Objective To investigate the relationship between obstructive sleep apnea hypopnea syndrome(OSAHS) and cardiac arrhythmia. Methods 160 snorers were recruited to undergo more than 7 hours nocturnal polysomnography(PSG) and 24 hours ECG monitoring, and were divided into OSAHS group (n=98) and control group (n=62) based on the results of PSG monitoring. Results There were significant differences in sleep apnea hypopnea index(AHI), SpO_2 and cardiac arrhythmia frequency between the OSAHS and control groups. Accompanying with the breath pause, SpO_2 decreased, and heart rate was periodic changes. The frequency of cardiac arrhythmia obviously increased when SpO_2 was lower than 80%. Conclusion During sleep the low oxygen saturations and fluctuation of autonomic nervous system play important roles in the cardiac arrhythmia in OSAHS patients.

Objective To explore the changes of arterial pressure in patients with snore during sleep and to increase the acknowledge for the relationship between obstructive sleep apnea syndrome(OSAS) and hypertension(HT).Methods 266 patients with snoring were monitored during overnight nocturnal sleep monitored with Autoset diagnosis-treatment system and measured arterial pressure before and after sleep.166 patients of them as OSAS group,the other 100 patients as controls.Data for each group such as Apnea Index,SaO 2 and arterial pressure were chosen for statistical analysis.Results The blood pressure in OSAS group before sleep was(128 94?19 32/87 46?12 30)mmHg,after sleep was(139 66?19 38/99 68?16 28)mmHg(P

Objective To investigate the significance of changes in serum uric acid levels in elderly patients with obstructive sleep apnea hyponea syndrome (OSAHS).Methods The study recruited elderly patients aged 60 years and over undergoing polysomnography (PSG) at the Center for Diagnosis and Treatment of Sleep Disorders of our hospital from January 2012 to December 2014.According to the diagnostic criteria established by the Group of Sleep and Breathing Disorders,Respiratory Diseases Branch,Chinese Medical Association (2011),patients were divided into the simple snoring group,the mild OSAHS group,the moderate OSAHS group and the severe OSAHS group.Levels of serum uric acid,blood glucose,blood lipids and high-sensitive C-reactive protein (hsCRP) were compared between all groups after adjusting for age,gender and underlying diseases.Independent risk factors associated with serum uric acid were analyzed using Spearman' s rank correlation and stepwise multivariate analysis.Results A total of 129 elderly subjects including 100 males and 29 females,with a mean age of (63.6±2.25) years,were enrolled.Of these subjects,23 were grouped as simple snoring,24 as mild OSAHS,39 as moderate OSAHS and 43 as severe OSAHS.Serum uric acid and hs-CRP levels were increased in the severe OSAHS group as compared with the simple snoring group (both P＜0.05).Spearman's rank correlation analysis showed that the apnea-hypopnea index (AHI) and the oxygen desaturation index (ODD were positively correlated with the serum uric acid level (r =0.251 and 0.210,P =0.004 and 0.018,respectively).Stepwise multivariate analysis showed that,with serum uric acid level as the dependent variable,AHI was an independent risk factor for increased serum uric acid levels (β=0.354,P =0.000).Conclusions Serum uric acid levels are elevated in elderly patients with severe OSAHS,and AHI is an independent risk factor for the increased serum uric acid levels.

ObjectiveTo investigate changes of the cellular immune function in the elderly patients with nonsmall-cell lung cancer (NSCLC) after chemotherapy.Methods T-lymphocyte subsets and natural killer cell were detected in 29 elderly patients with NSCLC,20 adults with NSCLC and 22 healthy elderly,and their levels were compared between pre-chemotherapy and at the end of 2 cycles of chemotherapy in the elderly patients with NSCLC.ResultsThe levels of CD3,CD4,CD8,CD4/CD8andNK cell were (58.9±15.8),(32.3±12.7),(22.0±9.8),(1.3±0.7),(21.6± 7.7),respectively in the elderly patients with NSCLC,(65.9 ± 7.2),(38.5 ± 7.6),(23.1 ± 9.2),(1.5±0.7),(16.8±6.2),respectively in adults with NSCLC and (67.3±9.0),(39.0±7.8),(23.9±9.3),(2.0±1.6),(22.5±5.8),respectively in healthy elderly.The levels of CD3 and CD4 were decreased (t=2.109,2.159,P＜0.05) and NK cell was increased (t=2.273,P＜0.05) while CD8 and CD4/CD8 had no difference(t = 0.406,0.736,P＞ 0.05 ) in the elderly patients with NSCLC as compared with adults with NSCLC.The levels of CD3,CD4,and CD4/CD8 were lower (t = 2.234,2.200,2.016,all P＜ 0.05) in elderly patients with NSCLC than in healthy elderly,with no significant change in the levels of CD8 and NK cell(t= 0.700,0.474,P＞0.05) between the two groups.The levels of CD3 (51.6 ±10.3)was reduced(t=2.067,P＜0.05) and CD4 (31.7 ± 11.7),CD8(21.6 ± 6.5),CD4/CD8 (1.3 ± 0.7),NK cell (26.0 ±12.7)had no remarkable difference (t =0.186,0.180,0.289,1.570,all P＞ 0.05)after chemotherapy in elderly patients with NSCLC.ConclusionsThe cellular immune function in the elderly patients with NSCLC is lower than in adults with NSCLC and healthy elderly,and further decreases after chemotherapy.

Objective:To explore the incidence,mortality,trends and time distribution of food poisoning in Hunan Province.Methods:The data on food poisoning was derived from the Information Office of Hunan Provincial Health Department.Using the trend-test and circular distribution methods,we have described the current situation of food poisoning and tested the central tendency of the peak time points and the peak time zone of food poisoning in Hunan from 2000 to 2009.Results:On average,the incidence of food poisoning in Hunan from 2000 to 2009 was 0.072 per 100000 population.And the average number of people affected in these incidents was 1.937 per 100000 population.There were no apparent trends in either the number of incidents or people affected between 2000 and 2009 (u=-0.98,P＞0.05; u=-1.34,P＞0.05,respectively).The average mortality was 0.015 per 100000 population.The trend-test indicated that the average annual mortality decreased significantly from 2000 to 2009 (u=-1.72,P＜0.05).Meanwhile the average annual fatality rate was 0.77％.The trend-test revealed statistically significant differences for the average annual fatality rate (u=-1.88,P＜0.05).The circular distribution analysis showed that there was a central tendency of the distribution of food poisoning cases,with the average peak time atAugust 28th and the average peak time zone from June 7th to November 18th for food poisoning from 2000 to 2008.Conclusion:From 2000 to 2009,there is a significant tendency in the average annual mortality and fatality rate of food poisoning in Hunan.Summer and fall are the high seasons for food poisoning.We should pay attention to the peak time zone,especially the peak time point of food poisoning for food safety monitoring,and strengthen the prevention and control on food poisoning.

Objective To investigate the effect of β-lactam antibiotics on the false positive rate of the serum Aspergillus galactomannan (GM) assay in patients with lung diseases.Methods We selectively recruited 77 lung disease patients who did not meet the diagnostic criteria of invasive pulmonary Aspergillosis (IPA) and received different β-lactam antibiotics,while 41 patients without IPA who did not receive any antibiotic treatment were recruited as the control group.Serum samples for GM detection were collected from all participants.The rate of false-positive Aspergillus galactomannan was compared between the two groups.Results False-positive serum results were found in patients who received piperacillin-tazobactam (30.8％ or 8/26) and cefoperazone sulbactamand (27.8％ or 5/18).The rate of false-positive Aspergillus galactomannan in patients who receive β-lactam antibiotics were significantly higher than that in the control group (24.7％ or 19/77vs.7.3％ or 3/41,x2 =5.315,P=0.025).Taking false-positive serum Aspergillus galactomannan as the dependent variable and β-lactam antibiotic treatment as the independent variable,univariate logistic regression analysis showed that the rate of false-positive Aspergillus galactomannan in patients who received β-lactam antibiotics were 4.149 times more than that in the control group (OR=4.149,P=0.030).Conclusions The administration of β-lactam antibiotics may increase the occurrence of false-positive serum Aspergillus galactomannan,and physicians should be aware of this possible interference.

Objective To investigate the change of serum cystatin C (CC) level and its clinical significance in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS),and to evaluate the diagnostic value of serum CC for renal impairment in elderly OSAHS patients.Methods Elderly snoring subjects (age ≥60 years) undergoing sleep apnea monitoring in our sleep laboratory were recruited.Patients were divided into simple snoring group,mild OSAHS group,moderate OSAHS group and severe OSAHS group according to the diagnostic criteria of American academy of sleep medicine.Anthropometric characteristics,lipid profiles,blood glucose,creatinine,estimated glomerular filtration rate (eGFR) and serum CC were compared between groups after age,gender and basic diseases were adjusted.The independent risk factors associated with serum CC were analyzed by Spearman's rank correlation and stepwise linear regression.Results Totally 89 elderly patients [70males and 29 females,aged (68.4±6.3) years in average] were collected.21 subjects were grouped as simple snoring,14 subjects as mild OSAHS,21 subjects as moderate OSAHS and 33 subjects as severe OSAHS.There were no differences in age,gender,basic diseases (hypertension and diabetes),lipid profiles,creatinine and eGFR among groups.The levels of body mass index,systolic blood pressure,diastolic blood pressure and serum CC were higher in severe OSAHS group than in simple snoring group [(28.3±3.9) vs.(24.6±5.9),(136.55±16.14) mm Hgvs.(122.43±16.64) mm Hg,(89.18±11.92) mm Hgvs.(78.10±9.55) mm Hg,(0.95±0.22) mg/L vs.(0.76±0.13)mg/L,respectively,all P＜0.05].Serum CC was significantly correlated with apnea hypopnea index (AHI),oxygen desaturation index,creatinine,eGFR,high sensitive C reactive protein (r=0.397,0.347,0.275,－0.354,0.254 respectively,all P％0.05).Regression analysis showed that AHI was an independent factor for serum CC (β=0.449,P＜ 0.001).Conclusions Serum CC level is increased in elderly patients with severe OSAHS.AHI is an independent factor for the increase of serum CC.Serum CC can be as an index for the early impairment of renal function in patients with OSAHS.

Objective To evaluate the vascular endothelial dilatation function in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Thirty elderly patients with moderate to severe OSAHS and twenty-eight control subjects were studied. Their blood concentration of nitric oxide (NO) were quantified. Brachial artery diameter was measured with Doppler ultrasound under baseline conditions, during reactive hyperemia (an endothelium-dependent dilatation) and after sublingual administration of nitroglycerin ( an endothelium-independent vasodilator). The dilative rate of brachial artery in different conditions was calculated to evaluate the endothelial function. Subjects with OSAHS were treated by nasal continuous positive airway pressure (nCPAP) for 4 weeks, and the level of NO in plasma and vascular endothelial function were measured. Results Compared with control group, there was a significant decrease of NO level in elderly patients with moderate to severe OSAHS [(50. 35±8.65)μmol/L vs. (57.31±9.31)μmol/L, t=2.95,P=0.005], and the level of NO in plasma was increased after nCPAP treatment for 4 weeks [(55.77±8.87)μmol/L vs. (50.35± 8.65)μmol/L,t=2.40,P=0.023. The elderly patients with moderate to severe OSAHS had lower endothelium-dependent flow-mediated dilation (FMD) compared with control subjects [(9.78± 4.82)%vs. (13.21±5.81)%,t=2.45, P=0.017], and there was no significant difference in endothelium-independent nitroglycerin ( NTG)-induced dilation [( 16.87±6.15)% vs. (14.74 ± 5.82)%,t=1.36,P=0.18]. After nCPAP treatment for 4 weeks, the patients with moderate to severe OSAHS had significant increase in FMD[(14.33±6.13)% vs. (9.78±4.82)%, t=3.20,P= 0.002], whereas there was no significant change in NTG-induced dilation [(14.74±5.82)% vs. (15.15±4.21)%, t=0.31,P=0.76]. Conclusions The elderly patients with moderate to severe OSAHS have abnormal vascular endothelial function, and nCPAP treatment can reverse the dysfunction effectively, which may be associated with the reversal of intermittent hypoxia.

Objective To explore the guiding role of serum procalcitonin (PCT) in antibiotic therapy during acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Totally 72 patients with AECOPD were randomly divided into PCT group (n=40) and conventional therapy group(n=32).For patients in PCT group,the use of antibiotics was based on PCT serum levels,antibiotics were stopped when PCT＜0.25 μg/L,while in conventional treatment group,the use of antibiotics was based on clinical symptoms of patients.The main observation indexes included ratio of antibiotic usage,time of antibiotics use,hospital stay,clinical efficacy,aggravating cases and death cases. Results There were no significant difference in clinical efficacy between the two groups(82.5％ vs.75.8％,x2 =0.217,P=0.641),however,the ratio of antibiotics usage in PCT patients was significantly lower than conventional therapy group (47.5％ vs.71.9％,x2 =4.346,P=0.037),average time of antibiotics use and days of hospital stay were shorter in PCT treatment group than conventional therapy group [(6.84±3.27) d vs.(10.22±3.67)d,x2 =3.116,P=0.003; (11.7±5.2) d vs.(20.3±8.7) d,x2 =5.202,P=0.000].There were no difference in double infection incidence (2.5％ vs.18.8％,x2 =3.657,P=0.056),aggravating cases (3 cases vs.4 cases,x2 =0.097,P=0.756) and mortality (2.5％ vs.6.3％,x2 =0.039,P=0.843) between the two groups.Conclusions Serum PCT level may be an appropriate indicator to guide antibiotic therapy in patients with AECOPD in view of its effective decreases of excessive use of antibiotics,double infection opportunities and hospitalization time.

Objective To investigate the cellular immune function changes and the effect of thymosin alpha-1 on the changes in elderly patients with severe pneumonia. Methods T cell subset and natural killer (NK) cell were detected in 66 elderly patients with severe pneumonia and 34 elderly patients with common pneumonia. The severe pneumonia patients were randomly divided into 2 groups: the treatment groups (34 cases) and the control group (32 cases). All patients received conventional therapy of pneumonia. The treatment group received 1.6 mg of thymosin alpha-1 through subcutaneous injection once a day for a week and twice a week later. Results The levels of CD3, CD4, CD8 and NK cell were lower in elderly patients with severe pneumonia than in patients with common pneumonia [(43.54%±18.97%) vs. (45.46%±10.43%), (25.43%±12.72%) vs. (38.47%±8.20%), (16.68%±9.30%) vs. (22.36%±8.06%), (13.52%±4.66%) vs. (17.87%±7.11%), t=-6.779、-5.85、-3.161、-3.285 respectively all P＜0.05]. The levels of CD3, CD4, CD4/CD8 and NK cell increased significantly after treatment in treatment group [(64.22%±5.53%) vs. (61.53%±13.41%), (31.70%±4.38%) vs. (26.07%±4.31%), (1.27%±0.91%) vs. (0.97%±0.22%), (17.67%±4.56%) vs. (15.44%±3.82%), F=5.591,11.526,8.934,4.564 respectively, all P＜0.05]. The duration of antibiotic injection and length of stay were lower in treatment group than in control group [(14.17±2.51) d vs. (14.42±2.79) d, (12.69±2.80) d vs. (15.04±3.58) d, t=-3.152、-2.690 respectively, all P＜0.05]. Conclusions The immune function of the elderly patients with severe pneumonia is lower. Thymosin alpha-1 can improve the immune function of the elder patients with severe pneumonia and is helpful for controlling an infection.