Characteristics of the sleep structures of patients with both chronic insomnia and obstructive sleep apnea in plateau area / 中华健康管理学杂志

Objective:To explore the characteristics of the sleep structures of patients with both chronic insomnia and obstructive sleep apnea (OSA) in plateau area.Methods:Polysomography Alice 5 was applied to 23 patients with primary chronic insomnia [insomnia group, age (48.2±9.9) years], 22 patients with both chronic insomnia and OSA [comorbidity group, age (46.8±8.9) years], who both came from Qinghai Red Cross Hospital between January, 2014 to June, 2015 and 20 subjects with normal sleep [healthy group, age (46.2±7.1) years] in plateau area (mainly in Xining, altitude 2 250 meters or above) to compare and explore their sleep structures by the whole night sleep monitoring in the sleep monitoring room. The sleep structures were compared according to the American Academy of Sleep Medicine (AASM) Manual for the Scoring of Sleep and Associated Events.Results:Compared to healthy group, insomnia group and comorbidity group both had significantly lower sleep efficiency [(62.4%±16.7%), (59.8%±16.0%) vs (80.9%±8.8%)], non-rapid eye movement (NREM) phase 2 sleep ratio [(37.9%±12.2%), (36.2%±12.5%) vs (49.7%±6.2%)] and rapid eye movement (REM) sleep ratio [(7.7%±4.0%), (6.5%±4.0%) vs (12.5%±4.6%)] (all P<0.05); comorbidity group had a significantly higher oxygen desaturation index than insomnia group and healthy group [(30.8±29.2) vs (7.9±7.5), (5.9±2.7) times/h] ( P<0.05); insomnia group′s sleep latency of NREM3 stage was significantly longer than comorbidity group and healthy group [(148.9±113.6) vs (89.3±51.8), (59.1±40.3) min] (both P<0.05). Conclusion:Patients with both chronic insomnia and OSA and patients with chronic insomnia only in plateau area have different sleep structures, and both of their sleep quality are lower than the people with normal sleep; patients with both chronic insomnia and OSA could enter deep sleep more quickly after sleep onset.

Enteric dysbiosis-linked gut barrier disruption triggers early renal injury induced by chronic high salt feeding in mice

Chronic high-salt diet-associated renal injury is a key risk factor for the development of hypertension. However, the mechanism by which salt triggers kidney damage is poorly understood. Our study investigated how high salt (HS) intake triggers early renal injury by considering the ‘gut-kidney axis’. We fed mice 2% NaCl in drinking water continuously for 8 weeks to induce early renal injury. We found that the ‘quantitative’ and ‘qualitative’ levels of the intestinal microflora were significantly altered after chronic HS feeding, which indicated the occurrence of enteric dysbiosis. In addition, intestinal immunological gene expression was impaired in mice with HS intake. Gut permeability elevation and enteric bacterial translocation into the kidney were detected after chronic HS feeding. Gut bacteria depletion by non-absorbable antibiotic administration restored HS loading-induced gut leakiness, renal injury and systolic blood pressure elevation. The fecal microbiota from mice fed chronic HS could independently cause gut leakiness and renal injury. Our current work provides a novel insight into the mechanism of HS-induced renal injury by investigating the role of the intestine with enteric bacteria and gut permeability and clearly illustrates that chronic HS loading elicited renal injury and dysfunction that was dependent on the intestine.

Visual function and morphological changes in the macular area of patients with type 2 diabetes mellitus after intensive insulin therapy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intensive insulin therapy has been found to lessen the progress of diabetic retinopathy (DR) to some extent, while it has also been implicated to be responsible for decrease of DR. We investigated visual function and morphological changes in the macular area in short-term follow-up of patients with type 2 diabetes mellitus after intensive insulin therapy.</p><p><b>METHODS</b>This was a prospective clinical study of nonproliferative DR patients (102 eyes, 120 patients) undergoing intensive insulin therapy. The Contrast Glare Tester (Takagi CGT-1000) was used to examine contrast sensitivity (CS) and Heidelberg Retina Tomograph (HRT) II and Stratus Model 3000 OCT were used to observe the changes of morphology in the macular area. Follow-up times were pre-intensive therapy, 3 and 6 months post-intensive therapy.</p><p><b>RESULTS</b>CS at low and middle frequencies was higher at 3 and 6 months post-therapy compared with pre-therapy (P < 0.05). Significant differences in CS at low frequency were found between 6 and 3 months post-therapy (P < 0.05). Macular edema index was lower in the first, second, and third rings of the macular area after intensive therapy compared with pre-therapy (P < 0.05). Compared with 3 months post-therapy, the macular edema index was lower in the first, second, and third rings of the macular area at 6 months post-therapy (P > 0.05). No significant differences in the thickness of the first, second, and third rings of the macular area were detected between 3 and 6 months post-therapy and pre-therapy (P > 0.05).</p><p><b>CONCLUSION</b>CS and macular edema indexes were significantly improved in nonproliferative diabetic retinopathy patients after intensive insulin therapy, but thickness of the macular area was unchanged.</p>

The influence of labor analgesia on maternal T-lymphocyte subsets / 中国基层医药

Objective To observe the subarachnoid space the epidural space joint block labor analgesia (CSEA) changes of T lymphocyte subsets.Methods 100 cases of full-term mothers were randomly divided into two groups,analgesia group and the control group.The analgesic group row CSEA childbirth analgesia.Two groups of maternal cervix large 2 to 3cm (T1),when the baby was delivered (T2),24h (T3),blood was colleoted after childbirth,detected by radioimmunoassay of cortisol.Flow cytometry assay was wsed to test T lymphocyte subsets CD3+,CD4+,CD8+,CD4+/CD8+,And the birth process,Apgar score,Labor pain visual analogue score (VAS) were recoroded.Results (1) Active phase of the first stage of childbirth analgesia group was significantly shorter than the control group (t =2.182,P ＜ 0.05).The second and third stage of Childbirth and neonatal Apgar score difference between the two groups was not statistically significant.(2)Serum cortisol concentration at T2 analgesia group was significantly lower that of than the control group (P ＜ 0.05).(3) The two groups in maternal blood of CD3+,CD4+,CD4+ / CD8+ were reduced to varying degrees,T3 was reduced significantly (P ＜ 0.05),Analgesia group was significantly lower than that of the control group (all P ＜ 0.05).Conclusion CSEA analgesia in Childbirth can shorten the first stage of Childbirth active period,has no significant effect on the Apgar score,can alleviate the pain and stress reactions such as the suppression of the maternal immune function.