Obstructive sleep apnea and metabolic syndrome: an association study based on a large sample clinical database / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the prevalence and associated risk factors of metabolic syndrome (MS) in patients with obstructive sleep apnea (OSA). Methods: From July 2007 to June 2017, a total of 8 155 adult subjects, including 6 484 males and 1 671 females, aged 18-90 (43.13±12.28), body mass index 14.61~59.56 (25.59±3.98) kg/m2,who were admitted to the Department of Otorhinolaryngology head and Neck surgery of The Sixth People's Hospital affiliated to Shanghai Jiao Tong University, were retrospectively analyzed. All patients underwent polysomnography and biochemical tests. Subjects were divided into four groups (non-OSA, mild OSA, moderate OSA, and severe OSA) according to OSA severity. The prevalence of MS was expressed as percentage, and the correlation between OSA and MS and its characteristic pathophysiological indicators was evaluated by logistic regression model after adjusting for factors such as gender, age, BMI, neck circumference, hip circumference, smoking and alcohol consumption, and was expressed by odds ratio (OR). SPSS 25.0 software was used for statistical analysis. Results: The overall prevalence of MS was 43.6%, and that of non-/mild/moderate/severe OSA group was 18.6%, 30.4%, 43.8%, 57.1%.Logistic regression showed that patients with mild/moderate/severe OSA had an increased risk of MS compared with non-OSA patients, with adjusted OR values and confidence intervals of 1.27 (1.05-1.54), 1.84 (1.53-2.22), and 2.08 (1.76-2.46), respectively (P<0.01).In addition, indicators of OSA anoxic burden [oxygen drop index(Toxygen=7.1), minimum blood oxygen(Tminimum=56.3), blood oxygen saturation below 90% cumulative time ratio (TCT90=10.6) ]were closely associated with MS disease(P<0.01), but sleep fragmentation index (arousals index) was not significantly associated with MS disease. Conclusion: The risk of MS gradually increases with the severity of OSA, and the indicators reflecting OSA hypoxia burden are closely related to MS disease.

Efficacy of Han-uvulopalatopharyngoplasty (HUPPP) combined with radiofrequency ablation of tongue base or HUPPP with traction of tongue base on moderate to severe patients with obstructive sleep apnea hypopnea syndrome (OSAHS):a multicenter randomized controlled trial / 中华耳鼻咽喉头颈外科杂志

Objective: To compare the therapeutic efficacy of Han-uvulopalatopharyngoplasty (HUPPP) combined with radiofrequency ablation of tongue base or HUPPP with traction of tongue base on moderate to severe patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: This is a multicenter randomized controlled trial. From March 2017 to July 2019, moderate to severe OSAHS patients from three clinical center in Shanghai who were intolerant to continuous positive airway pressure (CPAP) and with velopharyngeal and glossopharyngeal plane obstruction were enrolled in this study. According to the surgical type, they were 1∶1 randomized to HUPPP plus radiofrequency ablation of tongue base group (Ablation group) or HUPPP plus traction of tongue base group (Traction group). All patients completed over-night standard Polysomnography (PSG), upper-airway assessment (Friedman classification, Müller test, CT and cephalometric examination), preoperative routine examination, Epworth Sleepiness Scale (ESS) and Quebec sleep questionnaire (QSQ). Six to 12 months after operation, all the above-mentioned examinations were repeatedly performed. Changes of aforementioned variables before and after operation were assessed. Results: A total of 43 patients with moderate to severe OSAHS were enrolled in this study. One patient lost to follow-up, the remaining 21 were allocated to Ablation group and 21 were allocated to Traction group. The total therapeutic efficacy of all patients was 69.05% (61.90% in Ablation group and 76.19% in Traction group), but there was no statistical significance between the two groups (P= 0.317). The value of sleep scale score (ESS and QSQ), objective sleep variables (apnea-hypopnea index, oxygen saturation, percentage of time with blood oxygen less than 90% in total sleep time, oxygen desaturation index and micro-arousals) and upper airway cross-sectional area (palatopharyngeal and retrolingual area) of the two groups were improved (P<0.05), but the differences between the two groups were not statistically significant (P>0.05). Conclusion: For moderate to severe OSAHS who had glossopharyngeal plane obstruction, both HUPPP plus radiofrequency ablation of tongue base or HUPPP plus traction of tongue base are effective treatment for OSAHS, and the curative effect is similar. The choice of surgical type could be selected according to patient's or surgical conditions.

Study on enzymatic extraction process of polysaccharide from Urena lobata L.and investigation on its antioxidant activity / 中国药理学与毒理学杂志

OBJECTIVE This study aimed to optimize polysaccharides extraction from Urena lobata L.and investigate its antioxidant activity.METHODS The mathematical model was established by re-sponse surface method (RSM) based on the results of single factor experiments, using polysaccha-rides extraction rate as response value,and using the ratio of water to material,cellulase concentra-tion,extraction temperature and time as experimental factors,which was used to screen optimum poly-saccharide extraction conditions from Urena lobata L.. Antioxidant activity of polysaccharides was stud-ied by DPPH and ·OH free radical elimination method. RESULTS The optimum conditions obtained by RSM were as follows:the cellulase level was 10.8 g·L-1,extraction time duration was 72 min,the ra-tio of water to feedstock was 7 mL·g-1,extraction temperature was 43℃,the pH value was 5.0.Under the optimal conditions, there was a difference of less than 5％ between predicted extraction rate 13.37％ and experimental extraction rate 13.32％. The polysaccharide yield was most significantly af-fected by cellulase concentration,followed by extraction time,water to material ratio and extraction tem-perature.IC50of DPPH and·OH were 1.082 g·L-1and 3.202 mg·L-1,respectively.Antioxidant activity of sample polysaccharides was weaker than those of vitamin C. CONCLUSION The polysaccharide extraction process from Urena lobata L. by cellulase enzymolysis approach was obtained, which was convenient and feasible,and extracted polysaccharides had good free radical scavenging activity.

Evaluation of etiological characteristics of Chinese women with recurrent spontaneous abortions: a single-centre study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Various etiologies that contribute to the loss of pregnancy have been proposed. Despite the lack of established and uniform screening methods for recurrent pregnancy loss (RPL), there are several factors considered to be definite (or probable) causes of RPL. Data describing the etiological characteristics of RPL consist almost entirely of Caucasian populations. As we were interested in the Chinese population, the goal of this study was to determine the etiological characteristics of RPL in the Chinese patients.</p><p><b>METHODS</b>The study was performed retrospectively by analyzing 1122 women with RPL. Patients were divided into three groups according to their number of pregnancy losses. Diagnostic tests included the following 9 critiria: parental genetics, uterine anatomy, autoimmune factors, alloimmune factors, thrombophilic factors, endocrine parameters, genital infection, toxoplasma, rubella, cytomegalovirus, herpes (TORCH) titers and RH blood groups. The criteria for abnormal results were defined before diagnosis.</p><p><b>RESULTS</b>We found that 87.1% (977/1122) patients had no more than 3 abnormal aspects, and the proportion of total abnormal results was similar among groups. The prevalence of abnormal results for each test did not differ among groups, except in the cases of parental genetics, uterine anatomy and presence of mixed lymphocyte reaction blocking antibodies (MLR-Bf). Absence of MLR-Bf, as well as abnormally increased levels of CD3⁺CD19⁺ and CD56⁺CD16⁺ cells, was commonly detected in Chinese RPL patients.</p><p><b>CONCLUSION</b>Immunological disorders play an important role in RPL among Chinese patients.</p>

Preparation and Identification of Monoclonal Antibody Against Cloxacillin / 中国生物工程杂志

CX-conjugated antigen(BSA-CX) were produced by methods of EDC.The spleen cells of BALB/C mouse immunized by BSA-CX were fused with SP2/0 plasmacytoma cells using PEG4000,and selected cultured with HAT and HT medium.A hybridoma cell line of 2H8-B1-F4 was secreened for specificity to CX,and cloned by limited dilution method for 3 times,which secrete high affinity and stable monoclonal antibodies against CX with indirect ELISA. The antibody was characterized by IgG1 isotype, the titers of antibody in cell supernatant and ascites were 1∶1000 and 1∶4?10~5,respectively.The mAb against CX was selective toward dicloxacillin, oxacillin with cross-reactivity of about 19.6% and 21.3%,which can be used to detect CX residues by competitive ELISA.