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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 investigate the relationship of the neutrophil/lymphocyte ratio (NLR) on admission and angiographic no-reflow phenomenon in patients with ST-segment elevation myocardial infarction (STEMI) who had undergone primary percutaneous coronary intervention (PCI).Methods 232 patients who had undergone PCI between 2010 and 2013,were included and divided into two groups based upon the thrombolysis in myocardial infarction (TIMI) flow gradings.No-reflow was defined as post-PCI TIMI Grade 0,1 and 2 flows (group Ⅰ).Normal-flow was defined as TIMI 3 flow (group Ⅱ).Receiver operating characteristic curve (ROC) analysis was used to identify the predictive effect of NLR on no-reflow phenomenon.Relationship of NLR and no-reflow was assessed by multivariate logistic regression.All statistical calculations and analyses were performed using SPSS 11.0.Results NLR was significantly higher in group Ⅰ (n=45) compared with group Ⅱ (n=187) [4.1 (2.4-6.5) vs.2.4 (1.7-3.8),P=0.001].In ROC analysis,NLR＞3.2 predicted no reflow with 80％ sensitivity and 73％ specificity.Patients with elevated NLR had a higher incidence of no-reflow phenomenon than those with non-elevated NLR (34.8％ vs.9.3％,P＜0.001).Also,NLR (＞3.2) was an independent predictor of no-reflow development [odds ratio 3.70,95％ confidence interval (1.39-9.80),P=0.009].Conclusion NLR was an independent predicator for no-reflow development in STEMI patients who had undergone PCI.This simple and low-cost parameter could provide useful information for the early risk evaluation on these patients.
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<p><b>OBJECTIVE</b>To compare the efficacy between left radial approach (LRA) and right radial approach (RRA) for coronary angiography (CAG).</p><p><b>METHODS</b>The following databases were searched, including PubMed, Embase, Web of science, Cochrane Library, CBM, VIP, Wanfang databases and CNKI, from creation of database to January 2013. Two reviewers extracted data independently, according to inclusive criteria, exclusion criteria and methods of Cochrane Collaboration. Statistical analysis was performed using Review Manager Software (RevMan 5.1).</p><p><b>RESULTS</b>Eleven trials with 5 442 patients were included in the systematic review. The results of meta-analysis showed that when compared with RRA, LRA did not increase the failure rate of the procedures (OR = 1.04, 95%CI 0.80-1.35, P > 0.05) and amount of contrast medium (mean difference = 2.39, 95%CI -0.30-5.08), P > 0.05). However, LRA was superior to RRA in reducing fluoroscopy time (standardized mean difference = 0.15, 95%CI 0.06-0.24, P < 0.01). In addition, the incidence of severe tortuosity of subclavian artery was significantly lower with LRA (OR = 4.65, 95%CI 1.98-10.88, P < 0.01).</p><p><b>CONCLUSIONS</b>Based on the current evidence, LRA shares similar safety with RRA for CAG and is superior to RRA in certain respects. LRA can thus be used either as an alternative approach or routine approach for CAG.</p>