Correlation analysis of cardiopulmonary exercise test indices and conditions of overweight patients with obstructive sleep apnea: a retrospective study

ABSTRACT BACKGROUND: The cardiopulmonary function of patients with obstructive sleep apnea (OSA) is significantly lower than that of patients with simple snoring and is significantly related to the severity of OSA. Currently, only a few studies have been conducted on cardiopulmonary exercise testing in overweight patients with OSA. OBJECTIVE: To analyze the correlation between cardiopulmonary exercise test (CPET) indices and the condition of overweight patients with OSA. DESIGN AND SETTING: Retrospective study in Guangdong Provincial Hospital of Chinese Medicine. METHODS: This study included 73 hospitalized overweight patients. The patients were divided into no, mild, moderate, and severe OSA groups. Differences in the CPET indices among the four groups were compared. The correlation between the CPET indices and conditions was analyzed. RESULTS: No, mild, moderate, and severe OSA groups had 18 men and 5 women, 11 men and 3 women, 12 men and 2 women, and 21 men and 1 woman, respectively (P > 0.05). No significant difference was observed in resting pulmonary function among the four groups (P > 0.05). In the CPET, the anaerobic threshold, maximum oxygen uptake, and oxygen pulse were significantly lower in the severe OSA group than those in the normal OSA group (P < 0.05). Moreover, CPET indices negatively correlated with the apnea-hypopnea index. CONCLUSION: Changes in CPET indices occurred earlier than changes in resting pulmonary function in patients with OSA. CPET might be a potential method for evaluating the severity of OSA combined with overweight status.

Correlation analysis of sleep behavior and overweight and obesity in junior high school students / 中国学校卫生

Objective@#To analyze the association between different sleep behaviors and overweight and obesity of junior high school students in Yangzhou City, and to provide a basis for policies and interventions related to adolescent health management.@*Methods@#A total of 1 589 students in grades 7-9 from two middle schools in Yangzhou City were selected using the cluster sampling method and were administered with sleep time, bedtime, social jetlag difference, and sleep habits.@*Results@#Totally 64.38% were sleep deprived during the school days, 86.78% went to bed too late, 46.51% had a social jetlag of ≥1 h, and 37.44% took a nap every day(Incluldes holidays and school days). Social jetlag length was statistically different between grades( F =6.97, P < 0.01 ). Girls[(0.95±0.65)h] shown significantly higher social jetlag than the boys[(0.76±0.59)h]( t=6.19, P <0.01). Later bedtime on weekends, later wake up time on weekends and poor sleep behavior were risk factors for overweight and obesity in junior high school students( OR=1.20, 1.14, 1.04, P <0.05).@*Conclusion@#Junior high school students had less sleep and later bedtimes with the increase of grade, and weekend bedtimes,wake up times and poor sleep behavior were independently associated with the risk of overweight and obesity in junior high school students. Parents and schools should be instructed to pay attention to their sleep health and carry out adolescent sleep health guidance.

Development of datasets for basic medical information system / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To develop dataset for basic medical information system.</p><p><b>METHODS</b>All items of basic medical information system dataset were drafted by literature review, brain storm and group discussion. A Delphi study was conducted to evaluate and adjust the candidate items; then items were finalized based on comprehensive scores.</p><p><b>RESULTS</b>The final dataset developed through two-round Delphi study contained 20 first-level items, 102 second-level items, 40 third-level items and 88 fourth-level items. The response rates were 71.79% and 92.86% in round 1 and 2, respectively. The authority coefficient was both 0.77 and the coordination coefficient of the specialists' opinion was 0.239 and 0.516, respectively.</p><p><b>CONCLUSION</b>The dataset for basic medical information system determined from Delphi study is credible and can be used for development of related software.</p>

Effects of apolipoprotein E genetic polymorphism on susceptibility of depression and efficacy of antidepressants / 中国医学科学院学报

<p><b>OBJECTIVE</b>To assess the effects of apolipoprotein E (APOE) polymorphism on the susceptibility of depression and the efficacy of antidepressants.</p><p><b>METHODS</b>A total of 275 patients with depression, who met the diagnostic criteria of both CCMD-3 and DSM-4, were randomly assigned into venlafaxine group (n=136)and paroxetine group(n=139). Another 202 healthy subjects were enrolled as the control group. Hamilton Rating Scale for Depression (HAMD)-17 was adopted as the primary rating instrument to evaluate the severity of depression on the baseline and the end of the 1st, 2nd, 4th, 6th week after treatment, respectively. HAMD scores ≤7 was defined as remission, and the reduction of HAMD scores ≥50% was defined as response while <50% was defined as invalid. PCR-restriction fragment length polymorphisms (PCR-RFLP) was applied to detect the genetic polymorphism of the APOE in the case groups and control group.</p><p><b>RESULTS</b>In the venlafaxine group, the remission rate was 52.9%(n=72), the response rate was 26.5%(n=36), and the invalid rate was 20.6%(n=28), whereas the corresponding data in the paroxetine group wee 42.4%(n=59), 31.7%(n=44), and 25.9% (n=36), respectively. There were no significant differences in the efficacy between the two groups(p>0.05). In the venlafaxine group, there were no significant differences in the genotypes and the allele distribution frequency of APOEΕ2/Ε3/Ε4 between the remitters, nonremitters, and healthy controls at the end of the 6th week(p>0.05), but there was significant differences in the allele distribution frequency between the nonremitters and healthy controls(p=0.02). In paroxetine group, there were no significant differences in the genotypes and the allele distribution frequency of APOEΕ2/Ε3/Ε4 among the remitters, nonremitters and healthy controls at the end of the 6th week(p>0.05), but there were significant differences in the allele distribution frequency between the nonremitters and healthy controls (p=0.04); in addition, there were also significant differences in Ε2/Ε3 and Ε4 allele between the two groups (p=0.014).</p><p><b>CONCLUSIONS</b>The APOE gene may not play a major role in the pathogenesis of major depression. The efficacy of venlafaxine is same as paroxetine after treatment for six weeks. The APOE (Ε2+Ε3) allele may be an indicator of the bad efficacy of paroxetine treatment.</p>

Comparison of mail and meeting forms in evaluation of Delphi study / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate and compare mail and meeting forms in evaluation of Delphi study.</p><p><b>METHODS</b>Delphi study by mail and meeting approaches was used to determine the health information dataset. Experts were required to grade the listed items through three indexes: importance, necessity and availability. Study duration, coefficient of variation of items, authority coefficient and coordination coefficient of the experts' opinion of two forms of study were calculated and compared.</p><p><b>RESULT</b>The study duration was four months through mail form and 2 days through meeting. Compared with the first round, the coefficient of variation decreased (P<0.001, all of the three indexes by two forms), and the cooperation index increased (P<0.005) in the second round. The experts' opinions were easier to be consistent through meeting than through mail(P<0.033). And the authority coefficient by meeting consultation (0.83 ± 0.05) was higher than that by mail (0.77 ± 0.03) (P=0.001).</p><p><b>CONCLUSION</b>Both mail and meeting forms of Delphi study can determine the health information dataset,but meeting consultation is better and requires shorter study duration.</p>

Gene polymorphisms of Toll-like receptors in Chinese Han children with sepsis in Wenzhou / 中华儿科杂志

<p><b>OBJECTIVE</b>Sepsis remains a serious clinical problem because of high morbidity and mortality. The importance of Toll-like receptors (TLRs) for the induction of immune responses against sepsis was demonstrated in humans. The present study aimed to probe the gene polymorphisms of TLR4 (Asp299Gly and Thr399Ile) and TLR2 (Arg753Gln) in patients with sepsis among Chinese Han children in Wenzhou, and investigate the correlation with sepsis.</p><p><b>METHOD</b>This study was conducted as a case-control study. Using polymerase chain reaction and DNA sequencing, gene polymorphisms of TLR4 (Asp299Gly and Thr399Ile) and TLR2 (Arg753Gln) in 59 children with sepsis, 38 children with severe sepsis (including 20 septic shock) and 57 healthy controls were analyzed. Hardy-Weinberg method of statistics was used to compare the frequency of genotypes alleles among three groups.</p><p><b>RESULT</b>The mutant genotypes of TLR4 gene (Asp299Gly and Thr399Ile) were not found among sepsis, septic shock and control groups. In severe sepsis group, the Arg753Gln TLR2 polymorphism occurred in 2 out of 38 severe sepsis patients and both of the subjects with the TLR2 Arg753Gln polymorphism had fatal staphylococcal infections.</p><p><b>CONCLUSION</b>TLR4 gene (Asp299Gly and Thr399Ile) polymorphisms may not be correlated with susceptibility to sepsis among Chinese Han children in Wenzhou. The fact that only 2 out of 38 severe sepsis patients had Arg753Gln TLR2 polymorphism suggests that a larger sample size is needed because of the rarity of the TLR2 allele among Chinese Han children in Wenzhou.</p>

Study on the incidence of β-Thalassemia and genotypes among children under 7 year-olds in Nanning, Liuzhou and Baise areas, Guangxi province / 中华流行病学杂志

Objective To conduct research of β-Thalassemia incidence and genotypes on children below 7 years of age in Nanning, Liuzhou and Baise areas, Guangxi province. Methods A total of 2261 children aged below 7 in Nanning, Liuzhou and Baise areas were studied. Venous blood was detected by routine blood test, hemoglobin analysis and β-Thalassemia genotyping. Results Among 2261 samples, 125 showed high level of HbA2 and were diagnosed as β-Thalassemia (5.53%). Genotypes of the patients were classified as: 59 cases with β-globin gene eondon (CD) 41-42 mutation, 33 cases CD17 mutation, 18 cases with TA TA box nt-28 mutation, 7 with IVS-Ⅱ-654 mutation, 3 with CD43 mutation, 3 with HbE mutation, one with CD71-72 and TATA box nt-29 mutation, respectively. The genotyping frequencies of β-Thalassemia were as follows: 47.20% for CD41-42 mutation, 26.40% for CD17 mutation, 14.40% for TATAbox nt-28 mutation, 5.60% for IVS-Ⅱ -654 mutation, 2.40% for CD43 mutation, 2.40% for HbE mutation, 0.80% for CD71-72 mutation and TATAbox nt-29 mutation respectively. Conclusion This study on children in the area with high incidence of β-Thalassemia reflected the incidence and characteristics of genotypes in this area. Our data also provided evidence for the development of a program on genetic counseling and prevention for thalassemia.

A comparative study on mental health among students and adults in the earthquake-hit areas / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand mental health status of the students and adults in the earthquake disaster areas, as to providing guidance on intervention for post-disaster psychological crisis.</p><p><b>METHODS</b>The Self-Reporting Questionnaire (SRQ-20), an appendix of The Ministry of Health of "emergency psychological crisis intervention guiding principles", was used among 1222 victims in Wenchuan earthquake, Sichuan province. This questionnaire survey was conducted in 729 students and 493 adult victims in a randomized method. Of the 734 questionnaires distributed and received in students, 729 were validly responded with efficiency rate of 99.32%; while for adults, 496 questionnaires distributed, 496 received, 493 were valid with efficiency rate of 99.39%.</p><p><b>RESULTS</b>(1) In students victims, 65% responded that they did feel "uneasy, nervous or worried", followed by "easy to be scared", "feel unhappy", "easy fatigue" and "hard to make a decision". For adult victims, 80.5% replied that they felt "uneasy, nervous or worried", followed by "feel unhappy", "easy fatigue", "difficult sleeping", "easy to be scared". (2) The average of the SRQ score of student victims was 6.58 +/- 3.99, and 6.07 +/- 4.02 for males, 7.03 +/- 3.91 for females. The average of the SRQ score of student victims was 7.36 +/- 3.98, male 6.68 +/- 3.82, female 7.99 +/- 4.03. The significant differences (t(women) = 2.985, P < 0.01; t(total) = 3.332, P < 0.01) was observed in women and the total group of students and adults. (3) The SRQ positive screening rate of students group was 46.50%, the adult group was 52.33%, SRQ >or= 7 points and SRQ < 7 sub-group of students and adults of the total score there were significant differences (t(1) = 39.771, P < 0.01; t(2) = 31.961, P < 0.01). SRQ >or= 7 sub-group of students and adult women in between there was a significant difference (t = 23.641, P < 0.01), SRQ < 7 sub-group of students and adults in general and women there were significant differences (t(1) = 3.092, P < 0.01; t(2) = 2.911, P < 0.01). (4) SRQ scores with gender and age had had a positive relation (r(SRQ total-sex) = 0.118, P = 0.000; r(SRQ total-age) = 0.103, P = 0.000).</p><p><b>CONCLUSION</b>The emotional suffering symptoms of students victims and adult victims should be "nervous, unhappy, vulnerable on issues such as fatigue", the adult group had a higher symptom rate than the group of students, the mental health was more serious than that of students, as influenced by some factors including age and gender. Students, being a special population group should be paid more attention to focusing a designated behavior intervention, as a planned manner of intervention.</p>