Background: The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is termed overlap syndrome (OS). COPD and OSA both have increased risks of developing cardiovascular diseases. This study aimed to explore if patients with OS exhibited a higher prevalence of cardiovascular complications, and if patients with OS exhibited vascular endothelial dysfunction and abnormalities in the cellular immune function of T lymphocytes. Methods: Totally 25 patients with stable COPD (COPD group), 25 patients with OSA (OSA group), 25 patients with OS (OS group), and 20 healthy adults (control group) were enrolled between January 2017 and December 2017 from the Respiratory Department of Tianjin Medical University General Hospital. The clinical characteristics of the four groups were collected and the expression levels of soluble vascular cell adhesion molecule-1 (sVCAM-1), tumor necrosis factor-α (TNF-α), and T-lymphocyte subsets were detected. One-way analysis of variance, χ² test and Pearson correlation were used to manage the data. Results: The prevalence of hypertension and coronary heart disease was significantly higher in the OS group than in the control, OSA, and COPD groups (χ² = 20.69, P < 0.05 and χ² = 11.03, P < 0.05, respectively). The levels of sVCAM-1 and TNF-α were significantly higher in the OS group than in other groups (F = 127.40, P < 0.05 and F = 846.77, P < 0.05, respectively). The percentage of CD4+ lymphocytes and CD4+/CD8+ were both significantly lower in the OS group than in any other group (F = 25.40, P < 0.05 and F = 75.08, P < 0.05, respectively). There were significantly negative correlations in the levels of sVCAM-1 and TNF-α with CD4+/CD8+ lymphocytes (r = –0.77, P < 0.05 and r = –0.83, P < 0.05, respectively). Conclusions The prevalence of hypertension and coronary heart disease was higher in patients with OS than in patients with either OSA or COPD alone. Patients with OS exhibited more severe vascular endothelial injury, stronger inflammatory response, and lower cellular immune function.

Objective To analyze the clinical features and related risk factors of sleep hypopnea (SH) in obstructive sleep apnea hypoventilation syndrome (OSAHS). Methods A total of 63 patients with OSAHS who were underwent polysomnography (PSG) and transcutaneous carbon dioxide partial pressure (TCPCO2) monitoring were selected in this study. All patients were divided into pure OSAHS group (n=35) and OSAHS with SH group (n=28) according to the diagnostic criteria of SH. The clinical features of nocturnal carbon dioxide and related risk factors were compared between two groups, including gender, age, complications, body mass index (BMI), Epworth sleepiness scale (ESS), micro awakening index, arterial blood gas analysis, PSG and TCPCO2. Correlation analysis were used to analyze the correlation between the highest TCPCO2 and other variables. The influencing factors of the highest TCPCO2 were analyzed by multiple linear regression analysis. Receiver operating characteristic (ROC) curve analysis was used to analyze the value for related variables in the diagnosis of SH. Results Twenty-eight patients were diagnosed as SH in all the 63 patients with OSAHS, the proportion was 44.4%. There were no significant differences in gender, age and smoking proportion between the two groups. Data of BMI, arterial carbon dioxide partial pressure [p(CO2)], prevalence of hypertension, ESS, apnea hypopnea index, micro arousal index, percentage of nighttime sleep with blood oxygen saturation less than 90%, highest TCPCO2 and TCPCO2 during each sleep stage were significantly higher in the OSAHS with SH group than those in the pure OSAHS group (P<0.05), while arterial oxygen partial pressure [p(O2)] and the lowest pulse oxygen saturation (SpO2) were significantly lower than those in pure OSAHS group (P<0.05). The highest TCPCO2 was positively correlated with p(CO2), ESS and BMI (P<0.01). Multiple linear regression analysis showed that the highest TCPCO2 was affected by BMI and ESS. As a possible predictor for OSAHS with SH, BMI>31.43 kg/m2 showed a sensitivity of 64.3%and specificity of 91.4%, and ESS score>12 showed a sensitivity of 78.6%and specificity of 71.4%. Conclusion The patients of OSAHS with SH have more severe nocturnal hypercapnia and hypoxemia. OSHAS patients are recommend to undergo TcPCO2 monitoring, when BMI is greater than 31.43 kg/m2 and ESS is greater than 12 scores.

Objective To construct human metapneumovirns (hMPV) DNA vaccines and evaluate the cellular and humoral immune response in mice.Methods Fusion protein FATM (without transmembrane domain) gene and M gene of hMPV were amplified from cDNA by PCR, then DNA vaccines pcDNA3. 1His-FΔTM and peDNA3.1His-M were constructed to verify the expression of F and M protein by Western blotting and indirect immunofluorescent assay (IFA) respectively. Serum IgG and spleen cell CTL were detected with ELISA and ELISPOT assay after the BALB/c mice were immunized intramuscularly with the vaccines. Results The candidate DNA vaccines could express FATM and M protein as detected with Western blotting and IFA. The IgG antibody titers of mice was 1:44 when immunized with poDNA3.1His-FΔTM, but could increase te 1:64 when co-immunized with pcDNA3.1His-M. ELISPOT assay demonstrated that IFN-γ-secreting effector T cells reached 42 ±8.9 in co-immunization group, higher than single vaccine pcDNA3.1His-FΔTM group (32 ± 7.4). Conclusion DNA vaccine pcDNA3.1His-FΔTM could induce specific cellular and humoral immune responses, and the immune response could increase when co-immunization with pcDNA3.1His-M was carried out.

Objective To understand the genotypes of human metapneumovirus (hMPV) and the genetic character of hMPV attachment protein G sequence in Hunan, China. Methods 232 nasopharyngeal aspirates (NPA) samples from hospitalized children with aeute respiratory infections were collected from Hunan, China in 2005. HMPV was detected. The full length of G glycoprotein genes were amplified and sequenced. Bioinformatics soft-wares were employed to analyze the sequences. Results 17/232 (7.3% ) were showed hMPV positive. And co-infection rate with other viruses is 35% .The diagnoses of these hMPV positive cases are pneumonia,bronchiolitis and bronchopneumonia. Phylogenetic analysis for G genes from 13 hMPVs revealed the existence of four major subgroups: A1, A2, B1, B2 in Hunan, China in 2005. There are four types of sequence lengths of hMPV G glycoprotein, which are 711, 675, 660, 696nt. It is different in potential N-linked glycosylation sites and number of eysteine residues among these hMPVs of Hunan, China and Beijing, China. Also it is different from those in Japan and North America. Conclusion The investigation of hMPV from Hunan, China in 2005 revealed the high speed of genetic variation and the marked character of geographic epidemic differences.