Objective To investigate the differences in biological features between male and female patients with obstructive sleep apnea-hypopnea syndrome( OSAHS) . Methods 192 cases of patients with snoring were analyzed in the Sleep Medicine Center of West ChinaHospital fromSeptember 2004 to February 2005. The standard sleep disorder questionnaires, neck circumference, hight, weight, and all night polysomnography ( PSG) were evaluated. The clinical features of the male and female patients with OSAHS were compared. Results 170 cases of patients met the criteria of OSAHS for the apnea-hypopnea index ( AHI) more than 5 times per hour. Male gender accounted for 90% of the total patients ( male vs. female 153 vs. 17, 9∶1) . The age of male patients with OSAHS was younger than that of female ( 45. 7 ±11. 4 yearsvs. 58. 0 ±6. 1 years, P = 0. 000) . Parameters including neck circumference ( 37. 6 ±3. 2 cm vs. 35. 6 ±3. 2 cm, P =0. 000) , waist/hip rate ( 0. 94 ±0. 04 vs. 0. 9 ±0. 06, P = 0. 000) , AHI ( 36. 4 ±25. 7 vs.21. 4 ±17. 4, P =0. 004) , oxygen desaturation index ( 34. 5 ±27. 4 vs. 22. 2 ±20. 8, P =0. 035) , the number of smoking ( 52. 9% vs. 5. 9% , P = 0. 000) and drinking ( 46. 4% vs. 5. 9% , P = 0. 001) were different among the male and female patients with OSAHS. On the other hand, the morning headache ( 70. 6% vs.26. 1%, P = 0. 005) , mouth dry( 76. 5% vs. 47. 7% , P = 0. 025) , bad temper ( 52. 9% vs. 19. 0% , P =0. 004) , and hypertension ( 52. 9% vs. 20. 9% , P =0. 007) were more common in the female patients with OSAHS. Conclusion There are significant differences between male and female patients with OSAHS in prevalence, age, symptoms, and severity of the disease.
Objective To assess the effectiveness and safety of adenoidectomy on otitis media with effusion (OME) in children. Methods Electronic databases were searched including Medline (1966-2001), EMbase (1974-2001), the Cochrane Controlled Trials Register (CCTR), Chinese Biomedical Database (CBM, 1989-2001). Five Chinese otolaryngology journals were handsearched. References of eligible studies were also screened for inclusion. Selection criteria were restricted to randomized controlled trials comparing adenoidectomy with other treatments in patients with OME in children. At least two reviewers independently assessed trial quality and extracted data. RevMan 4.1 was used for statistical analysis. Results Of the 248 literatures identified, 13 trials with 1 430 patients were eligible and were included in the systematic review. Overall, the methodological quality of the included trials was high, all from developed countries. None of the trials showed that the effects of adenoidectomy better than those of myringotomy and no treatments for OME in children. Four trials comparing adenoidectomy with grommets showed that the effects of grommets were better than those of adenoidectomy. Ten trials described post-surgical bleeding, velopharyngeal incompetence and nasopharyngeal stenosis. Conclusions At present, there is no evidence to either ascertain that adenoidectomy is better than other treatments for OME, or to suggest which type of surgery is the most effective one. Current trials indicate that early administration of adenoidectomy concomitant with grommets might be the most appropriate therapy for OME in children who fail to response to drug treatment, if multiple risk factors exist.
Objective To investigate the diagnostic efficacy of 99mTc-MDP three-phase bone scintigraphy (TPBS) combined with C-reactive protein (CRP) for periprosthetic joint infection (PJI). MethodsThe clinical data of 198 patients who underwent revision surgery of artificial joint between January 2017 and January 2024 and received TPBS examination before surgery were retrospectively analyzed. There were 77 males and 121 females with an average age of 63.74 years ranging from 24 to 92 years. There were 90 cases of hip arthroplasty and 108 cases of knee arthroplasty. PJI was diagnosed according to the 2013 American Musculoskeletal Infection Society (MSIS) standard diagnostic criteria. The sensitivity, specificity, accuracy, negative predictive value (NPV), and positive predict value (PPV) were calculated. The receiver operating characteristic (ROC) curve was used to compare the diagnostic performance of the three methods, and the area under curve (AUC) was used to evaluate the diagnostic performance. ResultsAccording to the 2013 MSIS criteria, 116 cases were diagnosed as PJI, and the remaining 82 cases were aseptic loosening. The cases of PJI diagnosed by TPBS, CRP, and TPBS-CRP were 125, 109, and 137 respectively, and the cases of aseptic loosening were 73, 89, and 61 respectively. The sensitivity, accuracy, NPV, and PPV of TPBS-CRP combination in the diagnosis of PJI were higher than those of TPBS and CRP, but the specificity was lower than that of TPBS and CRP. ROC curve analysis further showed that the AUC value of TPBS-CRP combination was better than that of TPBS and CRP. The severity of bone defect and the duration of symptoms in patients with false positive TPBS diagnosis were worse than those in patients with true negative TPBS diagnosis (P<0.05), but there was no significant difference in the survival time of prosthesis between the two groups (P>0.05). Among the patients diagnosed with PJI by TPBS, CRP, and TPBS-CRP, 49, 35, and 54 patients had received antibiotic treatment 2 weeks before diagnosis, respectively. There was no significant difference in the diagnostic accuracy of TPBS and TPBS-CRP before diagnosis between patients treated with and without antibiotics and those not treated (P>0.05). The diagnostic accuracy of antibiotic therapy before CRP diagnosis was significantly lower than that of untreated patients (P<0.05). Conclusion TPBS and CRP have limited specificity in differentiating PJI from aseptic loosening. The TPBS-CRP combination diagnostic method can synergize the local bone metabolic characteristics and systemic inflammatory response to achieve higher diagnostic accuracy, but caution should be exercised in patients with severe bone defects and longer symptom duration.