Outcomes of upper airway reconstructive surgery for obstructive sleep apnea syndrome based on polysomnography after nasopharyngeal tube insertion / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The most common obstruction sites for obstructive sleep apnea hypopnea syndrome (OSAHS) are the oropharynx and the glossopharyx. The diagnosis of glossopharyngeal airway obstruction is difficult. The study aimed to assess the effect of upper airway reconstructive surgery for OSAHS based on polysomnography (PSG) after nasopharyngeal tube insertion (NPT-PSG), and to evaluate the clinical value of NPT-PSG in localizing the obstructive sites.</p><p><b>METHODS</b>Seventy-nine OSAHS patients diagnosed with PSG were included in the study. PSG was repeated with a nasopharyngeal tube in place (NPT-PSG).</p><p><b>RESULTS</b>of the two PSGs were compared. A NPT-PSG apnea hypopnea index (AHI) greater than 15 times per hour was used as a threshold for glossopharyngeal surgery. The cause of glossopharyngeal airway obstruction was taken into consideration in planning glossopharyngeal surgery. Assessment of efficacy was followed-up.</p><p><b>RESULTS</b>After NPT-PSG, patients' AHI significantly decreased and lowest oxygen saturation (LaSO2) significantly increased. Of the 79 patients, 47 were treated with uvulopalatopharyngoplasty (UPPP) alone and 32 with UPPP + glossopharyngeal surgery. Thirty-two patients were considered cured, 33 markedly improved, and 14 failed. The overall surgery success rate was 82.3%.</p><p><b>CONCLUSIONS</b>NPT-PSG can be used as a diagnosis tool for localizing airway obstruction in OSAHS patients. Surgical treatment based on NPT-PSG results in good treatment efficacy.</p>

Treatment and prevention of serious perioperative complications of obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To summarize experiences of serious perioperative complications management of obstructive sleep apnea hypopnea syndrome (OSAHS), and evaluate the effect of intervention in decreasing the incidence of serious complications.</p><p><b>METHODS</b>Retrospective analysis of clinical data in Shenyang General Hospital of PLA and Liaoning Province Jinqiu Hospital of OSAHS surgery cases from January 1995 to December 2009 were included in this study, patients were divided into two groups according to with or without intervention. Experience and lessons were analyzed.</p><p><b>RESULTS</b>Patients without and with intervention were 402 and 521 respectively, and uvulopalatopharyngoplasty (UPPP) cases in each group were 387 and 390. Five patients in the first group who accepted UPPP had breathing difficulty and were all successfully rescued, while no one in the second group had breathing difficulty. The difference was significant (P < 0.05). Sixteen patients in the first group had severe bleeding after UPPP, while only 5 patients had the severe bleeding in the second group. The difference was significant, too P < 0.05. No breathing difficulty cases in the second group, and serious bleeding cases in each group was 5 and in 1, there was no significant difference (P > 0.05).</p><p><b>CONCLUSIONS</b>Breath difficulty and serious bleeding are serious perioperative complications of OSAHS surgery, and with systemic intervention the incidence of the complications can be decreased.</p>

Down-regulation of Twist1 increases the sensitivity of nasopharyngeal carcinoma cell lines HNE1 to taxol / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate whether down-regulation of Twist1 could change sensitivity of nasopharyngeal carcinoma cell line HNE1 to taxol.</p><p><b>METHODS</b>HNE1 cells were transfected with the small interfering RNA (siRNA) expression vector pSuppressor-Retro-Si-Twist, containing the short hairpin RNA (shRNA) sequence targeting the Twist gene-coding region by Fugene 6. Positive clones were then selected in Neomycin (400 microg/ml) for 21 days. The low expressions of Twist1 were examined by real-time reverse-transcription polymerase chain reaction (RT-PCR) and Western blot. Drug sensitivity of si-Twist1 HNE1 to taxol was determined by Annexin V-fluorescein isothiocyanate( FITC)/propidium lodide (PI) double-labeled flow cytometry and detection of DNA ladder. The Effect of Twist1 inactivation on HNE1 cell proliferation was observed by MTT assay and flow cytometry.</p><p><b>RESULTS</b>Annexin V- FITC-PI assay showed that apoptosis ratio was 40.2% in si-Twist HNE1 after treated with 10 ng/ml taxol, significantly higher than that in the control siRNA group 24.3%. The deference had statistic meaning. After the re-expression of HNE1, apoptosis ratio was 44.80% +/- 4.80% (x +/- s) in low Twist1 protein expression group and that was 27.00% +/- 2.91% in high expression group. The deference had statistic meaning (t = 4.374, P = 0.049). Real time PCR test revealed apoptosis protein bcl-2 expression in si-Twist HNE1 was 0.28 +/- 0.05, significantly lower than that in the control siRNA HNE1 (0.57 +/- 0.08, t = 6.710, P = 0.021), nevertheless, significant bax and bcl-XL changes were not observed (t = 2.000, P = 0.184 and t = 1.502, P = 0.272). MTT and FCM showed that down-regulation of Twist1 did not alter cell proliferation rate (P>0.05).</p><p><b>CONCLUSIONS</b>Down-regulation of Twist1 could increase drug sensitivity of nasopharyngeal carcinoma cell line HNE1 to taxol by inducing apoptosis. These results suggested that Twist1 may be a promising treatment target for nasopharyngeal carcinoma therapy.</p>

Study of lingual arterial CT angiography and security of partial glossectomy in obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the difference of lingual arterial CT angiography images(CTA) between obstructive sleep apnea hypopnea syndrome (OSAHS) patients and normal subjects, and to investigate the safety of partial glossectomy guided by lingual arteria CT angiography.</p><p><b>METHODS</b>Seventy-four patients with OSAHS and 10 control adults were included in the study. The lingual upper airway and lingual arterial CT angiography were obtained. The area and the dimensions of lingual upper airway, and the length and thickness of lingua, length of lingual arteria, depth and bilateral lingual arteria spacing were studied. The CT measuring data of OSAHS patients and normal adults were compared. The multinomial logistic regression analysis was used to investigate the main factors which affects the lingual arterial measuring results. Guided by the lingual arterial CT angiography and measuring results, glossectomy was performed in 23 OSAHS patients with lingua hypertrophy.</p><p><b>RESULTS</b>The area and dimensions of lingual airway of OSAHS patients were less than those of control adults, and the length and thickness of lingua of OSAHS were more than those of control adults (t test, P < 0.05 or P < 0.01). There were no difference in length of lingual arteria and bilateral lingual arteria spacing between OSAHS patients and control adults. The 3 measured points' depth (x(-) +/- s) of lingual arteria of OSAHS patients were (29.1 +/- 5.5) mm, (26.9 +/- 5.1) mm and (25.6 +/- 5.2) mm, respectively, and those of control adult were (23.0 +/- 3.8) mm, (22.6 +/- 2.7) mm and (21.5 +/- 2.6) mm, the depth of lingual arteria of OSAHS was more than that of control adults (t test, P < 0.05 or P < 0.01). The main factors affects lingual arterial depth were body mass index (BMI), lingual length and lingual thickness, unstandardized regression coefficient were 0.255, 0.11 and 0.03, respectively (analysis of variance, F = 6.216, P < 0.05). No damage of lingual arteria and nerve in 23 patients who had expanded glossectomy.</p><p><b>CONCLUSIONS</b>The study showed statistical difference significance of lingual arterial CTA measurements between OSAHS patients and control adults. Guided with lingual arteria CTA data, the expanded glossectomy in OSAHS patients has proved good safety and high cure rate.</p>

Self-reported prevalence of allergic rhinitis in eleven cities in China / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The aim of this study is to investigate the self-reported prevalence and other epidemiological characteristics of allergic rhinitis from 11 cities throughout the mainland of China.</p><p><b>METHODS</b>Telephone interviews were conducted in the two main municipalities (Beijing, Shanghai) and eight capital cities (Changsha, Changchun, Hangzhou, Guangzhou, Nanjing, Shenyang, Wuhan, Urumqi and Xi'an) of main provinces throughout the mainland of China after sampling target phone numbers by the approach of random digital dialing (RDD) via computer.</p><p><b>RESULTS</b>In total, the survey had sampled 684 blocks of telephone numbers in 11 cities, and dialed 119 319 telephone numbers. Of the 38 203 respondents, 4253 subjects reported allergic rhinitis, while the other 33 950 were screened negative in the telephone interviews. The self-reported prevalence of allergic rhinitis was lowest in Xi'an (8.0%), and highest in Urumqi (21.4%), with Nanjing having intermediate value (11.5%). The gender-adjusted prevalence ranged from 8.5% in Xi'an to 21.3% in Urumqi, while the age-adjusted prevalence of self-reported allergic rhinitis ranged from 8.7% in Beijing to 24.1% in Urumqi.</p><p><b>CONCLUSIONS</b>The study demonstrates that the self-reported prevalence of allergic rhinitis in 11 cities throughout the mainland of China has wide variations, and the strategy of prevention for allergic rhinitis should be conducted according to the epidemic features of it.</p>