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.
目的:探讨TCR(低温等离子射频)序贯治疗在治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)临床疗效。方法:我院2003年8月至2007年2月收治153例轻中度OSAHS患者,采用TCR序贯治疗,初次手术后追踪患者情况,必要时分阶段分部位反复消融,并在术后半年,1年进行PSG检查等,对其疗效、并发症进行分析。结果:153例患者半年有效率86.27%。1年有效率73.20 %,无严重并发症发生。结论:TCR序贯治疗疗效确切,组织反应轻,可作为治疗轻中度OSAHS的有效方案。
【摘要】 目的 观察低温等离子射频治疗阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hypopnea syndrome，OSAHS）合并变应性鼻炎的疗效。 方法 对2010年1－5月收治的42例OSAHS合并变应性鼻炎患者，采用低温等离子射频双下鼻甲减容、鼻腔内蝶腭神经及筛前神经末梢阻滞，并配合鼻中隔成形等手术。使用Epworth嗜睡评分量表（epworth sleepiness scale， ESS）和视觉模拟评分法（visual analogue scale，VAS）对治疗前及治疗3个月后的总体感受评分。 结果 ESS评分与VAS评分均符合正态分布，手术前、后ESS评分[（14.22±4.21）分，（6.78±4.12）分]与VAS评分[（8.34±2.72）分，（3.96±1.02）分]差异有统计学意义（Plt;0.05）。 结论 低温等离子射频治疗OSAHS合并变应性鼻炎疗效较好。【Abstract】 Objective To observe the clinical effect of treatment by low-temperature plasma radio frequency on obstructive sleep apnea-hypopnea syndrome (OSAHS) complicated with allergic rhinitis. Methods A total of 42 patients with OSAHS complicated with allergic rhinitis between January 2010 and May 2010 were chosen. All of the patients were treated by low-temperature plasma radio frequency nerve block, concha nasalis inferior ablation and other operations such as nasal septal construction. The nerve terminals of sphenopalatine nerve and anterior ethmoid nerve were blocked by ablation. Epworth sleepiness scale (ESS) and visual analogue scale (VAS) were used to estimate the curative effects. Results The results of ESS and VAS were consistent with gaussian distribution. There were statistical significant difference between the scores of pre-and post-operation (Plt;0.05). Conclusion The low-temperature plasma radio frequency treatment for OSAHS complicated with allergic rhinitis is easy，safe and efficient.
Objective To analyze the causes of missed diagnosis of sleep apnea hypopnea syndrome ( SAHS) . Methods 42 missed diagnosed cases with SAHS from May 2009 to May 2011 were retrospectively analyzed and related literatures were reviewed. Results The SAHS patients often visited the doctors for complications of SAHS such as hypertension, diabetes mellitus, metabolic syndrome, etc. Clinical misdiagnosis rate was very high. Lack of specific symptoms during the day, complicated morbidities, and insufficient knowledge of SAHS led to the high misdiagnosis rate and the poor treatment effect of patients with SAHS. Conclusion Strengthening the educational propaganda of SAHS, detail medical history collection, and polysomnography monitoring ( PSG) as early as possible can help diagnose SAHS more accurately and reduce missed diagnosis.
Sleep apnea causes cardiac arrest, sleep rhythm disorders, nocturnal hypoxia and abnormal blood pressure fluctuations in patients, which eventually lead to nocturnal target organ damage in hypertensive patients. The incidence of obstructive sleep apnea hypopnea syndrome (OSAHS) is extremely high, which seriously affects the physical and mental health of patients. This study attempts to extract features associated with OSAHS from 24-hour ambulatory blood pressure data and identify OSAHS by machine learning models for the differential diagnosis of this disease. The study data were obtained from ambulatory blood pressure examination data of 339 patients collected in outpatient clinics of the Chinese PLA General Hospital from December 2018 to December 2019, including 115 patients with OSAHS diagnosed by polysomnography (PSG) and 224 patients with non-OSAHS. Based on the characteristics of clinical changes of blood pressure in OSAHS patients, feature extraction rules were defined and algorithms were developed to extract features, while logistic regression and lightGBM models were then used to classify and predict the disease. The results showed that the identification accuracy of the lightGBM model trained in this study was 80.0%, precision was 82.9%, recall was 72.5%, and the area under the working characteristic curve (AUC) of the subjects was 0.906. The defined ambulatory blood pressure features could be effectively used for identifying OSAHS. This study provides a new idea and method for OSAHS screening.
Objective To evaluate the application value of optical coherence tomography angiography (OCTA) in obstructive sleep apnea syndrome (OSAS). Methods A comprehensive search of both domestic and international databases was conducted to identify clinical studies on the use of OCTA in OSAS, from the establishment of the databases to May 2024. A meta-analysis was performed using Revman 5.4 software. Results A total of 134 studies were initially identified, with 14 studies meeting the inclusion criteria, encompassing 999 subjects (739 in the OSAS group and 260 in the healthy group). Meta-analysis results indicated that the superficial capillary plexus (SCP) density in the fovea (MD=–2.05, 95%CI –3.75 to –0.35, P=0.02) and parafovea (MD=–1.56, 95%CI –2.44 to –0.68, P=0.000 5) was significantly lower in the OSAS group compared with the healthy group. In the mild to moderate OSAS group, SCP density was significantly lower in the fovea (MD=–2.41, 95%CI –4.32 to –0.49, P=0.01), parafovea (MD=–1.17, 95%CI –2.01 to –0.32, P=0.007), and perifovea (MD=–1.73, 95%CI –2.69 to –0.77, P=0.000 4) compared with the healthy group. In the severe OSAS group, SCP density in the perifovea (MD=–1.33, 95%CI –2.53 to –0.13, P=0.03) was significantly lower than that of the healthy group. SCP density in the whole area (MD=0.36, 95%CI 0.05 to 0.68, P=0.02) was significantly higher in the mild to moderate OSAS group compared with the severe OSAS group. In the deep capillary plexus (DCP) density, the OSAS group showed significantly lower densities in the whole area (MD=–2.16, 95%CI –3.51 to –0.81, P=0.002), fovea (MD=–2.38, 95%CI –4.38 to –0.37, P=0.02), and parafovea (MD=–2.33, 95%CI –3.93 to –0.73, P=0.004) compared with the healthy group. The mild to moderate OSAS group also showed significantly lower densities in the whole area (MD=–2.02, 95%CI –3.33 to –0.72, P=0.002) and parafovea (MD=–1.65, 95%CI –3.04 to –0.26, P=0.02) compared with the healthy group. The severe OSAS group had significantly lower DCP density in the whole area (MD=–2.26, 95%CI –3.85 to –0.66, P=0.006) and parafovea (MD=–1.47, 95%CI –2.31 to –0.62, P=0.000 7) compared with the healthy group. DCP density in the whole area (MD=0.54, 95%CI 0.02 to 1.07, P=0.04) was significantly higher in the mild to moderate OSAS group compared with the severe OSAS group. Regarding the retinal nerve fiber layer (RNFL) thickness, the inferior quadrant (MD=4.01, 95%CI 0.69 to 7.32, P=0.02) and temporal quadrant (MD=4.35, 95%CI 1.88 to 6.82, P=0.000 6) were significantly thicker in the mild to moderate OSAS group compared with the severe OSAS group. In terms of the foveal avascular zone (FAZ) area, the severe OSAS group showed a significantly larger FAZ area (MD=0.06, 95%CI 0.03 to 0.08, P<0.000 01) compared with the healthy group. Conclusion OCTA-related ocular biomarkers may be associated with the occurrence and progression of OSAS and have potential applications in the diagnosis and treatment of OSAS.
目的 探讨在Sprague-Dawley大鼠右心房注射缓激肽对呼吸的影响。 方法 7～9 d和21～23 d大鼠在迷走神经完整和迷走神经切断的情况下从右心房注射缓激肽，观察呼吸指标的变化。 结果 ① 右心房注射缓激肽后，7～9 d大鼠出现呼吸暂停，而在21～23 d大鼠仅出现呼吸抑制（P＜0.05）；② 切断迷走神经后，右心房注射缓激肽在两组大鼠均不再出现呼吸暂停。 结论 右心房注射缓激肽在7～9 d大鼠产生呼吸暂停，且依赖于迷走神经的完整性。
Objective To explore the correlation between the levels of serum nuclear factor-erythroid 2-related factor 2 (Nrf2) as well as heme oxygenase-1 (HO-1) and cognitive dysfunction by determining the levels of Nrf2 and HO-1 in patients with obstructive sleep apnea (OSA) to different degrees and combining Montreal cognitive assessment (MoCA). Methods Serum levels of Nrf2 and HO-1 were determined in 32 patients with mild-moderate OSA, 23 patients with severe OSA and 20 healthy controls. The differences of Nrf2 and HO-1 levels among groups were compared. All subjects were evaluated by MoCA score. According to MoCA score, OSA patients were divided into two groups: OSA with mild cognitive impairment (MCI) group and OSA with normal cognition group. Serum Nrf2 and HO-1 levels were compared between the two groups, and the differences in the OSA patients with or without cognitive impairment were understood. Spearman correlation coefficient was used to explore the correlation between serum Nrf2 and HO-1 levels and cognitive function of OSA patients. The diagnostic value of serum Nrf2 and HO-1 in the OSA patients with cognitive impairment was determined by receiver operating characteristic curve. Results Serum levels of Nrf2 and HO-1 in the mild-moderate and severe OSA groups were higher than those in the control group, and those in the severe OSA group were higher than those in the mild-moderate OSA group (P<0.05). Compared with the OSA with normal cognition group, the serum HO-1 level in the OSA patients with MCI was higher (P<0.05), but the serum NRF2 level had no significant difference between the two groups (P>0.05). There was a negative correlation between serum HO-1 level and total MoCA score in the OSA patients (r=–0.495, P=0.000), but there was no significant correlation between serum Nrf2 and total MoCA score in the OSA patients (P>0.05). Serum Nrf2 and HO-1 were 0.791 and 0.818 for predicting OSA patients with cognitive impairment. The sensitivity was 84.20% and 86.80%, and the specificity was 67.60% and 73.00%, respectively. Conclusions Serum Nrf-2 and serum HO-1 play important role in the pathogenesis of OSA. Serum HO-1 level may be closely related to cognitive dysfunction in OSA patients. Detection of serum HO-1 may be helpful in early identification of cognitive dysfunction in OSA patients, which has potential clinical application value.
Sleep apnea syndrome (SAS) is a kind of common and harmful systemic sleep disorder. SAS patients have significant iconography changes in brain structure and function, and electroencephalogram (EEG) is the most intuitive parameter to describe the sleep process which can reflect the electrical activity and function of brain tissues. Based on the non-stationary and nonlinear characteristics of EEG, this paper analyzes the correlation dimension of sleep EEG in patients with SAS. Six SAS patients were classed as SAS group and six healthy persons were classified into a control group. The results showed that the correlation dimension of sleep EEG in the SAS group and the control group decreased gradually with the deepening of sleep, and then increased to the level of awake and light sleep stage with rapid eye movement (REM). The correlation dimension of SAS group was significantly lower than that of control group (P<0.01) throughout all the stages. The results suggested that there were significant nonlinear dynamic differences between the EEG signals of SAS patients and of healthy people, which provided a new direction for the study of the physiological mechanism and automatic detection of SAS.
目的：探讨高血压合并阻塞性睡眠呼吸暂停综合征（OSAS）患者血浆5-羟色胺（5-HT）水平的变化。方法：应用放射免疫法测定45例高血压合并阻塞性睡眠呼吸暂停综合征患者血清5-HT浓度。结果：高血压合并阻塞性睡眠呼吸暂停综合症患者与单纯高血压不合并OSAS的患者相比，血压控制较差，而血浆5-HT水平明显增高（P＜0.05），轻、中、重度阻塞性睡眠呼吸暂停综合征患者血浆5-HT水平之间相比较有差异（P＜0.05）。结论：5-HT水平可能与血压控制和阻塞性睡眠呼吸暂停综合征的发病有关。