively analyzed. There were 556 males and 64 females, and their age ranged from 21 to 79 years (median 45.0 years). Of the all 620 patients, the median of the weight was 82.0 kg ( range 50 to 130 kg), median of height was 172.0 cm (range 147 to 178 cm), median of body mass index was 28.0 (range 18.5 to 42.9), median of apnea-hypopnea index (AHI) was 37.2 (range 0 to 126.1), median of lowest arterial oxygen saturation (LSAT) was 0.75 (range 0.21 to 0.93), median of ESS was 13.0 (range 0 to 24). OSAHS was diagnosed in 513 patients and simple snorer was diagnosed in 107 patients by PSG. All the patients filled in ESS questionnaire in sleep disorder centre before PSG.</p><p><b>RESULTS</b>The correlation coefficients of the ESS and AHI, LSAT was -0.314 and -0.312 respectively (P <0. 05). The median of ESS in severe OSAHS group was higher than that in simple snorer, mild and moderate OSAHS groups (P < 0.001), but no difference was found among the simple snorer, mild and moderate OSAHS groups (P < 0.05). The median of ESS in severe hypoxemia group was higher than that in no, mild and moderate hypoxemia groups (P < 0.001), but no difference was found among no, mild and moderate hypoxemia groups (P > 0.05).</p><p><b>CONCLUSIONS</b>The Epworth sleepiness scale has little value in assessment of OSAHS severity. A new sleepiness scale method which is suitable for Chinese should be made.</p>

Clinical shapes of vocal cord polyps and their pathological features / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the clinical shapes of vocal cord polyps and their pathological features.</p><p><b>METHODS</b>The laryngoscopic photographs of 156 patients with vocal cord polyps were reviewed. All patients received phonomicrosurgery. Eighty eight males and 68 females were included. Their ages ranged from 14 to 76 years (median 43.0 years). The clinical courses of the diseases were 1 to 132 months (median 6.5 months). There were 57 cases with right vocal cord polyps, 61 cases with left vocal cord polyps, 38 cases with bilateral vocal cord polyps. The vocal cord polyps with pedicles were found in 27 cases, without pedicles in 129 cases. The specimens of the vocal cord polyps were fixed in formalin solution and embedded in paraffin. Sections were cut, stained with HE method, and observed under light microscope.</p><p><b>RESULTS</b>The vocal cord polyps were classified into 5 types according to the clinical shapes of vocal cord polyps and their pathological features: edematous type in 70 cases (44.9%), vascular type in 49 cases (31.4%), fibrous type in 15 cases (9.6%), hemorrhagic or thrombotic type in 13 cases (8.3%), and amyloid type in 9 cases (5.8%). The clinical courses among the five types of vocal cord polyps had no statistic significance (P > 0.05).</p><p><b>CONCLUSIONS</b>The classification of the vocal cord polyp according to the clinical shapes of vocal cord polyps has clinical significance for the treatment. Some vocal cord polyps of edematous type, vascular type and hemorrhagic type can be cured with voice therapy. The vocal cord polyps of fibrous type and amyloid type need treatment with phonomicrosurgery. The differentiation diagnosis between amyloid type vocal cord polyps and vocal cord carcinoma should be made.</p>

Interventional effect of oral negative pressure on chronic pharyngitis and its influence on nail fold microcirculation / 中国组织工程研究

BACKGROUND: Microcirculation disturbance of pharynx may be one of the pathogenesis base caused recurrent attacks of chronic pharyngitis. The negative pressure can improve the microcirculation of inflammary target organs by biomechanical changes.OBJECTIVE: To explore the therapeutic effect of oral negative pressure on patients with chronic pharyngitis and nail fold microcirculation.DESIGN: A randomized single blind controlled observation.SETTING: Department of Pathophysiology of Hebei North University.PARTICIPANTS: A total of 65 patients with chronic pharyngitis and course of disease about 1-3 years admitted to Department of Neurology,First affiliated Hospital of Hebei North University from January to September 2002 were selected. They were randomly divided into treatment group (n=35) and control group (n=30), including 36 cases with chronic pharyngitis (18 cases from the treatment group, 18 cases from the control group), 29with chronic hypertrophied pharyngitis (17 cases from the treatment group,12 cases from the control group).METHODS: The Hices oral negative pressure instrument was used and the negative pressure exert equipment was put into the optimal position of the patients' mouth to keep the negative pressure of (0.05±0.01) Mpa, 10minutes once (the first therapy time was 5 minutes), once daily and the time was fixed, 5 days as a period of therapy for three periods. Patients in the control group were also given the negative pressure exerts equipment,but no negative pressure was exerted.MAIN OUTCOME MEASURES: ① Observation and evaluation of nail fold microcirculation: The nail fold microcirculation was observed by the XTL- Ⅱ microcirculation micro-television system, and the first row nail fold of the left ring figure was checked conventionally to record the state of microvessel, state of micro-bloodstream and peri-loop. The degree of microcirculatory disturbance was quantitatively analyzed according to Tian Niu's weighing integral method, the lower the scores, the better the microcirculation. ②The improvement of chronic pharyngitis after treatment of 3courses.RESULTS: Totally 65 patients with chronic pharyngitis entered the stage of result analysis. ①After 1 course of treatment, the symptoms of 1/3 of the patients in the treatment group were significantly improved; after 3 courses of treatment, except there was no obvious changes of hypertrophied morphology such as lymphatic follicle proliferation on posterior wall of throat and hypertrophy on side cable of throat, the pathological signs and prevalence of mucosa congestion were obviously lower than those before treatment and the control group (P ＜ 0.05-0.01) effective rate was 88.6%.②) Improvement of microcirculation disturbance with chronic pharyngitis was evident, restoring to basically normal from medium degree abnormality before treatment, the total score values reduced to 1.941 ±0.165 from 4.836±0.242 (P ＜ 0.01).CONCLUSION: Oral negative pressure can significantly release or eliminate the symptoms and signs of chronic pharyngitis, which may relate to improvement of microcirculation disturbance.

Varices of the vocal cord: report of 21 cases / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the diagnosis and treatment of varices of the vocal cord.</p><p><b>METHODS</b>The clinical data of 21 cases with varix of vocal cord were analyzed. All the patients presented hoarseness. There were 15 female and 6 male cases with their ages ranged from 23 to 68 years (median 44 years old). The varix was found on the right vocal cord in 12 cases, on the left vocal cord in 9 cases. Isolated varix existed on the vocal cord in 10 cases, varix with vocal cord polyps or nodules in 10 cases, varix with vocal cord paralysis in 1 case.</p><p><b>RESULTS</b>All the patients were diagnosed under the laryngovideoscopy. The lesions appeared on the superior surface of the vocal cord. Varices manifested as abnormally dilated capillary running in the anterior to posterior direction in 6 cases, as clusters of capillary in 3 cases, as a dot or small sheet or short line of capillary in 12 cases. The varices were disappeared in 2 of 8 cases with vocal cord varices and polyps after removed the polyps. The varices of others patients had no change after following up for more than 6 months, but one patient happened hemorrhage of the contralateral vocal cord.</p><p><b>CONCLUSIONS</b>Varices are most commonly seen in female. Laryngovideoscopy is the key in determining the vocal fold varices. Management of patients with a varix includes medical therapy, speech therapy, and occasionally surgical vaporization.</p>

Alpha-galactosidase A gene mutation in a Chinese family with Fabry disease mimicking clinical features of hypertrophic cardiomyopathy / 中华心血管病杂志

<p><b>OBJECTIVE</b>To screen gene mutation in alpha-galactosidase A (alpha-Gal A) in a nonconsanguineous Chinese family with Fabry disease (FD) with clinical manifestations similar to hypertrophic cardiomyopathy (HCM).</p><p><b>METHODS</b>Mutation analysis was performed by using purified PCR products to direct sequence analysis on an ABI-377XL automated DNA sequencer. DNA analysis of alpha-Gal A gene and physical and clinical examinations were performed in a female proband and in her relatives (15 subjects in total).</p><p><b>RESULTS</b>Three hemizygotes and 6 heterozygotes were diagnosed for FD by the alpha-Gal A gene analysis with a missense mutation in exon 5 of the alpha-Gal A sequence, leading to a TGG32TGA substitution, which may induce the absent of tryptophan's translation (corresponded to TGG) by the terminator codon TGA. Six patients in the family were revealed as HCM by echocardiography.</p><p><b>CONCLUSIONS</b>Present results show that it is important to differentiate FD from other causes of hypertrophy in patients with cardiac hypertrophy. Screening for alpha-Gal A gene mutations in patients with FD and in their relatives could help to identify all suspected cases within the families.</p>