BACKGROUND5-Hydroxytryptamine (5-HT) is a common neurotransmitter in the brain which plays an important role in the pathogenesis of sleep apnea. Dysfunction of 5-HT and 5-HT(2) receptors may lead to the collapse of the upper airway and the instability of respiratory control, which in turn produce apnea. Genioglossus (GG) is one of the most important oropharyngeal muscles maintaining the upper airway open. The present study aimed to investigate the effects of 5-HT and 5-HT(2) receptor on GG activity and the sleep apnea in Sprague-Dawley (SD) rats.

METHODSMicroinjection probes were placed within the fourth ventricle of sixteen SD rats. After recovery for a week, the electromyogram (EMG) of GG was recorded in the anesthetized and vagotomized rats. The changes of GG activity before and after the microinjection of 5-HT or 5-HT(2A/2C) agonist -2,5-dimethoxy-4-iodoamphetamine hydrochloride (DOI) were observed. Probes were also laid in another eight SD rats. Electroencephalogram (EEG), EMG of neck muscle and respiration were recorded at the same time a week later. The effects of DOI on the occurrence of sleep apnea were explored.

RESULTSBoth 5-HT and DOI significantly enhanced the activity of GG just 3 minutes after the completion of injection. The effect of 5-HT disappeared quickly and the effect of DOI lasted for more than 27 minutes. DOI also significantly decreased the post-sigh apnea index in non-rapid-eye-movement (NREM) and rapid-eye-movement (REM) sleep and decreased the spontaneous apnea index only in NREM sleep (P < 0.05, respectively).

CONCLUSION5-HT and 5-HT(2A/2C) system correlated closely with the pathogenesis of the sleep apnea syndrome and 5-HT receptors may become the target of the drug treatment.

Amphetamines ; pharmacology ; therapeutic use ; Animals ; Electroencephalography ; Male ; Rats ; Rats, Sprague-Dawley ; Serotonin ; pharmacology ; therapeutic use ; Serotonin Receptor Agonists ; pharmacology ; therapeutic use ; Sleep Apnea Syndromes ; drug therapy ; Sleep, REM ; drug effects

Objective To evaluate the value of measuring ankle brachial index (ABI) for diagnosing peripheral arterial disease(PAD)compared with conventional digital subtraction angiography (DSA) as the reference standard.Methotis A total of 383 consecutive inpatients (245 male.mean age 64.1 ±11.7 years) underwent both conventional DSA and ABI measurements.Results The rate of statin intervention was 90.9%,ACEI 69.2%,antiplatelet 96.6% and β-blockers 67.9%.The intravascular stenosis was classified into six degrees:normal,<30%,30%-49%,50%-69%,70%-89% and≥90%.Compared to the traditional gold standard (DSA) in diagnosis PDA.the ABI value decreased in proportion to the sevefity of PAD (the ABI value was 1.08±0.11,1.05±0.16,0.99±0.17,0.66±0.24,0.55±0.28 and 0.54±0.00 respectively in the six ranks).There was a significant correlation between DSA and ABI in diagnosis PAD.Conclusion ABI measurement is an accurate and reliable non-invasive altemative to conventional DSA in the assessment of lower extremity arteries in patients with peripheral arterial disease.

A simple, sensitive, selective, and reproducible liquid chromatography-tandem mass spectrometric method was developed for the simultaneous determination of repaglinide and metformin in human plasma using d5-repaglinide and d6-metformin as internal standards (ISs). After a simple protein precipitation using acetonitrile as the precipitation solvent, both analytes and ISs were separated on a Venusil ASB C 18 (150 mm x 4.6 mm, 5 microm) via gradient elution using acetonitrile--10 mmol x L(-1) ammonium acetate as the mobile phase. A chromatographic total run time of 7.5 min was achieved. Mass spectrometric detection was conducted with atmospheric pressure chemical ionization under positive-ion and multiple-reaction monitoring modes. The method was linear over the 0.2 to 60.0 ng x mL(-1) concentration range for repaglinide and over the 4 to 1 000 ng x mL(-1) range for metformin. For both analytes, the intra- and inter-accuracies and precisions were within the +/- 15% acceptable limit across all concentrations. The validated method was successfully applied to a clinical bioequivalence study.
Administration, Oral ; Adolescent ; Adult ; Area Under Curve ; Carbamates ; administration & dosage ; blood ; pharmacokinetics ; Chromatography, Liquid ; Drug Stability ; Female ; Humans ; Hypoglycemic Agents ; administration & dosage ; blood ; pharmacokinetics ; Male ; Metformin ; administration & dosage ; blood ; pharmacokinetics ; Middle Aged ; Piperidines ; administration & dosage ; blood ; pharmacokinetics ; Tandem Mass Spectrometry ; Therapeutic Equivalency ; Young Adult

There are irreversible eyeball structural changes in high myopic patients. These changes include axial length, corneal radius, anterior chamber depth, fundus degeneration, macula thickness, etc. There is a close relationship between the damage degree of visual function and these changes. The incidence of complications, such as vitreous opacity, posterior vitreous detachment, cataract, glaucoma, posterior staphyloma and retina detachment, is also highly related to the myopia diopter. More and more researches have indicated that the myopia diopter and the level of visual function are affected by multiple factors. It is promising to detect all of these changes by different kinds of methods, and to assess visual function through these changes. By clarifying these changes, it is also useful to distinguish traumatic damage from disease to provide evidence for forensic assessment of eye injuries.
Eye/physiopathology* ; Forensic Medicine ; Humans ; Myopia/pathology* ; Vision, Ocular/physiology*

Objective:To analyze the incidence and mortality of lung cancer in Luwan district,Shanghai from January 2004 to December 2011.Methods:The data of the incidence and mortality of lung cancer in registered residents of Luwan district in the Shanghai Cancer Registry Report from January 2004 to December 2011 were collected and analyzed.The incidence and mortality of lung cancer were calculated.The rates were standardized by the demographic composition of the Fifth National Population Census in 2000.The average annual rate of change was calculated and the trend analysis was carried out. Results:A total of 1 572 cases of lung cancer were reported from January 2004 to December 2011,accounting for 15.09%of the malignant tumors in this region.The incidence rate of lung cancer ranks first in male malignant tumors and third in female malignant tumors.The standardized incidence rate was significantly higher in males than in females (U= 16.70,P<0.01).A total of 1 376 cases died of lung cancer during this period,making it the leading cause of cancer death among both males and females.The standardized mortality rate was significantly higher in males than in females (U= 12.64,P<0.01).The trends of standardized lung cancer incidence and mortality rate were both stable from 2004 to 2011.Conclusions:Lung cancer is a highly fatal disease,with its mortality close to its incidence among registered residents of Luwan district,Shanghai from 2004 to 2011.Age and gender are the main risk factors influencing the incidence of lung cancer.For prevention and control of lung cancer,it is important to identify high-risk groups,take effective measures and carry out early intervention.

Objective:To analyze the incidence and mortality of breast cancer among female residents in Luwan district of Shanghai from January 2004 to December 2011.Methods:Data of breast cancer in permanent female residents of Luwan district were collected from the database of cancer registration and management system in Shanghai.The incidence and mortality of breast cancer were calculated.The rates were standardized by the demographic composition developed in the Fifth Nationwide Census in 2000.The average annual change percentage was adopted to calculate the average annual rate and the trend analysis was made.Results:A total of 980 breast cancer cases were diagnosed from January 2004 to December 2011,accounting for 19.17 ％ of the total female malignant tumors and ranking first among newly diagnosed female malignant tumors.A total of 313 cases died of breast cancer during this period,making it the third leading cause of cancer death among females.The trends of standardized breast cancer incidence and mortality were relatively stable from 2004 to 2011.From 2004 to 2011,the standardized incidence and standardized mortality rate of female breast cancer were relatively stable in Luwan district of Shanghai.Conclusions:Breast cancer is a major malignant tumor among female residents in Luwan district of Shanghai.Age is an important risk factor affecting the incidence and mortality of breast cancer,and we should focus on the prevention and screening of breast cancer.

Objective To evaluate the therapeutic effects of combination administration of hydrochlorothiazide and nitrendipine at low dosage in the treatment of rural hypertension patients.Methods By the method of cluster random sampling,5292 primary hypertension patients from Fuxin,Liaoning Province were divided into health education group(control group)and drug intervention group in June 2006.The drug intervention group were treated with hydrochlorothiazide,nitrendipine and captopril by stepwise approach and we observe the antihypertensive effect of drug and the effect on the onset of stroke.Results The average follow-up time was 15 months.At last,308 patients were lost to follow-up(the lost follow-up rate was 5.8 percent).The 4984 in cohort,including 2530 of intervention group and 2454 of control group,had examination of all indicators.Through health education and drug intervention,the average blood pressure in drug intervention group decreased by 16.1/9.4 mm Hg(1 mm Hg=0.133 kPa)while the average blood pressure in control group decreased by 6.7/3.5 mm Hg.The control rate of blood pressure in drug intervention group was higher than control group(33.1%vs.15.1%,P＜0.001).Through drug intervention,the morbidity risk of nonfatal stroke in drug intervention group decreased by 57.3%compared to control group,the total morbidity risk of stroke decreased by 59.4%.The results had significant statistical difference.And,the morbidity of severe hypopotassaemia(K~+＜3.0 mmol/L)and diabetes mellitus had no significant statistical diffefence between two groups.Conclusions The low-cost antihypertensive program based on thiazide had good antihypertensive effect,high safety and good cost-effect ratio.The program could be used in rural areas of China.

OBJECTIVETo investigate the value of cardiac troponin I (cTnI) levels in assessing myocardial protection by remifentanil precondition against myocardial injury induced by off-pump coronary artery bypass (OPCAB).

METHODSTwenty-four patients undergoing OPCAB were randomized into control and remifentanil preconditioning group (n=12). All the patients received pretreatment with oral diazepam (10 mg), intramuscular morphine (10 mg) and hyosine (0.3 mg). General anesthesia was induced with midazolam (0.08 mg/kg), etomidate (0.1-0.3 mg/kg), fentanyl (5-10 microg/kg), and rocuronium (1 mg/kg), and maintained with isoflurane inhalation and propofol infusion. Intermittent fentanyl and pipecuronium were given intravenously. In remifentanil preconditioning group, remifentanil (5 microg/kg in 50 ml normal saline) was infused in 10 min after anesthesia induction, and only NS was administered in the control group. Blood samples were obtained before and at 0, 2, 6, 24, and 48 h after the operation to determine serum cTnI levels.

RESULTSIn both of the two groups, the cTnI levels increased significantly at the postoperative time points (0, 2, 6, 24, and 48 h) as compared with those before the operation (P<0.05). The cTnI levels of remifentanil preconditioning group were markedly decreased after the operation in comparison with those of the control group (P<0.05).

CONCLUSIONRemifentanil preconditioning decreases the cTnI levels and reduces myocardial injury induced by OPCAB.

Aged ; Coronary Artery Bypass, Off-Pump ; adverse effects ; Female ; Heart ; drug effects ; Humans ; Ischemic Preconditioning, Myocardial ; Male ; Myocardial Reperfusion Injury ; blood ; etiology ; metabolism ; Myocardium ; metabolism ; Piperidines ; pharmacology ; Postoperative Period ; Time Factors ; Troponin I ; blood ; metabolism

OBJECTIVETo conduct a meta-analysis of the effect of levosimendan on B-type natriuretic peptide (BNP) levels and evaluate the therapeutic effect of levosimendan on advanced heart failure.

METHODSA meta-analysis was performed on the selected data to analyze the effect of levosimendan on BNP levels.

RESULTSLevosimendan decreased BNP by a mean of 337.66 [95%CI (-296.30, -379.02)] pg/ml 24 h after the administration, and by 259.92 [95%CI (-195.76, -324.08)] pg/ml at 48 h, and by 123.09 [95%CI(-53.32,-195.86)] pg/ml at 1 week. Levosimendan resulted in improvements of the cardiac function by about 29%, 22%, and 10% at 24 h, 48 h and 1 week after the administration.

CONCLUSIONLevosimendan produces favorable effects on the cardiac functions and BNP levels.

Cardiotonic Agents ; therapeutic use ; Heart Failure ; blood ; drug therapy ; Humans ; Hydrazones ; therapeutic use ; Natriuretic Peptide, Brain ; blood ; Pyridazines ; therapeutic use

BACKGROUNDThis study aimed to evaluate the effects of standard rescue procedure (SRP) in improving severe trauma treatments in China.

METHODSThis study was conducted in 12 hospitals located in geographically and industrially different cities in China. A standard procedure on severe trauma rescue was established as a general rule for staff training and patient treatment. A regional network (system) efficiently integrating prehospital rescue, emergency room treatments, and hospital specialist treatments was built under the rule for information sharing and improving severe trauma treatments. Treatment outcomes were compared between before and 1 year after the implementation of the SRP.

RESULTSThe outcomes of a total of 74,615 and 12,051 trauma cases were collected from 12 hospitals before and after the implementation of the SRP. Implementation of the SRP led to efficient cooperation and information sharing of different treatment services. The emergency response time, prehospital transit time, emergency rescue time, consultation call time, and mortality rate of patients were 24.24 ± 4.32 min, 45.69 ± 3.89 min, 6.38 ± 1.05 min, 17.53 ± 0.72 min, and 33.82% ± 3.87% (n = 441), respectively, before the implementation of the standardization and significantly reduced to 10.11 ± 3.21 min, 22.39 ± 4.32 min, 3.26 ± 0.89 min, 3.45 ± 0.45 min, and 20.49% ± 3.11%, separately (n = 495, P < 0.05) after that.

CONCLUSIONSStaff training and SRP can significantly improve the efficiency of severe trauma treatments in China.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; Emergency Medical Services ; standards ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Wounds and Injuries ; Young Adult