Study on upper airway structure of children with obstructive sleep apnea hypopnea syndrome using electronic pharyngorhinoscopy / 中国医师进修杂志

Objective To study the upper airway structure characteristics of children with obstructive sleep apnea hypopnea syndrome (OSAHS) using electronic pharyngorhinoscopy.Methods Seventy-eight children with OSAHS (34 cases mild group,44 cases moderate and severe group) and 52 children with chronic pharyngitis in the same period (control group) were selected.Each group was examined by electronic pharyngorhinoscopy.The adenoid-nasopharynx ratio (ANR),degree of palatopharyngeal anteroposterior diameter collapse,degree of palatopharyngeal right-and-left diameter collapse,degree of palatopharyngeal cavity collapse,degree of glossopharyngeal anteroposterior diameter collapse,degree of glossopharyngeal right-and-left diameter collapse,degree of glossopharyngeal cavity collapse were compared,and the relevance between thegn were analyzed.Results The ANR in mild group,moderately and severe group was significantly higher than that in control group (0.84 ± 0.21 and 0.69 ± 0.25 vs.0.34 ± 0.12),and the ANR in moderate and severe group was significantly higher than that in mild group.There were statistical differences (P ＜ 0.05).The degree of palatopharyngeal anteroposterior diameter collapse,degree of palatopharyngeal right-and-left diameter collapse,degree of palatopharyngeal cavity collapse,degree of glossopharyngeal anteroposterior diameter collapse,degree of glossopharyngeal right-and-left diameter collapse,degree of glossopharyngeal cavity collapse in moderately and severe group were significantly higher than those in control group and mild group (0.81 ± 0.25 vs.0.41 ± 0.17 and 0.54 ± 0.20,0.66 ± 0.23 vs.0.31 ±0.08 and 0.43 ±0.14,0.51 ±0.18 vs.0.14 ±0.04 and 0.23 ±0.11,0.55 ±0.21 vs.0.29 ±0.14 and 0.32 ± 0.13,0.69 ± 0.28 vs.0.42 ± 0.12 and 0.43 ± 0.11,0.33 ± 0.12 vs.0.10 ± 0.03 and 0.14 ± 0.05),and there were statistical differences (P ＜ 0.05).There were no statistical difference in the indexes between mild group and control group (P ＞ 0.05).In children with OSAHS,the ANR,degree of palatopharyngeal anteroposterior diameter collapse,degree of palatopharyngeal cavity collapse,degree of glossopharyngeal right-and-left diameter collapse,degree of palatopharyngeal cavity collapse were positively correlated with AHI (P ＜ 0.05),while there was no correlation between the degree of palatopharyngeal right-and-left diameter collapse,degree of glossopharyngeal anteroposterior diameter collapse and AHI (P ＞ 0.05).Conclusions Upper airway structural changes in children with OSAHS have certain correlation with the severity of sleep apnea.And there is clinical value by using electronic pharyngorhinoscopy in children with OSAHS to research airway morphology.

Study of three-grade preventive health education and lifestyle intervention in the treatment of allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Investigate the effect of three-grade preventive health education and lifestyle intervention in the treatment of allergic rhinitis (AR).@*METHOD@#Two hundred and ten selected cases needed for triple prevention were randomly divided into three groups, each group included 70 cases were undertaken for a three-year randomized controlled study. Group A, treated with Budesonide nasal spray. Group B, combined Budesonide nasal spray with Hydrochloric acid left Kabbah Sting nasal spray. Group C, taking health education management and lifestyle intervention on the basis of group B's therapy. A health lecture or health problems counseling and the dissemination of health education information were undertaken, quarterly. It was mainly for health knowledge awareness, and healthy behaviors formation rate guidance. Lifestyle intervention included a balanced diet, avoiding the allergens of living environment and aerobic exercise (daily 0.5-1.0 h). The score of the signs and symptoms in each group were obtained respectively at the beginning of study, 1 year after intervention and 3 years after intervention, as well as the comparison of patient compliance of follow-up.@*RESULT@#The improved score of the signs and symptoms, endoscopy and radiological results were used to evaluate the treatment effect. There was no significant difference among the score of signs and symptoms in three groups. Comparing in group, before intervention,1 year after intervention and 3 years after intervention, the signs and symptoms of patients in three groups had improvement at different degree. The score of four symptoms (rhinobyon, rhinorrhoea, rhinocnesmus, sneezing) and signs were significant lower than before the intervention, there were a significant difference (P < 0.05). There were 8 patients in group A (11.43%), 6 patients in group 13 (8.57%) and 1 patient in group C (1.43%) lost to follow-up at 3 years after the intervention. The patient compliance of group C was significantly higher than groups A and B.@*CONCLUSION@#Triple prevention health education for AR can significantly improve the treatment compliance of AR patients for treatment, while ensuring clinical efficacy.

Changes of leukotriene D4 in nasal discharge and plasma of patients with persistent allergic rhinitis and the effects of antihistamine / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the changes of leukotriene D4 (LTD4) in nasal discharge and plasma of patients with persistent allergic rhinitis (AR) and the effects of antihistamine.@*METHOD@#The investigation was a prospective, randomized controlled trial. Forty AR patients (group C) were divided randomly into two subgroup. One group received oral antihistamine 10 mg everyday for one week (group CA) and another group received no loratadine tablets 10 mg everyday for one week (group CB). Fifteen age matched healthy (group D) people were enrolled as control. The level of LTD4 and interleukin-5 (IL-5) in both nasal discharge and plasma by using enzyme linked immunosorbent assay (ELISA) and enzyme immunoassay (EIA), cell counts and cell differentials in nasal discharge, were measured before and after three month. The clinical symptom and life quality scores of group C were also investigated.@*RESULT@#The concentrations of LTD4 in nasal discharge [(794 +/- 305) pg] and plasma [(5219 +/- those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P 1185) ng/L] in group C were significantly higher than those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P 0.05).@*CONCLUSION@#The results suggested that LTD4 was involved in airway inflammation in AR. Antihistamine was not effective enough in decreasing the levels of LTD4 in both nasal discharge and plasma of AR patients.