Objective To investigate the effect of anti-snoring pillow for the treatment of obstructive sleep apnea in patients with heart failure.Methods Forty seven HF patients with OSAHS and 12 HF patients with simple snoring were enrolled.All the patients were divided into 3 groups:control group (n =12),mild-moderate OSAHS group (n =26) and severe OSAHS group (n =21).All the patients received the treatment of anti-snoring pillow and their sleep apnea parameters were evaluated by PSG at the same time.Results The sleep apnea parameters including AHI,OAI,ODI,mean SpO2％ and snore index were significantly improved in severe and mild moderate OSAHS group with anti-snoring pillow.Conclusion Anti-snoring pillow can reduce snoring index in all OSAHS patients and simple snorers.Sleep apnea and hypoxemia were greatly improved in mild-moderate OSAHS-HF patient while the anti-snoring pillow is not perfect in severe OSAHS patients with HF to replace PAP.

[Summary] To investigate the effect of microRNA126 on glucose metabolism in the normal liver cell lines. In vitro, the chang liver cell lines were cultured. Under the most effective transfection conditions ascertained above, microRNA126 mimic, microRNA126 inhibitor, and relative negative control were transfected into the cultured normal liver cells. And the transfection efficiency was tested by realtime fluorescent quantitative PCR. After 48 hours, the cells were stimulated with synthetic insulin ( 100 nmol/L ) and respective substrates for 2 hours. Then the glycogenesis, gluconeogenesis, and glycolysis in cells were measured. The level of microRNA126 of the microRNA126 mimic group was higher than the other groups, and the difference was statistically significant ( P<0. 05 ). MicroRNA126 mimic group significantly decreased glucose utilization, reduced glycogen synthesis, effectively increased the account of gluconeogenesis, reduced lactate production, and pyruvate kinase activity ( all P<0. 05). The over-expressing microRNA126 in hepatocytes may reverse the function of glucose metabolism, and enhance output of hepatic glucose.

Penicillins are one type of the most important antibiotics used in the clinic.Control of drug impurity profiles is an important part of ensuring drug safety.This is particularly important in penicillins where polymerization can lead to polymers as elicitors of passive cutaneous anaphylaxis.The current under-standing of penicillin polymerization is based on reactions with amino groups,but no comprehensive mechanistic understanding has been reported.Here,we used theoretical calculations and column switching-LC/MS techniques to study penicillin dimerization.Ampicillin and benzylpenicillin were selected as representative penicillins with or without amino groups in the side chain,respectively.We identified four pathways by which this may occur and the energy barrier graphs of each reaction process were given.For benzylpenicillin without an amino group in the 6-side chain,dimerization mode A is the dominant mode,where the 2-carboxyl group of one molecule reacts with the β-lactam of another molecule.However,ampicillin with an amino group in the 6-side chain favors dimerization mode C,where the amino group of one molecule attacks the β-lactam of another molecule.These findings can lead to a polymer control approach to maintaining penicillin antibiotics in an active formulation.

Logistic regression is a kind of multiple regression method to analyze the relationship between a binary outcome or categorical outcome and multiple influencing factors, including multiple logistic regression, conditional logistic regression, polytomous logistic regression, ordinal logistic regression and adjacent categorical logistic regression. This paper illustrates the basic principle, independent variable selection and assignment, applied condition, model evaluation and diagnosis for multiple logistic regression model. Moreover, the principle and application for polytomous logistic regression and ordinal logistic regression models were also introduced. By providing SAS codes and detailed explanations of the result for an example of obesity, readers could be able to better understand logistic regression model, and apply this method correctly to their research and daily work, so as to improve their capacity of the data analysis.

Objective:To explore the effect of swallowing different viscosities and volumes on the swallowing of dysphagic stroke survivors, and also penetration and aspiration.Methods:A total of 59 stroke survivors with dysphagia were evaluated using videofluoroscopy while completing the Chinese version of the volume viscosity swallow test. They were required to swallow 3, 5 and 10ml of food of medium, low, zero and high viscosity. Modified barium swallowing impairment profiles (MBSImPs) and the Rosenbek penetration aspiration scale were used for quantitative analysis.Results:Tongue control, initiation of the pharyngeal swallow and larynx closure showed the worst performance when swallowing zero-viscosity food. Oral residue performance was poor when swallowing large volumes and pharyngeal peristalsis was poor with small volumes. The risk of penetration and aspiration was greater with low-viscosity, large-volume swallowing tasks. There was a significant positive correlation between the penetration aspiration grade and total pharyngeal score. Larynx closure was especially strongly correlated with the penetration aspiration grade.Conclusions:The characteristics of physiological swallowing are closely related to the viscosity and volume of the material being swallowed. The risk of penetration and aspiration is greater with large volumes of low-viscosity food.

Objective:To systematically review the barriers encountered by nursing staff in the implementation of early activities in adult ICU units.Methods:A systematic search was conducted on CNKI, Wanfang Database, VIP Database, China Biomedical Database, PumMed, Web of Science, Cochrane Library and EMBASE for the research on the obstacles of early activity nursing implementation in adult ICU from the establishment of the database to July 2020, and the final integrated analysis of the included literature was carried out.Results:A total of 26 articles were included, and 59 obstacles in 5 categories were integrated, including 6 kinds of technical level, 13 kinds of organizational culture level, 7 kinds of personnel level, 4 kinds of structural level, and 29 kinds of 6 sub categories of patients level. The most frequent obstacles were unstable condition of patients, sedation or continuous deep sedation, low staffing level, disturbance of consciousness of patients, insufficient equipment related to early activities, and low willingness or compliance of patients to participate.Conclusion:The nursing staff are facing with many obstacles in guiding and assisting ICU adult patients to carry out early activities. It is necessary to formulate modified policies aiming at changeable factors in order to promote the application of early activities in adult ICU units.

Objective To explore the effect of OASL expression on the proliferation and migration of pancreatic cancer cells. Methods The GEPIA database was used to analyze the differences in OASL expression in pancreatic cancer tissues and normal pancreatic tissues. The TIMER database was used to analyze the relationship between OASL expression and patient survival. The TCGA database was used to analyze the correlation of OASL expression with the clinicopathological parameters of pancreatic cancer. shRNA was used to knock down the expression of OASL gene in pancreatic cancer panc-1 cells. Lentiviruses were used to overexpress the OASL gene in pancreatic cancer cells. MTT assay was used to evaluate their proliferation ability, and scratch and Transwell experiments were used to evaluate their migration ability. Western blot experiments were used to detect changes in proteins related to tumor proliferation, migration, and invasion. Results OASL expression in the pancreatic cancer group was significantly higher than that in normal pancreatic tissue (P < 0.05), and patients with high OASL expression in pancreatic cancer patients had worse OS than patients with low expression (P < 0.05). After OASL gene knockdown, the proliferation and migration abilities of panc-1 cells were inhibited, whereas the overexpression of OASL gene promoted the proliferation and migration ability of panc-1 cells. Western blot experiments showed that after OASL knockdown, p-STAT3 protein expression increased, whereas STAT3 and BAK protein expressions decreased. After OASL overexpression, p-STAT3 protein expression decreased, and STAT3 and BAK protein expression increased. Conclusion OASL may affect the proliferation and migration of pancreatic cancer cells through the STAT3 signaling pathway while affecting BAK expression to induce cell death.

Objective:To explore the incidence and severity of esophageal clearance impairment in stroke survivors with dysphagia, the clinical characteristics of patients with abnormal esophageal clearance, and their relationship with swallowing physiology, penetration and aspiration.Methods:Clinical data were collected describing 174 stroke survivors whose swallowing had been studied videofluoroscopically. In each selected case there was a good anterior-posterior view of esophageal clearance. Their anterior-posterior and lateral imaging results while swallowing 5ml of high-consistency food were analyzed. The esophageal clearance item of the modified barium swallow impairment profile was then used to rate each subject′s esophageal clearance and each physiological component of swallowing in the oral and pharyngeal phases. The Rosenbek penetration aspiration scale was employed evaluate the safety of their swallowing.Results:Seventy of the patients (40.2%) displayed abnormal esophageal clearance, and more than half of the 70 (43 patients, 24.7%) showed mid- to distal esophageal retention. Those with abnormal esophageal clearance had a higher average age and more severe overall impairment in the pharyngeal phase of swallowing. Esophageal clearance was not, however, significantly correlated with swallowing physiology in the oral phase or with penetration or aspiration grade. There were, however, significant positive correlations with laryngeal elevation, anterior hyoid excursion, pharyngeal stripping waves, pharynx contraction, upper esophageal sphincter opening, tongue base retraction and pharyx residue.Conclusion:Stroke survivors with dysphagia may display abnormal esophageal clearance. The risk is closely related to age and the severity of the dysphagia. Abnormal physiology during the pharyngeal phase of swallowing and reduced pharyngeal stripping may predict abnormal esophageal clearance. Swallowing assessment can be made more comprehensiveness and systematic by incorporating anterior-posterior videography in routine barium swallowing studies.

To investigate the relationship between serum C-reactive protein (CRP) levels and work impairment in patients with ankylosing spondylitis (AS) based on real-world evidence. Outpatients with confirmed AS at Chinese PLA General Hospital were recruited consecutively by Smart-phone SpondyloArthritis Management System (SpAMS) from April 2016 to April 2018. The relationship between CRP and work productivity and activity impairment questionnaire (WPAI) were evaluated. Five hundred and fifty-one outpatients with AS in paid employment were recruited. The presenteeism, overall work impairment, and activity impairment rates increased by 1.4% (1.1%, 1.8%), 1.1% (0.5%, 1.6%), and 1.7% (1.3%, 2.1%), respectively, for every 10 mg/L increase in the CRP level (all P value<0.01). However, the CRP level was not associated with absenteeism after adjusting for covariates [0.5%(-0.4%, 1.0%), P>0.05]. There is a significant association between increased serum CRP levels at baseline and the previous 7-day work impairment in patients with AS. Higher CRP levels contribute to worse presenteeism, overall work impairment, and activity impairment rates, which suggests the necessity of monitoring CRP on treatment, and also indicates that anti-inflammatory therapy may be effective for improving work productivity.

Congenital anomalies of the kidneys and urinary tracts（CAKUT）include a wide range of structural malformations resulting from defects in the morphogenesis of the kidney and the urinary tract. Congenital renal anomaly is common in CAKUT. The pathogenesis of congenital renal anomaly is considered to be multi-factor，involving maternal or external environment，and heredity. With the continuous progress of molecular diagnosis technology，genetic factors have attracted more and more attention. The PBX1 gene was initially discovered by the formation of an E2A-PBX1 fusion gene from a t（1；19）（q23；p13.3）chromosome translocation，which results in pre-B-cell lymphoblastic leukemia.PBX1 gene mutation can cause congenital renal and urogenital malformation syndromes with or without hearing loss，ear abnormalities，and developmental delay. This review deepens the understanding of the role of genes in regulating kidney development by describing the embryonic basis of kidney development，the structure and function of the PBX1 gene，and the pathogenesis of renal anomalies caused by mutations. Further，it summarizes the phenotype and genotype of the PBX1 gene，in order to promote the diagnosis，treatment，and determination progression of congenital renal anomaly.