OBJECTIVEThe aim of this study is to investigate the occurrence and mechanism of Cheyne-Stokes breathing pattern in patients with heart failure.

METHODSFifty-six patients who performed polusomnography sleep testing at National Center of Cardiovascular Diseases Fuwai Hospital from March to May in 2015. We divided them into chronic heart failure (CHF) group and non-CHF group.

RESULTSThe occurrences of sleep apnea in two groups were high. In CHF group (n = 11) , there were 10 patients with apnea hypopnea index (AHI) > 5; and their AHI was 23.93 ±14.63. In non-CHF group (n = 45), there were 33 patients whose AHI > 5; and their AHI was 16.20 ± 18.76. The ratio of center sleep apnea to all gross sleep apnea ratio in CHF group was higher than that in non-CHF group (80.21% ± 30.55% vs 27.16% ± 35.71%, P < 0.01 ).

CONCLUSIONBased upon the new theory of holistic integrative physiology and medicine, we explain the mechanism of circulatory dysfunction induce the oscillation breathing in patients with CHF. The sleep apnea and C-S respiration in CHF should be called circulatory sleep apnea, rather than central sleep apnea.

Cheyne-Stokes Respiration ; Chronic Disease ; Heart Failure ; physiopathology ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; physiopathology ; Sleep Apnea, Central

Adult ; Antiviral Agents ; pharmacology ; therapeutic use ; DNA, Viral ; Female ; Genotype ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Lamivudine ; pharmacology ; therapeutic use ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVETo examine the genetic polymorphisms in the promoter region of cyclooxygenase-2 ( COX-2) and evaluate their association with the risk of gastric cancer.

METHODSSingle-strand conformational polymorphism and DNA sequencing were used to screen the genetic variants of the COX-2 promoter region. Total 323 patients with gastric cancer and 646 frequency-matched controls were genotyped by polymerase chain reaction-restriction fragment length polymorphism method. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression. Haplotype frequency was estimated using Haplo. stat software.

RESULTSThree single nucleotide polymorphisms, including - 1290A > G, -1195G > A, and -765G > C were identified in the promoter of COX- 2. Case-control analysis showed an increased risk of developing gastric cancer for the -1290AG (OR 1.64; 95% CI 1.03-2.61), -1195AA (OR 2.68; 95% CI 1.65-4.33), and -765CG (OR 2.66; 95% CI 1.53-4.64) genotype carriers, respectively, compared with noncarriers. A greater risk of developing gastric cancer was observed for the A(-1290) -A(-1195) -C(-765) haplotype compared with the A(-1290) -G(-1195) -G(-765) haplotypes (OR 11.80; 95% CI 2.43-57.25).

CONCLUSIONGenetic polymorphisms in COX-2 promoter region may play a role in gastric carcinogenesis.

Adult ; Aged ; Cyclooxygenase 2 ; genetics ; Female ; Genetic Predisposition to Disease ; Haplotypes ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; genetics ; Risk ; Stomach Neoplasms ; enzymology ; genetics

We have observed earlier that testosterone at physiological concentrations can stimulate tissue factor pathway inhibitor (TFPI) gene expression through the androgen receptor in endothelial cells. This study further investigated the impact of testosterone on TFPI levels in response to inflammatory cytokine tumor necrosis factor-alpha (TNF-alpha). Cultured human umbilical vein endothelial cells were incubated in the presence or absence of testosterone or TNF-alpha. TFPI protein and mRNA levels were assessed by enzyme-linked immunosorbent assay and quantitative real-time reverse transcription polymerase chain reaction. To study the cellular mechanism of testosterone's action, nuclear factor-kappa B (NF-kappaB) translocation was confirmed by electrophoretic mobility shift assays. We found that after NF-kappaB was activated by TNF-alpha, TFPI protein levels declined significantly by 37.3% compared with controls (P < 0.001), and the mRNA levels of TFPI also decreased greatly (P < 0.001). A concentration of 30 nmol L(-1) testosterone increased the secretion of TFPI compared with the TNF-alpha-treated group. NF-kappaB DNA-binding activity was significantly suppressed by testosterone (P < 0.05). This suggests that physiological testosterone concentrations may exert their antithrombotic effects on TFPI expression during inflammation by downregulating NF-kappaB activity.
Androgens ; pharmacology ; Cells, Cultured ; Down-Regulation ; drug effects ; Drug Combinations ; Endothelium, Vascular ; drug effects ; metabolism ; Humans ; Infant, Newborn ; Lipoproteins ; genetics ; metabolism ; NF-kappa B p50 Subunit ; antagonists & inhibitors ; genetics ; RNA, Messenger ; metabolism ; Testosterone ; pharmacology ; Tumor Necrosis Factor-alpha ; pharmacology

OBJECTIVETo investigate the effect of Compound Qingqin Liquid (CQL) on the expression level of angiotensin II (Ang II) and COX-2 mRNA transcription and protein expression in the renal tissue of rats with uric acid nephropathy.

METHODSSD rats were randomly divided into the blank control group, the model group, the positive drug group, the high, moderate, and low dose CQL group according to number randomization principle. The model was established by gastrogavage of adenine, accompanied with yeast feeding. Distilled water was given by gastrogavage to rats in the blank control group and the model group. Allopurinol at the daily dose of 9.33 mg/kg was given by gastrogavage to rats of the positive control group. CQL at the daily dose of 3.77 g/kg, 1.89 g/kg, and 0.09 g/kg was respectively given by gastrogavage to rats in the high, moderate, and low dose CQL groups. All treatment lasted for 6 weeks. Rats were randomly divided at week 4 (3 in the blank control group, and 6 in the rest groups), and the rest rats were killed at week 6. The renal tissue was extracted. The expression level of Ang II and COX-2 mRNA transcription were detected by RT-PCR. The expression level of Ang II was detected by ELISA. The expression level of COX-2 protein was detected by Western blot and immunohistochemical assay.

RESULTSCompared with the blank control group, except the mRNA expression of Ang II at week 4, the mRNA and protein expression of Ang II and COX-2 obviously increased at week 4 and 6 in the model group (P < 0.01, P < 0.05). The COX-2 protein expression at week 4 was obviously lower in the high and moderate dose CQL groups than in the model group and the low dose CQL group (P < 0.05); the average integral of optical density value was obviously lower in the positive control group than in the model group. Except the mRNA expression of Ang II in the high dose CQL group at week 6, the mRNA and protein expression of Ang II obviously decreased in the positive control group and each dose CQL group (P < 0.01, P < 0.05). Of them, the effects were better in the high and moderate dose CQL groups than in the positive control group and the low dose CQL group (P < 0.05, P < 0.01). Besides, the mRNA expression of COX-2, the average integral of optical density value were obviously lower in the positive control group and each dose CQL group than in the model group (P < 0.05). The protein expression of COX-2 was obviously lower in the high and moderate dose CQL groups than in the model group (P < 0.05). Of them, the mRNA expression of COX-2 was better in the moderate dose CQL group than in the positive control group (P < 0.05); the protein expression of COX-2 was better in the high dose CQL group than in the low dose CQL group (P < 0.05).

CONCLUSIONCQL was capable of lowering the expression level of Ang II, COX-2 mRNA transcription and protein expression, thus suppressing the inflammatory pathological injury of the renal tissue.

Angiotensin II ; metabolism ; Animals ; Cyclooxygenase 2 ; genetics ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Kidney ; metabolism ; Kidney Diseases ; drug therapy ; metabolism ; Male ; RNA, Messenger ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Uric Acid

OBJECTIVEExercise induced oscillatory ventilation (EIOB) during cardiopulmonary exercise testing (CPET) is associated with severity and prognosis of disease, but clinical approach for the character of EIOB due to circulatory dysfunction are seldom reported.

METHODSThis retrospective analysis of symptom-limited maximum CPET data with an increment of 10-20 W/min in 38 patients with CHF. We calculated the duration, frequency, amplitude and other parameters of EIOB.

RESULTSThere were 31 presenting with EIOB (82%) in all patients with CHF. In EIOB group, VE amplitude were (12.4 ± 4.4)L/min (accounting for 81% ± 30% of mean) and duration were (77.0 ± 20.0)s. The number of patients whose EIOB presenting at rest, exercise, recovery stage and the whole eriod were 24, 31, 4 and 4, respectively. Except VE, there were VO2, VCO2, RER and PETO2 presenting EIOB in all 31 patients; VE/VCO2, VO2/VE and breath frequency in 29 patients; PETCO2 in 26 patients; VT and VO2/HR in 25 patients; and HR in 2 patients.

CONCLUSIONEIOB may occur in any period of CPET, mostly in severe patient with CHF, and presenting in many variables. Due to it is resulted from the circulatory dysfunction, we should call it circulatory (cardiac) oscillatory breathing abnormality.

Exercise Test ; Heart Failure ; physiopathology ; Humans ; Oxygen Consumption ; Respiratory Physiological Phenomena ; Retrospective Studies

OBJECTIVESTo evaluate the academic status and influence of the National Journal of Andrology (NJA).

METHODSThe data of articles and citations in 16 issues of NJA (2000-2002) were collected, then the quality of this journal was evaluated in terms of bibliometric parameters.

RESULTSExcept for reviews and translations, the sums of original papers accounted for 183 (53.5%), the articles with citation in 16 issues were 333 (97.08%), and funded project papers accounted for 62 (18.08%). The number of the articles and funded project papers increased every year; the average publishing cycle of the articles was 8.7 months; the average number of authors was 3.7 per article; the average age of the first author was 36.3 years old; the authors distributed in 30 provinces, 43.37% of the authors had senior professional title and 40.80% of the authors had master's or doctor's degrees, the journal had a high rate of self-citation (6.30%).

CONCLUSIONSNational Journal of Andrology is a high quality journal, with excellent authors, strong influence and bright future.

Andrology ; statistics & numerical data ; Bibliometrics ; China ; Periodicals as Topic ; statistics & numerical data

Objective To analyze the data of road traffic accidents, deaths and injuries in 31 provinces and municipalities in China from 2010 to 2017, and to predict that the number of deaths and injuries caused by road accidents set in the sustainable development goals (SDGs) will be halved by 2020 compared with the target set in 2015. Methods Describing and analyzing the current situation of road traffic accidents in 31 provinces and municipalities in China, and using the trend extrapolation method to predict whether the SDGs target can be achieved by 2020. Results The numbers of traffic accidents, deaths and injuries in Guangdong, Jiangsu, Zhejiang and Shandong Provinces showed a downward trend from 2010 to 2017, but still ranked the front in China. In 2017, Beijing had the highest death rate followed by Guizhou as the second, and Guizhou had the highest injury rate followed by Tianjin as the second. The projected results showed that the numbers of deaths and injuries caused by road traffic accidents in China would be increased by 17% and 1.3% respectively in 2020 indicating that SDGs target could not be met. Among the 31 provinces/municipalities, it was predicted that the numbers of deaths and injuries in Hunan would be reduced to 50.7% and 65.3% in 2015, respectively by 2020, and the target could be achieved; the number of injuries in Shanghai was decreased by 83.3%, but the deaths was only decreased by 34.5%, and there was still a gap with the target; the rest 29 provinces/municipalities could not meet SDGs target. It was expected that the deaths in 11 provinces and municipalities would increase by 2020, with Beijing, Jilin, Jiangxi, Hubei and Guizhou Provinces showing the most significant growth. The number of injured people in 8 provinces and municipalities shows an increasing trend, with Jilin, Jiangxi, Hubei and Guizhou provinces showing significant growth. Conclusions Except for Hunan Province, it was difficult for the whole country and the rest provinces and municipalities to reach the SDGs target. According to the forecast results and the actual situation, a targeted scientific prevention and control strategy can be formulated. The measures taken by Hunan and Shanghai in traffic accident prevention and control were effective and worth learning.

Objective Midkine ( MK ) and nuclear factor-kappa B ( NF-kB ) play pivotal roles in tumorigenesis, which are considered as promising cancer biomarkers. The efficacy of MK and NF-kB as markers for diagnosis and prediction of synchronous metastasis in papillary thyroid cancer ( PTC ) was the aim of present investigation. Methods Seventy six cases of PTC and seventy cases of multi-nodular goiter ( MNG ) were retrieved. The PTC group was further divided into subgroup 1 (16 cases with synchronous metastasis) and subgroup 2 (60 cases without metastases). A retrospective review of clinical information, radiological examinations,131 I treatments and post-131 I-therapy scans were done. Immunohistochemistry of MK, NF-kB p65, and Ki-67 was performed on paraffin-embedded specimens and results were quantified. Diagnostic values of the parameters were conducted by receiver operating characteristic (ROC) curves. Diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were determined. Protein levels of MK and NF-kB p65 were then confirmed by Western blot. Results Immunoreactivities of MK and NF-kB p65, and positive percentage of Ki-67 were significantly higher in PTC group than in MNG group (all P<0. 01). ROC showed good differential diagnostic capabilities of all three parameters with diagnostic accuracies of 82. 192% , 80. 137% , and 84. 091%respectively. Moreover, all three parameters were significantly higher in subgroup 1 than those in subgroup 2 (all P<0. 01). ROC showed good predicting efficacies in synchronous metastasis of all three parameters with diagnostic accuracies of 82. 895% , 80. 263% , and 76. 316% respectively. By one-way analysis of variance, Western blot showed that MK and NF-kB p65 protein levels in lesions from subgroup 1 were significantly higher than those from subgroup 2, both were significantly higher than those in MNG lesions ( P<0. 01). Conclusion MK and NF-kB immunohistochemistry can potentially be used for differential diagnosis between PTC and MNG, and for prediction of synchronous metastases.

OBJECTIVEThe research tended to approach applying of adjustable appliance in the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS).

METHODS30 OSAHS patients (24 males and 6 females) participated in the adjustable group, with a mean age of (49.9 +/- 9.9) years old. AHI was (33.1 +/- 22.7) per hour. The control group consisted of 30 OSAHS patients wearing ordinary mandibular advancing appliance in the corresponding period, with age, weight and AHI at the same level. Monoblind way was designed to obtain and analyze the therapy differences. Differences in changes of upper airway, mandible and hyoid bone were also analyzed among the doctor-experience position, final adjusted position and original position.

RESULTSAHI decreased by 85.5% in the adjustable appliance group. The change in AHI was greater significantly (P = 0.025) in the adjustable group than in the control group. In the final adjusted position, the amount of mandibular advancement was (5.8 +/- 1.4) mm [(71 +/- 26)% of the maximum range of protrusion] and that of bite opening (the distance between upper and lower incisor edges) was (4.6 +/- 1.1) mm.

CONCLUSIONSThe adjustable appliance had shown better therapy effect in OSAHS patients. The final adjusted position provided useful information on determining mandibular position using other appliances.

Adult ; Female ; Humans ; Male ; Mandibular Advancement ; instrumentation ; Middle Aged ; Single-Blind Method ; Sleep Apnea, Obstructive ; therapy ; Treatment Outcome