The airway management and treatment of newborns with micrognathia and laryngomalacia / 临床耳鼻咽喉头颈外科杂志

Objective:To explore the perioperative airway management and treatment of newborns with micrognathia and laryngomalacia. Methods:From January to December 2022, a total of 6 newborns with micrognathia and laryngomalacia were included. Preoperative laryngoscopy revealed concomitant laryngomalacia. These micrognathia were diagnosed as Pierre Robin sequences. All patients had grade Ⅱ or higher symptoms of laryngeal obstruction and required oxygen therapy or non-invasive ventilatory support. All patients underwent simultaneous laryngomalacia surgery and mandibular distraction osteogenesis. The shortened aryepiglottic folds were ablated using a low-temperature plasma radiofrequency during the operation. Tracheal intubation was maintained for 3-5 days postoperatively. Polysomnography（PSG） and airway CT examination were performed before and 3 months after the surgery. Results:Among the 6 patients, 4 required oxygen therapy preoperatively and 2 required non-invasiveventilatory support. The mean age of patients was 40 days at surgery. The inferior alveolar nerve bundle was not damaged during the operation, and there were no signs of mandibular branch injury such as facial asymmetry after the surgery. Laryngomalacia presented as mixed type: type Ⅱ+ type Ⅲ. The maximum mandibular distraction distance was 20 mm, the minimum was 12 mm, and the mean was 16 mm. The posterior airway space increased from a preoperative average of 3.5 mm to a postoperative average of 9.5 mm. The AHI decreased from a mean of 5.65 to 0.85, and the lowest oxygen saturation increased from a mean of 78% to 95%. All patients were successfully extubated after the surgery, and symptoms of laryngeal obstruction such as hypoxia and feeding difficulties disappeared. Conclusion:Newborns with micrognathia and laryngomalacia have multi-planar airway obstruction. Simultaneous laryngomalacia surgery and mandibular distraction osteogenesis are safe and feasible, and can effectively alleviate symptoms of laryngeal obstruction such as hypoxia and feeding difficulties, while significantly improving the appearance of micrognathia.

Nursing care for patients receiving percutaneous antegrade ureteral stent implantation for ureteral stricture / 介入放射学杂志

Objective To discuss the nursing measures for patients who are receiving percutaneous antegrade ureteral stent implantation for ureteral stricture.Methods A total of 35 patients with ureteral stricture,who were treated with percutaneous antegrade ureteral stent implantation,were included in this study.The nursing care for these patients included the following measures:comprehensive preoperative ward nursing and nutritional support therapy;active preparation,cooperation and monitoring of vital signs during operation;strict postoperative dietary guidance,body position guidance,observation and nursing of complications,and discharge guidance.Results Successful implantation of ureteral stent with single procedure was accomplished in all 35 patients.Mter the procedure,the renal function was markedly improved,when compared with the preoperative data the difference was statistically significant (P＜0.05).The complications,including soreness of waist,lumbago,bladder irritation,hematuria,urinary tract infection,etc.were effectively relieved by positive nursing intervention measures.Conclusion Comprehensive,thoughtful and meticulous nursing care is an important guarantee to ensure a successful percutaneous antegrade ureteral stent implantation for ureteral stricture as well as to reduce the postoperative complications.(J Intervent Radiol,2017,26:277-280)

Effect of pediatric obstructive sleep spnea hypopnea syndrome with attention deficit hyperactivity disorder on sleep and quality of life / 临床儿科杂志

Objective Related factors of pediatric obstructive sleep apnea hypopnea syndrome (OSAHS) combined with attention deficit hyperactivity disorder (ADHD) were retrospectively analyzed in OSAHS children. Methods The research included 437 cases of children hospitalized for OSAHS from January, 2014 to December, 2014. All the cases were divided into OSAHS group and OSAHS combined with ADHD group, according to the presence or absence of ADHD. Patient's general conditions (gender, age, height, weight, allergic rhinitis history, tonsil grade and adenoid grade), OSA-18 quality of life score, intention-hyperactivity score, polysomnography parameter (apnea hypopnea index, lowest oxygen) were collected as variables. SPSS20.0 was used to perform statistical analyses.Results There were 437 cases in this research, 298 of them were males, and 139 of them were females. Of 437 patients, 147 had OSAHS combined with ADHD (33.64%). Higher apnea hypopnea index (P <0.01) and severer oxygen deflciency (P < 0.01) were found in OSAHS combined with ADHD group than those in OSAHA group. Five projects of OSA - 18 score of in OSAHS combined with ADHD group were all higher than those in OSAHS group (P <0.01).Conclusions The incidence of pediatric OSAHS combined with ADHD in this research was more than 30%. More OSAHS combined with ADHD were found in male children. The quality of life was lower in pediatric OSAHS combined with ADHD. Oxygen deflciency was suggested to be the most important risk factor of ADHD in pediatric OSAHS.

c-fos Expression in Medial Vestibular Nucleus of Guinea Pigs After Unilateral Labyrinthectomy / 听力学及言语疾病杂志

Objective To investigate the c-fos ex pr ession in guinea pigs' medial vestibular neuleus (MVN) following unilateral laby rinthectomy (UL). Methods Twenty-seven SCO guinea pigs were randomly divide d into nine groups, three in each group. After resection of right labyrinth,th e immunohistological staining of c-fos was performed. Fos-like immunoreactivity (FLI) was analyzed at fifteen minutes, and 1?2?6?8?12 and 24 h, and 2 and 7 days after UL. Results Results showed no Fos expression in the control g roup. By contrast, Fos was consistently induced in the UL guinea pigs. Asymmetri cal labeling was found in the bilateral medial vestibular nucleus, with more Fos -like neurons in the ipsilateral MVN of the lesioned side than that in the contr alateral MVN(P