Objective To analyze the emergency-event in patients with obstructive sleep apnea-hypopnea syndrome( OSAHS), and to discuss the risk factors and preliminary strategies for prevention of emergency-event. Method A total of 257 OSAHS patients in Zhejiang Provincial Peoples Hospital, were enrolled from January 2000 to December 2009 for the retrospective study. Demographics of patients include age, sex,height, weight, related diseases, AHI and LSaO2 before operation , the way of anesthesia and operation,when and how the emergency-events happened, the way to cure and the results. Risk facts of emergency-event were analyzed by using univariate analysis and multiple logistic regression analysis. Results Of the 257patients, the incidents of emergency-event was 7.3%. The independent risk factors of emergency-event were general anesthesia, multiple level surgery in one time, BMI and AHI. Performing CPAP treatment before operation had a beneficial effect to the avoidance of emergency-event. Conclusions Emergency-event are more common in severe OSAHS patients, especially when they were operated under general anesthesia and multiple level surgery in one time. Performing CPAP treatment before operation had a beneficial effect to the avoidance of emergency-event.

Objective To analyze the risk factors of respiratory depression occurring during recovery period in patients after having undergone general anesthesia and laparoscopic operation.Methods A total of 374 patients after general anesthesia and laparoscopic surgery admitted to the First Affiliated Hospital of Wenzhou Medical University from June 2015 to June 2016 were enrolled, they were divided into with or without the incidence of respiratory depression two groups by whether or not respiratorydepression, with the incidence of respiratory depression group 52 cases, without the incidence of respiratory depression group 322 cases. The patients' gender, age, body mass index (BMI), operation time, anesthesia maintenance mode, artificial airway mode, operative type and medication used in operation, intra-operative hypotension presence or absence, and type of operation were recorded. Univariate and multivariate logistic regression analyses were used to evaluate the risk factors of respiratory depression occurring in the recovery period after general anesthesia; receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of age, intraoperative medication, and age combine with intraoperative medication respectively in the occurrence of respiratory depression during recovery period after general anesthesia and lapatoscopic operation.Results Univariate analyses showed that there were no statistical significant differences in gender, BMI, operation time, anesthesia maintenance mode, artificial airway mode, intra-operative hypotension presence or absence, type of operation, etc. compared between patients with and without the incidence of respiratory depression groups (allP > 0.05); while the differences were statistically significant in age and drug used in the operation (dezocine, flurbiprofen, dexmedetomidine or dezocine combined with dexmedetomidine, allP < 0.05). Multivariate analyses showed that age and medication used in operation were the independent risk factors for the occurrence of respiratory depression during the anesthesia recovery stage (P values being 0.000, 0.002 respectively). ROC curve showed that age, intra-operative medication and age combine with intraoperative medication respectively had certain predictive value for the occurrence of respiratory depression during the recovery period after general anesthesia and laparoscopic surgery, the area under the ROC curve (AUC) of age combine with intraoperative medicationfor prediction of occurrence of respiratory depression during recovery period after anesthesia and laparoscopic surgery was significantly larger than that of single age or single intraoperative medication (0.826 vs. 0.668, 0.750,P < 0.01), 95% confidence interval (95%CI) of age, intraoperative medication and age combined with intraoperative medication were 0.598-0.738, 0.670-0.830, 0.764-0.888, the sensitivity, specificity and accuracy rate of age combine with intraoperative medication were 53.8%, 94.4% and 88.8%, respectively.Conclusion Elderly patients undergoing general anesthesia and laparoscopic operation and dezocine, dexmedetomidine or dezocine combined with dexmedetomidine being applied in the laparoscopic operation are more easily associated with incidence of respiratory depression during recovery period of anesthesia.

Objective To investigate whether emodin suppresses angiogenesis in pancreatic cancer.Methods A nude mouse pancreatic cancer xenograft model was established with SW1990 human pancreatic cancer cells by surgical orthotopic implantation.Different doses of emodin were injected into the abdominal cavities of the tumor-bearing mouse models and controls 3 times weekly for 2 weeks.The expression of CD34 was detected by immunochemistry,and microvessel density was calculated.Quantitative RT-PCR and Western blot were performed to determine the mRNA and protein expressions of TGF-β1 and Smad4.Results A negative dose-dependent association was found among emodin treatments about the weight of tumors.Emodin was associated with lower levels of TGF-β1 mRNA and protein,and higher levels of the mRNAs and proteins Smad4.Conclusion Emodin may repress angiogenesis in pancreatic cancer by altering activities of the TGF-β1 and Smad4.

OBJECTIVE: To screen aptamers binding CD33+/CD34- cells from patients with acute myeloblastic leukemia M2 subtype (AML-M2). METHODS: CD33+/CD34- cells from patients with AML-M2 were taken as targeted cells, CD33+/ CD34- cells from normal people were taken as anti-selecting cells, and aptamers in the single strand deoxyribonucleic acid (ssDNA) library were then selected repeatedly by cell-systematic evolution of ligands by exponential enrichment (C-SELEX) technology, and amplified by polymerase chain reaction (PCR) to generate sub-ssDNA library. During the experiment, PCR amplification with fluorescently labeled primer and flow cytometry were performed to analyze the aptamers'enrichment of sub-library, and the final round product of the sub-ssDNA library was cloned. After the sequencing, the primary and secondary structures of the aptamers were analyzed. RESULTS: Electrophoresis indicated that the product of PCR amplification for each round subssDNA library was able to see a clear DNA band in the agarose gel. After 13 rounds of screening, the fluorescence intensity of the sub-ssDNA library binding the cells ranged from 2.14% to 51.12%, reaching a steady state at the 13th round. A total of 30 clones were selected and sequenced, 22 of which contained 1 of the 4 conserved sequences of AAGTA, TATCT, AGATG and AAATT in their primary structure, but the remained eight aptamers contained none of the conserved sequence. Secondary structure analysis indicated that four stem-loops and loop simulation convex structures existed in the aptamers. CONCLUSION C-SELEX technology can be used to screen the aptamers binding primary cells from patients with leukemia. The aptamers selected from the CD33+/CD34- cells from the patients of AML-M2 subtype might be used for the diagnosis and treatment for leukemia.
Adolescent ; Adult ; Antigens, CD34 ; genetics ; immunology ; Antigens, Differentiation, Myelomonocytic ; genetics ; immunology ; Aptamers, Nucleotide ; genetics ; metabolism ; DNA, Single-Stranded ; genetics ; Female ; Humans ; Leukemia, Myeloid, Acute ; genetics ; immunology ; Male ; Middle Aged ; SELEX Aptamer Technique ; Sialic Acid Binding Ig-like Lectin 3 ; genetics ; immunology ; Young Adult

OBJECTIVE: To investigate the effect of extracts with water and alcohol from Radix Trichosanthis on the cell survival and the expression of hepatitis B surface antigen (HBsAg) and hepatitis B e-antigen (HBeAg) in HepG2.2.15 cell supernatant. METHODS: The cell survival rate of HepG2.2.15 cells was detected by MTT assay. The HBsAg and HBeAg in HepG 2.2.15 cell supernatant were evaluated by enzyme linked immunosorbent assay. RESULTS: The water and alcohol soluble extracts from Radix Trichosanthis significantly inhibited the levels of HBsAg and HBeAg in HepG2.2.15 cells in a time-and-concentration-dependent manner. However, the therapeutic index of extracts with water from Radix Trichosanthis was better than that in the alcohol group. CONCLUSION The activity of water-soluble extract from Radix Trichosanthis is stronger on anti-hepatitis B virus than that of the alcohol-soluble extract.
Antiviral Agents ; pharmacology ; Drugs, Chinese Herbal ; classification ; pharmacology ; Hep G2 Cells ; Hepatitis B Surface Antigens ; biosynthesis ; Hepatitis B e Antigens ; biosynthesis ; Hepatitis B virus ; drug effects ; Humans

Objective: To investigate the effect of visceral obesity on the short-term outcomes after radical operation for mid-low rectal cancers. Methods: We conducted a prospective study on patients who underwent selective rectal cancer resection at The Second Affili-ated Hospital of Wenzhou Medical University between April 2017 and October 2018. The cutoff visceral fat area (VFA) for visceral obe-sity was≥134.6 cm2 for men and≥91.1 cm2 for women. Results: A total of 127 patients were included in the study, of whom 64 were diagnosed as having visceral obesity and 63 as having non-visceral obesity. The patients with visceral obesity had a higher body mass index (BMI) (P<0.001) than those without visceral obesity. The proportions of female patients and those who had a laparoscopy-assist-ed surgery were higher in the visceral obesity group than in the non-visceral obesity group. We found no significant differences in age, albumin level, hemoglobin count, American Society of Anesthesiologists (ASA) stage, Nutritional Risk Screening (NRS) 2002 score, Charlson comorbidity index, tumor location, TNM stage, lymphatic invasion, and laparoscopy-assisted surgery between the two groups. The postoperative complication rate was significantly higher in the visceral obesity group than in the non-visceral obesity group (35.9% vs . 19% , P=0.033). A multivariate Logistic regression analysis revealed that visceral obesity [odds ratio (OR)=2.732, P=0.019] and NRS 2002 scores of≥3 (OR=2.574, P=0.042) were independent risk factors for postoperative complications. Conclusions:Visceral obesity was an independent risk factor for complications after surgery for mid-low rectal cancers.

OBJECTIVES: To investigate the risk factors as well as their impact on patients' survival of central nervous system (CNS) complications following allogeneic hematopoietic stem cell transplantation (HSCT). METHODS: All relevant clinical data from a total of 323 patients, who underwent allogeneic HSCT in Xiangya Hospital of Central South University from September 2016 to September 2019, were retrospectively reviewed in this study. The complications' occurrence time, common symptoms and some other clinical data of the patients who developed CNS complications were analyzed descriptively. The risk factors for CNS complications following allogeneic HSCT were analyzed through univariate and multivariate analysis. And the survival analysis was conducted as well. RESULTS: Among the 323 patients who underwent allogeneic HSCT, 32 patients developed CNS complications. These complications occurred in these patients at a median of 32 (range from -1 to 584) d after transplantation. Common symptoms were disturbance of consciousness (78.1%), convulsion (59.4%), and headache (12.5%). Univariate analysis showed that there were significant differences in neutrophil engraftment, platelet (PLT) engraftment, serum cytomegalovirus (CMV) DNA positive, combined with acute graft-versus-host disease (aGVHD), donor selection ( CONCLUSIONS The delay or the failure of PLT engraftment and combined with aGVHD are the risk factors for CNS complications. The facts indicate that we should prevent CNS complications when patients who underwent allogeneic HSCT with the delay or the failure of PLT engraftment or aGVHD. Compared with non-CNS complication group, patients who developed CNS complications usually have poor prognosis.
Central Nervous System ; Graft vs Host Disease/etiology* ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Humans ; Retrospective Studies ; Risk Factors

To study the molecular mechanism for DNA hypomethylation of STAT3 promoter in CD4+ T cells from acute graft-versus-host disease (aGVHD) patients.
 Methods: We collected CD4+ T cells from peripheral blood of 42 patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) from HLA-identical sibling donors. GADD45A expression level in CD4+ T cells was measured by real-time PCR and Western blot. The binding level between HMGB1 and GADD45A in CD4+ T cells was analyzed by co-immunoprecipitation, while the binding levels of HMGB1/GADD45A with STAT3 promoter were detected by chromatin immunoprecipitation-quantitative real-time PCR (ChIP-qPCR). After overexpression of HMGB1 and knockdown of GADD45A in normal CD4+ T cells, STAT3 expression and DNA methylation were measured by Western blot and bisulfite sequencing PCR, respectively.
 Results: GADD45A expression was significantly up-regulated in patients with aGVHD compared with that in the patients without aGVHD. More HMGB1-GADD45A complexes were found in CD4+ T cells from patients with aGVHD compared with that in patients without aGVHD. The bindings of HMGB1/GADD45A with STAT3 promoter were significantly increased, and the binding levels of HMGB1/GADD45A were negatively correlated with STAT3 promoter DNA methylation. The expression of STAT3 was significantly reduced and the DNA methylation of STAT3 promoter was significantly increased in CD4+ T cells with overexpression of HMGB1 and knockdown of GADD45A compared with CD4+ T cells only with overexpression of HMGB1.
 Conclusion: The increased expression of HMGB1/GADD45A plays an importent role in STAT3 promoter DNA hypomethylation, thereby promoting STAT3 expression in CD4+ T cells from aGVHD patients.
CD4-Positive T-Lymphocytes ; Cell Cycle Proteins ; metabolism ; DNA Demethylation ; Gene Expression Regulation ; genetics ; Graft vs Host Disease ; genetics ; HMGB1 Protein ; metabolism ; Hematopoietic Stem Cell Transplantation ; Humans ; Nuclear Proteins ; metabolism ; Promoter Regions, Genetic ; genetics ; STAT3 Transcription Factor ; genetics ; metabolism