Objective To explore effects of edaravone on apoptosis and expressions of apoptotic proteins Smac and XIAP in hippocampal CA1 pyramidal cell of rats under intermittent hypoxia. Methods A total of 96 adult male Wistar rats were randomly divided into control group, 5% intermittent hypoxic group and edaravone group, and each group was divided into 4 time groups at 7 d, 14 d, 21 d and 28 d, respectively, with 8 rats in each subgroup. The content of reactive oxygen species (ROS) in hippocampal tissues of the experimental rats was detected by the reactive oxygen species detection kit. Immunohistochemistry and Western blot were used to detect the expressions of Smac and XIAP protein in hippocampal CA1 region. The Tunel method detected the apoptosis of neurons. Results Compared with the control group, the content of ROS, the expressions of Smac and XIAP proteins and the neuronal apoptosis index in the hippocampus were increased in the 5% intermittent hypoxia group and the edaravone group at each time point (all P<0.05). The content of ROS, the Smac protein expression and the neuronal apoptosis index in the edaravone group were significantly lower than those in the 5% intermittent hypoxia group (all P<0.05). The expression of XIAP protein in the edaravone group was significantly higher than that in the 5% intermittent hypoxia group (P<0.05). Conclusion Edaravone may improve the antioxidant capacity of the body by scavenging oxygen free radicals and regulate Smac and XIAP- mediated apoptosis, thus playing a protective role on neurons.
ObjectiveTo evaluate the prevalence of obstructive sleep apnea hypopnea syndrome (OSAHS) in patients with asthma, and explore the association of OSAHS with asthma. MethodsPatients who were diagnosed as asthma between March 2014 and February 2015 were recruited in the study. They were categorized into an OSAHS group and a non-OSAHS group according to the Berlin questionnaire. The data of clinical characteristics and pulmonary function test were collected. Logistic regression analysis was performed to evaluate the factors associated with the incidence of OSAHS in asthma. ResultsA total of 64 patients with asthma were enrolled and 36 patients were complicated with OSAHS. The body mass index (BMI), allergic rhinitis history, inspiratory capacity, maximal mid-expiratory flow and provoking dose which make FEV1 reduce 20% were significantly different between two groups (all P < 0.05). Multivariate logistic regression analysis revealed that the increased BMI was an independent risk factor of OSAHS in patients with asthma. ConclusionThe occurrence of OSAHS with asthma is very high, and BMI may be an important associated risk factor.
Objective To explore the diagnosis and treatment of critically ill patients suffering from obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods Critically ill patients with OSAHS admitted in intensive care unit from January 2003 to December 2007 were retrospectively analyzed. Results Seventy-nine critically ill patients were diagnosed as OSAHS. The initial diagnosis of OSAHS was made by history requiring, physical examination, and Epworth sleepiness score evaluation. The final diagnosis was comfirmed by polysomnography thereafter. Base on the treatment of primary critical diseases, the patients were given respiratory support either with continuous positive airway pressure ( CPAP) or with bi-level positive airway pressure ventilation ( BiPAP) . Two cases died and the remaining 77 patients were cured anddischarged. Conclusions Timely diagnosis of OSAHS is important to rescue the critically ill patients. Respiratory support combined with treatment of primary critical diseases can improve the outcomes of these patients.
ObjectiveTo investigate the diagnostic value of oximetry in sleep apnea hypopnea syndrome (SAHS). MethodsAdult patients suspected for SAHS were enrolled between May 2010 and May 2013. The patients underwent both polysomnography (PSG) and oximetry for further diagnosis. Apnea hyponea index (AHI) and oxygen desaturation index four (ODI4) were calculated on a single night. The relationship between AHI and ODI4 were analyzed. ResultsA total of 628 adult patients were recruited.ODI4 was linearly correlated with AHI with a regression coefficient of almost 1. The cut-off values of ODI4 for indentifing SAHS and moderate to severe SAHS were 10 events per hour and 20 events per hour, with specificities of 99.9% and 99.3%, and AUCs of 0.931 and 0.934, respectively. Female, lower weight and less severe SAHS patients were easily misdiagnosed. ConclusionsThere is a high agreement between AHI and ODI4. Oximetry is less likely misdiagnose SAHS.
ObjectiveTo observe the relationship of serum tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and C-reactive protein (CRP) with obstructive sleep apnea hypopnea syndrome (OSAHS) associated pulmonary hypertension (OSAHS-PH). MethodsFrom September 2013 to October 2014, 38 OSAHS patients, 32 OSAHS-PH patients and 35 healthy subjects were enrolled from the General Hospital of Ningxia Medical University. OSAHS was diagnosed by polysomnography. The pulmonary artery systolic pressure (PASP) was measured by echocardiograph, and the diagnose criteria for pulmonary hypertension was PASP≥40 mm Hg. Serum TNF-α, IL-6, CRP and endothelin 1 (ET-1) were detected by enzyme-linked immunosorbent assay. The correlation between TNF-α, IL-6, CRP, ET-1 and PASP was analyzed. ResultsThe serum levels of TNF-α, IL-6, CRP and ET-1 were remarkably different among three groups (F=55.34, 25.05, 23.85, 34.06 respectively; all P < 0.05). The levels of TNF-α, IL-6, CRP and ET-1 in the OSAHS group were higher than those in the healthy group, and lower than those in the OSAHS-PH group (all P < 0.05). The PASP was positively correlated with the levels of the four factors (r=0.755, 0.762, 0.747, 0.759 respectively; all P < 0.01). ConclusionThe levels of serum TNF-α, IL-6 and CRP are correlated with pulmonary hypertension and they may be involved in the process of OSAHS-PH.
Objective To investigate the differences in biological features between male and female patients with obstructive sleep apnea-hypopnea syndrome( OSAHS) . Methods 192 cases of patients with snoring were analyzed in the Sleep Medicine Center of West ChinaHospital fromSeptember 2004 to February 2005. The standard sleep disorder questionnaires, neck circumference, hight, weight, and all night polysomnography ( PSG) were evaluated. The clinical features of the male and female patients with OSAHS were compared. Results 170 cases of patients met the criteria of OSAHS for the apnea-hypopnea index ( AHI) more than 5 times per hour. Male gender accounted for 90% of the total patients ( male vs. female 153 vs. 17, 9∶1) . The age of male patients with OSAHS was younger than that of female ( 45. 7 ±11. 4 yearsvs. 58. 0 ±6. 1 years, P = 0. 000) . Parameters including neck circumference ( 37. 6 ±3. 2 cm vs. 35. 6 ±3. 2 cm, P =0. 000) , waist/hip rate ( 0. 94 ±0. 04 vs. 0. 9 ±0. 06, P = 0. 000) , AHI ( 36. 4 ±25. 7 vs.21. 4 ±17. 4, P =0. 004) , oxygen desaturation index ( 34. 5 ±27. 4 vs. 22. 2 ±20. 8, P =0. 035) , the number of smoking ( 52. 9% vs. 5. 9% , P = 0. 000) and drinking ( 46. 4% vs. 5. 9% , P = 0. 001) were different among the male and female patients with OSAHS. On the other hand, the morning headache ( 70. 6% vs.26. 1%, P = 0. 005) , mouth dry( 76. 5% vs. 47. 7% , P = 0. 025) , bad temper ( 52. 9% vs. 19. 0% , P =0. 004) , and hypertension ( 52. 9% vs. 20. 9% , P =0. 007) were more common in the female patients with OSAHS. Conclusion There are significant differences between male and female patients with OSAHS in prevalence, age, symptoms, and severity of the disease.
Objective To investigate the clinical efficacy and safety of coblation-assisted adenotonsillectomy for treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods From June 2007 to May 2008, after monitoring polysomnography (PSG) confirmed 82 cases of OSAHS in children aged 3 to 14 years, with an average age of 6.2 years old, the ENT CoblatorII surgical instrument made by Arthrocare in the US and one-time EVac 70 T amp; A segment was used under complete anesthesia to remove tonsils and(or)adenoid ablation. Polysomnography monitoring was used preoperatively and 6 months postoperatively to determine the therapeutic effect. Results No significant complications occurred among the children both during the operation and postoperatively. Patients were followed for 6 months, and a satisfactory effect was achieved. The lowest oxygen saturation (LSaO2) improved significantly (Plt;0.001); the apnea-hypopnea index (AHI) decreased significantly after the operation (Plt;0.001). In accordance with OSAHS diagnosis and efficacy evaluation standards, 45 patients were cured after 6 months, 21 patients showed an excellent effect, 10 patients showed a good effect, six patients had no effect, and the total effective rate was 92.6%. Conclusion Low-temperature coblation-assisted adenotonsillectomy has good clinical efficacy with a shortened surgical time, less intraoperative and postoperative blood loss, less postoperative pain, few complications, and a simple operation procedure. It can effectively expand the nasopharynx, oropharynx ventilation cross-sectional area, lift the upper airway obstruction, and can be especially suitable for surgical treatment of children with OSAHS.
Objective To investigate the possible association between serum level of hepatocyte growth factor( HGF) and obstructive sleep apnea hypopnea syndrome( OSAHS) with hypertension.Methods 58 cases of OSAHS without hypertension, 61 cases of OSAHS with hypertension, and 50 normal controls were enrolled. Serum level of HGF was measured by enzyme-linked immunosorbent assay( ELISA) , and the relationships between the serum HGF level and blood pressure( BP) , apnea hypopnea index( AHI) , lowest SaO2 ( LSaO2 ) were analyzed by linear correlation analysis. Results The serum HGF level ( pg/mL) was 761. 46 ±60. 18, 970. 87 ±60. 94, and 487. 34 ±45. 52 in the OSAHS patients without hypertention, OSAHS patients with hypertention, and normal subjects, respectively. Which was significantly higher in the OSAHSpatients than the normal subjects, and highest in the OSAHS patients with hypertension( P lt; 0. 05) . The serum HGF level was positively related to AHI( r = 0. 452, P lt;0. 05) and negatively related to LSaO2 ( r =- 0. 328, P lt;0. 05) in the OSAHS patients without hypertention, positively related to AHI, SBP, DBP( r =0. 670, P lt;0. 01; r =0. 535, P lt;0. 05; r =0. 424, P lt;0. 05) and negatively related to LSaO2 ( r = - 0. 572,P lt;0. 01) in the OSAHS patients with hypertension. Conclusions SerumHGF level increases significantly in patients with OSAHS especialy in OSAHS patients with hypertension, and positively correlates with the severity of OSAHS and hypertension.
Objective To investigate the correlation between serum level of visfatin and obesity in patients with obstructive sleep apnea hypopnea syndrome ( OSAHS) . Methods Forty-seven patients with OSAHS and 20 healthy controls were recruited in this study. Polysomnography was performed in all subjects to detect apnea-hypopnea index ( AHI) . The serumlevels of cisfatin, C-reactive protein ( CRP) , TNF-α, and IL-6 were measured by enzyme linked immunosorbent assay. The body mass inex ( BMI) was calculated.The level of cisfatin was compared between the OSAHS patients with different severity and the controls, and its relationship with the levels of AHI, BMI, CRP, TNF-α, and IL-6 was analyzed. Results The serumlevel of visfatin in the OSAHS patients was higher significantly than that in the controls ( P lt;0. 01) and increased by the severity of OSAHS. There were positive correlations between the serum level of visfatin and AHI,BMI, CRP, TNF-α, IL-6 in the OSAHS patients ( P lt;0. 05) . Conclusion The expression of visfatin may play an important role in the pathogenesis of OSAHS.