Objective To explore the value of microarousal in the diagnosis and treatment of obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods 120 snorers were monitored by standard polysomnography(PSG). The overnight PSG recordings were also performed 1 year after operation in 24 patients, who had filled in the Epworth Sleep Score(ESS) before and after treatment, to evaluate the improvement of daytime sleepiness. Results After operation, obstructive sleep apnea of the 24 patients disappeared, their ODI 4 decreased from (52?26)/h to (10?8)/h, microarousal decreased from (28?16)/h to (14?6)/h, and the subjective and objective daytime sleepiness was improved. Conclusion The EEG changes of microarousal with at least 3 seconds in OSAHS patients can be recorded by computerized EEG analysis. Microarousal can serve as an index for daytime sleepiness, and be complementary to AHI in the diagnosis and treatment of OSAHS.

Objective To analyze the correlation between subjective symptoms and function of nasal ventila-tion in nonallergic rhinitis with eosinophilia syndrome ( NARES) ,in order to provide the basis for the clinical diagno-sis.Methods 44 patients with NARES were selected as the NARES group ,and 50 healthy people were selected as the control group at the same time .The total nasal resistance ( TNR ) , MCA of the two groups were compared , and Pearson or Spearman correlation was used to analyze the subjective symptoms and objective test indexes in patients with NARES.Results Before contraction,the TNR values of NARES group in 75Pa and 150Pa were higher than those of the control group (Mann-Whiteny Z=7.365,8.125,all P<0.05).After contraction,the differences of TNR values in 75Pa and 150Pa,MCA,the correlation analysis in 8 subjective symptoms and 7 objective index of NARES had no statistically significant differences between the two groups ( all P >0.05).Conclusion The correlation between subjective symptoms and function of nasal ventilation in NARES patients is not obvious .Clinical diagnosis should be comprehensive ,in case of missed diagnosis and misdiagnosis .

BACKGROUND:Nowadays, gene therapy has become a new trend for disease therapy and brought promise for some refractory diseases. Its key is to choose proper cel s, genes and vectors. OBJECTIVE:To use recombinant adeno-associated virus mediatedβ-nerve growth factor (β-NGF) to transfect rat bone marrow-derived endothelial progenitor cel s in vitro, and to investigate the effect ofβ-NGF expression on the proliferation of endothelial progenitor cel s. METHODS:The endothelial progenitor cel s were isolated, cultured and identified from the bone marrow of rats. Empty vector or recombinant adenovirus-associated virus containingβ-NGF gene was transferred into endothelial progenitor cel s. We examined the transfection efficiency by fluorescence expression of green fluorescent protein. Expression ofβ-NGF protein was detected using ELISA, and its effect on the proliferation of endothelial progenitor cel s was determined using MTT method. RESULTS AND CONCLUSION:Rat endothelial progenitor cel s were isolated and cultured successful y in vitro and were identified positive by the function of cel s and immunofluorescence staining. The endothelial progenitor cel s were infected directly by the recombinant adenovirus-associated virus containingβ-NGF gene with an efficiency of 65.3%.β-NGF protein was detected in the culture supernatant of transfected endothelial progenitor cel s, which reached a high level at 10 days after gene transfection. Furthermore, there was noβ-NGF protein in the blank and empty vector groups. After transfection, the proliferative ability of endothelial progenitor cel s was increased, which was significantly higher than the blank and empty vector groups (P<0.05). But there was no difference between the latter two groups (P>0.05). These findings suggest that recombinant adenovirus-associated virus containingβ-NGF gene can be successful y transferred into rat bone marrow-derived endothelial progenitor cel s and promote the proliferation of endothelial progenitor cel s.

Objective To observe the ultrastructure change of the EOSinophil(EOS) apoptosis in the sputum of induced patients with bronchial asthma and investigate its clinical significance.Methods Using 3%hypertonic saline ultrasonic atomizing inhalation to induce sputum in the 90 patients with bronchial asthma in shenyang hospital of shenyang medical college,From August 2000 to December 2007,and observing the ultrastructure change of the EOSinophil apoptosis in the sputum of induced patients with bronchial asthma before and after treatment.Results Before treatment,the FEV1 oftreatment group with aminophyline,with glucocorticoid and combined treatment is(1.91?0.23) L、(1.96?0.27) L、(2.02?0.32) L ampare with results,FEVl(2.2?0.22) L、(2.29?0.24) L、(2.51?0.18) L after treatment is significant different(P

Objective:To explore the related risk factors of antepartum depression and anxiety,and to provide the theoretical support for early screening,clinical intervention and prevention of antepartum depression and anxiety.Methods:At the time of 28 weeks of prenatal examination,the Edinburgh Postnatal Depression Scale (EP-DS),Self-Rating Anxiety Scale (SAS)were used to survey 2112 pregnant women who were selected from Maternal and Child Health Hospital of Kunming City.Non conditional logistic regression analysis was used to explore the re-lated risk factors of prenatal depression and anxiety.Results:At the 28 weeks of pregnancy,the detection rate of de-pression symptoms and anxiety symptoms were 25.4% and 6.6%.Logistic regression analysis showed that the risk factors for perinatal depression symptoms were younger age (OR =0.80,95%CI:0.68 -0.94),not stick to work during pregnancy (OR =1.18,95%CI:1.02 -1.36),not satisfied with the living environment (OR =1.50,95%CI:1.23 -1.83),expectations for boys (OR =0.86,95%CI:0.77 -0.96),not only daughter (OR =1.37,95%CI:1.06 -1.76),unplanned pregnancy (OR =1.38,95%CI:1.10 -1.72).The risk factors for perinatal anxiety symp-toms were being not satisfied with the living environment (OR =1.64,95%CI:1.19 -2.26),not harmonious with her husband (OR =2.01,95%CI:1.20 -3.37),unplanned pregnancy (OR =1.50,95%CI:1.05 -2.14).Conclu-sion:It suggests that the pregnant women with younger age,less working during pregnancy,being not satisfied with the living environment,having more expectations for boys,being not only daughter,with unplanned pregnancy are more likely to suffer from antepartum depression;those being not satisfied with living environment,having harmoni-ous relation with her husband,and with unplanned pregnancy are more likely to suffer from antepartum anxiety.

Objective:To invetigate the value of a novel puncture and drainage of intracranial hematoma for the treatment of hypertensive intracerebral hemorrhage.Methods:In the group there were 27 patients with hypertensive intracerebral hemorrhage,with mean age of 61 years. Their hematomas located in thalamus(1 patient),basal ganglia(22 patients),and lobe(4 patients).The mean(SD)hematoma volume was 40(3.2)mL,the mean Glasgow Coma Scale (GCS)score was 10.15,and the mean National Institutes of Health Stroke Scale(NIHSS)score was 30.65 at admission.CT scan provided hematoma location.and the percutaneous puncture. grind and drainage were performed under the local anesthesia by using a novel puncture and drainage of intracranial hematoma.Results:No adverse events occurred during the punctures and after the procedures.One patiems died 20 days after procedure.Other patients were followed up for more than 6 months.Eight patients had a good outcome as assessed by Glasgow Outcome Scale(GOS)scores,15 had mild disability,2 had serious disability,and 1 was in a permanent vegetative state.Conclusions:This novel puncture and drainage of intracranial hematoma can be used in the treatment of hypertensive intracerebral hemorrhage,and it is simple and safe.

Objective To investigate the effects of inhibition of adenosine monophosphate -activated protein kinase (AMPK) on expressions of cytochrome c (CytC) and caspase -3 and apoptosis in the cerebral cortex after cerebral ischemia-reperfusion injury in mice. Methods Thirty-six male C57BL/6 mice w ere randomly divided into three groups, a sham operation group, a ischemia -reperfusion group, and a AMPK inhibitor group, 12 in each group. A model of middle cerebral artery occlusion w as induced by suture method. The AMPK inhibitor compound C ( 20 mg/kg) w as injected intraperitonealy in the AMPK inhibitor group, the equal volume normal saline w as injected intraperitonealy in the sham operation group and the ischemia-reperfusion group w hen a thread w as inserted. Immunohistochemical staining w as used to detect the expression levels of CytC and caspase-3 and TUNEL method w as used to detect apoptosis at 24 h after ischemia-reperfusion. Results Compared w ith the ischemia-reperfusion group, the numbers of CytC (28.86 ±9.65/HP vs.58.86 ±9.65/HP; t = 7.615, P = 0.030 ) and caspase-3 (7.16 ±5.85/HP vs. 14.36 ±7.85/HP; t =2.548, P =0.035), and TUNEL (67.14 ±8.55/HP vs.95.00 ±13.51/HP; t = 6.891, P = 0.030) positive cels in the cerebral cortex w ere reduced significantly in the AMPK inhibitor group. Conclusion Inhibition of AMPK activity after cerebral ischemia-reperfusion may decrease apoptosis by dow nregulating the expressions of CytC and caspase -3, and play a neuroprotective effect.

Objective To observe the changes and clinical significance of procalcitonin(PCT) level in children with bacterial pneumonia.Methods The levels of PCT,hs-CRP and WBC were detected in 31 pneumonia children pre and post antibiotic treatment,and the changes were observed.Results The PCT levels of the 31 patients were all increased before treatment.After cured,PCT level of 28 cases returned to normal.But in the 28 normal cases,WBC level increased in 10 cases(35.7％),and hs-CRP level elevated in 4 cases(14.3％).In the other 3 cases,the PCT levels decreased from 5.69ng/mL,1.25ng/mL and 0.83ng/mL at admission to 0.51ng/mL,0.55ng/mL and 0.52ng/mL,respectively.And in these 3 cases,there was one case with the levels of WBC and hs-CRP respectively ascended,in which WBC level descended from 13.1 × 109/L to 12.1 × 109/L and hs-CRP level reduced from 20.92mg/L to 7.38mg/L.Conclusion The sensitivity of the index PCT is the highest at the accurate time phase of bacterial pneumonia,which can guide the reasonable use of antibiotics.

OBJECTIVE: To study the relationship between arousal and nocturnal apnea-hypopnea syndrome (OSAHS). METHOD: Fifty four patients with OSAHS underwent overnight polysomnography (PSG) were enrolled, An hour continuous PSG monitoring in non-rapid eye movement (NREM) was recorded for all patients. The mean heart rate (HR) in 10 s before each arousal and the peak HR IN 10 s after arousal were compared, and the breathing disorder related arousal index (B-ArL) and pulse rate rise index (PRRI) were calculated at this time, and then a correlation analysis were performed and then Delta HR at apnea termination between these events were compared. RESULT: the peak HR in 10 s after arousal onset was significantly higher than the mean HR in 10 s before arousal onset, and B-Arl was positively correlated to PRRI. the Delta HR of events with EEG arousal at apnea termination was higher than those without EEG arousal. CONCLUSION The results indicate that arousal can influence the function of cardiovascular regulation; Frequent arousal is one of the main causes of the cardiovascular consequences in OSAHS patients. Operation can reduce these influences.
Adult ; Arousal ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Polysomnography ; Sleep Apnea, Obstructive ; physiopathology ; surgery

OBJECTIVETo explore the correlation between UGT1A1 (*28, *60 and * 93) polymorphism and the adverse reactions in small cell lung cancer patients after irinotecan chemotherapy.

METHODSClinical data of 58 small cell lung cancer patients in extensive stage treated in our hospital were retrospectively analyzed. Polymerase chain reaction was used to amplify the UTG, and direct sequencing was performed to determine the UGT polymorphism. The adverse reactions ≥ grade 3 after irinotecan chemotherapy in patients with different UGT genotype were analyzed.

RESULTSAmongthe 58 patients with extensive stage small cell lung cancer, there were 45 (77.6%) cases of wild type UGT1A1*28, 40 (69.0%) cases of wild type UGT1A1* 93, 38 (65.5%) cases of wild type UGT1A1*60, 18 cases of mutation in UGT1A1* 93 and 20 cases of mutation in UGT1A1*60. In UGT1A1 promoter position 28, there were 8 (13.8%) cases of TA5 mutation and 5 (8.6%) cases of TA7 mutation. Among the patients with TA5 mutation, 5 cases had ≥ grade 3 diarrhea, 3 cases had ≥ grade 3 leucopenia and 3 cases had ≥ grade 3 neutropenia, while among the patients with UGT1A1 * 93 mutation, 7 cases had ≥ grade 3 diarrhea, 6 cases had ≥ grade 3 leucopenia and 4 cases had ≥ grade 3 neutropenia.

CONCLUSIONSTA5 and UGT1A1* 93 mutation increase the risk of diarrhea and ≥ grade 3 leukopenia and neutropenia, however, wild type UGT1A1 (*28, * 93, *60) and mutant UGT1A1*60 do not increase those risks. Further prospective study in a larger number of patients is needed to clarify the association between UGT1A1*28, UGT1A1* 93 and UGT1A1*60 polymorphism and adverse reactions of irinotecan, and to help clinicians in choosing a better therapeutic modality for personalized chemotherapy to improve curative effect and reduce adverse reactions.

Antineoplastic Agents, Phytogenic ; adverse effects ; Camptothecin ; adverse effects ; analogs & derivatives ; Diarrhea ; Genotype ; Glucuronosyltransferase ; genetics ; metabolism ; Humans ; Neutropenia ; Polymorphism, Genetic ; Promoter Regions, Genetic ; Prospective Studies ; Retrospective Studies ; Small Cell Lung Carcinoma ; drug therapy ; genetics