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Increasing reports demonstrate that long noncoding RNAs participate in the regulation of numerous malignancies, cervical cancer included. Although lncRNA LOXL1 antisense RNA 1 has been commonly accepted to be an oncogene in many cancers. Here, the role of LOXL1-AS1 in CC still need to be explored. In this study, LOXL1-AS1 was found elevated in CC tissues and cells. LOXL1-AS1 depletion restrained CC cell proliferation, migration, invasion, and angiogenesis in vivo. Furthermore, we found that LOXL1-AS1 upregulated Lysophospholipase 1 expression via sequestering miR-526b-5p. Rescue assays revealed that overexpression of LYPLA1 reversed the LOXL1-AS1 silencing-induced inhibitory effects on the malignant phenotypes of CC cells. To conclude, this study showed that LOXL1-AS1 facilitates cellular process in CC via functioning as a miR-526b-5p sponge.

Background Artificial intelligence (AI) assistance has been considered as a promising way to improve colonoscopic polyp detection, but there are limited prospective studies on real‐time use of AI systems. Methods We conducted a prospective, multicenter, randomized controlled trial of patients undergoing colonoscopy at six centers. Eligible patients were randomly assigned to conventional colonoscopy (control group) or AI‐assisted colonoscopy (AI group). AI assistance was our newly developed AI system for real‐time colonoscopic polyp detection. Primary outcome is polyp detection rate (PDR). Secondary outcomes include polyps per positive patient (PPP), polyps per colonoscopy (PPC), and non‐first polyps per colonoscopy (PPC‐Plus). Results A total of 2352 patients were included in the final analysis. Compared with the control, AI group did not show significant increment in PDR (38.8% vs. 36.2%, p = 0.183), but its PPC‐Plus was significantly higher (0.5 vs. 0.4, p, Artificial intelligence (AI) assistance plays a limited role in overall polyp detection. AI system increases detection of easily missed polyps, including non‐first polyps, diminutive and flat polyps. The impact is greater for male operators, longer withdrawal time, and elderly obese patients.

Cervical cancer (CC), as a serious menace to the health of women, has long been one of the most lethal gynecologic neoplasms throughout the world. Long non-coding RNA (LncRNA)This study aimed to explore the function and molecular mechanism ofThe expression levels of NR2F1-AS1, miR-642a-3p, NR2F1 in CC tissues, and cell lines were examined by reverse transcription real-time quantitative polymerase chain reaction. Cell viability, proliferation, migration, and invasion were detected by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide, colony formation and Transwell assays. The protein levels of epithelial-mesenchymal transition markers and NR2F1 in CC cells were assessed by Western blot analysis. The correlations among NR2F1-AS1, miR-642a-3p, and NR2F1 were estimated through luciferase reporter and RNA immunoprecipitation assays.These findings revealed that NR2F1-AS1 played a tumor suppressor role in CC by mediating the miR-642a-3p/NR2F1 axis.

To observe the clinical effect of the cannula under laparoscopy, percutaneous puncture cannula, and conventional surgery cannula for peritoneal dialysis.From May 3, 2015 to February 14, 2020, 87 patients with end-stage renal disease needing peritoneal dialysis in Ningbo Zhenhai People's Hospital were enrolled. These patients were divided into three groups including cannula under laparoscopy (23 cases), percutaneous puncture cannula (29 cases), and conventional surgery cannula (35 cases). The baseline characteristics, perioperative conditions (surgical time, post-surgical hospitalization time), the incidence of recent complications (abdominal hemorrhage, direct abdominal hemorrhage, incision pain, leakage, catheter shift, peritonitis), and long-term complications (catheter shift, peritonitis, hernia, thoracic and abdominal fistula, abdominal tube obstruction) among the three groups were compared.Compared with the group of conventional surgery cannula, the operation time in the group of cannula under laparoscopy and the group of percutaneous puncture cannula were significantly shorter (minutes: 32.5±12.3, 28.9±11.8 vs. 61.3±15.4, both P0.05), the in-hospital stay in the group of cannula under laparoscopy and the group of percutaneous puncture cannula were reduced (days: 9.8±3.4, 9.2±2.6 vs. 10.7±3.2), but there was no statistical significance among the three groups (P0.05). The incidence of abdominal bleeding, rectus abdominis bleeding, and incision pain in the group of cannula under laparoscopy and the group of percutaneous puncture cannula were significantly lower than those in the group of conventional surgery cannula [incidence of abdominal bleeding: 4.3% (1/23), 3.4% (1/29) vs. 22.9% (8/35), incidence of rectus abdominis bleeding: 4.3% (1/23), 3.4% (1/29) vs. 22.9% (8/35), incidence of incision pain: 8.7% (2/23), 10.3% (3/29) vs. 42.9% (15/35), all P0.01]. The difference between the group of cannula under laparoscopy and the group of percutaneous puncture cannula had no statistical significance. Compared with the group of conventional surgery cannula and the group of percutaneous puncture cannula, the incidence of catheter displacement in the group of cannula under laparoscopy was significantly reduced [4.3% (1/23) vs. 27.6% (8/29), 31.4% (11/35), both P0.05]. Compared with the group of conventional surgery cannula and the group of percutaneous puncture cannula, the incidence of catheter displacement in long-term complications in the group of cannula under laparoscopy was significantly reduced [4.3% (1/23) vs. 24.1% (7/29), 31.4% (11/35), both P0.05], however, the difference of that between the group of conventional surgery cannula and the group of percutaneous puncture cannula was not statistically significant. The incidence of hernia in the group of cannula under laparoscopy was significantly higher than that in the group of percutaneous puncture cannula or in the group of conventional surgery cannula [21.7% (5/23) vs. 3.4% (1/29), 2.8% (1/35), both P0.05], and all of that were umbilical hernia, however, the difference of that between the group of percutaneous puncture cannula and the group of conventional surgery cannula was not statistically significant.Compared with the traditional conventional surgical cannula placement methods, percutaneous puncture has the advantages of simple operation, short operation time, small trauma, but still cannot reduce the incidence of drift tube; laparoscopic peritoneal dialysis tube has the advantages of short operation time, small trauma and low catheter displacement rate, but increases the risk of umbilical hernia.

Background/Aim This study aimed to investigate the clinical significance of changes in vitamin D [25(OH)D] levels and vitamin D receptor (VDR) mRNA expression in colorectal adenoma development. Methods Plasma concentrations of 25(OH)D and mRNA expression of VDR in tissues were determined by enzyme‐linked immunosorbent assay (ELISA) and real‐time fluorescence quantitative polymerase chain reaction (RT‐qPCR), respectively. In addition, the concentration of plasma 25(OH)D and levels of VDR mRNA in tissues were compared among healthy individuals and adenoma and adenocarcinoma patients. Results Vitamin D receptor expression in colorectal adenocarcinoma tissues was significantly lower than that in para‐cancerous tissues that were >5 cm away from malignant tumor sites (p, The levels of 25(OH)D and VDR mRNA expression might be associated with the development of colorectal adenoma and the progression to adenocarcinoma.

Cantharidin (CTD) is the main bioactive component of Cantharides, which is called Banmao in Traditional Chinese Medicine (TCM). Norcantharidin (NCTD) is a structural modifier of CTD. To compare with CTD, NCTD has lighter side effects and stronger bioactivity in anti-cancer through inhibiting cell proliferation, causing apoptosis and autophagy, overwhelming migration and metastasis, affecting immunity as well as lymphangiogenesis. Examples of these effects include suppressing Protein Phosphatase 2A and modulating Wnt/beta catenin signal, with Caspase family proteins, AMPK pathway and c-Met/EGFR pathway involving respectively. Moreover, NCTD has the effects of immune enhancement, anti-platelet aggregation and inhibition of renal interstitial fibrosis with distinct signaling pathways. The immunological effects induced by NCTD are related to the regulation of macrophage polarization and LPS-mediated immune response. The antiplatelet activity that NCTD induced is relevant to the inhibition of platelet signaling and the downregulation of α2 integrin. Furthermore, some of novel derivatives designed and synthesized artificially show stronger biological activities (e.g., anticancer effect, enzyme inhibition effect, antioxidant effect) and lower toxicity than NCTD itself. Plenty of literatures have reported various pharmacological effects of NCTD, particularly the anticancer effect, which has been widely concerned in clinical application and laboratory research. In this review, the pharmaceutical activities and derivatives of NCTD are discussed, which can be reference for further study.

Aim Evidence of the lungs being a target organ of diabetes-related pathophysiology is increasing, and decreased pulmonary function increases the risk of diabetes after adjusting for demographic and metabolic factors. This systematic review and meta-analysis evaluates the bidirectional relationship between diabetes and pulmonary function. Methods MEDLINE, Embase, The Cochrane Library and Web of Science databases were searched, and all studies describing this bidirectional relationship were identified. Two reviewers independently extracted study characteristics and assessed the risk of bias. Results A total of 93 studies were included in the meta-analysis. The pooled weighted mean difference (WMD) between diabetes patients and non-diabetic participants for forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were −5.65% and −5.91%, respectively, of predicted values. Diabetes-related microvascular complications and poor glycaemic control were associated with poorer pulmonary function in those with diabetes. In addition, diabetes was associated with a restrictive spirometry pattern (RSP) in both cross-sectional studies [odds ratio (OR): 2.88, 95% confidence interval (CI): 2.18–3.81, I2 = 0.0%] and prospective cohort studies [hazard ratio (HR): 1.57, 95% CI: 1.04–2.36]. In five longitudinal studies, the conclusions were inconsistent as to whether or not diabetes accelerates pulmonary function decline. However, every 10% decrease in baseline predicted FVC value was associated with a 13% higher risk of incident diabetes (HR: 1.13, 95% CI: 1.09–1.17, I2 = 0.0%). Conclusion There is a bidirectional relationship between diabetes and pulmonary function. However, further investigations into whether dynamic changes in glycaemic levels before and shortly after diabetes onset mediate the deleterious effects on pulmonary function, or vice versa, are now required.

The activity of ABC294640, a small-molecular sphingosine kinase 2 (SphK2) inhibitor, in human skin squamous cell carcinoma (SCC) cells was tested in this study. SphK2 mRNA and protein are expressed in established (A431 cheilocarcinoma cell line) and primary human skin SCC cells. ABC294640 dose-dependently inhibited survival, cell cycle progression and proliferation of skin SCC cells. Furthermore, ABC294640 induced caspase-3/-9 and apoptosis activation in skin SCC cells. The SphK2 inhibitor was however non-cytotoxic to SphK2-null skin melanocytes, keratinocytes and fibroblasts. ABC294640 induced ceramide accumulation, sphingosine-1-phosphate (S1P) reduction, Akt-S6K1 inhibition and JNK activation in skin SCC cells. Conversely, its cytotoxicity against SCC cells was largely attenuated by co-treatment of S1P, the Akt activator SC79, and the JNK inhibitor SP600125. In vivo, ABC294640 oral administration inhibited A431 xenograft tumor growth in nude mice. Akt-S6K1 inhibition and JNK activation were observed in ABC294640-treated tumors. Collectively, ABC294640 efficiently inhibits human skin SCC cell growth in vitro and in vivo.

Recently, increasing evidence has indicated that lncRNAs may play a critical role in the progression of oral cancer (OC). However, whether lncRNA-ANRIL is involved in the tumorigenesis of OC remains undetermined. In the present study, ANRIL showed significantly higher, while miR-125a showed lower, expression in OC tissues and sera than in normal controls. MTT, colony formation, flow cytometry analysis, wound-healing, transwell and mice xenograft model assays were used to detect the proliferation, migration, and invasion of ARNIL-overexpressing HB56 cells and ARNIL-knockdown CAL27 cells. The results showed that cell proliferation, migration, and invasion were significantly increased by ARNIL overexpression and decreased by ARNIL silencing in oral cancer cells. Furthermore, we found a negative correlation between ARNIL and miR-125a, and ARNIL acts as a miRNA-sponge by directly interacting with miR-125a.

Primary biliary cholangitis (PBC) is an autoimmune liver disease with a strong hereditary component. Here, we report a genome-wide association study that included 1,122 PBC cases and 4,036 controls of Han Chinese descent, with subsequent replication in a separate cohort of 907 PBC cases and 2,127 controls. Our results show genome-wide association of 14 PBC risk loci including previously identified 6p21 (HLA-DRA and DPB1), 17q12 (ORMDL3), 3q13.33 (CD80), 2q32.3 (STAT1/STAT4), 3q25.33 (IL12A), 4q24 (NF-κB) and 22q13.1 (RPL3/SYNGR1). We also identified variants in IL21, IL21R, CD28/CTLA4/ICOS, CD58, ARID3A and IL16 as novel PBC risk loci. These new findings and histochemical studies showing enhanced expression of IL21 and IL21R in PBC livers (particularly in the hepatic portal tracks) support a disease mechanism in which the deregulation of the IL21 signalling pathway, in addition to CD4 T-cell activation and T-cell co-stimulation are critical components in the development of PBC., Primary biliary cholangitis is an autoimmune liver disease. Here, the authors show that variants in interleukin genes which potentially deregulate their expression are associated with this condition, and suggest that the IL21 signalling pathway may have a role in disease aetiology.

To evaluate the influence of different vitrectomy probe gauge sizes and their fluidics, under various vacuum settings, on tissue attraction.An apparatus was designed to model the retinal membrane during vitrectomy. A cantilever beam was constructed from a wire (diameter, 0.076 mm) with a latex strip (simulating ocular membranes) attached at a right angle to its tip. The beam was clamped vertically in a container of balanced salt solution. The port of the vitrectomy probe (20 gauge, 23 gauge, and enhanced 25 gauge) was aligned with the membrane. With the cutter off, the vacuum was increased until the membrane was attracted into the port. The aspiration flow rate was measured with a noninvasive flow meter. Attraction distance, vacuum pressure, and flow rate were recorded.For any given distance, the 20-gauge probe needed the lowest amount of vacuum and the highest aspiration flow, while the enhanced 25-gauge and 23-gauge probes needed larger vacuum and smaller aspiration flow rates to attract the membrane into the port.The sphere of influence on surrounding tissue was greatest with large-gauge vitrectomy probes. This laboratory model indicated that small-gauge probes could be used to target specific tissues while minimizing the effects on adjacent tissue structures.

The apoptosis of glomerular mesangial cells (GMC) in rat Thy-1 nephritis (Thy-1N), a model of human mesangioproliferative glomerulonephritis, is accompanied by sublytic C5b-9 deposition, but the mechanism of sublytic C5b-9-mediated GMC apoptosis has not been elucidated. In the present study, the gene expression profiles both in the GMC stimulated by sublytic C5b-9 and the rat renal tissue of Thy-1N were detected using microarrays. Among the co-up-regulated genes, the up-regulation of interferon regulatory factor-1 (IRF-1) was further confirmed. Increased caspase 8 and caspase 3 expression and caspase 8 promoter activity in the GMC were also identified. Meanwhile, overexpression or knockdown of IRF-1 not only enhanced or inhibited GMC apoptosis and caspase 8 and 3 induction but also increased or decreased caspase 8 promoter activity, respectively. The element of IRF-1 binding to the caspase 8 promoter was first revealed. Furthermore, silencing IRF-1 or repressing the activation of caspases 8 and 3 significantly reduced GMC apoptosis, including other pathologic changes of Thy-1N. These novel findings indicate that GMC apoptosis of Thy-1N is associated with the IRF-1-activated caspase 8 pathway.

The biological functions of the BC047440 gene highly expressed by hepatocellular carcinoma (HCC) are unknown. The objective of this study was to reconstruct antisense eukaryotic expression vectors of the gene for inhibiting HepG(2) cell proliferation and suppressing their xenograft tumorigenicity. The full-length BC047440 cDNA was cloned from human primary HCC by RT-PCR. BC047440 gene fragments were ligated with pMD18-T simple vectors and subsequent pcDNA3.1(+) plasmids to construct the recombinant antisense eukaryotic vector pcDNA3.1(+)BC047440AS. The endogenous BC047440 mRNA abundance in target gene-transfected, vector-transfected and naive HepG(2) cells was semiquantitatively analyzed by RT-PCR and cell proliferation was measured by the MTT assay. Cell cycle distribution and apoptosis were profiled by flow cytometry. The in vivo xenograft experiment was performed on nude mice to examine the effects of antisense vector on tumorigenicity. BC047440 cDNA fragments were reversely inserted into pcDNA3.1(+) plasmids. The antisense vector significantly reduced the endogenous BC047440 mRNA abundance by 41% in HepG(2) cells and inhibited their proliferation in vitro (P0.01). More cells were arrested by the antisense vector at the G(1) phase in an apoptosis-independent manner (P = 0.014). Additionally, transfection with pcDNA3.1(+)BC047440AS significantly reduced the xenograft tumorigenicity in nude mice. As a novel cell cycle regulator associated with HCC, the BC047440 gene was involved in cell proliferation in vitro and xenograft tumorigenicity in vivo through apoptosis-independent mechanisms.

Gp96 (GRP94) is a chaperone that is responsible for molecular folding and assembly of proteins. To investigate correlations among Gp96 expression, sensitivity to radiotherapy and clinical features of nasopharyngeal carcinoma (NPC), the expression of Gp96 in 98 NPC samples was analyzed by immunohistochemistry and Western blotting at the protein level, and by real-time PCR at the mRNA level. Clinicopathological features, including stage, sex, grade and survival, were compared between the high and low Gp96 expression groups. As a result, Gp96 was expressed at a higher level in NPC tissues than in noncancerous nasopharyngeal mucosa (p = 0.001). Univariate analysis suggested that a higher Gp96 expression level was associated with significantly decreased disease-free and 5-year survival rates (p = 0.000, p = 0.000, respectively). Multivariate Cox proportional-hazard regression analysis, which adjusts for clinicopathological variables, indicated that it was only associated with the 5-year overall survival rate (p = 0.002). Furthermore, patients with high Gp96 expression levels were significantly more resistant to radiotherapy (p = 0.001). These data are the first indication of a positive correlation between Gp96 expression levels and radiosensitivity and 5-year survival rate. Gp96 might serve as a novel candidate marker for predicting the long-term prognostic outcome of NPC.

To study the effects of educational background of men who have sex with men (MSM) on their high risk sexual behaviors and the HIV/STI infection rates.During July to November of 2009 and March to October of 2010, snowball and convenience sampling methods were adopted to recruit MSM from MSM venues and via the internet in Changzhou city of Jiangsu province, and finally 659 MSM were conducted a questionnaire survey and serological testing. According to the educational background of MSM, they were divided into 3 groups, that is, junior high school group (206 cases), high school group (254 cases), and university group (199 cases). The questionnaire mainly includes information on social demography, sexual behaviors, condom use, etc. Blood samples were collected for HIV and syphilis spirochete detection, and urine samples were also collected in 291 MSM who were recruited during July to November of 2009 for neisseria gonorrhoeae and chlamydia trachomatis nucleic acid detection. χ(2) test and other statistical analysis methods were used to compare the characteristics of sexual behaviors and HIV/STI infections in 3 groups.Of the 659 valid questionnaires returned, junior high school group, high school group, and university group accounted for 31.3% (206 cases), 38.5% (254 cases) and 30.2% (199 cases). Places where MSM of different education levels most often to seek sexual partners, were significantly different. Junior high school group and high school group mostly went to bath house/sauna club (56.3%, 116 cases) and bar (34.8%, 88 cases) for partners, respectively, while the university group sought partners mainly through the internet (41.1%, 81 cases) (χ(2) = 99.35, P0.05). 53.4% (109/204) of the junior high school group had anal sex with men in the last 6 months, which was higher than that of high school group (67.7%, 172/254) (χ(2) = 9.74, P0.05) and university group (72.7%, 144/198) (χ(2) = 16.04, P0.05) . A total of 54.4% (111/204) of the junior high school group had sex with women in the last 6 months, which was higher than that of university group (38.6%, 76/197) (χ(2) = 10.10, P0.05) , but was not statistically significantly different from that of high school group (46.9%, 119/254) (χ(2) = 2.59, P = 0.11) . The rates of condom use with men at the last anal sex in junior high school group (73.4%, 80/109) , high school group (78.0%, 131/168) and university group (73.9%, 105/142) were similar. The rates of condom use with women in the last intercourse in junior high school group, high school group and university group were 51.8% (57/110), 54.6% (65/119) and 61.8% (47/76), respectively(χ(2) = 1.88, P = 0.39) . In junior high school group, high school group and university group, the infection rates of HIV were 9.2% (19/206), 10.6% (27/254) and 5.6% (11/197) (χ(2) = 3.68, P = 0.16), the positive rates of neisseria gonorrhoeae were 3.8% (3/79), 3.4% (4/117) and 0.0% (0/95) (χ(2) = 3.85, P = 0.14), the positive rates of chlamydia trachomatis were 5.1% (4/79), 9.4% (11/117) and 4.2% (4/95) (χ(2) = 2.70, P = 0.26). The infection rate of syphilis in junior high school group was 19.9% (41/206), which was higher than high school group (12.2%, 31/254) (χ(2) = 5.11, P0.05) and university group (10.2%, 20/197) (χ(2) = 7.45, P0.05 ).There was no obvious correlation between education level and high risk sexual behaviors;MSM with lower education level were at higher risk of infection of syphilis.

To analyse the clinical outcomes of the Z-osteotomy of the distal fibula to correct widened mortice of the ankle after fracture.Between September 2009 and February 2011, 5 patients (5 feet) with widened ankle mortice after fracture underwent Z-osteotomy. There were 4 males and 1 female, aged from 23 to 58 years (mean, 38 years). At 3 months after operation of internal fixation when function exercises were done, patients got pains. The interval between trauma and operation ranged from 5 to 36 months (mean, 13.2 months). Lateral pressure test showed positive in 2 cases and negative in 3 cases. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 50.2 +/- 17.3.Primary healing of incision was achieved in all cases. Five patients were followed up 9 to 24 months (mean, 15.6 months). Mild to moderate swelling of the affected limb and anterolateral skin numbness of the ipsilateral dorsal foot occurred, and gradually improved. The clinical exam and radiology showed bone union at 12-15 weeks (mean, 13.5 weeks). Postoperative range of motion of ankle had no significant improvement. AOFAS ankle-hindfoot scores were 76.8 +/- 11.2 at 6 months after operation, and 85.4 +/- 3.2 at last follow-up, showing significant differences when compared with preoperative score (P0.05).Shortened fibula is the main cause of widened ankle mortice after fracture; Z-osteotomy can effectively reduce the width of the ankle mortice, increase the stability of ankle joint, and decrease the complication rate.

To evaluate the possibility and reliability of hyoid graft and pedicle sternohyoid muscle flaps in the reconstruction of laryngotracheal stenosis.Using the single or double pedicle sternohyoid muscle flaps and hyoid graft, we repaired laryngotracheal stenosis.In all 21 cases with laryngotracheal stenosis, 16 cases were cured after one surgical procedure, and 3 cases were cured after two times of surgical procedures, and 19 cases were decannulated, but one case was failure, and one case was lost visiting.The hyoid sternohyoid graft transfer method was convenient, slightly damaging, and had good supporting effects and high survival rate in the reconstruction of laryngotracheal stenosis.

To summarize the curative effect and esthesioneuroblastoma (ENB) by classic surgical approaches and surgical approaches with the assistant of nose endoscope.A retrospective review was conducted in 19 cases treated from 1980 to 2000. Ten cases were treated by classical surgical approaches. Tumors in 4 patients (According to the Kadish system, stage A, 3 cases; stage B, 1 case) were removed via a transnasal approach, 6 patients (stage B, 5 cases; stage C, 1 case) were performed by lateral rhinotomy. After 1995, 9 cases (stageA, 2 case; stageB, 5 cases; stageC, 2 cases) received surgical resection with nasale endoscope. All of the patients were conducted radiation after operation.The 5-year survival rate for the classic procedure and the surgical procedure with the assistant of endoscope were 50.0%, 88.9%, respectively. And the local recurrence rates were 50.0%, 33.3%, respectively (had no statistical significance). And the mean recurrent time were 5.2 months, 16 months, respectively. With the assistant of endoscope, the recurrent time was significant retarded.There are better illumination and better operation field during the surgical operation with the assistant of endoscope. And the tumors are more likely resected entirely and the tumor recurrent time could be deferred.

To explore the diagnose and treatment of severe OSAHS with distinction of different extent.All 256 severe OSAHS patients were divided into two groups according to sleep apnea hypopnea index (AHI): group one (severe group), 40AHI65; group two (extra severe group), AHIor = 65. All patients were underwent CPAP treatment for at least one week before modified UPPP in general anesthesia. UPPP and (or) nasal septum plasty or partial inferior turbinectomy were operated in one stage if tracheotomy was conducted. If tracheotomy were not conducted, the patient was only accepted UPPP under general anesthesia. The other operations to remove the multi block factors were operated in local anesthesia.In 198 group one patients, there were 169 patients accepted UPPP in general anesthesia without tracheotomy, the other 29 patients were conducted with tracheotomy. The tracheotomy rate was 14.6%. The total effective cure rate was 85.9%. In all 58 group two patients, tracheotomy were conducted, and the total effective cure rate was 63.8%. The complication rate of all the two groups' patients was 3.5%. After three weeks,the uvulas decurtated from(4.89 +/- 0.58) cm to (3.12 +/- 0.46)cm.It is important to divide the severe OSAHS patients into severe group and extra severe group because the treatments were different. Not all the severe OSAHS patients need tracheotomy. There were advantages to retain the uvula in UPPP and patients' life quality was improved with uvula reserved.

Purpose To theorize the effect of Schlemm canal (SC) and/or collector channel (CC) dilation combined with a trabecular bypass on intraocular pressure (IOP) in eyes with primary open angle glaucoma. Methods The elliptic shaped SC is dilated in conjunction with a trabecular bypass and its expanded height is largest at the bypass and linearly deceases to the nondilated height over the dilated circumferential length. The CC dilation is modeled with a reduced outflow resistance of second order polynomial over the same dilated length. Equations governing the pressure and circumferential flow in SC are solved numerically for both the unidirectional and bidirectional bypasses. The reduced IOP is deduced from the solution. Results IOP is reduced substantially with moderate SC dilation from the normal height of 20 microm to 40 to 50 microm at the bypass; additional IOP reduction diminishes with further dilation. SC dilation is more effective for eyes with smaller SC. CC dilation also lower IOP significantly. With the trabecular bypass alone, the elevated IOP in primary open angle glaucoma is expected to drop to the mid-to-high teens. IOP can be further reduced by another 3 to 6 mm Hg with moderate SC and CC dilation. The circumferential length of dilated SC affects the efficacy of IOP reduction. In theory, the dilation of SC with a trabecular bypass is analogous to a partial trabeculotomy in terms of IOP reduction. Conclusions In theory, a moderate dilation of SC and CC in conjunction with a trabecular bypass reduces the IOP to the low-to-mid teens.

Purpose To introduce a hypothesis that theorizes the effect of a trabecular bypass, a channel created through the trabecular meshwork, on the facility of outflow and the intraocular pressure (IOP). Methods Equations that govern the pressure and circumferential flow in Schlemm's canal are established, based on the linear relationships between pressure drop and flow, the balance of flows in the canal, and a uniform leaking structure of collector channels. Two types of bypasses permitting either unidirectional or bidirectional flow are incorporated through boundary conditions to solve the equations and to derive the facility of outflow and the reduced IOP. Results In normal healthy eyes, the facility of outflow increases by 13% and 26% in the presence of a unidirectional and bidirectional bypass, respectively. The circumferential flow is significant only in the immediate quadrant to the bypass. The elevated IOP due to the abnormally high resistance in trabecular meshwork in open angle glaucoma is substantially reduced with a single bypass. Mean physiological level of IOP is attained if the bidirectional bypass is placed; slightly higher IOP is attained if a unidirectional bypass is placed. In either case, the higher the baseline IOP, the greater the reduction. The effectiveness of the bypass on IOP reduction is related to the resistances in the canal and the collector channels. Multiple bypasses can be used to further reduce the IOP. Conclusion It is theoretically demonstrated that a single patent trabecular bypass can enhance the facility of outflow and reduce the IOP to physiological levels.

To determine the effect on intraocular pressure (IOP) of bypassing the trabecular meshwork in cultured human anterior segments.Prospective laboratory investigation using normal human eyes obtained at autopsy.Anterior segments from 21 eyes were placed in perfusion culture, and trabecular bypass stents were inserted through the trabecular meshwork, with the lumen of the tube opening into Schlemm's canal. Eyes received from one to four stents, placed equidistant apart. In eyes receiving one or two stents, additional stents were later added to a maximum of four per eye.Intraocular pressure was lowered after placement of a single stent, from 21.4 +/- 3.8 mm Hg to 12.4 +/- 4.2 (P.001). This corresponded to an 84% increase in facility of outflow. Eyes receiving more than one stent had final IOP of 11.9 +/- 3.7 mm Hg. Nine eyes had sequential addition of stents, and seven of these had a further decrease of IOP (13.6 +/- 4.1 to 10.0 +/- 4.3; P = .02). Excision of the entire meshwork, between stents, dropped IOP to 6.3 +/- 3.2 mm Hg, indicating some residual meshwork or canal resistance remained even after placement of three stents.Bypass of the trabecular meshwork lowers IOP in cultured human anterior segments. One stent produced the greatest change in pressure. The sequential addition of more stents further lowered pressure in seven of nine eyes. This technique holds promise as a new clinical surgery for glaucoma.