The accuracy and influencing factors of sleep staging based on single-channel EEG via a deep neural network / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate theaccuracy of artificial intelligence sleep staging model in patients with habitual snoring and obstructive sleep apnea hypopnea syndrome (OSAHS) based on single-channel EEG collected from different locations of the head. Methods: The clinical data of 114 adults with habitual snoring and OSAHS who visited to the Sleep Medicine Center of Beijing Tongren Hospital from September 2020 to March of 2021 were analyzed retrospectively, including 93 males and 21 females, aging from 20 to 64 years old. Eighty-five adults with OSAHS and 29 subjects with habitual snoring were included. Sleep staging analysis was performed on the single lead EEG signals of different locations (FP2-M1, C4-M1, F3-M2, ROG-M1, O1-M2) using the deep learning segmentation model trained by previous data. Manual scoring results were used as the gold standard to analyze the consistency rate of results and the influence of different categories of disease. Results: EEG data in 124 747 30-second epochs were taken as the testing dataset. The model accuracy of distinguishing wake/sleep was 92.3%,92.6%,93.5%,89.2% and 83.0% respectively,based on EEG channel Fp2-M1, C4-M1, F3-M2, REOG-M1 or O1-M2. The mode accuracy of distinguishing wake/REM/NREM and wake/REM/N1-2/SWS , was 84.7% and 80.1% respectively based on channel Fp2-M1, which located in forehead skin. The AHI calculated based on total sleep time derived from the model and gold standard were 13.6[4.30,42.5] and 14.2[4.8,42.7], respectively (Z=-2.477, P=0.013), and the kappa coefficient was 0.977. Conclusions: The autonomic sleep staging via a deep neural network model based on forehead single-channel EEG (Fp2-M1) has a good consistency in the identification sleep stage in a population with habitual snoring and OSAHS with different categories. The AHI calculated based on this model has high consistency with manual scoring.

Multiple hemodynamic effects of endogenous hydrogen sulfide on central nervous system in rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Endogenous hydrogen sulfide is a new neuromodulator which takes part in the regulation of central nervous system physiology and diseases. Whether endogenous hydrogen sulfide in the central nervous system regulates cardiovascular activity is not known. In the present study, we observed the hemodynamic changes of hydrogen sulfide or its precursor by intracerebroventricular injection, and investigate the possible roles of endogenous digitalis like factors and sympathetic activity in the regulation.</p><p><b>METHODS</b>Ninety-four Sprague-Dawley rats underwent a right cerebroventricular puncture, then the hydrogen sulfide saturation buffer or its precursor injected by intrcerebroventricular catheter. A heperin-filled catheter was inserted into the right femoral artery or into the left ventricle, and changes of blood pressure or cardiac function recorded by a Powerlab/4S instrument. Phentolamine or metoprolol were pre-injected to observe the possible role in autonomic nerve activity. After rats were sacrificed, plasma was collected and endogenous digitalis-like factors were measured with a commercial radioimmunoassay kit. The aortic, cardiac sarcolemmal vesicles were isolated and the activity of Na(+)-K(+)-ATPase was measured as ouabain-sensitive ATP hydrolysis under maximal velocity conditions by measuring the release of inorganic phosphate from ATP. Unpaired Student's t test for two groups or analysis of variances (ANOVA) for multiple groups were used to compare the differences of the changes.</p><p><b>RESULTS</b>Intracerebroventricular injection of hydrogen sulfide induced a transient hypotension, then dramatic hypertenive effects in a dose-dependent manner. Bolus injection of L-cysteine or beta- mercaptopyruvate also increased mean arterial pressure (P < 0.01), whereas hydroxylamine-a cystathionine beta synthase inhibitor decreased the arterial pressure (P < 0.01). Hydrogen sulfide and L-cysteine increased mean arterial pressure, left ventricular develop pressure and left-ventricle maximal rate of systolic and diastolic pressure; these functions were decreased by hydroxylamine (P < 0.01). Glibenclamide (a K(ATP) channel blocker) blocked the transient hypotensive effect, phentolamine (an alpha-adrenergic receptor blocker) blocked the hypertensive effect, and metoprolol (a selective beta 1 receptor blocker) blocked the positive inoptropic effect of central nervous system hydrogen sulfide. The endogenous digitalis-like factors in plasma were elevated (P < 0.01) after treatment with L-cysteine, association with decreasing Na(+)-K(+)-ATPase activity in cardiac or aortic sarcolemmal vesicles (P < 0.01). Hydroxylamine injection reduced the endogenous digitalis-like factors level in plasma association with increasing Na(+)-K(+)-ATPase activity in cardiac and aortic sarcolemmal vesicles.</p><p><b>CONCLUSION</b>Central nervous system endogenous hydrogen sulfide upregulated mean arterial pressure and cardiac systolic function by activation of sympathetic nerves or release of endogenous digitalis-like factors.</p>

Treatment of chronic bacterial prostatitis by perfusion with double-balloon and triple-channel catheter: a control study / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of the double-balloon and triple-channel catheter (DBTC) in the treatment of chronic bacterial prostatitis (CBP).</p><p><b>METHODS</b>One hundred and three CBP patients were randomly assigned to three different groups and received three different therapies, respectively: 1. 61 cases by transurethral perfusion and drainage with antibiotics with DBTC catheter; 2. 29 cases by intravenous antibiotics, and 3. 13 cases by transurethral irrigation with 0.9% saline. The lecithin, white blood cells (WBC) in expressed prostatic secretion (EPS) and Meares-Stamey's test fractionary urine culture pre- and post-therapies were compared.</p><p><b>RESULTS</b>The improvement rates of clinical symptoms and lecithin corpuscles were 81.9% and 68.9%, respectively. And the decline rate of WBC and bacteriological efficacy rate were 75.4% and 91.8%, respectively. There was a significant statistical difference between the DBTC group and the intravenous group in the lecithin, WBC and bacterial culture (P < 0.05, < 0.01 and < 0.01, respectively), and so was there between the saline group and the intravenous group in the decline of WBC(chi 2 = 5.6, P < 0.05), but with no difference in lecithin and bacterial culture. Among 61 patients treated with DBTC, 3 developed mild allergic reaction in urethra.</p><p><b>CONCLUSIONS</b>Transurethral DBTC has a better clinical efficacy than traditional intravenous treatment for CBP. DBTC perfusion combined with other hypurgia holds obvious advantages of being safe, effective, easy and repeatable in the treatment of CBP.</p>