Analysis of cases of laryngeal airway diseases in infants / 临床耳鼻咽喉头颈外科杂志

Objective:To analyze the clinical data of laryngeal airway diseases in infants and provide reference for the standardized diagnosis and treatment of the disease. Methods:From June 2022 to August 2023, analyze the clinical data of 4 cases of children with laryngeal airway diseases recently admitted to Department of Otolaryngology, Fuzhou Children's Hospital of Fujian Province, and summarize the experience and lessons of diagnosis and treatment by consulting relevant literature. Results:Three cases had symptoms such as laryngeal wheezing, dyspnea, backward growth and development, etc. After electronic laryngoscopy, the first case was diagnosed with laryngeal softening （severe, type Ⅱ）, and the angular incision was performed. While cases 2, 3 diagnosed with case 2 and 3 were diagnosed with laryngeal cyst and underwent laryngeal cyst resection. All three cases underwent low-temperature plasma surgery under visual laryngoscope, and the symptoms were relieved after operation. Case 4 was laryngeal wheezing and dyspnea after extubation under general anesthesia. The electronic laryngoscopy showeded early stage of globetic stenosis, and endoscopic pseudomembrane clamping was performed, and the postoperative symptoms were relieved. Conclusion:Infants and young children with laryngeal airway diseases should pay attention to the early symptoms and be diagnosed by electronic laryngoscopy as soon as possible. With good curative effect and few complications, low-temperature plasma surgery under visual laryngoscope is recommended. The formation of pseudomembrane under the gluteal caused by tracheal intubation causes rapid onset and rapid development. The pseudomembrane extraction by clamping is convenient and fast, with good curative effect.

New progress in diagnosis and treatment of congenital laryngomalacia in infants / 临床耳鼻咽喉头颈外科杂志

Congenital laryngomalacia is the most common disease causing laryngeal stridor in infants. The pathogenesis has not yet been clearly concluded. It may be related to abnormal development of laryngeal cartilage anatomical structure, neuromuscular dysfunction, gastroesophageal and laryngeal reflux disease, etc. The typical manifestations of the disease are inspiratory laryngeal stridor and feeding difficulties, which can be divided into mild, moderate and severe according to the severity of symptoms. The diagnosis is mainly based on clinical symptoms, signs and endoscopy, among which endoscopy is an important diagnostic basis. The treatment of laryngomalacia depends on the severity of symptoms. Mild and some moderate congenital laryngomalacia children can be relieved by conservative treatment, and severe and some moderate congenital laryngomalacia children should be treated by surgery. Supraglottic plasty is the main surgical method, which can effectively improve the symptoms of laryngeal stridor, dyspnea, feeding difficulties and growth retardation in most children, and the surgical effect is good.

Establishment of HPLC Fingerprint of Schisandra sphenanthera and S. chinensis and Analysis of Chemical Pat- tern Recognition / 中国药房

OBJECTIVE：To establish HPLC fingerprint of Schisandra sph enanthera and S. chinensis，and to analyze chemical pattern recognition. METHODS ：HPLC method was adopted. Using schizandrin A as reference ，HPLC fingerprints of 10 batches of S. sphenanthera and S. chinensis （N1-N10，S1-S10） were drawn. Similarity Evaluation System of TCM Chromatographic Fingerprint（2012 edition）was adopted for similarity evaluation to determine the common peaks. SPSS 20.0 and SIMCA 14.1 software were used for HCA ，unsupervised madel of PCA ，supervised model of OPLS-DA. Using variable importance projection （VIP）value greater than 1 as the standard ，the differential markers that affected the quality of S. sphenanthera and S. chinensis were screened. RESULTS ：S. sphenanthera and S. chinensis were identified 32 and 33 common peaks ，respectively. The similarity of 10 batches of S. sphenanthera and 10 batches of S. chinensis were all higher than 0.9，and the similarity of S. sphenanthera and S. chinensis was 0.05. A total of 19 characteristics peaks were identified ，among which five common peaks were identified as schisandraol A ，schisandraol B ，schisantherin A ，schizandrin A and schisandrin B by reference. HCA results showed that N 1-N10 were clustered into one category ，and S 1-S10 were clustered into one category ，of which N 1，N3，N8，and N 9 were clustered into one category ，and the rest were clustered into one category ；S1，S3，S6，and S 9 were grouped together ，and the rest were grouped together. The results unsupervised model of PCA showed that the cumulative variance contribution rate of the first two principal component factors was 87.20％. Supervised model of OPLS-DA showed that schizandrin A ，schisandraol A ，schisantherin A and schisandrin B were the differential markers that affected 、the quality of S. sphenanthera and S. chinensis （VIPs were 2.29，2.24，1.73，1.48，respectively）. CONCLUSIONS ：The established fingerprint is accurate ，scientific，simple and easy to use ，combined with multivariate statistical analysis can be 话：0395-3356116。E-mail：wangrui56116@163.com used to evaluate the quality of S. sphenantherae and S. chinensis. The components of S. sphenanthera and S. chinensis were different ，schisanolrin A is differential marker.

Three-dimensional reconstruction visualization system enhances the accuracy of lower cervical pedicle screw implantation / 中国组织工程研究

BACKGROUND:Pedicle screw implantation is a common method to repair many kinds of diseases of the lower cervical spine. Three-dimensional (3D) reconstruction visualization system can be used in order to improve the accuracy of the implant and improve the prognosis. OBJECTIVE:To investigate the effect of 3D reconstruction visualization system on the accuracy of cervical pedicle screw implantation. METHODS: The clinical data of 89 patients with cervical spine dislocation, who underwent cervical pedicle screw implantation, were analyzed retrospectively. Patients were divided into control group (46 cases) and observation group (43 cases) according to the navigation method. Patients in the control group underwent C arm X ray two dimensional navigation. Patients in the observation group underwent three-dimensional reconstruction visualization system navigation. Intraoperative placement time was observed, and the accuracy of screw placement was assessed in both groups. The cases were folowed up for 12 months, and the adverse events were recorded and compared. RESULTS AND CONCLUSION: (1) Intraoperative implantation time was shorter in the observation group than in the control group, but no significant difference was found (P> 0.05). (2) Accuracy rate: There were no three types of nail cases in the observation group, and the accuracy rate was 93% (40/43). In the control group, two cases affected three types of nailing, and the accuracy rate was 81% (37/46). The accuracy rate was significantly higher in the observation group than in the control group (P < 0.05). (3) Postoperative folow-up: None suffered from nerve tissue injury to vertebral artery, blood vessel and spinal cord. The screws of the two groups were in stable condition, without screw breakage or loosening. (4) Results suggested that in lower cervical pedicle nail implantation, 3D reconstruction navigation system can effectively improve the accuracy of screw placement, and does not increase nailing time or lead to adverse events. It is a safe and effective navigation mode.

Discussion on the treatment methods of pediatric obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the treatment methods of pediatric obstructive sleep apnea hypopnea syndrome (OSAHS).</p><p><b>METHODS</b>A total of 386 children with OSAHS were enrolled from June 2008 to April 2011.Ninety children with adenoid and tonsil ≤ degree III (group A) were randomly divided into A1 subgroup and A2 subgroup, while 22 of 296 (group B) children aged less than 3 years old with degree IV adenoid and(or) tonsil were divided into B1 subgroup, and the other 274 of 296 children with degree IV adenoid and (or) tonsil were divided into B1 subgroup, B2 subgroup and B3 subgroup. The adenoid, tonsil size examination and nasal endoscopic examination scores were performed before treatment, 3 months and 6 months after treatment. Drug therapy included oral antibiotics, mometasone furoate as a nasal spray, leukotriene receptor antagonist (LTRAs), mucoactive medications. Conservative treatment meant drug therapy plus negative pressure of sputum aspiration.Surgical treatment meant coblation adenotonsillectomy. A1 subgroup received drug therapy for 3 months; A2 and B1 subgroup received conservative treatment for 3 months; B2 subgroup received coblation adenotonsillectomy after 3 days conservative treatment and postoperative drug therapy for 2 weeks; B3 subgroup received coblation adenotonsillectomy after 2 weeks conservative treatment and postoperative drug therapy for 3 months.</p><p><b>RESULTS</b>The adenoid and tonsil size of A2 subgroup decreased at 3 months after treatment (Wald χ² were 10.584 and 8.366, respectively, P < 0.05), no significant re-increase was found at 6 months, and no decrease was found in the A1 subgroup (P > 0.05). The nasal endoscopic examination scores decreased in both A1 and A2 subgroup at 3 months after the treatment (F = 403.420, P < 0.05), but it was found re-increase in A1 subgroup at the 6 months (P < 0.05), no significant re-increase was found in the A2 subgroup. The polysomnography (PSG) monitor of A2 subgroup was 100.0% normal at 3 months after treatment, while the A1 subgroup was only 43.2% (χ² = 36.189, P < 0.05). B2 and B3 subgroups cured after coblation adenotonsillectomy, but no decrease of the adenoid and tonsil size was found in B1 subgroup (P > 0.05). The nasal endoscopic examination scores of B1, B2 and B3 subgroups showed significant decrease after the treatment, but re-increase was found in both B1 and B2 subgroups at the 6 months (F = 1 614.244, P < 0.05), no significant re-increase was found in the B3 subgroup. The PSG monitor of B3 subgroup was 100.0% normal at 3 months after treatment, B2 subgroup 73.4%, and B1 subgroup only 57.4% (χ² = 90.846, P < 0.05).</p><p><b>CONCLUSIONS</b>The treatment method of children with OSAHS should be selected according to the age, condition of disease, and size of the adenoid and tonsil. Adenoid and tonsil ≤ degree III should select conservative treatment; while for degree IV adenoid and (or) tonsil, surgical treatment should be primary choice. Conservative treatment can reduce the risk of perioperative and adequate postoperative drug therapy can help prevent recurrence after surgery.</p>

The relationship between obstructive sleep apnea hypopnea syndrome and adenoid size as well as tonsil size in children / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) and adenoid size as well as tonsil size in Children.@*METHOD@#A total of 545 patients, 338 OSAHS patients (treated group) diagnosed by PSG and 207 patients with vocal cord nodules but symptoms of upper airway obstruction (control group), were enrolled from inpatient and outpatient between June, 2008 and October, 2010. The oropharynx and electron-nasopharyngolaryngoscopy examination records of the two groups were retrospectively analyzed. The patients in the treated group were also divided into mild group, moderate group and severe group according to obstructive apnea index (OAI) or AHI. SPSS 17.0 was used for statistical analysis.@*RESULT@#In the treated group, 89.7% had grade III-V adenoid and 68.4% had grade III-IV tonsil, compared with 30.9% (adenoid) and 13.5% (tonsil) in the control group. The significant differences were found (all P < 0.01). The comparison between patients with different grades of adenoidal size and tonsil size in the treated group had indicated that patients with grade IV adenoid or grade IV tonsil have a higher risk of OSAHS than patients with grade III adenoid or grade III tonsil. In the treated group, the ratio of patients with different severity of adenoid or tonsil had increased with the severity of OSAHS (P < 0.01). This retrospective study had also found that most of the grading results from Electron-nasopharyngolaryngoscopy examination were consistent with that from oropharynx examination. 13 (37.1%) of 35 patients with grade I or II tonsil diagnosed by Oropharynx examination were considered as grade III by Electron-nasopharyngolaryngoscopy examination.@*CONCLUSION@#Adenoidal hypertrophy and tonsil hypertrophy are the risk factors for OSAHS in children. The risk of OSAHS and the severity of OSAHS are positively associated with the severity of adenoid and tonsil. The electron-nasopharyngolaryngoscopy examination is an important examination method for diagnosing OSAHS in children, as well as determination of tonsil size.