Chemerin in Obstructive Sleep Apnea-hypopnea Patients' Pharyngeal Fat Deposition / 昆明医科大学学报

Objective To analyze the effect of chemerin on the pharyngeal fat deposition by comparing the level of chemerin of fat tissue in pharynx between the patients with OSAHS and non-snorer. Methods OSAHS patients finished PSG and non-snoring patients with tonsillitis as controlled group were examined to observe their chemerin level of space veli palatine. Comparisons of the chemerin level and the indexes of MS were made to analyze the relationship between chemerin and MS. Results The level of chemerin of space veli palatine in OSAHS patients was higher than that of the control groups. And the level of chemerin within the OSAHS patients also had positive correlation with TG、HOMA-IR and uric acid. We also found that the TG, HDL-C, FINS, HOMA-IR and the uric acid had statistical differences ( <0.05) between the two groups. Conclusion The level of chemerin of OSAHS group is exceed the control group and positively related with indexes of MS. Chemerin may take part in the development of fat deposition in pharynx of OSAHS patients , which may be through MS pathway.

The Application of 256-Slice Spiral CT in the Diagnosis of Obstructive Sleep Apnea Hypopnea Syndrome / 昆明医科大学学报

Objective To measure the upper airway of obstructive sleep apnea hypopnea syndrome by 256 slice spiril CT, and to access the airway obstruction plane with the airway plane data in OSAHS patients.Through these measurements, we can provide assistance for clinical diagnosis and treatment.Methods This study randomly selected 178 patients diagnosed with OSAHS and 110 cases non-snoring healthy people as the control group by the Philips 256 slice CT.Under the nasopharyngeal area, velopharyngeal area, glossopharyngeal area, epiglottis area, we measured the cross-sectional area and volume of the narrowest plane in the two groups of quiet respiration and Müller status.Results The OSAHS group underwent quiet respiration and Müller status during CT scanning, and the two states about epiglottis area in cross-sectional area and volume had no significant difference, Other groups had differences between the parameters.There was a significant difference in the volume about velopharyngeal area and glossopharyngeal area. In the control group undergoing quiet respiration and Müller status during CT scanning, there was difference in velopharyngeal cross-sectional area.Other parameters had no significant difference.Conclusions The obstruction plate of OSAHS patients with 256-slice spiril CT measurement is mostly in the velopharyngeal area and glossopharyngeal area. The volume measurement of upper airway by CT can predict airway obstruction plate in patients with OSAHS.

Single Nucleotide Polymorphism rs10919543 in FCGR2A/FCGR3A Region Confers Susceptibility to Takayasu Arteritis in Chinese Population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Takayasu arteritis (TA) is a rare inflammatory arteriopathy of unknown etiology. The aim of this study was to investigate the genetic susceptibility to TA in a Chinese population.</p><p><b>METHODS</b>Four single nucleotide polymorphisms (SNPs) those locate in the IL12B region (rs56167332), the MLX region (rs665268), the FCGR2A/FCGR3A locus (rs10919543), and the HLA-B/MICA locus (rs12524487), associated with TA in different population, were genotyped in 123 Chinese TA patients and 147 healthy controls from January 2013 to August 2014. A Chi-square test was used to test for genotype/allele frequencies variants.</p><p><b>RESULTS</b>Among the four SNPs, rs10919543 was found to be significantly associated with TA in the studied population. The GG genotype of rs10919543 at the FCGR2A/FCGR3A locus is a high risk factor (odds ratio [OR] = 6.532, 95% confidence interval [CI] = 2.402 - 17.763, P < 0.001) for TA. Among TA patients, the level of eosinophil granulocytes (Eos) in the peripheral blood was observed to be higher in the GG group of rs10919543 (n = 23, Eos = 0.11 [0.08, 0.17] ×109/L) than the GA + AA group (n = 100, Eos = 0.08 [0.05, 0.13] ×109/L, P = 0.028). No correlation between the genotypes of the other three SNPs and TA patients was observed.</p><p><b>CONCLUSIONS</b>Our findings revealed unique genetic pattern in Chinese TA patients that may be partly responsible for the higher risk of TA in this population. FCGR2A/FCGR3A-related immune disorder might contribute to the etiology of TA.</p>

Prognostic value of Picco monitoring combined with plasma microRNA-150 detection in septic shock patients / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To assess the prognostic value of pulse indicator continuous cardiac output (Picco) monitoring combined with plasma microRNA-150 detection in septic shock patients.</p><p><b>METHODS</b>Clinical data of 48 patients with septic shock admitted in General Intensive Care Unit (GICU), Shanghai First People's Hospital Songjiang Branch Affiliated to Shanghai Jiaotong University from August 2012 to August 2014 were analyzed retrospectively. The plasma levels of microRNA-150 in 48 patients at admission were assayed by qRT-PCR; and Picco monitoring was performed to record hemodynamic changes. The correlation of microRNA-150 or Picco parameters with prognosis of patients was assessed by univariate analysis and multivariate logistic analysis. Spearman correlation test showed the relationship between microRNA-150 and Picco parameters. Finally, the clinical value of combining microRNA-150 with Picco monitoring to predict the outcome of septic shock patients was analyzed by ROC curves.</p><p><b>RESULTS</b>Twenty-three patients survived and 25 died in 28 d after admission in GICU. Compared with survival patients, microRNA-150 was significantly lower in fatal patients (t=-10.32, P<0.05). Univariate analysis showed that low microRNA-150 level was a risk factor for poor prognosis(OR=2.176,95% CI:1.121-4.223, P<0.05). Compared with fatal cases, the cardiac index of survival patients was higher, while EVLWI and PVPI were lower. MicroRNA-150 level was positively correlated with cardiac index (r=0.712, P<0.05), negatively correlated with EVLWI and PVPI (r=-0.622 and-0.689, both P<0.05). ROC curves showed a satisfactory diagnostic efficiency of combining microRNA-150 with Picco monitoring.</p><p><b>CONCLUSION</b>Lower microRNA-150 may indicate a poor prognosis, and Picco monitoring combined with microRNA 150 detection may improve the prognostic efficiency in septic shock patients.</p>

Impact of neonatal exposure to different doses of bisphenol A on puberty in female rats / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the effects of neonatal exposure to different doses of bisphenol A (BPA) on the vaginal opening day (VOD), hypothalamic Kiss-1 mRNA expression, and ovarian estrogen receptor (ER) mRNA expression in female rats.</p><p><b>METHODS</b>Neonatal female Sprague-Dawley (SD) rats were randomly divided into six groups: blank control, vehicle, 17β-estradiol (17β-estradiol, E2, 10 μg/d), low-dose BPA [25 μg(kg·d)], medium-dose BPA [50 μg(kg·d)], and high-dose BPA groups [250 μg(kg·d)]. The rats were subcutaneously injected with respective agents on postnatal days 0-6. The VOD was recorded, and each rat was sacrificed on the same day. The hypothalamus and ovary were taken and weighed, and the organ coefficients of hypothalamus and ovary were calculated. The hypothalamic Kiss-1 mRNA expression and ovarian ERα and ERβ mRNA expression were measured by real-time PCR.</p><p><b>RESULTS</b>Compared with the control group, the E2 and medium- and high-dose BPA groups had advanced VOD, and the E2 group had significantly reduced hypothalamic Kiss-1 mRNA expression and ovarian ERβ mRNA expression (P<0.05).</p><p><b>CONCLUSIONS</b>Neonatal exposure to medium- and high-dose BPA[50 and 250 μg/(kg·d)] can induce precocious puberty in rats, but it may not result from the change in hypothalamic Kiss-1 mRNA expression. Neonatal exposure to low-dose BPA [25 μg/(kg·d)] does not induce precocious puberty in rats.</p>

Genetic diagnosis of Liddle's syndrome by mutation analysis of SCNN1B and SCNN1G in a Chinese family / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Liddle's syndrome is a rare autosomal-dominant monogenic form of salt-sensitive hypertension. This study aimed to screen the gene mutation in β and γ subunits of the epithelial sodium channel (ENaC) of a Chinese family with Liddle's syndrome, an autosomal dominant form of hypertension.</p><p><b>METHODS</b>DNA samples from the proband with early-onset, treatment-resistant hypertension and suppressed plasma renin activity were initially screened for mutations in the C-terminal exons of the ENaC β or γ subunit genes, using amplification by polymerase chain reaction and direct DNA sequencing. We also screened the C-terminus of SCNN1B and SCNN1G in family members, and screened for the mutation in 150 controls.</p><p><b>RESULTS</b>Genetic analysis of the β ENaC gene revealed a missense mutation of CCC to TCC at codon 616 in the proband, her mother and her grandmother. One hundred and fifty randomly selected controls had not the mutation, indicating that this is not a common genetic polymorphism. There was no mutation of the γ ENaC gene in any of the individuals examined.</p><p><b>CONCLUSIONS</b>Through direct DNA sequencing analysis, we established the diagnosis of Liddle's syndrome for the proband and her families, and provided tailored therapies to this abnormality. These results provide further evidence that Pro616Ser is a critical amino acid that has a key role in the inhibition of sodium channel activity.</p>

Comparison of the safety of simultaneous bilateral carotid artery stenting versus unilateral carotid artery stenting: 30-day and 6-month results / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Severe bilateral carotid stenosis caused by atherosclerosis has not been unusual in the elderly. Such patients have high stroke risk. Many studies show that carotid artery stenting (CAS) is an alternative to treat unilateral carotid stenosis. However, the optimal procedural strategy of bilateral carotid stenosis remains unclear. The purpose of our study was to evaluate the safety of simultaneous bilateral carotid artery stenting (SBCAS) compared with unilateral carotid artery stenting (UCAS).</p><p><b>METHODS</b>In this single-center retrospective study, we analyzed 234 consecutive patients who underwent carotid stenting from January 2005 to December 2009. Thirty-nine patients (16.7%) of them underwent SBCAS, and the others (n = 195) underwent UCAS. Indication for CAS was defined as carotid artery diameter reduction > 60% (symptomatic) or > 80% (asymptomatic). Six-month and 30-day hemodynamic depression (HD), hyperperfusion syndrome (HPS), stroke, death and myocardial infarction (MI) after carotid stenting were assessed.</p><p><b>RESULTS</b>SBCAS group had no more HD and HPS compared with UCAS group at 30 days (HD: 28.2% vs. 20.0%, P = 0.396; HPS: 2.6% vs. 2.1%, P = 0.262). Moreover, there was no statistically significant difference between SBCAS group and UCAS group in major stroke, death, MI and their combinations within 30 days (major stroke: 0 vs. 3.6%, P = 0.604; death: 2.6% vs. 1.5%, P = 0.520; MI: 2.6% vs. 0.5%, P = 0.306; and their combinations: 5.1% vs. 4.6%, P = 1.000) and 6 months (major stroke: 0 vs. 3.6%, P = 0.604; death: 5.1% vs. 2.1%, P = 0.262; MI: 5.1% vs.1.0%, P = 0.130 and their combinations: 7.7% vs. 5.1%, P = 0.459).</p><p><b>CONCLUSIONS</b>The patients undergoing SBCAS had no more events than those undergoing UCAS in 30-day and 6-month follow-up. Our finding suggests that SBCAS appears to be as safe as UCAS.</p>

Clinical analysis of simultaneous bilateral carotid stenting for treating patients with bilateral atherosclerotic carotid stenosis / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the safety and feasibility of simultaneous bilateral carotid stenting for treating patients with bilateral atherosclerotic carotid stenosis.</p><p><b>METHODS</b>The clinical data of 39 consecutive patients with bilateral atherosclerotic carotid stenosis undergoing simultaneous bilateral carotid artery stenting in Fuwai hospital from January 2005 to December 2009 were collected and analyzed retrospectively. The reduction of the angiographic diameter stenosis after stenting and clinical outcomes of 30 days after stenting including hyperperfusion syndrome, hemodynamic depression, stroke, myocardial infarction and death were assessed.</p><p><b>RESULTS</b>The patients were 43 - 78 (65.9 ± 8.5) years old, and there were 25 (64.1%) male. Carotid stenting procedure success rate was 100%. Distal embolic protection devices were used in all patients, and 20 (51.3%) out of 39 patients underwent coronary artery bypass surgery after carotid stenting. The angiographic diameter stenosis reduced from (87.0 ± 5.8)% to (10.2 ± 5.6)% after stenting (P < 0.01). Up to 30 days after carotid artery stenting, the incidence of hyperperfusion syndrome, hemodynamic depression, minor stroke, major stroke, myocardial infarction and death was 2.6% (1/39), 28.2% (11/39), 5.1% (2/29), 0, 2.6% (1/39), 2.6% (1/39), respectively.</p><p><b>CONCLUSION</b>The data show that simultaneous bilateral carotid stenting is a technically feasible and safe alternative for patients with severe bilateral atherosclerotic carotid stenosis.</p>

Role of plasma C-reactive protein and white blood cell count in predicting in-hospital clinical events of acute type A aortic dissection / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A few recent studies have reported that inflammation is associated with the prognosis of acute aortic dissection (AD). There is, however, no systemic investigation regarding the role of plasma C-reactive protein (CRP) and white blood cell (WBC) levels in predicting in-hospital clinical events of acute type A AD.</p><p><b>METHODS</b>The levels of high-sensitivity CRP and WBC counts were systemically determined after admission in 36 patients with acute type A AD. The variations of plasma CRP and WBC levels in different time windows (admission, 1, 2, 3, 4, 6, 8 days) in patients with acute type A AD were analyzed between patients with events and without events.</p><p><b>RESULTS</b>During hospitalization, five patients died, and increased levels of CRP and WBC were found in patients died with acute type A AD compared with patients survived (P < 0.01, respectively). Medical treatment may significantly decrease inflammatory response in survived patients with acute type A AD. Additionally, patients with complication of pleural effusion showed higher CRP and WBC levels (P = 0.046, P = 0.018, respectively). Lower WBC levels were found in survived patients treated medically (P = 0.001). Moreover, mean CRP and WBC levels had positive correlations with aortic diameter (r = 0.364, P = 0.000; r = 0.333, P = 0.000, respectively) and age (r = 0.270, P = 0.000, respectively), while negative correlations with the time from onset of symptoms to hospital admission (r = -0.229, P = 0.000, r = -0.200, P = 0.002, respectively). Univariate analysis showed that age ≥ 65 years, CRP ≥ 12.05 mg/L, WBC ≥ 12.16 × 10(9)/L, aortic diameter ≥ 48 mm, pleural effusion and diastolic blood pressure ≥ 105 mmHg were associated with hospital mortality. While CRP ≥ 12.05 mg/L, WBC ≥ 12.16 × 10(9)/L, aortic diameter ≥ 48 mm were strongly associated with hospital mortality in multiple Logistic regression analysis.</p><p><b>CONCLUSIONS</b>The results suggested that CRP and WBC were preferred markers for predicting the clinical events in patients with acute type A AD, especially death during hospitalization. Therefore, further study enrolling larger cohort, prospective study would be warranted.</p>

Outcome of patients with coronary artery disease underwent carotid artery stenting before coronary artery bypass surgery / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of carotid artery stenting before open heart surgery.</p><p><b>METHODS</b>Patients with heart disease and severe carotid artery stenosis received carotid stenting before open heart surgery were included in this prospective cohort study. The incidence of stroke, myocardial infarction and death from carotid stenting to 30 days after cardiac surgery was assessed.</p><p><b>RESULTS</b>A total of 42 patients were enrolled. The carotid stenting procedural success rate was 100%. Distal embolic protection devices were used in 97.6% patients (41/42). Thirty-six (85.7%) patients received bypass surgery, 5 patients received bypass and valve replacement surgery (11.9%) and 1 patient received valve replacement surgery (2.4%) post carotid stenting. The incidence of stroke, myocardial infarction and death from carotid stenting to 30 days after cardiac surgery was 2.4% (1/42), 0% and 0% respectively.</p><p><b>CONCLUSIONS</b>Our data from this small cohort study showed that carotid artery stenting before open heart surgery was safe and effective for patients with heart disease and severe carotid artery stenosis.</p>

Relationship between methimazole and antineutrophil cytoplasmic antibody-positive vasculitis / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the relationship between methimazole (MMI) and antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis.</p><p><b>METHODS</b>Thirty-three cases with Graves' disease were tested for serum ANCA before and after taking MMI. At the same time, clinicopathological data of two patients with Graves' disease who had antineutrophil cytoplasmic antibody-positive vasculitis during treatment with MMI were analyzed.</p><p><b>RESULTS</b>Two patients developed antineutrophil cytoplasmic antibody-positive vasculitis during the medication with MMI for 5-6 years; their major clinical manifestations were hematuria and renal failure. Renal biology showed renal vasculitis and vascular necrosis. The disease was relieved after treatment with immunosuppressor. Serum ANCA in the 33 cases was negative before taking MMI. In 3 cases serum ANCA became positive after taking MMI for 2 months, 3 months and 2 years, respectively. The positive rate is 9% (3/33). The major finding was microscopic hematuria. ANCA positive rate was significantly higher after taking MMI than that before taking MMI (chi2) = 5.3, P < 0.05). Microscopic hematuria disappeared after general treatment.</p><p><b>CONCLUSION</b>There may be a relationship between methimazole and development of antineutrophil cytoplasmic antibody-positive vasculitis. Renal impairment can occur. The signs and symptoms of the vasculitis can disappear after proper treatment.</p>

Procedural success rate and short-term outcomes of percutaneous interventional therapy for severe subclavian artery stenosis in 152 patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of percutaneous transluminal angioplasty (PTA, with or without stents) for the treatment of patients with subclavian artery stenosis.</p><p><b>METHODS</b>Using the brachial (n = 25), radial (n = 3), femoral (n = 96), or combined (n = 28) approach, PTA was performed in consecutive 152 [bilateral n = 27, unilateral n = 125, 88 male, aged 17 approximately 82 (58 +/- 16) years old] subclavian artery stenosis patients with 179 lesions. Stenosis was caused by atheroma in 114 of 152 patients (75%) and by aortoarteritis in the other patients (25%). The indications for intervention were arm claudication in 130 of 152 patients (85.5%), subclavian steal in 138 of 152 patients (90.8%), blue finger syndrome in 2 of 152 patients (1.3%), coronary steal syndrome in 2 of 162 patients (1.3%), or anticipated coronary artery bypass grafting using the internal mammary artery in 10 asymptomatic patients (6.6%). All patients were followed up for at least 9 months after procedure.</p><p><b>RESULTS</b>PTA was succeeded in 142 of 152 patients (93.4%) and procedural success rate was 100% in 133 stenotic lesions (diameter reduction 70% approximately 99%) and 78.2% in total occlusive lesions (36/46). Stents were deployed in 145 of 169 lesions. In the 142 patients successfully treated with PTA, the percent diameter stenosis was reduced from (90 +/- 8)% to (6 +/- 8)%, and lesions diameter improved from (1.0 +/- 0.9) mm to (7.0 +/- 0.5) mm (all P values < 0.001). No severe procedure related complications were observed. During 9 months follow-up in these 142 patients with successful PTA, sustained clinical improvement was seen in 135 patients and restenosis occurred in 7 patients with aortoarteritis (n = 4) and atheroma (n = 3).</p><p><b>CONCLUSIONS</b>Percutaneous transluminal angioplasty is effective and safe for the treatment of subclavian artery stenosis.</p>

Correlativity between the polymorphisms of aldosterone synthase gene, Hind III restriction site on Y chromosome and essential hypertension / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationship of associating the polymorphisms of CYP11B2 -344C/T and Hind III restriction site on Y chromosome with essential hypertension.</p><p><b>METHODS</b>This study enrolled 654 patients with essential hypertension and 386 healthy subjects as control group. The genomic DNA was extracted from blood leukocytes. The DNA segments of CYP11B2 and Y chromosome were amplified from genomic DNA by polymerase chain reaction (PCR). The PCR products were digested with Hae III or Hind III at 37 degrees centigrade respectively. The digested products were subjected to agarose gel electrophoresis and stain with ethidium bromide.</p><p><b>RESULTS</b>(1)The Hind III (-) genotype was found at 42.0% for patients with essential hypertension and 32.9% for control. The Hind III (-) genotype frequency of hypertension patient was significantly higher than that of the control (P was 0.03). The Hind III (+) genotype had a lower SBP and DBP than the Hind III (-) genotype (P was 0.01, P was 0.03). (2)With combining CC or CT genotype with Hind III (-) genotype, the relative risk suffering from hypertension was 1.998 fold high (P was 0.01).</p><p><b>CONCLUSION</b>The polymorphism of Hind III restriction site on Y chromosome is associated with essential hypertension, and when combined with polymorphism of CYP11B2 -344C/T, may have a united role to increase the risk of suffering from hypertension disease.</p>

Clinical results of stent revascularization as treatment for renal artery stenosis during 6 months of follow-up / 中华心血管病杂志

<p><b>OBJECTIVES</b>To evaluate the safety and midterm efficacy of stent revascularization as treatment for renal artery stenosis.</p><p><b>METHODS</b>Percutaneous transluminal renal angioplasty with stent (PTRA) was performed because of poorly controlled hypertension or preservation of renal function in 150 consecutive patients with severe renal artery stenosis, caused by atheroma (96 patients), arteritis (44 patients) and fibromuscular dysplasia (10 patients). All of them subsequently underwent 6-month clinical follow-up to observe the effect of the procedure on renal function, blood pressure control, number of antihypertensive medications.</p><p><b>RESULT</b>Angiographic success was obtained in 148 (98.7%) of 150 patients after PTRA. At 6 months, both systolic and diastolic blood pressures significantly decreased (from 169.6 to 142.7 mm Hg and from 97.3 to 83.3 mm Hg, respectively; P < 0.001), and less antihypertensive medication was taken (from 2.7 to 1.9). The blood pressure became normal without taking any antihypertensive medications in 48 of 150 patients (32.0%), and the blood pressure control was more facile in 78 patients (52.0%), however, there were no improvement in 22 patients (16.0%). Creatinine level decreased in 34 patients (22.7%), remained stable in 112 patients (74.6%), and increased in 4 (2.7%). There was no statistical significance. No deaths occurred during 6-months follow-up.</p><p><b>CONCLUSIONS</b>Renal artery stent revascularization had a beneficial effect on blood pressure control and a nondeleterious effect on renal function during 6-months follow-up. The long-term efficacy should be investigated. The procedure is safe in usual.</p>