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Objective:To investigate the expression levels of matrix metalloproteinase-9 (MMP-9), procalcitonin (PCT), soluble triggering receptor expressed on myeloid cells (sTREM-1) and soluble cell differentiation 14 (sCD14) in pregnant women with premature rupture of membranes (PROM) and their predictive value for chorioamnionitis.Methods:A total of 132 pregnant women with PROM who received treatment in Tengzhou Central People's Hospital from January 2016 to June 2017 were included in the study group. These women were assigned to pre-term PROM group (gestational age < 37 weeks, n = 58) and full-term PROM group (gestational age > 37 weeks, n = 74). A total of 106 concurrent full-term healthy pregnant women were included in the control group. Pregnant women in the PROM group were also assigned into an infection group ( n = 51) and a non-infection group ( n = 81). Serum levels of MMP-9, PCT, sTREM-1 and sCD14 were compared between study and control groups, and their value in the diagnosis of PROM complicated with chorioamnionitis was analyzed. Results:The expression levels of MMP-9 [(271.42 ± 34.16) ng/L], PCT [(54.57 ± 8.16) pg/mL], sTREM-1 [(0.51 ± 0.11) ng/mL] and sCD14 [(60.23 ± 9.49) ng/mL] in the study group were significantly higher than those in the control group [(54.97 ± 10.08) ng/L, (26.04 ± 1.98) pg/mL, (0.19 ± 0.04) ng/mL, (42.04 ± 10.33) ng/mL, t = 27.064, 13.767, 14.831, -13.342, all P < 0.01). The expression levels of MMP-9 [(314.05 ± 45.37) ng/L], PCT [(0.61 ± 0.18) ng/mL], sTREM-1 [(63.12 ± 10.12) pg/mL] and sCD14 [(68.07 ± 11.05) ng/mL] in the pre-term PROM group were significantly higher than those in the full-term PROM group [(238.01 ± 40.45) ng/L, (47.87 ± 8.90) pg/mL, (0.43 ± 0.14) ng/mL, (54.09 ± 10.33) ng/mL, t = 9.103, 8.862, -10.538, 6.494, all P < 0.05). The expression levels of MMP-9 [(343.74 ± 43.74) ng/L], PCT [(69.88 ± 8.83) pg/mL], sTREM-1 [(0.67 ± 0.16) ng/mL], sCD14 [(70.41 ± 8.89) ng/mL] in the infection group were significantly higher than those in the non-infection group [(230.09 ± 49.82) ng/L, (45.82 ± 11.04) pg/mL, (0.42 ± 0.19) ng/mL and (54.41 ± 12.42) ng/mL, t = 23.655, 12.014, 9.382, 11.306, all P < 0.01]. The sensitivity (94.23%), specificity (93.75%), positive predictive value (92.45%) and negative predictive value (96.20%) of combined detection of these indexes in the diagnosis of PROM complicated by chorioamnionitis were significantly higher than those of other indexes detected alone (all P < 0.05). Conclusion:Combined detection of serum levels of MMP-9, PCT, sTREM-1 and sCD14 can be used as an effective auxiliary index for the diagnosis of early premature rupture of membranes complicated with chorioamnionitis.
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Objective To investigate the protective effects of a Yiqi Huatan Quyu formulation on liver injury in chronic intermittent hypoxia rats.Methods Thirty healthy male Sprague-Dawley rats of SPF grade were randomly divided into 3 groups:Group A(normoxia and normal saline gavage),Group B(chronic intermittent hypoxia and normal saline gavage)and Group C(chronic intermittent hypoxia and Yiqi Huatan Quyu formulation gavage)(n =10 in each group).After 8 weeks of treatment,the liver tissue was extracted for protein and RNA.Western blot was used to test the protein levels of B-cellymphoma-2 associated X protein (BAX) and B-cellymphoma-2 (BCL-2),and Realtime PCR was used to test gene expression of BAX and BCL-2.Transferase-mediated dUTP nick end-labeling(TUNEL)was used to assay the apoptotic rate of liver cells.Results The expression of the BAX protein and BAX gene was higher and the expression of the BCL-2 protein and BCL-2 gene was lower in Group B than in Group A(t =13.490 and 16.480,P =0.005 and 0.002;t =5.142 and 9.776,P =0.036 and 0.001,respectively).The levels of the BAX protein and BAX gene were lower and the levels of the BCL-2 protein and BCL-2 gene were higher in Group C than in Group B(t =6.088 and 15.240,P =0.026 and 0.005;t =5.296 and 16.380,P =0.034 and 0.004,respectively).The apoptosis rate of hepatocytes was higher in Group B than in Group A(t =7.698,P =0.002),and was lower in Group C than in Group B(t=4.345,P =0.012).Conclusions The Yiqi Huatan Quyu formulation may alleviate the apoptosis of liver cells in chronic intermittent hypoxia rats by upregulating BCL-2 and down-regulating BAX levels,thus exerting protective effects on the liver.
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Objective To observe the adverse reaction of Xuebijing injection and its prognosis.Methods 27 cases with adverse reactions caused by Xuebijing injection were collected.The clinical data,including medication time,dosage,combined medication,adverse reaction,clinical treatment and prognosis were analyzed.Results The dose of Xuebijing injection in 27 ADR patients were 10-50mL,mean (28.4 ± 4.3) mL.In 27 patients,males were significantly more than females(66.7％ vs.33.3％),40-70 years old patients were significantly higher than other age groups,the differences were statistically significant(x2 =6.000,20.691,all P ＜ 0.05).In 27 cases of adverse reactions,the highest proportion of skin in the involved organs was 48.1％,which was significantly higher than other organs,the difference was statistically significant(x2 =18.796,P ＜ 0.05).The highest proportion of 5-30min in adverse reaction time was 51.9％,which was significantly higher than that of less than 5min(25.9％) and 30min (22.2％),the difference was statistically significant (x2 =6.333,P ＜ 0.05).After stopping the treatment,the hormone,calcium gluconate,oxygen treatment and the expansion treatment,the patients all obviously improved or cured.The symptom disappearance time was 10minutes to 3 days,mean (39.5 ± 10.4) min.Conclusion The adverse reactions of Xuebijing injection are more common in men,and most of them are caused by the use of 5-30min.The highest proportion is skin involvement,the clinical work should pay attention to prevention and treatment.
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Objective To investigate the significance of changes in serum uric acid levels in elderly patients with obstructive sleep apnea hyponea syndrome (OSAHS).Methods The study recruited elderly patients aged 60 years and over undergoing polysomnography (PSG) at the Center for Diagnosis and Treatment of Sleep Disorders of our hospital from January 2012 to December 2014.According to the diagnostic criteria established by the Group of Sleep and Breathing Disorders,Respiratory Diseases Branch,Chinese Medical Association (2011),patients were divided into the simple snoring group,the mild OSAHS group,the moderate OSAHS group and the severe OSAHS group.Levels of serum uric acid,blood glucose,blood lipids and high-sensitive C-reactive protein (hsCRP) were compared between all groups after adjusting for age,gender and underlying diseases.Independent risk factors associated with serum uric acid were analyzed using Spearman' s rank correlation and stepwise multivariate analysis.Results A total of 129 elderly subjects including 100 males and 29 females,with a mean age of (63.6±2.25) years,were enrolled.Of these subjects,23 were grouped as simple snoring,24 as mild OSAHS,39 as moderate OSAHS and 43 as severe OSAHS.Serum uric acid and hs-CRP levels were increased in the severe OSAHS group as compared with the simple snoring group (both P＜0.05).Spearman's rank correlation analysis showed that the apnea-hypopnea index (AHI) and the oxygen desaturation index (ODD were positively correlated with the serum uric acid level (r =0.251 and 0.210,P =0.004 and 0.018,respectively).Stepwise multivariate analysis showed that,with serum uric acid level as the dependent variable,AHI was an independent risk factor for increased serum uric acid levels (β=0.354,P =0.000).Conclusions Serum uric acid levels are elevated in elderly patients with severe OSAHS,and AHI is an independent risk factor for the increased serum uric acid levels.
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Objective To analyze the relationship between daytime sleepiness and oxygen desaturation in the male eldcrly with obstructive sleep apnea /hyponea syndrome (OSAHS).Methods 147 male elderly (aged 60-80 years) with OSAHS in our sleep laboratory from March 2008 to February 2011 were divided into daytime sleepiness and daytime non-sleepiness groups. Epworth sleeping scale (ESS) and polysomnography (PSG) were employed to detect the degree of sleepiness.Oxygen desaturation were evaluated by oxygen desaturation index (ODI),average and minimum blood oxygen,time percentage of 90％ oxygen desaturation (CT90). Resulls There were significant differences between the two groups in body mass index (BMI) (t=4.157),ODI (t=-10.063),average (t=5.800) and minimum (U=916) blood oxygen,CT90(U=887)and apnca/hypopneaindex (AHI) (t =-11.361) (all P＜0.001).ESS scores were related with desaturation parameters of ODI,average and minimum blood oxygen and CT90 (r=0.683,-0.450,-0.583,0.507,all P＜0.001).ODI was correlated with average and minimum blood oxygen and CT00 (r=-0.628,-0.763,0.689,all P＜0.001).Among parameters of oxygen desaturation,only ODI had influence on ESS scores (odds ratio=1.11,95％CI:1.07 1.15),The sensitivity and specificity predicting daytime sleepiness at ODI ≥23 times/h were about 79.2％ and 84.3％,respectively.Conclusions Daytime sleepiness is associated with oxygen desaturaion and may be predicted by ODI through which average and minimum blood oxygen and CT00 are related with daytime sleepiness in the male elderly with OSAHS.
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Objective To observe the expression level change of vascular endothelial growth factor (VEGF) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), and to explore the relationships of VEGF expression with OSAHS, OSAHS related cardiovascular and cerebrovascular diseases. Methods Polysomnography (PSG) was used to conduct sleep apnea monitoring in 24 OSAHS patients from 6OSAHS popular families and 48 healthy controls with normal physical examination results. The expression of VEGF mRNA was examined by reverse transcriptionpolymerase chain reaction (RT-PCR) analysis, meanwhile, the level of VEGF in plasma was measured VEGF mRNA in PBMC were significantly higher in simple OSAHS group [plasma levels: (205.75±2.79) pg/ml; mRNA: 0. 61±0. 02] than in control group [(168.72±4.64) pg/ml; 0. 47±0. 02,cardiovascular and cerebrovascular diseases group [(288.74 ± 2.73) pg/ml, 1.16 ± 0. 03] than in simple OSAHS group [ ( 205.75 ± 2.79 ) pg/ml, 0. 61 ± 0.02, P ＜ 0. 01]. ( 2 ) There was a positive correlation of the levels of VEGF in plasma and mRNA with AHI as well as systolic and diastolic blood pressure in early morning. There was a negative correlation of the level of VEGF in plasma and VEGF mRNA with the lowest saturation of blood oxygen. There was a positive correlation of the level of VEGF mRNA with AHI as well as systolic and diastolic blood pressure in early morning.Conclusions The level of VEGF in OSAHS significantly increases, which may play a role in the pathophysiology of OSAHS and OSAHS related cardiovascular and cerebrovascular diseases.