[Correlation analysis of standardized palatal sensory threshold with airway obstruction and hypoxia during sleep].

Objective: To study the correlation between the standardized palatal sensory threshold and airway obstruction and hypoxia during sleep, and to infer its role in the pathogenesis of OSAHS. Methods: From August 2016 to May 2017, 92 OSAHS patients as experimental group and 48 non-OSAHS volunteers as control group were recruited in Department of Otorhinolaryngology Head and Neck Surgery, Changhai Hospital Affiliated to the Naval Medical University. The tactile sense was measured by Smmes-Weinstein Monofilaments in the middle of uvula and both side of hard palate,then the threshold of the uvula minus, the average threshold of the hard palate as the standardized palatal sensory threshold(SPST). The control point of both groups was located in the central underlip. Mann-Whitney U test for comparing two independent samplesand partial correlation analysis. Results: There was no difference in tactile threshold of underlip between the experimental group and the control group(0.020[0.008,0.020] g/mm(2) vs. [0.020(0.008,0.020] g/mm(2), Z=293.0, P=0.221); the tactile sense of the experimental group was larger than that of the control group in thehardpalate(0.040[0.140,0.055] g/mm(2) vs. 0.138[0.064,0.400] g/mm(2), Z=4.5, P=0.000), soft palate(0.400[0.280,0.400] g/mm(2) vs. 1.400[1.000,4.000] g/mm(2), Z=0, P=0.000) and SPST(0.355[0.125,0.373] g/mm(2) vs. 1.285[0.896,3.025] g/mm(2), Z=0, P=0.000). The SPST was positive correlation with apnea hypopneaindex(AHI)(r=0.835, P=0.000) and negative correlation with the nadir oxyhemoglobin saturation (r=-0.636, P=0.000). Conclusion: The greater the standardized palatal sensory threshold, the worse the condition of OSAHS, the lower, the lowest blood oxygen at night, and the impaired upper airway sensory function plays an important role in the pathogenesis of OSAHS.

[Bleeding control of periodontal mechanical therapy for patients taking aspirin].

OBJECTIVE: To investigate the feasibility of periodontal mechanical therapy for chronic periodontitis and coronary heart disease patients with low dose of aspirin. METHODS: Sixty nine chronic periodontitis patients with coronary heart disease were randomly selected as the experimental group (medication group, group A), the control group (withdrawal group, group B) including 20 chronic periodontitis patients with coronary artery disease, stopping the drug for one week and another control group with 50 chronic periodontitis patients (group C). The three groups were examined with pocket probing, and received supragingival scaling, subgingival scaling, and root planning. Local bleeding after operation was observed. In 30 minutes after periodontal mechanical treatment, there was still a need to take some hemostatic measures (containing the oxidized cellulose putting in the periodontal pocket, gauze oppressing, and suturing). Nd:YAG laser was used to stop bleeding 60 minutes after operation. RESULTS: At baseline, there was no significant difference in the three groups, as to the plaque index(PLI), the probing depth (PD), and the attachment loss (AL). The bleeding index (BI)in group A was significantly higher than that in group C (P=0.024), higher than that in group B (P=0.088). The platelet maximum aggregation rate (Agg(max)) was detected in some subjects. The average Agg(max) value group A was 15.2%, which was much greater than that in group B (60.7%) and group C (62.5%). The three groups were all safe in the treatment of periodontal therapy. There were five cases of active bleeding in group A, one case in group B and one case in group C in 30 minutes after operation. In 60 minutes after operation, there was one case of bleeding actively in group A. Nd:YAG laser was used to stop bleeding successfully. CONCLUSION: The chronic periodontitis and coronary heart disease patients with long-term oral administration of low dose of aspirin can be safely treated with periodontal mechanical treatment, and the effect of local hemostasis is positive without stopping the drug.

[Obstructive sleep apnea hypopnea syndrome study on pathogenesis and prognosis].

OSAHS is a common disease during sleep and its pathogenesis is complex. The anatomic level of upper airway is a more recognized pathogenic factor. Recent studies have shown that nonanatomic factors, such as insufficiency in dilation muscles of upper airway, high loop gain and low arousal threshold, play an important role in the pathogenesis of OSAHS. This paper revives the latest literature home and abroad on the anatomical and nonanatomical factors in the pathogenesis of OSAHS and makes a systemic review.

The serum level of C-reactive protein in patients undergoing GnRH agonist protocols for in vitro fertilization cycle.

BACKGROUND: The synchronization of the uterus and mature eggs at the molecular level is the key factor in embryo transfer, and the regulation of synchronization depends on a variety of cytokines. C-reactive protein (CRP), as the first acute phase reaction protein, is involved in the entire process of embryo transfer. The study is designed to investigate the correlation among CRP, sex hormone, controlled ovarian hyperstimulation (COH) cycle, and pregnancy outcome. MATERIALS AND METHODS: Ninety-two patients who accepted in vitro fertilization (IVF) treatment cycles because of tubal factor were included in the study. Seventy treated cases were included to complete final analysis with the full set of results. Respectively on the second day of the menstruation (Day-2) in gonadotropin-releasing hormone agonist (GnRH-a) short program treatment, on the morning in human chorionic gonadotropin (hCG) treatment (Day-hCG) and the embryo transplant day (Day-ET), plasma CRP level was tested by enzyme-linked immunosorbent assay (ELISA). The correlativity among CRP level, sex hormone, COH, and pregnancy outcome was analyzed by statistical methods. RESULTS: In the short program GnRH-a of 70 cases, there was no relationship between serum CRP level and the infertility age, gonadotropin (Gn) dosage, number of oocytes retrieved, the number of normal fertilization, and sex hormone. In the short program of GnRH-a, the change of serum CRP levels in Day-2, Day-hCG, Day-ET: serum CRP in Day-2 < Day-hCG < Day-ET and the level of serum CRP gradually increased in Day-2, Day-hCG, and Day-ET in both the pregnant group and non-pregnant group. In non-pregnant group, the ratio of hCG/D2 and ET/hCG-day were significantly higher than the pregnant group. The area under receiver operating characteristic (ROC) curve was 0.806, indicating the accuracy of diagnostic tests is medium, the authors chose the point which presents the ratio of CRP in Day-ET to Day-hCG which was less than 1.752 as a predictor of treatment outcome, the sensitivity of the experiment was 77.8%, and the specificity 75%. CONCLUSION: CRP as a sensitive inflammatory marker, CRP ratio of Day-ET/Day-hCG could be a predictor of treatment outcome by ROC curve analysis in COH program.

Expression and changes of Fos protein in the rat forebrain after gamma knife irradiation targeted to the caudate putamen.

OBJECTIVE: Forebrain expression and changes of Fos protein immunoreactivity were investigated in rats subjected to gamma knife irradiation (dose, 100 Gy), focusing on the right caudate nucleus. METHODS: Serial cryostat forebrain sections were processed with Fos protein antiserum and then by avidin-biotin-peroxidase complex immunohistochemistry after gamma knife irradiation. RESULTS: Some neurons, glial cells, and endothelial cells were positive for Fos-like immunoreactivity (LI). Fos-LI was mainly distributed in the target area of irradiation, as well as in white matter surrounding lateral ventricles, cortex, hippocampus, and certain nuclei reportedly implicated in the regulation of stress responses. From 0.5 hour to 30 days after irradiation, expression of Fos-LI displayed two peaks. The first peak arose from 3 hours to 24 hours, with cell nuclei being positive for Fos-LI. The second peak was noticeable at the 14th day postirradiation. Subsequently, three types of Fos-LI-positive cells were identified during the period between 14 and 30 days: in the first type, only the nucleus was positive; in the second type, the cytoplasm was stained; and in the third type, the cells were positive in both the nucleus and the cytoplasm. CONCLUSION: During the early stages after gamma knife irradiation, a specific stress response (significant Fos expression with two peaks) is observed not only in the target region but also in the surrounding forebrain regions. The characteristics and significance of two types of Fos-LI-positive cells are discussed in the context of this investigation.

Expression and significance of three types of Fos-immunoreactive cells after gamma knife irradiation of the forebrain in the rat.

The expression and significance of three types of Fos-like immunoreactive (Li) cells were investigated after gamma knife irradiation of the forebrain in the rat. Three months after the irradiation, the brain sections were immunostained with an antiserum against Fos protein. It was shown that the Fos-like immunoreactivity (LI) appeared in some of the neurons, glial cells and endothelial cells in the target area, the white matter surrounding the lateral ventricle, the cerebral cortex and the hippocampus. Three characteristic types of Fos-Li cells were identified in these regions. (1). Only the nuclei of the cells were Fos-ir, (2). Only the cytoplasm was immunostained, and (3). Both the nuclei and the cytoplasm showed Fos-LI. It is suggested that type 1 are the normal responsive cells, type 2 are seriously injured cells, so that the Fos translocation mechanism is damaged, and type 3 represents the intermediate form.

Neuronal responses of the anterior commissural nucleus to osmotic stimulation and angiotensin II in hypothalamic slices in the rat.

The firing rate and pattern of activity of neurons in the anterior commissural nucleus (ACN), which was rich in oxytocin-containing neurons, were studied electrophysiologically in hypothalamic slices. Extracellular recording showed that most ACN neurons exhibited irregular or regular continuous spontaneous unit activity. Other neurons showed short burst patterns of activity or were silent. The majority of ACN neurons were activated by bath application of angiotensin II, and a substantial number of them showed inhibitory or excitatory responses to hypertonic bathing medium. These results indicate that magnocellular neurosecretory neurons in the ACN may participate in the regulation of water balance.

Third ventricular subependymal oxytocin-like immunoreactive neuronal plexus in the rat.

In a previous retrograde tracing study, a dense subependymal neuronal plexus was found along the anterior ventral third ventricle that projects to the posterior pituitary. In the work reported here, the oxytocin-like immunoreactive neurons of this plexus were studied in detail. It has a population of about 650 cells with a great wealth of dendrites. The neurons are of magnocellular neurosecretory type with long straight dendrites running parallel to the ependyma. The plexus is composed of a dorsal and a ventral part. The dorsal part consists of about 75% of the whole population and is most dense at the levels of the anterior and medial magnocellular paraventricular nuclei. Their dendrites appear vacuous in immunohistochemically stained sections and have a tendency to form fascicles. The ventral part is more sparse. The dendrites of the subependymal plexus are well organized so the anteriorly located ones tend to be directed rostrally and the posteriorly ones caudally. The functional significance of the plexus is discussed.