Effectiveness of respiratory muscle training for patients with obstructive sleep apnea: A protocol of systematic review and meta-analysis.

BACKGROUND: This study will evaluate the effectiveness and safety of respiratory muscle training (RMT) for patients with obstructive sleep apnea (OSA). METHODS: Randomized controlled trials will be retrieved through electronic database searches from MEDLINE, EMBASE, Cochrane Library, CINAHL, Scopus, CBM, and CNKI from the beginning to the present. All electronic databases will be searched without any language limitation. Two researchers will independently select studies, collect data, and assess study quality, respectively. RevMan 5.3 software will be used for statistical analysis. RESULTS: The primary outcome is severity of OSA, as measured by polysomnography or any relevant tools. The secondary outcomes are hypopnea index, apnea index, respiratory event index, respiratory disturbance index, sleep-related quality of life, and any expected or unexpected adverse events. CONCLUSION: The results of this study will summarize current evidence of RMT for the treatment of patients with OSA. SYSTEMATIC REVIEW REGISTRATION: INPLASY202040051.

Efficacy of rivaroxaban for pulmonary embolism.

BACKGROUND: Previous clinical trials have addressed that rivaroxaban is effective for the treatment of patients with pulmonary embolism (PE). This study will systematically assess its efficacy and safety for PE. METHODS: We will carry out this study by searching the following electronic databases from inception to March 1, 2019 without language restrictions: Cochrane Library, EMBASE, PUBMED, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. In addition, we will also search clinical trial registries, dissertations, and conference abstracts to avoid any missing potential studies. All randomized controlled trials of rivaroxaban for patients with PE will be fully considered. Two researchers will independently perform literature selection, data collection, and methodological quality assessment. If it is appropriate, outcome data will be pooled by using a fixed-effect model or random-effect model, and meta-analysis will be considered for operation. RESULTS: All efficacy and safety of rivaroxaban for PE will be assessed through all primary and secondary outcomes. The primary outcomes are all-cause mortality and major bleeding. The secondary outcomes are recurrent venous thromboembolism, duration of hospital stay, quality of life, patient satisfaction, and adverse events. CONCLUSION: The findings of this study will summarize updated evidence on the efficacy and safety of rivaroxaban for patients with PE. ETHICS AND DISSEMINATION: It is not necessary to inquire ethical approval for this study, because it will not analyze any individual patient data. The results of this study will be published through peer-reviewed journals. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019126095.

[Expression of GC-C mRNA in peripheral blood mononuclear cells and its clinical roles in determining state of gastric cancer].

OBJECTIVE: To detect the expression of GC-C mRNA in peripheral blood of gastric carcinoma patients and determine its potential candidacy as a molecular biological marker for predicting the micrometastasis and determining the status of gastric cancer. METHODS: GC-C mRNA from peripheral blood samples of gastric carcinoma (n = 60), dysplastic (n = 21), intestinal metaplasia (n = 15) and healthy cases (n = 20) from November 2009 to August 2010 at Affiliated Hospital of Nantong University were assessed by real-time fluorescent quantitative PCR (RFQ-PCR). RESULTS: The expressions of GC-C mRNA in peripheral blood from patients with dysplasia, intestinal metaplasia and healthy controls were absent or very low. And a high level of GC-C mRNA was detected in the patients with gastric carcinoma than those with dysplastic and intestinal metaplasia, and the positive rate were 48.3% (29/60), 9.5% (2/21), 20.0% (3/15), respectively (all P < 0.05). The levels of GC-C mRNA were significantly correlated with Lauren typing, clinical stage, tumor differentiation degree, depth of invasion and lymph node metastasis (all P < 0.05). The GC-C mRNA expressions were positively correlated in peripheral blood and gastric carcinomas tissues (r = 0.4009, P = 0.0015). CONCLUSIONS: The over-expression of GC-C mRNA is found in peripheral blood from gastric carcinoma patients. Due to its close correlation with clinical stage and lymph node metastasis, it may become a potential prognostic marker of gastric carcinoma.

Ectopic expression of guanylyl cyclase C and endogenous ligand guanylin correlates significantly with Helicobacter pylori infection in gastric carcinogenesis.

The molecular mechanisms leading to gastric carcinogenesis still remain unclear. Recently, several studies demonstrated that over-expression of guanylyl cyclase C (GCC) has been detected in intestinal-type gastric cancer (GC) and precursor lesions. Our objective was to explore the expression levels of GCC and endogenous ligands guanylin (GN) and uroguanylin (UGN) and the correlation between Helicobacter pylori (H. pylori) and GCC, GN, and UGN expressions in patients at different stages from normal mucosa to superficial gastritis, atrophic gastritis, intestinal metaplasia (IM), dysplasia, and finally adenocarcinoma. The expression of GCC and GN was absent in the distal normal gastric tissues and superficial gastritis in all cases, whereas they were measured in IM, dysplasia, and GC. The expression of GCC and GN was closely related to intestinal-type GC. From superficial gastritis to gastric carcinomas, the H. pylori positive rate was 19.7, 33.3, 69.6, 80.0, and 82.1%, respectively. The positive correlation was found between GCC and GN in IM, dysplasia, and GC. Also, the positive correlation was found between GCC, GN, and H. pylori infection in them. These results demonstrate that the detection of GCC and GN will be beneficial to diagnosis human gastric carcinoma and precancerous lesions. Ectopic expression of GCC and GN in human gastric mucosa and H. pylori infection may play an important role in the carcinogenesis of the intestinal-type GC.