Objective To investigate the clinical efficiency of nasal continuous positive airway pressure (nCPAP) on patients with chronic heart failure(CHF) due to hypertensive heart disease complicated with severe obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Fifty cases with CHF due to hypertensive heart disease complicated with severe OSAHS were divided into treatment group and control group with 25 cases each by the method of random digits table.nCPAP and routine drug treatment were administered in treatment group,while only routine drug treatment was given in control group.Cardiac functional grading,blood pressure,left ventricular end diastolic dimension (LVDd),left ventricular ejection fraction (LVEF),B-type natriuretic peptide (BNP),high-sensitivity C-reactive protein (hs-CRP) were compared before and after 3-month therapy.Results The effective rate in treatment group was significantly higher than that in control group [76.00％(19/25) vs.40.00％(10/25)],and there was significant difference (P ＜0.05).There was significantly decreased in blood pressure in two groups at the end of the therapy [treatment group:(127.52 ± 10.38)/(72.44 ±4.92) mmHg(1 mmHg =0.133 kPa) vs.(176.80 ± 12.90)/ (100.44 ±5.55) mmHg;control group:(150.12 ± 18.96)/ (81.64 ±9.42) mmHg vs.(176.00 ± 11.69)/ (96.08 ± 18.59) mmHg] (P ＜ 0.01),but the blood pressure was significantly lower in treatment group than that in control group (P ＜0.05).LVDd,BNP and hs-CRP in treatment group was declined significantly [(49.12 ± 3.18) mm vs.(57.44 ± 3.62) mm,525.52 ng/L vs.785.25 ng/L,(7.76 ± 1.69) mg/L vs.(18.04 ± 2.58) mg/L](P＜ 0.01);LVEF was significantly increased [(46.12 ± 2.52)％ vs.(38.68 ± 4.65)％](P＜ 0.01).There was no significant difference in LVDd and LVEF in control group before and after therapy (P ＞ 0.05).BNP and hs-CRP also were declined significantly [668.66 ng/L vs.850.96 ng/L,(12.88 ± 2.02) mg/L vs.(19.40 ± 2.30) mg/L] (P ＜ 0.05 or ＜ 0.01),but the above two were significantly lower in treatment group than those in control group(P ＜ 0.05).Conclusion nCPAP therapy can effectively improve the symptoms of heart failure,decrease blood pressure,improve cardiac function,reduce the inflammation response to patients with CHF due to hypertensive heart disease complicated with severe OSAHS.

Objective To investigate the influence of nasal continuous positive airway pressure (nCPAP) therapy on tumor necrosis factor-ot (TNF-α) and interleukin-6 (IL-6) in patients with chronic heart failure (CHF) and severe obstructive sleep apnea syndrome (OSAS).Methods Seventy-two cases with CHF and severe OSAS were divided into treatment group (36 cases) and control group (36 cases) by random digits table.Treatment group was treated by nCPAP and routine drug while control group only by routine drug treatment for 12 weeks.The changes of TNF-α and IL-6 before and after therapy were observed.Results The serum TNF-αt and IL-6 before treatment between two groups was no significant difference (P＞ 0.05).The serum TNF-αt and IL-6 after 12 weeks treatment in both two groups was significantly lower than that before treatment [treatment group:(29.94 ± 8.27) ng/L vs.(13.17 ± 3.61) ng/L,(92.08 ± 11.88) ng/L vs.(46.17 ± 20.01) ng/L;control group:(28.01 ± 7.21) ng/L vs.(22.13 ± 5.43) ng/L,(96.01 ± 12.19) ng/L vs.(68.66 ± 11.10) ng/L] (P ＜ 0.05),the treatment group decreased more significantly (P ＜ 0.05).Conclusion nCPAP therapy could effectively decrease the levels of TNF-α and IL-6 and reduce inflammation response in patients with CHF and severe OSAS.

Adult ; Epilepsy ; genetics ; Humans ; Hyperhomocysteinemia ; genetics ; Hypogonadism ; genetics ; Intellectual Disability ; genetics ; Male ; White Matter ; pathology

Fatal Outcome ; Herbicides ; poisoning ; Humans ; Injections, Intravenous ; Paraquat ; poisoning ; Poisoning ; mortality

Objective To look for more serum biomarkers supporting the diagnosis of multiple system atrophy ( MSA) and providing more evidence for early treatment.Methods All patients and healthy controls were enrolled from January 2011 to March 2015 in the First Affiliated Hospital of Zhengzhou University.Demographic features and biochemical examination results were collected.The t test was used to compare the lipid levels between MSA patients and controls.LSD-t test was used to compare the lipid levels among subtypes of MSA patients.Multivariate Logistic regression analysis was conducted to analyze the influencing factors.The relevance between lipid levels and onset age, disease duration and Hoehn & Yahr stage was calculated by Spearman correlation coefficients.Results Participants included 195 MSA patients and 195 age-and gender-matched controls with no neurological diseases.The levels of total cholesterol ((4.33 ±0.90) mmol/L), triglyceride ((1.27 ±0.71) mmol/L), low-density lipoprotein (LDL;(2.70 ±0.76) mmol/L) were significantly lower in patients than in controls ((4.52 ±0.85), (1.47 ± 0.86), (2.85 ±0.71) mmol/L ,t=2.056,2.528 and 2.149 respectively, all P<0.05).The levels of total cholesterol ((4.28 ±0.96) mmol/L) and triglyceride ((1.20 ±0.64) mmol/L) were significantly lower in MSA-P patients than in control group ((4.52 ±0.85), (1.47 ±0.86) mmol/L;LSD-t=1.983, 2.566, both P<0.05).After adjusting for age, gender and histories, the odds ratio ( OR) was 0.31 (95%CI 0.15-0.65, P =0.002 ) for MSA patients in the highest quartile of triglyceride and 0.38 (95%CI 0.17 -0.83,P=0.016) for those in the highest quartile of high-density lipoprotein (HDL), compared with the lowest quartiles.And HDL level was in a significantly positive correlation with onset age (r=0.15, P=0.039).Conclusion Our data suggest that triglyceride and HDL may be associated with the prevalence of MSA, and the lower levels of HDL, the earlier onset of MSA.

Objective To understand the prevalence and the factors associated with depression and anxiety among patients attending the community-based methadone maintenance treatment(MMT) program.Methods 9 MMT clinics in 3 provinces were randomly selected,in which 1 301 MMT patients who met the criteria of recruitment were all interviewed.A cross-sectional study by administrative questionnaire was employed to investigate the demographics,drug abuse and MMT treatment status of the respondents.The 1301 respondents were also evaluated for depression and anxiety by SDS(Self-Rating Depression Scale) and SAS(Self-Rating Anxiety Scale) respectively.ANOVA and multivariate linear regressions analysis was used to verify the factors associated with depression and anxiety respectively.Results The prevalence of depression and anxiety among the MMT patients were 38.3%(498/1 301) and 18.4%(239/1 301).The multivariates linear regression analysis indicated that at the level of ?=0.05,gender,employment status were associated with depression,while gender,employnment status,educational level,drug abuse and methadone daily dosage were associated with anxiety.Conclusions There are certain proportions of MMT clients who suffer from depression and anxiety.The MMT clinic staff should put more emphasis on the efforts to reduce psychological disorders and its potential risks by enhancing psychological councelling,intervention and social support towards the MMT patients.

Objective To investigate correlation between the rs12122341 polymorphism and ischemic stroke and its major subtypes in Chinese Han population.Methods The patients with ischemic stroke and matched healthy controls in Chinese Han population were enrolled.The rs12122341 genotype was detected by the improved multiple ligase detection reaction (iMLDR).Results A total of 776 patients with ischemic stroke (415 large artery atherosclerotic stroke and 361 small artery occlusive stroke) and 776 healthy controls were enrolled.Genotyping showed that only rs12122341 CC and CG genotypes were detected in all subjects,and no GG genotype was detected.There was no significant difference in frequencies of allele and genotype between the patient group and the control group.Multivariate logistic regression analysis showed that there were no significant correlations between rs12122341 polymorphism and ischemic stroke (odds ratio [OR] 1.482,95％ confidence interval [CI]0.641-3.421;P =0.447),large artery atherosclerotic stroke (OR 1.972,95％ CI 0.655-6.034;P=0.227),and small arterial occlusive stroke (OR 1.632,95％ CI 0.437-6.262;P =1.000).Conclusions There is no significant correlation between the rs12122341 polymorphism and risk of ischemic stroke and its major subtypes in Chinese Han population.

Objective The purpose of study was to evaluate the safety and effectiveness of theblood-letting and herbal-cupping therapy for lumbar spinal stenosis.Methods A multi-center prospective case series was performed.The LSS patients meeting the inclusion criteria received 8 treatments as a course and 4 courses in total.The primary outcomes were the symptom severity and physical function scale ofthe Swiss Spinal Stenosis Measurement (SSM,total score 0-5 for each domain).The secondary outcomes were thethe 12-item short form health survey (SF-12,total score 0-100),and Oswestry disability index (ODI,total score 0-100) at time of baseline,completion of last treatment of each course.The minimal clinically important differences (MCIDs) were calculated for estimating the percentage of improvement in the population.The adverse events were reported at any time of the intra-and post-operation.This was a phrase analysis of the studyat seven months.Results Forty-eight patientswere included,with 64.6％ (31/48) of LSS showing neurogenic claudication (walking distance ≤200 m).The average age was 63.1 ± 11.7 years,19 (39.6％) female,and the average BMI was 25.3 ± 3.3 kg/m2.The scores of symptom severity scale of SSM were 2.8 ± 0.6,2.6 ± 0.7,2.3 ± 0.6,1.9 ± 0.2 at baseline,1st,2nd,3rd course,and the scores of physical function scale were 2.5 ± 0.8,2.4 ± 0.7,2.1 ± 0.5,1.8 ± 0.3,and all the changes between baseline and each course showed significant improvement.The patient satisfaction of SSM,ODI and SF-12 showed significantimprovements after the 1st,2nd,3rd course (P＜0.05).The SF-12 subgroup physical composite scores after 3rd course and mental composite score after 1st showed no significant improvement.The minimal clinically important difference for the “SymptomSeverity scale” in the SSM was achieved withimprovement of 18.8％,40.6％,83.3％ in the LSS patient population after 1st,2nd,3rd course;and the "physical function scale" in SSM was achieved withimprovement of 22.9％,31.3％,50.0％.A total of 15 patients felt pain when they were micro-punctured with little blood at first time,but the symptom wereimmediately relieved without any treatment.Conelusions The Blood-letting and herbal-cupping therapy could benefit patients with lumbar spinal stenosis after third course of treatment in the fields of symptom relief and quality of life with no severe adverse event.However,this was a phrase analysis,so more evidence of this study and large comparative researches should be warranted in future.

Objective:To detect the expression level of RAB39B gene and the effect of RAB39B on autophagy and α-synuclein, and then investigate the role of RAB39B gene mutation c.536dupA in the pathogenesis of Parkinson′s disease.Methods:Based on the novel RAB39B gene c.536 dupamutation identified in the previous work, the recombinant expression plasmid (pcDNA3.1-HA-RAB39B-536) of RAB39B gene with this mutation and wild-type recombinant expression plasmid (pcDNA3.1-HA-RAB39B) of RAB39B gene were constructed, and the recombinant expression plasmid was transfected into N2a cells with liposome as experimental group. The control group was made up with N2a cells transfected with plasmid pcDNA3.1-HA-RAB39B. Real-time polymerase chain reaction, Western blotting, immunofluorescence and immunoprecipitation techniques were used to detect the expression level of mutant RAB39B gene and the effects of RAB39B on autophagy and α-synuclein.Results:In the N2a cell model, the transcription level of mutant RAB39B was about twice that of wild type RAB39B, while the protein level of mutant RAB39B (0.30±0.00) was significantly lower than that of wild type (1.50±0.25, t=8.313, P<0.05). After adding proteasome inhibitor MG132, the protein level of mutant RAB39B increased (0.70±0.10, t=6.925, P<0.05); the level of microtubule-associated protein 1 light chain 3 BⅡ/Ⅰ of mutant RAB39B (3.11±0.30) was significantly lower than that of wild type (7.03±0.20, t=18.831, P<0.05); overexpression of wild type and mutant RAB39B did not affect the level of endogenous α-synuclein; overexpression of wild-type RAB39B resulted in elevated level of exogenous wild-type (p.A53T; from 0.60±0.11 to 1.25±0.08, t=8.254, P<0.05) and mutant (from 0.55±0.08 to 1.15±0.08, t=9.293, P<0.05) α-synuclein. Conclusions:The stability of the RAB39B protein decreased with the appearance of c.536 dupA mutation, the mutant protein may be degraded through the ubiquitin-proteasome pathway, and this mutation may affect the autophagy level of cells. RAB39B protein may interact with α-synuclein in vivo and may be involved in the maintenance of the stable level of α-synuclein.

Objective:To report the clinical, electrophysiological and genetic features in a Chinese family with distal hereditary motor neuropathy type V (dHMN-V) and screen the pathogenic mutant gene.Methods:A family with the history of inherited peripheral neuropathy was recruited in the First Affiliated Hospital of Zhengzhou University in July 2017. The clinical features and electrophysiological data were investigated. Genetic testing on well-established genes associated with hereditary peripheral neuropathy was conducted by targeted high throughput sequencing and the candidate variant was screened in the family and normal controls.Results:There were four affected individuals in the family. The proband, a 25-year-old male, was characterized by weakness and atrophy in the distal extremities primarily affected the upper extremities without sensory impairment. Electrophysiological study showed chronic neurogenic pattern in the upper and lower limb muscles. The motor conduction showed reduced velocity and compound muscle action potential amplitude, while the sensory conduction studies results were normal. The grandfather, a maternal uncle and a cousin of the proband exhibited similar clinical manifestations and electrophysiological abnormality. Genetic testing revealed a heterozygous mutation, c.880G>A(p.G294R), in the GARS gene in the proband. Proband′s mother and two other affected individuals carried the mutation which was confirmed by Sanger sequencing. The mutation site was not found in the unaffected members from the family and 300 unrelated normal controls. The variant is a novel mutation which has not been reported in dbSNP, ExAC and 1000 Genomes Project databases. Conclusion:The results suggest that the novel c.880G>A(p.G294R) mutation of the GARS gene is responsible for the Chinese patients with dHMN-V, and the findings broaden the mutational spectrum of GARS gene.