Objective To investigate the changes of renal medulla aquaporin 2 expression and morphological changes of epithelia of collecting tube after bile duct recanalizaiton operation. Methods Thirty rats were divided into two groups randomly. Common bile duct ligation was performed on 20 experimental rats with silicon tubes 2 mm in extre-diameter, and sham operation on the other 10 rats. Seven days later, bile duct recanalizaiton was performed on obstructive jaundice group and sham operation on contrast group. Experimental rats were divided into two subgroups randomly. Half of them were killed immediately and the others would be killed 24 hours later. Serum of each rat was collected to detect hepatic function and renal function. Renal medulla was fixed for microscopic examination and was kept in the -80 ℃ refrigerator for aquaporin 2 expression measurement by Western blot technique. Results All of the animals accomplished the experiment smoothly. Golden ascites were found in the rats of obstructive jaundice group. Twenty-four hours after recanalization, serum bilirubin levels decreased 〔(45.95±8.39) μmol/L〕, P＜0.01, and there was no significant change in blood urine and creatine level. Compared with sham operation group (21 966.20±1 544.70), expression of aquaporin 2 decreased significantly after common bile duct ligation in obstructive jaundice group (15 665.30±1 181.85), P＜0.01. After recanalizaion, the expression of aquaporin 2 in obstructive jaundice group increased (19 490.80±4 239.32), P＜0.01. Conclusion Common bile duct obstruction would lead to epithelium injury of renal collecting tube, and down regulate the aquaporin 2 expression.
【Abstract】Objective To study the expression of serum soluble interleukin-2 receptor (sIL-2R) level in perioperative period of patients with obstructive jaundice and its clinical significance. Methods Serum sIL-2R was measured during perioperative period in 30 patients with obstructive jaundice by using a sandwich enzyme linked immunosorbent assay (ELISA). Results The preoperative serum sIL-2R level in patients with obstructive jaundice was increased obviously. The expression of serum sIL-2R level in them was correlated with the degree and duration of obstructive jaundice and nutritional status respectively (r=0.734, P＜0.01; r=0.646, P＜0.01; r=0.594, P＜0.05). The serum sIL-2R in the patients with malignant obstructive jaundice was significantly higher than that with benign obstructive jaundice (P＜0.05). Among the patients with malignant obstructive jaundice, the serum sIL-2R level in the patients with metastasis was higher than in those without metastasis (P＜0.05). The immunologic function underwent a process from temporary suppression to gradual recovery during perioperative period. On the 21th day after operation the sIL-2R was recovered to normal level in patients with benign obstructive jaundice while it only recovered to preoperative level in patients with malignant obstructive. Conclusion Depressed immunity is observed in patients with obstructive jaundice. The abnormal expression of sIL-2R is related to the type, degree and duration of obstructive jaundice and the nutritional status and metastasis. The result that preoperative sIL-2R might be used to evaluate the state of immunity, clinical condition, and treatment and prognosis of patients with obstructive jaundice.
Objective To investigate the effects of cimetidine on the red cell immune function and interleukin-2(IL-2) in rats with obstructive jaundice. Methods Sixty SD rats were divided into bile duct ligation(BDL) group, cimetidine therapy (BDLC) group and sham operation(SO) group respectively. The red cell immue function and serum IL-2 level were determined with the red cell yeast-rosttes test and radioimmunoassay respectively. Results The red blood cell C3b receptor rosette rate(RBC-C3bRR), the red blood cell immune complex rosette rate(RICR), the red blood cell C3b receptor rosette-forming excited rate(RFER) and serum IL-2 level were significantly lower in BDL group as compared with SO group, the red blood cell C3b receptor rosette-forming inhibitory rate(RFIR) in BDL group was higher than that of SO group. After 7 days’ cimetidine therapy RBCC3bRR, RICR, RFER and IL-2 became higher than those of BDL group, but RFIR was lower than that of BDL group. Conclusion Supplemental cimetidine can significantly enhance the impaired red cell immune function and IL-2 production in rats with obstructive jaundice.
Aippuric acid test(HAT) and hepatic energy metabolism and mitochondrial oxidative phosphorylation activity in rabbit with acute obstractive jaunidce was studied.The result showed that the HAT values were decreased from 98.4±32.0mg/h to 32.7±17.6mg/h(Plt;0.001),energy charge(EC) decreased from 0.81±0.01 to 0.72±0.02(Plt;0.001),and phosphorylation rate(PR)decreased from 62.1V5.1 to 38.3V2.4(Plt;0.001).Correlation coefficients between HAT and EC was 0.786,(Plt;0.001).This result suggests that HAT can be used as an indicator of hepatic energy metabolism status in acute obstructive jaundice.
In order to guide diagnosis and treatment in children with sleep disordered breathing aged 1 to 23 months, the European Respiratory Society(ERS) summarized the evidence and released the European Respiratory Society statement based on clinical experience in 2016. This article aims to interpret the ERS statement. Children with apparent upper airway obstruction during wakefulness and those with SDB symptoms and complex conditions requires treatment. Adenotonsillectomy and continuous positive airway pressure are the most frequently used treatment measures along with interventions targeting specific conditions. Obstructive SDB in children aged 1 to 23 months is a multifactorial disorder that requires objective assessment and treatment of all underlying abnormalities.
Objective To investigate the protective effect of melatonin on rat liver injury induced by bile duct ligation. Methods Sixty-four rats were randomly divided into four groups：control group （CN group， n=16）， shamoperation group （SO group， n=16）， bile duct ligation group （BDL group， n=16）， and bile duct ligation with melatonin injection （BDL＋MT group， n=16）. The model of obstructive jaundice was done by ligation of the common bile duct. Melatonin was injected daily （0.5 mg/kg） via peritoneal cavity from 1 d before the operation to 7 d following oper-ation. On day 4 and 8 after the ligation， the plasma levels of total bilirubin （TBIL）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， gamma glutamyl transferase （GGT）， and alkaline phosphatase （AKP） were measured by routine methods. Malonaldehyde （MDA）， superoxide dismutase （SOD）， glutathione （GSH）， catalase （CAT）， and glutathione peroxidase （GSH-Px） in the liver tissue were determined by spectrophtometry， too. Hepatocytes apoptosis was analyzed by terminal deoxynucleotidyl transferase-mediated deoxynuridine triphosphate nick-end labeling （TUNEL） assay. Results Compared with the CN group and SO group， the levels of TBIL， ALT， AST， GGT， and AKP in the plasma， the content of MDA in the liver tissue， and the apoptosis index （AI） in the hepatocyte markedly increased （P＜0.05， P＜0.01）， the content of GSH and the activities of SOD， CAT， and GSH-Px in the liver tissue markedly decreased（P＜0.01） in the BDL group. Compared with the BDL group， the levels of TBIL， ALT， AST， GGT， and AKP in the plasma， the content of MDA in the liver tissue， and the AI in the hepatocyte markedly decreased （P＜0.01）， the content of GSH and the activities of SOD， CAT， and GSH-Px in the liver tissue markedly increased （P＜0.01） in the BDL＋MT group. In the BDL group， the level of MDA in the liver tissue and the levels of TBIL， ALT， AST， GGT， and AKP were positively correlated （P＜0.01）， the content of GSH and the activities of SOD， CAT， and GSH-Px in the liver tissue and TBIL， ALT， AST， GGT， and AKP were negatively correlated （P＜0.01）. The level of MDA in the liver tissue and AI in the hepatocyte was positively correlated （P＜0.01）. The content of GSH and the activities of SOD， CAT， and GSH-Px in the liver tissue and AI were negatively correlated （P＜0.01）. Conclusions The participation of free radical of oxygen in the pathogenesis and severity of cholestasis produced by the acute obstruction of the extra-hepatic biliary duct is likely. The result of the present study indicates that melatonin exerts a protective effect on cholestatic liver injury in rats with BDL. The mechanism of melatonin’s protection on hepatocyte may be through its antioxidant action and by inhibiting hepatocyte apoptosis.
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 effect of continuous positive airway pressure (CPAP) on sleep disorder and neuropsychological characteristics in patients with early Alzheimer’s disease (AD) combined with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of forty-two early AD patients with OSAHS were randomly divided into a CPAP combined treatment group (20 cases) and a simple medicine treatment group (22 cases). The changes of neurocognitive function were assessed by Montreal Cognitive Assessment (MoCA), Mini-mental State Examination (MMSE) and Hopkins Verbal Learning Test-revised (HVLT). Patient Health Questionnaire-9 (PHQ9) was used to evaluate the depression mood changes. The sleep characteristics and respiratory parameters were evaluated by polysomnography. The changes of the patients’ sleep status were assessed by Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). The changes of sleep status, cognitive function and mood in the CPAP combined treatment group were compared before and three months after CPAP treatment, and with the simple medicine treatment group. Results After three months of CPAP treatment, the ESS, PSQI and PHQ9 scores in the CPAP combined treatment group were significantly decreased compared with those before treatment, whereas MoCA, MMSE and HVLT (total scores and recall ) in the CPAP combined treatment group were increased compared with those before treatment (P<0.05). After CPAP treatment, the respiratory parameters apnea hypopnea index in the CPAP combined treatment group was significantly lower than that before treatment (P<0.05), and the minimum blood oxygen saturation was significantly higher than that before treatment (P<0.05). However, the sleep characteristics and parameters did not show statistically significant changes compared with those before treatment (P>0.05). The ESS, PSQI and PHQ9 scores were significantly reduced in the CPAP combined treatment group compared with the simple medicine treatment group (P<0.05), while there was no statistically significant changes of cognitive scores between the two groups (P>0.05). Conclusions The degree of low ventilation and hypoxia is alleviated, and the daytime sleepiness and depression is improved in early AD patients with OSAHS after three-month continuous CPAP treatment. Cognitive function is significantly improved, whereas there is no significant change in sleep structure disorder.
ObjectiveTo systematically review whether or not obstructive sleep apnea hypopnea syndrome (OSAHS) increases the incidence of atrial fibrillation in coronary artery disease patients.MethodsPubMed, EMbase, The Cochrane Library, SinoMed, CNKI, VIP and WanFang Data databases were searched for studies on the relationship between OSAHS and the incidence of atrial fibrillation in coronary artery disease patients from inception to July 2nd, 2018. Two reviewers independently screened literatures, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software.ResultsIn total, 11 cohort studies were included, involving 709 in exposed group and 975 in non-exposed group. The results of meta-analysis indicated that OSAHS was associated with the incidence of atrial fibrillation in coronary artery disease patients (RR=2.01, 95%CI 1.72 to 2.36, P<0.000 01). The subgroup analysis showed that OSAHS of PSG diagnosis increased the risk of the incidence of atrial fibrillation in coronary artery disease patients (RR=2.40, 95%CI 1.84 to 3.12, P<0.000 01); moderate and severe OSAHS of PSG diagnosis had higher risk of the incidence of atrial fibrillation in coronary artery disease patients (RR=3.73, 95%CI 2.51 to 5.53, P<0.000 01); high risk OSAHS of Berlin questionnaire assessment increased the incidence of atrial fibrillation in CAD patients (RR=1.56, 95%CI 1.27 to 1.92, P<0.000 1).ConclusionThe current evidence indicates that OSAHS is associated with an increased risk of atrial fibrillation in coronary artery disease patients. Due to the limitation of quality and quantity of the included studies, more large-scale and fine quality research are needed to warrant the accuracy of conclusion above.
Objective To investigate the effect of angiopoietin-like protein 3 (ANGPTL3) on lipid metabolism in patients with obstructive sleep apnea (OSA). Methods A total of 59 OSA patients and 20 healthy controls from the First Affiliated Hospital of Zhengzhou University between May 2023 and February 2024 were included in the study. All participants underwent overnight polysomnography (PSG). Based on the apnea-hypopnea index (AHI), the OSA patients were divided into a mild group and a moderate-to-severe group. Morning blood samples were collected after an 8-hour fast to measure lipid profiles and ANGPTL3 levels. Statistical analyses were performed using SPSS 25.0 software. Results The levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and ANGPTL3 were significantly higher, while high-density lipoprotein cholesterol (HDL-C) was significantly lower in the OSA group compared with the control group (P<0.05). ANGPTL3 level was higher in the moderate-to-severe OSA group than that in the mild OSA group and the control group, and higher in the mild OSA group than that in the control group (P<0.05). In the severe hypoxemia group, ANGPTL3 level was significantly higher than that in the mild-to-moderate hypoxemia group (P<0.05). The ANGPTL3 level was also significantly higher in the hyperlipidemia group compared wiht the non-hyperlipidemia group (P<0.05). In the OSA group, ANGPTL3 was positively correlated with TC, TG, percentage of cumulative time with oxygen saturation below 90% in total sleep time (T90) and oxygen desaturation index (ODI), and negatively correlated with lowest arterial oxygen saturation (LSaO2) and mean arterial oxygen saturation (MSaO2). After adjusting for relevant confounding factors, logistic regression analysis indicated that ANGPTL3 might be a potential independent risk factor for OSA, with an odds ratio of 1.021 (95%CI 1.002 - 1.040). Conclusions The level of ANGPTL3 is elevated in OSA patients. The elevation of blood lipid levels in OSA patients may be associated with chronic intermittent hypoxia-induced regulation of ANGPTL3 levels.