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Objective To investigate maternal awareness and knowledge of obstructive sleep apnea syndrome (OSAS) and their compliance with polysomnography monitoring in snoring gravidas.Methods This study enrolled 589 volunteered gravidas who were treated at the 908th Hospital of Chinese People's Liberation Army Joint Logistic Support Force or Maternal and Child Health Hospital of Jiangxi Province from April 2016 to April 2017.The maternal knowledge of OSAS (0 point:complete lack of knowledge of OSAS;1 to 4 points:with partial knowledge of OSAS;5 points:correct understanding of OSAS) and the way of obtaining this knowledge were studied using a self-designed questionnaire.Influencing factors,including gestational weeks,educational background,snoring and high-risk pregnancy,were also analyzed.Chi-square test was used for statistical analysis.Results The 589 gravidas had few knowledge of OSAS and only 11 of them [1.9％ (11/589)] were able to fully understand OSAS (5 points).The proportion of women who were completely lack the knowledge of OSAS (0 point) in those less-educated women was higher than in those well-educated group [61.9％ (78/126) vs 52.0％ (241/463),x2=3.873,P=0.049].Among the gravidas who were unaware of their snoring condition,those completely lack the knowledge of OSAS (0 point) accounted for 67.0％ (209/312),which was higher than the percentage among gravidas knowing they had or did not have snoring problem [35.6％ (21/59),40.8％ (89/218);x2=20.755,35.687;both P＜0.017].There was no significant difference in OSAS awareness among gravidas regardless of their gestations and whether they were classified as high-risk or not (all P＞0.05).Of 59 gravidas with snoring,only 15 (25.4％) accepted polysomnography monitoring.Eight out of the 589 gravidas (1.4％) were diagnosed with OSAS during pregnancy.Conclusions Gravidas have poor knowledge and awareness of OSAS,especially those with low educational background and not knowing their snoring condition,resulting in poor compliance with polysornnography monitoring and low diagnostic rate of OSAS during pregnancy.
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We reported a case of severe preeclampsia presented with chest tightness, dyspnea and pink foam sputum after cesarean section. The patient was diagnosed with obstructive sleep apnea hypopnea syndrome (OSAHS) with acute left heart failure based on her physical examination, medical history and polysomnogram. Symptoms of heart failure were relieved after continuous positive airway pressure ventilation.
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Objective To analyse the relationships between islet β-cell function and infection,inflammation and major organ function in multiple organ dysfunction syndrome (MODS) patients with severe traumatic hemorrhage.Methods A total of 187 cases of MODS patients hospitalized in the 94th Hospital of PLA from January 2013 to January 2016 were selected,and were divided into the MODS survival group (MODS-S group,104 cases) and MODS dead group (MODS-D group).Other 100 healthy subjects were selected as the control group.The fasting blood glucose (GLU0) and insulin (INS0) levels,blood glucose (GLU30) and insulin (INS30) levels after 30 min of glucose loading,and levels of soluble triggering receptor expressedon myeloid cells-1 (sTREM-1),tumor necrosis factor-α (TNF-a),interleukin-6 (IL-6),alanine aminotransferase (ALT),creatinine (Cre) and creatine kinase isoenzyme (CK-MB) in different groups were determined.The insulin-β-cell function was evaluated by homeostasis model assessment of β-cell function (HOMA-β) index and ratio of insulin increment and blood glucose increment after 30 min of glucose loading (ΔINS30/ΔGLU30),and their relationships to other indexes,including sTREM-1,TNF-α,IL-6,GLU0,ALT,Cre and CK-MB,in MODS patients with severe traumatic hemorrhage were analysed.Results The HOMA-β and AINS30/AGLU30 ratio in the MODS-D group were lower than those in the MODS-S group,and levels of sTREM-1,TNF-α,IL-6,ALT,Cre and CK-MB in the MODS-D group were higher than those in the MODS-S group,there were statistically significant differences (P＜0.01).In MODS patients with severe traumatic hemorrhage,HOMA-β and ΔINS30/AGLU30 was both negatively correlated with sTREM-1,TNF-α,IL-6,GLU0,ALT,CreandCK-MB (r=-0.356 4,-0.532 1,-0.345 8,-0.772 1,-0.762 5,-0.684 8,-0.606 4;r=-0.428 5,-0.567 8,-0.487 0,-0.743 6,-0.781 7,-0.717 6,-0.640 1,P＜0.01).Conclusion MODS patients with severe traumatic hemorrhage have islet β-cell dysfunction which may be used as a prognostic and diagnostic indicator.
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Objective:To establish an HPLC method for the determination of paraquat in human serum.Methods:The analytical column was a Kromasil C18column (200mm×4.6mm,5μm).The mobile phase was a mixture of acetonitrile and water ( containing 0.03 mol·L-1sodium heptanesulfonate and 0.24 mol·L-1phosphoric acid) (3 :97,pH was adjusted to 2.0 by triethylamine),the detection wavelength was set at 258 nm,the column temperature was 25℃,the injection volume was 20 μl,and the flow rate was 0.8 ml·min-1.Results:The calibration curve of paraquat was linear within the range of 0.106-10.6 mg·L-1( r =0.999 3),and the lower limit of detection was 0.065 mg·L-1. The absolute recovery of paraquat at low,medium and high concentration was more than 89.4%,and the method recovery was more than 94.4%. The intra-day RSDs were 0.12%-1.74%,and the inter-day RSDs were 0.44%-2.89%.Conclusion:The method is simple,quick,accurate,sensitive and specific,and can be used for detecting paraquat con-centration in human serum.
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Objective To examine the mRNA and protein expression of peroxisome proliferator-activated receptors (PPAR) and fatty acid binding protein-4 (FABP-4) in placenta, and to investigate their correlation with the prognosis of pre- eclampsia. Methods The data of 177 women who delivered from January 2013 to December 2015 in Chinese People′ s Liberation Army No.94 Hospital were collected. Among them, 60 cases were term pregnancy and not in labor (TN); 46 cases were term pregnancy with preeclampsia and not in labor (TPE); 42 cases were preterm pregnancy and not in labor (PN); 29 cases were preterm pregnancy with pre-eclampsia and not in labor (PPE). Real-time PCR and western blot were used to examine the PPAR and FABP-4 mRNA expression and protein expression in placentas. And linear correlation was used to analyze the relationship between PPAR and FABP-4 protein expression and the prognosis of pre-eclampsia. Results (1)Real-time PCR showed that:① PPAR-α, PPAR-β mRNA expression were not statistically different between placentas from TN and TPE (P>0.05), but PPAR-γ mRNA level in TPE (0.59±0.17) was significantly lower than that in TN (0.81±0.19, P0.05). However,PPAR-γ mRNA in the PPE group (0.33±0.14) was significantly lower than that in PN (0.52±0.16, P<0.01), and FABP-4 mRNA level in the PPE group (0.80±0.29) was significantly higher than in the PN group (0.63±0.22, P<0.01).(2)Western-blot showed the same tendency as the mRNA results. ①There were no statistical differences in the protein expression of PPAR-α, PPAR-β, not in term groups(TN and TPE), nor in premature groups (PN and PPE). PPAR-γ protein level in the TPE group (0.46 ± 0.17) was significantly lower than that in TN (0.65±0.20, P<0.01) and FABP-4 protein level in the TPE group (0.60± 0.19) was significantly higher than that in the TN group (0.50±0.21, P<0.05). ②The PPAR-γ protein level in the PPE group (0.30±0.16) was significantly lower than that in the PN group (0.61±0.16, P<0.05), while the FABP-4 protein expression in the PPE group (0.58±0.19) was significantly higher than that in the PN group (0.40±0.19, P<0.05).(3)Linear correlation showed that:①PPAR-γ protein expression correlated negatively with FABP-4 protein expresssion [P<0.01, R2=0.12 in the term groups(TN+TPE), R2=0.15 in the premature groups(PN+PPE)]. ②PPAR-γ protein expression correlated negatively with blood pressure recovery time, 24-hour urinary protein quantification and blood lipid recovery time (P<0.01, R2=0.37,0.35,0.18). FABP-4 protein expression correlated positively with lipid recovery time and blood cholesterol concentrations (P<0.01, R2=0.13,0.25). Conclusions The expression of PPAR-γ decreases in placentas from patients with pre-eclampsia, while the expression of FABP-4 increases. The expression of FABP-4 correlates negatively with the expression of PPAR-γ, and both are associated with the prognosis of pre-eclampsia.
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Objective To analyse the relationships between islet β-cell function and infection,inflammation and major organ function in multiple organ dysfunction syndrome (MODS) patients with severe traumatic hemorrhage.Methods A total of 187 cases of MODS patients hospitalized in the 94th Hospital of PLA from January 2013 to January 2016 were selected,and were divided into the MODS survival group (MODS-S group,104 cases) and MODS dead group (MODS-D group).Other 100 healthy subjects were selected as the control group.The fasting blood glucose (GLU0) and insulin (INS0) levels,blood glucose (GLU30) and insulin (INS30) levels after 30 min of glucose loading,and levels of soluble triggering receptor expressedon myeloid cells-1 (sTREM-1),tumor necrosis factor-α (TNF-a),interleukin-6 (IL-6),alanine aminotransferase (ALT),creatinine (Cre) and creatine kinase isoenzyme (CK-MB) in different groups were determined.The insulin-β-cell function was evaluated by homeostasis model assessment of β-cell function (HOMA-β) index and ratio of insulin increment and blood glucose increment after 30 min of glucose loading (ΔINS30/ΔGLU30),and their relationships to other indexes,including sTREM-1,TNF-α,IL-6,GLU0,ALT,Cre and CK-MB,in MODS patients with severe traumatic hemorrhage were analysed.Results The HOMA-β and AINS30/AGLU30 ratio in the MODS-D group were lower than those in the MODS-S group,and levels of sTREM-1,TNF-α,IL-6,ALT,Cre and CK-MB in the MODS-D group were higher than those in the MODS-S group,there were statistically significant differences (P＜0.01).In MODS patients with severe traumatic hemorrhage,HOMA-β and ΔINS30/AGLU30 was both negatively correlated with sTREM-1,TNF-α,IL-6,GLU0,ALT,CreandCK-MB (r=-0.356 4,-0.532 1,-0.345 8,-0.772 1,-0.762 5,-0.684 8,-0.606 4;r=-0.428 5,-0.567 8,-0.487 0,-0.743 6,-0.781 7,-0.717 6,-0.640 1,P＜0.01).Conclusion MODS patients with severe traumatic hemorrhage have islet β-cell dysfunction which may be used as a prognostic and diagnostic indicator.
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To observe the effect of multiple electroacupuncture (EA) on the pain threshold and the regulation of N-methyl-D-aspartate (NMDA) receptor in dorsal root ganglia (DRG) of neuropathic pain rats. Rats were prepared with a unilateral chronic constriction injury (CCI) to the sciatic nerve. EA was done in acupoints "Huan Tiao" and "Yang Ling Quan" for 30 min every day and the thermal thresholds were detected after EA at 3, 5, 7, 10, 14 days after operation. On day 14 after nerve injury, the in situ hybridization method was used to investigate the change of NMDA R1 mRNA in L4-L5 DRG. The thermal threshold reduced significantly from day 3 after operation in CCI rats. After multiple EA treatment, the ipsilateral thermal hyperalgesia relieved gradually and the thermal threshold had no difference with control side after day 5 (P > 0.05). From Day 7 after operation, the thermal threshold at each time point were significantly different compared with CCI group respectively (P > 0.05). Moreover the EA had accumulative effect. On Day 14 after operation, the NMDAR1 mRNA positive neurons and the mean optic density in ipsilateral L4-5 DRG were less than that of control side (P < 0.05), mainly in medium and small neurons. After EA treatment, the NMDAR1 mRNA positive neurons in ipsilateral DRG had no considerable difference comparing with those of control side, significantly increased comparing with CCI group (P < 0.05). It's concluded that the NMDA receptors in DRG relate closely with the generation and development of neuropathic pain. The multiple EA treatment can attenuate the thermal hyperlagesia of neuropathic pain rats and regulate the NMDA receptor.