RESUMO
Objective To study the incidence of hypertension in patients with different severity of obstructive sleep apnea hypopnea syndrome(OSAHS) and to observe the effects of short-term continuous positive airway pressure (CPAP) treatment on hypertension in patients with hypertension Ⅲ complicated with OSAHS.Methods According to sleep apnea hypopnea index (AHI) and the lowest oxygen saturation value at night,184 patients with OSAHS were divided into mild group(n =55),moderate group(n =63) and severe group(n =66).We observed the incidence of hypertension among patients and their mean systolic and diastolic blood pressures before sleep and after wakening.There were 46 patients with severe OSAHS combined with hypertension Ⅲ received short-term (at least 7 days) CPAP treatment.We observed and analyzed the effect of CPAP on blood pressure values.Results In the 184 cases,incidence of hypertension of the three groups were 36.4％ (20/55),42.9％ (27/63) and 62.1％ (41/66) respectively.The incidence of hypertension in OSAHS patients was significantly higher in the severe group than in the moderate group (x2 =4.799,P ＜ 0.05) and the mild group(x2 =7.962,P ＜ 0.05).There were significant differences among mild,moderate and severe OSAHS patients in mean systolic and diastolic blood pressures before sleep Systolic ((135.08 ± 6.71) mm Hg vs.(136.59 ± 15.14) mm Hg vs.(144.73 ± 15.80)mm Hg,F =4.202,P ＜0.05) and Diastolic((90.96 ±6.06)mm Hg vs.(91.41 ± 4.05) mm Hg vs.(94.13 ± 13.97) mm Hg,F =13.690,P ＜ 0.05)) and after wakening Systolic((136.83 ± 8.23) mm Hg vs.(137.89 ± 17.03)mm Hg vs.(148.59 ± 14.83) mm Hg,F =4.158,P ＜0.05) and Diastolic((91.25 ± 9.96) mm Hg vs.(93.40 ± 8.82) mm Hg vs.(98.75 ± 9.39) mm Hg,F =5.638,P ＜0.05)).Severe OSAHS patients had significantly higher systolic and diastolic blood pressures after wakening than before sleeping (P ＜ 0.05).The changes of blood pressure had significant difference after CPAP treatment than before CPAP treatment (Systolic:(175.09 ± 9.66) mm Hg vs.(168.22 ± 8.55)mm Hg,t =3.556,P＜0.05;Diastolic:(105.82 ± 12.44) mm Hg vs.(100.61 ± 11.26) mm Hg,t =2.741,P ＜0.05).Conclusion OSAHS and hypertension are closely related to each other.CPAP is an effective treatment to OSAHS combined with hypertension.
RESUMO
Objective To evaluate the efficacy and safety of tulobuterol patch in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) in the elderly. Methods Totally 165 elderly patients with moderate to severe AECOPD were divided into trial group and control group randomly.83 patients of trial group were treated with tulobuterol patch,2 mg once a day,and fluticasone inhalation 250 μg twice a day; 82 patients of control group were treated with inhalation of salmeterol/fluticasone 250 μg/50 μg twice a day.Basic therapy was the same in two groups. Results After 10-14 days' treatment,forced expiratory volume in one second(FEV1),peak expiratory flow (PEF),6-min walking distance and symptom scores were ( 1.30 ± 0.31 ) L,(245.3 ± 56.1 ) L/min,(263.0±53.2)m,(33.2±12.1)scores in trial group,and (1.21±0.23)L,(213.9±58.4) L/min,(230.0±45.6)m,(37.8± 14.5) scores in control group,respectively.The lung function,6 minute walk distancc and symptom score were improved (t=2.120,3.521,4.279,2.212,all P＜0.05).The frequencies of rescue medication,waking-up suffocating at night and the days of hospital stay were deceased significantly in trial group as compared with control group[(2.5 ± 0.6) time/d,( 1.8 ± 0.5)time/week,(12.9±1.6)dvs.(2.90.8) time/d,(2.2±0.7) time/week,(14.1±1.8) d,t=3.610,4.219,4.524,all P＜0.05].The incidence of adverse reactions was not significant difference between two groups[8 cases(9.6％)vs.7 cases(8.5％),P＞0.05] and the adverse reactions were mild.Conclusions Tulobuterol patch is a newly formulated,effective and safe medication for the treatment of acute exacerbation of AECOPD.
RESUMO
Objective To investigate the effects of tumor necrosis factor-α ( TNF-α ) on the resensitization of human lung cancer cell lines A549/DDP to cisplatin (DDP) and to explore the relationship between the expression of TNF-αand resistance-related protein (LRP) in lung tissue.Methods The cytotoxic effects of combinational treatment by TNF-α and cisplatin on A549/DDP were measured by MTT assay.The expression of LRP was assessed by immunocytochemistry methods.Results The IC50 of A549/DDP to cisplatin were decreased from 7.12 ng/L to 5.02 ng/L,4.41 ng/L respectively by 250 U/ml and 1000 U/ml TNF-α treatment ( P ＜ 0.01 ),with the sensitivity of A549/DDP to cisplatin increased by 1.42 and 1.62 fold respectively.LRP was overexpressed in A549/DDP cell.250 U/ml or 1000 U/ml TNF-α plus cisplatin treatment down-regulated the expression of LRP with the positive rates of ( 60.14 ± 6.54 ) ％ and ( 57.23 ± 5.98 ) ％respectively,which were significantly lower than that of cisplatin alone treatment ( 75.97 ± 5.32 ) ％ and control group (79.63 ± 4.78 ) ％ ( both P ＜ 0.01 ).Conclusion Tumor necrosis factor-α can reverse the resistance of A549/DDP to cisplatin,which may be partially attributed to down-regulating LRP expression.