Partial Alleviation of Homologous Superinfection Exclusion of SeMNPV Latently Infected Cells by G1 Phase Infection and G2/M Phase Arrest.

Viral infection can regulate the cell cycle, thereby promoting viral replication. Hijacking and altering the cell cycle are important for the virus to establish and maintain a latent infection. Previously, Spodoptera exigua multiple nucleopolyhedrovirus (SeMNPV)-latently infected P8-Se301-C1 cells, which grew more slowly than Se301 cells and interfered with homologous SeMNNPV superinfection, were established. However, the effects of latent and superinfection with baculoviruses on cell cycle progression remain unknown. In this study, the cell cycle profiles of P8-Se301-C1 cells and SeMNPV or Autographa californica multiple nucleopolyhedrovirus (AcMNPV)-infected P8-Se301-C1 cells were characterized by flow cytometry. The results showed that replication-related genes MCM4, PCNA, and BAF were down-regulated (p < 0.05) in P8-Se301-C1 cells, and the S phase of P8-Se301-C1 cells was longer than that of Se301 cells. P8-Se301-C1 cells infected with SeMNPV did not arrest in the G2/M phase or affect the expression of Cyclin B and cyclin-dependent kinase 1 (CDK1). Furthermore, when P8-Se301-C1 cells were infected with SeMNPV after synchronized treatment with hydroxyurea and nocodazole, light microscopy and qRT-PCR analysis showed that, compared with unsynchronized cells and S and G2/M phase cells, SeMNPV-infected P8-Se301-C1 cells in G1 phase induced G2/M phase arrest, and the amount of virus adsorption and intracellular viral DNA replication were significantly increased (p < 0.05). In addition, budded virus (BV) production and occlusion body (OB)-containing cells were both increased at 120 h post-infection (p < 0.05). The expression of Cyclin B and CDK1 was significantly down-regulated at 48 h post-infection (p < 0.05). Finally, the arrest of SeMNPV-infected G1 phase cells in the G2/M phase increased BV production (p < 0.05) and the number of OB-containing cells. In conclusion, G1 phase infection and G2/M arrest are favorable to SeMNPV proliferation in P8-Se301-C1 cells, thereby alleviating the homologous superinfection exclusion. The results contribute to a better understanding of the relationship between baculoviruses and insect cell cycle progression and regulation.

Nanobubbles improve peroxymonosulfate-based advanced oxidation: High efficiency, low toxicity/cost, and novel collaborative mechanism.

Cl- activated peroxymonosulfate (PMS) oxidation technology can effectively degrade pollutants, but the generation of chlorinated disinfection byproducts (DBPs) limits the application of this technology in water treatment. In this study, a method of nanobubbles (NBs) synergistic Cl-/PMS system was designed to try to improve this technology. The results showed the synergistic effects of NBs/Cl-/PMS were significant and universal while its upgrade rate was from 12.89% to 34.97%. Moreover, the synergistic effects can be further improved by increasing the concentration and Zeta potential of NBs. The main synergistic effects of NBs/Cl-/PMS system were due to the electrostatic attraction of negatively charged NBs to Na+ from NaCl, K+ from PMS, and H+ from phenol, which acted as a "bridge" between Cl- and HSO5- as well as phenol and Cl-/HSO5-, increasing active substance concentration. In addition, the addition of NBs completely changed the oxidation system of Cl-/PMS from one that increases environmental toxicity to one that reduces it. The reason was that the electrostatic attraction of NBs changed the active sites and degradation pathway of phenol, greatly reducing the production of highly toxic DBPs. This study developed a novel environmentally friendly oxidation technology, which provides an effective strategy to reduce the generation of DBPs in the Cl-/PMS system.

Targeted degradation of naphthalene by peroxymonosulfate activation using molecularly imprinted biochar.

Polycyclic aromatic hydrocarbons (PAHs) in aquatic environments are threatening ecosystems and human health. In this work, an effective and environmentally friendly catalyst based on biochar and molecular imprinting technology (MIT) was developed for the targeted degradation of PAHs by activating peroxymonosulfate. The results show that the adsorption amount of naphthalene (NAP) by molecularly imprinted biochar (MIP@BC) can reach 82% of the equilibrium adsorption capacity within 5 min, and it had well targeted adsorption for NAP in the solution mixture of NAP, QL and SMX. According to the comparison between the removal rates of NAP and QL by MIP@BC/PMS or BC/PMS system in respective pure solutions or mixed solutions, the MIP@BC/PMS system can better resist the interference of competing pollutants (i.e., QL) compared to the BC/PMS system; that is, MIP@BC had a good ability to selectively degrade NAP. Besides, the removal rate of NAP by MIP@BC/PMS gradually decreased as pH increased. The addition of Cl- greatly promoted the targeted removal of NAP in the MIP@BC/PMS system, while HCO3- and CO32- both had an inhibitory effect. Furthermore, SO4•-, O2•- and 1O2 produced by BC activating PMS dominated the NAP degradation, and it was inferred that the vacated imprinted cavities after NAP degradation can continue to selectively adsorb NAP and this could facilitate the reusability of the material. This study can promote the research on the targeted degradation of PAHs through the synergism of biochar/PMS advanced oxidation processes and MIT.

Resource utilization of rice straw to prepare biochar as peroxymonosulfate activator for naphthalene removal: Performances, mechanisms, environmental impact and applicability in groundwater.

Herein, biochar was prepared using rice straw, and it served as the peroxymonosulfate (PMS) activator to degrade naphthalene (NAP). The results showed that pyrolysis temperature has played an important role in regulating biochar structure and properties. The biochar prepared at 900°C (BC900) had the best activation capacity and could remove NAP in a wide range of initial pH (5-11). In the system of BC900/PMS, multi-reactive species were produced, in which 1O2 and electron transfer mainly contributed to NAP degradation. In addition, the interference of complex groundwater components on the NAP removal rate must get attention. Cl- had a significant promotional effect but risked the formation of chlorinated disinfection by-products. HCO3-, CO32-, and humic acid (HA) had an inhibitory effect; surfactants had compatibility problems with the BC900/PMS system, which could lead to unproductive consumption of PMS. Significantly, the BC900/PMS system showed satisfactory remediation performance in spiked natural groundwater and soil, and it could solve the problem of persistent groundwater contamination caused by NAP desorption from the soil. Besides, the degradation pathway of NAP was proposed, and the BC900/PMS system could degrade NAP into low or nontoxic products. These suggest that the BC900/PMS system has promising applications in in-situ groundwater remediation.

Effects of functional group loss on biochar activated persulfate in-situ remediation of phenol pollution in groundwater and its countermeasures.

Biochar is considered a good activator for use in advanced oxidation technology. However, dissolved solids (DS) released from biochar cause unstable activation efficiency. Biochar prepared from saccharification residue of barley straw (BC-SR) had less DS than that prepared directly from barley straw (BC-O). Moreover, BC-SR had a higher C content, degree of aromatization, and electrical conductivity than BC-O. Although the effects of BC-O and BC-SR on activation of Persulfate (PS) to remove phenol were similar, the activation effect of DS from BC-O was 73% higher than that of DS from BC-SR. Moreover, the activation effect of DS was shown to originate from its functional groups. Importantly, BC-SR had higher activation stability than BC-O owing to the stable graphitized carbon structure of BC-SR. Identification of reactive oxygen species showed that SO4•-, •OH, and 1O2 were all effective in degradation by BC-SR/PS and BC-O/PS systems, but their relative contributions differed. Furthermore, BC-SR as an activator showed high anti-interference ability in the complex groundwater matrix, indicating it has practical application value. Overall, this study provides novel insight that can facilitate the design and optimization of a green, economical, stable, and efficient biochar-activated PS for groundwater organic pollution remediation.

A narrative review of research progress on the role of NLRP3 inflammasome in acne vulgaris.

Background and Objective: Acne vulgaris is a common skin disease around the world which affects the appearance of patients, as well as their physical and mental health. Cutibacterium acnes plays a vital role in the occurrence and development of acne vulgaris. Pattern recognition receptors (PRRs) are the first line of defense against external pathogens. The nucleotide oligomerization domain (NOD)-like receptor family pyrin containing 3 (NLRP3) inflammasome has recently been shown to contribute to the pathogenesis of acne vulgaris. The purpose of this review is to clarify the underlying mechanisms of NLRP3 inflammasome in the pathogenesis of acne vulgaris, and its potential as a therapeutic target for the condition. Methods: The PubMed database was searched for relevant articles published in English between January 2003 to December 2021 using keywords "acne vulgaris", "NLRP3 inflammasome", and "Cutibacterium acnes". The reference lists of retrieved articles were also reviewed to identify relevant articles. Key Content and Findings: Cutibacterium acnes infection can lead to a series of inflammatory reactions and the production of inflammatory factors such as interleukin (IL)-1ß. In vitro and in vivo studies demonstrated that the NLRP3 inflammasome plays essential roles in acne vulgaris. Further, innate immunity and adaptive immunity pervade the entire pathogenesis of acne vulgaris. Conclusions: The NLRP3 inflammasome may be a potential therapeutic target for acne vulgaris. Future studies are needed to investigate the potential therapeutic effects of NLRP3 inhibitors on acne vulgaris.

Associations between coagulation factor XII, coagulation factor XI, and stability of venous thromboembolism: A case-control study.

BACKGROUND: Pulmonary embolism (PE) is a fatal clinical syndrome that is generally caused by an embolus from unstable deep venous thrombosis (DVT). However, clinical and biochemical factors that are related to the stability of DVT are not fully understood. AIM: To evaluate the relationships between plasma antigen levels of factor XII (FXII:Ag) and factor XI (FXI:Ag) with the stability of DVT. METHODS: Patients with DVT and no PE, DVT and PE, and controls with no DVT or PE that matched for age, gender, and comorbidities were included in this study. FXII:Ag and FXI:Ag in peripheral venous blood were measured using enzyme-linked immunosorbent assays. RESULTS: Using the 95th percentile of FXI:Ag in patients with DVT and PE as the cut-off, a higher FXI:Ag was associated with a higher risk of unstable DVT (odds ratio: 3.15, 95% confidence interval: 1.18-8.43, P = 0.019). Stratified analyses showed consistent results in patients ≤ 60 years (P = 0.020), but not in those > 60 years (P = 0.346). CONCLUSION: Higher plasma FXI:Ag might be a marker for unstable DVT, which might be associated with PE in these patients.

[Analysis of the Performance and Mechanism of Phosphorus Removal in Water by Steel Slag].

In view of the significant differences in phosphorus removal processes by different steel slags, electric furnace slag was taken as the research object to discuss the effects of environmental factors, including the adsorption time and adsorption temperature, on phosphorus removal and to verify the phosphorus removal performances of steel slag for phosphate, pyrophosphate, and actual water bodies. With the help of spectral techniques including scanning electron microscopy(SEM), energy dispersive X-ray spectroscopy(EDS), X-ray fluorescence spectroscopy(XRF), and an X-ray diffractometer(XRD), the phosphorus removal mechanisms of steel slag were explored. Moreover, the phosphorus removal abilities of different absorptive media of steel slag, ceramsite, and zeolite were compared, and the safety performances of phosphorus removal by steel slag were evaluated. The results showed that the adsorption time significantly affected the phosphorus removal efficiency of steel slag. The phosphorus removal efficiencies of phosphate solutions with a concentration range of 1-20 mg·L-1 using steel slag could reach over 97% when the adsorption time was 30 min. The effect of temperature on phosphorus removal by steel slag was not significant. The pyrophosphate adsorption capacity of steel slag was weaker than that of orthophosphate, and the removal rate of pyrophosphate with an initial concentration of 3 mg·L-1 was 82.45%. Spectral analysis showed that the mechanisms of phosphorus removal by steel slag were chemical adsorption assisted by physical adsorption, and calcium-phosphorus was the main precipitate component. CaHPO4·2H2O was the main precipitate. Steel slag exhibited excellent phosphorus removal properties for removing phosphorus in the biological pond effluent and wetland system, achieving total phosphorus removal rates of 98.36% and 93.33%, respectively. In comparison, the phosphate removal performance of steel slag was better than that of ceramsite and zeolite, and the removal efficiencies of PO43- were 96%, 40%, and 10%, respectively. The contents of heavy metals in the leaching solution of steel slag met the requirements of the Class I standard of surface water; thus, the steel slag was safe and reliable.

Nasal septal foreign body as a complication of dental root canal therapy: A case report.

BACKGROUND: Currently, there have been no reports on foreign bodies found in the nasal septum after dental root canal therapy. Herein, we present an unusual case of a foreign body found in the nasal septum, which occurred after dental root canal therapy and two unsuccessful surgeries. CASE SUMMARY: A 55-year-old man was referred to our department due to slight nasal discomfort that persisted for about 1 wk. Before consulting our department, the patient visited three different hospitals/clinics and underwent two surgeries that were not successful in removing a foreign body completely. A computed tomography scan was performed to detect the shift of the foreign body from dental root to the nasal septum, which resulted in the healing of oral inflammation and nasal septum discomfort. An endoscopic foreign body extraction surgery (3rd removal surgery) was then successfully performed, using a needle as the reference. No nasal reconstruction was required after the operation. Postoperative healing was uneventful. CONCLUSION: Medical healthcare professionals should consider past medical history when dealing with foreign body cases. During septal foreign body extraction surgery, a needle could be used as a helpful reference.

[Effects of nitrogen deposition and management intensity on stoichiometry of leaf litter in Moso bamboo forest.] / 氮沉降和经营强度对毛竹林凋落叶生态化学计量特征的影响.

In this study, a field experiment was conducted to estimate the effects of simulated nitrogen (N) deposition (low-N: 30 kg N·hm-2·a-1, moderate-N: 60 kg N·hm-2·a-1, high-N: 90 kg N·hm-2·a-1) on ecological stoichiometry of leaf litter in Moso bamboo forest under conventional management (CM) and intensive management (IM) practices. The results showed that compared with CM, IM significantly increased C, N and P concentrations of leaf litter by 9.3%, 32.4% and 22.7%, respectively, but significantly decreased C:N, C:P and N:P ratios by 17.4%, 54.3% and 44.6%, respectively. In CM Moso bamboo plots, low- and moderate-N deposition significantly increased C, N and P concentrations of leaf litter but decreased C:N, C:P and N:P, high-N deposition significantly increased C, N concentrations, C:P and N:P, but decreased P concentration. In IM Moso bamboo plots, low-N deposition significantly increased P concentration but decreased C concentrations, C:P and N:P, moderate-N deposition significantly increased N and P concentrations but decreased C concentration, C:N, C:P and N:P, high-N deposition significantly increased C:N, C:P and N:P but decreased P concentration. The interaction of management intensity and N deposition significantly influenced stoichiometry of leaf litter, except for C:N. The P concentration of leaf litter was significantly correlated with P concentration in soils.

Deletion of the transcriptional regulator GntR down regulated the expression of Genes Related to Virulence and Conferred Protection against Wild-Type Brucella Challenge in BALB/c Mice.

Brucellosis, which is caused by Brucella spp., is a zoonotic infectious disease that can cause great hazard to public health and safety. The virulence of Brucella is essential for survive and multiply in host macrophages. GntR is a transcriptional regulator in Brucella that is required for virulence in macrophages and mice, and involved in resistance to stress responses. To determine the expression levels of target genes of GntR, we detected the expression levels of the GntR target genes in Brucella infected BALB/c mice. The results showed that several genes related to virulence, including omp25, virB1, vjbR, dnaK, htrA and hfq, were regulated by GntR during infection in BALB/c mice. Moreover, the 2308ΔgntR mutant induced high protective immunity in BALB/c mice challenge with B. abortus 2308 (S2308), and elicited an anti-Brucella-specific immunoglobulin G (IgG) response and induced the secretion of gamma interferon (IFN-γ) and interleukin-4 (IL-4). All together, these results indicated that gntR promoted the virulence of Brucella. The 2308ΔgntR was significantly attenuated in macrophages and mice and induced protective immune response during infection, suggested that 2308ΔgntR mutant is an attractive candidate for the design of a live attenuated vaccine against Brucella.

Paradoxical embolism: A report of 2 cases.

RATIONALE: Paradoxical embolism (PDE) refers to direct passage of venous thrombi into the arterial circulation through an arteriovenous shunt. PATIENT CONCERNS: Case 1 presented with initial symptoms of shock and cerebral infarction. Case 2 developed middle cerebral artery occlusion during angiography. DIAGNOSES: 2 cases were diagnosed as PDE. INTERVENTIONS: They received thrombolytic therapy and anticoagulant therapy. OUTCOMES: The patients had recovery. LESSONS: This report highlights the myriad clinical manifestations of PDE and underlines the importance of meticulous history taking and physical examination for early diagnosis.

The effects of the 5-HT2A receptor antagonist sarpogrelate hydrochloride on chronic hypoxic pulmonary hypertension in rats.

PURPOSE OF THE STUDY: This study investigated whether sarpogrelate hydrochloride (SPG), a 5-HT2A receptor antagonist, alleviates chronic hypoxic pulmonary hypertension (CH-PH) in rats by stimulating apoptosis and inhibiting proliferation in pulmonary artery smooth muscle cells (PASMCs). MATERIALS AND METHODS: Forty male Sprague-Dawley rats were pretreated with SPG (50 mg/kg/day by oral gavage) or saline vehicle and then subjected to chronic hypoxia (CH) (hypobaric chamber set to 380 mmHg, 10% oxygen) or normoxia for 14 days. Mean pulmonary artery pressure (PAP) and right ventricular hypertrophy (RVH) were measured. Hypertensive pulmonary vascular remodeling was assayed by light microscopy. Terminal deoxynucletidyl transferase dUTP nick end ligase (TUNEL) assays, western blotting, and real-time polymerase chain reaction were used to assess apoptosis, proliferation and underlying signaling pathways in PASMCs from lung tissue and isolated pulmonary artery rings. RESULTS: CH increased mean PAP and RVH. CH increased the percentage of muscularized arteries in the peripheral pulmonary vasculature and medial wall thickness in small muscular arteries. CH increased pulmonary protein and mRNA levels of the B-cell lymphoma protein 2 (Bcl-2), pyruvate dehydrogenase kinase (PDK), phosphorylation of extracellular signal-regulated kinases 1 and 2 (pERK1/2), cyclin D1, proliferating cell nuclear antigen (PCNA) and decreased protein and mRNA levels of Bcl-2-associated X protein (BAX), cleaved caspase-3. Pretreatment with SPG, which has been shown previously to inhibit ERK1/2 phosphorylation and PDK, countered all of these effects. Isolated pulmonary artery rings incubated with 5-HT increased pERK1/2, PDK, and Bcl-2 expression, and decreased Bax expression. CONCLUSION: Administration of SPG ameliorated the development of CH-PH by stimulating apoptosis in and inhibiting proliferation of PASMCs.

Immunization of BALB/c mice with Brucella abortus 2308ΔwbkA confers protection against wild-type infection.

Brucellosis is a zoonotic disease that causes animal and human diseases. Vaccination is a major measure for prevention of brucellosis, but it is currently not possible to distinguish vaccinated animals from those that have been naturally infected. Therefore, in this study, we constructed the Brucella (B.) abortus 2380 wbkA mutant (2308ΔwbkA) and evaluated its virulence. The survival of 2308ΔwbkA was attenuated in murine macrophage (RAW 264.7) and BALB/c mice, and it induced high protective immunity in mice. The wbkA mutant elicited an anti-Brucella-specific immunoglobulin G response and induced the secretion of gamma interferon. Antibodies to 2308ΔwbkA could be detected in sera from mice, implying the potential for use of this protein as a diagnostic antigen. The WbkA antigen would allow serological differentiation between infected and vaccinated animals. These results suggest that 2308ΔwbkA is a potential attenuated vaccine against 16M. This vaccine will be further evaluated in sheep.

A Meta-Analysis of Concurrent Chemoradiotherapy for Advanced Esophageal Cancer.

BACKGROUND: Concurrent chemoradiotherapy is a standard treatment for local advanced esophageal cancer, but the outcomes are controversial. Our goals were to compare the therapeutic effects of concurrent chemoradiotherapy and radiotherapy alone in local advanced esophageal cancer using meta-analysis. METHODS: MEDLINE, EMBASE and the Cochrane library were searched for studies comparing chemoradiotherapy with radiotherapy alone for advanced esophageal cancer. Only randomized controlled trials were included, and extracted data were analyzed with Review Manager Version 5.2. The pooled relative risks (RR) and their 95% confidence intervals (CI) were calculated for statistical analysis. RESULTS: Nine studies were included. Of 1,135 cases, 612 received concurrent chemoradiotherapy and 523 were treated with radiotherapy alone. The overall response rate (complete remission and partial remission) was 93.4% for concurrent chemoradiotherapy and 83.7% for radiotherapy alone (P = 0.05). The RR values of 1-year, 3-year, and 5-year survival rates were 1.14 (95% CI: 1.04 - 1.24, P = 0.006), 1.66 (95% CI: 1.34 - 2.06, P < 0.001), and 2.43 (95% CI: 1.63 - 3.63, P < 0.001), respectively. The RR value of the merged occurrence rate of acute toxic effects was 2.34 (95% CI: 1.90 - 2.90, P <0.001). There was no difference in the incidence of late toxic effects, which had an RR value of 1.21 (95% CI: 0.96 - 1.54, P = 0.11). The RR level of persistence and recurrence was 0.71 (95% CI: 0.62 - 0.81, P <0.001), and for the distant metastasis rate, the RR value was 0.79 (95% CI: 0.61 - 1.02, P = 0.07). CONCLUSIONS: Concurrent chemoradiotherapy significantly improved overall survival rate, reduced the risk of persistence and recurrence, but had little effect on the primary tumor response, and increased the occurrence of acute toxic effects.

An irregular approach of right atrial lead placement in a patient with persistent left superior vena cava and concomitant agenesis of the right-sided superior vena cava.

Persistent left superior vena cava (PLSVC) is the most common venous anomaly of the thorax. It could lead to catheter malplacement and even vascular injuries. We describe an unusual way to deliver a right atrial (RA) endocardial pacing lead in a 61-year-old female with a PLSVC concomitant agenesis of the right-sided SVC. After failed attempts with the standard procedure, we placed the RA lead tip in the PLSVC near the right auricle. The pacemaker worked well after one and 17 months of follow-up. We conclude that when placement of the RA lead fails, the PLSVC near the right auricle could be a next choice in the RA lead placement in patients with PLSVC concomitant agenesis of the right-sided SVC.

Efficacy of topical ALA-PDT combined with excision in the treatment of skin malignant tumor.

BACKGROUND: Photodynamic therapy (PDT) is a successful treatment for non-melanoma skin cancers in clinical practice. In China, more and more doctors use PDT to cure the patients with skin cancer, especially in the elder. The purpose of this study was to evaluate the efficacy of topical PDT using aminolevulinic acid (5-ALA) combined with excision in the treatment of skin malignant tumor and its role in surgical improvements. METHODS: A total of 58 cases including 32 cases of BCC, 13 cases of Bowen's disease, 8 cases of Paget's disease and 5 cases of SCC were included in this study. All cases were treated with topical ALA-PDT after surgery. Each tumor region was irradiated with 120 J/cm(2) using a 635-nm laser for 15 min. A total of 3 times of assisted ALA-PDT was applied after surgery. RESULTS: There was no recurrence in 6 months after treatment. Only 5 cases of Paget's disease and 2 cases of SCC experienced disease recurrence in 1 year. All patients were able to complete the treatment protocol, with well cosmetic results and no moderate adverse reactions. CONCLUSIONS: As an assistive therapy after tumor resection, ALA-PDT can reduce the excision range of the tumor lesions. However, its role in the reduction of recurrence rate remains to be further investigated.

[Upper airway changes in obstructive sleep apnea suffers after H-uvulopalatopharyngoplasty and H-uvulopalatopharyngoplasty combined with transpalatal advancement pharyngoplasty].

OBJECTIVE: To compare the different postoperative changes of the pharynx in obstructive sleep apnea hypopnea syndrome (OSAHS) patients treated with H-uvulopalatopharyngoplasty (H-UPPP) combined with transpalatal advancement pharyngoplasty (PA) surgery or H-UPPP alone. METHODS: The upper airway in 43 patients with OSAHS were scanned during the end of normal respiration before and after treatment. There were 17 patients undergoing H-UPPP alone, 26 patients undergoing H-UPPP combined with PA, with PSG before and after treatment. To compare the efficacy of H-UPPP with PA surgery or H-UPPP alone, upper airway characteristics were measured following each procedure in 43 patients using a quantitative 3-D CT. The 3-D CT measurement were made in lateral and anterior-posterior diameters, cross-section areas and volumes of retropalatal and retroglossal region. The changes in the structure of OSAHS patients treated with H-UPPP combined with PA surgery and H-UPPP alone were compared preoperatively and postoperatively, and the correction features that were presented in AHI and structural changes were analysed. RESULTS: The difference between H-UPPP combined with PA (n = 26) and H-UPPP (n = 17) in the changes in apnea hypopnea index (AHI) were (67.5 ± 18.9, 38.7 ± 42.0, t = 2.84, P < 0.05), hard palate lengths were (4.50 ± 3.72) mm and (0.06 ± 0.22) mm (t = 5.55, P < 0.01); anteroposterior diameters of the hard palate level were (3.5 ± 4.3) mm and (-1.7 ± 4.4) mm (t = 3.90, P < 0.01); the minimum anteroposterior diameters of retropalatal were (1.2 ± 2.2) mm and (-1.2 ± 2.3) mm (t = -3.49, P < 0.01); the minimum lateral diameters of retroglossal area were (4.9 ± 9.6) mm and (13.1 ± 9.1) mm (t = 2.80, P < 0.01) preoperatively and postoperatively. The changes in the hard palate lengths were positively correlated to the change in AHI (r = 0.407, P < 0.01), also the change in anteroposterior diameter of the hard palate level (r = 0.351, P < 0.05), the minimum anteroposterior diameter of retropalatal area (r = 0.381, P < 0.01), and the minimum cross-section area of retropalatal (r = 0.312, P < 0.05). CONCLUSIONS: H-UPPP combined with PA offers benefit over H-UPPP alone in OSAHS patients, which may be achieved by increased retropalatal airway size. Both the anteroposterior dimensions and the cross-area size are related with the efficacy of surgery.

[Correlation between lung volume and the severity of obstructive sleep apnea hypopnea syndrome in obese patients].

OBJECTIVE: To examine the relationship between the severity of obstructive sleep apnea hypopnea syndrome (OSAHS), lung volume and obesity. METHODS: The study included 60 adult male obese patients with OSAHS determined by overnight polysomnogram (PSG) using American Academy of Sleep Medicine-defined criteria. Lung volume measurements were made in maximum vital capacity (VCmax), forced vital capacity (FVC), maximum voluntary ventilation (MVV), functional residual capacity (FRC) and total lung capacity (TLC). RESULTS: The aponea hypopnea index (AHI) were negatively correlated with FVC, MVV, VCmax (r were -0.533, -0.276 and -0.575, P < 0.01 or P < 0.05). But the lowest arterial oxygen saturation (LSaO2) and the mean arterial oxygen saturation (MSaO2) were positively correlated with FVC, MVV and VCmax (r were 0.299, 0.435, 0.412, and 0.344, 0.474, 0.457, P < 0.01 or P < 0.05). The body mass index (BMI) were positively correlated with AHI (r = 0.728, r(2) = 0.530, P < 0.01). The FVC, MVV, VCmax, LSaO2 and MSaO2 varied inversely with BMI. FRC and TLC had no relation with AHI, LSaO2, MSaO2 and BMI. CONCLUSIONS: There are significant correlations among obesity, dynamic lung volume and OSAHS severity. This result suggests that changes in dynamic lung volume may play an important role in the pathogenesis of OSAHS in obese patients.

[Improved minimally invasive DHS internal fixation for old age patients with intertrochanteric fractures].

OBJECTIVE: To discuss the improved minimally invasive DHS fixation for treatment of intertrochanteric fractures in aged and the influence on the lateral wall of the femoral. METHODS: From January 2005 to December 2010,480 aged patients with intertrochanteric fractures were treated by modified minimally invasive DHS fixation. There were 21 males and 268 females,with an average age of 78.3 years old ranging from 60 to 103 years. Aaccording to the Evans type,there were 166 cases of type 1,212 of type II , 86 of type 111, 16 of type IV, among them 46 cases had the dangerous fractures of the lateral wall. The incision length,blood loss volume,time from extending surgical incision in the side panel to close and postoperative complications were observed and recorded. At 1 month, 3 and 6 months after operation,the patients were followed-up,the outcome were evaluated according to the imaging evaluation index and clinical effect assessment indexes. RESULTS: The surgical incision length averaged (8.0+/-1.2) cm, peri-operative bleeding averaged (150.0+/-6.4) ml,time from extending the incision in the operation to close incision averaged (22.0+/-1.3) min, 1 case had postoperative rupture of the external wall, and 3 cases had tension screw cut out in the femoral head,4 cases had excessive shrink back. Postoperative 6 months basic daily living skills (BADL) averaged (14.8+/-1.1) scores, and the ability of walk averaged (6.40+/-0.34) scores. CONCLUSION: Improved minimally invasive DHS fixation for treatment of intertrochanteric fractures in aged had advantages of small trauma surgery,short wound exposure time, less peri-operative bleeding and the integrity of the lateral wall after operation, the basic daily living skills and ability to walk has an ideal recovery activities, satisfied clinical curative effect.