Humans ; Aminoquinolines/therapeutic use* ; Carcinoma, Non-Small-Cell Lung/genetics* ; Lung Neoplasms/genetics* ; Mutation/genetics* ; Standard of Care

Objective:To evaluate the effect of general anesthesia combined with epidural block on postoperative sleep in the frail elderly patients undergoing gastrointestinal tumor surgery.Methods:Ninety frail patients of either sex, aged 65-80 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiology physical status Ⅱ-Ⅲ, scheduled for elective open gastrointestinal tumor surgery (FRAIL score >2), were divided into 2 groups ( n=45 each) using a random number table method: general anesthesia group (GA group) and general anesthesia combined with epidural block group (GE group). Combined intravenous-inhalational anesthesia was carried out in group GA.Epidural block was performed before induction of anesthesia, and the method of general anesthesia was the same as that described in group GA, and the consumption of propofol and remifentanil was adjusted according to the BIS value, sweat and tears, heart rate and blood pressure during operation in group GE.Postoperative intravenous analgesia was performed to maintain VAS score ≤3.Wearable devices were used to monitor sleep parameters at 1 day before surgery and 1, 3 and 7 days after surgery.Sleep quality was assessed using Pittsburgh Sleep Quality Index and Quality of Recovery-15 questionnaire at 1 day before surgery and 1, 3, 7 and 30 days after surgery.The intraoperative consumption of propofol, sufentanil and remifentanil were recorded.The requirement for postoperative rescue analgesia and total pressing times of patient-controlled analgesia (PCA) within 48 h after surgery were recorded.Serum C-reactive protein concentrations were determined by immunoturbidimetry at 1 day before surgery and 1 day after surgery, and the adverse reactions at 7 days after surgery were recorded. Results:Compared with group GA, the consumption of remifentanil was significantly reduced, the total sleep score, deep sleep ratio, rapid eye movement ratio and Quality of Recovery-15 score were increased, the Pittsburgh Sleep Quality Index was decreased, and the incidence of postoperative nausea and vomiting was decreased on 1st and 3rd days after operation ( P<0.05), and no significant change was found in the serum C-reactive protein concentration and postoperative requirement for rescue analgesia, and total pressing times of PCA in group GE ( P>0.05). Conclusions:General anesthesia combined with epidural block can improve short-term sleep quality and recovery quality after gastrointestinal tumor surgery in elderly frail patients.

【Objective】 To genetically analyze the D^el sample from a blood donor in Jiangyin and make clear the molecular basis of the serological phenotype. 【Methods】 The EDTA anticoagulant blood were collected: buffy coat were used for nucleic acid extract and cDNA analysis; red blood cells for serological test. Tube method and microcolumn gel were used for serological test. Genotyping kit were used for exon analysis. Gene mutation was analyzed using the sequence analyzer. 【Results】 Serological analysis demonstrated the sample′s RhD phenotype was D^el. The phenotype of RhCE was CCEe. Real-time fluorescence quota PCR result demonstrated the existence of all exones. Weak D15 and RHD^* DEL1 [RHD(1227G>A)], which had a high frequency of occurrence in China, were excluded according to real-time fluorescence quota PCR result. Sequence analyzing result verified RHD(28C>T) SNP mutation in cDNA. The genotype of this sample was RHD^*01 W. 61[RHD(28C>T)]. 【Conclusion】 A weak D61 was found among blood donors in our city, Jiangyin.

P450 fatty acid decarboxylase OleT from Staphylococcus aureus (OleTsA) is a novel cytochrome P450 enzyme that catalyzes the oxidative decarboxylation of fatty acids to yield primarily terminal alkenes and CO2 or minor α-and β-hydroxylated fatty acids as side-products.In this work,the interactions between a series of cycloalkyl phosphorus heterocycles (CPHs) and OleTsA were investigated in detail by fluores-cence titration experiment,ultraviolet-visible (UV-vis) and 31p NMR spectroscopies.Fluorescence titration experiment results clearly showed that a dynamic quenching occurred when CPH-6,a repre-sentative CPHs,interacted with OleTsA with a binding constant value of 15.2 × 104 M-1 at 293 K.The thermodynamic parameters (△H,△S and △G) showed that the hydrogen bond and van der Waals force played major roles in the interaction between OleTsA and CPHs.The UV-vis and 31p NMR studies indicated the penetration of CPH-6 into the interior environment of OleTsA,which greatly affects the enzymatic activity of OleTsA.Therefore,our study revealed an effective way to use phosphorus hetero-cyclic compounds to modulate the activity of cvtochrome P450 enzymes.

OBJECTIVE: To investigate the correlation between the severity of obstructive sleep apnea syndrome (OSAS) and red cell distribution width (RDW) in elderly patients. METHODS: A cross-sectional study was conducted among 311 elderly patients diagnosed with OSAS in the snoring clinic between January, 2015 and October, 2016 and 120 healthy controls without OSAS from physical examination populations in the General Hospital of PLA. The subjects were divided into control group with apnea-hypopnea index (AHI) <5 (=120), mild OSAS group (AHI of 5.0-14.9; =90), moderate OSAS group (AHI of 15.0-29.9; =113) and severe OSAS group (AHI ≥ 30; =108). The clinical characteristics and the results of polysomnography, routine blood tests and biochemical tests of the subjects were collected. Multiple linear regression analysis was used to examine the correlation between OSAS severity and RDW. RESULTS: The levels of RDW and triglyceride were significantly higher in severe OSAS group than in the other groups ( < 0.01). The levels of fasting blood glucose and body mass index were significantly higher in severe and moderate OSAS groups than in mild OSAS group and control group ( < 0.05 or < 0.01). Multiple linear regression analysis showed that AHI was positively correlated with body mass index (β=0.111, =0.032) and RDW (β=0.106, =0.029). The area under ROC curve of RDW for predicting the severity of OSAS was 0.687 (=0.0001). CONCLUSIONS The RDW increases as OSAS worsens and may serve as a potential marker for evaluating the severity of OSAS.
Aged ; Cross-Sectional Studies ; Erythrocyte Indices ; Humans ; Polysomnography ; Severity of Illness Index ; Sleep Apnea, Obstructive

OBJECTIVE: To evaluate the changes of cardiac structure and function and their risk factors in elderly patients with obstructive sleep apnea syndrome (OSA) without cardiovascular complications. METHODS: Eighty-two elderly OSA patients without cardiovascular disease admitted between January, 2015 and October, 2016 were enrolled in this study. According to their apnea-hypopnea index (AHI, calculated as the average number of episodes of apnoea and hypopnoea per hour of sleep), the patients were divided into mild OSA group (AHI < 15) and moderate to severe OSA group (AHI ≥ 15). The demographic data and the general clinical data were recorded and fasting blood samples were collected from the patients on the next morning following polysomnographic monitoring for blood cell analysis and biochemical examination. Echocardiography was performed within one week after overnight polysomnography, and the cardiac structure, cardiac function and biochemical indexes were compared between the two groups. RESULTS: Compared with those with mild OSA group, the patients with moderate to severe OSA had significantly higher hematocrit (0.22±0.08 CONCLUSIONS Cardiac diastolic function impairment may occur in elderly patients with moderate or severe OSA who do not have hypertension or other cardiovascular diseases, and the severity of the impairment is positively correlated with AHI.
Aged ; Cardiovascular Diseases/etiology* ; Humans ; Risk Factors ; Severity of Illness Index ; Sleep Apnea, Obstructive/complications* ; Stroke Volume ; Ventricular Dysfunction, Left ; Ventricular Function, Left

Objective: To understand the iodine nutritional status of residents in the newly identified high iodine and non-high iodine areas in Puyang, and to provide evidence for relevant departments to adjust the iodine supplementation policy. Methods: According to the survey results of drinking water iodine content in 2017, in 2018 stratified and systematic sampling methods were used to extract 25 villages in the newly identified high iodine areas and non-high iodine areas in Puyang City. Each village surveyed 40 children and 20 pregnant women, the urinary iodine content of the subjects and the salt iodine content at their home were measured, and the thyroid volume of children in 10 villages in high iodine and non-high iodine areas was measured. Results: In high iodine areas and non-high iodine areas, the household salt samples collected were 1 357 and 1 544, respectively, the iodized salt coverage rate was 87.91% (1 193/1 357) and 85.62% (1 322/1 544), respectively, and the difference was not statistically significant (χ² = 3.291, P > 0.05). A total of 1 028 children and 329 pregnant women in high iodine areas were investigated, their median urinary iodine content was 337.0 and 289.0 μg/L, respectively; a total of 1 041 children and 503 pregnant women in non-high iodine areas were investigated, their median urinary iodine content were 310.0 and 265.0 μg/L, the differences of the urinary iodine content between high iodine and non-high iodine areas were statistically significant (Z = -3.825, -2.795, P < 0.05). Thyroid volume was measured in 407 children in high iodine areas and 423 children in non-high iodine areas. The thyroid enlargement rate was 8.85% (36/407) and 3.78% (16/423), respectively, and the difference was statistically significant (χ² = 9.053, P < 0.05). Conclusions The iodine nutrition levels of children and pregnant women in high iodine areas are higher than those in non-high iodine areas. Iodized salt should be stopped supplying in high iodine areas as soon as possible. In non-high iodine areas, the feasibility of reducing the iodine concentration of iodized salt should be investigated to ensure the iodine nutrition level of local residents.

Objective This study aimed to investigate the renal expression change of high mobility of nucleosome binding protein 1 ( HMGN1) in epithelia-mesenchymal transition ( EMT) process, and to study the effect of HMGN1 on renal fibrosis in the diabetic nephropathy mice model. Methods 20 C57BL/6 mice were randomly divided into control group, model group, benazepril group, and insulin group. After 8 weeks of drug intervention, blood, urine and kidney tissue samples were taken from mice. The routine physiological and biochemical indexes were detected. Renal structure and fibrosis were detected by HE and Sirius red staining, respectively. Immunohistochemistry and in situ hybridization were used to investigate the protein and mRNA expression levels of HMGN1, CD68, F4/80,α-smooth muscle actin (α-SMA) , and E-cadherin in renal tissue. Results Blood glucose, renal index, and urinary albumin to creatinine ratio ( UACR) were significantly higher in the model group than those in the normal group. In the model group, HE staining showed glomerular hypertrophy and interstitial inflammatory cell infiltration, and Sirius red showed collagen deposition in the renal tissue. Compared with normal group, HMGN1, CD68, F4/80 positive cell counts andα-SMA protein expression were all increased, while E-cadherin protein expression was downregulated in the model group ( all P<0.05) . The above indexes were not improved significantly in the benazepril group. And after intervention of insulin, the expression levels of CD68 positive cell count andα-SMA protein were decreased and the expression levels of E-cadherin protein were increased compared with the model group ( all P<0.05) . The correlation analysis showed that the level of HMGN1 was correlated with CD68, F4/80, α-SMA, E-cadherin and collagen protein, while CD68 and f4/80 were correlated withα-SMA, collagen protein and blood glucose, respectively ( all P<0. 05 ) . Conclusion HMGN1 is involved in the progression of diabetic nephropathy fibrosis, and its underlying mechanism might be related to the macrophage-mediated EMT process.

Objective To study the impact of splenectomy and esophagogastric devascularization on the nutritional status of patients with cirrhosis and portal hypertension.Methods Sixty consecutive patients with cirrhosis and portal hypertension who underwent splenectomy and esophagogastric devascularization at the Beijing YouAn Hospital from April 5,2015 to January 23,2017 were included in this study.The body mass index (BMI),albumin (Alb),prealbumin (PA) and lymphocyte counts were prospectively collected at the end of 1-week,1-month,3-month,6-month and 1-year after surgery.The postoperative results were compared with the preoperative results in these patients.Results The BMI results obtained at 1-week and 1-month after surgery were significantly lower than the preoperative level [(22.14 ± 3.08)kg/m2 vs.(22.85 ± 3.14) kg/m2,(21.72 ± 3.05) kg/m2 vs.(22.86 ± 3.16) kg/m2,P ＜ 0.05].The BMI result at the end of 1-year after surgery was significantly elevated when compared with the preoperative level [(23.24 ± 3.64) kg/m2 vs.(22.68 ± 3.47) kg/m2,P ＜ 0.05].The ALB levels at 1-month and 3-month after surgery were significantly higher than the preoperative level [(39.87 ± 4.22)g/L vs.(35.35 ±5.15) g/L,(39.35 ± 4.75) g/L vs.(34.82 ± 5.50) g/L,P ＜ 0.05].The PA obtained at 1-week after surgery was significantly lower than the preoperative levels [(79.59 26.52)mg/L vs.(121.77 ±39.96)mg/L,P ＜ 0.05].The lymphocyte counts at all the points after surgery were significantly higher than the preoperative level (P ＜ 0.05).Conclusion Short term and long term nutritional status improved in patients with cirrhosis and portal hypertension after splenectomy and esophagogastric devascularization.

Objective:To measure serum levels of salusins and catestatin and analyze their correlation in patients with essential hypertension (EH) .Methods :A total of 90 EH patients were selected as hypertension group .According to blood pressure level ,they were further divided into hypertension stage 1 group (n=31) ,hypertension stage 2 group (n=30) and hypertension stage 3 group (n=29) .Another 40 normotensive subjects undergoing physical examina‐tion were selected as normal control group .Enzyme linked immunosorbent assay (ELISA) was used to measure ser‐um levels of salusins and catestatin , and the correlation between serum levels of salusins and catestatin was analyzed . Results :Compared with normal control group ,there were significant reductions in serum levels of salusins [ (3.01 ± 0.66) ng/ml vs .(1.44 ± 0.42) ng/ml ,(1.35 ± 0.89) ng/ml ,(1.41 ± 0.32) ng/ml] and catestatin [(132.24 ± 7.55) ng/ml vs .(89.22 ± 6.12) ng/ml vs .(82.51 ± 8.37) ng/ml ,(83.34 ± 4.47) ng/ml] in hypertension stage 1 ,stage 2 and stage 3 group , P<0.01 all;compared with stage 1 group ,there were significant reductions in serum catestatin levels in stage 2 and stage 3 group (P<0.01 both) ,but there were no significant difference in serum salusins level a‐mong three groups of hypertension ( P>0.05 all) .Pearson correlation analysis indicated that serum salusins level had no correlation with catestatin level ( r=0.363 , P>0.05) in normal control group ,while serum salusins level was significant positively correlated with catestatin level (r=0.723 ,P<0.01) in hypertension group .Conclusion:Serum levels of salusins and catestatin significantly reduce and they is positive correlation in patients with hyperten‐sion .Along with blood pressure level rises ,serum catestatin level reduces .