Point-of-care ultrasound for monitoring catheter tip location during umbilical vein catheterization in neonates: a prospective study.

Background: Point-of-care ultrasound (POCUS) can guide umbilical vein catheter placement in real time and monitor catheter tip position, allowing avoidance of severe complications due to catheter malposition. This study aims to explore the effectiveness of POCUS in guiding venous catheter insertion and monitoring complications. Methods: Sixty-eight neonates with ultrasound-guided venous catheter insertion at the Neonatal Department of Dongguan Children's Hospital between December 2020 and February 2022 were included. POCUS was applied to monitor catheter tip location daily until catheter removal. A displacement range exceeding the intersection of the inferior vena cava and right atrium by ±0.5 cm was considered misalignment. Results: Sixty-four neonates had a displaced catheter tip (94.1%, 64/68), with a median displacement distance of 0.4 cm (minimum -0.2 cm, maximum 1.2 cm). Ten neonates had a misalignment (14.7%, 10/68) caused by displacement. Displacement usually occurs within 2-4 days after placement, with displacement rates of 94.1% (64/68), 90.6% (58/64), and 98.3% (59/60) on days 2, 3, and 4, respectively, and could still occur on day 9 post-placement. In addition, misalignment mainly occurs on the second day after placement. During the monitoring process, 58 neonates had catheter tip displacement ≥2 times, resulting in 252 displacement and 22 misalignment incidents. Among them, the catheter tip migrated outward from the inferior vena cava seven times, all of which were removed in time. Ultrasound was used for positioning 486 times, and x-ray was indirectly avoided 486 times. Conclusion: The catheter tip is prone to displacement and misalignment after umbilical vein catheterization, which most commonly occurs on days 2-4. POCUS is recommended for daily monitoring of the tip location during umbilical vein catheterization until catheter removal.

[Clinical features of severe meconium aspiration syndrome (MAS) and early predicting factors for severe MAS in neonates with meconium-stained amniotic fluid]. / èƒŽç²ªæ±¡æŸ“ç¾Šæ°´æ–°ç”Ÿå„¿å‘ç”Ÿé‡åº¦èƒŽç²ªå¸å ¥ç»¼åˆå¾çš„ä¸´åºŠç‰¹å¾åŠé¢„è­¦å› ç´ åˆ†æž.

OBJECTIVES: To study the clinical features of severe meconium aspiration syndrome (MAS) and early predicting factors for the development of severe MAS in neonates with meconium-stained amniotic fluid (MSAF). METHODS: A total of 295 neonates who were hospitalized due to Ⅲ° MSAF from January 2018 to December 2019 were enrolled as subjects. The neonates were classified to a non-MAS group (n=199), a mild/moderate MAS group (n=77), and a severe MAS group (n=19). A retrospective analysis was performed for general clinical data, blood gas parameters, infection indicators, and perinatal clinical data of the mother. The respiratory support regimens after birth were compared among the three groups. The receiver operating characteristic (ROC) curve and multivariate logistic regression analysis were used to investigate predicting factors for the development of severe MAS in neonates with MSAF. RESULTS: Among the 295 neonates with MSAF, 32.5% (96/295) experienced MAS, among whom 20% (19/96) had severe MAS. Compared with the mild/moderate MAS group and the non-MAS group, the severe MAS group had a significantly lower 5-minute Apgar score (P<0.05) and a significantly higher blood lactate level in the umbilical artery (P<0.05). Compared with the non-MAS group, the severe MAS group had a significantly higher level of interleukin-6 (IL-6) in peripheral blood at 1 hour after birth (P<0.017). In the severe MAS group, 79% (15/19) of the neonates were born inactive, among whom 13 underwent meconium suctioning, and 100% of the neonates started to receive mechanical ventilation within 24 hours. Peripheral blood IL-6 >39.02 pg/mL and white blood cell count (WBC) >30.345×109/L at 1 hour after birth were early predicting indicators for severe MAS in neonates with MSAF (P<0.05). CONCLUSIONS: Meconium suctioning cannot completely prevent the onset of severe MAS in neonates with MSAF. The neonates with severe MAS may develop severe respiratory distress and require mechanical ventilation early after birth. Close monitoring of blood lactate in the umbilical artery and peripheral blood IL-6 and WBC at 1 hour after birth may help with early prediction of the development and severity of MAS.

Clinical features and prognosis of severe meconium aspiration syndrome with acute respiratory distress syndrome. / é‡åº¦èƒŽç²ªå¸å ¥ç»¼åˆå¾å¹¶å‘æ€¥æ€§å‘¼å¸çª˜è¿«ç»¼åˆå¾ä¸´åºŠç‰¹å¾åŠè½¬å½’åˆ†æž.

OBJECTIVES: To study the clinical features and prognosis of neonates with severe meconium aspiration syndrome (MAS) and acute respiratory distress syndrome (ARDS). METHODS: A retrospective analysis was performed on the medical data of 60 neonates with severe MAS who were admitted from January 2017 to December 2019. According to the presence or absence of ARDS, they were divided into two groups: ARDS (n=45) and non-ARDS (n=15). Clinical features and prognosis were compared between the two groups. RESULTS: Among the 60 neonates with severe MAS, 45 (75%) developed ARDS. Arterial blood gas analysis showed that the ARDS group had a significantly higher median oxygenation index within 1 hour after birth than the non-ARDS group (4.7 vs 2.1, P<0.05), while there was no significant difference between the two groups in white blood cell count, C-reactive protein (CRP), and interleukin-6 (IL-6) on admission and the peak values of procalcitonin, CRP, and IL-6 during hospitalization (P>0.05). The ARDS group had a significantly higher incidence rate of shock than the non-ARDS group (84% vs 47%, P<0.05). There was no significant difference between the two groups in the incidence rates of persistent pulmonary hypertension, pneumothorax, pulmonary hemorrhage, hypoxic-ischemic encephalopathy, intracranial hemorrhage, and disseminated intravascular coagulation (P>0.05). The ARDS group required a longer median duration of mechanical ventilation than the non-ARDS group (53 hours vs 3 hours, P<0.05). In the ARDS group, 43 neonates (96%) were cured and 2 neonates (4%) died. In the non-ARDS group, all 15 neonates (100%) were cured. CONCLUSIONS: Neonates with severe MAS and ARDS tend to develop respiratory distress earlier, require a longer duration of mechanical ventilation, and have a higher incidence rate of shock. During the management of children with severe MAS, it is recommended to closely monitor oxygenation index, give timely diagnosis and treatment of ARDS, evaluate tissue perfusion, and actively prevent and treat shock. Citation.

CircRNA ZNF609 promotes angiogenesis in nasopharyngeal carcinoma by regulating miR-145/STMN1 axis.

Nasopharyngeal carcinoma (NPC) is the most common type of human malignant tumor in the head and neck, and tumor angiogenesis is essential for its development. Here, we showed that the circRNA ZNF609/microRNA (miR)-145/Stathmin 1 (STMN1) axis regulated angiogenesis in NPC.Circ-ZNF609, miR-145, and STMN1 expression in NPC cells and NPC samples were examined using qRT-PCR. The protein levels of STMN1, VEGFR1, and VEGFR2 were evaluated using western blotting. VEGF level was determined by ELISA. The proliferation of NPC cells and HUVECs was examined using a CCK-8 assay. Transwell assays and wound-healing assays were applied to assess the migration of NPC cells and HUVECs, respectively. Angiogenesis of HUVECs was evaluated by an angiogenesis assay. In addition, a dual-luciferase reporter assay and RNA pull-down assays were employed to verify the binding relationship between circ-ZNF609 and miR-145 as well as between miR-145 and STMN1. Here, we showed that circ-ZNF609 and STMN1 expression was increased, while miR-145 expression was decreased in NPC cells and NPC samples. Circ-ZNF609 may negatively regulate miR-145 expression by acting as a ceRNA. Silencing circ-ZNF609 suppressed cell proliferation, migration, and angiogenesis in NPC, while knockdown of miR-145 reversed these effects. In addition, we found that STMN1 was the downstream target of miR-145. MiR-145 overexpression suppressed cell proliferation, migration, and angiogenesis in NPC, which was abolished by STMN1 overexpression. Our data suggested that circ-ZNF609 promotes cell proliferation, migration, and angiogenesis in NPC by upregulating the expression of STMN1 by sponging miR-145 in NPC.

[Impact of mild hypothermia therapy on hemodynamics during the induction stage in neonates with moderate to severe hypoxic-ischemic encephalopathy].

OBJECTIVE: To study the changes in hemodynamics during the induction stage of systemic mild hypothermia therapy in neonates with moderate to severe hypoxic-ischemic encephalopathy (HIE). METHODS: A total of 21 neonates with HIE who underwent systemic mild hypothermia therapy in the Department of Neonatology, Dongguan Children's Hospital Affiliated to Guangdong Medical University, from July 2017 to April 2020 were enrolled. The rectal temperature of the neonates was lowered to 34℃ after 1-2 hours of induction and maintained at this level for 72 hours using a hypothermia blanket. The impedance method was used for noninvasive hemodynamic monitoring, and the changes in heart rate (HR), mean arterial pressure (MAP), stroke volume (SV), cardiac output (CO), cardiac index (CI), and total peripheral resistance (TPR) from the start of hypothermia induction to the achievement of target rectal temperature (34℃). Blood lactic acid (LAC) and resistance index (RI) of the middle cerebral artery were recorded simultaneously. RESULTS: The 21 neonates with HIE had a mean gestational age of (39.6±1.1) weeks, a mean birth weight of (3 439±517) g, and a mean 5-minute Apgar score of 6.8±2.0. From the start of hypothermia induction to the achievement of target rectal temperature (34℃), there were significant reductions in HR, CO, and CI (P < 0.05), while there was no significant change in SV and MAP (P > 0.05). There was a significant increase in TPR (P < 0.05) and a significant reduction in LAC (P < 0.05), while there was no significant change in RI (P > 0.05). CONCLUSIONS: The systemic mild hypothermia therapy may have a significant impact on hemodynamics in neonates with moderate to severe HIE, and continuous hemodynamic monitoring is required during the treatment.

Postoperative secondary aggravation of obstructive sleep apnea-hypopnea syndrome and hypoxemia with bilateral carotid body tumor: A case report.

BACKGROUND: Carotid body tumor (CBT) is a chemoreceptor tumor located in the carotid body, accounting for approximately 0.22% of head and neck tumors. Surgery is the main treatment method for the disease. CASE SUMMARY: We reviewed the diagnosis and treatment of one patient who had postoperative secondary aggravation of obstructive sleep apnea-hypopnea syndrome (OSAHS) and hypoxia after surgical resection of bilateral CBTs. This patient was admitted, and relevant laboratory and imaging examinations, and polysomnography (PSG) were performed. After the definitive diagnosis, continuous positive airway pressure (CPAP) treatment was given, which achieved good efficacy. CONCLUSION: This case suggested that aggravation of OSAHS and hypoxemia is possibly caused by the postoperative complications after bilateral CBTs, and diagnosis by PSG and CPAP treatment are helpful for this patient.

[Effect of different antibiotic use strategies on infection in neonates with premature rupture of membranes and high-risk factors for neonatal infection].

OBJECTIVE: To study the effect of different antibiotic use strategies on infection in neonates with premature rupture of membranes and the high-risk factors for neonatal infection. METHODS: A retrospective analysis was performed for the clinical data of 223 neonates with premature rupture of membranes. According to the antibiotic use strategies, they were classified into two groups: study group (n=95) and control group (n=128). The neonates in the study group were given antibiotics based on risk assessment and infection screening, and those in the control group were given antibiotics based on risk assessment alone after admission. General status and prognosis were compared between the two groups. According to the presence or absence of infection, the neonates were classified into two groups: infection group (n=32) and non-infection group (n=191). The clinical data were compared between the two groups. A logistic regression model was used to investigate the high-risk factors for infection in neonates with premature rupture of membranes. RESULTS: Compared with the control group, the study group had a significantly longer time of premature rupture of membranes, a significantly higher rate of cesarean section, and a significantly lower antibiotic use rate at admission and a significantly lower total antibiotic use rate (P<0.05). The study group also had a significantly higher incidence rate of infection and a significantly lower incidence rate of sepsis (P<0.05). There were no significant differences in the incidence rates of other complications between the two groups (P>0.05). Compared with the non-infection group, the infection group had a significantly lower gestational age, a significantly longer time of premature rupture of membranes, a significantly higher rate of cesarean section, and significantly higher levels of C-reactive protein (CRP) and procalcitonin on admission and during reexamination (P<0.05), with fever as the most common symptom. The logistic regression analysis showed that preterm birth and cesarean section were high-risk factors for infection in neonates with premature rupture of membranes (P<0.05). CONCLUSIONS: Strict adherence to the indications for antibiotic use in neonates with premature rupture of membranes does not increase the incidence rate of complications. Neonates with premature rupture of membranes, especially preterm infants and infants delivered by cesarean section, should be closely observed for the change in disease conditions, and infection indices including CRP should be reexamined in case of fever and antibiotics should be used to prevent serious infection.

Use of Neonatal Lung Ultrasound for the Early Detection of Pneumothorax.

OBJECTIVE: Pneumothorax (PTX) can be diagnosed using lung ultrasonography (LUS) in adult patients, but there are only a few reports of LUS in PTX diagnosis in neonates. The aim of the study was to assess the diagnostic accuracy for PTX. STUDY DESIGN: This was a retrospective review study performed in our neonatal intensive care unit (level III) between June 2015 and June 2018. All eligible patients underwent an LUS scan before undergoing a chest X-ray (CXR), which was considered the reference standard. When a diagnosis of PTX was inconsistent between LUS and CXR, a chest computed tomography (CT) scan or chest drain was considered the gold standard. RESULTS: Among 86 infants included in the study, 30 (34.9%) were diagnosed with PTX. In these 30 infants, 35 PTXs were detected by bedside LUS (five bilateral PTXs). Moreover, 11 infants with 14 PTXs were diagnosed only by LUS and were missed by CXR. Out of these 11 infants, 7 underwent a CT scan, whereas the remaining 4 underwent thoracentesis that confirmed PTX diagnosis. CONCLUSION: In neonates with PTX, LUS was more sensitive and specific for the early detection of PTX compared with CXR.

[Study on Multi-Bands Recognition for Varieties of Mutton by Using Hyperspectral Technologies].

This paper focused on the research on identifying and classifying for mutton varieties of Tan-han hybrid sheep,Yanchi Tan-sheep and small-tailed sheep in Ningxia by using visible/ near-infrared (400~1 000 nm). Near infrared (900~1 700 nm) hyperspectral technologies, baseline and SG convolution smoothing spectra pretreatment methods were applied respectively according to the characteristics of different spectrum bands; the characteristic wavelengths were extracted by using successive projection algorithm (SPA);then combined with linear discriminant analysis (LDA) and radial basis kernel function of support vector machine (RBFSVM) model were applied to identify the different mutton varieties under characteristic wavelengths and full-wave bands. Results showed that there were good effects for mutton varieties identification in different hyperspectral bands, among which Baseline-Fullwave-RBFSVM and the same models under 12 characteristic wavelengths obtained accuracy of 100% and 98.75% in 400~1 000 nm respectively, and Baseline-Fullwave-RBFSVM and the same models under 7 characteristic wavelengths obtained accuracy of 96.25% and 87.80% in 900~1 700 nm respectively.The identification accuracy of RBFSVM nonlinear classification was higher than the LDA linear discriminant result, meanwhile the identification accuracy in 400~1 000 nm bands was better than in 1 000~1 700 nm bands, which explained that the differences of color and texture were more significant than the component contents among the 3 varieties mutton. Combined hyperspectral technologies with RBFSVM models can obtain a better recognition effect of mutton varieties.

Candidate single-nucleotide polymorphisms and cerebral palsy: A case-control study.

Certain genetic polymorphisms have been suggested to be associated with cerebral palsy; the candidate genes are involved in thrombophilia, inflammation and preterm labor, but the mechanism remains to be elucidated. The aim of the present study was to investigate the associations between selected single-nucleotide polymorphisms (SNPs) and cerebral palsy among children. A case-control study was conducted, including 74 infants with cerebral palsy (case group) and 99 healthy infants (control group). The distributions of the allele and genotype frequencies were examined for the total cerebral palsy patient population in addition to subgroups divided according to gestational age (preterm versus full-term). The results showed that the rs1042714 variant in adrenergic receptor ß-2 (ADRB2) and heterozygosity for ADRB2 were associated with the cerebral palsy risk among the preterm infants. No significant differences in the allele or genotype frequencies were observed between the total cerebral palsy patient population and controls for the eight SNPs investigated.

Surgical treatment of gynecomastia: mastectomy compared to liposuction technique.

BACKGROUND: Gynecomastia is a benign enlargement of the male breast. Yet enlarged breasts cause anxiety, embarrassment, psychosocial discomfort, and fear of breast cancer. The aim of this study was to assess the experience of gynecomastia patients undergoing mastectomy and liposuction surgery. METHODS: Seven hundred thirty-three patients were analyzed for age, chief complaint, position, grade, operation approach, biopsy, and complication between mastectomy group and liposuction group, from 1990 to 2010. RESULTS: Four hundred two patients (436 breasts) were treated with mastectomy and 331 patients (386 breasts) were treated with liposuction techniques. Three hundred thirty (82%) patients complained of breast lump and lump with pain in mastectomy group, and 204 (61%) patients complained of enlargement breast and enlargement with pain in liposuction group (P < 0.05). All excision specimens were performed for routine histological analysis which showed pathologic diagnosis in patients with mastectomy (100%). One hundred fifty-nine (41%) patients with liposuction acquired pathologic diagnosis through fine needle aspiration and/or core biopsy (P < 0.05). The reoperation rates in mastectomy group and liposuction group were 1.4% and 0.5%, respectively. There were no nipple/areola necrosis and scars in liposuction group. CONCLUSIONS: The surgical treatment of gynecomastia required an individual approach, depending on symptoms (lump or enlargement) and requirements of patients. Patients who chose mastectomy were looking for reassurance that their pathologic diagnosis was benign. The increase in the number of liposuction patients was reflected in our study because it was associated with superior esthetic results and few complications.

Peritoneal metastasis of third ventricular atypical teratoid/rhabdoid tumor after VP shunt implantation for unexplained hydrocephalus.

BACKGROUND: Atypical teratoid/rhabdoid tumor (AT/RT) of the central nervous system (CNS) is a highly malignant neoplasm seen frequently in infancy and early childhood. This report presents a 9-year-old girl of primary third ventricular AT/RT with peritoneal metastasis after ventriculoperitoneal (VP) shunt catheter implantation for hydrocephalus before the identification of the CNS tumor. METHODS: The data of clinical course, laboratory and imaging studies were obtained and carefully reviewed. Serial imaging studies including enhanced CT and MRI were performed at the first admission, during which the patient was diagnosed with a non-malignant communicating hydrocephalus. Secondary radiological studies were carried out 5 months after VP shunt, during which the patient demonstrated worsening clinical signs of intracranial hypertension. An imaging study identified a tumor in the third ventricle. RESULTS: The patient was treated by a surgical resection, showing the specimen was pathologically consistent with AT/RT 5 months after VP shunt. Systematic chemotherapy and radiotherapy were prescribed for the patient. After 6 months, PET/CT revealed peritoneal metastasis but negative findings in the CNS. The parents of the patient refused further intervention, and she died one month later. CONCLUSION: VP shunt in a patient with AT/RT may cause distant seeding of the tumor in unrelated areas of the body, even after intensive multimodality treatment. Further studies on shunt related metastases are needed.

Covariation of copy number located at 16q22.1: new evidence in mammary ductal carcinoma.

Copy number variation (CNV) is crucial for gene regulation in humans. A number of studies have revealed that CNV contributes to the initiation and progression of cancer. In this study, we analysed four breast cancer cell lines and six fresh frozen tissues from patients to evaluate the CNV present in the genome using microarray-based comparative genomic hybridization (aCGH). Six genes located at 16q22.1 were analysed by real-time PCR. The real-time PCR analysis revealed that the loss of CDH1/E2F4 may be associated with worse clinical and pathological findings. Interestingly, covariation of CDH1, CDH3, CTCF and E2F4 was found to be associated with triple negative breast cancer and HER-2 receptor status. In conclusion, our study supports the idea that CNV at 16q22.1 in breast cancer is a frequent event; furthermore, it reveals the covariation of CDH1, CDH3, CTCF and E2F4. The role of the covariation is more complex than a simple additive effect of these four separate genes, which may provide a novel target for breast cancer.

TRB3 overexpression due to endoplasmic reticulum stress inhibits AKT kinase activation of tongue squamous cell carcinoma.

Our investigation aims to evaluate the significance of TRB3, an endoplasmic reticulum stress (ERS)-inducible gene, and explore its relationship with AKT in oral tongue squamous cell carcinoma (OTSCC). Expression of TRB3 and phosphorylated AKT (p-AKT) in OTSCC tissues and adjacent normal tissues were assessed by RT-PCR, Western blot and immunohistochemistry assay. Correlation of TRB3 and AKT was validated by TRB3 adenovirus plasmid (Ad-TRB3) transfection and short hairpin RNA (shRNA) inhibition. The mRNA expression of TRB3 was significantly higher than adjacent noncancerous tissues by RT-PCR in 15 of 18 specimens of OTSCC (83.3%, P<0.01). Both of TRB3 and AKT were highly expressed in 13 of 18 (72.2%) specimens of OTSCC comparing with adjacent noncancerous tissues by Western blot assay (P<0.05). TRB3 was significantly elevated in 49.2% (63/128) of pathologically confirmed specimens and 13.3% (4/30) of adjacent noncancerous specimens by immunohistochemical analysis (P<0.01). TRB3 overexpression was closely correlated with tumor pathological T stage, lymph node metastasis and tumor recurrence. In addition, both mRNA and protein expression of TRB3 was increased under thapsigargin (TG) or tunicmycin (TU)-induced ERS in Tca8113 and CAL-27 cells. Moreover, expression of p-AKT protein decreased when Ad-TRB3 was transected with OTSCC Tca8113 cells. However, expression of p-AKT protein increased when TRB3 was inhibited by TRB3 shRNA inhibition. TRB3 expression was closely correlated with OTSCC prognosis. Under ERS, TRB3 was up-regulated, resulting in inhibiting the activation of AKT in OTSCC.

Proteomic profiling between CNE-2 and its strongly metastatic subclone S-18 and functional characterization of HSP27 in metastasis of nasopharyngeal carcinoma.

Metastasis to secondary sites remains the leading cause of nasopharyngeal carcinoma (NPC)-associated death. In order to identify the candidate protein(s) responsible for the differential metastatic capacity, the protein expression profiling between NPC cell line CNE-2 and its highly metastatic subclone S-18 were compared by 2-DE. In total, 18 spots were differentially expressed between these two cell lines. Among all, seven proteins were identified with further MS analysis. Western blotting further validated upregulation of HSP27 and ezrin, and downregulation of valosin containing protein and keratin 18 in S-18. Moreover, the knockdown of HSP27 was found to significantly decrease the invasive ability of S-18. On the other hand, overexpression of HSP27 in NP460 cells, which generated little endogenous HSP27 and less invasive, was noted to gain enhanced metastatic capability. Real-time PCR confirmed that the transcriptional levels of NF-κB and MMP9, MMP11 were downregulated after inhibition of HSP27 in S-18, which implicated that HSP27 enhanced the metastatic property of NPC cells probably via the NF-κB-mediated activation of MMPs. The findings in this work provided us a platform for further elucidating the underlying mechanisms of NPC metastasis and demonstrated that HSP27 would be a valid target for anti-cancer drug development.

[Effects of garlicin on the expression of transcription factor T-bet and GATA-3 in blood lymph cells in rats with allergic rhinitis].

OBJECTIVE: To investigate the effects of garlicin on the expression of transcription factors T-bet and GATA-3 in blood lymph cells of experimental rats with allergic rhinitis. METHODS: Thirty healthy SD rats were randomly divided into 3 groups, with 10 rats for each. Ten rats (pharmacological group) were sensitized and intranasally challenged by ovalbumin (OVA), aluminium hydroxide hydrate gel and Bordetella pertussis (B. pertussis) inactive microorganism suspension adjuvants, as the allergic rhinitis models, and then injection of garlicin (0.4 ml) intraperitoneally per day for 10 days. Ten rats in the control group were immunized as the pharmacological group, and then injection of physiological saline as equal volume as garlicin. Ten rats in the negative control group were investigated using physiological saline only. Plasma and lymph cells were separated from 2 ml blood which was extracted from rat heart. Enzyme linked immunosorbent assay (ELISA) was utilized to detect the levels of plasma IL-4 and IFN-γ, and RT-PCR was utilized to detect the expression of T-bet and GATA-3. RESULTS: The levels of IL-4 (x(-) ± s) were (6.292 ± 1.734), (14.252 ± 1.971), (4.916 ± 0.600) pg/ml, respectively, and the levels of IFN-γ were (24.338 ± 2.375), (12.364 ± 1.749), (16.136 ± 2.012) pg/ml, respectively, among the pharmacological, control and negative control groups. The plasma level of IL-4 in the pharmacological group rats was lower than that of control group rats (t = 4.23, P < 0.05), while there was no significant difference between the pharmacological and negative control group rats (t = 1.01, P > 0.05). The plasma level of IFN-γ was increased significantly in the pharmacological group rats when compared with the value of control group rats (t = 4.61, P < 0.05) and with the negative control group (t = 5.79, P < 0.05), respectively. There was no significant difference (t = 1.17, P > 0.05) in plasma level of IFN-γ in the control group rats when compared with the negative control group. Relative quantization of expression of GATA-3 (median) was 0.826, 1.029 and 0.474, and those of T-bet (median) were 1.245, 0.280 and 0.544, respectively, among the pharmacological, control and negative control groups. There were significant difference among 3 groups (chi² = 6.599, P = 0.019; chi² = 9.884, P = 0.007, respectively). Relative quantization of expression of GATA-3 in the control group rats was significantly higher than that in the negative control group and pharmacological group rats (chi² value were 10.113 and 2.384, respectively, all P < 0.05), and that of GATA-3 in the pharmacological group rats was increased as compared to the negative control group rats (chi² = 3.784, P < 0.05). The level of expression of T-bet in pharmacological group rats was elevated markedly with a significant difference as compared to both control (chi² = 16.021, P < 0.05) and negative control groups (chi² = 14.103, P < 0.05). CONCLUSIONS: Garlicin may upregulate the expression of T-bet dramatically and downregulate the expression of transcription factor GATA-3 in the experimental models of allergic rhinitis.

Laryngotracheal closure and cricopharyngeal myotomy for intractable aspiration and dysphagia secondary to cerebrovascular accident.

OBJECTIVE: To investigate the clinical value, technique, indications and contraindications of laryngotracheal closure (LTC) and cricopharyngeal myotomy (CPM) for intractable aspiration and dysphagia secondary to a cerebrovascular accident (CVA). MATERIALS AND METHODS: Patients (n = 45) with intractable aspiration and dysphagia secondary to a CVA were treated with LTC and CPM. The LTC was performed by suturing the double cords, and packing the strap muscle flap into the subglottic tracheal cavity. RESULTS: Intractable aspiration was completely eradicated in all patients. The swallowing function was partially improved, and the patients' quality of life was greatly improved. It became easier to care for these patients after surgery. CONCLUSIONS: LTC and CPM are suitable for intractable aspiration and dysphagia secondary to a CVA.

[Plasma resistin level in obstructive sleep apnea hypopnea syndrome].

OBJECTIVE: To explore the changes and clinical implications of plasma resistin level in obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS: Plasma resistin level was measured by radioimmunoassay in 30 obese OSAHS patients (obese OSAHS group), 7 in the low apnea hypopnea index (AHI) subgroup, 9 in the medium AHI subgroup, and 14 in the high AHI subgroup, 30 obese subjects (obese group), and 28 normal healthy adults (control group). Stepwise multiple linear regression analysis was conducted to determine the correlation of plasma resistin level with body mass index (BMI), body fat percentage, waist to hip ratio (WHR), fasting blood glucose (FBG), blood lipid, AHI, and lowest arterial oxygen saturation (LSaO(2)). RESULTS: The plasma resistin levels of the obese OSAHS group and obese group were (8.48 +/- 1.44) and (7.60 +/- 1.53) microg/L respectively, both significantly higher than that of the control group [(5.78 +/- 1.62) microg/L, both P < 0.05], and that of the obese OSAHS group was significantly higher than that of the obese group (P < 0.05). The plasma resistin level of the high AHI obese OSAHS subgroup was (9.60 +/- 0.51) microg/L, significantly higher than those of the medium and low AHI obese OSAHS subgroups [(7.96 +/- 1.06) and (6.90 +/- 1.32) microg/L respectively, both P < 0.01]. Correlation analysis demonstrated that the fasting plasma resistin level was positively correlated with BMI, neck circumference, waist circumference, WHR, FBG, total cholesterol, triglyceride, and AHI (r = 0.52, 0.66, 0.74, 0.52, 0.59, 0.48, 0.46, and 0.80, all P < 0.05); and negatively correlated with high-density lipoprotein cholesterol and LSaO(2) (r = -0.52, r = -0.60, both P < 0.01). A stepwise multiple linear regression analysis showed that AHI was the most significant contributing factor for the increased plasma resistin level in the obese OSAHS group (R(2) = 0.618). CONCLUSIONS: Plasma resistin level in obese OSAHS patients are increased, and are positively correlated with AHI. It may be used as an important biological index to evaluate the severity of OSAHS.

[Pathologic changes of palatopharyngeal muscle in patients with obstructive sleep apnea hypopnea syndrome].

OBJECTIVE: To study the pathologic changes of the palatopharyngeal muscles in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), the role of the above muscles in OSAHS pathogenesis was discussed. METHODS: Thirty OSAHS patients receiving uvulopalatopharyngoplasty selected, and ten normal subjects without snoring as the control group. The successive longitudinal sections of palatopharyngeal muscle were stained for observing Troponin-I's content. All specimens were examined with transmission electronmicroscopy (TEM) and light microscopy. RESULTS: Twenty nine of 30 specimens obtained from OSAHS patients evaluated with TEM showed pathologic changes of different degrees. While 2 among 10 specimens in control group showed mild myofibril edema or hypertrophy, no pathologic changes shown in other specimens. Immunohistochemistrial results of all specimens sections stained for observing Troponin-I antibody have shown that negative grey degree value is 146.30 +/- 10.72 in study group and 107.50 +/- 4.81 in control group respectively. There is significant difference between these two groups (P < 0.05). The negative grey degree value of study groupl and study group2 are 143.12 and 148.80 respectively , no statistical difference (P > 0.05). CONCLUSIONS: Palatopharyngeal myelofibrosis may affect pharyngeal dilator muscles function, this could be one mechanism of upper airway collapsibility.