Volume 85  ·   Issue 44  ·  2005

sleep disorders can be divided into exogenous and endogenous sleep disorders according to the etiology [1]. The former includes different types of sleep disorders such as environmental, adjustment and alcohol-dependent, which can be clearly diagnosed according to the medical history, and normal sleep can be restored after removing external factors. The etiology of obstructive sleep apnea hypopnea syndrome (OSAHS), central sleep apnea syndrome (CSAS), narcolepsy, periodic limb movement, etc. all come from the body itself, and belong to endogenous sleep disorders, and their diagnosis and treatment are complicated. The emergence of the following three landmark technologies has laid a solid foundation for the research of sleep breathing disorders, making it the most important research progress of sleep medicine in the last century.

The craniofacial anatomy which is different from other animals is the result of long-term changes in functional movement, posture and posture. As for each individual, besides inheriting the genetic manifestations of ancestors, there will also be changes due to environmental factors, specifically in the change of growth direction and growth amount of related tissues, thus affecting the appearance of dental and maxillofacial.

Sleep apnea hypopnea syndrome (SAHS) is essentially a disease of respiratory dysfunction. In awake state, the airway can remain open even with obvious anatomical stenosis, which is related to the ability of respiratory center to produce effective compensation and release sufficient nerve impulses to stimulate pharyngeal dilator muscle; After falling asleep, the arousal stimulation is weakened or disappeared, and the activity of upper airway muscles depends on the local receptive reflex and the stimulation of the respiratory center by afferent impulses such as low O2, high CO2 and increased resistance load. If the central response ability is weakened, the airway will easily collapse and apnea will occur. It is of guiding significance for the choice of treatment plan to deeply understand the role of abnormal respiratory regulation function in the occurrence of sleep apnea.

From macroscopic to microscopic, the human body is in movement all the time, and these movements belong to rhythmic movements, or pseudo-periodic movements.Awakening and sleep are like pendulum,which transform into each other in life activities, and are a kind of periodic movements necessary for human body to maintain life.Sleep medicine has aroused widespread interest of scholars at home and abroad increasingly, especially the harm of sleep apnea to cardiovascular system has aroused the attention of cardiologists [1,2].

Objective to investigate the minimum gamma knife dose to induce electrophysiological changes of optic nerve in compressed cats. Methods Twenty animal models of optic nerve compression in cats were made. Two months after the model was made, they were randomly divided into five groups, four animals in each group, one group as control, and the other four groups received 10, 11, 12 and 13 Gy gamma knife irradiation, respectively. Electrophysiological monitoring was performed at 3 d, 1 week, half month, 1, 2, 3, 4 and 5 months after irradiation, respectively. Results The electrophysiological changes in 10 Gy group were observed within 1 week after gamma knife irradiation, and the changes recovered at half month, and gradually recovered with the prolongation of time. The irreversible electrophysiological changes appeared in the group above 11 Gy after gamma knife irradiation, and the changes aggravated with the prolongation of time. Conclusion 10 Gy can induce reversible electrophysiological changes of optic nerve in compressed cats, and 11 Gy can induce irreversible radiation damage of optic nerve.

Objective to investigate the effects of single nucleotide polymorphism of cytokines and cytokine receptors in renal transplant recipients on early postoperative acute graft rejection. Methods (1) According to the presence or absence of acute rejection, 129 renal transplant recipients were divided into acute rejection group and no rejection group (within 6 months). According to HLA-A-B-DR mismatch, neurocalcin inhibitor, delayed recovery of renal function, ATG or MAb induction therapy, cold ischemia time, etc., the genotype distribution of 21 loci of 5 cytokines and 5 receptors in the two groups was compared. (2) According to the HLA-DR matching, they were divided into 0~1 HLA-DR mismatch group (0~1MM) and HLA-DR complete mismatch group (2MM), and the distribution of gene polymorphism was compared between the two groups. Results (1) Among 129 renal transplant recipients, 39 cases (30.2%) had acute rejection. (2) The difference of HLA-DR mismatch in acute rejection group and no rejection group was statistically significant (P<(3) The distribution of polymorphism of cytokine and cytokine receptor sites was significantly different between acute rejection group and non-rejection group, and the difference was statistically significant. (4) The distribution of polymorphism between HLA-DR complete mismatch group (2MM group) and 0~1 site mismatch group (0~1MM group) was also different. Conclusion Different gene polymorphism in renal transplantation donors and recipients has guiding significance for predicting the occurrence of rejection.

Objective to evaluate the effect of endoscope in the treatment of optic nerve injury. Methods Thirteen patients with internal and inferior wall fracture of optic canal were selected. After middle turbinate resection under the guidance of rhinoscope, the sphenoid sinus opening and posterior ethmoid sinus were opened, the fracture location, the optic canal, internal carotid artery impression and optic nerve recess were identified, the orbital and cranial orifices of optic nerve and the whole length were opened, and the optic nerve sheath was not cut. Two patients with dural rupture at the cranial orifice of optic canal were applied with the mucosa cut from the middle turbinate to the leakage, and an oil gauze strip was filled in the sphenoid sinus and middle nasal passage. The gauze strip was removed for 7~10 days in patients with suspected cerebrospinal fluid leakage, and the gauze strip was removed for 3 days in other patients. The criteria for evaluating visual acuity were: blindness, photosensitivity, manual movement in front of eyes, fingers in front of eyes, and signs of visual acuity chart. After operation, visual acuity was improved by more than 1 grade, and visual field was also improved. Conclusion Endoscopic optic canal decompression surgery is a minimally invasive treatment, which can decompress the optic nerve in the whole course, with little interference to the optic nerve and quick recovery after operation.

Objective to compare the efficacy of different surgical procedures for hypertensive intracerebral hemorrhage and analyze the main influencing factors of short-term prognosis. Methods A multi-center clinical single-blind controlled study was conducted on 2464 patients with hypertensive intracerebral hemorrhage treated by surgical treatment in 92 hospitals in China. The traditional craniotomy for hematoma evacuation (called traditional group) was used as the control group, and minimally invasive intracerebral hematoma evacuation (called minimally invasive group) and CT-guided stereotactic hematoma aspiration (called fragmented aspiration group) were used as the study group. The influencing factors of the efficacy of the three surgical procedures were analyzed by multivariate analysis. Results There were 639 cases in the traditional surgery group, 409 cases in the minimally invasive surgery group and 1416 cases in the fragmented aspiration group. The main factors affecting short-term prognosis of minimally invasive surgery were: preoperative Glasgow Coma Score (GCS) and postoperative complications; The main factors affecting the short-term prognosis of the fracture aspiration group were: preoperative GCS, preoperative disease course, bleeding volume, postoperative complications and whether urokinase was used during operation. The main factors affecting the short-term prognosis of the traditional surgery group were: diastolic blood pressure at admission, preoperative GCS, preoperative muscle strength and postoperative complications. It is helpful for the design of future clinical trials; It is helpful to guide doctors' treatment strategies, reasonably distribute medical resources, and better serve social groups.

Objective to evaluate the degree of hypoxemia in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods the polysomnography data of 108 patients with OSAHS and 37 patients with simple snoring diagnosed by polysomnography respiratory monitor were analyzed. The correlation coefficients between minimum oxygen saturation (MiO2) and the percentage of time of oxygen saturation<90% in total monitoring time (TS90%) and apnea hypopnea index (AHI) were calculated according to the diagnostic criteria of Hangzhou Conference. Results With the increase of the severity of OSAHS, the value of TS90% increased gradually, while the value of MiO2 decreased gradually (TS90% and MiO2 were 1.47, 82.00, 4.23, 80.00, 12.85, 74.00, 37.82 and 62.00 in simple snoring, mild OSAHS, moderate OSAHS and severe OSAHS, respectively), and the differences were statistically significant (all P<Conclusion TS90% can objectively reflect the severity of hypoxemia during sleep in patients, and can reflect the degree of hypoxia in patients as a whole and objectively when compared with MiO2.

Objective to investigate the size and collapsibility of pharyngeal cavity cross-sectional area between obstructive sleep apnea hypopnea syndrome (OSAHS) \simple snoring patients and normal persons.Methods 171 patients with OSAHS (mild 44 cases, moderate 51 cases, severe 76 cases), 47 patients with simple snoring and 47 normal persons were measured by acoustic reflex, and the curves of lung volume at functional residual air position (FRC) and residual air position (RV) were recorded. Results the cross-sectional area of the pharyngeal cavity in the snoring group (2.63 cm2±0.42 cm2), the mild, moderate and severe OSAHS group (2.70 cm2±0.44 cm2, 2.62 cm2±0.52 cm2 and 2.57 cm2±0.46 cm2) were less than that in the normal control group (3.05 cm2±0.6 cm2) during FRC (all P<When the lung volume decreased from FRC to RV, the lung volume decreased from 2.63 cm2±0.42 cm2 to 1.96 cm2±0.35 cm2, 2.70 cm2±0.44 cm2 to 1.78 cm2±0.39 cm2, 2.62 cm2±0.52 cm2 to 1.79 cm2±0.37 cm2, 2.57 cm2±0.46 cm2 to 1.75 cm2±0.40 cm2 and 3.05 cm2±0.6 cm2 to 2.38 cm2±0. The pharyngeal cross-sectional area decreased significantly in the mild, moderate and severe OSAHS groups (33.93%±11.81%, 31.13%±10.76% and 31.31%±13.44%) and the simple snoring group (25.07%±10.39%) compared with the normal control group (21.11%±8.19%) (all P<Conclusion the pharyngeal cavity cross-sectional area of patients with snoring is similar in FRC and smaller than that of normal subjects regardless of whether they are accompanied by OSAHS or not. When the lung volume decreases from FRC to RV, the pharyngeal cavity collapsibility of patients with mild, moderate and severe OSAHS and patients with simple snoring is significantly greater than that of normal subjects, while the pharyngeal cavity collapsibility of patients with OSAHS is greater.

Objective to compare the clinical and electrophysiological characteristics of early-onset and late-onset narcolepsy patients. Methods There were 105 cases of narcolepsy, including 63 cases of early-onset patients under 15 years old, with an average onset age of 9.7 years ± 3.1 years; The average age of onset was 22.8 ± 9.3 years in 42 patients with late onset of disease over 15 years old. The results of clinical, multi-channel physiological recorder and multiple nap sleep latency test (MSLT) were compared and analyzed. Results All patients had daytime drowsiness. The incidence of paroxysmal cataplexy was 92% in early onset patients, which was higher than 76% in late onset patients (P =0.023). The incidences of sleep paralysis, hallucination of sleep and night sleep disorder were similar in the two groups (P>0.05). MSLT examination showed that the mean sleep incubation period (4.5 min±4.0 min and 7.0 min±5.7 min, P =0.018) and REM sleep incubation period (3.4 min±3.2 min and 4.8 min±2.2 min, P =0.02) were shorter in early onset patients. The patients with early onset narcolepsy had more frequency of sleep (3.4±2.0 and 2.5±1.9, P =0.009), more frequency of AHI (9.2±16.5 and 1.9±6.3, P =0.009), and more serious sleep dyspnea. All three patients with family history were early onset patients. Conclusion The symptoms and clinical features of drowsiness and cataplexy in early onset narcolepsy were more typical than those in late onset patients, and their occurrence may be more closely related to genetic factors.

eosinophilic angiocentric fibrosis (EAF) is a chronic progressive fibrous disease that mainly involves the nasal septum and lateral wall of the nose, and may also involve the subglottic area. The disease was first reported by Holmes and Panje in 1983, and was called "intranasal granuloma faciale" at that time [1]. In 1985, Roberts and McCann reported three cases, and first defined as "eosinophilic angiocentric fibrosis" [2]. Up to now, a total of 28 cases have been reported in the literature. There is no relevant report in China. However, recently, a young male patient has been found in Peking Union Medical College Hospital, which is being diagnosed and treated. In order to improve the understanding of this disease, the research status of this disease is summarized as follows.

obstructive sleep apnea hyponea syndrome (OSAHS) is a common disease, with a prevalence of 2% ~4% in adults reported abroad. It is characterized by the collapse of the upper airway during sleep, which leads to the disappearance or reduction of airflow, decrease of oxygen saturation and destruction of sleep structure. OSAHS is a major risk factor for cardiovascular and cerebrovascular diseases including hypertension,congestive heart failure,myocardial infarction and stroke [1]. Multiple therapeutic methods are used for obstructive sleep apnea hyponea syndrome. In fact, the severity of sleep apnea determines which method to use for treatment. Behavioral therapy, including sleep posture training and weight loss, may be beneficial to some patients; Surgical or oral appliances may be considered for mild to moderate patients, but it is very critical to select the appropriate patient and determine the site of upper airway obstruction. At present, the first choice for patients with moderate to severe OSAHS is still nasal continuous positive airway pressure (nCPAP).

Herceptin is a humanized murine antibody designed for HER-2/neu protein.It is a novel targeted anti-tumor drug.It can significantly prolong the survival of advanced breast cancer patients with high HER-2/neu expression.The overexpression rate of HER-2/neu protein in ovarian cancer is 20% ~30% [1], which is similar to breast cancer.In this study, Herceptin combined with cisplatin on human ovarian cancer with high HER-2/neu expression in vitro was experimentally studied, and its mechanism was discussed.

cell apoptosis can be seen in many physiological phenomena and pathological conditions [1]. In recent years, apoptosis detection technology has been reported successively [2-4]. Among them, radionuclide-labeled Annexin V in vivo apoptosis imaging technology is unique because of its non-invasive, early and quantitative advantages [5, 6]. Its principle is that chemotherapy drugs induce apoptosis in tumor cells. In the early stage of apoptosis, phosphatidylserine (PS) is exposed to the cell membrane surface, which leads to an increase in the uptake of radionuclide-labeled Annexin V, which has high specificity binding to it. In vitro radiation detection instruments such as single photon emission computed tomography (SPECT) and positron emission tomography (PET) can observe the uptake status of tumor sites, so as to judge the tumor response to chemotherapy. In vivo apoptosis imaging can monitor the therapeutic effect, evaluate the prognosis and treatment plan of tumor patients

Senile plaque (SP) is one of the main histopathological changes in Alzheimer's disease (AD). Since the core component of senile plaque, β-amyloid peptide (A β) was successfully isolated for the first time in 1987, its structure and function have been attracting considerable attention [1]. A large number of data show that A β is a neurotoxic substance, which can cause neuronal damage and death, and plays a very important role in the pathogenesis of AD [2]. Its toxic effects on nerve cells are diverse and the mechanism is complex, and its molecular mechanism is still not very clear. In this study, a cDNA expression profile gene chip containing 4200 rat genes was selected to analyze the gene expression profile of rat hippocampus after A β 1-40 induction, in order to explore the molecular mechanism of A β 1-40 toxicity.

Synovial sarcoma is a kind of highly malignant soft tissue sarcoma with poor prognosis, but there are relatively few studies on its prognostic factors. In this study, the apoptosis of synovial sarcoma was detected by in situ end labeling (TUNEL) technique, and the expression of apoptosis-related proteins Bcl-2, Bax, p53 and cell proliferation index Ki-67 were detected by immunohistochemistry.

It was found that single nucleotide polymorphisms (SNPs) of ADAM33 gene were significantly related to the occurrence of asthma and airway hyperresponsiveness [1]. ADAM33 gene was mainly expressed in smooth muscle cells, myofibroblasts and fibroblasts of lung, but less expressed in epithelial cells, T cells or immune cells. Because of the selective expression of ADAM33 gene in lung mesenchymal cells, ADAM33 gene may be related to small airway remodeling. IL-4 and IL-13 are both Th2 cytokines, which play an important role in chronic airway inflammation of asthma. Recently, it was found that IL-4 and IL-13 can promote airway remodeling by increasing the release of transforming growth factor-β from bronchial epithelial cells [2]. Therefore, we investigated the effects of IL-4 and IL-13 on ADAM33 gene expression in human lung fibroblasts, and explored the role of abnormal ADAM33 gene expression in airway remodeling of asthma.

Alzheimer's disease (AD) is a progressive cerebral degenerative disease, and hippocampal atrophy is an early neuroimaging feature of AD. A recent magnetic resonance spectroscopy (MRS) study suggests that the concentration of neurometabolites in the temporal neocortex and the paleocortex is different [1], which is particularly important in exploring neurodegenerative diseases (such as AD). The distribution of neurofibrillary tangles in AD brain may have regional characteristics [2]. The purpose of this study was to compare with that in mild vascular dementia (VaD) and healthy elderly people by quantitative MRI technique.

Lung cancer is a malignant tumor with the fastest increasing morbidity and mortality and the greatest threat to human health and life.A large number of experimental studies have shown that the occurrence, development and metastasis of lung cancer are regulated by many genes [1]. Modern genetic research has shown that the occurrence and development of lung cancer is a gradual evolutionary process, which involves the activation of many proto-oncogenes and the inactivation of tumor suppressor genes.To explore the role of tumor suppressor gene inactivation in the pathogenesis of lung cancer is a hot topic.In this study, the candidate tumor suppressor gene KIAA1173 was cloned, and then cDNA probe was prepared, and in situ hybridization (ISH) was performed to detect the mRNA expression level of this gene in lung cancer tissues, and its expression rule was analyzed, aiming to explore the relationship between the expression of this gene and the occurrence, development and metastasis of lung cancer.

A 65-year-old male was admitted to the hospital mainly because of "paroxysmal chest pain for 7 years and aggravated for 1 month". The admission diagnosis was: coronary heart disease, unstable angina pectoris, old anterior and inferior myocardial infarction, and hyperlipidemia after coronary artery bypass grafting. Coronary angiography was performed in the local hospital 1 month before admission.

A 41-year-old female was admitted to hospital on May 17, 2004 due to lower back pain with asymmetric swelling and pain of lower limb joints for 16 years, scaly erythema for 10 years, and recently worsened lower back pain with low fever. There was no special past history. Physical examination: body temperature 37.7℃, pulse 84 beats/min, breathing 18 beats/min, no abnormalities in heart, lung and abdomen.