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

0.05),the symptoms and activities of daily living were improved significantly in three groups after treatment(P0.05),but the clinical effect had obvious difference between traditional Chinese medicine group and traditional Chinese medicine-western medicine group or western medicine group and traditional Chinese medicine-western medicine group(P

Aged ; Aortic Valve Insufficiency ; diagnostic imaging ; Echocardiography ; Humans ; Male

Objective To analyze the ischemia degree of initial electrocardiogram in the patients of acute ST-segment elevation myocardial infarction (STEMI) and investigate its value in the predicting cardiogenic shock (CS) after percutaneous coronary intervention (PCI).Methods Three hundred and ninety patients with STEMI from the onset of symptoms to admission within 12 h were divided into two groups based on grade Ⅱ ischemia (group A,248 cases) or grade Ⅲ ischemia (group B,142 cases) in the initial electrocardiogram.Clinical data,TIMI risk score,ST-segment resolution (STR),CS and cardiovascular events (hospital mortality,ventricular arrhythmias,reinfarction) were recorded in all patients.Results The gender,time from onset to balloon opening,smoking,hypertension,type 2 diabetes,hyperlipidemia,stroke,postoperative TIMI flow 3 grade,coronary artery lesions and lesions in the left main stem between two groups was not statistically significant (P ＞0.05).In group B,the rate of ST segment resolution ＞ 50％ was significantly lower than that in group A [53.2％ (132/248) vs.29.6％ (42/142)] (P ＜ 0.01).The incidence of CS,in-hospital death,malignant ventricular arrhythmias in group B was higher than that in group A,and the difference was statistically significant (P ＜ 0.05).The age,left ventricular ejection fraction,TIMI risk score ＞ 3 points,Killip grade ＞ 1 grade,anterior myocardial infarction between two groups was statistically significant (P ＜ 0.05 or ＜ 0.01).The indicators that were statistically significant in the univariate analysis were included into Logistic regression model and analyzed,with CS-related factors as independent variables and CS as the dependent variable and found that age (P =0.008),Killip class ＞ 1 grade (P =0.049),ST segment resolution rate (P =0.008) and grade Ⅲ ischemia (P =0.001) as independent predictors of CS after PCI.Conclusions Grade Ⅲ ischemia is an independent predictor of CS after PCI in STEMI patients.And it has predictive value for hospital mortality and ventricular arrhythmias.

Objective To investigate the effect of mixed-skin grafting with autologous microskin and allogenetic acellular dermal matrix microskin on wound healing in rats,and to make a further study on the related mechanism.Methods Wistar rats were served as a allogenetic acellular dermal matrix donor rats,and SD rats as acceptors with mould of full thickness skin defects on their back.The ninety SD rats were divided into 5 groups with 18 rats in each group.Group 1 was transplanted with autologous microskin,and group 2 with allogenetic acellular dermal matrix microskin.Groups 3,4 and 5 were grafted with mixed-skin ratio between autologous microskin and allogenetic acellular dermal matrix microskin 1 ∶ 1,1 ∶ 0.5 and 1 ∶ 0.25,repectively.The rate of wound healing was measured,wound samples collected,hematoxylin and eosin stain carried out,fibronectin (FN) and laminin (LN)detected,and intergroup comparison made,respectively,2,3 and 4 weeks after skin grafting.Results The wound healing rates and FN and LN expression of mixed-skin grafting groups were higher than those of the group with autologous microskin grafting.The group of 1 ∶ 0.25 obviously increased (P＜0.05 or P＜0.01).Conclusions The wound healing rate with mixed-skin grafting is higher than that with autologous microskin grafting.The best effect is achieved when the skin ratio between autologous microskin and allogenetic acellular dermal matrix microskin is 1 ∶ 0.25.It is possibly due to the increase of FN and LN on wound skin surface.

Objective To observe the effects of Suoquan Wan(SQW) on the endocrine and immune function of the polyuria rats with kidney-yang deficiency. Methods The model rats were induced by gastric infusion of adenine(250 mg/kg) for 4 weeks, then treated respectively with SQW (at low, middle and high dose respectively), Shenqi Wan and desmopressin for another 4 weeks. The bodyweight and organ index were recorded, and serum cortisone concentration were detected. T cell subsets in peripheral blood were determined by flow cytometry. Results The bodyweight of rats in model group was lower than that in the normal control group. And the bodyweight of rats in desmopressin group, middle-and high-dose SQW groups differed from that in the model group (P < 0. 05 or P < 0. 01). The decreased organ indexes of pituitary, adrenal and thymic glands were found in the model group (P < 0. 05 or P < 0. 01 compared with the normal group). The thymus index was elevated in all the medication groups except the low-dose SQW group (P < 0. 05). The elevated organ indexes of pituitary and adrenal glands were only found in Shenqi Wan group and high-dose SQW group (P < 0. 05). In the model group serum cortisone concentration was decreased (P < 0. 01). In Shengqi Wan group and middle-and high-dose SQW groups, the cortisone concentration was significantly increased (P < 0. 05 or P < 0. 01, compared with the model group). In the model group, the percentages of CD3+ and CD3+/CD4+ T cell subsets in pe-ripheral blood were decreased, and the percentage of CD3+/CD8+ T cell subset was increased (P < 0. 05 or P < 0. 01 compared with the normal group). Compared to the model group, the percentages of CD3+ and CD3+/CD4+ T cell sub-sets were increased and the percentage of CD3+/CD8+ T cell subset was decreased in SQW group and Shenqi Wan group. But the differences of T lymphocyte subsets were insignificant between desmopressin group and the model group. Conclu-sion SQW can regulate the endocrine and immune function of the polyuria ratwith kidney-yang deficiency.

Objective To investigate the effect of intrathecal (IT) dexmedetomidine on the expression of cAMP response element-binding protein phosphorylation (p-CREB) in spinal dorsal horn in a rat model of bone cancer pain. Methods Sixty-four adult female Wistar rats weighing 200-240 g were randomly divided into 4 groups (n = 16 each): sham operation group (group S); bone cancer pain group (group BP); normal saline group ( group NS) ; dexmedetomidine group (group D) . Bone cancer pain was induced by injecting Walker 2S6 mammary gland carcinoma cell suspension (2 ×106 cells/ml) 10μl into the medullary cavity of the tibia in BP, NS and D groups. Groups S and BP received no IT injection. Croups NS and D received IT injection of NS 10 μl and dexme detomidine 5 μg/kg respectively 7 days after successful establishment of the model. Ten animals were selected from each group at 1 day before IT administration (T0), immediately before IT administration (T1 ) and at 1, 6, 12 and 24 h after IT administration (T2-5 ) and paw withdrawal threshold (PWT) to mechanical stimuli was measured with von Frey filaments. The other 6 rats in each group were sacrificed at T4 and the spinal cord was removed for determination of p-CREB expression in the spinal dorsal horn.Results PWT was significantly decreased at T1-5 and pCREB expression up-regulated at T4 in BP, NS and D groups compared with group S ( P ＜ 0.05) . Compared with group BP, PWT was significantly decreased at T2-5 and p-CREB expression down-regulated at T4 in group D ( P ＜0.03), while no significant change in PWT and p-CREB expression was found in group NS (P ＞ 0.05) .Conclusion IT dexmedetomidine can reduce the bone cancer pain through inhibiting the phosphorylation of CREB in rat spinal dorsal horn.

Diabetic Ketoacidosis ; Humans ; Infant, Newborn ; Male

Antibodies, Antineutrophil Cytoplasmic ; blood ; Biopsy ; Child ; Diagnosis, Differential ; Female ; Humans ; Kidney Glomerulus ; pathology ; Lupus Erythematosus, Systemic ; complications ; immunology ; Lupus Nephritis ; diagnosis ; etiology ; immunology ; pathology ; Necrosis

Objective To explore the value and advantage of intracranial pressure (ICP) monitoring in the treatment of hypertensive intracerebral hemorrhage (HICH) through minimally invasive surgery. Methods Seventy-three HICH cases were randomly selected and then divided into control group and treatment group. Thirty-four of them in control group received soft-channel minimally invasive hematoma removal. The head of the soft-channel was placed in the center of the hematoma. One third to half of the initial hematoma was extracted during the operation. Urokinase was injected into the soft channel to dissolve the hematoma. Thirty-nine of them in treatment group underwent the same operation procedure but with ICP monitoring to control aspirating hematoma during the operation. The target ICP was 15 mmHg. The aspiration of hematoma may stop once the ICP down to the target. Treatment such as urokinase injection was adjusted according to the value of ICP monitoring throughout the operation. The incidence of rebleeding, hematoma evacuation time and the average length of stay between two groups were compared. Results The results showed that one fifth of hematoma extracted was enough for a desired ICP. There found no rebleeding case in treatment group while 4 cases in control group and the difference had statistical significance. The hematoma evacuation time and the average length of stay between two groups had statistical significance. Conclusion Continuous ICP monitoring combined with directional software channel minimally invasive surgery changes the concept of empirically intraoperative hematoma evacuation and postoperative drug injection and proposes the idea of controlling drainage. It can shorten the course, provide sensitive and objective indicators and basis, reduce the secondary brain injury and improve prognosis.