血清IL-6、CRP在阻塞型睡眠呼吸暂停低通气综合征并发冠心病患者发病中的作用

目的:探讨血清白细胞介素-6(IL-6)和C反应蛋白(CRP)在阻塞型睡眠呼吸暂停低通气综合征(OSAHS)并发冠心病(CHD)患者发病中的作用。方法:选取2013年12月~2015年2月我院的健康人群(正常组)、单纯OSAHS患者(OSAHS组)、OSAHS合并CHD患者(OSAHS+CHD组)作为研究对象,对比三组的睡眠呼吸指标、血清IL-6、CRP水平,并分析患者中三者的相关性分析。结果:正常组的血清IL-6和CRP水平均显著低于单纯OSAHS组与OSAHS+CHD组(P0.05),且OSAHS+CHD组高于单纯OSAHS组(P0.05);单纯OSAHS组与OSAHS+CHD组在睡眠呼吸暂停低通气指数(AHI)、平均Sa O2、最低Sa O2、呼吸暂停时间百分比上具有显著差异(P0.05);单纯OSAHS组和OSAHS+CHD组患者血清IL-6与CRP均为正相关关系(P0.05);单纯OSAHS组与OSAHS+CHD组血清IL-6和CRP均与AHI、呼吸暂停时间百分比呈正相关(P0.05),与最低Sa O2呈负相关(P0.05)。结论:IL-6、CRP和OSAHS合并CHD有密切关联性,为临床研究探讨炎性过程在OSAHS并CHD中的作用机制,以及心血管事件的防治等方向提供了依据。     

酪酸梭菌活菌散在治疗母乳性黄疸中的应用

目的观察在常规治疗的基础上加用酪酸梭菌活菌散（商品名：宝乐安）治疗新生儿母乳性黄疸的疗效。方法176例母乳性黄疸患儿随机分为治疗组和对照组,治疗组90例,对照组86例,对照组采用常规治疗,治疗组在常规治疗基础上加服酪酸梭菌活菌散,2组均不停止母乳喂养,并观察2组患儿日均总胆红素水平及黄疸消退时间的变化。结果治疗组日均胆红素下降值为（58．61±26．52）μmol／L,显著高于对照组（39．12±25．41）μmol／L（P〈0．01）;黄疸消退时间,治疗组为（4．25±2．68）d,显著短于对照组（6．42±2．74）d（P〈0．01）。结论在常规治疗的基础上加用酪酸梭菌活菌散治疗母乳性黄疸,可迅速降低胆红素水平,缩短治疗时间。     

茵栀黄口服液联合布拉酵母 对新生儿黄疸的治疗

目的探讨茵栀黄口服液联合布拉酵母治疗新生儿黄疸的效果。方法回顾性分析2012年5月至2016年2月我院收治的108例新生儿黄疸患儿的临床资料,根据治疗方法的不同将患儿分为对照组(50例)和观察组(58例)。两组患儿均给予蓝光处理,对照组同时给予布拉酵母治疗,观察组在对照组的基础上联用茵栀黄口服液进行治疗。比较两组患儿凝血指数、血气指标、生化指标及治疗效果。结果观察组患儿治疗后有效率高于对照组(98.28%vs 90.00%,χ~2=24.92,P0.05)。观察组患儿治疗后PaCO_2、pH、BE及Ca~(2+)和Mg~(2+)水平均低于对照组,差异有统计学意义(均P0.05)。观察组患儿治疗后PT、APTT、FIB、TT异常发生率与对照组比较差异无统计学意义(均P0.05)。观察组患儿治疗后血清总胆红素水平低于对照组,住院时间及黄疸消退时间均短于对照组,差异有统计学意义(均P0.05)。结论茵栀黄口服液联合布拉酵母治疗新生儿黄疸效果显著,能够明显缩短黄疸消退时间,改善血气分析指标及生化指标水平,安全有效。     

内镜下逆行胰胆管造影置放胆道支架治疗恶性梗阻性 黄疸98 例疗效分析

目的:探讨内镜下逆行胰胆管造影置放胆道支架对恶性胆道梗阻的疗效及并发症的防治。方法:选择2008年2月至2011年9月我院收治的无法手术切除或不愿手术的恶性胆道梗阻患者98例,通过放置内置支架引流观察其操作成功率、支架通畅期和退黄效果、并发症发生情况及其防治效果和患者生存期等。结果:98例患者中有88例成功通过置入胆道内置引流管,成功率为89.8%,并发症发生率为11.22%,所有成功患者术后1周黄疸明显减退,支架平均通畅期137天,患者平均生存期为163天。结论:行胆道内置支架引流创伤小,并发症少,通畅性能好,可持久有效地控制黄疸,有效缓解病情,改善全身情况,明显延长恶性胆道梗阻患者的生存期。     

OSAHS儿童手术后血浆Orexin-A水平测定的初步分析

目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)儿童血浆Orexin-A水平以及手术后血浆Orexin-A水平的变化.方法:对96例经多导睡眠监测(PSG)确诊的OSAHS患儿行腺样体和(或)扁桃体切除术,选择29例儿童作为对照组.采用放射免测定法,测定OSAHS患儿术前、术后6个月血浆Orexin-A水平.记录OSAHS患儿PSG检查结果AHI和最低血氧(LSaO2).结果:OSAHS组血浆Orexin-A水平与对照组比较差异有统计学意义(P＜0.01),术后6个月血浆Orexin-A水平与术前比较差异有统计学意义(P＜0.01).血浆Orexin-A与AHI呈正相关(r=0.542,P＜0.01),与最低血氧(LSaO2)呈负相关(r=-0.798,P＜0.01).结论:OSAHS患儿Orexin-A水平升高,手术治疗可使血浆Orexin-A水平下降,血浆Orexin-A水平和AHI、最低血氧(LSaO2)有相关性.     

Nocturnal CPAP improves walking capacity in COPD patients with obstructive sleep apnoea

Background

Exercise limitation is an important issue in patients with chronic obstructive pulmonary disease (COPD), and it often co-exists with obstructive sleep apnoea (overlap syndrome). This study examined the effects of nocturnal continuous positive airway pressure (CPAP) treatment on walking capacity in COPD patients with or without obstructive sleep apnoea.

Methods

Forty-four stable moderate-to-severe COPD patients were recruited and completed this study. They all underwent polysomnography, CPAP titration, accommodation, and treatment with adequate pressure. The incremental shuttle walking test was used to measure walking capacity at baseline and after two nights of CPAP treatment. Urinary catecholamine and heart rate variability were measured before and after CPAP treatment.

Results

After two nights of CPAP treatment, the apnoea-hypopnoea index and oxygen desaturation index significantly improved in both overlap syndrome and COPD patients, however these changes were significantly greater in the overlap syndrome than in the COPD group. Sleep architecture and autonomic dysfunction significantly improved in the overlap syndrome group but not in the COPD group. CPAP treatment was associated with an increased walking capacity from baseline from 226.4 ± 95.3 m to 288.6 ± 94.6 m (P < 0.05), and decreased urinary catecholamine levels, pre-exercise heart rate, oxygenation, and Borg scale in the overlap syndrome group. An improvement in the apnoea-hypopnoea index was an independent factor associated with the increase in walking distance (r = 0.564).

Conclusion

Nocturnal CPAP may improve walking capacity in COPD patients with overlap syndrome.

Trial registration

{"type":"clinical-trial","attrs":{"text":"NCT00914264","term_id":"NCT00914264"}}NCT00914264     

酪酸梭菌活菌散在迟发型母乳性黄疸中的应用

目的探讨酪酸梭菌活菌散促进迟发型母乳性黄疸消退的疗效。方法将87例迟发型母乳性黄疽患儿随机分为对照组和观察组,对照组43例和观察组44例,对照组采用常规治疗,观察组在常规治疗的基础上加服酿酸梭菌活菌散,500mg/次,3次/d,两组均不停止母乳喂养。观察两组患儿日均胆红素水平的变化及黄疽消退时间。结果观察组日均胆红素下降程度显著大于对照组（P〈0. 01）,观察组黄疸消退时间明显短于对照组（P〈0. 01）,差异有统计学意义。结论在常规治疗的基础上加用酪酸梭菌活菌散治疗迟发型母乳性黄疸,不仅可加速胆红素降低水平,缩短黄疽持续时间,而且能显著缓解茵扼黄颗粒引起的腹泻,是一种简单、安全、有效的治疗措施,并减少停喂母乳对乳母及乳儿的不利影响,值得临床推广应用。     

脂肪细胞型脂肪酸结合蛋白的研究进展

脂肪细胞型脂肪酸结合蛋白（adipocyte fatty acid binding protein,AFABP/aP2）作为脂肪酸结合蛋白（FABPS）超家族成员之一,广泛存在于各种正常的组织细胞中,参与脂肪酸贮存,运输与降解等过程。近年来,对脂肪细胞型脂肪酸结合蛋白的研究已成为热点,本文就其主要特征及其与各类疾病的关系作一简要综述。     

Targeted Disruption of Ig-Hepta/Gpr116 Causes Emphysema-like Symptoms That Are Associated with Alveolar Macrophage Activation

Ig-Hepta/GPR116 is a member of the G protein-coupled receptor family predominantly expressed in the alveolar type II epithelial cells of the lung. Previous studies have shown that Ig-Hepta is essential for lung surfactant homeostasis, and loss of its function results in high accumulation of surfactant lipids and proteins in the alveolar space. Ig-Hepta knock-out (Ig-Hepta^−/−) mice also exhibit emphysema-like symptoms, including accumulation of foamy alveolar macrophages (AMs), but its pathogenic mechanism is unknown. Here, we show that the bronchoalveolar lavage fluid obtained from Ig-Hepta^−/− mice contains high levels of inflammatory mediators, lipid hydroperoxides, and matrix metalloproteinases (MMPs), which are produced by AMs. Accumulation of reactive oxygen species was observed in the AMs of Ig-Hepta^−/− mice in an age-dependent manner. In addition, nuclear factor-κB (NF-κB) is activated and translocated into the nuclei of the AMs of Ig-Hepta^−/− mice. Release of MMP-2 and MMP-9 from the AMs was strongly inhibited by treatment with inhibitors of oxidants and NF-κB. We also found that the level of monocyte chemotactic protein-1 is increased in the embryonic lungs of Ig-Hepta^−/− mice at 18.5 days postcoitum, when AMs are not accumulated and activated. These results suggest that Ig-Hepta plays an important role in regulating macrophage immune responses, and its deficiency leads to local inflammation in the lung, where AMs produce excessive amounts of reactive oxygen species and up-regulate MMPs through the NF-κB signaling pathway.     

Sestrin 2 Protein Regulates Platelet-derived Growth Factor Receptor β (Pdgfrβ) Expression by Modulating Proteasomal and Nrf2 Transcription Factor Functions

We recently identified the antioxidant protein Sestrin 2 (Sesn2) as a suppressor of platelet-derived growth factor receptor β (Pdgfrβ) signaling and Pdgfrβ signaling as an inducer of lung regeneration and injury repair. Here, we identified Sesn2 and the antioxidant gene inducer nuclear factor erythroid 2-related factor 2 (Nrf2) as positive regulators of proteasomal function. Inactivation of Sesn2 or Nrf2 induced reactive oxygen species-mediated proteasomal inhibition and Pdgfrβ accumulation. Using bacterial artificial chromosome (BAC) transgenic HeLa and mouse embryonic stem cells stably expressing enhanced green fluorescent protein-tagged Sesn2 at nearly endogenous levels, we also showed that Sesn2 physically interacts with 2-Cys peroxiredoxins and Nrf2 albeit under different reductive conditions. Overall, we characterized a novel, redox-sensitive Sesn2/Pdgfrβ suppressor pathway that negatively interferes with lung regeneration and is up-regulated in the emphysematous lungs of patients with chronic obstructive pulmonary disease (COPD).