The efficacy of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) plus radiotherapy in the treatment of lung adenocarcinoma patients with central nervous system metastases: a meta-analysiss / 中国医师杂志

Objective:To systematically evaluate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) combined with radiotherapy in the treatment of lung adenocarcinoma with central nervous system (CNS) metastasis.Methods:PubMed, EMBASE, Medline, Cochrane Library, clinical trials and other databases were searched to collect the clinical control studies of EGFR-TKI combined with radiotherapy versus EGFR-TKI or radiotherapy alone in the treatment of lung adenocarcinoma with CNS metastasis published at home and abroad from January 2012 to April 2019. After evaluating the data, Revman 5.3 software was used for meta-analysis.Results:10 studies involving 1 379 participants were included. The results indicated that compared with EGFR-TKI or radiotherapy alone, EGFR-TKI plus radiotherapy had a significant benefit on overall response rate (ORR) [ OR: 3.81, 95% CI(1.73, 8.39); P<0.01], overall survival (OS) [ HR: 0.60, 95% CI(0.41, 0.89); P=0.01], neurological progression free survival (nPFS) [ HR: 0.65, 95% CI(0.46, 0.91); P=0.01] compared with EGFR-TKI or radiotherapy alone. Conclusions:EGFR-TKI plus radiotherapy had better ORR, OS, nPFS compared with TKI or radiotherapy alone.

Correlation between the oxygen desaturation rate and blood pressure among patients with severe obstructive sleep apnea syndrome and the possible mechanism / 中华健康管理学杂志

Objective:To investigate the association between oxygen desaturation rate and blood pressure (BP) among severe obstructive sleep apnea syndrome (OSAS) and the possible mechanism.Methods:Patients with snoring were enrolled from the Department of Sleep Medicine Center, the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University form March 2018 to January 2019 and underwent polysomnography (PSG). Noninvasive BP and Heart rate variability were full-night monitored continuously and synchronized with PSG. Based on the PSG results and exclusion criteria, a total of 86 severe OSAS patients were enrolled in this study and divided into two groups according to the ambulatory BP measurements: hypertensive group ( n=44) and normotensive group ( n=42). Oxygen desaturation rate was expressed as the change in the percentage of pulse oxyhemoglobin saturation (SpO 2) per second during desaturation events after the obstructive apnea events occurred. The PSG parameters were compared between the two group and the multiple regression analyses were used to explore the association between oxygen desaturation rate and BP and its possible mechanism. Results:The apnea-hyperpnoea index (AHI) and respiratory event-related arousals (RERAs) were significantly higher in hypertensive group than those in normotensive group [(69.8±18.2) vs. (56.5±13.9) event/h; (40.5±17.4) vs. (30.2±14.6) event/h, both P<0.01]. In addition, hypoxia exposure conditions in the hypertensive group were more severe than those in the normotensive group, especially oxygen desaturation rate [(0.45±0.14)%/s vs. (0.33±0.10)%/s, P<0.001]. After adjusting for age, sex, neck circumference, waist circumference, smoking, drinking, the regression analyses showed that only the oxygen desaturation rate was significantly associated with both awake and asleep BP in OSAS patients ( β=0.473, 0.478, both P<0.01) and the correlation analyses suggested that the oxygen desaturation rate was related to the both awake and asleep sympathetic-parasympathetic imbalance ( r=0.367, 0.337, both P<0.01). Conclusion:Oxygen desaturation rate is closely related to BP levels in patients with severe OSAS, and the underlying mechanism is associated with the increased sympathetic activity.

Superoxide dismutase 2 mediates the protective effect of berberine on neuronal damage induced by oxygen-glucose deprivation in HT22 mouse hippocampal neuronal cell / 国际脑血管病杂志

Objective To investigate the protective effect of berberine (BBR) on neuronal damage induced by oxygen-glucose deprivation (ODD) in HT22 mouse hippocampal neuronal cell,and the role of superoxide dismutase 2 (SOD2) in it.Methods HT22 cells were exposed to OGD for 4 h and then reoxygenated for 24 h to simulate ischemia-reperfusion injury.The HT22 cells were divided into control group,OGD group,BBR + OGD group,SOD2-siRNA + BBR + OGD group,and scrambled (SC)-siRNA + BBR + OGD group.Cell viability was measured by thiazole blue method.Cell morphology was observed by phase contrast microscopy.Medium lactate dehydrogenase (LDH) level,intracellular glutathione (GSH),and catalase (CAT) content were detected by colorimetric assay.The cell apoptosis rate was detected by flow cytometry.The expression level of cleaved caspase-3 was detected by Western blot analysis.Results Compared with the control group,OGD significantly decreased cell viability,intracellular GSH,and CAT level (all P ＜0.05),increased cell LDH release,apoptosis rate,and cleaved caspase-3 protein expression level (all P＜0.05).At the same time,cell morphology destruction was observed.BBR significantly reduced the above damage of HT22 cells induced by OGD (all P ＜0.05),while SOD2-siRNA significantly reversed the protective effect of BBR on HT22 cells (all P ＜0.05).Conclusions BBR significantly alleviated neuronal damage induced by recovery of oxygen-glucose after OGD.SOD2 might mediate its protective effect.

Effects of continuous positive airway pressure treatment on patients of obstructive sleep apnea syndrome accompanying with asthma / 中华全科医师杂志

Objective To investigate effects of continuous positive airway pressure (CPAP)treatment on pulmonary function, frequency of asthmatic attack, and quality of life in patients of moderate to severe obstructive sleep apnea syndrome (OSAS) accompanying with asthma. Methods Twenty-three patients of OSAS accompanying with mild-to-moderate asthma were studied. They were divided into two groups, gastroesophageal reflux ( GER ) group ( n = 9 ) and non-GER group ( n = 14 ), based GER questionnaire score equal to or greater than 12, or less than 12. Pulmonary function tests (PFTs), Epworth sleepy score (ESS), quality of life for obstructive sleep apnea (QOLAp) score, quality of life for asthma (QOLAs) score and polysomnography (PSG) were measured for all the patients before and after four-week CPAP, respectively. Results No significant difference in PFTs was revealed before and after four-week CPAP between the two groups. However, there was significant difference in scores of QOLAp, ESS and QOLAs before and after four-week CPAP treatment, ( 12. 8 ± 2. 8 ) and (4. 6 ± 0. 9), ( 5. 1 ± 0. 7 ) and (6.3 ±0.6), and (4. 1 ±0.5) and (6.3 ±0.5) in GER group, and (13.0 ±2.9) and (4.6 ± 1.1),(4.7±0.5) and (5.6±0.6), and (3.6±0.3) and (5.8 ±0.6) in non-GER group, respectively (P＜0. 01 or 0. 05). Frequencies of asthmatic attack and nocturnal asthmatic attack reduced to ( 1.7 ± 1.1 )episodes per week and (0. 7 ± 0. 3) episodes per week after four-week treatment from (2. 9 ± 2. 0) episodes per week and ( 1.4 ± 0. 8) episodes per week before treatment ( P ＜ 0. 05 ) in GER group, but no significant difference was found before and after treatment in non-GER group. Scores of QOLAs increased more significantly in GER group than that in non-GER group ( P ＜ 0. 05 ). Conclusion CPAP treatment can significantly improve quality of life, rather than pulmonary function, in patients of OSAS accompanying with asthma, especially in those with GER symptoms.

Spectral analysis of breath sounds in asthmatics and chronic asthmatic bronchitis during acute episode / 医学研究生学报

0.05). However, during episode the inspiratory frequencies in patients with chronic asthmatic bronchitis〔PF=(176.68 ?36.84)Hz,Q 25% =(171.32?32.64)Hz,Q 50% =(229.69? 31.87 )Hz,Q 75% =(382.36? 55.21 )Hz, respectively〕 was significantly lower than that in asthmatics 〔PF=(354.21?67.58)Hz,Q 25% =( 286.42 ? 53.68 )Hz,Q 50% =(386.77?74.18)Hz,Q 75% =(554.68?84.72)Hz,respectively, P

Effect of 15-deoxyspergualin on coronary arteriosclerosis and platelet-derived growth factor-A mRNA expression in transplanted heart / 中华器官移植杂志

Objective To investigate the effect of 15-deoxyspurgualin (DSG) on graft coronary arteriosclerosis (GCA) and the platelet-derived growth factor-A (PGDF-A) mRNA expression of graft myocardium after heterotopic heart transplantation and the possible mechanism. Methods The rat heterotopic heart transplantation model was developed. Two groups of Lewis rats ( n =7 in each group) underwent heterotopic heart transplantationin from Wistar-King donors and were treated with either DSG (5 mg/kg daily, DSG group) or cyclosporine A (10 mg/kg daily, control group). Histological examinations of rejection and coronary arteriosclerosis, as well as Northern blot analysis of graft PDGF-A mRNA expression were made 60 days after transplantation. Results No significant difference in the degree of rejection was found between the two groups. However, the degree of coronary arterial intimal thickening in the DSG group was significantly less than that in the control group ( P

The pathogenesis of Chlamydia pneumoniae-type pneumonitis in mice / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate mice as experimental animals for Chlamydia pneumoniae (C. pneumoniae) infection and investigate the pathogenesis of C. pneumoniae derived pneumonitis.</p><p><b>METHODS</b>Icr mice were inoculated with the C. pneumoniae strain, CWL-029, either intranasally or intravenously. After a single dose inoculation, mice were killed on the 1st, 3rd, 7th, 14th, 21st, 28th and 60th days. The pathological changes in lung tissue were analyzed.</p><p><b>RESULTS</b>The Icr mice were shown to be susceptible to C. pneumoniae. Inoculation into mice with C. pneumoniae induced a prolonged course of lung infection, as demonstrated by persistence of lung pathology (up to 60 days). Via intranasal inoculation of mice, lung pathology was characterized by patchy interstitial pneumonitis with predominantly neutrophil leukocyte infiltration early (within the first 7 days) and lymphocyte infiltration in the later stages (14 days later) of infection. After intravenous inoculation, a similarly developed interstitial pneumonitis was observed, but it was milder and patchier, especially in early stages. C. pneumoniae DNA was detected by polymerase chain reaction (PCR) intermittently in the lung tissue. Inoculated mice developed serum IgG antibody responses.</p><p><b>CONCLUSION</b>The Icr mice were susceptible to C. pneumoniae, resulting in a pulmonary infection characterized by interstitial pneumonitis, occurring most strongly via intranasal inoculation.</p>

Effect of continuous positive airway pressure treatment on elderly Chinese patients with obstructive sleep apnea in the prethrombotic state / 中华医学杂志(英文版)

<p><b>OBJECTIVES</b>To characterize the prethrombotic state (PTS) in elderly Chinese patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and the effect of nasal continuous positive airway pressure (nCPAP) ventilation on their PTS.</p><p><b>METHODS</b>Forty-one elderly patients with moderate and severe OSAHS were enrolled into the OSAHS group and underwent nCPAP treatment. Their blood samples were drawn at 6:00 am and 4:00 pm before and during nCPAP treatment, respectively, to test hemocrit, platelet aggregation (PAG), whole blood viscosity (WBV), plasma fibrinogen (fng), prothrombin time (PT) and activated partial thromboplastin time (APTT). All blood factors were also tested in a control group consisting of 32 healthy elderly Chinese with neither OSAHS nor cerebrocardiac vascular disease.</p><p><b>RESULTS</b>In the OSAHS group there was a significantly higher hemocrit, WBV, fng, and a significantly shorter PT and APTT at 6:00 am compared to 4:00 pm before nCPAP treatment, while there was no significant difference among all blood test factors between 6:00 am and 4:00 pm on day 30 of the nCPAP treatment. In the OSAHS group, the hemocrit, WBV, PAG and plasma fng were significantly lower and the PT and APTT were significantly longer at 6:00 am on day 30 of the nCPAP treatment compared to 6:00 am before the nCPAP treatment. A significantly lower hemocrit, but a much longer PT and APTT were observed at 4:00 pm on day 30 of the treatment, compared with 4:00 pm before the treatment. No significant difference among the blood test factors was found between 6:00 am and 4:00 pm blood in the control group or between the control and OSAHS groups after 30 days of nCPAP treatment.</p><p><b>CONCLUSION</b>In elderly Chinese OSAHS patients, PTS could be effectively eliminated by nCPAP treatment.</p>

Relationship between sleep apnea hypopnea syndrome and cardiovascular events in elderly Chinese snorers / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the relationship between sleep apnea hypopnea syndrome (SAHS) and some cardiovascular abnormalities in elderly snorers, as well as the effectiveness of nasal continuous positive airway pressure on those with SAHS.</p><p><b>METHODS</b>With the use of polysomnography, 73 elderly snorers (older than 60 years) were examined and placed into either the SAHS group or the control group. Using ambulatory electrocardiogram (ECG) and blood pressure measurement, daily nocturnal rhythm of blood pressure, hypertension, heart rate variability, some arrhythmia and angina pectoris of coronary heart disease (CHD) were monitored and compared between the two groups before and after 5 - 7 days of treatment with nasal continuous positive airway pressure on the SAHS group.</p><p><b>RESULTS</b>This study indicated a higher incidence (47.9%) of sleep apnea syndrome in elderly snorers and demonstrated that there was a significantly higher incidence of hypertension, disappearance in daily nocturnal rhythm of blood pressure, poor effectiveness of nitrate on angina pectoris of coronary heart disease, decreased heart rate variability during sleep, increased arrhythmia and lower pulse oxygen saturation (SpO(2)) levels in the SAHS group than in the control group. After nasal continuous positive airway pressure treatment during sleep, snoring control, significantly higher SpO(2) levels and lower index of apnea/hypopnea were achieved in the SAHS group; heart rate variability (HRV) and blood pressure day nocturnal rhythm were returned to normal levels.</p><p><b>CONCLUSION</b>This research suggests that there is a close relationship between the development of sleep apnea syndrome and some cardiovascular diseases. Continuous positive nasal airway pressure is effective not only on SAHS but also on coexisting cardiovascular disorders.</p>

Assessment of polymerase chain reaction and serology for detection of chlamydia pneumoniae in patients with acute respiratory tract infection / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To study Chlamydia pneumoniae (C. pneumoniae) infection in 110 patients with respiratory tract infection admitted to our hospital from January to December 1995 in Nanjing.</p><p><b>METHODS</b>Sputum and throat swab specimens were taken and C. pneumoniae DNA was detected by using polymerase chain reaction (PCR) with the HM-1-HR-1 primer pair. At the same time, serum samples were taken and immunoglobulin G and M (IgG and IgM) fractions of antibodies to C. pneumoniae were studied by microimmunofluorescence test.</p><p><b>RESULTS</b>Prevalence of specific IgG was 70% in patients with respiratory tract infection. Seventeen patients (15.5%) were serologically diagnosed as having recent C. pneumoniae infections and 12 patients (10.9%) had positive PCR in sputum and/or swab specimens. The total positive rate was 22.7% (25/110) detected by PCR combined with serological tests. Acute infection of C. pneumoniae was common in patients with asthma (57.1%), pneumonia (35.0%), COPD (25.9%) and bronchitis (25.0%). Clinical features between C. pneumoniae infection and non-C. pneumonia infection showed no significant differences.</p><p><b>CONCLUSIONS</b>Chlamydia pneumoniae is an important pathogen that causes infection of the human respiratory tract and attention should be drawn to this special illness.</p>

Changes of pulmonary malondialdehyde ,glutathione and total-antioxidation content in SD rat with nitrogen dioxide exposure / 医学研究生学报

Objectives:To evaluate lung injury mechanism in SD rat with nitrogen dioxide(NO2) exposure. 　Methods:In the test-control study, pulmonary malondialdehyde(MDA),glutathione(GSH) and total-antioxidant content(T-AOC) were determined in 10 SD rats with long-term NO2 exposure,10 SD rats with short-term NO2 exposure and 10 SD rats with fresh air as control. 　Results: Pulmonary MDA content was increased and T-AOC was decreased significantly in SD rat exposed to NO2. Pulmonary GSH was decreased significantly in long-term NO2 exposure group as compared with short-term NO2 exposure group and control group. 　Conclusions: Imbalance between oxidant and antioxidant was an important mechanism in the pathogenesis of oxidizing lung injury in SD rat with NO2 exposure.

Interpretation of "the expert consensus on sleep apnea and cardiovascular diseases" / 中国实用内科杂志

This paper introduces the concensus on the relationship between sleep apnea and cardiovascular disease reached by experts with corresponding backgrounds from Chinese Medical Association.The relationship is that of sleep apnea with hypertension,coronary artery disease,arrhythmias,and congestive heart failure,and the relationship can improve the diagnosis and treatment of these two types of diseases.

Craniofacial morphological changes induced by a mandibular repositioning oral appliance and their significance / 医学研究生学报

Objectives: To identify any craniofacial morphological changes induced by a mandibular-repositioning oral appliance (MRA) and to explore the possibility of predicting the treatment response to MRA by cephalometric analysis in patients with obstructive sleep apnea (OSA). Methods: Seventy OSA patients [male/female: 63/7; age: (50.5±11.6) years; BMI: (27.6±4.6) kg/m2; AI: (34.9±21.3) episodes/hour; and oxygen saturation nadir: (66.3±16.5) %] were enrolled. MRA was fabricated individually for each patient after the consultation by a dentist. Polysomnographic (PSG) examination was repeated with MRA in place 3 months after the initiation of the MRA therapy. For cephalometric analysis, a pair of cephalograms of each patient was obtained, one with and another without MRA. Results and Conclusions: After 3 months' treatment, AI was (156±19.2) episodes/hour, significantly reduced compared with the pre-treatment average AI (34.9±21.3 episodes/hour,P<0.000 1). Oxygen saturation nadir improved from (66.3±16.5)% (pre-treatment) to (74.1±15.5)% (with MRA) (P<0.001). A reduction of AI≥50% was achieved in 42 patients. Insertion of MRA led to anterior shift of the mandible, increase in upper airway width and area and decrease in upper airway length. Those with evident retrognathia and longer anterior upper facial height were more likely to benefit from the MRA management.

Synthetic Treatment of the Ⅲa Stage of Non-small-cell Lung Cancer byCombining Chemotherapy of Bronchus Artery Instillation and Radiotherapy of Line Accelerator / 实用放射学杂志

Objective To make an inquiry into the feasibility and clinical effect of treating the Ⅲa stage of non-small-cell lung cancer(NSCLC)by combining chemotherapy of bronchus artery instillation and radiotherapy of line accelerator.Methods 76 cases of patients with NSCLC were randomly divided into two groups of A and B.Chemotherapy of bronchus artery instillation (BAI) was exerted twice to group A first,then radiotherapy (RT) of line accelerator was followed one～two weeks later after completing the second BAI;Group B was simply performed two times of BAI (contrast group).Results Clinical curative effect of group A (BAI+RT) and group B (BAI) were respectively 89.47% and 60.53% (?

Effects of artificial cardiopulmonary bypass on P(a-E~1)CO_2 / 第三军医大学学报

The difference between the arterial and the end-tidal carbon dioxide tension [P(a-E1)CO2] was observed before and after cardiopulmonary bypass(CPB)was performed in 34 patients,who were divided into 3 groups according to the duration of CPB.It was found that there was an increase of P(a-E1)CO2 after CPB in all the patients and the increase was more significant in Group C(CPB duration of 158 to 186 minutes)than in Group A(CPB duration of 82 to 106 minutes)(P