Changes of nitric oxide, endothelin-1, homocysteine and C-reactive protein levels in patients with obstructive sleep apnea hypopnea syndrome complicated with hypertension and their relationship with polysomnography monitoring indexes / 中国综合临床

Objective:To investigate the changes of nitric oxide, endothelin-1 (ET-1), homocysteine (Hcy), C-reactive protein (CRP) levels in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) combined with hypertension and the relationship between the changes and polysomnography monitoring indicators.Methods:A retrospective case-control study was conducted to analyze the clinical data of 115 patients with OSAHS complicated with hypertension, 110 patients with simple OSAHS and 136 healthy persons in Kailuan general hospital and Linxi Hospital of Kailuan general hospital from March 2016 to March 2018. The relationship between sleep related indexes and serological indexes was compared among the three groups.Results:In the control group, simple OSAHS group, OSAHS with hypertension group, the apnea hypopnea index (AHI) was (2.4±0.8), (35.7±12.1), (46.8±13.9) times/h, the lowest oxygen saturation(LSaO 2) was (87.1±6.8) %, (77.8±6.5) %, (66.9±5.1) %, and the mean oxygen saturation(MSpO 2) was (92.7±6.9) %, (80.9±6.7) %, (71.4±6.3) %, and the longest apnea time (LAT) was(4.5±0.7), (48.6±11.3), (58.2±10.4) s. The difference between the three groups was statistically significant ( F values were 637.92, 329.49, 322.96, 1 420.03, respectively, all P<0.05). Nitric oxide in control group, simple OSAHS group and OSAHS combined with hypertension group were (72.8±8.8), (53.7±7.4), (42.6±5.9) μmol/L.Endothelin-1 was(31.1±6.5), (45.4±6.7), (56.6±7.8) ng/L.Hcy was (8.7±1.9), (15.9±6.7), (31.4±6.3) μmol/L.CRP was (1.8±0.6), (18.6±4.3), (25.2±6.4) mg/L.The difference between the three groups was statistically significant ( F valves were 517.46, 419.02, 594.40, 982.14, respectively, all P<0.05). Pearson correlation analysis showed that the levels of endothelin 1, Hcy and CRP in OSAHS patients with hypertension were positively correlated with AHI and LAT (r values were 0.525, 0.704, 0.578, 0.434, 0.464 and 0.449, respectively; all P<0.05), and negatively correlated with LSaO 2 and MSpO 2 (r values were-0.477, -0.458, -0.429, -0.517, -0.534 and -0.617, respectively; all P<0.05). Conclusion:In OSAHS patients with hypertension, nitric oxide decreased, ET-1, Hcy, CRP increased, and polysomnography monitoring indicators were closely related to endothelin-1, Hcy, CRP.

Diagnostic Value of Astograph Airway Responsiveness Measurement in Chest Suffocation Variant Asthma / 中国综合临床

Objective To investigate the diagnostic value of Astograph methacholine provocation test in patients with chest tightness variant asthma ( CTVA)??Methods From January 2011 to February 2017,156 patients with CTVA in outpatient or inpatient department of respiratory medicine of Kailuan General Hospital affiliated to North China University of Science and Technology were selected as case group ( chest tightness variant asthma group )??The control group were 361 non?asthmatic patients including interstitial lung disease ( 23 cases), coronary disease ( 157 cases), hypertensive cardiopathy ( 22 cases), myocardiosis (16 cases),congenital heart disease ( 3 cases),rheumatic valvular heart disease (6 cases), central airway disease (3 cases),thyromegaly (10 cases),mediastinal tumor (5 cases),thoracic or spinal deformity (8 cases),phrenoparalysis (2 cases) and vegetative nerve functional disturbance (106 cases)??All participants received pulmonay ventilation test, average daily and nightly variation rate of PEF ( Peak expiratory flow) or PEF weekly variability, Astograph methacholine provocation test ( forced expirataory volume in one second≥70% expectation),and other relevant examinations??The diagnostic value of Astograph methacholine provocation test on CTVA was assessed by analyzing the sensitivity, specificity, positive predictive value,negative predictive value,and Yunden index of Astograph methacholine airway??Results Compared with the control group (( 1??18 ± 0??44)%), theforced expiratory flow from 75% of Forced vital capcacity ( FEF75 ) index of CTVA group (( 1??29 ± 0??50 )%) had significant difference (, t＝ 2??96, P＝0??006)??The sensitivity,specificity,positive predictive value,negative predictive value,Yunden index,and diagnostic accuracy of Astograph methacholine provocation test on CTVA were 0??814,0??695,0??536,0??305, 0??509 and 0??731, respectively??Conclusion The sensitivity, negative predictive value, Yunden index and diagnostic accuracy of Astograph methacholine provocation test on CTVA were higher,whereas the specificity and positive predictive value were relatively lower,suggesting that Astograph methacholine provocation test had a reliable diagnostic value on CTVA,with lower false negative and higher false positive??

Effect of caffeine citrate on pulmonary function, VEGF and insulin-like growth factor in sleep apnea hypopnea syndrome rats / 中国生化药物杂志

Objective To analysis the effect of caffeine citrate on pulmonary function, vascular endothelial growth factor (VEGF)and insulin like growth factor -1 (IGF-1) in the apnea syndrome rats.Methods 80 male Wistar rats were selected, 20 were randomly selected to be the control group, the rest of the rats were replicated of apnea syndrome model.The rats were randomly divided into model group, experiment group and positive drug group, 20 of each group.The experimental group was given caffeine citrate injection of 5 mg/kg intraperitoneal injection, the positive drug group was given intraperitoneal injection of aminophylline 3 mg/kg, the model group was given intraperitoneal injection of normal saline, once a day, continuously for 1 week.Pulmonary function, serum VEGF, IGF-1 levels and sleep apnea were compared after the experiment.ResuIts Compared with the positive drug group, the related indexes of pulmonary function of the experimental group increased significantly ( P<0.05 ) .Serum VEGF levels decreased significantly (P<0.05).The serum IGF-1 level increased significantly (P<0.05).The sleep apnea index decreased significantly during the period of NREM and REM.(P<0.05).ConcIusion Caffeine citrate can improve apnea syndrome rats lung function, reduce the serum VEGF level, promote the formation of serum IGF-1, reduce the sleep apnea index.

Relationship Between Baseline Levels of High Sensitivity C-reactive Protein With the Morbidity of Pulmonary Embolism / 中国循环杂志

Objective: To evaluate the predictive value for baseline levels of high sensitivity C-reactive protein (hs-CRP) in morbidity of pulmonary embolism (PE). Methods: We conducted a prospective cohort study of 101510 subjects in Kailuan Group by regular physical examination from 2006-07 to 2007-10, and 94314 subjects were enrolled by relevant criteria including 75252 male and 19062 female. The baseline levels of hs-CRP were divided by quartile levels as①hs-CRP0.05. As the increased baseline level of hs-CRP, PE occurrence was elevated accordingly,P0.05. WBC counts had the increasing trend in quartile①,②,③ groups and had the decreasing trend in quartile④ group, while it was similar between quartile③ and quartile④ groups,P>0.05. Conclusion: Baseline hs-CRP level may predict the risk of PE morbidity; the increased hs-CRP level could be used as one of the predictors for PE occurrence.

Effect of Luoyutong capsule on focal cerebral ischemia-reperfusion injury in rats / 中国脑血管病杂志

Objectives To observe the effect of Luoyutong capsule on neurological function following focal cerebral ischemia-reperfusion in rats and to preliminarily study the protective mechanism of Luoyutong capsule for focal cerebral ischemia-reperfusion in rats. Methods A rat model of middle cerebral artery occlusion (MCAO)was induced by the modified Longa method. After 1. 5 h of ischemia,reperfusion started. Ten male SD rats were selected as sham operation group,and forty male SD rats were randomly divided into 4 groups:Model (MCAO),Luoyutong moderate-dose (LYTM),Luoyutong high-dose (LYTH),and citicoline sodium (CS)groups (n=10 in each group). At day 3 and 7 after modeling,the neurological function of the rats was evaluated by using 12 neurological score and forelimb placing test. Western blotting was used to detect the expression levels of brain derived neurotrophic factor (BDNF),basic fibroblast growth factor (b-FGF),and phosphor/protein kinase (p-AKT/AKT)on the ischemic side of the rats and in the ipsilateral brain tissue at day 3 after modeling,as well as the expression level of Caspase-12 at day 7 after modeling in the ipsilateral brain tissue,and a comparison was performed among the groups. Results (1 )Neurological score:At day 3 after modeling,there was no significant difference between the 12 neurological score and the forelimb placing test score (all P>0. 05);At day 7 after modeling, there were obvious improvement in the LYTM,LYTH,and CS groups compared with model group (all P0. 05);the expression levels of proCaspase-12 and cleavage Caspase-12 in the CS group were obviously lower than those of the MCAO group (P<0. 05). Conclusion Luoyutong capsule may play a protective effect for focal cerebral ischemia-reperfusion injury in rats by promoting neural survival and regeneration,and this protective effect may be associated with the inhibition of neuronal apoptosis.

Association Study between polymorphism of IL1β-31T/C,-511C/T and chronic obstructive pulmonary disease / 中国综合临床

Objective To investigate the relationship between polymorphism of interleukin-1β(IL-1β)-31,-511C/T and chronic obstructive pulmonary disease.Methods Two hundred and sixty patients with chronic obstructive pulmonary disease (COPD) were selected as our subjects who were hospitalized in General Hospital of Kailuan from January 2009 to June 2012.At same time,the 260 healthy controls were recruited in medical examine center.The data was collected by the physical examination and a unified questionnaire.Enzyme-linked immunosorbent assay (ELISA) was used to measure the level of IL-1β in serum.Polymerize chain reaction-Restriction fragment length polymorphism (PCR-RLFP) was used to detect the genotypes of IL-1β (-31,-511).Multivariate logistic regression was used to analyze the relations between risk factors with susceptibility of COPD.Results The level of serum IL-1β was (3.92 ± 0.42) μg/L in COPD group,higher than that in control group ((2.69 ± 0.11) μg/L,t =12.889,P ＜ 0.001).The frequency of genotype of IL-1β-31 site in COPD group were 20.8％ (54/260) for TT,58.1％ (151/260) for CT and 21.2％ (55/260) for CC respectively.Meanwhile IL-1β-31 genotype rate were 19.2％ (50/260),58.8％ (153/260) and 21.9％ (57/260) respectively in control group and no significant difference was found between two groups (x2 =0.203,P =0.904).The frequency of genotype of IL-1β-511 site were 20.0％ (52/260) for CC,63.1％ (164/260) for CT and 16.9％ (44/260) for TT in COPD group.The three genotype rate in control group were 21.9％ (57/260),60.8％ (158/260) and 17.3％ (45/260) respectively,and no significant difference was found between two groups (x2 =0.352,P =0.838).Moreover there was also no significant difference in terms of gender(P ＞ 0.05)Conclusion The concentration of IL-1β in serum in COPD group was higher than in control group.The polymorphism of-31 and-511 were proved non association with COPD.

The relationship between fasting plasma glucose level and first cerebral infarction event in the population with diabetes / 中华内分泌代谢杂志

ObjectiveTo study the relationship between fasting plasma glucose (FPG) level and the first cerebral infarction event in the population with diabetes.Methods This was a prospective cohort stndy.8 306 diabetic subjects who determined FPG ≥ 7.0 mmol/L or treated with insulin or hypoglycemic drugs and FPG ＜7.0 mmool/L as the observation population and were followed-up for (48.01 ± 3.14) months.During the course,cerebral infarction events were determined every 6 months.Results( 1 ) By the end of following-up,with the increasing levels of the baseline FPG,the total cholesterol (TC),triglyceride (TG) levels were gradually increased in the diabetic population,the differences were significant [ TC:( 4.93 ± 1.15,5.10 ± 1.20,5.15 ± 1.28,5.33 ± 1.35 ) mmol/L,TG:( 1.70 ± 1.26,1.83 ± 1.29,2.18 ± 1.76,2.41 ± 2.08 ) mmol/L,P＜0.05 ] ; the plasma low density lipoprotein-cholesterol (LDL-C),systolic blood pressure ( SBP),diastolic blood pressure ( DBP),and body mass index (BMI) levels were also increased significantly ( P＜0.05 ).(2) The ineidence of cerebral infarction event in the group of patients with 7.0 mnol/L ≤ FPG ＜ 9.0 mmol/L was the lowest,the differences were significant ( 2.1％,P ＜0.01 ).Compared with the group of 7.0 mmol/L≤ FPG＜9.0 mmol/L,after adjusting for age,sex,BMI,SBP,DBP,TC,TG,low density lipoprotein-cholesterol,high density lipoprotein-cholesterol,smoking,diabetic duration and treatment,the relative risk for cerebral infarction events were 1.85 (95％ CI 1.09-3.15,P＜0.05) and 1.54 (95％CI 1.16-2.05,P ＜ 0.01 ) for those groups with 6.1 mmol/L ≤ FPG ＜ 7.0 mmol/L and FPG ≥ 9.0 mmol/L respectively.ConclusionThe risk of new in cidence of cerebral infarction events seems to be the lowest in the group of diabetic patients whose FPGs are wihin 7.0-9.0 mmol/L range.

Level and influential factors of serum high-sensitivity C-reactive protein in new-onset diabetic population / 中华内分泌代谢杂志

The level of serum high-sensitivity C-reactive protein (hsCRP) in the population with new-onset diabetes was detected and its influential factors were analyzed.The concentrations of hsCRP increased with age in the population with new-onset diabetes( Ptrend＜0.01 ).The percentage of subjects with hsCRP levels ＞3 mg/L was 18.8％in men and 26.7％ in women.A logistic regression analysis indicated that age,gender,body mass index,waist circumference,fasting plasma glucose,and triglyceride were the influential factors of hsCRP levels in diabetic population( P＜0.05 or P＜0.01 ).A variety of cardiovascular factors affected hsCRP level and a strong association existed between hsCRP and abdominal obesity.

The distribution and influential factors of serum high sensitivity C-reactive protein in general population / 中华内科杂志

Objective To observe the distribution and influence factors of serum high sensitivity C-reactive protein (hs-CRP) in general population. Methods In a cross-sectional population survey, a total of 101 510 subjects who were employed by Kailuan Group had been carried out a healthy examination in the period of 2006 to 2007. In the statistical analysis, we observed 91 123 subjects (males 72 805, females 18 318) who had full information and met the inclusion criteria of the study. Results ( 1 ) The geometric means of hs-CRP were 0. 70 mg/L, 0. 70 mg/L and 0. 73 mg/L in all subjects, males and females,respectively, the 95th percentiles were 6.28 mg/L, 6.20 mg/L and 6.49 mg/L, respectively. The concentrations of hs-CRP increased with age in both males and females (P trend = 0. 001 ). Serum hs-CRP geometric mean was 0. 54 mg/L and the 95th percentile was 5.40 mg/L in health group, while the geometric mean was 0. 80 mg/L and the 95th percentile was 6. 57 mg/L in non-health group. (2) Multiple linear regression analysis showed that concentrations of hs-CRP were positively associated with gender, age,systolic blood pressure, body mass index, total cholesterol, triglycerides, fasting blood glucose, smoking history, history of coronary heart disease and stroke history, but concentrations of hs-CRP were inversely related with diastolic blood pressure, high-density lipoprotein cholesterol and alcohol history. Conclusion Serum concentrations of hs-CRP level increased with age, concentrations of hs-CRP were higher in females than males; a variety of cardiovascular factors effected the concentrations of hs-CRP.

Beat to beat analysis of morphological difference of ECG waveforms / 生物医学工程学杂志

Three different kinds of ECG data including the healthy, angina and myocardial infarction from the ECG database were analyzed to obtain the morphological difference sequence of their P-waves, QRS-wave and T-wave, and their RR interval sequences. Then the variability of these four sequences was analyzed by detrended fluctuation analysis (DFA) method. The results indicate that, the changing pattern in the DFA index of RR interval sequence from the healthy to the morbidity is different from those of the P-wave, QRS-wave and T-wave. The DFA indices of the RR interval sequence are about 1 in all three states, while the DFA indices of the other three sequences are about 0.5 in the healthy and all decrease from the healthy to morbidity.

Determination of optimal complexity for long ECG sequence / 生物医学工程学杂志

In this article is reported a study on the optimal complexity of the long electrocardiogram (ECG) signal. At first, the original signal sequence was symbolized, then its complexity was calculated by Lempel-Ziv algorithm, and different factors of the complexity were discussed, and three different kinds of ECG signals, i.e., normalcy, angina and myocardial infarction, were studied. The results indicate that the optimal threshold-value to symbolize the original signal and the optimal signal length are two main factors that affect the complexity value, and the optimal complexity value can effectively distinguish normal ECG and patients' ECG.