Objective To analyze the relationship between obstructive sleep apnea syndrome (OSAS) and metabolic syndrome (MS) in petrol field workers.Methods A total of 100 cases of OSAS patients of petrol field workers were enrolled as the study objects from March 2013 to August 2015 in emergency and respiratory department in Daqing Longnan Hospital and were divided into three groups:simple snoring group (Group A,n =26),mild OSAS group (Group B,n =42),and severe OSAS group (Group C,n =32).The comparison of dietetic status score,sleep status score and the patients with MS among 3 groups were carried out.The relationship between OSAS and MS was analyzed by using univariate and multivariable Logistic regression analyses were used.Results In Group C,sleep status score (8.3 ± 1.2) and dietetic status score (7.6 ± 1.4) and the rates of MS (23/32) were higher than those in the other two groups (P ＜ 0.05).Univariate and multivariable Logistic regression analyses,showed OSAS was the risk factorofMS [r=11.211 (OR =9.412,95％ CI:5.992～15.202)].Conclusions Dietetic status and sleep status were obviously influenced by OSAS in petrol field workers.The incidence of MS were more common in petrol field workersevere with OSAS and OSAS was a risk factor of MS.

Objective To evaluate the effect of dexmedetomidine on cognitive dysfunction after thoracic surgery in patients undergoing one-lung ventilation.Methods Sixty-two patients,aged 45-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index ranged from 17.5 to 25.5 kg/m2,scheduled for elective thoracic surgery,were randomly allocated into 2 groups (n =31 each) using a random number table:dexmedetomidine group (Dex group) and control group (C group).Dexmedetomidine 0.5 μg/kg was infused for 10 min starting from the time point before induction of anesthesia,followed by continuous infusion at a rate of 0.5 μg · kg-1 · h-1 until 30 min before the end of surgery in Dex group.The equal volume of normal saline was administered instead in group C.Before induction and at 24,48 and 72 h after surgery,venous blood samples were collected for determination of levels of S-100 beta protein and neuronspecific enolase in serum by ELISA.Cognitive function was assessed by Mini-Mental State Examination at 72 h after surgery.Results The levels of S-100 beta protein and neuron-specific enolase in serum were significantly increased after surgery than before induction in the two groups.Compared to C group,the levels of S-100 beta protein and neuron-specific enolase in serum were significantly decreased after surgery,and the incidence of postoperative cognitive dysfunction was decreased in Dex group (26％ vs 6％).Conclusion Dexmedetomidine can effectively reduce the nerve damage during one-lung ventilation and significantly inhibit the development of postoperative cognitive dysfunction in patients undergoing thoracic surgery,indicating that dexmedetomidine is suitable for thoracic surgery.

Objective To investigate the changes of plasma ghrelin,growth hormone (GH) and growth hormone releasing hormone (GHRH) and gastric ghrelin in patients with chronic obstructive pulmonary disease( COPD ) and to explore their clinical significances.Methods Plasma ghrelin,GH,GHRH,TNFα,IL-6 and C reactive protein (CRP) were measured in 40 COPD patients and 20 controls with chronic bronchitis. Correlated factors of plasma ghrelin,TNFα,IL-6,CRP were analyzed. Body composition was assessed with bioelectrical impedance analysis.The expression of gastric ghrelin in patients with COPD was detected.Results Plasma ghrelin was higher in the underweight patients than in the normal weight patients and in the controls [ ( 1.78 ± 0.46 ) ng/L,( 1.39 ± 0.46 ) ng/L,( 1.36 ± 0.39 ) ng/L,respectively].Plasma GH was lower in the underweight patients than in the normal weight patients and in the controls [(4.12 ±0.83) μg,/L,(5.17 ±0.72) μg/L,(6.49 ± 1.13) μg/L,respectively].Plasma GHRH was lower in the underweight patients than in the normal weight patients and in the controls [ (20.43 ± 4.41 ) ng/L,(23.47 ± 3.97) ng/L,( 27.48 ± 10.06) ng/L,respectively ].Plasma ghrelin was higher in the underweight patients than in the controls ( P ＜ 0.01 ).Plasma ghrelin was higher in the underweight patients than in the normal weight patients with COPD.Plasma ghrelin (log transformed) was negatively correlated with BMI and percentage of body fat in the COPD patients.Plasma GHRH was positively correlated with ghrelin in the underweight patients ( r =0.515,P ＜ 0.05 ),while no correlation was found between plasma G H and ghrelin in the underweight patients (r =0.415,P ＞ 0.05 ).Plasma ghrelin was positively correlated with TNFα and IL-6 in the underweight patients.The gastric expression of ghrelin showed no evident difference between the patients with COPD and the controls.Conclusions The plasma GH in COPD patients may not be correlated with ghrelin.The plasma ghrelin level may be a useful indicator for malnutrition in COPD patients.Plasma ghrelin might be involved in the pathogenesis of CODP by affecting the body energy metabolism.

Objective:To assess the clinical utility of a fluorescence in situ hybridization(FISH) assay as a non-invasive method for diagnosing and monitoring urothelial carcinoma(UC) in the upper urinary tract(UUT).Methods:Urine specimens from 63 consecutive patients with UUT-UC and 69 controls with benign disease were analyzed by means of cytology and FISH.For FISH analysis,labeled probes specific for chromosomes 3,7,and 17 and for the p16(9p21) gene were used to assess chromosomal abnormalities indicative of malignancy.Sensitivity and specificity of both techniques were determined and compared.The frequency of chromosomal aberrations of malignant cells from UUT-UC was also determined.Results:Of 63 patients with UUT-UC,FISH affords an overall sensitivity of 84.1%(53/63),the figure being 71.4%(20/28)for PTa and PT1 tumors,94.3%(33/35) for PT2-4 tumors.The sensitivities of urine cytology were 35.7%(10/28)for PTa and PT1 tumor,45.7%(16/35)for PT2-4 tumors,with an overall sensitivity of 41.3%(26/63).The sensitivities of the two methods for the low grade tumors were 80%(20/25)and 44%(11/25),and for high grade tumors were 86.8%(33/38)and 39.5%(15/38),respectively.Specificities for FISH and urine cytology were 91.3%(63/69)and 94.2%(65/69)respectively.Conclusion:According to the results,the sensitivity of FISH for the detection of UUT-UC is superior to that of urine cytology and the specificities of FISH and urine cytology are not significantly different.FISH can promote the diagnosis of UUT-UC,especially for the low stage and low grade cases,it may be a new promising non-invasive method for the diagnosis of UUT-UC.

Objective To investigate the effect of remote ischemic postconditioning (RIPostC ) on the platelet reactivity in the patients with acute myocardial infarction (AMI) receiving reperfusion therapy .Methods Seventy-one cases of AMI entering the group received the reperfusion therapy .The patients were divided into the two groups .The treatment group received RIPostC ,while the control group received sham RIPostC .The venous blood samples were collected before transcutaneous coronary intervention (PCI) ,instantly after RIPostC and at 24 h ,48 h after PCI .The platelet activation indicators CD62P and PAC-1 ,and platelet apopto-sis indicator mitochondrial transmembrane potential(ΔΨm) were measured by flow cytometry .Results CD62P expression on plate-let surface at 24 h after PCI in the treatment group was significantly lower than that in the control group (P<0 .05) ,but which at other time points had no statistical difference between the two groups (P>0 .05);there was no statistical difference in platelet PAC-1 expression at each time point between the two groups (P>0 .05);the platelet ΔΨm at each time point had no statistical difference between the two groups(P>0 .05) .Conclusion RIPostC can somewhat reduce platelet activation in AMI patients without causing platelet early apoptosis .

ObjectiveTo analyze the clinicopathological characteristics and survival time of penile cancer after surgery.MethodsThe clinicopathological data of 93 cases of penile cancers patients treated from January 2002 to December 2010 were collected retrospectively.The Kaplan-Meier method was used to draw the survival function and calculate the survival rate.Log-rank test was further used to compare survival difference.ResultsThe median age of the 93 patients was 51 years ( range,23 to 82).Squamous carcinoma was most common with 87 eases (93.5％) in our group.Sixty-one patients were successfully followed up and the median follow up duration was 28 months(range,2 to 89 months).All 3 cases of verrucous carcinoma had progression free survive after surgery after follow up of 12,19,and 67 months.In the 55 patients with penile invasive squamous carcinoma,11 patients died of metastatic disease with a median survival time of 10 months ( range,2 to 24 months).Two years cumulative survival rate was 75.7％ (95％ CI 63.0％ to 88.4％ ).Six cases of 12 patients with lymph node metastasis died of penile cancer while only 5 cases of 43 patients without lymphnode metastasis died.The survival difference was significant (log rank,P =0.000).ConclusionsSquamous carcinoma is the most common type,and patients with lymphnode metastasis have poor prognosis.Verrucous carcinoma has good prognosis.

Objective:To evaluate the impacts of clinical,pathological,and laboratory factors on on-cological outcomes of patients with T3 N0 M0 renal cell carcinoma.Methods:The clinical data,laboratory exam results,and follow-up outcomes of 182 patients with T3 N0 M0 renal cell carcinoma who underwent nephrectomy from 2007 to 2012 in Peking University First Hospital were retrospectively collected.The 5-year cancer-specific survival and 5-year recurrence-free survival of all the patients were calculated using Kaplan-Meier method,and the statistical significance between the survival curves were compared using the Log-rank test.Variables with significant differences in the univariate analysis were subjected to the multivariate analysis by Cox regression model.All the comparisons were conducted using two-tailed test and P <0.05 was considered statistically significant.Results:A total of 182 patients were included in this study.Of all the 182 patients,126 were male (69.23%)and 56 were female (30.77%).The mean age was (56.75 ±12.45)years.The median follow-up time was 48 months (3 -99 months).At the end of the follow-up,50 patients (27.47%)died due to the disease after a median of 29.74 months and 59 patients (32.42%)had tumor recurrence after a median of 22.12 months.The 5-year cancer-specific survival of all patients was 68.30% (95% CI:60.16% -75.84%);the 5-year recurrence-free survival was 60.70% (95% CI:53.16% -68.84%).In the univariate analysis,diabetes mellitus, tumor invasion status,Fuhrman grade,serum album,serum cholestenone,anemia,and neutrophils per-centage were associated with the cancer-specific survival and Fuhrman grade,serum album and anemia were associated with the recurrence-free survival.Variables with significant differences on univariate analysis were included in Cox multivariate regression analysis.Multivariate Logistic regression analysis showed that diabetes mellitus (HR =2.434,95% CI:1.243 -4.769,P =0.010),hypoalbuminemia (HR =2.188,95% CI:1.074 -1.074,P =0.031),and anemia (HR =3.320,95% CI:1.839 -5.991,P <0.001)were independent risk factors significantly associated with cancer-specific survival;and higher Fuhrman grade (HR =2.552,95% CI:1.433 -4.545,P =0.001),anemia (HR =2.535, 95% CI:1.497 -4.293,P =0.001)were independent factors significantly associated with recurrence-free survival.Conclusion:Diabetes mellitus,hypoalbuminemia,and anemia were independent risk fac-tors significantly associated with cancer-specific survival of T3 N0 M0 renal cell carcinoma patients;higher Fuhrman grade and anemia were independent risk factors significantly associated with tumor recurrence of T3 N0 M0 renal cell carcinoma patients.

Objective:To evaluate the effect of dexmedetomidine on pyroptosis in rats with endotoxin-induced acute lung injury (ALI).Methods:Sixty SPF male Sprague-Dawley rats, aged 6 weeks, weighing 200-220 g, were divided into 5 groups ( n=10 each) by a random number table method: control group (group C), ALI group and different doses of dexmedetomidine groups (D 1-3 groups). In ALI group and D 1-3 groups, LPS 5 mg/kg was intraperitoneally injected to establish endotoxin-induced ALI model.Immediately after establishing the model, dexmedetomidine 12.5, 25.0 and 50.0 μg/kg were intraperitoneally injected in D 1-3 groups, and the equal volume of normal saline was intraperitoneally injected in group C, once a day for 14 consecutive days.After the end of administration, the rats were sacrificed, the left bronchus was lavaged, and the left bronchoalveolar lavage fluid (BALF) was collected for determination of the concentrations of interleukin-1beta (IL-1β), IL-6 and tumor necrosis factor-alpha (TNF-α) (by enzyme-linked immunosorbent assay), and the lung tissue was taken for determination of the wet/dry weight ratio (W/D ratio) and expression of cleaved-caspase-1, N-terminal of the spliceosome (GSDMD-N), IL-18 and IL-1β (by Western blot) and for microscopic examination of the pathological changes (with a light microscope). Results:Compared with group C, the W/D ratio of lung tissues was significantly increased, the concentrations of IL-1β, IL-6 and TNF-α in BALF were increased, the expression of cleaved-caspase-1, GSDMD-N, IL-1β and IL-18 in lung tissues was up-regulated ( P<0.05), and the pathological damage was aggravated in ALI group and D 1-3 groups.Compared with group ALI, the W/D ratio of lung tissues was significantly decreased, and the concentrations of IL-1β, IL-6 and TNF-α in BALF were decreased, the expression of cleaved-caspase-1, GSDMD-N, IL-1β and IL-18 in lung tissues was down-regulated in a dose-dependent manner ( P<0.05), and the pathological damage was significantly reduced in D 1-3 groups. Conclusion:The mechanism by which dexmedetomidine attenuates endotoxin-induced ALI may be related to inhibition of pyroptosis and reduction of inflammatory responses in rats.

Objective To discuss the prostate biopsy results in young men with age less than 50 years and with PSA 4-10 μg/L.Methods From January 2006 to December 2011,22 patients with PSA 4-10 μg/L underwent prostate biopsy for free/total PSA ≤ 0.16 (20 cases) and/or positive digital rectal examination (DRE) (4 cases).The nean age was 43 years (range,24-49 years),the mean PSA level was 7.08 μg/L (range,4.17-9.74 μg/L),the mean free/total PSA level was 0.11 (range,0.03-0.53).Radiologic suspicious lesion was founded in 13 cases.Clinicopathological data from these patients were reviewed.Results The results of the biopsy were 1 (4.5％) case of prostate cancer,2 cases (9.1％) with tuberculosis,9 cases (40.9％) with inflammation,10 cases (45.5％) with benign tissue.In 20 cases with free/total PSA ≤0.16,only 1 case was diagnosed as prostate cancer.In 4 cases with positive DRE,tuberculosis (2 cases) and inflammation (1 case) were diagnosed.Conclusions The prostate cancer detection was rare in young men less than 50 years of age with PSA 4-10 μg/L.The most common cause was prostate hyperplasia with inflammation.

Objective:To analyze the impact of different surgical methods on perioperative complication rate after radical cystectomy in patients over 75 years of age.Methods:A retrospective study reviewed 1 432 patients who received radical cystectomy from January 2003 to January 2015.A total of 239 pa-tients were ≥75 years (median age:78 years),of whom,74 patients (31.0%)suffered one or more perioperative complications.According to the different operation methods,patients could be divided into ileal conduit group and cutaneous ureterostomy group.The ileal conduit group included laparoscopic and open radical cystectomy with ileal conduit.The cutaneous ureterostomy group included transperitoneal laparoscopic,transperitoneal and extraperitoneal open radical cystectomy with cutaneous ureterostomy. Results:Perioperative complications were significantly associated with the patient’s age (P =0.012), American Society of Anesthesiologists (ASA)score (P =0.001),node staging (P =0.043),and dif-ferent surgical methods.Perioperative complications caused a prolonged hospital stay and delayed recovery (34 d vs.21 d,P =0.002).For different surgical methods,the perioperative complication rate of ileal conduit was higher than cutaneous ureterostomy (P =0.013).However,there were no significant differences between transperitoneal laparoscopic and open radical cystectomy with ileal conduit in perioperative complication rate (P =0.836).The perioperative complication rate was statistically signifi-cant among transperitoneal laparoscopic,transperitoneal and extraperitoneal open radical cystectomy with cutaneous ureterostomy (P =0.022).On multivariate analysis,age (hazard ratio =4.856,95% CI:1.465 -16.103,P =0.010),ASA score (P =0.008),and different surgical methods (P =0.016) were significantly associated with the perioperative complication rate.Conclusion:The perioperative complication rate after radical cystectomy in elderly patients was associated with the patients’age,ASA score,and different surgical methods.Patients who received extraperitoneal open radical cystectomy with cutaneous ureterostomy suffered fewer perioperative complications,which was an appropriate choice for elderly patients.