Sleep apnea includes obstructive sleep apnea,central sleep apnea and mixed sleep apnea.Ob-structive sleep apnoea syndrome(OSAS)is affecting up to 5.7% of children,which hss adverse impact on growth,development cognitive and behavioral outcomes,and untreated OSAS increases cardiovascular risk,so paying closer attention to childhood OSAS early diagnosis and treatment seems more important.First-line treat-ment in OSAS children is adenotonsillectomy,although other treatment options available include continuous posi-tive airways pressure,anti-inflammatory therapies,airway adjuncts and orthodontic appliances.Central sleep ap-nea may be related to respiratory regulation center immaturity or dysplasia.Central sleep apnea may be hereditary or acquired.Therefore,the treatment of central sleep apnea should be focused on primariy etiology.

Objective To investigate the effect of neuropeptide substance P on airway smooth muscle cell contraction amplitude.Methods According to random method, 10 Wistar rats were divided into normal group and asthmatic group.By inhaled OVA to make asthmatic rat model;primary culture ASMC;confocal microscopy were used to observe the morphological changes and measure the length before and after different intervention.The percent of contraction length come from different group ASMC were used for statistical analysis.Results The ASMCs volume in acetylcholine intervented group and substance P intervented group decreased significantly,cell diameters shorten, cytoplasm reduction and cell arranged densely.The ASMCs volume in substance P receptor antagonist intervented group and nimodipine intervented group are about the same size as the ones in normal control group, were spindle-shaped, abundant cytoplasm and arrangement regularly.The contraction length percent of Ach intervened group is the biggest(19.60 ± 3.47) ％, contraction length percent of nimodiping intervented group is the shortest(3.25 ± 1.14)％ ,the contraction length percent in substance Precepter antagonist intervented group is bigger than the one in control group (3.54 ± 1.26) ％, but less than the one in Ach intervented group, asthmatic (14.36 ± 2.37) ％ and substance P intervened group (17.79 ± 3.19) ％.Conclusion Substance P can increase the amplitude of airway smooth muscle cell contraction, but the effect less than Ach;substance P receptor antagonists can inhibit smooth muscle cell contractility, but the effect less than nimodipine.Substance P participates in acute attack of asthma, increases airway reactivity by increasing airway smooth muscle contraction intensity.

Objective To investigate the effect of budesonide on NK-1 receptor expression in airway smooth muscle cell (ASMC). Methods According to the random method,45 wistar rats were divided into three groups: asthmatic group, budesonide treatment group and control group. Aerosolize ovalbumin was used to make asthmatic rat model. Budesonide treatment group were given budesonide after inhaled ovalbumin. On day 21 .primary rat ASMC culture was conducted. The fourth cell passage and purified ASMC was collected for RT-PCR. The content of NK-1R was determined by real-time quantitative PCR. Data were expressed as mean±standard error (SE). The ANOVE Tukey test was carried out by using SPSS17.0 software and P＜0. 05 was considered significant. Results As compared with that of asthmatic group(1.1687±0.1356),NK-1R mRNA in therapy group( 1.0820 ±0. 1146) decreased significantly (P ＜0.05) ,but remained still higher than that of control group(1.034 7±0.2503) (P＜0. 05). Conclusion NK-1R may be involved in the pathogenesis of asthma. Budesonide may down-regulate the expression of the NK-1R mRNA in the airway smooth muscle cell, which may inhibit inflammation in asthmatic attacks.

Objective Investigate the effect of substance P and receptor antagonist on the current of NCX in ASMC.Methods Primary rat ASMC cultures were established.Immunofluorescence was used to identify ASMCs.Patch clamp exam was used to assess NCX currents in ASMC before and after intervented by Ach,substance P,NK-1R receptor antagonist and nimodiping,Voltage-current curves were drawn according to variation of voltage and current.PA indicates current amplitude,PF indicates cell area,and PA/PF indicates current density.Results As the voltage increased,the current density increased.When voltage up to-40mV the reverse current appeard.When the voltage is 60mV the current density in the Ach intervention group was highest,but lowest in the nimodipine intervention group;the current density in the substance P intervention group is more than in control group but lower than in Ach interevention group.The current density in the substance P receptor antagonist intervention group higher than nimodipine interevention goup,but lower than the other group (P ＜0.05).Conclusion In asthma airways,Ca2 + overload is related to the appearance of reverse-mode NCX.NK-1R antagonist plays a role in decreasing the Ca2 + concentration,which can relieve the current of reverse-mode NCX,and may benefit alleviating airway inflammation and responsiveness.As a result,NK-1R antagonist may be an attractive target for therapeutic approaches to asthma.

ObjectiveTo investigate the effect of neuropeptide substance P on airway resiatance in rats with asthma.MethodsSixty Wistar rats were randomly divided into 3 groups including normal control group(n =20),asthma group(n =20) and substance P group(n =20).Asthmatic rat model was established.We detected inspiratory resistance and expiratory resistance in the airway of rats in each group with the intervention of different concentrations (0.062 5,0.125 0,0.250 0,0.5000 mg/ml) of methacholine(MCh) by using animal pulmonary function analyzer.Substance P group rats were given substance P ( 10-7 mol/L,0.2 ml) when airway resistance was detected.ResultsWith the increase in MCh concentration,the increase in airway resistance in rats was found,rat airway inspiratory resistance and expiratory resistance were all positively correlated with the concentration of MCh ( r=0.947,P＜0.05 ; r=0.965,P＜0.05 ).With the intervention of different concentration of Mch (0.0625,0.125 0,0.2500,0.5000 mg/ml),the significant differences were found among the three groups in rat airway inspiratory resistance ( F=73.4,89.3,91.2,106.4,P＜0.05) and expiratory resistance(F=67.3,77.5,83.4,126.5,P＜0.05).Airway resistance to MCh concentration response curves were shifted upward significantly in asthma group compared with normal control group and in substance P group compared with asthma group.Inspiratory resistance and expiratory resistancc in asthma group were significantly increased compared with normal control group( P＜0.05)and in sutstance P group compared with asthma group( P＜0.05 ).ConclusionSubstance P can increase asthmatic rat's airway resistance and the airway resistance increase with the increasing of MCh concentration.

Objective To investigate the influence of Mycoplasma pneumonia (MP) on the levels of interferon (IFN)-γ,interleukin (IL)-4 and IL-5 in bronchoalveolar lavage fluid (BALF) of BALB/c mice infected by MP,and to study whether MP infection may be involved in the pathogenesis of asthma through the pathway of influencing T helper type 1 (Th1)/T helper type 2 (Th2) immune response.Methods Forty BALB/c mice were randomly divided into two groups,control group and MP infected group,each group 20 mice.The BALF of MP infected group was respectively collected after MP infection at 3,7,14,21 days,each time 5 mice.The levels of IFN-γ,IL-4 and IL-5 were detected by enzyme linked immunosorbent assay.Results The levels of IFN-γ,IL-4 and IL-5 increased in MP infected group compared with control group,the differences were significant respectively (P ＜ 0.05).The levels of IFN-γ,IL-4 and IL-5 reached the peak at 7 d after MP infection.The IFN-γ/IL-4 ratio was significantly lower in MP infected group than control group,and achieved the trough at 7 d,the difference was significant (P ＜ 0.05).Conclusion MP infection can lead to the increased level of IFN-γ,IL-4 and IL-5 in BALF of BALB/c mice,peaked at 7 d.MP infection can increase the discharging of Th1 cytokines and Th2 cytokines,induce Th1/Th2 immune response disequilibrium,and it may be involved in the pathogenesis of asthmatic airway inflamation through the pathway.

Objective According to the clinical imaging for mycoplasma pneumoniae pneumonia,lung CT imaging features of mycoplasma pneumoniae pneumonia were summarized in children.Methods The CT findings and clinical features of 66 patients were retrospectively reviewed(average age was 7 years with 30 males and 36 females) with confirmed pneumoniae pneumonia.The CT images were analyzed by two experienced pulmonologists.Results The most common finding in the mycoplasma pneumoniae pneumonia group was bronchial wall thickening with 69.9％,air bronchogram up 65.1％,over all age groups there was no significant difference;ground-glass-like changes up to15.1％,scattered patchy shadows up to 45.5％,more common in infants; lung consolidation accounted for 48.4％, tree bud accounted for 34.8％,the above results more common in older children.Conclusions Mycoplasma pneumoniae pneumonia HRCT imaging features include:bronchial wall thickening inflatable, the tree bud tree fog sign,ground glass-like changes,scattered patchy shadows,dense coalescent consolidation,and lung CT may improve the early diagnosis of mycoplasma pneumonia.

Objective To detect the development of fetal nasal bone with ultrasound scan in the second and third trimester, and to evaluate the value of fetal nasal bone hypoplasia in diagnosing fetal chromosomal abnormalities. Methods Prenatal ultrasound examination was performed in 1415 normal fetuses. The nasal bone length (NBL) and the nasal bone angle (NBA) were measured on the mid-sagittal plane. The karyotype of the cases with nasal bone abnormality was analyzed. Results The fetal nasal bone was successfully detected with two-dimensional ultrasonography in 95% of the subjects. The NBL increased with the gestational age while the NBA kept unchanged with the average value of 54. 4?(44. 4?-69. 2?). Forty-two cases with nasal bone hypoplasia were diagnosed prenatally including nasal bone defect (20 cases), small NBA (15 cases), short nasal bone (4 cases) and short nasal bone with small NBA (3 cases). Cordocentesis was performed in 21 cases among which 12 with abnormal karyotype, including 3 cases of trisomy 21, 3 cases of trisomy 13, 4 cases of trisomy 18 and 3 other chromosomal abnormalities. Conclusions Fetal nasal bone hypoplasia was closely related to the chromosomal abnormalities. The evaluation of fetal nasal bone with prenatal sonography is an important criteria for screening fetal chromosome abnormalities during the mid-trimester.

Objective To provide evidences for fall prevention through environmental safety assessment of elderly patients admitted in different grade hospitals. Methods 24 different levels hospitals located in 10 cities in southwest of China were surveyed with assessment form of fall-related factors of hospital environment for elderly patients. Results Hospital public environment and ward public environment were assessed well by elderly patients which were 4.10 points and 4.06 points, but the scores for ground channel environment and toilet environment were lower which were 3.92 points and 3.65 points;Scores of tertiary-class hospitals were better than that in second-class hospitals, including ward facilities (t=-2.756, P<0.01), bathroom facilities (t=-3.752, P<0.01), public ward environment (t=-2.438, P<0.05) and public hospital environment (t=-2.263, P<0.05). As the ground-channel was concerned, there was no statistically significant different between them (P>0.05). Conclusions Public hospital environment and public ward environment got higher scores, and the scores of ground-channel environment and the bathroom environment were relatively lower. Environment in second-class hospitals need to improve in order to prevent fall of elderly patients. Assessment form of fall-related factors of hospital environment for elderly patients is helpful to disclose the unsafety factors of the hospital environment, and should be windely used in futher clinical practice.

Objective:To investigate the relationship between polymorphism of leptin gene -2548A/G and leptin receptor gene ( LEPR) Gln223Arg and asthma and metabolic syndrome.Methods: 82 asthma-combined metabolic syndrome patients,114 asthma patients,100 metabolic syndrome patients and 96 normal controls were conducted.The polymerase chain reaction and restriction fragment length polymorphism ( PCR-RFLP) analysis were performed to investigate the polymorphism of leptin gene -2548A/G and LEPR gene Gln223Arg site.In addition, asthma was graded into mild AS and mod-severe AS according to lung function.Then the associations between the polymorphism of leptin gene -2548A/G and LEPR gene Gln223Arg and different grades of asthma were performed.Results:①The biochemical indicators were different compared between each group.②The genotype and allele frequencies in leptin gene polymorphism -2548A/G were significantly difference between metabolic syndrome patients(P=0.047 and 0.046), asthma-combined metabolic syndrome patients( P=0.038 and 0.044) ,mod-severe asthma patients( P=0.019 and 0.028) and control group.③There was a significant difference of genotype and allele frequencies in LEPR gene Gln223Arg between metabolic syndrome patients and controls(P=0.037 and 0.023);between metabolic syndrome patients and asthma patients(P=0.000 and 0.000).There was a significant difference of allele frequencies in LEPR gene Gln223Arg between asthma-combined metabolic syndrome patients and asthma(P=0.032) .Conclusion: Polymorphisms of the leptin gene -2548A/G site may be associated with metabolic syndrome and mod-severe asthma.Polymorphisms of the LEPR gene Gln223Arg site may be only associated with metabolic syndrome.The two genes would be the candidate genes in early prevention and control.