Objective To investigate possible independent association between metabolic syndrome (MS) and obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods According to polysomnography (PSG) examination, 82 obese patients were divided into OSAHS group (n = 55) and non OSAHS group (n = 27) and 30subjects with normal weight were recruited as the control group. PSG parameters such as AHI (apnea hyponea index), oxygen saturation (Spo2,) in obese patients were measured. MS-associated parameters, such as fasting blood glucose (FBG), fasting insulin (FINS), plasma lipid profile, insulin homeostasis model assessment of insulin resistance (HOMA-IR) and blood pressure, height, body weight, waist circumference, were measured in all cases. The prevalence of MS and the parameters were compared among different groups. The correlations between them were analyzed. Results The prevalence of MS in obese patients with OSAHS was significantly higher than that in obese patients without OSAHS (69.09% vs 37.04%, P <0.01). Systolic blood pressure and diastolic blood pressure (DBP), FBG and HOMA-IR were higher in subjects with OSAHS than those without OSAHS (P <0.05 or P <0.01). Multiple stepwise regression showed that DBP was negatively correlated with Spo2, FINS and HOMA-IR were positively correlated with AHI. Conclusion OSAHS is found to be independently associated with MS, which may be a risk factor of cardiovascular disease and other systemic diseases.

Objective To explore the expression and significance of p38MAPKin the pathogenesis of nonalcoholic steatohepatitis (NASH).Methods Sixty mice which were 6-weeks-old were randomized by bodyweight into high lipid high fructose group and control group with 30 mice in each and were given the corresponding feed.The nice were sacrificed respectively at the end of weeks 4,8,and 16,and their NASH-related parameters such as liver function,blood lipid etc.were determined,and the liver histopathological changes were evaluated after HE and oil red O staining of liver tissue specimens and NAS scoring was performed; immunohistochemistry and Western Blotting were applied to determine expression of p38MAPK in the model mice at weeks 4,8 and 16,at the same time,RT-PCR was used to determine mRNA expression levels of p38MAPK,TNF-a,MCP-1,IL-1,IL-6 and IL-8.Results As compared with the control mice at the same stage,the oil red O stained area and density increased in the high lipid high fructose group; HE staining showed that foci of different degree occurred with time after the model was established.The NAS score at the end of model establishment was 5-8 points,which reached the diagnostic criterion for NASH.At the end of 4th and 8th weeks,total cholesterol,high density lipoprotein,low density lipoprotein significantly increased as compared to the control group.At the end of the 16th week,the liver function tests and blood lipid of the high lipid high fructose group significantly increased.MCP-1 and IL-1 markedly increased at the early stage,TNF-α and IL-8 increased at the end of the 8th week,while p38MAPK and IL-6 showed a trend of increase,and increased significantly at the end of 16th week.Immunohistochemistry for p-p38MAPK showed nuclear stainingat 8th and 16th weeks; Western Blotting showed significant increase of p38MAPK expression in the model group at 4,8,and 16th weeks in the liver tissue as compared with the control group.Conclusion Mouse model of NASH was successfully established by using modified western food-like feed,and in the model group p38MAPK and inflammatory factors play roles in formation of NASH,and p38MAPK and IL-6 may be used as a basis for assessment of targeted therapy of NASH.

Objective:To Investigate comprehensive predictive ability of first-trimester complete blood count combined with maternal characteristics for gestational diabetes mellitus (GDM).Methods:From May 2015 to July 2018, 1 412 pregnant women were retrospectively screened at the Fifth People′s Hospital of Shanghai, Fudan University. We recruited 258 women who developed GDM and 1 154 women who had normal glucose level during pregnancy. At the first visit, clinical data and complete blood count result were obtained. GDM prediction models were established through logistic regression analysis of GDM related risk factors and the prediction abilities of each model were compared.Results:Logistic regression analyses identified age, pre-pregnancy body mass index, previous GDM history, family history of diabetes mellitus, the neutrophil-to-lymphocyte ratio, leukocyte, neutrophil, and monocyte counts were significantly independent predictors of GDM. In the entire cohort, the predictive ability of neutrophil and monocyte counts together with maternal basal characteristics model for the development of GDM [areas under the receiver operating characteristic curve (AUC-ROC)=0.809, integrated discrimination improvement (IDI)=0.056, P=0.001] was the best among various models (basal characteristics model, AUC-ROC=0.753; Monocyte count+ basal characteristics model, AUC-ROC=0.764; neutrophil count + basal characteristics model, AUC-ROC=0.775). Similar results obtained by the same way in all pregnant women without previous GDM history. Conclusion:It could improve the prediction of GDM with model incorporated maternal characteristics and first-trimester neutrophil and monocyte counts.

Objective: To investigate the role of neutrophil elastase inhibitor, sivelestat, in preventing and treating nonalcoholic steatohepatitis (NASH) and its underling mechanisms. Methods: A total of forty 4-week-old male C57BL/6J ApoE-/-mice were equally divided into the following four groups: standard chow (SC)+isotonic saline; SC+sivelestat; high-fat, high-cholesterol (HFHC) diet+isotonic saline; and HFHC+sivelestat. These mice were treated with above methods for 12 weeks. Blood and liver tissue samples were collected to measure biochemical parameters, hepatic steatosis and non-alcoholic fatty liver disease (NAFLD) activity score (inflammation) were evaluated by oil red O staining and HE staining, respectively. The mRNA and protein expression levels of hepatic inflammatory cytokines, CD68, and F4/80 were determined by quantitative RT-PCR and immunohistochemistry, respectively. Comparison of means between the four groups was made by one-way analysis of variance, and comparison between any two groups was made by the LSD or SNK method (for data with homogeneity of variance) or the Tamhane or Dunnett method (for data with heterogeneity of variance). Results: Mice fed with an HFHC diet for 12 weeks developed typical pathological features of NASH compared with those fed with SC. Compared with mice fed with HFHC diet without sivelestat, those treated with HFHC and sivelestat exhibited the following features: (1) significantly reduced fast blood glucose, blood cholesterol, and hepatic biochemical parameters, as well as increased insulin sensitivity; (2) significantly reduced NAFLD activity score (5.71±1.11 vs 3.16±1.16, P < 0.05); (3) reduced monocyte chemoattractant protein-1 and tumor necrosis factor -α; (4) significantly reduced mRNA levels of CD68 and F4/80; and (5) reduced expression of CD68 in the liver. Conclusion Sivelestat alleviates the hepatic steatosis and inflammation of NASH in mice by inhibiting the activation of Kupffer cells.