The Mammallan Intervertebral Disc. Composition of the Nucleus Pulposus of Whales During Development and Aging

The composition of the nucleus from 25 intervertebral discs of sperm and fin whales of different fetal developmental stages and postnatal ages is reported. Early stages in the nucleus intrauterine life (one quarter to one half development) show drastic changes in the proportion of galactosamine and glucosamine. The collagen content of the dry fetal nucleus is higher than the hexosamine content in early stages although it rapidly decreases to a plateau in specimens of one half to full term development. Afterward, in the postnatal nucleus and during aging, the amount of hexosamine greater than that of collagen on a dry weight basis; furthermore, both remain invariant, although irregular changes in the proportion of galactosamine and glucosamine are observed.

The polysaccharides from the fetal tissue are more polydisperse and undersulfated than those isolated from postnatal specimens. The major polysaccharides of the whale nucleus are CS-4SO₄, CS-6SO₄, and KS. The fetal nucleus also contains CS. The distribution of CS-4SO₄ and CS-6SO₄ in the cartilage plates is the reverse of that observed in the nucleus pulposus. Characteristic of both anatomic structures is a decrease of CS during fetal development.

The proteoglycan fraction of the postnatal nucleus (PG-L) was found to contain polysaccharide peptides. Similar fractions from fetal specimens contained no polysaccharide peptides. The polydispersity of the proteoglycans in the fetal nucleus appears to be regulated by the amount of a cystine-containing proteoglycan fraction (Fraction F) sensitive to disulfide reducing reagents. Such a correlation was not observed in preparations from postnatal specimens.     

A case of ectopic salivary gland of the larynx

A 46-year-old man presented with sore throat. Laryngoscopic findings revealed a smooth yellow mass occupying the anterior portion of the false vocal fold on the left side. The authors performed biopsy under general anesthesia. The histopathological diagnosis was ectopic salivary gland. Because salivary glands are usually not found under the false vocal fold mucosa, ectopic salivary gland of the larynx was diagnosed.It is necessary to consider the possibility of ectopic salivary gland for mass lesions if swelling of the provisional vocal cord is found.     

帕瑞昔布钠预防腹腔镜胆囊切除术后咽喉痛疗效观察

目的观察帕瑞昔布钠预防腹腔镜胆囊切除术后咽喉痛的疗效。方法选取2018年6月至2019年1月在重庆市北碚区中医院择期行腹腔镜胆囊切除术的130例全身麻醉患者作为研究对象,性别不限,年龄21~67岁,美国麻醉医师协会分级为Ⅰ、Ⅱ级,随机分为帕瑞昔布钠组(P组)和生理盐水组(S组)。手术结束前10 min P组患者静脉注射帕瑞昔布钠40 mg,S组患者静脉注射等容量生理盐水。记录两组患者术后拔管即刻,术后2、6、12、24 h咽喉痛的视觉模拟评分(VAS评分)。观察并记录拔管期间出现不良反应情况,随访记录患者术后6 h咽喉部并发症发生率、静脉自控镇痛(PCIA)使用情况,以及术后24、48 h 15项恢复质量量表评分。结果P组患者术后拔管即刻,术后2、6、12 h VAS评分均低于S组,PCIA按压次数均少于S组,拔管期间不良反应发生率、术后6 h咽喉部并发症发生率均明显低于S组,术后24、48 h QoR-15项恢复质量量表评分均明显高于S组,差异均有统计学意义(P<0.05)。结论帕瑞昔布钠能有效减轻腹腔镜胆囊切除术后咽喉痛发生情况。     

慢性咽喉炎应用蓝芩口服液治疗的临床分析

目的：探讨慢性咽喉炎应用蓝芩口服液治疗的临床分析。方法将2013年7月—2014年7月在该院内科治疗的100例慢性咽喉炎患者随机分为两组,对照组采用常规治疗的方法,观察组在此基础上服用蓝芩口服液,治疗2个疗程后比较两组患者的临床效果、症状改善时间、不良反应等。结果对照组治疗有效率为82%,观察组治疗有效率为94%,差异有统计学意义（P＜0.05）;观察组咽部疼痛充血、咽部粘膜干燥、咽痒咽干、咽部异物感等在症状改善时间上明显短于对照组,差异有统计学意义（P＜0.05）;两组均未有明显不良反应（P＞0.05）。结论慢性咽喉炎应用蓝芩口服液治疗效果显著,利于症状的缓解,减少复发,具有积极的临床意义。     

双果喉乐汤局部喷雾缓解全身麻醉插管患者术后咽痛的临床疗效研究

目的:探讨双果喉乐汤局部喷雾缓解全身麻醉插管患者术后咽痛的临床疗效。方法:选取2018年8月至2019年8月中山市中医院收治的行全身麻醉插管的患者140例,根据随机数字表法分为观察组和对照组,每组70例。对照组患者采用温开水局部喷雾,观察组患者采用双果喉乐汤局部喷雾。比较两组患者咽部不适发生情况、症状改善时间、咽痛程度视觉模拟评分(visual analogue scale,VAS)及不良反应发生情况的差异。结果:观察组患者咽部不适发生率为5.71%(4/70),明显低于对照组的17.14%(12/70),差异有统计学意义(P<0.05)。观察组患者咽部疼痛、声音嘶哑及吞咽痛改善时间明显短于对照组,差异均有统计学意义(P<0.05)。干预后30 min、6 h、12 h和24 h,观察组患者咽痛程度VAS评分明显低于对照组,差异均有统计学意义(P<0.05)。两组患者在观察期间均未见不良反应发生。结论:双果喉乐汤局部喷雾缓解全身麻醉插管患者术后咽痛的临床疗效良好,能有效降低患者咽部不适发生率,显著缩短咽部不适症状改善时间,改善咽痛程度,缓解术后咽痛症状。     

A case-control study of obstructive sleep apnea-hypopnea syndrome in obese and nonobese chinese children

BACKGROUND: Obesity is a risk factor for obstructive sleep apnea-hypopnea syndrome (OSAHS) in adults. However, the prevalence of OSAHS in children is not clear, and the relationship between obesity and OSAHS remains controversial. METHODS: Obese children were recruited from the endocrinology, respiratory, and ear, nose, and throat clinics. Weight-matched, age-matched, and sex-matched children were recruited as control subjects. Standard questionnaires were administered, and a standardized physical examination was carried out. Lateral neck roentgenography, sleep polysomnography, full blood count, and arterial blood gas analysis were also performed. Children with body mass index z-scores of > 1.96 were considered to be obese. An adenoidal/nasopharygeal ratio of > 0.67 was considered to constitute adenotonsillar hypertrophy (ATH). OSAHS was defined as an apnea-hypopnea index (AHI) score of > 5 or obstructive apnea index (OAI) score of > 1. RESULTS: Ninety-nine obese children and 99 control subjects were recruited into the study. Obese patients had significantly higher AHI and OAI scores, and lower sleep efficiency and minimum arterial oxygen saturation (MinSao(2)) than control subjects. The prevalence of OSAHS was significantly higher in obese children with or without the ATH groups than their nonobese counterparts (odds ratio, 1.9 vs 108, respectively; 95% confidence interval, 1.21 to 4.7 vs 6.2 to 191, respectively). Obesity, tonsillar hypertrophy, and adenoid hypertrophy were independent risk factors for OSAHS (p < 0.001, p = 0.042, and p = 0.004, respectively). There was a positive correlation between the degree of obesity and AHI (r = 0.535; p < 0.001), and an inverse correlation between obesity and MinSao(2) (r = -0.507; p < 0.001). End-tidal CO(2), Paco(2), and bicarbonate levels were within the normal range. CONCLUSIONS: Obesity is a risk factor for OSAHS, and the degree of obesity is positively correlated with the severity of OSAHS.     

“J”状塑型双腔气管导管插管操作对成功率及术后声音嘶哑、咽喉痛的影响

目的 观察双腔气管导管(double-lumen endotracheal tube,DLT)塑型对插管成功率及术后声音嘶哑(声嘶)、咽喉痛的影响,从而为寻求更好的DLT塑型插管提供依据. 方法 择期全身麻醉下行胸科手术患者160例,美国麻醉医师协会(ASA)分级Ⅰ～Ⅲ级,参照随机数字表法分成DLT插管塑型组和非塑型组(每组80例),两组根据左右DLT插管各分为两组(A、B、C、D组,每组40例),又根据性别再各分为两个亚组(A1、A2、B1、B2、C1、C2、D1、D2组,每组20例).两组均采用经口明视气管插管,塑型组采用塑成“J”状的DLT进行插管,非塑型组采用未经塑型保留原有弯度的DLT进行插管.观察DLT插管时间、插管尝试次数及插反情况,患者术后声嘶、咽喉痛发生率及严重程度. 结果 塑型组插管时间[(154±6)s]明显短于非塑型组[(185±13)s](P＜0.05);塑型组插管尝试次数[(1.4±0.4)次]明显少于非塑型组[(1.7±0.8)次](P＜0.05);塑型组插反情况(3次)明显比非塑型组少(11次)(P＜0.05),且与性别无关,但左DLT比右DLT易于插反(P＜0.05).患者术后声嘶发生率塑型组(15/80)明显低于非塑型组(33/80)(P＜0.05);患者术后咽喉痛发生率塑型组(15/80)明显低于非塑型组(31/80) (P＜0.05),且与性别有关,女性较男性术后易发生声嘶、咽喉痛. 结论 “J”状DLT塑型插管成功率高、刺激小,可降低患者术后声嘶、咽喉痛发生率,具有一定的临床推广意义.