Diurnal variation of serum hypoxia inducible factor-1 α in obese patients with obstructive sleep apnea / 国际外科学杂志

Objective:To observe the diurnal changes of serum hypoxia inducible factor-1α (HIF-1α) and its relationship with polysomnography (PSG) parameters in obese patients with obstructive sleep apnea (OSA).Methods:In this study, 64 obese subjects with OSA (experimental group) and 24 normal subjects (control group) were included. PSG monitoring was performed in all subjects, and peripheral blood samples were collected at night and next early morning to detect the expression level of HIF-1 α mRNA and protein concentration in serum. The data were analyzed by SPSS25.0 software. The counting data was represented by n(%), and t-tests were used for inter group comparisons. The measurement data of normal distribution adopted mean ± standard deviation ( ± s), and the inter group comparison adopted Chi-square. Serum HIF-1α mRNA levels and protein concentrations in the two groups were compared and analyzed by Two-way ANOVA, and Spearman rank correlation was used to analyze the correlation. Results:The ratio of male to female in the control group was 15: 9 and the average age was (39.25 ±10.58) years old, while that in the experimental group was 41∶24 with an average age of (41.31 ±15.20) years. The body mass index (BMI) of experimental group was higher, while all the relevant parameters recorded by PSG were significantly different between two groups ( P<0.001). The results showed that there was no significant difference in the expression of HIF-1α mRNA between the control group and the experimental group ( P=0.914), or between night and morning ( P=0.167). The concentration of HIF-1α protein in the control group was significantly lower than that in the experimental group ( P<0.001), but there was no significant difference in the concentration of HIF-1α protein in the same group at night and in the morning ( P=0.798). The results of correlation analysis showed that there was a significant correlation between PSG related indexes(AHI, minimum blood oxygen, mean blood oxygen and SIT90), night and morning mRNA expression and protein concentration ( P<0.05). Conclusions:Compared with normal people, the concentration of serum HIF-1 α protein in obese patients with OSA is higher, but there is no difference between night and morning. The process of HIF-1 α induced by CIH may be involved in post-translational regulation rather than transcription, and other compensatory mechanisms may also be involved.

Analysis of continuous polysomnography in children with recurrent vertigo / 临床耳鼻咽喉头颈外科杂志

Objective:To explore the relationship between sleep status and the disease in children with recurrent vertigo（RVC） by analyzing the objective sleep condition of children with recurrent vertigo. Methods:According to the diagnostic criteria of RVC, 50 children with RVC and 20 normal controls without RVC were selected. According to the vertigo questionnaire score, the RVC group was divided into mild, moderate and severe groups according to severity. Continuous polysomnography（PSG） was performed for all participants, and SPSS 25.0 statistical software was used to analyze the monitoring results. Results:①There were significant differences in sleep time of each period, total sleep time and sleep efficiency between RVC group and control group（P<0.05）, but there was no significant difference in sleep latency（P>0.05）. The specific manifestations were that the proportion of sleep time in N1 and N2 phases increased, the proportion of sleep time in N3 and REM phases decreased, the total sleep time and sleep efficiency decreased in RVC group. ②The abnormal rate of sleep apnea hypopnea index, that is, the proportion of AHI≥5 times/h and the abnormal rate of lowest blood oxygen saturation in RVC group were higher than those in normal control group. There was significant difference between the two groups（P<0.05）. ③There were significant differences in the proportion of AHI≥5 times/h and lowest SpO2 among mild group, moderate group and severe group（P<0.05）. ④There was no significant correlation between the degree of vertigo and the abnormal rate of AHI in children with RVC, but there was a negative correlation between the degree of vertigo and the abnormal rate of lowest SpO2 in children with RVC. Conclusion:Children with RVC are often accompanied by sleep disorders, clinicians should pay attention to both the symptoms of vertigo and sleep condition in children. Polysomnography is non-invasive and operable, providing a new idea to the auxiliary examination of RVC in children. It is of certain clinical significance for the comprehensive treatment of children with RVC to actively improve vertigo symptoms and pay attention to improving sleep quality.

Risk factors analysis of hypotension in patients with hemodialysis-related superior vena cava diseases / 中华肾脏病杂志

Objective:To explore the risk factors of hypotension in patients with hemodialysis-related superior vena cava diseases.Methods:This was a retrospective cohort study. The maintenance hemodialysis patients diagnosed as superior vena cava stenosis ≥50% or occlusion in West China Hospital of Sichuan University from January 1, 2019 to March 31, 2022 were selected. The patients were divided into hypotensive group and non-hypotensive group according to the occurrence of hypotension during non-dialysis period. The differences of general clinical data, cardiac ultrasound parameters and blood biochemical indexes between the two groups were compared. Multivariate logistic regression model was used to analyze the risk factors of hypotension in patients with hemodialysis-related superior vena cava lesions.Results:A total of 202 patients with hemodialysis-related superior vena cava lesions were included, of whom 84 patients (41.6%) developed hypotension during non-dialysis. Compared with the non-hypotensive group, patients in the hypotensive group had longer dialysis age ( Z=2.093, P=0.036), shorter left atrial diameter ( t=2.316, P=0.022), lower aortic valve orifice flow rate ( t=3.702, P=0.001) and serum calcium ( t=2.320, P=0.021), thicker left ventricular posterior wall ( t=3.042, P=0.003), lower proportions of hypertension history ( χ2=9.125, P=0.003), and higher proportion of residual superior vena cava ≤30% or occlusion ( χ2=8.940, P=0.003) and azygous vein opening ( χ2=11.067, P=0.001). Multivariate logistic regression analysis results showed that no history of hypertension ( OR=0.383, 95% CI 0.156-0.943, P=0.037), slow aortic valve orifice flow ( OR=0.207, 95% CI 0.062-0.695, P=0.011) and low blood calcium ( OR=0.236, 95% CI 0.066-0.841, P=0.026) were the independent influencing factors of hypotension in patients with hemodialysis-related superior vena cava diseases. Conclusions:Hemodialysis patients with severe stenosis or occlusion of the superior vena cava during non-dialysis have a higher risk of hypotension. No history of hypertension, slow aortic valve orifice flow, and low blood calcium are the independent risk factors of hypotension in patients with hemodialysis-related superior vena cava diseases.

Relationship between clinicopathological characteristics and lymph node metastasis in papillary thyroid carcinoma / 肿瘤研究与临床

Objective To investigate the clinicopathological characteristics of papillary thyroid carcinoma (PTC), and analyze their relationship with lymph node metastasis (LNM). Methods The clinicopathological data of 914 cases of PTC from January 2012 to December 2016 was analyzed retrospectively byχ2 test andχ2 trend test, including age, gender, tumor size, the number of lesions and LNM, in order to illuminate the characteristics of incidence and variation trend of PTC. Results The numbers of PTC cases in Shanxi Dayi Hospital increased year by year in recent 5 years (χ2=64.009, P=0.001). The rate of LNM was higher in age of ≤40 years old [34.9 % (84/241)] and > 70 years old [44.0 % (11/25)] than age 41-70 years old [15.6 % (101/648)] (χ2 = 39.577 and 14.009, both P= 0.000). It showed a triphasic pattern, which presented a uptrend with age decreasing in patients ≤ 40 years old (χ2= 10.490, P= 0.010), on the contrary, it appeared a rising trend with age increasing in patients>40 years old (χ2=10.170, P=0.010). The sex ratio of male and female was 1:2.97. The rate of LNM for male was higher than female (χ2=5.845, P=0.013). There was approximate risk of LNM between tumor diameter ≤1 cm and>1 cm (χ2=0.070, P=0.610). The rate of LNM in the cases of multiple lesions was apparently higher than that in cases of single lesions (χ2=145.440, P=0.000). Conclusions The incidence of PTC is on the rise. The risk factors of LNM are age (≤40 years old and>70 years old), male and multiple lesions.

Biological safety of nanomaterials: the opportunity and challenge of preventive medicine / 中华预防医学杂志

Nanotechnology, as a newly arisen technology, does not only benefit people, but also become one of the inevitable threats to public health due to the widely application of nanomaterials. The safety evaluation of nanomaterials has become one of the hottest research topics in the 21st century, which provides opportunities and challenges in the field of preventive medicine once in a blue moon. Although the history of development in the safety assessment of nanomaterials is just over twenty years, the achievements could not be underestimated. This paper summarized the research of nano biological, predicted the directions for future research, and proposed several recommendations, based on which, we hope it can promote the sustainable development safety in China.

Effect of Ipratropium bromide combined with atomization inhalation of budesonide on acute exacerbation of chronic obstructive pulmonary disease / 中华老年医学杂志

Objective To assess the clinical efffects off Ipratropium bromide combined with atomization inhalation of budesonide via a ventilator with a Y-shaped connector on acute exacerbation off chronic obstructive pulmonary disease (AECOPD).Methods A total off 62 AECOPD patients treated at our hospital from June 2013 to September 2014 were randomly divided into the experimental group (n=31,treated with ipratropium bromide combined with atomization inhalation of budesonide) and the control group (n =31,treated with the same amount of saline).Results The airway pressure of mechanical ventilation,the time of mechanical ventilation and the time of staying in the intensive care unit all showed significant differences between the experimental and control groups [(25.4±5.2) cmH2O vs.(38.1±3.4) cmH2O,(6.5±1.3) d vs.(6.8±1.4) d,(8.9±2.1) d vs.(9.5±1.5) d,t=10.934,0.960,1.108,respectively,P＜0.05 for all].The rate of tracheotomy was lower in the experimental group than in the control group (17/31 or 54.8％ vs.20/31 or 64.5％,x2 =0.603,P＜0.05).Conclusions Ipratropium bromide combined with budesonide inhalation under mechanical ventilation via a Y-shaped connector has ffavorable clinical effects on AECOPD.

Citrate lock versus heparin lock for the prevention of catheter related infections in hemodialysis patients with tunneled catheters: a Meta-analysis of randomized controlled trials / 中华肾脏病杂志

Objective To study whether citrate lock is superior to heparin lock in the prevention of catheter related infections,bleeding complications and catheter malfunctions among hemodialysis patients with tunneled catheters.Methods By searching in Pubmed,the Cochrane Library,EMBASE,Ovid,WanFang,VIP,CNKI and CBM databases as well as related journals,qualified randomized controlled trials were included in a Meta-analysis using Revman 5.0 and STATA 10.0 software.The endpoints included catheter related infection,bleeding complication,thrombolytic treatment,catheter removal for malfunction,catheter thrombosis and all-cause death.Results Fifteen randomized controlled trials were included with 1621 patients involved.Eight studies compared citrate alone with heparin lock,while 7 trials focused on citrate in combination with other antimicrobials.Pooled analysis demonstrated that incidence of catheter related infections in patients receiving citrate lock decreased by 47％ compared with those on heparin (RR=0.53,95％CI 0.36-0.77,P ＜ 0.01).Subgroup analysis by types of citrate lock indicated that all combined lock solutions of citrate and other antimicrobials (citrate + gentamicin,citrate + taurolidine,citrate + methylene blue +methylparaben + propylparaben) were superior to heparin lock in preventing catheter-related infections (P =0.01,0.04,0.01,respectively); citrate alone seemed to reduce catheter-related infection risk (RR =0.68),but no statistically significant difference was observed (95％CI 0.38-1.21,P=0.19).There were fewer patients with bleeding complications in citrate group (RR =0.53,95％ CI 0.34-0.S4,P ＜ 0.01),while citrate showed no advantage over heparin lock in terms of thrombolytic treatment (P =0.93),catheter removal for malfunction (P =0.35),catheter thrombosis (P =0.64) and all-cause death (P =0.35).Conclusions For hemodialysis patients with tunneled catheters,combined lock solutions of citrate and other antimicrobials,rather than citrate alone,are superior to heparin in preventing catheter related infections.Citrate locks are associated with less bleeding complications,and are comparable to heparin in the maintenance of catheter patency.

A standardization study of Meta-analyses on nephropathy published in Chinese journals / 中华内科杂志

Objective To evaluate the standardization of Meta-analyses on nephropathy published in Chinese journals.Methods By searching in WANFANG,VIP,CNKI databases and Chinese Biomedical Literature Database(CBM) as well as related Chinese journals,eligible Meta-analyses were enrolled and analyzed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement and the MOOSE (Meta-analysis of Observational Studies in Epidemiology) Checklist.Results A total of 217 Meta-analyses were enrolled with 166 on randomized controlled trials (RCT) and 51 on observational studies.Based on the PRSIMA Statement,of the 166 Meta-analyses on RCT,51.8％(86 papers) were found with the complete research hypothesis,13.9％ (23) with the literature screening flow chart,15.7％ (26) with the subgroup analysis,53.0％ (88) with the publication bias analysis and 28.3％ (47) with the sensitivity analysis.According to the MOOSE Checklist,of the 51 Meta-analyses on observational studies,only 9.8％ (5) had done the statistical stability calculation,54.9％ (28) with the outlook of application,45.1％ (23) with the limitation of the study,2.0％ (1) with the quantitative analysis on potential bias and 17.6％ (9) with the suggestion for future studies.Conclusions Unclear hypothesis,limited methodological description,lack of in-depth analysis on heterogeneity and bias are the common defects in Meta-analyses published in Chinese journals on nephrology.

The effect of different combinations between irradiation and cisplatin or lobaplatin on tumor growth in mice / 中华放射肿瘤学杂志

Objective To learn the effect of different combination model between irradiation and cisplatin or lobaplatin on the radiosensitization of xenographt tumor in mice.Methods Seventy C57BL/6 mice with Lewis lung carcinoma were randomly divided into fourteen groups.Then a single intravenous bolus injection of 10 mg/kg either cisplatin or lobaplatin was given.Tumor tissues were collected at the indicated times of 0.5 h, 2.0 h, 4.0 h, 24.0 h, 48.0 h, 72.0 h, and 96.0 h.The platinum levels were determined by inductively coupled plasma-mass spectrometry.Eighty tumor-bearing mice were randomly divided into 10 groups, including a blank control group, a irradiation group, two drug treatment groups and 6 combined treatment groups.The tumors were irradiated at 1 h, 24 h or 72 h after either cisplatin or lobaplatin injection.The tumor size of the groups was compared.Results The concentrations of cisplatin and lobaplatin in tumors rapidly reached 4.78 μg/g and 2.79 μg/g (t=3.82,P=0.005), respectively, then declined rapidly to 3.39 μg/g and 0.99 μg/g (t=9.10,P=0.000) at 4 h, 1.41 μg/g and 0.23 μg/g (t=3.70,P=0.006) at 96 h, respectively.The tumor growth among the three groups of irradiation at 1 h, 24 h or 72 h after cisplatin was similar, which was slower than the blank control group, the irradiation group and the cisplatin treatment group.At the 15th day, the relative volume of tumor in the three combined treatment groups were 4.73, 5.52 and 2.15(F=0.84,P=0.451), While was 16.63(F=10.50,P=0.000) in the blank control group, 10.34(F=3.12,P=0.046) in the irradiation group, and 12.80(F=8.06,P=0.001) in the cisplatin treatment group, respectively.The tumor growth among the three groups of irradiation at 1 h, 24 h or 72 h after lobaplatin was also similar, which was slower than the blank control group, the irradiation group and the lobaplatin treatment group.At the 15th day, the relative volume of tumor in the three combined treatment groups were 3.49, 4.90 and 3.86(F=0.32,P=0.727), While was 16.63(F=15.21,P=0.000) in the blank control group, 10.34(F=4.12,P=0.016) in the irradiation group, and 14.28(F=10.67,P=0.000) in the lobaplatin treatment group, respectively.The sensitizing enhancement ratio (SER) at 1 h, 24 h and 72 h after the injection were 2.13, 2.03 and 3.45 of cisplatin, and 2.53, 2.00 and 2.50 of lobaplatin, respectively.Conclusions After intravenous bolus injection, the cisplatin concentration in the tumor can be kept at least 96 hours, which results in a persistent radiosensitizing effect.Lobaplatin and cisplatin have similar anti-tumor and radiosensitizing effect.

In vitro study about the inhibitory effect of CDAⅡ in combination with sodium butyrate on breast cancer cells / 北京大学学报(医学版)

Objective:To investigate if the combined use of CDAⅡ and sodium butyrate can induce demethylation and re-expression of retinoic acid receptor?2(RAR?2)gene in cultured human breast cancer cells MCF7.To explore if the two drugs can inhibit cell growth and induce cell apoptosis synergetically.Methods:MCF7 cell line was treated with CDAⅡ,sodium butyrate,combination of the two drugs respectively.Methylation was assessed by methylation-specific polymerase chain reaction(MSP)for RAR?2 gene.Gene expression was evaluated by reverse transcription polymerase chain reaction(RT-PCR).Apoptosis was detected by terminal deoxynucleotidyl transferase mediated dUTP-biotin nick end labeling(TUNEL)and Hoechst33342/propidiumiodide(PI)staining.Cell growth inhibition was measured by MTT assay.Results:Neither CDAⅡ nor sodium butyrate induced demethylation and re-expression of RAR?2 gene,Combination of the two drugs partially demethylated gene promoter accompanied by re-expression of RAR?2.The apoptotic cells in the double-drug group were obvious following Hoechst33342/PI staining.The percentage of apoptotic cells in the double-drug group was significantly higher than that of the two single-drug group(39.5% vs 5.2%,8.1%)(P