[Study on the application value of portable pulse oximeter in adult patients with obstructive sleep apnea].

Objective: To evaluate the application value of portable pulse oximeter in adult obstructive sleep apnea (OSA). Methods: This study prospectively enrolled adult patients who underwent polysomnography (PSG) due to snoring at the Respiratory and Sleep Medicine Department of Peking University People's Hospital from July 2022 to July 2023. During PSG monitoring, CS-WOxi was continuously used to monitor blood oxygen levels. The consistency between 3% oxygen desaturation index (ODI3) measured by portable pulse oximeter and ODI3 of polysomnography was evaluated using difference test, Pearson's correlation coefficient, and Bland-altman method. Receiver operating characteristic curve was used to determine the optimal threshold for diagnosing OSA. Results: A total of 184 subjects were included, including 121 males (65.8%) and 63 females (34.2%). The mean age was 46.0 (34.3, 59.0) years, body mass index was 26.0 (23.3, 29.6) kg/m², and the apnea-hypopnea index was 18.2 (5.8, 40.8) events/h. There was a significant difference between CS-ODI3 and PSG-ODI3 [17.1(6.2, 42.7) vs. 14.0(2.9, 32.6), P<0.001], and the Pearson correlation coefficient was 0.93 (P<0.001). There was a good correlation between CS-ODI3 and PSG-AHI (r=0.92, P<0.001). Bland-Altman consistency test showed that the average difference between the two was 0.7 events/h, and the 95% consistency limit was (-17.9, 19.3 events/h). When the CS-ODI3≥5 events/h was used to identify OSA, the sensitivity was 94.4%, the specificity was 80.0%, and the accuracy was 91.3%. When PSG-AHI≥5 events/h was used as the diagnostic criteria, the area under the receiver operating characteristic curve was 0.933. Conclusion: Portable pulse oximeter can monitor pulse oxygen saturation accurately and has good sensitivity and specificity for OSA high-risk patients, and is a reliable tool for OSA screening.

Starting hemoglobin value predicts early phase prognosis after liver transplantation.

Few studies have addressed the relationship between starting hemoglobin (Hb) value and early phase prognosis after liver transplantation (OLT). The aim of our study was to determine the relationship between the starting Hb value and the early phase prognosis after OLT by retrospectively reviewing the medical records of 102 consecutive recipients. Within this cohort, 47 patients had pulmonary complications after OLT, including eight cases of pulmonary edema, 12 cases of acute lung injury, six cases of acute respiratory distress syndrome, and 21 cases of pneumonia. According to whether the patients had pulmonary complications or not, they were categorized into the "no" versus the pulmonary complication groups. Twenty-two perioperative variables were analyzed in both groups to screen for variables that affected early pulmonary complications. A starting Hb ≤ 100 g/L was an independent risk factor for postoperative pulmonary complications. The duration to initial passage of flatus and the intensive care unit length of stay were significantly prolonged in patients with starting Hb values ≤ 100 g/L; these patients had poorer arterial blood gas analyses. The starting Hb value predicted the early phase prognosis after OLT for cirrhosis-associated hepatocellular carcinoma.

[The effect of Chinese cobra venom factor on guinea pig to rat cardiac xenotransplantation].

OBJECTIVE: In the guinea pig-to-rat cardiac xenotransplantation model, the effect of complement depletion by using Chinese Cobra Venom Factor(CVF) on hyperacute rejection was evaluated. METHODS: Cardiac xenograft from guinea pig was transplanted into the abdomen of rat after the recipient being given i.p. a dose of CVF 0.20 microgram/g. the recipients were divided into group A (control group), group B (only given CVF), group C (CVF + Cytoxan + Splenectomy), group D (Cytoxan + Splenectomy) Cytoxan was injected into the abdominal cavity with a dose of 60 mg/Kg. The survival time of xenograft was measured and histologic observation was carried out after the cardiac arrest. RESULTS: The survival time of xenograft ranged from 15 to 3,120 minutes. There were significant difference among group A compared with group B and C (P < 0.01), and no difference between group A and group D, as well as group B and C (P > 0.05). There were significant difference between group B and D, as well as group C and D(P < 0.01). The histologic observation proved that the hyperacute rejection in group A and D was milder than group B and C. CONCLUSION: The study reveals that CVF can prolong the xenograft time by depleting complement activities and restricting hyperacute rejection in this model. Further basic and clinical study of effect of CVF in xenograft transplantation is worthwhile.