Objective To investigate the acoustic characteristics of snoring sound in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and with simple snoring. Methods 22 patients with OSAHS and 15 with simple snoring were included in this study. Natural overnight snoring was digitally recorded and portable sleep mo-nitoring was performed simultaneously. 10 snores, which were the 1st snores after 10 cycles of obstructive apnea, from each patient in OSAHS group, and 10 snores from each patient in simple snoring group were analyzed in the time and frequency domains. Results The sound waves of snoring in the two groups exhibited different patterns both in the time and frequency domains. The snoring spectrum of patients with simple snoring showed distinct fun-damental- harmonic structures which were not clear in patients with OSAHS. The central frequency of the patients with OSAHS was higher, and 800 Hz power ratio was lower than those of the patients with simple snoring. In the OSAHS group, the central frequency of the patients with moderate-to-severe OSAHS was higher, and 800 Hz power ratio was lower than those of the patients with mild OSAHS. The differences of the two parameters were of statistical significance. Conclusion The snoring sounds in patients with OSAHS and with simple snoring have dif-ferent characteristics in time and frequency domains, indicating that it is feasible to research the OSAHS by way of snore monitoring and analyzing technique.

Objective To assess the value of C-reactive protein(CRP) for the prognosis of acute pulmonary embolism (PE). Methods 56 acute pulmonary embolism patients, confirmed by spiral computed tomography (sCT), magnetic resonance imaging(MRI), or pulmonary angiography (CTPA). CRP as well as electrocardiogram (ECG), echocardiography(UCG), blood gas analysis, were taken after admission. Results Among these patients,24 cases with higher CRP(≥10 mg/L),were diagnosed as massive (50.0%), sub-massive PE(45.8%), mini-massive (4.2%) or died(25.0%). 24 cases (100.0%) showed right heart dysfunction and 24 cases showed pulmonary hy-pertension on UCG, right ventricular 20 (83.8%) on ECG, 22 cases (91.7%) showed hypoxemia. 8 cases (33.3%) had syncope,and 9 cases (37.5%) had cardiogenic shock. CRP was lower than 10 mg/L in 32 patients, among whom,3 cases (9.4%) were with massive PE,6 cases (18.8%) were with sub-massive PE,23(71.8%) were with small PE,1 cases(6.3%) died. 13 (40.6%) had right heart dysfunction and 16(50.6%) had pulmona-ry hypertension on UCG, right ventricular on ECG in 15 cases (46.9%), hypoxemia in 11 cases (34.4%), syncope in 2 cases (6.3%), cardiogenic shock in 4 cases (12.5%). The occurrence of massive PE, mortality (P<0.01) and sub-massive PE (P<0.05)were statistically different between the groups with higher CRP and the groups with lower CRP. The ratio of right heart dysfunction, pulmonary hypertension, right ventricular overloading, hypoxemia had statistical significance (P<0.01). There was statistical significance in the occurrence of syncope, cardiogenic shock (P<0.05). Conclusions CRP can be used as a parameter for PE, and can be used to stratify risk levels for severi-ty and assess the effectiveness of treatment.

OBJECTIVE: To discuss the main influence factors of sound pressure level parameters in patients with simple snoring (SS) and obstructive sleep apnea hypopnea syndrom (OSAHS). METHOD: Eighty-four cases with snoring disease underwent polysomnography and simultaneously snoring sound pressure level recording. The correlations between AHI, age, BMI, abdomen circumference, neck circumference, the lowest oxygen saturation total apnea time and sound pressure level parameters: equivalent continuous sound level(LAeq)and maximum sound pressure level(L10) were analyzed. RESULT: LAeq was significantly correlated to AHI (P= 0. 000) and BMI (P= 0. 007), and the odd ratios of AHI and BMI were 5. 74,2. 09 respectively, but it was unrelated to age, abdomen circumference, neck circumference, the lowest oxygen saturation and total apnea time. A significantly association also existed between L10 and AHI(P=0. 000), BMI(P=0. 032), and the odd ratios were 4. 11 and 2. 33 respectively. Other factors had nothing to do with L10. CONCLUSION The main factors which affect the snoring sound pressure level parameters LAeq and L10 are AHI and BMI.
Humans ; Polysomnography ; Pressure ; Sleep Apnea, Obstructive ; physiopathology ; Snoring ; physiopathology ; Sound

Objective To establish rabbit model of remnant carcinoma after RFA therapy, and to observe pathomorphological changes of remnant carcinoma in different time. Methods Forty-eight New Zealand white rabbits underwent ultrasound-guided percutaneous inoculation with VX2 carcinoma, then RFA therapy was performed to made models of remnant carcinoma. These models were averagely divided into 6 groups randomly (each n=8). Rabbits in each group was killed and pathologically observed before RFA and 1 d, 3 d, 1 week, 2 and 3 weeks after operation, respectively. Results The expression of MVD,VEGF and PCNA in remnant VX2 carcinomas tissues decreased significantly, but increased 2-3 weeks after RFA. The remnant VX2 carcinomas tissues were in inhibitory state 2 weeks after RFA. Conclusion The growth of remnant carcinoma could be inhibited in short term after RFA. Further therapy is necessary.

OBJECTIVE:To study the effects of spirulina kinase(SPK)on the vascular endothelial function of model rats with atherosclerosis. METHODS:60 rats were randomly divided into normal control group(distilled water),model group(distilled wa-ter),positive control group(simvastatin,0.005 g/kg)and SPK low-dose,medium-dose,high-dose groups(80,160,320 U/kg). Except for normal control group,rats in other groups were induced for model of atherosclerosis. All groups were intragastrically ad-ministrated relevant medicines at the same time,once a day for consecutive 12 weeks. Total cholesterol(TC),triglyceride(TG), low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α) contents in serum of rats were measured. And the changes of thoracic aortic endothelium morphology were ob-served by HE staining. RESULTS:Compared with normal control group,TC,TG,LDL-C,IL-6,TNF-α contents in serum of rats in model group were increased(P<0.01),HDL-C content in serum was decreased(P<0.01);vascular endothelial cells fell off, intimal proliferation projected into the lumen,smooth muscle cell proliferated and disordered,medium film elastic fiber disintegrat-ed and fractured. Compared with model group,TC,TG,LDL-C,IL-6,TNF-α contents in serum of rats in administration groups were decreased(P<0.05 or P<0.01),HDL-C content in positive control group and SPK medium-dose,high-dose groups was in-creased (P<0.05). Vascular endothelial cell morphology was improved significantly in administration groups,in which,vascular endothelial cells were structurally intact in SPK medium-dose,high-dose groups,inner membrane was basically smooth;medium smooth muscle cells arranged slightly disordered in SPK medium-dose group. Compared with normal control group,there were no obvious changes. CONCLUSIONS:SPK shows obvious lipid-lowering and anti-inflammatory effects,it can protect vascular endo-thelial function. The mechanism may be related to reducing TC,TG,LDL-C,HDL-C,IL-6,TNF-αcontents and increasing HDL-C content in serum.

Tacrolimus exhibits varied individual pharmacokinetic and a narrow therapeutic window, resulting in difficulties in personalized medication.In order to improve the safety of tacrolimus in clinical application and its efficiency and rationality in clinical practice, many countries and regions in the world have issued a number of guidelines for tacrolimus application.However, these guidelines generally aim at particular disease and race, and have certain limitation.In this article, the guidelines were explicated and analyzed in detail.Moreover, an individual tacrolimus medication recommendation for Chinese population was summarized based on the latest research of tacrolimus pharmacogenomics and therapeutic drug monitoring so as to provide assistance for the rational use of tacrolimus.

Objective To investigate the effect of long-term high-fat diet on cognitive function and hippocampus neurons ultrastructure in obese rats.Methods Forty SD rats were randomly assigned to a high fat diet (HFD) group and a common diet (CD) group.Meanwhile,HFD-induced obese rat model were established.The spatial learning and memory were measured by the Morris water maze,and the neurons ultrastructural changes in rat hippocampus CA1 region at the corresponding period were observed by transmission electron microscopy.Results The average weight of rats was 25％,28％,and 22％ higher in the HFD group than in the CD group at the 12,16,and 20 weeks,respectively;the Lee's indexes were 6％,4％,and 8％ higher;the average swimming latency were 52％,44％,and 40％ longer;the average swimming distance were 85％,45％,and 51％ longer;the average swimming speed were 57％,34％,and 18％ higher;the duration of staying in the target quadrant were 32％,54％,and 63％ shorter;and the average times of crossing the plate form were 30％,34％,and 34％ shorter,respectively (all P ＜0.001).In comparison of ultrastructure in hippocampus CA1 region of rats at corresponding time points,the amounts of degenerated and necrosis neurons,of the deformed and vacuolar mitochondria,and of the less rough endoplasmic reticulum were significantly more at 12,16,and 20 weeks in the HFD group than in the CD group.Conclusions Long-term HFD-induced obesity damages the structure of neurons in the hippocampus,impairs spatial learning and memory function,and accelerates cognitive aging in rats.

Objective To explore the relationship between anxious depression and cortisol rhythm disorder and influencing factors of immune metabolism. And to look for biological markers that can be used for clinical diagnosis and treatment of anxious depression. Methods Totally 43 patients with anxious depres-sion(A-MDD group) and 44 patients with non-anxious depression matched by sex,age and years of education (NA-MDD group)were recruited. Electrochemiluminescence was used to detect the plasma levels of adreno-corticotropic hormone(ACTH),cortisol(COR),c-reactive protein(CRP) and IL-6. Automatic biochemical a-nalysis was used to detect plasma total TC,TG,HDL and LDL. Using logistic regression analysis to discuss the influencing factors of anxiety depression. Results The comparison between the two group showed that the age of first onset,BMI and SBP in the A-MDD group((35. 15±11. 56),(24. 11±3. 03)kg/m2,(130. 09 ±13. 33)mmHg) were significantly higher than those in the NA-MDD group((31. 34± 14. 08),( 22. 70± 3. 19)kg/m2,( 121. 89±12. 49)mmHg)(t=2. 631,2. 009,2. 964,all P<0. 05). The HAMD score and the factor scores of cognitive impairment,change of day and night,delay,sleep disorder and feeling of despair in the A-MDD group((31. 81±5. 39),(8. 03±3. 00),(1. 17±0. 70),(6. 88±1. 93),(4. 44±1. 44),(4. 67± 2. 37)) were significantly higher than those in the NA-MDD group((25. 25±5. 017),(3. 87±3. 12),(0. 79 ±0. 78),(4. 64±2. 22),(3. 34±1. 54),(3. 61±2. 02))(t=2. 297,6. 524,2. 505,5. 210,3. 452,2. 421,all P<0. 05). The plasma TG,CRP and IL-6 levels in the A-MDD group((1. 63±1. 11)mmol/L,(1. 20±0. 77) mg/L,(3. 54±1. 90) pg/L) were significantly higher than those in the NA-MDD group (( 1. 19 ± 0. 66) mmol/L,(0. 933±0. 89)mg/L,(2. 65±1. 34)pg/L) (t=2. 254,2. 250,2. 352,all P<0. 05). The incidence of cortisol disturbance was 72% in the A-MDD group,and 48% in the NA-MDD group,and the difference was statistically significant (χ2=5. 369 P=0. 020). Multivariate Logistic regression found that sleep disorder (β=0. 729,OR=2. 072,95%CI=1. 018-3. 119),IL-6(β=0. 583,OR=1. 792,95%CI=1. 168-2. 748),cog-nitive impairment (β=0. 099,OR=1. 104,95% CI=1. 022-1. 193),cortisol rhythm disorders(β=0. 075, OR=1. 078,95%CI=1. 014-1. 146) were the risk factors for anxious depression. Conclusion Anxious de-pression has a high incidence of cortisol rhythm disorder. The COR and IL-6 may be mediators of cortisol rhythm disorder. IL-6 and cortisol rhythm disorder together with sleep disorder and negative cognition consti-tute maybe high risk factors for anxious depression.

Objective:To evaluate the risk factors of rheumatoid arthritis associated interstitial lung disease (RA-ILD).Methods:Databases including PubMed, Sinomed, Embase, Wiley Online library were searched to collect studies on risk factors of RA-ILD. The deadline of the search was January 1 2021. Newcastle-Ottawa Scale (NOS) was used to assess the literature quality, data was extracted and analyzed by Statistical software in eligible studies.Results:This meta-analysis included 36 studies involving 3 280 patients with RA-ILD and 25 510 RA controls patients. The Incidence of RA-ILD was 6.25%. The risk of RA-ILD was 2.51 times greater in men than in women [ OR(95% CI)=2.51(2.25, 2.80)]. The mean onset age of patients with RA-ILD was 7.47 years [56.50 vs 49.04, 95% CI(6.56, 8.38)] older than those of patients with RA-nILD. The mean duration of patients with RA-ILD was 1.11 years longer than that of patients with RA-nILD [7.73 vs 6.62, 95% CI(0.68, 1.55)]. The risk of RA-ILD was two times greater in smoker than in non-smoker [ OR(95% CI)=2.25(2.01, 2.52]). Moderate evidence indicated that higher erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), disease activity score in 28 joints (DAS28)-ESR were risk factors for RA-ILD[Stan-dard Mean Difference ( SMD)(95% CI)=0.25(0.18, 0.31); SMD(95% CI)=0.25(0.18, 0.32); SMD(95% CI)=0.36(0.27, 0.45), respectively). The pooled [ OR(95% CI)=1.71(1.45, 2.01)] in rheumatoid factor (RF) positive and [ OR(95% CI)=2.41(1.80, 3.23)] anti-CCP antibody positive for the risk of RA-ILD. Conclusion:Male, smoking, older age of disease onset, long disease duration, elevated erythrocyte sedimentation rate, high C-reactive protein level, high DAS28-ESR, positive RF and anti-cyclic peptide containing citrulline antibody were risk factors for RA-ILD.