The influence study of vertebral artery dominance in basilar artery curvature and vertebrobasilar junctional infarction / 中国医师进修杂志

Objective To investigate the influence of vertebral artery (VA) dominance in basilar artery (BA) curvature and pontine or cerebellar infarction occurring around the vertebrobasilar junction.Methods Radiological data (infarction laterality,VA dominance,BA curvature and their directional relationships)were analyzed in 86 patients with acute unilateral pontine or posterior inferior cerebellar artery (PICA) territory infarction.Multiple Logistic regression analysis was performed to predict the moderate to severe BA curvature.Results The dominant VA frequently happened on the left side (69.8％,60/86).The BA curvature frequently happened to be right lateral flexion (74.4％,64/86).In 86 patients,71 patients had negative direction relationship between VA dominance and BA curvature.The diameter grade of VA had significant relationship with hypertension,moderate and severe BA curvature and right diameter of VA (P ＜ 0.05 or ＜ 0.01).The diameter of VA was the only independent predictor for moderate and severe BA curvature (OR =2.81,95％ CI:1.33-6.09).Conclusions VA dominance is an important predictive factor of BA curvature,and BA curvature is usually opposite to the side of VA dominance.VA dominance and BA curvature caused by VA dominance increase the incidence of vertebrobasilar junctional infarction.

Changes of serum leptin levels in patients with obstructive sleep apnea-hypopnea syndrome before and after treatment of surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the change of serum leptin levels in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after surgery.@*METHOD@#The cases were divided into effective (n=44) and non-effective (n=13) groups according to PSG. The effective cases were divided into decreased (> or = 5%, n=25) and non-decreased( or = 5%). The level of serum leptin after treatment (7.15 +/- 1.23 microg/L) was significantly decreased than before treatment (12.79 +/- 2.98 microg/L) in 19 cases of non-decreased BMI (<5%). Leptin level of all cases showed a positive correlation with AHI (P < 0.01).@*CONCLUSION@#The level of serum leptin in patients with OSAHS are increased. The serum leptin level of effective patients with OSAHS after treatment was significantly decreased. The level of serum leptin reflects the degree of AHI in patients with OSAHS.

Evaluation of the medical and surgical treatment of pediatric chronic rhinosinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the effect of the medical and surgical treatment of pediatric chronic rhinosinusitis (CRS).@*METHOD@#Seventy-two cases of pediatric CRS were randomly divided into medical group (35 cases) and surgical group (37 cases). The patients in medical group received a 12-week course of clarithromycin, alkaline nasal douche and intranasal mometasone furoate. The patients in surgical group underwent adenoidectomy or (and) tonsillectomy or ESS. All patients underwent pre- and post-treatment assessments of visual analogue score (VAS) and nasal endoscopy. The assessments of CT were arranged before starting the treatment and post-treatment in 12-month.@*RESULT@#Both groups of pediatric CRS significantly improved in VAS and endoscopic parameters of CRS in all stages. There were no significant difference between two groups in 1-month (P > 0.05). The surgical group demonstrated greater change than medical group in 3-month, 6-month and 12-month (P < 0.01). In surgical group, 37 cases underwent three different styles of operation: adenoidectomy (n = 19), adenoidectomy and tonsillectomy (n = 10) and ESS (n = 8). VAS and endoscopic parameters were not significantly different among three groups in all stages except in 1-month.@*CONCLUSION@#The results of this study warrant further that both medical and surgical treatment of pediatric CRS significantly improve in VAS and endoscopic parameters of CRS. The mainstay of management is medical treatment. Long-term, low-dose macrolide is an effective therapy and a valid alternative in pediatric CRS. Surgical intervention is necessary for cases that do not respond to prolonged course medical treatment. Adenoidectomy or (and) tonsillectomy seems to be a recommended surgical procedure for children with adenoid or (and) tonsil hypertrophy.

Effect of Plasma-mediated Temperature-controlled Radiofrequency Ablation on Obstructive Sleep Apnea Hypopnea Syndrome in Children / 中国微创外科杂志

Objective To evaluate the efficacy of tonsils and adenoid ablation by plasma-mediated temperature-controlled radiofrequency for obstructive sleep apnea hypopnea syndrome (OSAHS) in children. Methods From August 2005 to May 2007,43 cases with OSAHS received tonsillectomy and adenoid radical resection with Evac70 tool bit using a plasma-mediated temperature-controlled system. The clinical data of the patients were reviewed. Results The mean operation time was 16 minutes,ranged from 10 to 20 minutes. During the operation,the patients had a mean of 3 ml hemorrhage (1 to 10 ml). Compared with the preoperative examination,the patients showed significantly lowered AHI [(14.6?4.6) times/h vs (4.2?2.7) times/h,t=8.563,P=0.000] and OAI [(6.9?3.5) times/h vs (3.3?1.4) times/h,t=5.443,P=0.000] and increased minimum blood oxygen saturation [(85.7?4.4)% vs (99.7?0.2)%,t=-6.687,P=0.000]. Conclusions The ablation of the tonsil and adenoid using plasma-mediated temperature-controlled radiofrequency is effective and safe for children with OSAHS.

The effects of iron supplementation on auditory brain-stem response with iron deficiency anemia in rats / 临床耳鼻咽喉头颈外科杂志

Objective:To evaluate the therapeutic methods of sensorineural hearing loss with iron deficiency anemia and their effects. Method:Sixty-eight Wistar rats were randomly divided into 3 groups: Group A (iron deficiency group A) 24 rats, group B (iron deficiency group B) 24 rats and group C (control group) 20 rats. Group A and B were fed with iron deficiency diet for 6 weeks. By analyzing ABR and DPOAE, hearing loss was detected in group A and B. Then,group A was given iron supplementation diet and hyperbaric oxygen therapies. and group B was given iron supplementation diet only. Result:The auditory thresholds and period latencies (PL) of I waves of ABR and DPOAE amplitude in 2 kHz and 3kHz within group A and B were significantly different before and after treatment (P＜0.05). But the effects of treatment between these two groups had not significant differences (P＞0.05). Conclusion: It suggested that good results can be obtained by early iron supplementation in iron deficiency hearing loss cases. Hyperbaric Oxygen therapy may not be necessary.

Clinical study on the effect of lipid metabolic disturbance to the pathogenesis of obstructive sleep apnea hypopnea syndrome / 解放军医学杂志

Objectives To approach the effect of the disturbance of lipid metabolism, fatty infiltration in oropharyngeal tissues on the patient with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods 19 obese patients of OSAHS, 15 nonobese patients of OSAHS and 9 healthy people (as control) were selected. Among the three groups, The related clinical index and size and the weight of uvula were measured. The fatty weight of uvula was analyzed by biochemical methods. The uvular tissue sections were evaluated by light microscope (LM) and transmission electron microscope (TEM). Results 1 Both the obese and nonobese groups, the TC, TC/HDL, size and weight and the adipose tissue in uvula were obviously different compared with control group( P