OBJECTIVE: To evaluate the early cardiac injury caused by obstructive sleep apnea (OSA) before the development of cardiovascular symptoms of OSA. METHODS: Ninety-two patients without any known cardiovascular disorders who underwent polysomnography (PSG) were enrolled in the study. Subjects were divided into mild, moderate, and severe OSA groups by their apnea hypopnea index (AHI), and 25 healthy individuals were identified as controls. After PSG examination, fasting blood samples for the evaluation of N-terminal pro-brain natriuretic peptide (NT-proBNP) and heart-type fatty acid binding protein (h-FABP) were collected in the morning, and left ventricular(LV) functions were assessed by using echocardiographic methods. Thirty moderate and severe OSA patients were treated with continuous positive airway pressure respectively (CPAP). RESULTS: The levels of h-FABP and NT-proBNP were obviously higher in all OSA groups than those in the control group (<0.01), and were positively correlated with AHI (<0.01). The Em/Am values of all OSA groups and E/A values of the moderate and severe OSA groups were significantly reduced (<0.01). The difference in Em/Am values among the groups was statistically significant (<0.01). Compared with those before treatment, h-FABP and NT-BNP levels in serum of OSA patients after CPAP treatment were significantly reduced (<0.01), and Em/Am and E/A values were significantly increased (<0.01). CONCLUSIONS Left ventricular diastolic dysfunction and early myocardial microtrauma are major manifestations of early heart damage in patients with OSA. CPAP therapy could significantly improve early cardiac damage in OSA patients.
Continuous Positive Airway Pressure ; Heart Injuries ; Humans ; Polysomnography ; Sleep Apnea, Obstructive ; Ventricular Dysfunction, Left

AIM To investigate the preventive effects of herbal pair,Scutellariae Radix and Coptidis Rhizoma (SC),on Alzheimer's disease (AD),and its mechanism of action.METHODS Dementia mice induced by 8-week s.i.d subcutaneous injection of D-galactose (100 mg/kg),were simultaneously given respective,intragastric administration of SC crude drug at doses of 5,10,20 g/kg,or piracetam support at 0.75 g/kg,and isometrical distilled water was applied to the mice of normal control group.The mice had their learning and memory abilities checked by Morris water maze at intervals of four weeks and eight weeks since the start of the trial,and their blood and brain tissue biochemical indices measured at the end of the test.RESULTS Significantly shortened latent period in place navigation test and the time of enter into the original platform in the space exploration test were observed in the mice treated with 4-week D-galactose and SC (P ＜0.05 或 P ＜0.01).The 8-week intervention demonstrated SC capacity in the significant promotion of T-SOD activity,decreased blood MDA levels (P ＜ 0.01)and the brain AchE levels,and increased brain GSH-Px activity (P ＜ 0.01).CONCLUSION SC increases the concentration of acetylcholine in brain tissue and protects the central nervous tissue under oxidative stress,highlighting its therapeutic effect on AD.

Objective To design a reproducible solution for municipal population health information platform to solve the problems in multi facilities involved,long construction period and etc.Methods The present situation of municipal health information platform was described as "eight manys and eight insufficiencys",and the solutions of foreign countries and China were explored from the aspects of business and technology architectures as well as the requirements of national population health informatization overall architecture.Results The municipal medical informatization infrastructure optimized regional medical service flow,improved medical resources allocation and enhanced health management.Conclusion Municipal population health information platform contributes to promoting regional medical service to meet increasing public requirements.

OBJECTIVEMeasures of ventilation-CO₂output relationship have been shown to be more prognostic than peak O₂uptake in assessing life expectancy in patients with chronic heart failure (CHF). Because both the ratios (VE/Vco₂) and slopes (VE-vs-Vco₂) of ventilation-co₂ output of differing durations can be used, we aim to ascertain which measurements best predicted CHF life expectancy.

METHODSTwo hundred and seventy-one CHF patients with NYHA class II-IV underwent incremental cardiopulmonary exercise testing (CPET) and were followed-up for a median duration of 479 days. Four different linear regression VE-vs- Vco₂ slopes were calculated from warm-up exercise onset to: 180 s, anaerobic threshold (AT), ventilatory compensation point (VCP); and peak exercise. Five VE/Vco₂ ratios were calculated for the following durations: rest (120 s), warm-up (30 s), AT (60 s), lowest value (90 s), and peak exercise (30 s). Death or heart transplant were considered end-points. Multiple statistical analyses were performed.

RESULTSCHF patients had high lowest VE/Vco₂ (41.0 ± 9.2, 141 ± 30%pred), high VE/Vco₂ at AT (42.5 ± 10.4, 145 ± 35%pred), and high VE-vs-Vco₂ slope to VCP (37.6 ± 12.1, 126 ± 41%pred). The best predictor of death was a higher lowest VE/Vco₂ (≥ 42, ≥ 141%pred), whereas the VE-vs-Vco₂slope to VCP was less variable than other slopes. For death prognosis in 6 months, %pred values were superior: for longer times, absolute values were superior.

CONCLUSIONThe increased lowest VE/Vco₂ ratio easily identifiable and simply measured during exercise, is the best measurement to assess the ventilation-co₂output relationship in prognosticating death in CHF patients.

Carbon Dioxide ; metabolism ; Chronic Disease ; Disease Progression ; Exercise Test ; Heart Failure ; diagnosis ; mortality ; physiopathology ; Humans ; Life Expectancy ; Respiratory Function Tests

OBJECTIVETo explore the clinical value and efficacy of reduced field intensity modulated radiation therapy (RF-IMRT) for patients with advanced cervical cancer.

METHODSSeventy-one patients with stage IIB-IIIB cervical cancer, who underwent reduced field IMRT (RF-IMRT group) and 72 patients treated with conventional radiotherapy (c-RT group) in Shandong Cancer Hospital between 2005 August and 2011 August, were enrolled in this study. The RF-IMRT plans were as follows: whole pelvic IMRT plan was performed to deliver an initial dose of 30 Gy, then the irradiated volume was reduced to lymphatic drainage region as well as paracervix and parametrium for an additional 30 Gy boost. Conventional 2-field RT plan was performed in these patients using ADAC Pinnacle 3 planning system, to be given the same prescription dose, and to compare the irradiation dose of organs at risk (OARs). At the same time, conventional 2-field RT was performed in 72 patients of the c-RT group. Concurrent chemotherapy and intracavitary brachytherapy were also performed in the two groups. The treatment response, toxicities, normal tissue avoidance, and survival were assessed.

RESULTSSixty-six patients of the RF-IMRT group and 65 patients of the c-RT group fulfilled the treatment plan. IMRT plans yielded better dose conformity to the target (0.711 ± 0.057 vs. 0.525 ± 0.062, P = 0.032) and better sparing of the rectum, bladder and small intestine (rectum: 41.6 ± 6.8 vs. 50.8 ± 3.2, P = 0.016; bladder: 40.2 ± 2.9 vs. 51.4 ± 1.8, P = 0.007; small intestine: 22.3 ± 2.6 vs. 35.8 ± 3.9, P = 0.004). The mean dose delivered to the planning target volume (PTV) was significantly higher in the RF-IMRT group than that in the c-RT group (60.8 vs. 51.2 Gy, P = 0.006). The RF-IMRT patients experienced significantly lower acute and chronic toxicities with comparable short-term effects than did those treated with conventional RT (P > 0.05). No significant differences were found between the two groups for 1-, 3-, and 5-year overall survival (OS) rates, while a significantly higher progression-free survival (PFS, 65.2% vs. 46.2%, P = 0.031) rate was observed in the RF-IMRT group.

CONCLUSIONSRF-IMRT yields higher dose distributions and lower toxicities compared with conventional RT, and both the tumor target volume and pelvic lymphatic drainage region achieve curative dose irradiation, the adjacent organs at risk are well protected, and with tolerable adverse reactions. Yet, RF-IMRT provides comparable clinical outcomes and higher PFS.

Adenocarcinoma ; drug therapy ; pathology ; radiotherapy ; Brachytherapy ; Carcinoma, Squamous Cell ; drug therapy ; pathology ; radiotherapy ; Chemoradiotherapy ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Neoplasm Staging ; Organs at Risk ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated ; adverse effects ; methods ; Remission Induction ; Survival Rate ; Uterine Cervical Neoplasms ; drug therapy ; pathology ; radiotherapy

OBJECTIVETo evaluate the clinical effectiveness and safety of Fangfeng Tongsheng Granule (FTG) in the treatment of upper respiratory infection (superficial cold and interior heat syndrome, exterior and interior excess syndrome).

METHODSA randomized, double-blinded, multi-centered, placebo-parallel-controlled clinical trial was adopted. Totally 324 patients were enrolled and assigned to two groups, 216 patients in the treatment group and 108 patients in the control group. Those in the treatment group took FTG at the daily dose of 3 g, twice per day, the therapeutic course being 3 days. Those with axillary temperature more than 37 degrees C took one more time before medication. Those in the control group took simulated agent granules the same dose and dosage as the treatment group. The effect of Chinese medical syndrome (ECMS), the rate of temperature-dropping-to-normal (RT), the time of temperature-dropping-to-normal (TT), the curative effect of single symptom (CESS) and adverse reactions were observed.

RESULTSTotally 203 completed the trial in the treatment group and 101 in the control group. In the treatment group, the cured-effective rate was 55.67% (113/ 101), the total effective rate was 93.10% (189/101), the ECMS score decreased by 9.24 +/- 4.46, while they were 5.94% (6/101), 36.63% (37/101), and 3.27 +/- 3.29, respectively in the control group (P < 0.01). The RT was 87.50% (98/112) in the treatment group and 58.49% (31/53) in the control group (P < 0.01). The TT in the treatment group was superior to that of the control group (P < 0.01). As for CESS, all of the three primary symptoms and nine secondary symptoms were improved more obviously in the treatment group than in the control group. The integral decreased obviously, showing statistical difference (P < 0.01). The decrease was more obvious in the treatment group than in the control group (P < 0.01). There was no adverse event related to FTG.

CONCLUSIONFTG was effective and safe in treating upper respiratory infection (superficial cold and interior heat syndrome, exterior and interior excess syndrome).

Adolescent ; Adult ; Aged ; Apiaceae ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Respiratory Tract Infections ; drug therapy ; Treatment Outcome ; Young Adult