[Histological changes after the recontruction of tongue defect with rectus abdominis musculoperitoneal flap].

OBJECTIVE: To observe the cellular morphological and histological changes of the reconstructed tongue defect by rectus abdominis musculoperitoneal flap of dogs with or without nerve. METHODS: 12 Beagle dogs were randomly divided into two groups. Group A made rectus abdominis musculoperitoneal flap with the intercostal nerve while group B without the intercostal nerve. Nerve anastomosis was performed in Group A while not in Group B in the repairment. 12 weeks later, the length, width, surface area and cellular morphology and histological changes of the two transfer flaps were observed. RESULTS: The length, width, surface area of transplanted rectus abdominis musculoperitoneal flaps in group A were greater than those in Group B, and the differences were statistically significant at 12th week (P < 0.01). The microscope study found that the transplanted rectus abdominis musculoperitoneal flaps of group A had part of muscle fiber atrophy with some connective and adipose tissue, loose muscle fiber arrangement, while the transplanted rectus abdominis musculoperitoneal flaps of Group B had muscle cells atrophy with some adipocyte. The structure of muscle cells in Group A was basically normal, but it was disorder in Group B. The type II muscle fibers of Group B was atrophy and substituted by a lot of connective tissue. CONCLUSION: After tongue defect reconstructed by rectus abdominis musculoperitoneal flap with nerve, the changes of muscle fibers could be similar to tongue muscles, providing a basis for the dynamic recovery of the tongue.

[Changes of high-sensitivity CRP and insulin sensitivity index in children with obstructive sleep apnea hypopnea syndrome].

OBJECTIVE: To investigate the levels of high-sensitivity CRP (hsCRP) and insulin sensitivity index (ISI) in children with obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS: Twenty-nine children with OSAHS and 22 children with primary snoring (PS) were enrolled. Polysomnography was performed. Body mass index (BMI), hsCRP, serum lipids, fasting plasma glucose (FPG), and insulin (INS) were measured. ISI was calculated. RESULTS: The apnea hypopnea index (AHI) in the OSAHS group was higher than that in the PS group (13.2 ± 9.2 vs 1.2 ± 1.1; P<0.05). The lowest oxygen saturation (LSaO2) in the OSAHS group was lower than that in the PS group [(78.5 ± 5.4)% vs (87.4 ± 3.7)%; P<0.05]. The values of hsCRP in the OSAHS group was higher than those in the PS group (2.8 ± 2.7 mg/L vs 0.6 ± 0.9 mg/L; P<0.05). There were no significant differences in the ISI and serum lipids between the two groups. The hsCRP level was negatively correlated with LSaO2 in the OSAHS group (r=-0.531, P<0.05). CONCLUSIONS: The hsCRP level increases in children with OSAHS. The increased hsCRP level might be associated with an increased risk of cardiovascular diseases.

[Prevalence of upper respiratory tract group A Streptococcus carriage in school-age children from Tulufan City and Buerjin County of Xinjiang Province].

OBJECTIVE: To study the prevalence rate of upper respiratory tract group A Streptococcus (GAS) carriage in school-age children from Xinjiang Province. METHODS: A total of 478 children at age of 9-12 years from Tulufan City and Buerjin County of Xinjiang Province were enrolled by random cluster sampling. Throat swab cultures were performed once each season for the determination of presence of GAS. RESULTS: In the 1 827 samples, 196 GAS strains were isolated, with a GAS carrier rate of 10.7%. The prevalence rate of GAS carrier in Tulufan City ranged from 3.7%-16.5% compared with 4.7%-21.4% in Buerjin County (P < 0.05). The prevalence rate of GAS carrier in winter is the highest, followed by in autumn, spring and summer in both regions. There were significant differences in the GAS carriage rate in autumn between the two regions. There were no significant differences in the GAS carriage rate between boys and girls. Of the 196 GAS strains, 133 from Han, 22 from Uygur and 41 from Hazakh children. There were significant differences in the prevalence rate of GAS carriage among children with different ethic groups. CONCLUSIONS: The prevalence rate of GAS carriage is high in school-age children from Tulufan and Buerjin of Xinjiang Province. The GAS carrier rate is associated with the season and ethic group. The children from Buerjin County present a higher GAS carrier rate than those from Tulufan City.

[Protection of azithromycin against pulmonary II epithelial cell injuries induced by cigarette smoke extract and relevant mechanisms].

OBJECTIVE: Cigarette smoke extract (CSE) can induce injuries of pulmonary II epithelial cells, activate nuclear factor-kappaB and increase tumor necrosis factor-alpha(TNF-alpha) secretion. This study aimed to investigate whether azithromycin can protect pulmonary II epithelial cells from injuries induced by CSE and relevant mechanisms. METHODS: Pulmonary II epithelial cells (A549 cells) were cultured in vitro. After 48 hrs of culture the cells were randomly treated with serum-free DMEM only (blank control group), azithromycin + serum-free DMEM, CSE+ serum-free DMEM or CSE+azithromycin. Eight hours later the morphology of A549 cells, the activity of NF-kappaB and the levels of TNF-alpha were measured by inverted microscope, immunohistochemistry and ELISA. RESULTS: The morphology and structure of A549 cells were changed, NF-kappaB activity increased (dark brown staining ) and TNF-alpha levels (0.307 +/- 0.036 pg/mL vs 0.234 +/- 0.028 pg/mL)increased in the CSE+ serum-free DMEM group compared with the blank control group (P < 0.01). CSE together with azithromycin treatment recovered partly the morphological injuries of A549 cells. It also attenuated NF-kappaB staining and decreased TNF-alpha levels from 0.307 +/- 0.036 pg/mL (CSE+serum-free DMEM group) to 0.269 +/- 0.009 pg/mL (P < 0.05). CONCLUSIONS: Azithromycin may inhibit NF-kappaB activity, decrease TNF-alpha secretion and thus lessen cytotoxicity of CSE to A549 cells.

[Diagnostic values of serum orexin-A levels in children with obstructive sleep apnea-hypopnea syndrome].

OBJECTIVE: Currently people regard polysomnography (PSG) monitoring as the golden standard for diagnosis of obstructive sleep apnea-hypopnea syndrome (OSAHS) in children. However, due to the high cost, time and manpower consuming, PSG is not applicable to epidemiological investigation and clinical screening, especially not suitable for child patients and remote hospitals in Xinjiang. Therefore, it is of important clinical significance to find out a simple method (e.g. a kind of serum index) to primarily screen out suspicious patients for early diagnosis and treatment. The present study was conducted to assess the clinical usefulness of the measurement of orexin-A concentration in serum as a diagnostic predictor to screen patients with OSAHS in children. METHODS: Serum orexin-A concentration was measured with enzyme immunoassay (EIA) kit in 60 patient with snoring before performing polysomnography (PSG). Subsequently all the subjects underwent PSG test. Forty subjects were diagnosed as having OSAHS, and twenty subjects had no OSAHS. These 20 non-OSAHS subjects served as controls. Compared with the PSG results the clinical usefulness of the measurement of orexin-A concentration in serum was assessed as a diagnostic predictor to screen patients with OSAHS. Correlation between orexin-A levels and apnea hypoventilation index (AHI), micro-arousal index (MAI) and lowest SaO2 (LSaO2) were analyzed. RESULTS: The serum orexin-A levels in the OSAHS group [(0.49 +/- 0.10) microg/L] was significantly higher than that of the control group [(0.28 +/- 0.11) microg/L, P < 0.01]. If a patient's level of orexin-A was higher than 0.36 microg/L, the patient more likely to have OSAHS. The sensitivity rate was 85.0% and the specificity was 80.0%. Serum orexin-A levels in children with OSAHS correlated positively with the AHI (r = 0.427, P < 0.05) and MAI (r = 0.468, P < 0.05), but correlated negatively with the LSaO2 (r = -0.527, P < 0.01) and the mean oxygen saturation (MSaO2) (r = -0.541, P < 0.01), not correlated significantly with the BMI (r = -0.212, P > 0.05). The serum orexin-A levels in the OSAHS children after who under went tonsillectomy and adenoidectomy significantly decreased (P < 0.05) 3 months after surgery as compared with pre-operation level. CONCLUSION: These findings suggest that the serum level of orexin-A could be used as a predictor in screening for OSAHS children and a biological marker of the severity of OSAHS children.