Objective:To explore influence of nasal continuous positive airway pressure (nCPAP)on maximal oxygen uptake (V · O2 max )etc.in patients with chronic congestive heart failure (CHF)complicated moderate-to-severe ob-structive sleep apnea-hypopnea syndrome (OSAHS)and explore its significance.Methods:A total of 83 CHF com-plicated moderate-to-severe OSAHS patients were selected and randomly divided into routine treatment group (n=40)and nCPAP group (n = 43).Both groups were treated for six months.Left ventricular ejection fraction (LVEF),apnea hyponea index (AHI)and V · O2 max were measured and compared between two groups before and af-ter treatment.Results:Compared with routine treatment group after six-month treatment,there was significant re-duction in AHI [(27.5±6.2)vs.(6.8±1.2)],and significant rise in LVEF [(0.45±0.07)vs.(0.48±0.05)]and · V O2 max [(16.5±3.5)ml·kg-1 ·min-1 vs.(19.2±3.4)ml·kg-1 ·min-1 ]in nCPAP group,P <0.05 all.Con-· clusion:The nCPAP can improve ventilation function,heart function and V O2 max in patients with CHF complicated moderate-to-severe OSAHS,who have received basic medication.

Objective To investigate whether transcatheter renal sympathetic denervation (RSD) by radiofrequency ablation interfere with the development of left ventricular (LV) mechanical dyssynchrony during the progression of heart failure (HF).Methods Nineteen beagles were randomly divided into sham-operated group (six dogs),control group (seven dogs),and RSD group (six dogs).Sham-operated group were implanted with pacemakers without pacing;Control group were implanted with pacemakers and underwent 3 weeks of rapid right ventricular pacing;and RSD group underwent catheter-based RSD bilaterally and were simultaneously implanted with pacemakers.LV dyssynchrony was analyzed via 2D speckle-tracking strain echocardiography to evaluate LV function.Longitudinal dyssynchrony was determined as the standard deviation for time-to-peak speckle-tracking strain on apical 4-and 2-chamber views.Radial and circumferential dyssynchrony was determined as the standard deviation for time-to-peak speckle-tracking strain in mid-and base-LV short-axis views.LV systolic pressure (LVSP) and LV end-diastolic pressure (LVEDP) were measured.The LV interstitial fibrosis was determined by histological analysis.Results After 3 weeks,all of the dogs in both the control and RSD groups showed greater LV end-diastolic volume compared with the sham-operated group;however,the dogs in the RSD group had a higher LV ejection fraction (LVEF) than the dogs in the control group (P ＜0.001).The LV systolic strains were higher in the RSD group than in the control group (P ＜0.001 for longitudinal,circumferential and radial strain,respectively).The levels of LV dyssynchrony were lower in the RSD group than in the control group (P ＜ 0.001 for longitudinal,circumferential and radial dyssynchrony,respectively).Compared with control group,RSD group had lower LV end-diastolic pressures and less fibrous tissue.Conclusions RSD inhibites the development of left ventricular mechanical dyssynchrony during the progression of heart failure in dogs.

Objective To evaluate the effects of transcatheter renal sympathetic denervation (RSD) on the cardiac systolic function of dogs with pulmonary arterial hypertension(PAH)using two-dimensional speckle tracking imaging (2D-STI).Methods Twenty two dogs were divided in to three groups:control group (n=7),PAH group (n =8),PAH+RSD group(n =7).Pulmonary artery hypertension models were made by monocrotaline injection in PAH group and PAH+RSD group,while bilateral renal artery sympathetic nerve were also ablated in PAH+RSD group.Meanwhile,sham operation treatment were made in the control group and PAH group.The changes of blood pressure and cardiac indicies of ultrasound were observed before and after 8 weeks respectively.Then the left ventricular(LV)lateral strain,septal strain (IVS LS)and right ventricular(RV)strain were calculated.In the apical 4-chamber view,time from QRS onset to peak systolic strain in each the six segments of the LV and RV were measured and standard deviation of the time to peak longitudinal strain of six segments (LVTsl-6SD and RVTsl-6SD)were calculated.LV twist degree were obtained from LV rotation curve in basal and apical short-axis planes. Results After 8 weeks,there was no difference in the mean strain of LV lateral wall among the three groups,while the mean strain of RV lateral wall and septal were higher in PAH+RSD group than the PAH group [(18.91±0.86)% % vs 16.34±1.36)%,P <0.001;(18.39±1.03)% vs (17.02±1.00)%,P <0.001,respectively].Compared with PAH group,LVTsl-6SD and RVTsl-6SD of PAH + RSD group decreased significantly [(25.45±3.59)ms vs (40.40±2.83)ms,P <0.001;(34.16±2.81)ms vs (51.98± 3.64)ms,P <0.001,respectively].The LV twist degree of PAH+RSD group increased significantly[(10.47± 0.73)°vs (8.46±1.06)°,P <0.001].Conclusions RSD can reduce the influence of pulmonary artery hypertension on cardiac systolic function.

Extralevator abdominoperineal excision (ELAPE) has been suggested to potentially improve oncological outcomes in advanced low rectal cancer patients. However, the urogenital function impairment as one of the main complications deteriorates the quality of life in these patients. The key point to prevent urogenital function impairment is to avoid autonomic nerve injury, including the superior and inferior hypogastric nerve plexus and neurovascular bundle. Three areas should be especially focused during surgery, including the posterolateral aspect of the prostate during the separation of the rectum from prostate, the lateral wall of ischioanal fossa and the area in front of anal canal. Previous presumption supposed that extended resection, though promoting oncologic outcomes, might lead to enlarged injury to surrounding vessels and nerves that deteriorated patients′ urogenital function. But recent studies show that postoperative urogenital function outcomes of rectal cancer patients who underwent ELAPE are not inferior to conventional APE after the induction of minimal invasive approaches including laparoscopic and robotic surgery. Their quality of life can be comparable with patients who underwent conventional APE, and are even better in some particular area. Moreover, as further improvement of ELAPE procedure has been made, the concept of individualized ELAPE addressed the importance of personalized surgical procedure based on tumor stage and location, dedicating to avoid injury to vessels and nerves through preserving more surrounding tissues. Urogenital function outcomes, as part of postoperative outcomes, get more and more attention in recent years. We review current studies on urogenital function after ELAPE from anatomy to clinical research, in order to raise surgeons′ attention of nerve preservation technique and to improve their understanding of ELAPE procedure.

Most of the CHD patients reveal string pulse, mainly due to damage of heart function, lowering of arterial compliance and increase of total peripheral resistance. The common pulse in patients of blood diseases reveal frequent, tiny, string and slippery characteristic, mostly due to the increase of compensatory pumping action of the heart, shortening of ejection time of the left heart, with better vessel compliance and hemorheology, low total peripheral resistance.

Genome-wide association studies (GWASs) are the most widely used method to identify genetic risk loci associated with orofacial clefts (OFC). However, despite the increasing size of cohort, GWASs are still insufficient to detect all the heritability, suggesting there are more associations under the current stringent statistical threshold. In this study, we obtained an integrated epigenomic dataset based on the chromatin conformation of a human oral epithelial cell line (HIOEC) using RNA-seq, ATAC-seq, H3K27ac ChIP-seq, and DLO Hi-C. Presumably, this epigenomic dataset could reveal the missing functional variants located in the oral epithelial cell active enhancers/promoters along with their risk target genes, despite relatively less-stringent statistical association with OFC. Taken a non-syndromic cleft palate only (NSCPO) GWAS data of the Chinese Han population as an example, 3664 SNPs that cannot reach the strict significance threshold were subjected to this functional identification pipeline. In total, 254 potential risk SNPs residing in active cis-regulatory elements interacting with 1 718 promoters of oral epithelium-expressed genes were screened. Gapped k-mer machine learning based on enhancers interacting with epithelium-expressed genes along with in vivo and in vitro reporter assays were employed as functional validation. Among all the potential SNPs, we chose and confirmed that the risk alleles of rs560789 and rs174570 reduced the epithelial-specific enhancer activity by preventing the binding of transcription factors related to epithelial development. In summary, we established chromatin conformation datasets of human oral epithelial cells and provided a framework for testing and understanding how regulatory variants impart risk for clefts.
Chromatin ; Cleft Lip/genetics* ; Cleft Palate/genetics* ; Epithelium ; Genome-Wide Association Study ; Humans