Effects of CPAP treatment on electroencephalographic activity in patients with obstructive sleep apnea syndrome during deep sleep: Preliminary findings of a cross-sectional study.

Study objectives: To investigate whether electroencephalographic (EEG) activities during non-rapid eye movement sleep stage 3 (N3) in obstructive sleep apnea syndrome (OSAS) patients were changed with continuous positive airway pressure (CPAP) treatment.Methods: A cross-sectional study of EEG activity during N3 sleep was conducted in 15 patients with moderate to severe OSAS without and with CPAP treatment compared to 15 normal controls. The amplitude, and absolute and relative power of delta, theta, alpha and beta waves as well as the absolute power ratio of slow to fast EEG waves (i.e., absolute power of delta and theta waves/absolute power of alpha and beta waves) and the spectral power density of 0-30 Hz EEG activities were analyzed.Results: CPAP significantly increased N3 sleep, the absolute and relative powers, amplitudes of delta and theta waves, and absolute power ratio of slow to fast EEG waves, but decreased relative alpha and beta powers during N3 sleep. However, there were no significant differences in those parameters between the OSAS patients with CPAP treatment and normal controls.Conclusions: CPAP prolongs N3 sleep and increases the power and amplitude of slow EEG waves during N3 sleep, which indicates an improvement in sleep quality and further provides evidence for recommendation of CPAP treatment for OSAS patients.

Value of T6SS Core Gene hcp in Acinetobacter baumannii Respiratory Tract Infection.

Hospital-acquired pneumonia caused by Acinetobacter baumannii is a major healthcare burden. Type VI Secretion System (T6SS) contributes to both virulence and drug resistance in this bacteria. This study aims to investigate the diagnostic value of hemolysin co-regulated protein (Hcp) gene in A. baumannii pneumonia and further explore the effect of hcp on clinical, pathogenicity and drug resistance. 53 clinical A. baumannii strains from patients' respiratory tract at a teaching hospital were included in this study. Real-time quantitative polymerase chain reaction (qRT-PCR) was carried out to examine the expression of hcp. Recombinant Hcp expression plasmids (pET-28a(+)-hcp) were constructed and his-tagged Hcp were purified to stimulate Tohoku Hospital Pediatrics-1 (THP-1) macrophages. Nuclear Factor Kappa B p65 (NF-κBp65) and Interleukin 8 (IL-8) were detected by qRT-PCR. Antimicrobial susceptibility testing (AST) were examined by an automated instrument system. Hcp gene had 92.6% sensitivity and 75% specificity for distinguishing invasive or colonizing A. baumannii from the respiratory tract. His-tagged Hcp induced NF-κBp65 and IL-8 at gene level in THP-1 macrophages. Additional, high hcp expression isolates showed higher rate of antimicrobial agent exposure (< 30 days) of carbapenems, antibiotic combination therapy and multiple or extensive drug-resistant (MDR/XDR) and exhibited higher resistance rate to clinical commonly-used antimicrobial agents. Hcp gene could serve as a novel diagnostic biomarker to distinguish A. baumannii respiratory tract infection from colonization and participate in eliciting inflammatory responses in vitro. T6SS/hcp may play a role in the development of carbapenem-resistant A. baumannii (CRAB), multiple or extensive drug-resistant A. baumannii (MDRAB/XDRAB). Supplementary Information: The online version contains supplementary material available at 10.1007/s12088-023-01083-8.

Influence of sleep bruxism on QTc interval and QT variability in patients with OSA: A pilot study.

BACKGROUND: Obstructive sleep apnea (OSA) is associated with increases in QT interval corrected for heart rate (QTc interval) and QT variability index (QTVI) and sleep bruxism (SB) is prevalent in OSA patients. OBJECTIVES: To examine whether QTc interval and QT variability were changed during episodes of rhythmic masticatory muscle activities (RMMAs)/SB in SB patients with and without OSA. METHODS: The RR and QTc intervals, and QTVI during RMMAs with or without accompanied limb movements (RMMAs/LMs) in 10 normal controls and 10 SB patients without OSA and during apneic and recovery periods of OSA in 10 SB patients with OSA were analysed. RESULTS: In the SB patients without OSA and controls, QTc intervals and QTVI were significantly increased during RMMAs/LMs compared with those during the 10 s periods (from 10th to 20th s) before the onset and after the offset of RMMAs/LMs, and significantly increased during RMMAs/LMs with awakenings compared with those with microarousals and no arousals. In addition, QTc interval and QTVI were positively correlated with the duration of RMMAs/LMs. Moreover, in the SB patients with OSA, QTc interval and QTVI during the recovery period of OSA events were significantly longer and higher than those during the apneic period regardless of accompanied RMMAs/LMs, and QTc interval and QTVI during the apneic and recovery periods accompanied with RMMAs/LMs were significantly longer and higher than those without accompanied RMMAs/LMs. CONCLUSION: OSA and RMMAs/LMs events were associated with longer QTc intervals and higher QTVI, and RMMAs/LMs might contribute to these changes associated with OSA events accompanied with RMMAs/LMs.

Regulation of gene expression of hcp, a core gene of the type VI secretion system in Acinetobacter baumannii causing respiratory tract infection.

Purpose. The objective of the current study was to investigate whether hcp plays a role in the process of Acinetobacter baumannii infection and to examine clinically relevant factors that may affect hcp expression.Methodology. Seventy-seven A. baumannii isolates from patients with a respiratory infection at the Second Affiliated Hospital and Yuying Childrens Hospital of Wenzhou Medical University (Wenzhou, China) were included in this study. PCR was performed to screen for the presence of hcp. Quantitative real time polymerase chain reaction (qRT-PCR) was carried out to examine the expression of hcp.Results. A total of 77.9 % (60 of 77) of the A. baumannii clinical isolates possessed the hcp gene. Expression of hcp was found to be strain-specific and associated with the infection status. Higher gene expression of hcp was found for invasive A. baumannii isolates causing an infection relative to the colonization group, and for the same strain at a post-infection status compared with that prior to infection. Acid environment was also found to be a trigger of hcp gene expression.Conclusion. The type VI secretion system and hcp predominate in A. baumannii causing respiratory infections. Expression of hcp is regulated by the infection status and acid environment, and might play a role in the process of triggering infection by the colonizer.

Rotavirus NSP486-175 interacts with H9c2(2-1) cells in vitro, elevates intracellular Ca2+ levels and can become cytotoxic: a possible mechanism for extra-intestinal pathogenesis.

Rotavirus (RV) is the predominant cause of infantile gastroenteritis with multiple pathogenic factors, among which enterotoxin NSP4 is the most significant factor. NSP4 has been shown to induce elevation of the intracellular calcium concentration, alteration of the cytoskeleton organization, and cytopathic effect among other processes. However, increasing evidence suggests that RVs can escape from the gastrointestinal tract and invade other organs and tissues to cause extra-intestinal diseases. In this study, we investigated whether NSP4 has a pathogenic effect on extra-intestinal cells and examined possible molecular mechanisms in vitro. Our results showed that NSP486-175 has important functions in increasing intracellular Ca2+ concentration, altering actin cytoskeleton organization and inducing cellular damage in H9c2(2-1) cells. Blockade of the integrin α2 receptor using a specific antibody attenuated the increase of intracellular Ca2+ concentration and alleviated the observed cytopathic effects, suggesting that integrin α2 may be a receptor for NSP486-175. Collectively, these results indicate that extracellular NSP486-175 can induce elevation of the intracellular Ca2+ concentration, cause cytotoxic changes, and disrupt the actin cytoskeleton in H9c2(2-1) cells, which may constitute a possible mechanism for RV extra-intestinal pathogenesis.

Hydrogen bio-production through anaerobic microorganism fermentation using kitchen wastes as substrate.

In order to treat the kitchen wastes and produce hydrogen, anaerobic fermentation technology was used in this experiment. The results showed that the fermentation type changed from mixed acid fermentation to ethanol fermentation in a continuous stirred tank reactor (CSTR) 22 days after start-up. The maximum efficiency of hydrogen bio-production in the CSTR was 4.77 LH(2)/(L reactor d) under the following conditions: organic loading rate (OLR) of 32-50 kg COD/(m(3) d), oxidation reduction potential (ORP) of -450 to -400 mV, influent pH value of 5.0-6.0, effluent pH value of 4.0-4.5, influent alkalinity of 300-600 mg/l, temperature of 35 +/- 1 degrees C and hydraulic retention time (HRT) of 7 h. An artificial neural network (ANN) model was established, and each parameter influencing the performance of the reactor was compared using the method of partitioning connection weights (PCW). The results showed that OLR, pH, ORP and alkalinity could influence the fermentation characteristics and hydrogen yield of the anaerobic activated sludge; with an influence hierarchy: OLR > pH values > ORP > alkalinity. An economic analysis showed that the cost of producing hydrogen in this experiment was less than the cost of electrolysis of water.