Efficacy and safety assessment of expiratory positive airway pressure (EPAP) mask for OSAHS therapy.

OBJECTIVE: We have designed the expiratory positive airway pressure (EPAP) mask to provide a new sort of therapeutic strategies for Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS). And this study aims to assess the safety, efficacy and compliance of the EPAP therapy. METHODS: 40 healthy volunteers were enrolled to measure the end-tidal carbon dioxide pressure (PETCO2) while being treated by EPAP mask. 40 symptomatic moderate or severe OSAHS patients (AHI≥15/h) recruited were equally divided into two groups randomly and treated with CPAP or mask for a week respectively. After a week of washing out, the patients were applied with exchanged therapeutic methods for another week. The PSG was performed at the end of each week of treatment with device-on. RESULTS: There were no significant differences of PETCO2 under different exhaled positive pressure level between CPAP, EPAP therapies and non-therapy for the healthy volunteers (P>0.05). After being treated, among the OSAHS patients in the two groups, the ESS scores and AHI decreased, and minimum SaO2 and mean SaO2 increased significantly (all P>0.05). There was no significant differences of the efficacy between EPAP and CPAP therapy. CONCLUSIONS: EPAP mask therapy was safe and reliable with significant efficacy for selected OSAHS patients. However, the compliance needs further improvement.

Use of polarized light microscopy is essential in the efficient diagnosis of respiratory amyloidosis and could decrease disease prevalence.

INTRODUCTION: Primary tracheobronchial amyloidosis (TBA) is a rare disease of unknown etiology, with a high misdiagnosis rate. The current gold standard diagnostic criteria require double-positive results for Congo red staining and polarized light microscopy examination. OBJECTIVES: The aim of the present report was to examine the diagnostic value of polarized light microscopy in TBA diagnosis in China. METHODS: Thirteen cases from the Shandong University Qilu Hospital were reviewed. Polarized light microscopic examination was conducted after searching for cases with positive Congo red staining. RESULTS: Among the 13 patients, eight displayed yellow-green birefringence body with polarized light microscopic examination. This result indicated a false-positive rate of 38.5% with Congo red staining used as the single criteria for TBA diagnosis. After reviewing the Chinese literature and selecting 104 reported cases of TBA in China, we found that diagnosis with the gold standard was confirmed in <30% patients, which may lead to misdiagnosis and delayed treatment. CONCLUSION: The universal use of polarized light microscopy in China is currently limited, and there is a big gap from the international diagnosis standards. There is a need to include polarized light microscopy in routine TBA diagnosis to reduce the misdiagnosis rate, and achieve optimal treatment.

A GIS-based spatial correlation analysis for ambient air pollution and AECOPD hospitalizations in Jinan, China.

BACKGROUND: Acute exacerbations of COPD (AECOPD) are important events during disease procedure. AECOPD have negative effect on patients' quality of life, symptoms and lung function, and result in high socioeconomic costs. Though previous studies have demonstrated the significant association between outdoor air pollution and AECOPD hospitalizations, little is known about the spatial relationship utilized a spatial analyzing technique- Geographical Information System (GIS). OBJECTIVE: Using GIS to investigate the spatial association between ambient air pollution and AECOPD hospitalizations in Jinan City, 2009. METHODS: 414 AECOPD hospitalization cases in Jinan, 2009 were enrolled in our analysis. Monthly concentrations of five monitored air pollutants (NO2, SO2, PM10, O3, CO) during January 2009-December 2009 were provided by Environmental Protection Agency of Shandong Province. Each individual was geocoded in ArcGIS10.0 software. The spatial distribution of five pollutants and the temporal-spatial specific air pollutants exposure level for each individual was estimated by ordinary Kriging model. Spatial autocorrelation (Global Moran's I) was employed to explore the spatial association between ambient air pollutants and AECOPD hospitalizations. A generalized linear model (GLM) using a Poisson distribution with log-link function was used to construct a core model. RESULTS: At residence, concentrations of SO2, PM10, NO2, CO, O3 and AECOPD hospitalization cases showed statistical significant spatially clustered. The Z-score of SO2, PM10, CO, O3, NO2 at residence is 15.88, 13.93, 12.60, 4.02, 2.44 respectively, while at workplace, concentrations of PM10, SO2, O3, CO and AECOPD hospitalization cases showed statistical significant spatially clustered. The Z-score of PM10, SO2, O3, CO at workplace is 11.39, 8.07, 6.10, and 5.08 respectively. After adjusting for potential confounders in the model, only the PM10 concentrations at workplace showed statistical significance, with a 10 µg/m(3) increase of PM10 at workplace associated with a 7% (95%CI: [3.3%, 10%]) increase of hospitalizations due to AECOPD. CONCLUSIONS: Ambient air pollution is correlated with AECOPD hospitalizations spatially. A 10 µg/m(3) increase of PM10 at workplace was associated with a 7% (95%CI: [3.3%, 10%]) increase of hospitalizations due to AECOPD in Jinan, 2009. As a spatial data processing tool, GIS has novel and great potential on air pollutants exposure assessment and spatial analysis in AECOPD research.

Primary Sjögren's syndrome accompanied by pleural effusion: a case report and literature review.

Sjögren's syndrome (SS) is a systemic autoimmune disease characterized by the infiltration of lymphocytes in exocrine glands, specifically the salivary and lacrimal glands, resulting in the typical symptoms of xerophthalmia and xerostomia. SS may be accompanied by pleural effusion when the lung is involved, but this occurrence has been reported in only 10 cases in the literature. We report the case of a 42 year-old woman with severe bilateral pleural effusion for eight years. Primary Sjögren's Syndrome was finally diagnosed based on the presence of xerophthalmia and xerostomia, biopsy of the minor salivary glands, and positive anti-SS-A antibody in the serum and pleural effusion. Biopsy of the parietal pleura through video-assisted thoracoscopy revealed infiltration of lymphocytes. The patient had a long history of pleural effusion without clear etiology. Malignant disease was first suspected because of abnormal density lesion on the left lung and malignant cells found on cytology, but PET-CT revealed no malignant lesion. Examinations did not support infection, malignant tumor, pulmonary sarcoidosis, or other connective tissue diseases. This data could be useful for the future study of pleural effusion in SS.

People with older age and lower FEV1%pred tend to have a smaller FVC than VC in pre-bronchodilator spirometry.

We enrolled 1772 subjects who underwent pulmonary function test before preoperative examination in our study. Pre-bronchodilator forced expiratory volume in one second (FEV1), vital capacity (VC) and forced vital capacity (FVC) were measured as primary data. According to the numerical relationship between VCmax and FVC, two groups were divided: VCmax>FVC and VCmax=FVC. Age, gender, height, weight, BMI and FEV1/FVC, FEV1%pred, FEV1/VCmax were compared between the two groups. Using multivariate logistic regression, factors related to classification of VCmax=FVC or VCmax>FVC were estimated. Of the 1772 spirometric results analyzed, 614 (34.65%) with VCmax=FVC and 1158 (65.35%) with VCmax>FVC were identified. Compared to VCmax=FVC group, subjects in VCmax>FVC group have older age (95%CI [1.50, 3.99], P<0.001), lower FEV1%pred (95%CI [-12.22, -8.07], P<0.001) and lower FEV1/VCmax (95%CI [-0.07, -0.05], P<0.001), parameters such as height, weight, BMI, FEV1/FVC showed no statistical significance. We made a conclusion that people with older age and lower FEV1%pred tend to have a smaller FVC than VC in pre-bronchdilator spirometry.

Isolation and characterization of two YUCCA flavin monooxygenase genes from cultivated strawberry (Fragaria × ananassa Duch.).

UNLABELLED: In strawberry (Fragaria × ananassa Duch.), auxin has been recognized as the main signal molecule coordinating the growth and initiation of ripening of fruits. The molecular mechanism regulating auxin biosynthesis in strawberry remains unknown. This project reports two YUCCA flavin monooxygenase genes FaYUC1-2 isolated from cultivated strawberry. FaYUC1 and FaYUC2 are most homologous to AtYUC6 and AtYUC4, respectively. Significant expression of FaYUC1-2 is found in vegetative meristems and reproductive organs, with overlapping but distinct patterns. During fruit development, both transcripts of FaYUC1 and FaYUC2 in achenes reach a peak around large green fruit (G2) stage, but the sudden rise in FaYUC2 transcript level is much steeper and begins earlier than that in FaYUC1. FaYUC2 is also obviously expressed in the receptacles from green fruits, hinting another auxin source for receptacle development, other than achenes. FaYUC1 over-expression Arabidopsis exhibits typical auxin hyper-accumulation phenotype in many aspects, such as the narrow and downward curled leaves, strong apical dominance, short and hairy root. It is also severely sterile, due to the disruption of floral meristems initiation and floral organs development. Transgenic analysis indicates that strawberry YUC gene may hold conserved role in auxin biosynthesis like their homologs in other plants. Integrated with the spatiotemporal expression features, these results led us to propose that FaYUC1-2 may involve in many developmental processes including flower and fruit development in strawberry. KEY MESSAGE: This paper is the first report of isolation and characterization of strawberry auxin biosynthesis genes. And their conserved functions in auxin biosynthesis were confirmed after ectopic expression.