Tapia's Syndrome after Posterior Cervical Spine Surgery under General Anesthesia

We present a case report to remind surgeons of this unusual complication that can occur in any surgery, even posterior cervical spine surgery under general anesthesia and discuss its causes, treatment methods, and the follow-up results in the literature. The peripheral Tapia''s syndrome is a rare complication of anesthetic airway management. Main symptoms are hoarseness of voice and difficulty of tongue movement. Tapia''s syndrome after endotracheal general anesthesia is believed to be due to pressure neuropathy of the vagus nerve and the hypoglossal nerve caused by the endotracheal tube. To our knowledge, no report has been published or given an explanation for Tapia''s syndrome after posterior cervical spine surgery. Two patients who underwent posterior cervical surgery complained hoarseness and tongue palsy postoperatively. There is no direct anatomical relation between the operation, the vagus nerves and the hypoglossal nerves, and there is no record of displacement or malposition of the endotracheal tube. After several months, all symptoms are resolved. To avoid this problem in posterior cervical spine surgery, we suggest paying special attention to the position of the endotracheal tube to avoid excessive neck flexion before and during the positioning of the patient.     

广州市2015-2016年50~74岁社区人群大肠癌筛查结果分析

目的 分析广州市开展现行大肠癌筛查策略的效果。方法 收集、整理2015－2016年广州市大肠癌筛查数据，评价问卷调查、便隐血检查和全结肠镜检查的筛查效果。结果 2015－2016年广州市50～74岁重点人群完成初筛220 834人，初筛阳性37 040例（16.77%）。全结肠镜检7 821人，肠镜检查顺应率为21.12%（7 821/37 040）。发现各类肠道病变4 126例（52.76%），其中进展性腺瘤614例（7.85%）、伴中/重度异型增生的其他病变73例（0.93%），大肠癌230例（2.94%）；各类病变中男性检出率均高于女性（P<0.01）。病变早诊率为87.24%；筛查发现早期癌99例，占总大肠癌的46.26%。大肠癌筛查发现率为104.15/10万，明显高于相应年龄段（50～74岁）大肠癌监测发病率81.18/10万（P<0.001），表现为≤69岁年龄段大肠癌发现率明显高于相应发病率，≥70岁年龄段则相反。结论 广州市大肠癌筛查策略可以发现大肠癌高危人群，提高全结肠镜病变检出率、癌前病变早诊率和早期大肠癌的诊断比例，≤69岁人群受益高于70～74岁人群，是大肠癌筛查重点关注人群，应需进一步促进高危人群肠镜检查顺应性。     

Impact of Obstructive Sleep Apnea on the Global Myocardial Performance Beyond Obesity

We aimed to assess the impact of obstructive sleep apnea (OSA) on the left ventricular (LV) function independent of obesity using the myocardial performance index (Tei index) and the global longitudinal LV strain (GLS) and its reversibility after surgery. Twenty‐five newly diagnosed OSA patients, normal weight (n = 15) and obese (body mass index [BMI] ≥ 25; n = 20) controls without OSA were enrolled and underwent transthoracic echocardiographic evaluation. The OSA and obese groups had a significantly comparable increased BMI and LV chamber dimension, prolonged isovolumic relaxation time, reduced early mitral filling velocity, and increased late mitral filling velocity and Tei index as compared to the normal weight group. However, GLS was significantly reduced only in the OSA group (–16.5 ± 1.9%) as compared to the normal weight group (–20.6 ± 2.0%, P < 0.001) and obese group (–19.1 ± 2.5%, P < 0.001). As a treatment, 13 of 25 patients underwent surgical modification, and the follow‐up echocardiogram revealed significantly improved Tei index and GLS as compared to baseline (0.37 ± 0.06 and –18.9 ± 3.3% vs. 0.42 ± 0.04 and –16.3 ± 2.4%, P = 0.006 and 0.031, respectively), which was comparable to the obese controls. A reduction in the apnea‐hypopnea index had a significant effect on the improvement in the GLS (r = 0.73, P < 0.001). LV systolic and diastolic function significantly deteriorated in the patients with OSA beyond obesity, and an improvement in the LV function was observed within 6 months after the surgical modification. GLS is considered to be one of the parameters that can be used in the early detection of LV systolic dysfunction in patients with OSA and a normal ejection fraction.     

血清高尔基体蛋白73在原发性肝癌中的表达及早期诊断意义

目的探讨血清高尔基体蛋白73(GP73)在原发性肝癌(primary hepatic carcinoma,PHC)患者血清中的表达及其临床意义。方法采用酶联免疫吸附试验(ELISA)检测我院收治的47例PHC(肝癌组)及40例肝硬化(肝硬化组)血清中GP73,同时用电化学发光法检测血清甲胎蛋白(AFP),并将检测结果进行对比。结果 GP73和AFP测定值肝癌组分别为(220.44±89.71)μg/L、(404.06±135.43)μg/L,肝硬化组分别为(112.67±34.89)μg/L、(71.17±16.24)μg/L,组间比较差异均有统计学意义(t=93.485,t=250.924;P均<0.001)。GP73和AFP阳性率肝癌组分别为85.11%(40/47)、61.70%(29/47),肝硬化组分别为15.00%(6/40)、22.50%(9/40),组间比较差异均有统计学意义(χ2=70.654,χ2=31.284;P均<0.001)。肝癌组GP73异常与合并肝硬化或淋巴结转移有关(t=2.061,t=2.133;P均<0.05),与肿瘤大小及临床分期无关(t=0.560,t=0.573;P均>0.05)。结论肝癌患者血清高表达GP73,可能与肝癌的发生、发展有关,检测GP73有助于PHC早期诊断。     

Micropatterns of Non‐Circular Droplets of Nanostructured PS‐b‐PEO Copolymer by Solvent‐Assisted Wetting on a Chemically Periodic Surface

A method to fabricate micropatterns of non‐circular droplets of a self‐assembled block copolymer by solvent‐assisted wetting on chemically periodic surface is presented. The block copolymer is dewetted on a topographic pre‐pattern to form an array of microdroplets with a sphere‐capped shape and circular contact line. The droplets are then transferred onto a chemically periodic Au line pattern microcontact‐printed with two types of self‐assembled monolayers (SAMs). Solvent vapor application provides sufficient mobility to the block copolymer molecules to induce spreading of the transferred droplets, resulting in two types of non‐circular microdroplet growth. The growth behavior depends on the size of initial droplets relative to periodic line width and on the initial registries of as‐transferred droplets.     

Clinical Efficacy of Cervical Length and Volume for Prediction of Labor Onset in VBAC Candidates

Background: The purpose of this research is to discover whether measurement of cervical length and cervical volume at term is helpful in predicting the onset of labor in VBAC candidates.Methods: Transvaginal sonographic evaluations of the cervixes of pregnant women who desired to undergo VBAC were performed between 36 - 40 weeks gestation. Clinical information such as labor onset time, gestational age at delivery and delivery mode was gathered from medical records.Results: A total of 514 pregnant women participated in this study. Cervical length was significantly longer in the group that delivered 7 days or more after measurement than in the group that delivered within 7 days of measurement (43±0.77 cm vs. 2.99±0.72 cm, p< 0.001). Cervical volume was significantly larger in the group that delivered at and after 7 days than in the group that delivered within 7 days (29.21±11.62 cm³ vs. 34.07±13.41 cm³, p=0.014). The cervical length ROC curve was significantly more predictive than the cervical volume ROC curve (AUC: 0.711 vs 0.594, p= 0.001). There were no significant differences between the combined cervical length/volume ROC curve and the cervical length ROC curve alone (p= 0.565). The AUC of the cervical length ROC curve to predict postterm pregnancy was 0.729.Conclusion: Measuring cervical length is helpful in predicting the onset of spontaneous labor within 7 days and posterm delivery in VBAC candidates.