[Study on the application value of portable pulse oximeter in adult patients with obstructive sleep apnea].

Objective: To evaluate the application value of portable pulse oximeter in adult obstructive sleep apnea (OSA). Methods: This study prospectively enrolled adult patients who underwent polysomnography (PSG) due to snoring at the Respiratory and Sleep Medicine Department of Peking University People's Hospital from July 2022 to July 2023. During PSG monitoring, CS-WOxi was continuously used to monitor blood oxygen levels. The consistency between 3% oxygen desaturation index (ODI3) measured by portable pulse oximeter and ODI3 of polysomnography was evaluated using difference test, Pearson's correlation coefficient, and Bland-altman method. Receiver operating characteristic curve was used to determine the optimal threshold for diagnosing OSA. Results: A total of 184 subjects were included, including 121 males (65.8%) and 63 females (34.2%). The mean age was 46.0 (34.3, 59.0) years, body mass index was 26.0 (23.3, 29.6) kg/m², and the apnea-hypopnea index was 18.2 (5.8, 40.8) events/h. There was a significant difference between CS-ODI3 and PSG-ODI3 [17.1(6.2, 42.7) vs. 14.0(2.9, 32.6), P<0.001], and the Pearson correlation coefficient was 0.93 (P<0.001). There was a good correlation between CS-ODI3 and PSG-AHI (r=0.92, P<0.001). Bland-Altman consistency test showed that the average difference between the two was 0.7 events/h, and the 95% consistency limit was (-17.9, 19.3 events/h). When the CS-ODI3≥5 events/h was used to identify OSA, the sensitivity was 94.4%, the specificity was 80.0%, and the accuracy was 91.3%. When PSG-AHI≥5 events/h was used as the diagnostic criteria, the area under the receiver operating characteristic curve was 0.933. Conclusion: Portable pulse oximeter can monitor pulse oxygen saturation accurately and has good sensitivity and specificity for OSA high-risk patients, and is a reliable tool for OSA screening.

[Effect of traditional Chinese medicine treatment as maintenance therapy on regulating the serum concentration of sCTLA-4 in patients with advanced non-small-cell lung cancer and its relationship with prognosis].

Objective: To evaluate the effect of traditional Chinese medicine (TCM) treatment as maintenance therapy on regulating the serum concentration of soluble cytotoxic T lymphocyte associated antigen-4 (sCTLA-4) in patients with advanced non-small-cell lung cancer (NSCLC) and the relationship between sCTLA-4 and time to progression (TTP). Methods: This study was conducted as a prospective, randomized, controlled trial. 64 non-progressive patients who responded to initial therapy were randomized 1∶1 to the TCM arm (treated with cinobufacini injection, herbal decoction and Chinese acupoint application, n=32) or to the chemotherapy arm (n=32). Each cycle was 21 days. Cycles were repeated until disease progression, unacceptable toxicity, or until the patient requested therapy discontinuation.The serum concentration of sCTLA-4 was detected by enzyme linked immunosorbent assay (ELISA) in the 64 patients with advanced NSCLC before and after two cycles of maintenance treatment. Cox regression was used to analyze the relative ratio for the risk of disease progression. Results: After 2 cycles of maintenance TCM treatment, the serum concentration of sCTLA-4 in patients with advanced NSCLC was (12.77±2.37 pg/ml), significantly lower than that before treatment (40.30±10.75)(P=0.013). After 2 cycles of maintenance chemotherapy, the serum concentration of sCTLA-4 was higher than that before treatment, but was not significantly different (44.48±10.12 vs. 46.64±11.21 pg/ml, P=0.612). After 2 cycles of maintenance treatment, TCM treatment can significantly bring down the serum concentration of sCTLA-4 compared to chemotherapy (12.77±2.37 vs. 46.64±11.21 pg/ml, P=0.004). The multivariate analysis indicated that sCTLA-4 levels and treatment regimen were independent prognostic factors for TTP (P<0.05 for both). Conclusions: Regulating the serum concentration of sCTLA-4 may be one of the mechanisms of TCM maintenance treatment of NSCLC. Trial registration Chinese Clinical Trial Register, ChiCTR-TRC-10001017.

Intramucosal carcinomas of the stomach: phenotypic expression and loss of heterozygosity at microsatellites linked to the APC gene.

Evaluation of the role of somatic genetic alterations in cancer development is best performed by examining small tumors in the earlier stages of carcinogenesis. We examined the relationship between allelic deletions of 4 microsatellites linked to the adenomatous polyposis coli (APC) gene and differential histogenetical phenotypes in 34 intramucosal carcinomas of the stomach, of which, structurally, 24 cases were the gland-forming type (so-called "intestinal type") and 10 were the diffuse type. Using mucin and immunohistochemical staining techniques specific for gastric- and intestinal-type mucins, the phenotype of each tumor was histogenetically classified as exclusively gastric, predominantly gastric, predominantly intestinal or exclusively intestinal. There was generally a free combination between structural types and phenotypic mucin expression. Allelic deletions were detected in 6 carcinomas of the exclusively intestinal phenotype. The incidence of allelic deletions was significantly higher in the predominantly and exclusively intestinal phenotypes (6/16, 37.5%) than in the predominantly and exclusively gastric phenotypes (0/18) (p = 0.0060, Fisher's test). Taking the high frequency of allelic deletions in 5q in invasive stomach carcinomas, the present study suggests that genetic alteration in this region is a very early event in stomach carcinomas with intestinal differentiation but a relatively late event in those with gastric differentiation.

[Bronchopulmonary infection due to Branhamella catarrhalis in patients with obstructive lung disease].

During the period from February 1988 to April 1990, 214 sputum samples from COPD patients with bronchopulmonary infection were quantitatively cultured. 17 strains were identified as Branhamella catarrhalis, being present in 7.9% of all sputum cultures and 11.0% of those positive for a pathogen (Quantity = 10(10)/L of Isolated Organism). Half of B. catarrhalis infection was isolated in mixed with other pathogens. Haemophilus influenza was the most frequently associated pathogen. The second was H. influenza plus Streptococcus pneumoniae. Of 17 B. catarrhalis, 2 strains were positive for beta-lactamase. The incidence of B. catarrhalis infection varied with the seasons, being prevalent in late winter and early spring. Many factors contributed to the pathogenicity of B. catarrhalis, such as the rapid increase of positive beta-lactamase strains and the change of seasons. The result showed that B. catarrhalis was the fourth frequent pathogen in COPD patients accompanied with bronchopulmonary infection. Most of the strains were resistant to penicillin, and beta-lactamase strains were discovered. Therefore, B. catarrhalis should be as a potential pathogen to be identified in sputum. A suitable method was recommended to identified B. catarrhalis.

The JAK2/STAT3 and mitochondrial pathways are essential for quercetin nanoliposome-induced C6 glioma cell death.

The formulation of quercetin nanoliposomes (QUE-NLs) has been shown to enhance QUE antitumor activity in C6 glioma cells. At high concentrations, QUE-NLs induce necrotic cell death. In this study, we probed the molecular mechanisms of QUE-NL-induced C6 glioma cell death and examined whether QUE-NL-induced programmed cell death involved Bcl-2 family and mitochondrial pathway through STAT3 signal transduction pathway. Downregulation of Bcl-2 and the overexpression of Bax by QUE-NL supported the involvement of Bcl-2 family proteins upstream of C6 glioma cell death. In addition, the activation of JAK2 and STAT3 were altered following exposure to QUE-NLs in C6 glioma cells, suggesting that QUE-NLs downregulated Bcl-2 mRNAs expression and enhanced the expression of mitochondrial mRNAs through STAT3-mediated signaling pathways either via direct or indirect mechanisms. There are several components such as ROS, mitochondrial, and Bcl-2 family shared by the necrotic and apoptotic pathways. Our studies indicate that the signaling cross point of the mitochondrial pathway and the JAK2/STAT3 signaling pathway in C6 glioma cell death is modulated by QUE-NLs. In conclusion, regulation of JAK2/STAT3 and ROS-mediated mitochondrial pathway agonists alone or in combination with treatment by QUE-NLs could be a more effective method of treating chemical-resistant glioma.

Three-dimensional contrast-enhanced magnetic resonance angiography at 3.0T scanner: significance in the classification of peripheral arterial occlusive disease.

AIM: Aim of this study was to evaluate the clinical efficacy of three-dimensional contrast-enhanced magnetic resonance angiography (3D CE-MRA); at 3.0T scanner in the classification of peripheral arterial occlusive disease (PAOD). METHODS: Thirty-five patients diagnosed of PAOD underwent 3D CE-MRA, 30 cases underwent digital subtracted angiography (DSA) successfully, and 12 cases underwent surgery. RESULTS: The vascular tree from the distal aorta to the lower limbs was well demonstrated. The extent and grade of disease seen in 3D CE-MRA closely matched those seen in DSA and/or surgery. Compared to the results of DSA and/or surgery, the common coincidence of 3D CE-MRA in diagnosing PAOD was 96.89% (780/805), the coincidence in diagnosing mild, moderate, severe stenosis and occlusion was 90.48% (76/84), 87.14% (61/70), 95.77% (68/71), and 98.29% (115/117) respectively, the rate of overestimate in mild, moderate, and severe stenosis was 5.95% (5/84), 10% (7/70), and 2.82% (2/71) respectively, the rate of underestimate in mild, moderate, severe stenosis and occlusion was 3.57% (3/84), 2.86% (2/70), 1.41% (1/71) and 1.74% (2/115) respectively. CONCLUSION: 3D CE-MRA at 3.0T scanner is of great value in the accurate assessment of the classification of PAOD; it is a reliable and promising new technique.

Hydrodynamic conditions in designed spiral photobioreactors.

In this work, a series of spiral tube PBRs were introduced. Flow dynamics of microalgae fluid, light intensity histories of tracked cells and swirl numbers within the spiral PBRs were numerically simulated. Results show that strong swirl motions are formed in the cross-sections along axial coordinate of spiral PBRs, but no such vortice is observed for tubular PBR. The light intensity histories identify that the microalgae cells experience the so-called light/dark cycle, which is necessary to their growth. With high swirl numbers ranging from 0.15 to 0.35, the mixing performances of the spiral tube PBRs are much better than that of tubular PBR, indicating such innovative geometries of spiral tube PBRs may be applicable for large scale commercial cultivation of microalgae in the future.