Objective To establish the rat overlap syndrome (OS) model of intermittent hypoxia (IH) and emphyse-ma, explore the systematic and endothelial inflammation status, and observe the changes of endothelial progenitor cell (EPC) level in peripheral blood. Methods Sixty male Wistar rats were randomly divided into four groups:normal oxygen control group (A), IH group (B), emphysema group (C) and OS group (D). The rat model of emphysema was established by smoke ex-posure for 16 weeks. From the 13-week, pre-programmed intermittent hypoxia/re-oxygenation (IH/ROX) exposure was giv-en in the meantime of smoke exposure. After exposure, ELISA method was used to detect values of tumor necrosis factor al-pha (TNF-α) and interleukin (IL)-6 in plasma and in the endothelium of right common carotid artery. Real-time-PCR assay was used to analyze RhoA mRNA level in the endothelium of right common carotid artery. The percentage of intima-media thickness (IMT) in the all wall of right carotid artery (C-IMT%) was measured. Flow cytometry was used to detect EPC levels. Results The values of TNF-α, IL-6, RhoA mRNA and C-IMT%were significantly higher in D group than those of A, B and C groups (P<0.05). The EPC levels were significantly lower in D group than those of A, B and C groups (P<0.05). Con-clusion OS rats had more serious vascular endothelial injury than that of emphysema or IH rats. Meanwhile, the repair ca-pacity of EPC for endothelium was worse, which increased the risk of cardiovascular diseases.

To study the effect of different levels intermittent hypoxia on inflammatory cytokines and adipokines in a rat model. 160 male Wistar rats were divided into five groups, three groups with intermittent hypoxia (5% O2:IH-1 group;7. 5% O2: IH-2 group;10% O2: IH-3 group), continuous hypoxia group (10% O2, CH group);and the intermittent normal oxygen control group(IN). Before the exposure and at the second, fourth, sixth, and eighth week after the exposure, eight rats in each group were selected randomly with blood samples collected. Blood glucose was measured by glucose oxidase-peroxidase ( GOD-POD ) reagents, double sandwich enzyme-linked immunosorbent assay ( ELISA) was used to detect serum concentration of insulin, tumor necrosis factor alpha( TNF)-α, interleukin ( IL)-6, leptin, and adiponectin and adipocyte nuclear factor kappa B ( NF-κB) levels. In IH-1, IH-2, and IH-3 group, blood glucose, insulin, TNF-α, IL-6, leptin, and nuclear NF-κB in rats showed consecutive increment after exposure to intermittent hypoxia, and those findings in IH-1 group were higher than those in IH-2 and IH-3 group (P<0. 05), but the level of TNF-α dropped slightly on the 8th week. The level of adiponectin showed consecutive decrease from the outset and its level in IH-1 group was significantly lower than that in IH-2 and IH-3 group(P<0. 05). Cytoplasmic NF-κB levels did not have obvious difference in all these groups(P>0. 05). These results demonstrate that intermittent hypoxia could activate NF-κB and result in extensive changes of proinflammatory cytokines and adipokines in the serum of rats. The release of pro-inflammatory cytokines and adipokines keeps pace with the degree of intermittent hypoxia.

Objective To study the effect of different degrees of intermittent hypoxia (IH) on inflammatory cytokines and adipokines in 3T3-L1 adipocytes. Methods An intermittent hypoxia/reoxygenation (IH/ROX) from obstructive sleep apnea (OSA) adipocyte model was established. 3T3-L1 adipocytes were divided into five groups, three IH groups (5% O2, 7.5%O2 and 10%O2, referred to as IH-1, IH-2 and IH-3), sustained hypoxia group (10%O2, CH) and the normal oxygen control group (21%O2, IN). ELISA method was used to detect values of tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), leptin and adiponectin in cell supernatant. Western blot analysis was used to detect levels of hypoxia-inducible fac-tor-1α(HIF-1α) and glucose transporter-1 (Glut-1). RT-PCR assay was used to analyze HIF-1α, Glut-1, TNF-α, IL-6, leptin and adiponectin mRNA expression levels in adipocytes. Results The expression levels of TNF-α, IL-6 and leptin were significantly higher in IH and CH groups than those of IN group (P<0.05). The expression levels of TNF-α, IL-6 and leptin protein and leptin mRNA were significantly higher in IH-1 group than those of IH-2 and IH-3 groups (P<0.05). The adiponectin and its mRNA levels were significantly lower in IH and CH groups than those of IN group (P<0.05). The adipo-nectin level was significantly lower in IH-1 group than that of IH-2 and IH-3 groups (P<0.05). Conclusion These results demonstrate that IH is related to the extensive changes in the expression and release of inflammation-related adipokines in cultured adipocytes. IH from OSA may underlie the development of the inflammatory response in adipocytes, which is in-volved in insulin resistance in patients with OSA.

Objective To evaluate the value of DEB-TACE before liver transplantation for hepatocellular carcinoma patients.Methods From Jan.2016 to Jan.2018,23 patients received DEB-TACE before liver transplantation for hepatocellular carcinoma were induced.Complications evaluation was followed up after interventional therapy.4 weeks after the intervention,the imaging examination was performed to examine the tumor response rate depond on mRECIST,the pathological conditions and tumor free survival were studied in the patients who received liver transplantation.Results The achievement ration of operation was 100％ in 23 patients.23 patients received 24 times successfully,1 patient received DEB-TACE twice,and the remaining 22 patients received DEB-TACE once.No serious complications occurred.Eighteen patients (78.3％,18/23) had postembolic syndrome after interventional therapy,mainly fever and pain.Four weeks after DEB-TACE,the complete response rate was 47.8％ (11/23),partial response rate was 30.4％ (7/23),disease stability rate was 21.7％ (5/23).All the 23 patients were included in the waiting list for transplantation.Among them,15 cases received liver transplantation.Pathological results showed that the total necrosis rate was 53.3％ (8/15),and the tumour necrosis rate in 4 of them was less than 50％.The average tumour necrosis rate of the neoplasm was 75.0％.The 15 patients who received liver transplantation were alive with no tumor recurrence.Conclusion DEB-TACE is a safe and effective treatment for patients suffered from hepatocellular carcinoma in waiting for liver transplantation.However,due to the short time of DEBs in China,further research is needed.

Objective To evaluate the drug-eluting-beads (DEB)-TACE as down-stage therapy for hepatocellular carcinoma before liver transplantation.Methods Inclusion criteria:the hepatocellular carcinoma exceeding the standard of Milan criteria.From Jan 2016 to Jan 2018,30 patients received DEB-TACE as down-stage therapy for hepatocellular carcinoma before liver transplantation.4 weeks after DEB-TACE,the imaging examination was performed.The patients who received the liver transplantation,the pathological conditions were recorded and the tumor free survival of the patients was followed up.Results 30 patients received 30 times DEB-TACE successfully.76.7％ (23/30) patients was down-staged to meet UCSF criteria,53.3％ (16/30) patients was down-staged to meet Milan criteria.13 patients had being given liver transplantation,pathology showed that DEB-TACE achieved complete necrosis in 30.8 ％ (4/13)cases.No significant treatment related complications were observed.After liver transplantation 12 patients are alive with no tumor recurrence.The tumor recurrence rate after liver transplantation was 7.7％.Conclusion DEB-TACE is safe and effective as down-stage therapy for hepatocellular carcinoma before liver transplantation.