INTRODUCTION: REM sleep which shows characteristic muscle atonia and increased resistance of upper respiratory track is known to be vulnerable to sleep apnea. Previous studies reported that REM sleep-dependent (or related) obstructive sleep apnea syndrome (REM-dependent OSA) could be one of sleep disordered breathing. The present study aimed to investigate clinical findings and polysomnographic variables of REM-dependent OSA. METHODS: Fifty-six patients diagnosed with mild to moderate obstructive sleep apnea by overnight polysomnography (52. We compared clinical and polysomnographic findings between REM-dependent OSA and No REM-dependent OSA patients. RESULTS: Among 56 patients, 37.5% (n=21, average age of 52.3+/-19.7 years, 14 males) met the REM-dependent OSA criteria. There were no significant differences in age, sex and body mass index between two groups. After controlling for age, sex, body mass index and periodic leg movements index, REM-dependent OSA patients showed significantly lower AHI, lower number of oxygen desaturation events and higher stage 2 sleep proportion compared to No REM-dependent OSA patients (p=0.010, p=0.006, p=0.031, respectively). After controlling for age, sex, body mass index and periodic legs movements index, AHI-REM was positively correlated with the number of oxygen desaturation events in REM-dependent OSA group (p=0.002). CONCLUSION: Current results suggested that 37.5% of patients with mild to moderate severity of obstructive sleep apnea could be classified into REM-dependent OSA. REM-dependent OSA was more common in mild severity of OSA, equally prevalent in both sexes and accompanied with sleep architecture changes, i.e. increased proportion of stage 2. In addition, apneic events during REM sleep in REM-dependent OSA were related to oxygen desaturation.
Body Mass Index ; Humans ; Leg ; Muscles ; Oxygen ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Sleep, REM ; Track and Field

Objective To observe the protection effects of sodium ?-aescinate(SA) on the nervous function in the rats with early spinal cord injury(SCI). Methods One hundred and twenty SD rats were randomly divided into four groups(n=30).Rats in the blank control group were performed laminectomy only,while those in the other three groups were injured at the level of Tl1 spinal segment by Allen's weight drop method(10 g ?10 cm) and immediately intraperitoneally given normal saline(5.0 mg/kg)(control group), SA(5.0 mg/kg)(SA group) and methylprednisolone(100 mg/kg)(MP group) once daily,respectively.After 8 h,24 h,96 h,7 d and 14 d,spinal cord function change of posterior limb were determined with Rivlin method.The rats were sacrificed and the injured segments were resected for pathological analysis. Results As time prolonged,the rehabilitation of spinal cord function with various degree could be observed in each group.Function rehabilitation was found among the rats in the control group,SA group and MP group 96 h after injury,and more rehabilitation was gained later in the latter two groups,while that was not the case in the control group.Rats in the SA and MP group gained more significant rehabilitation than those in the control group(P0.05).It was revealed by pathological analysis that no necrotic neurons was found in the blank control group,and the necrotic neurons in the SA group and MP group were significantly less than the control group at the same time points(P

Objective To investigate the expression of heat shock protein-70(HSP70)in acute lung injury induced by paraquat poisoning.Methods A total of 72 Wistar rats were randomly divided into 3 groups(n=24 each group)and intraperitoneally injected with normal saline in group A,20 mg/kg paraquat in group B,and 40 mg/kg paraquat in group C.The lungs of rats were excised 1,3,6,12,and 24 hours after the injection,respectively.The expression of HSP70 in the lung tissue was detected by immunohistochemistry and Western blot.Results Paraquat induced acute lung injury in groups B and C.In group B,the expression of HSP70 increased at 2 hours,reached the peak at 6 hours,decreased at 12 hours,and returned to the baseline level at 24 hours.In group C,the expression of HSP70 increased at 1 hour,reached the peak at 3 hours,and returned to the baseline level at 24 hours.Conclusion Paraquat-induced acute lung injury may contribute to the enhanced expression of HSP70 in the bronchus,bronchiole,and alveolar epithelial cells,which indicates that HSP70 has a protective effect on lung injury.

PURPOSE: The purpose of this study was to identify nursing needs and burden of family caregivers of middle-aged patients with hepatocellular carcinoma. METHODS: The participants of this study were 101 family caregivers from 3 university hospitals in D city, South Korea. The levels of nursing needs and burden of family caregivers were measured using structured questionnaires from August 1, 2011 to February 29, 2012. The collected data were analyzed using t-tests, ANOVA, Scheffe tests, and Pearson's correlation coefficients. RESULTS: The greatest nursing need was for information about patients' health status. Among subdomains of burden, financial burden had the greatest mean score. Family caregivers with worsened health status since starting caregiving had significantly higher levels of total nursing needs and total burden. Total burden and physical burden scores showed significant correlations with all subdomains of nursing needs as well as total nursing need scores. CONCLUSION: Findings of this study suggest that family caregivers of middle-aged patients with hepatocellular carcinoma need provision of information about patients' health status and treatment plans, and financial support the most. Also maintaining family caregivers' health needs to be considered when providing nursing intervention for patients with hepatocellular carcinoma and their family caregivers.
Carcinoma, Hepatocellular* ; Caregivers* ; Cost of Illness ; Financial Support ; Hospitals, University ; Humans ; Korea ; Liver Neoplasms ; Needs Assessment ; Nursing* ; Surveys and Questionnaires

Power analyses(samples size calculation)is critical in protocol design for clinical trials.Adequate power ensures the credibility and reliability of the clinical trial results.In this article,omega-3 fatty acid supplementation study is chosen as an example to explain the power analysis in practice during the study design.First,obtaine the parameter estimates from the high-quality literature review and relevant systematic review(meta analyses)results.Then,calculate the sample size under different parameter settings and select the final patient number according to the clinical practice.Based on the above information,statistical simulation is performed to assume diverse possible combination of the outcome in real clinical trial.Further,under the specific determined sample size,the simulation pointing out the different positive or negative results when the real clinical trial is conducted.The determination of sample size of a clinical trial should be based on both the clinical and statistical considerations.

Objective To compare the clinical efficacy between standard sequential early enteral nutrition (EEN) plus parenteral nutrition (PN) and PN alone in patients undergoing gastrointestinal surgery. Methods Werandomly divided 126 patients who underwent laparotomy gastrointestinal surgery into EEN + PN group (n = 62) and PN group (n = 64). The levels of blood nutrition-related indicators, biochemical indicators, and inflammatory indicators were determined before surgery and 3 and 7 days after surgery, and the gastrointestinal function recovery time, complications, nutritional support cost, and length of hospital stay were compared between two groups. Results The preoperative nutrition-related indicators, biochemical indicators, and inflammatory indicators showed no significant differences between two groups (P >0. 05). Three days after operation, however, the levels of prealbumin in EEN + PN group were significantly higher than those in PN group [(160. 3 ±23. 0) g/L vs. (137.0±28.7) g/L, P=0.000]. Seven days after operation, the levels of albumin [(33.6±3.8) g/L vs. (31.8±4.7) g/L, P = 0.042], prealbumin [(210.6±34.6) g/L vs. (154.8 ±36.9) g/L, P=0.000], and lymphocyte cell count [(2.33±0.53) x 109/L vs. (1.04±0.36) × 109/L, P = 0. 046] in EEN + PN group were significantly higher than those in PN group, and the levels of serum γ-glutamyltransferase [(48. 12 ± 33.84) U/L vs. (71.54±34.00)U/L, P=0.048], C-reactive protein [(31.15 ± 19.00) mmol/L vs. (45.90 ± 23.21) mmol/L, P=0.042], total cholesterol [(3.09±0.83) mmol/L vs. (3.29±0.91) mmol/L, P = 0. 045] and low density lipoprotein [(2.01 ± 0. 39) mmol/L vs. (2. 31 ± 0. 72 ) mmol/L, P = 0. 049] were significantly lower than those in PN group. The postoperative gastrointestinal function recovery time in EEN + PN group was significantly shorter than that in PN group [(65. 7 ± 15. 6) hours vs. (75. 1 ± 27. 0) hours, P = 0. 036], and the total cost of perioperative nutrition in EEN + PN group was also significantly lower than in PN [(2634. 5 ±1306. 8) RMB vs. (3058. 6 ± 1216. 0) RMB, P= 0.046]. Conclusion Standard sequential EEN plus PN can increase the post-operative prealbumin level, improve the immune function, promote the recovery of gastrointestinal function, and decrease the cost of nutritional support.

Objective To evaluate the role of three vessels and trachea view (3VT) in diagnosis of fetal heart disease and great artery abnormality.Methods 39 pregnant women undergoing fetal ultrasound scan and diagnosed with great artery abnormality were enrolled in this study.Then the image characteristics and significance of 3VT in these 39 cases were analyzed and evaluated.Results In these 39 cases proved by autopsy,persistent truncus arteriosus(7 cases),transposition of the great arteries(7 cases),coarctation of the aorta(5 cases),tetralogy of Fallot (4 cases),pulmonary stenosis (3 cases),hypoplastic left ventricle syndrome(2 cases),persistent left superior vena cava (2 cases),pulmonary valve stenosis with single ventricle(2 cases),Ebstein anomaly with pulmonary stenosis (1 case),interruption of the aortic arch( 1 case),hypoplastic right ventricle(1 case),dextroaortic arch (1 case),and ductus arteriosus stenosis( 1 case) were detected.All of them had anomalies performance on 3VT.While in the 2 cases of double outlet right ventricle,only one eoncurrenting with pulmonary artery stenosis showed reduced inner diameter of pulmonary artery on 3VT.According to the performance of 3VT in great artery abnormality,it could be divided into 4 categories:abnormal location,abnormal ratio,abnormal amount and abnormal blood direction of great artery.Conclusions 3VT is a useful supplement to the 4-chamber view,and has significant value in diagnosis of fetal heart and great arteries abnormities.

Orbital mesenchymal chondrosarcoma, first described by Luis et. al in 1971, is a very rare tumor of characteristic histologic features. A 21-year-woman was admitted with a 4-month histoiry of rapidly progressive proptosis and visual disturbance. Right orbital exenteration was performed under the clinical diagnosis of orbital calcifying tumor. Grossly, the tumor presented as a multibloblated, circumscribed mass that measures 5.5 cm in the greatest dimentsion. Cut sections resembled ordinary chonrosarcoma. Microscopically, the tumor was composed of undifferentiated mesenchymal cells, interspersed nodules of well differentated cartilagenous tissue, areas of gradual transition from undifferentiated mesenchymal cells to cartilage, and hemangiopericytoma-like areas. A brief summary of the histopathological aspect of this tumor and a review of literature are presented.
Female ; Humans

Primary signet ring cell carcinoma of the prostate is extremely rare and about 18 cases have been reported in the literature. We report two cases of primary signet ring cell carcinoma of the prostate, arising in 79-year-old and 65-year-old men. Both cases were the poorly differentiated adenocarcinoma of the prostate with many signet ring cells. Signet ring cells were positive for prostatic specific antigen and prostatic acid phosphatase but negative for neutral and acid mucins. In summary, the signet ring cell carcinoma of the prostate is a rare variant of poorly differentiated adenocarcinoma of the prostate. The orgin of the prostate should be considered in cases of metastatic signet ring cell carcinoma, particularly when the signet ring cells are negative for neutral and acid mucins. Prostatic specific antigen and prostatic acid phosphatase should also be performed to confirm the primary signet ring cell carcinoma of the prostate.
Acid Phosphatase ; Adenocarcinoma ; Aged ; Carcinoma, Signet Ring Cell* ; Humans ; Male ; Mucins ; Prostate*

PURPOSE: To investigate the levels of radiation exposure of an operator which may be influenced by the wearing an apron, type of procedure, duration of fluoroscopy and operator's skill during various interventional procedures MATERIALS AND METHODS: Radiation doses were measured both inside and outside the apron(0.5mm lead equivalent) of the operator by a film badge monitoring method and the duration of fluoroscopy was measured in 96 procedures prospectively. The procedures were 30 transcatheter arterial embolizations (TAE), 25 percutaneous transhepatic biliary drainages (PTBD), 16 stone removals (SR), 15 percutaneous needle aspirations (PCNA) and 10 percutaneous nephrostomies(PCN). To assess the difference of exposure by the operator's skill, the procedures of TAE and PTBD were done separately by groups of staffs and residents. RESULTS: Average protective effect of the apron was 72.8%. Average radiation exposure(unit:micro Sv/procedure) was 23.3 in PTBD by residents, 10.0 in PTBD by staffs, 10.0 in SR, 8.7 in TAE by residents, 7.3 in TAE by staffs, 9.0 in PCN and 6.0 in PCNA. Average radiation exposure of residents were 1.9 times greater than those of staffs. CONCLUSION: Radiation exposure was not proportionally related to the duration of fiuoroscopy, but influenced by wearing an apron, various types o[procedure and operator's skills.
Aspirations (Psychology) ; Film Dosimetry ; Fluoroscopy ; Needles ; Pregnenolone Carbonitrile ; Proliferating Cell Nuclear Antigen ; Prospective Studies