Objective To study the effects of obstructive sleep apneas on endothelial function and autonomic modulation. Methods From June 2009 to June 2011, male patients with obstructive sleep apnea hypopnea syndrome (OSAHS) were consecutively enrolled in this study. Patients with an apnea/hypopnea index (AHI) of greater than 15 and without previous treatment for OSAHS were included as Group OSAHS and obese subjects with an AHI of less than 5 were included as non-OSAHS controls (Group Control). Electrocardiography and beat-to-beat blood pressure were continuously recorded from the radial artery by applanation tonometry which was synchronized with polysomnography recording. Endothelial function was measured by arterial augmentation index (AAI). Spectral analysis of heart rate variability (HRV) and blood pressure variability (BPV) were computed for cardiac parasympathetic modulation (high frequency power, HF); sympathetic modulation (low frequency power, LF), sympathovagal balance (LF/HF power of R-R variability, LF/HF) and BPV sympathetic modulation (BPV LF) in normalized units [total power of the components/(total power-very LF power)×100]. Results Finally, 27 moderate-severe OSAHS patients and 22 non-OSAHS obese controls were recruited in the Group OSAHS and Group Control, respectively. In Group OSAHS, the age was 43.3±9.3 year-old, body mass index (BMI) was 36.8±8.7 kg/m2; in Group Control, the age was 42.9±8.6 year-old, BMI was 34.4±7.9 kg/m2; there were no significant differences in age and BMI between the Group OSAHS and Group Control (all P>0.05). The baseline AAI (12.5%±2.2% vs. 8.2%±2.1%) and BPV LF (68.3%±13.5% vs. 61.1%±11.7%) of the Group OSAHS were significantly higher than those of the Group Control (all P<0.05). And after overnight sleep, systolic BP (143.7±14.2 vs. 132.8±13.3 mm Hg), diastolic BP (87.7±7.7 vs. 78.6±5.5 mm Hg), HRV LF (69.7%±14.4% vs. 64.3%±12.1%), HRV LF/HF (3.7±2.0 vs. 2.3±1.3) and BPV LF (77.8%±15.6% vs. 68.3%±13.5%) of the Group OSAHS were significantly increased (all P<0.001), while HRV HF was significantly decreased (21.1%±9.3% vs. 27.5%±10.3%, P<0.05) from baseline.
Adult ; Autonomic Nervous System ; Blood Pressure ; Heart Rate ; Humans ; Male ; Polysomnography ; Sleep Apnea, Obstructive

The incidence and proportion of right colon cancer is increasingly high in recent years with a relatively poor prognosis. Right hemicolectomy is the standard procedure for the treatment of right colon cancer. Recently, infrapyloric lymph node (No.206 nodes) dissection has become one of the hot topics of surgical treatment for right colon cancer. The incidence of infrapyloric lymph node metastasis is still unclear, and whether it belongs to the regional lymph node of the right colon cancer is controversial. There are few methods to judge and predict infrapyloric lymph node metastasis, and the accuracy of diagnosis is low. What's more, dissection of infrapyloric lymph node might increase the risk of complications and perioperative mortality, as well as lead to overtreatment. As a result, this series of problems and controversies result in the obscure of the clinical value of infrapyloric lymph node dissection. Therefore, there is urgent need to design more high-quality, multicenter and large-sample prospective randomized controlled trials to explore the standard of routine dissection of infrapyloric lymph node for right colon cancer. Based on research advances at home and abroad, the authors review the incidence of infrapyloric lymph node metastasis, methods for judgement of infrapyloric lymph node metastasis, inluencing factors for lymph node metastasis, value of lymph node dissection, and research of direction in the future.

Calcitonin ; metabolism ; Carcinoma, Medullary ; metabolism ; pathology ; Carcinoma, Papillary ; metabolism ; pathology ; Chromogranin A ; metabolism ; DNA-Binding Proteins ; metabolism ; Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; Synaptophysin ; metabolism ; Thyroglobulin ; metabolism ; Thyroid Neoplasms ; metabolism ; pathology ; Transcription Factors

Objective To study the expression of Toll-like receptor-2 (TLR-2) and caspase-3 in the intestine of premature rats with necrotizing enterocolitis (NEC),and to explore the protective effects and possible regulatory mechanism of glutamine (Gln) in the NEC.Methods Sixty premature rats (gestational age 21 d) were divided into three groups (n = 20 each) according to the random number table: control group,model group and Gln intervention group.Rats in model group were given formula feeding,hypoxia and cold stress.Rats in Gln intervention group were given Gln 0.3 g/kg to the formula feeding,hypoxia and cold stress.All the premature rats were sacrificed and the intestine tissues were obtained on the third day after birth.The histological changes of ileal tissues were scored after HE staining.The expression of TLR-2 and caspase-3 in jejunum,ileum and colon were detected by inmunohistochemistry,and the expression of TLR-2 mRNA in jejunum,ileum and colon were detected by real-time fluorescence quantitative reverse transcription-polymerase chain reaction.Results Pathology score of ileum in model group,Gln intervention group and control group were 3.10 ±0.99,2.40 ± 0.69 and 0.30 ±0.48,respectively.The expressions of TLR-2 protein in ileum were 2.53±0.94,2.15±0.82 and 1.57 ± 0.62 in the three groups respectively,and the expression of caspase-3 protein were 2.83 ± 0.45,2.70 ± 0.04 and 0.91 ± 0.29.The content of TLR2 mRNA in model group was 1.46 times higher than that of Gln intervention group and was 2.10 times higher than that of control group.Compared with the control group,the pathology score,expression of TLR-2 and caspase-3 protein,and TLR-2 mRNA in model group were significantly higher,P＜0.01.However,compared with the model group,those changes were improved in Gln intervention group,P＜0.05.Expression of TLR-2 mRNA positively correlated to the expression of caspase-3 protein (r=0.71,P＜0.01) and pathology score (r = 0.69,P＜ 0.01).Expression of caspase-3 protein positively correlated to the intestine injury pathology score (r=0.81,P＜0.01).Conclusions TLR-2 may be involved in the pathogenesis of NEC.Gln might reduce the expression of TLR-2 in the intestine,and decrease the apoptosis of intestinal epithelial cells to protect the intestine of preterm birth rats.

Adolescent ; Brain Neoplasms ; diagnosis ; Child ; Child, Preschool ; Endocrine System Diseases ; etiology ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Infant ; Luteinizing Hormone ; blood ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed

Objective To investigate the clinical significance of thyroglobulin antibody (ATG) and thyroid peroxidase antibody (ATPO) in patients with vitiligo. Methods Venous blood samples were obtained from 87 patients with vitiligo and 90 age- and sex-matched normal human controls. Chemiluminescence was applied to measure the serum levels of ATG, ATPO, free triiodothyronine, free tetraiodothyronine and thyroid stimulating hormone (TSH). Results There was a significant increase in the positivity rates of ATG (23.0% vs 6.7%, P < 0.01) and ATPO (24.1% vs 7.8%, P < 0.01) as well as the serum level of TSH (3.4 ± 2.4 vs 2.4 ± 1.2 pmol/L, P < 0.05) in the patients with vitiligo compared with the normal human controls. It is worth mentioning that all patients positive for ATG or ATPO were diagnosed with vitiligo vulgaris. The positivity rates of ATG and ATPO in patients with vitiligo aged from 11 to 20 years and 21 to 40 years were significantly higher than those in age-matched normal controls (all P < 0.05). Also, female patients had a higher positivity rate of ATG and ATPO than female controls did (34.1% vs 8.5%, χ2 = 8.90, P < 0.01; 34.1% vs 10.6%,χ2 = 7.29, P < 0.05). The highest positivity rates of both ATG and ATPO were 53.3%, which were observed in vitiligo patients aged from 11 to 20 years, followed by patients from 21 to 40 years (ATG 34.5%, ATPO 34.5%). In patients with vitiligo positive for both ATG and ATPO, the occurrence of autoimmune thyroid disease was 70% (14/20), significantly higher than that in ATG- and ATPO- positive healthy controls (16.7%, χ2 = 5.4, P < 0.05). Conclusions ATG and ATPO were observed in young female patients with vitiligo vulgaris, and they may be associated with the development of autoimmune thyroid diseases.

Objective To establish and evaluate three different necrotizing enterocolitis models,established by combination of formula feeding, hypoxia and cold exposure, hypoxia-reoxygenation, and intraperitoneal injection of lipopolysaccharides (LPS) in premature rats. Methods Group A was given formula feeding, hypoxia by exposing to 100% N2 for 90 s and 4 ℃ cold stress for 10 minutes, the hypoxia and cold stress were given twice a day for 2 d. Group B was put into 100% N2 for 5 min and then 100% O2for 5 min, twice a day for 3 d. Group C was injected intraperitoneally 5 mg/kg LPS. Group D, E and F were served as the corresponding controls for group A, B and C. Ileocecal junction, liver, kidney and lung tissues were harvested and evaluated by HE staining for histological analysis, histological changes of ileal tissues were scored, and rats with score higher than two were diagnosed with NEC. Results Premature rats in group A, B and C showed various degrees of decreasing activity, abdominal distention, diarrhea,intestinal dilatation and congestion. Histological score in group A to F were 3. 13 ± 0. 64, 1.40 ±0. 52,2. 00±0. 42,0. 30±0. 48, 0. 30±0. 48 and 0. 40±0. 52, respectively. There were significant differences between model groups and their corresponding control groups (P＜0. 01 ). Among the model groups, the histological score of group A was higher than group B (P＜0.01) and group C (P＜0.05). The incidences of NEC in group A, B and C were 6/8, 20% (5/10) and 4/8, respectively, while of zero in all control groups. Liver, kidney and lung injures were more serious in group C compared with the other groups.Conclusions Compared with the single-factor modeling approaches of intraperitoneal injection of LPS and hypoxiareoxygenation, the NEC animal model in preterm rats established by formula feeding, repeated hypoxia and cold exposure, is more similar to the etiological factors of neonatal NEC in human, with higher incidence, better reproducibility and specificity.

Objective To discuss the socialized management model of medical transportation service in large-scale grade three hospital.Methods Selected a company through a competitive bidding,using dual management model of company and nursing department.The nursing department developed and implemented a unified regulatory system,introduce competition mechanism,participate incentives reform quality inspection programs,hold multi-sect oral coordination meetings regularly and also the hospital and company projeot management meetings.Results Socialization of medical transportation service not onlyreduced the problem of the hospital management cost to solve the hospital's birth control and labor,but also improved the satisfaction of patients and medical staff to the transportation members,it provided a strong support system to clinical service.Conclusions Implementation of social management in allied transportation service in hospital is feasible.The company management,nursing supervision model is a new path for transportation management.It is a guarantee of mechanism innovation,intensive training,strict management and supervision of a stable multi-party transport team to provide high-quality transportation service.

OBJECTIVETo observe the clinical effect of Shen-reinforcing and menstrual cycle-regulating therapy (SRMCRT) combined with Western medicine (WM) in treating decline in ovarian reserve (DOR).

METHODSTotally 78 patients with DOR were assigned to the traditional Chinese medicine combined WM group (abbreviated as IM group, 40 cases), and the WM group (38 cases) according to random digit table method. Patients in the WM group were treated with hormone replacement therapy, while those in the IM group additionally received SRMCRT. The therapeutic course for all was 3 consecutive months. The therapeutic efficacy was compared between the two groups. The serum levels of follicle stimulating hormone (FSH), FSH/luteinizing hormone (LH), and estradiol (E2), as well as the development of sinus follicles were compared between before and after treatment in the two groups.

RESULTSThe therapeutic effective rate was 92.5% in the IM group, higher than that of the WM group (73.68%, P < 0.05). The serum levels of FSH, FSH/LH, and E2 decreased (P < 0.05) and the number of the sinus follicle increased (P < 0.05) in the two groups after treatment. Besides, IM was superior in decreasing serum levels of FSH and FSH/LH, and increasing the number of the sinus follicle (P < 0.05).

CONCLUSIONSSRMCRT was an effective method for treating ROD. IM was superior in decreasing serum levels of FSH and FSH/LH, and increasing the number of the sinus follicle.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Estradiol ; blood ; Female ; Follicle Stimulating Hormone ; blood ; Hormone Replacement Therapy ; Humans ; Integrative Medicine ; Luteinizing Hormone ; blood ; Ovarian Diseases ; drug therapy ; Ovarian Follicle ; drug effects ; Ovarian Reserve ; Young Adult

Objective To evaluate the effect of peer educatio n program by the application of the peer education on human immunodeficiency vir us/aeguired immune deficiency syndrome(HIV/AIDS) prevention and the analysis of the change on knowledge, attitude and behavior about HIV/AIDS among technical sc hool students in Shanghai. Methods Three technical schools in Shanghai were selected randomly. Two classes of each school were selected randomly as education group and the students added up to 284.Two hundred and sixty-one students of another 2 classes in each school were selected as the interior control group. Some freshmen came from medical un iversity were carefully trained as peer educators to conduct the education inclu ding 6 models. The same questionnaires were carried before and after the educati on in both groups. Results After peer education the score of average knowledge abo ut reproductive health, HIV/AIDS, STD was significantly higher than before (P 0.05). Conclusions The conduction of the peer education on HIV/AIDS pr evention among technical school students is effective in promoting the knowledge level,but the change of attitude and behavior is a long term. So we highly adv ocate that not only the health education for HIV/AIDS especially safe sex shall be given and strengthened among technical school students in order to promote t he notion of self-protection but also the conception of care others especially t he HIV/AIDS. J Appl Clin Pediatr,2005,20(2):167-169