Obstructive sleep apnea (OSA) is characterized by repeated intermittent hypoxia (IH), hypercapnia, sleep fragmentation and intrathoracic pressure change. IH is related to the clinical pathophysiological processes of hypertension, atherosclerosis, coronary heart disease, arrhythmia, stroke, heart failure and sudden death. IH from OSA can lead to metabol-ic dysregulation, endothelial dysfunction, systemic inflammation, oxidative stress and the change of nerve body fluids, which has been shown to increase the risk of cardiovascular diseases. This study mainly describes the pathogenesis of IH leading to the various cardiovascular diseases.

Objective The experimental evidences that long term colonization of H. pylori results in development of gastric cancer in Mongolian gerbils (MGs) have been reported only by two Japanese groups so far. This study aimed to investigate the carcinogenicity of long term H. pylori infection in MGs model. Methods Thirty six 6 week old outbred MGs (from Inner Mongolia, male∶female=1∶1) were orally inoculated with H.pylori ATCC43504 or H.pylori 161, which was isolated from a patient with gastric adenocarcinoma in our hospital. Another 10 MGs were inoculated with sterilized PBS served as controls. The animals were sacrificed 8, 20, 28 and 84 weeks, respectively, after inoculation for bacteria and histological examination. Results H.pylori was detected in 80%(23/29)of the inoculated MGs and the chronic active gastritis aggravated gradually during the course of experiment. At the 84th week, moderate to severe gastritis, characterized by diffuse infiltration of mononuclear cells and formation of multiple lymphoid follicles in the mucosa and submucosa, and even the lymphocytic epithelial lesions were observed. Atrophy and intestinal metaplasia were less common. The lesions of hyperplasia were dominating in almost all MGs, 24%(4/17)of the animals occurred hyperplastic polyps. Well differentiated gastric adenocarcinomas were developed in 18% (3/17) of the MGs by the end of the 84th week (1 infected with H.pylori 161 and 2 with H.pylori ATCC43504, two of them were female MGs). Conclusions The results reconfirm that H.pylori infection alone can cause gastric adenocarcinoma in MGs. It is suggested that different species of MGs and various strains of H.pylori can be utilized for carcinogenesis research. It is the first report of the development of gastric cancer in female MGs, which might make sense of investigation on the host susceptibility influenced by gender.

Objective To explore the difference in the incidence of deep vein thrombosis (DVT) following total knee arthroplasty (TKA) or total hip arthroplasty (THA) between different seasons.Methods The present retrospective study examined 2 363 patients undergoing TKA or THA from August 2008 to February 2016.There were 653 male and 1 710 female with the average age of 64.44±13.03 years old (17-91 years old),including 954 patients in TKA and 1 409 in THA.All of the patients received anticoagulant drugs and were compressed with a pressure pump starting on the first postoperative night.Routine venography of the bilateral lower limbs was performed at 3-5 days after the operation.The incidence of DVT in different seasons and different age groups (≥65 years old and ＜65 years old) were counted.Results The present study suggested that the probabilities of DVT after arthroplasty in spring,summer,fall and winter were 15.85％ (116/732),14.92％ (71/476),17.88％ (108/604),22.50％ (124/551) respectively with significantly difference (P＜0.05).The incidence of DVT in winter was higher than that in spring and summer (P＜ 0.017).The probabilities of DVT after TKA in spring,summer,fall and winter were 19.09％ (59/309),15.67％ (37/236),18.11％ (44/243),27.71％ (46/166) respectively with significantly difference (P＜0.05).The incidence of DVT in winter was higher than that in summer (P＜0.017).The probabilities of DVT after THA in spring,summer,fall and winter were 13.48％ (57/423),14.17％ (34/240),17.73％ (64/361),20.26％ (78/385) respectively with significantly difference (P＜0.05),and that in winter was higher than in spring (P＜0.017).The symptomatic DVT after arthroplasty in spring,summer,fall and winter were 3.55％ (26/732),3.78％ (18/476),4.97％ (30/604),6.90％ (38/551) with significantly difference in different seasons (P＜0.05),and that in winter was higher than in spring (P＜0.017).The symptomatic DVT after TKA in spring,summer,fall and winter were 3.88％ (12/309),4.24％ (10/236),4.94％ (12/243),9.64％ (16/166) with significantly difference in different seasons (P＜0.05).The symptomatic DVT in winter was higher than that in spring (P＜0.017).The symptomatic DVT after THA in spring,summer,fall and winter were 3.31％ (14/423),3.33％ (8/240),4.99％ (18/361),5.71％ (22/385) respectively (P＞0.05).The probability of DVT following arthroplasty in older patients (age≥65 years old) in spring,summer,fall and winter were 18.49％ (76/411),16.61％ (45/271),22.07％ (81/367),28.05％ (99/353) with significantly difference among the groups (P＜0.05),while symptomatic DVT in older patients (≥65 years old) in spring,summer,fall and winter were 4.38％ (18/411),4.43％ (12/271),5.72％ (21/367),8.78％ (31/353) respectively with significantly difference (P＜0.05).The probability of DVT in four seasons were 12.46％ (40/321),12.68％ (26/205),11.39％ (27/237),12.63％ (25/198) in younger patients (＜65 years old).However,the difference was not detected among different seasons (P＞0.05).The probability of symptomatic DVT in four seasons were 2.49％ (8/321),2.93％ (6/205),3.80％ (9/237),3.54％ (7/198) in younger patients (＜65 years old) without significant difference (P＞0.05).Conclusion Seasonal variations could place an important effect on the incidence of DVT following TKA or THA,especially for the old patients with age ≥65 years.

Hip Joint ; Humans ; Ischium/diagnostic imaging* ; Magnetic Resonance Imaging

OBJECTIVETo assess the clinical value of endoscopic submucosal dissection(ESD) for duodenal lesion.

METHODSA total of 78 patients with duodenal lesion were treated with ESD from November 2006 to August 2010. The clinical data were retrospectively analyzed.

RESULTSThere were 46 male and 14 female patients. The mean age was(54±9) years. The lesion location included the duodenal bulb(n=39, 50%), the junction of bulb and descending part(n=19, 24.4%), and the descending part(n=20, 25.8%). The mean diameter of the lesions was(2.1±1.7) cm. Fifty-one(65.4%) lesions originated from the mucosa, including inflammatory/ hyperplastic polyps(n=22, 28.2%), villous/tubular adenoma(n=26, 33.3%), and hamartomas polyps(n=3, 3.8%). Twenty-five(32.1%) lesions originated from the submucosa, including Brunner's glands adenoma(n=15, 19.2%), ectopic pancreas(n=3, 3.8%), carcinoid tumor(n=3, 3.8%), lipoma(n=2, 2.6%), myxoinoma(n=1, 1.3%), and angio-lymphangioma(n=1, 1.3%). There were two lesions originated from the muscularis propria(n=2, 2.5%), and both were ectopic pancreas. All cases received ESD successfully. The mean operative time was(37±41) min and the mean blood loss was(23±15) ml. The perioperative complication rate was 35.9%(28/78), including intraoperative perforation(n=6), delayed perforation(n=3), intraoperative hemorrhage(n=10), delayed bleeding(n=7), and transient elevation of serum amylase(n=2). Postoperative pathological examination showed vascular invasion with tumor cells in one patient, who received extended resection later. The remaining 77 patients showed no recurrence during the followed up(rang, 3-23 months) using endoscopy.

CONCLUSIONESD is an effective, safe, minimally invasive method for the management of duodenal lesions.

Adult ; Aged ; Duodenal Diseases ; surgery ; Female ; Follow-Up Studies ; Gastroscopy ; methods ; Humans ; Intestinal Mucosa ; surgery ; Male ; Middle Aged ; Retrospective Studies

Objective To investigate the role of circulating neutrophil extracellular trap (NET) levels in the postoperative formation of deep vein thrombosis (DVT) in patients undergoing total knee arthroplasty (TKA). Methods Circulating NET levels were measured preoperatively and on postoperative days 1, 3, and 7 in 30 patients diagnosed with DVT by venography after TKA and 30 controls from May 2014 to July 2015. Results In patients with DVT, the mean circulating NET levels were significantly higher on postoperative days 1 and 3 compared with those in the non?DVT group (postoperative day 1, 1.598 ± 0.067 vs. 1.212 ± 0.037, t=7.514, P=0.000;postoperative day 3, 1.305±0.044 vs. 1.167±0.032, t=2.675, P=0.015). ROC curve analysis revealed the inferior sensitivity and specificity of NET levels on postoperative day 3 compared with postoperative day 1. Area under the curve (AUC) postoperative day 1 was 0.828 (95%CI:0.722, 0.933, P=0.000);AUC postoperative day 3 was 0.677 (95%CI:0.541, 0.814, P=0.018). The cutoff point for NET levels on postoperative day 1 was 1.294, with a sensitivity of 80%, a specificity of 80%, a posi?tive predictive value of 80%, and a negative predictive value of 80%. After Logistic regression, the NET level on postoperative day 1 was considered an independent predictor of DVT (OR:24.08, 95%CI:4.94, 117.28, P=0.000). Conclusion High circulating NET levels are associated with DVT in patients who undergo TKA. NETs may serve as a potential biological marker to delineate patients undergoing TKA who are most at risk for DVT.

OBJECTIVETo evaluate the effect of titanoreine on early postoperative symptoms after procedure for prolapse and hemorrhoids (PPH).

METHODSFrom November 2002 to July 2003, 80 patients who received PPH were randomly divided in to titanoreine group (n=42) and control group without titanoreine (n=38). Symptom relief was recorded 24 hours, 6 days and 12 days after PPH, urine retention 24h after PPH, first stool time, wound healing time, mean hospital stay were also recorded.

RESULTSThe score of symptom was lower in titanoreine group (4.4) than that in the control group (6.1) 24 hours after PPH (P< 0.05), but no significant difference in symptom grade was found between the two groups 6 days and 12 days after PPH (P> 0.05). Decrements of symptom grade were lower in titanoreine group than those of control group at any point after PPH (P< 0.05). There was no significant difference in urine retention rate and mean hospital stay between two groups(P> 0.05).

CONCLUSIONSTitanoreine can effectively relieve the early postoperative symptoms after PPH.

Adult ; Carrageenan ; therapeutic use ; Drug Combinations ; Female ; Hemorrhoids ; drug therapy ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Period ; Prolapse ; Rectal Diseases ; surgery ; Titanium ; therapeutic use ; Zinc Oxide ; therapeutic use

Objective To explore the energy feature of the spontaneous neural activity in depressive patients with diurnal rhythm.Methods Twenty depressive patients with diurnal rhythm,20 depressive patients without diurnal rhythm and 20 gender-,age-,education-matched healthy controls were scanned with 3.0 T MRI Scanner.According to Results of ANOVA,group-wise two sample t-test was completed.The correlation analysis were conducted between ALFF of significant difference brain regions and the score of Hamilton rating scale for depression.Results The brain regions showing significant differences among three groups were located in the right parahippocampal gyrus(MNI:18,-36,-9;K=136),left parietal lobe(MNI:-54,-45,42;K=86),left cerebellum crus(MNI:-84,-60,36;K=86) and right cerebellum crus(MNI:9,-78,-36;K=91)(P<0.05,Alphasim correct).Compared with non-diurnal rhythm group,the diurnal rhythm group showed significantly increased ALFF in the right parahippocampal gyrus.Compared with healthy group,the diurnal rhythm group showed significantly increased ALFF in right parahippocampal gyrus,left parietal lobe,and significantly decreased ALFF in left cerebellum crus 1 and right cerebellum crus 2.Compared with healthy group,the non-diurnal rhythm group showed significantly increased ALFF in left parietal lobe,and significantly decreased ALFF in left cerebellum crus 1 and bilateral cerebellum crus 2.No correlation between ALFF of significant difference brain regions and clinical symptoms was found(P>0.05).Conclusion The diurnal rhythm observed in depression may be associated with aberrant activity of parahippocampal gyrus.

Procedure for prolapse and hemorrhoids( PPH) is one of the important techniques developed for the treatment of hemorrhoids with severe degree in the last decade. Its principle is based on the "anal cushion" theory.Compared with traditional hemorrhoidectomy , PPH has advantages of shorter operation time , minor degree of postoperative pain , shorter hospital stay and quicker recovery.However, the occurrence of relapse and re-prolapse of hemorrhoids is high. Besides, the short-term efficacy of PPH for the constipation outlet obstruction caused by anterior rectocele is also favorable.
Anal Canal ; Hemorrhoids ; diagnosis ; Humans ; Operative Time ; Pain, Postoperative ; Prolapse ; Surgical Stapling