LncRNA-m18as1 competitively binds with miR-18a-5p to regulate follicle-stimulating hormone secretion through the Smad2/3 pathway in rat primary pituitary cells / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Long noncoding RNAs (lncRNAs) are expressed in different species and different tissues, and perform different functions, but little is known about their involvement in the synthesis or secretion of follicle-stimulating hormone (FSH). In general, we have revealed lncRNA‍‒‍microRNA (miRNA)‍‒‍‍messenger RNA (mRNA) interactions that may play important roles in rat primary pituitary cells. In this study, a new lncRNA was identified for the first time. First, we analyzed the gene expression of lncRNA-m18as1 in different tissues and different stages by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and observed the localization of lncRNA-m18as1 with fluorescence in situ hybridization, which indicated that this lncRNA was distributed mainly in the cytoplasm. Next, we used RT-qPCR and enzyme-linked immunosorbent assay (ELISA) to analyze the regulation of FSH synthesis and secretion after overexpression or knockdown of lncRNA-m18as1 and found that lncRNA-m18as1 was positively correlated with FSH synthesis and secretion. In addition, mothers against decapentaplegic homolog 2 (Smad2) was highly expressed in our sequencing results. We also screened miR-18a-5p from our sequencing results as a miRNA that may bind to lncRNA-m18as1 and Smad2. We used RNA immunoprecipitation-qPCR (RIP-qPCR) and/or dual luciferase assays to confirm that lncRNA-m18as1 interacted with miR-18a-5p and miR-18a-5p interacted with Smad2. Fluorescence in situ hybridization (FISH) showed that lncRNA-m18as1 and miR-18a-5p were localized mainly in the cytoplasm. Finally, we determined the relationship among lncRNA-m18as1, miR-18a-5p, and the Smad2/3 pathway. Overall, we found that lncRNA-m18as1 acts as a molecular sponge of miR-18a-5p to regulate the synthesis and secretion of FSH through the Smad2/3 pathway.

Surgical treatment of pilonidal disease / 中华普通外科杂志

Objective To study the surgical treatment of the pilonidal disease.Methods The clinical data of 33 cases of the pilonidal disease were retrospectively analyzed from Jul 2007 to Feb 2014.18 cases were treated with Excision and Marsupialization,and 15 cases were treated with Rhomboid excision and Limberg flap.Results All 18 cases in the excision and marsupialization group,were cured by surgery.all 15 cases in the rhomboid excision and Limberg flap group were cured,five of these cases were delayed healing dehiscence or necrosis,all this cases were healed after dressing drainage.The average healing time of the Limberg flap group was shorter than that of the Marsupialization group[(19 ±7) d vs.(37 ± 12) d,t =6.556,P ＜ 0.01].Postoperative recurrence of the Marsupialization group was 1 case,the recurrence rate was 5.6％,and there was no recurrence after Limberg flap transfer.The recurrence rate of the 2 groups was statistically insignificant (P ＞ 0.05).Conclusion The excision and marsupialization and the rhomboid excision and Limberg flap are effective in the treatment of the pilonidal disease,and the Limberg flap transfer is recommended in complicated and recurrence cases.

Meta-analysis of bone metabolism indicators in patients with primary osteoporosis under different forms of exercises / 中国组织工程研究

BACKGROUND: Physical exercise can significantly reduce bone mass loss, relieve pain and improve bone metabolism in osteoporosis patients, but there is no evidence-based evidence. OBJECTIVE: To investigate the effect of different physical exercises on the treatment of primary osteoporosis. METHODS: Randomized controlled clinical trials regarding the therapeutic effect of physical exercise on primary osteoporosis were screened. The physical exercise group was subjected to physical exercise, and the control group had no regular exercise during the test. The main outcome measures included bone mineral density of lumbar spine L2-L4, visual analog scale score, bone metabolism index (osteocalcin, total type 1 procollagen amino terminal peptide, urine pyridinium/creatinine, blood calcium, blood phosphorus). The included outcome indicators were meta-analyzed using the Review Manager 5.3 software. RESULTS AND CONCLUSION: A total of 25 randomized controlled trials were included. Meta-analysis results showed that physical exercise could effectively improve the bone mineral density of L2-L4 segments in primary osteoporosis patients (mean difference=0.06, 95% confidence interval [0.04-0.08], P 0.05). Physical exercise significantly reduced the pain as determined by the visual analog scale in osteoporosis patients (mean difference=-0.93, 95% confidence interval [-1.08 to -0.79], P 0.05). The results of Egger’s and Begg’s tests indicated that publication bias of the included studies was at a low level. All these findings indicate that physical exercise has significant interventional effects on bone mineral density and pain in patients with primary osteoporosis.

Treatment-emergent central sleep apnea: a unique sleep-disordered breathing / 中华医学杂志(英文版)

Treatment-emergent central sleep apnea (TECSA) is a specific form of sleep-disordered breathing, characterized by the emergence or persistence of central apneas during treatment for obstructive sleep apnea. The purpose of this review was to summarize the definition, epidemiology, potential mechanisms, clinical characteristics, and treatment of TECSA. We searched for relevant articles up to January 31, 2020, in the PubMed database. The prevalence of TECSA varied widely in different studies. The potential mechanisms leading to TECSA included ventilatory control instability, low arousal threshold, activation of lung stretch receptors, and prolonged circulation time. TECSA may be a self-limited disorder in some patients and could be resolved spontaneously over time with ongoing treatment of continuous positive airway pressure (CPAP). However, central apneas persist even with the regular CPAP therapy in some patients, and new treatment approaches such as adaptive servo-ventilation may be necessary. We concluded that several questions regarding TECSA remain, despite the findings of many studies, and it is necessary to carry out large surveys with basic scientific design and clinical trials for TECSA to clarify these irregularities. Further, it will be vital to evaluate the baseline demographic and polysomnographic data of TECSA patients more carefully and comprehensively.

Progress of intestinal flora in colorectal cancer / 肿瘤研究与临床

The pathogenesis of colorectal cancer is related to genetic and environmental factors. Chronic inflammation of the intestinal mucosa is one of the most important factors in environmental factors. In inflammation factors, Intestinal flora plays a role in bridging and inducing intervention. Environmental changes disrupt the homeostasis of intestinal flora, intestinal flora maladjustment occurred, bacteria induces intestinal mucosal inflammation. The pathogenic bacterium adheres to the surface of the intestinal mucosa, it produces cytotoxic and genotoxic products, intestinal epithelial cells undergo genetic damage. The synthesis and metabolites of bacteria also control the occurrence of colorectal tumor process. This process leads to the progression of inflammation to cancer. This article reviews the process of intestinal flora mediated from inflammation to carcinogenesis, and the latest progress in related pathogenic bacteria, and proposes that the intestinal flora can be adjusted and targeted removal of the conditional pathogenic bacteria, and achieve the goal of cancer prevention. The relationship between intestinal flora, intestinal inflammation and colorectal cancer is reviewed.

Berberine enhances mitomycin C-induced cell cycle arrest and apoptosis of T24 bladder cancer cells / 中国病理生理杂志

AIM:To observe the effects of the combination of berberin (Ber) and mitomycin C (MMC) on the cell cycle arrest and apoptosis of T24 bladder cancer cells and the underlying mechanisms. METHODS:The T24 cells were exposed to MMC in the presence or absence of difference concentrations of Ber. The viability of the T24 cells was de-termined by CCK-8 assay. The cell cycle distribution was detected by flow cytometry. The apoptosis was analyzed by flow cytometry with Annexin V-FITC/PI staining, and the protein expression levels of cyclin D1, survivin, CDK2, CDK4, p21 and p27 were determined by Western blot. RESULTS:CCK-8 experiments showed that Ber enhanced the inhibitory effect of MMC on the viability of T24 cells. The results of flow cytometry showed that Ber also enhanced the blockade effect of MMC on T24 cells in G0/G1 phase (P<0.05). Compared with the MMC group, Ber increased the expression of p21 and p27 up-regulated by MMC, and decreased the expression of cynlin D1, CDK2 and CDK4 (P<0. 05). Meanwhile, Ber promoted MMC to inhibit the expression of survivin (P<0. 05). Ber increased the apoptosis of T24 cells induced by MMC (P<0. 05). CONCLUSION:Ber significantly enhances the inhibitory effect of MMC on the viability of T24 cells. The mechanism may be related to up-regulation of p21 and p27, thereby inhibiting the expression of cyclin D1, CDK-2 and CDK-4. At the same time, Ber inhibits the protein expression of survivin, which eventually leads to cell arrest in G0/G1 phase and promotes apoptosis.

Ethanol extract of Ilex hainanensis Merr. exhibits anti-melanoma activity by induction of G/S cell-cycle arrest and apoptosis / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate anti-melanoma effect of ethanol extract of Ilex hainanensis Merr. (IME) and elucidate its underlying mechanism.</p><p><b>METHODS</b>Thirty-six tumor-bearing mice were randomized into 6 groups (n=6) as follows: model group, IME 25, 50, 100, and 200 mg/kg groups and dacarbazine (DTIC) 70 mg/kg group. The mice in the IME treatment groups were intragastrically administered with IME 25, 50, 100 or 200 mg/kg per day, respectively. The mice in the DTIC group were intraperitoneally injected with DTIC 70 mg/kg every 2 days. The drug administration was lasting for 14 days. The cell viability was evaluated by 3-(4,5-dime-thylthylthiazol-2-yl)-2, 5-diphenyl-tetrazolium bromide (MTT) assay. Flow cytometry was employed to detect cell cycle and apoptosis. The gene and protein expressions of nuclear factor κB-p65 (NF-κB-p65), Bcl-2, B-cell lymphomaextra large (Bcl-xL) and Bax were detected by quantitative real-time polymerase chain reaction and Western blot analyses. Caspases-3, -8, and -9 activities were detected using the colorimetric method. In addition, a B16-F10 melanoma xenograft mouse model was used to evaluate the anti-cancer activity of IME in vivo. Furthermore, a survival experiment of tumor-bearing mice was also performed to evaluate the possible toxicity of IME.</p><p><b>RESULTS</b>IME significantly inhibited the proliferation of B16-F10 cells (P<0.01). Flow cytometric analysis showed that IME induced G/S cell cycle arrest and apoptosis (both P<0.01). IME inhibited activation of NF-κB, decreased the gene and protein expressions of Bcl-2, Bcl-xL, and increased the gene and protein expressions of Bax (all P<0.01). In addition, IME induced the activation of Caspases-3, -8, and -9 in B16-F10 cells. The study in vivo showed that IME significantly reduced tumor volume (P<0.01), and the inhibitory rate came up to 68.62%. IME also induced large areas of necrosis and intra-tumoral apoptosis that correlated with a reduction in tumor volume. Survival experiment showed that treatment with IME for 14 days significantly prolonged survival time and 20% of mice in the IME 200 mg/kg group were still alive until the 50th day. Notably, IME showed no apparent side-effects during the treatment period.</p><p><b>CONCLUSION</b>IME exhibited significant anti-melanoma activity in vitro and in vivo, suggesting that IME might be a promising effective candidate with lower toxic for malignant melanoma therapy.</p>

Thalidomide-based Regimens for Elderly and/or Transplant Ineligible Patients with Multiple Myeloma: A Meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Thalidomide is an immunomodulatory and anti-angiogenic drug that has shown promise in patients with myeloma. Trials comparing efficacy of standard melphalan and prednisone (MP) therapy with MP plus thalidomide (MPT) in transplant-ineligible or elderly patients with multiple myeloma (MM) have provided conflicting evidence. This meta-analysis aimed to determine the efficacy and toxicity of thalidomide in previously untreated elderly patients with myeloma.</p><p><b>METHODS</b>Medline, the Cochrane Controlled Trials register, conference proceedings of the American Society of Hematology (1995-2014), the American Society of Clinical Oncology (1995-2014), and CBM, VIP, and CNKI databases were searched for randomized control trials with the use of the medical subject headings "MM " and "thalidomide ". Trials were assessed by two reviewers for eligibility. Meta-analysis was conducted using a fixed effects model. Sensitivity analysis was performed to test the robustness of the findings.</p><p><b>RESULTS</b>Overall, seven trials were identified, covering a total of 1821 subjects. The summary hazard ratio (thalidomide vs. control) was 0.82 (95% confidence interval [CI]: 0.72-0.94) for overall survival (OS), and 0.65 (95% CI: 0.58-0.73) for progression-free survival, in favor of thalidomide treated group. The risk ratio of complete response with induction thalidomide was 3.48 (95% CI: 2.24-5.41). A higher rate of III/IV adverse events were observed in MPT arm compared with the MP arm. However, analysis of sub-groups administering anticoagulation as venous thromboembolism prophylaxis suggested no difference in relative risk of thrombotic events between two arms (RR = 1.47, 95% CI: 0.43-5.07, P = 0.54). Further analysis of trials on the treatment effects of MPT versus MP on adverse events-related mortality showed no statistical difference between two arms (RR = 1.24, 95% CI: [0.95-1.63], P = 0.120).</p><p><b>CONCLUSION</b>Thalidomide appears to improve the OS of elderly and/or transplant-ineligible patients with MM when it is added to standard MP therapy.</p>

Procedure for prolapsed hemorrhoids treatment for Ⅲ, Ⅳ hemorrhoids efficacy / 国际外科学杂志

Objective To investigate the consistent long-term clinical efficacy of the procedure for prolapsed hemorrhoids (PPH) treatment for hemorrhoids.Methods Data of 87 patients with third-and fourth-degree hemorrhoids treated by surgical procedure for prolapsed hemorrhoids were collected.In all cases,third-degree hemorrhoids in 65 cases,fourth-degree hemorrhoids in 22 cases,median followed up after PPH was (3.8 ± 0.5) years.The long-term efficacy and the occurrence of complications were followed up to assess the effect of surgical procedure for prolapsed hemorrhoids.Results In patients with third-degree hemorrhoids,bleeding recurred in 2 cases (3.1％) for again bleeding,for anal bulge in 4 cases (6.2％).In patients with fourth-degree hemorrhoids,prolapse recurred in 2 cases (9.1％) for bleeding in 5 cases (22.7％).anal bulge 3 patients (13.6％),defecation difficult in one case (4.5％),one-degree of fecal incontinence in 1 case (4.5％),no other complications found,such as anal pain,anal stenosis,foreign body discomfort and fecal urgency.The chi-square test for comparison analysis suggested that:third-degree hemorrhoids postoperative prolapse and bleeding recurrence rate was significantly lower than fourth-degree hemorrhoids.Conclusions Procedure for prolapsed hemorrhoids treatment for hemorrhoids is safe and feasible,has small trauma,little pain,and definite efficacy,fewer complications,shorter hospital stay,lower reoperation rate,etc.But the long-term efficacy for third-degree hemorrhoids is superior to the fourth-degree hemorrhoids.

Doppler hemorrhoid artery ligation combined with lauromacrogal sclerosis injection in treatment of hemorrhoids / 国际外科学杂志

ObjectiveTo study the clinical value of minimally invasive treatment of the doppler-guided hemorrhoid artery ligation with lauromacrogal sclerosis injection in treatment of hemorrhoids.MethodsA retrospective analysis was made on treatment of 32 cases with hemorrhoids using doppler-guided hemorrhoid artery ligation combined with lauromacrogal sclerosis injection.ResultsAccording to the branch of the Chinese Medical Association by the Surgery the clinical diagnosis and Treatment Guidelines of Hemorrhoids (draft),the Ⅰ degree hemorrhoid was found in 1 case,Ⅱ degree hemorrhoids in 18 cases,Ⅲ degree hemorrhoids in 13 cases.Recovery was found in 32 cases.The longest follow-up time was 30 weeks.No relapse was found. ConclusionsDoppler-guided hemorrhoid artery ligation combined with lauromacrogal case sclerosis injection is a low aggressive minimally invasive method to treat hemorrhoid and has small trauma,definite effect,less pain,fewer complications,and short course and other advantages,but the longterm outcome needs further observation.

Hippocampal impairments are associated with intermittent hypoxia of obstructive sleep apnea / 中华医学杂志(英文版)

Obstructive sleep apnea (OSA), which is the most common sleep-related breathing disorder, is characterized as frequent upper airway collapse and obstruction. It is a treatable disorder but if left untreated is associated with complications in several organ systems. The health risk to OSA patients shows a strong association with acute cardiovascular events, and with chronic conditions. To the central nervous system, OSA causes behavioral and neuropsychologic deficits including daytime sleepiness, depression, impaired memory, mood disorders, cognition deficiencies, language comprehension and expression deficiencies, all of which are compatible with impaired hippocampal function. Furthermore, there exists a significant correlation between disease severity and cognitive deficits in OSA. Children with severe OSA have significantly lower intelligence quotient (IQ) and executive control functions compared to normal children matched for age, gender and ethnicity. This corroborates the findings of several pediatric studies of cognition in childhood OSA, where deficits are reported in general intelligence and some measures of executive function. In studies of OSA, it is difficult to differentiate the effects of its two main pathologic traits, intermittent hypoxia (IH) and sleep fragmentation. Many OSA studies, utilize IH as the only exposure factor in OSA studies. These approaches simplify research process and attain most of the academic goals. IH, continuous hypoxia and intermittent continuous hypoxia can all result in decreases in arterial O2. There are striking differences to them in the response of physiological systems. There are multiple studies showing that IH treatment in a rodent model of OSA can impair performance of standard water maze tests associated with deficits in spatial learning and memory which most likely are hippocampal-dependent. Cellular damage to the hippocampal cornuammonis 1 (CA1) region likely contributes to neuropsychological impairment among OSA patients, since neural circuits in the hippocampus are important in learning and memory. In this article, studies of hippocampal impairments from IH are reviewed for elucidating the mechanisms and relationships between hippocampal impairments and IH of OSA.

Elevated nocturnal and morning blood pressure in patients with obstructive sleep apnea syndrome / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The nocturnal nondipping and elevated morning blood pressure (BP) in patients with obstructive sleep apnea syndrome (OSAS) have not yet been well investigated in Chinese patients. This study aimed to describe the BP profile, and to elucidate the relationships between daytime BP and nighttime BP, and between evening BP and morning BP in patients with OSAS.</p><p><b>METHODS</b>Twenty teaching hospital sleep centers in China were organized by the Chinese Medical Association to participate in this study and 2297 patients were recruited between January 2004 and April 2006. BP assessments were made at four time points (daytime, evening, nighttime and morning) and polysomnography (PSG) was performed and subjects were classified into four groups by their apnea-hypopnea index (AHI): control, n = 213 with AHI < 5; mild, n = 420 with AHI ≥ 5 and < 15; moderate, n = 460 with AHI ≥ 15 and < 30; and severe, n = 1204 with AHI ≥ 30. SPSS 11.5 software package was used for statistical analysis and figure drawing.</p><p><b>RESULTS</b>All the average daytime, nighttime, evening and morning BPs were positively correlated with AHI and negatively correlated with nadir nocturnal oxygen saturation. The ratios of nighttime/daytime and morning/evening average BP were positively correlated with AHI. The ratio of nighttime/daytime systolic BP became a "reversed BP dipping" pattern until the classification reached severe, while the ratio of nighttime/daytime diastolic BP became reversed at moderate. Similarly, the ratio of morning/evening diastolic BP becomes reversed even at mild.</p><p><b>CONCLUSIONS</b>OSAS may result in higher BP levels at all four time points. The ratios of nighttime/daytime and morning/evening BP increase with increased AHI. The increasing of diastolic BP, which is inclined to rise more quickly, is not parallel with increasing systolic BP.</p>

Clinical value of 64-slice spiral 3-phase CT enhanced scanning for preoperative TNM staging assessment of gastric carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the clinical value of 64-slice spiral 3-phase CT enhanced scanning for preoperative TNM staging assessment of gastric carcinoma.</p><p><b>METHODS</b>A retrospective study was performed to review the 64-slice spiral 3-phase CT enhanced scanning of 120 patients with gastric cancer diagnosed by biopsy prior to operation and postoperative pathological reports. All the findings were reviewed by two senior radiologic diagnosticians separately and compared with pathological findings.</p><p><b>RESULTS</b>The accuracy of 64-slice spiral CT enhanced scan was 79.2%(95/120) for T staging, 66.7%(10/15) for T1, 66.7%(14/21) for T2, 84.0%(42/50) for T3, and 85.3%(29/34) for T4. For gastric wall with single layer and multiple layers, the accuracy of CT enhanced scanning was 59.4%(19/32) and 81.8%(72/88) for T staging, and the difference was statistically significant(P<0.05). The accuracy of 64-slice spiral CT enhanced scan was 73.9%(85/115) for N staging, 75.5%(37/49) for N0, 70.3%(26/37) for N1, 75.9%(22/29) for N2. The accuracy of 64-slice spiral CT enhanced scanning was 89.2% for M staging.</p><p><b>CONCLUSION</b>64-slice spiral CT 3-phase enhanced scanning can monitor the invasion, lymphatic metastasis, and distant metastasis of gastric cancer dynamically, which may become an important examination item for the preoperative evaluation of gastric cancer.</p>

Influence of different degrees of chronic intermittent hypoxia on c-fos protein and apoptosis in rats / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To establish different degrees and duration of animal hypoxia model of sleep apnea hypopnea syndrome according to the mechanism of intermittent hypoxia, to observe the effect of c-fos protein and apoptosis, and to explore the mechanism of nervous system injury.</p><p><b>METHODS</b>By using the model of chronic intermittent hypoxia in rats, male Wistar rats (n = 72) were randomly divided into three groups: 5% of chronic intermittent hypoxia group (the fraction of oxygen volume reduced to 5% under hypoxia), 10% of chronic intermittent hypoxia group (the fraction of oxygen volume reduced to 5% under hypoxia) and control group. The levels of on c-fos protein and apoptosis of hippocampal cell in three groups were detected at the 2nd, 4th, 6th and 8th week respectively. The expression of c-fos protein in hippocampal cell was detected by immunohistochemical method and the apoptosis of hippocampal cell was detected by TUNEL.</p><p><b>RESULTS</b>The relative quantity of c-fos protein and apoptotic index in CIH groups were significantly higher than that of the control group on the 2nd, 4th, 6th and 8th weeks (F were 44.52, 57.56, 24.20 and 13.18, P < 0.05), and these were higher obviously in 5% CIH group than that in 10% CIH group (P < 0.05). The expression of c-fos protein and apoptotic index in two CIH groups was different depending upon the different degree and duration of chronic intermittent hypoxia. With increased exposure time, the expression of c-fos protein and apoptotic index was high generally at first, peaked at 6th week, then down at 8th week (P < 0.05). While it in UC group was invariability in different time (P > 0.05). The correlation between the relative quantity of c-fos protein and apoptotic index in two CIH groups was positive (r were 0.816 and 0.701, P < 0.01).</p><p><b>CONCLUSION</b>Moderate and severe intermittent hypoxia induced the excessive expression of c-fos protein in hippocampus, caused nerve cell apoptosis, and may play an important role in the mechanism of early brain injury of intermittent hypoxia.</p>

18F-FDG PET/CT for assessing therapeutic response to chemotherapy in patients with diffuse large B-cell lymphoma / 中华核医学杂志

Objective To explore the value of 18F-FDG PET/CT on the assessment of chemotherapy response in patients with diffuse large B-cell lymphoma (DLBCL). Methods 18F-FDG PET/CT was performed before and after 4 cycles of chemotherapy( R-CHOP or CHOP protocol) in 53 patients with DLBCL. The patients were divided into 3 groups: complete response group, partial response group and no response group. The therapeutic response was assessed by comparing post-treatment 18F-FDG PET/CT with pre-treatment PET/CT. Complete remission (CR) rate at the end of chemotherapy was calculated. χ2 test was performed with software SPSS 13.0. Results CR rates of complete response group, partially response group and no response group were 88.5% (23/26), 73.3% (11/15) and 8.3% (1/12), respectively (χ2=23.548, P=0.000). CR rates of the complete and partially response groups were significantly higher than those of no response group (χ2=22.656, P=0.000; χ2=11.407, P=0.001). Conclusion 18F-FDG PET/CT may be useful for the assessment of chemotherapy response in DLBCL.

Modulation of Toll-like signal path of allergic asthma by CpG-ODNs from Bordetella pertussis / 药学学报

This study focused on prevention and treatment of acute and chronic asthma by oligonucleotides containing unmethylated CpG motifs (CpG-ODNs). Acute and chronic asthma models of mice were made by sensitizing and inhaling ovalbumin (OVA); The number of white blood cells (WBC) and eosnophils (EOS) in bronchoalveolar lavage fluid (BALF) was counted and the concentration of cytokines and vascular endothelial growth factor (VEGF) was examined in BALF by ELISA kit. After that, TLR-9 mRNA was detected in mice spleen cells by reverse transcription polymerase chain reaction (RT-PCR) and TLR-9 protein was determined in mice lung tissues by Western blotting. Compared with acute asthma models of mice, WBC in BALF decreased obviously in the groups of Bordetella pertussis, CpG-ODNs and seq A to seq I which were administrated by both of intragastric (ig) and intraperitoneal (ip) injection group, EOS decreased obviously in Bordetella pertussis, CpG+ and seq A to seq D ig groups, and in all ip administrating groups, although it was not effective in the groups of seq E to seq I. In chronic asthma models of mice, IFN-gamma increased ((1) control: 176.45 +/- 23.46 pg x mL(-1); (2) model: 174.11 +/- 22.71 pg x mL(-1); (3) CpG+ ip: 220.56 +/- 15.42 pg x mL(-1); (4) seq A ip: 225.23 +/- 21.60 pg x mL(-1)) and IL-4 decreased obviously (1) control: 66.91 +/- 5.81 pg x mL(-1); (2) model: 81.02 +/- 11.24 pg x mL(-1); (3) CpG+ ip: 63.99 +/- 6.09 pg x mL(-1); (4) seq A ip: 62.75 +/- 10.03 pg x mL(-1)) in the BALF of CpG+ and seq A ip group, although VEGF was not changed in this research. And also, TLR-9 mRNA in spleen cells (TLR-9/GAPDH: (1) control: 0.62 +/- 0.13; (2) model: 0.66 +/- 0.17; (3) CpG+ ip: 1.46 +/- 0.26; (4) seq A ip: 1.42 +/- 0.34) and TLR-9 protein in lung tissues (TLR-9/beta-actin: (1) control: 0.63 +/- 0.16; (2) model: 0.61 +/- 0.07; (3) CpG+ ip: 1.15 +/- 0.25; (4) seq A ip: 1.03 +/- 0.29) both increased in ip groups, but the change was not significant in ig group. The study confirms that CpG-ODNs and seq A could inhibit airway inflammation remarkably, this mechanism might be related with regulating Th1/Th2 balance and controlling the expression of TLR-9.

Chest radiographic findings in children with 2009 influenza A (H1N1) virus infection / 中华儿科杂志

<p><b>OBJECTIVE</b>To evaluate chest radiographic findings of children with 2009 influenza (H1N1) virus infection.</p><p><b>METHOD</b>Data of 235 patients who had microbiologically confirmed H1N1 infection and available chest radiograph obtained between May 1(st) 2009 and Jan. 31(st) 2010 were retrospectively analyzed. The final study group was divided on the basis of clinical course [group 1 mild, outpatients without hospitalization (n = 172); group 2 moderate, inpatients with brief hospitalization (n = 49); group 3 severe, ICU admission (n = 14)]. Four pediatric radiologists reviewed all the chest radiographs of lung parenchyma, airway, pleural abnormalities and also anatomic distribution of the disease.</p><p><b>RESULT</b>No significant sex or age differences were found among the study groups (P > 0.05). The mean interval between the onset of clinical symptom and the initial chest radiography was (5.91 ± 1.64) days (group 1), (3.60 ± 1.43) days (group 2) and (1.21 ± 0.41) days (group 3), respectively. The differences among the three groups were significant statistically (χ(2) = 13.368, P < 0.01). The ratio of abnormality presented at initial chest X-ray was 79.7% in group 1, 91.8% in group 2 and 100% in group 3. Radiographically, there were prominent peribronchial markings (group 1, 55.2%; group 2, 83.7%; and group 3, 78.6%), consolidation (group 1, 34.3%; group 2, 69.4%; and group 3, 100.0%), hyperinflation (group 1, 22.1%; group 2, 44.9%; and group 3, 50.0%) and ground glass opacity (group 1, 0.6%; group 2, 2.0%; and group 3, 14.3%) in the chest radiographs. The differences of presenting were statistically significant (P < 0.01). In the severe group, the lesions distributed diffusely and asymmetrically with multi-lobe involvements.</p><p><b>CONCLUSION</b>In children with 2009 influenza A H1N1 viral infection, the interval between the onset of clinical symptom and initial chest radiography, the ratio of abnormality presented at initial chest X-ray film and the severity of chest film are parallel to their clinical situation.</p>

Asymptomatic patients of chronic obstructive pulmonary disease in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Chronic obstructive pulmonary disease (COPD) has a variable natural history and not all individuals follow the same course. This study aimed to identify the prevalence and characteristics of asymptomatic COPD patients from a population-based survey in China.</p><p><b>METHODS</b>A multistage cluster sampling strategy was used in a population from seven different provinces/cities. All residents (over 40 years old) were interviewed with a standardized questionnaire and spirometry. Post-bronchodilator forced expiratory volume in 1 second (FEV(1))/forced vital capacity (FVC) of less than 70% was defined as the diagnostic criterion of COPD. All COPD patients screened were divided into symptomatic group and asymptomatic group according to the presence or absence of chronic respiratory symptoms. Socio-demographic, personal and exposure variables were collected and analyzed.</p><p><b>RESULTS</b>Among the 1668 patients who were diagnosed with COPD from the 25 627 sampling subjects, 589 (35.3%) were asymptomatic. The age, sex, body mass index (BMI), rural and urban distributions, smoking habit and education levels were similar in the two groups. A total of 64.7% of the asymptomatic patients had no comorbidities. Cardiovascular diseases and lung cancer were more common among symptomatic COPD patients than asymptomatic group. Asymptomatic COPD group were less likely to present with poor ventilation in the kitchen, a family history of respiratory disease and recurrent childhood cough. Asymptomatic COPD patients had significantly higher FEV(1) (73.1% vs. 61.0%), FVC (91.9% vs. 82.0%), and a higher ratio of FEV(1)/FVC (62.9% vs. 58.7%) (all P < 0.001) than symptomatic group. More asymptomatic patients were underdiagnosed (91.9% vs. 54.3%, P < 0.001) than symptomatic patients.</p><p><b>CONCLUSIONS</b>This large population-based survey confirmed a high prevalence of asymptomatic COPD patients in China. More use of spirometry screening test may be important to the early detection of COPD.</p>

Sleep-related hypoxemia aggravates systematic inflammation in emphysematous rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Sleep disturbance is common in patients with emphysema. This study aimed to develop a novel model of sleep-related hypoxemia (SRH) in emphysema (SRHIE) with rats, and to explore the inflammatory status of SRHIE in lung, liver, pancreas, carotid artery and whole blood.</p><p><b>METHODS</b>Seventy-five male Wistar rats were assigned to 5 groups with 15 per group according to the exposure conditions. The protocols varied with the degree of hypoxia exposure and severity of pre-existing emphysema caused by cigarette smoke exposure: (1) SRH control (SRHCtrl) group, sham smoke exposure (smoke exposure, exposed to smoke of 15 cigarettes twice everyday, 16 weeks) and SRH exposure (12.5% O2, 3 hours, SRH exposure, divide total hypoxia time (1.5 hours or 3 hours) into 4 periods evenly (22.5 minutes or 45 minutes) and distribute these hypoxia periods evenly into physiological sleep time of rats identified by electroencephalogram, week 9 to week 16); (2) Emphysema control (ECtrl) group, smoke exposure and sham SRH exposure (21% O2, 3 hours); (3) Short SRH in emphysema (SRHShort) group, smoke exposure and short SRH exposure (12.5% O2, 1.5 hours); (4) Mild SRH in emphysema (SRHMild) group, smoke exposure and mild SRH exposure (15% O2, 3 hours); (5) Standard SRH in emphysema (SRHStand) group, smoke exposure and SRH exposure (12.5% O2, 3 hours). ECtrl, SRHShort, SRHMild and SRHStand groups were groups with emphysematous rats. Two days before the end of exposure, 5 rats in each group were randomly selected for arterial blood gas analysis. In the rest 10 rats in each group, we obtained blood samples and bronchoalveolar lavage fluid (BALF) for routine tests. We also obtained tissue blocks of lung, liver, pancreas, and right carotid artery for pathologic scoring and measurements of liver oxidative stress (measuring hepatic oxidative stress enzymes, superoxide dismutase (SOD) activity, catalase (CAT) activity and malondialdehyde (MDA) concentration).</p><p><b>RESULTS</b>Emphysematous groups had higher mean linear intercept (MLI) and mean alveolar number (MAN) values than SRHCtrl group. MLI values in SRHStand group were the highest (all P < 0.05). O2Sat in SRHStand rats when SRH exposure was (83.45 ± 1.76)%. Histological scores of lung, liver, pancreas and right carotid artery were higher in emphysematous groups than SRHCtrl group, and SRHStand group were the highest (all P < 0.05) (SOD and CAT values were lower and MDA values were higher in groups with emphysema than without and in SRHStand group than in ECtrl group (all P < 0.05)). MDA values were the highest in SRHStand group (all P < 0.05). Total cellular score in BALF and White blood cell (WBC) in whole blood were the highest in SRHStand group (all P < 0.05). Lymphocyte ratios were the highest in SRHStand group both in BALF and blood (all P < 0.05). Red blood cell (RBC) and hemoglobin in emphysematous groups were higher than that in SRHCtrl group, and SRHStand group were higher than ECtrl group (all P < 0.05).</p><p><b>CONCLUSIONS</b>With a proper novo model of SRHIE with Wistar rats, we have demonstrated SRH may aggravate the degree of emphysematous changes, polycythemia, oxidative stress and systematic inflammation. SRH and emphysema may have a synergistic action in causing systematic damages, and lymphocyte may be playing a central role in this process. Longer duration and more severe extent of SRHIE exposure also seem to result in more serious systematic damages. The mechanisms of all these concerned processes remain to be studied.</p>

Effect of different intermittent hypoxia patterns on interleukin-6 and interleukin-8 levels of human umbilical vein endothelial cells / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of different patterns of intermittent hypoxia on the levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) of vascular endothelial cell.</p><p><b>METHODS</b>The human umbilical vein endothelial cells of the line ECV304 were used to set up the cells model. The experiment cell strains contained one control group and eight experimental groups, 1 constance normoxia group (control group), 3 different intermittent hypoxia (IH) degree groups (10% O₂ group, 1.5% O₂ group, 0.5% O₂ group with 12 times/h), 4 different IH frequency groups (40 times/h, 20 times/h, 12 times/h, 9 times/h and 6 times/h with 0.5%O2). The specimen were put into a program-controlled gas delivery system with different level and frequency of IH respectively. Then enzyme linked immunosorbent assay (ELISA) was used to examine the levels of IL-6 and IL-8.</p><p><b>RESULTS</b>Higher level of IL-6 and IL-8 were found in 3 different IH degree groups than in control group (F were 1961.100 and 103.855 respectively, P all < 0.001). The level of IL-6 and IL-8 was gradually increased with the decreasing of IH degree. The difference of IL-6 and IL-8 levels between each two different groups in IH degree was significant (P all < 0.05). The level of IL-6 and IL-8 groups was significantly different in severe IH exposure (F were 544.396 and 149.328 respectively, P all < 0.001 in both groups). There was a trend as the IH frequency decreased, the level of IL-6 and IL-8 was tenderly increased in 20/hour group (P < 0.05), highest in 12/hour group (P < 0.05), decreased in 9/hour group (P < 0.05), and decreased further in 6/hour group (P < 0.05) in severe IH expose. There was statistical significance between each two different frequency IH groups (P < 0.05).</p><p><b>CONCLUSIONS</b>Intermittent hypoxia caused significant inflammatory reaction in vascular endothelial cells. The secreted level of IL-6 and IL-8 depended on the degree of hypoxia. There was a trend as the level of IH frequency decreased, the level of IL-6 and IL-8 gradually increased at first, and then decreased in the same way.</p>