Correction: Knowledge and Practices Regarding Human Papillomavirus and Cervical Cancer Screening Among Women in Low-Income Areas of China: A Cross-Sectional Study.

[This corrects the article DOI: 10.7759/cureus.55930.].

Knowledge and Practices Regarding Human Papillomavirus and Cervical Cancer Screening Among Women in Low-Income Areas of China: A Cross-Sectional Study.

BACKGROUND: Persistent human papillomavirus (HPV) infection is the primary cause of cervical cancer. However, this can be prevented through vaccination and screening. This study aimed to clarify the relationship between behavior, knowledge, and attitude toward cervical cancer and regular screening and HPV infection among women in Lueyang County. METHODS: Women who underwent cervical cancer screening at the outpatient department of a maternal and child health center between September and December 2021 were invited to participate. In total, 2,303 women completed the questionnaire. Women who underwent regular or irregular screening were 1:1 matched for age. Differences in knowledge of HPV and attitudes toward HPV vaccination among different populations were assessed. Logistic regression analysis was performed to identify the factors influencing HPV infection. RESULTS:  In total, 417 pairs of women who underwent regular and irregular screening were successfully matched. Multivariate logistic regression results indicated that age is a risk factor for HPV infection (OR=1.056 95%CI: [1.031 1.082]), while regular screening acts as a protective factor against HPV infection (OR=0.174 95%CI: [0.117 0.259]). Additionally, regular screening was associated with a higher level of knowledge about HPV among women compared to those who did not undergo regular screening (p<0.001). CONCLUSIONS:  Women in Lueyang County have low levels of knowledge regarding HPV and cervical cancer. Regular screening is a protective factor against HPV infection. The regular screening group demonstrates a higher level of HPV knowledge compared with the irregular screening group. These findings highlight the importance of regular screening and the need to strengthen public health education.

Recall Bias in the Assessment of Cough for Patients Discharged from Lung Surgery.

Purpose: This study aimed to evaluate the presence of recall bias when patients retrospectively report cough scores. Patients and Methods: Patients who underwent lung surgery between July 2021 and November 2021 were recruited for this study. We retrospectively assessed the severity of cough within the past 24 hours and the past 7 days using a 0-10 numerical rating scale. Recall bias was defined as the difference between the scores reported on the two assessments. Patients were grouped based on the longitudinal change in cough scores from pre-operation to 4 weeks after discharge using group-based trajectory models. Using generalized estimating equation to explore the factors influencing recall bias. Results: Overall, 199 patients were analyzed and demonstrated the three distinct trajectories of post-discharge cough: high (21.1%), medium (58.3%), and low (20.6%). Significant recall bias was found in week 2 for the high-trajectory patients (6.26 vs 5.10, P<0.01) and in week 3 for the medium-trajectory patients (2.88 vs 2.60, P=0.01). Among all recall bias, 41.8% were of underestimation, and 21.7% of overestimation. The high trajectory group (ß=1.14, P<0.01) and measurement interval (ß=0.36, P<0.01) were risk factors for underestimation, while post-discharge time (ß=-0.57, P<0.01) and measurement interval (ß=-0.13, P=0.02) were protective factors for overestimation. Conclusion: Retrospective assessment of post-discharge cough in patients who underwent lung surgery will introduce recall bias, with a tendency of underestimation. The high-trajectory group, interval time and post-discharge time are influencing factors of recall bias. For patients with severe cough at discharge, a shorter recall periods should be employed for monitoring, due to the large bias that results from a longer recall period.

Development of a Patient-Reported Symptom Item Bank for Patients with Hepatobiliary or Pancreatic Malignancies: A Systematic Review.

Background: Patients with hepatobiliary or pancreatic cancers often experience severe symptoms, resulting in a sharp decline in functioning, poor quality of life, and increased mortality risk. Early and effective management of symptoms allows a better quality of life and reduced mortality, depending on the selection of appropriate assessment of specific symptoms for a defined purpose. We aimed to develop a symptom measurement item bank for hepatobiliary or pancreatic cancers. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was applied to organize this systematic review. The articles validated patient-reported outcome measures (PROMs) for hepatobiliary or pancreatic cancer and published before December 2021 were retrieved from the Web of Science, PubMed, Embase databases and Cochrane Library. Items from the existing PROMs were selected and classified into different patient-reported symptoms based on the concepts and specific underlying constructs of the objects measured. Results: Sixteen unique PROMs were identified across the 29 eligible studies included in our analysis. Items from the literature review (14 PROMs with 421 items for which information was obtained) were selected and classified. As a result of this study, we developed a symptom item bank with 40 patient-reported symptoms and 229 assessment items for hepatobiliary or pancreatic cancer, and fatigue, pain and nausea were the most common symptom items. Conclusion: We developed an item bank to assess the patient-reported symptoms of hepatobiliary or pancreatic cancer. This item bank could allow researchers to select appropriate measures of symptom and provide a basis for the development of a single-item symptom-measurement system.

Efficacy of Velopharyngeal Surgery for Positional Obstructive Sleep Apnea Hypopnea Syndrome.

BACKGROUND: Positional obstructive sleep apnea hypopnea syndrome (P-OSAHS) is a distinct OSAHS type. Whether velopharyngeal surgery is efficacious for patients with P-OSAHS remains unclear. AIM/OBJECTIVE: To investigate the efficacy and factors influencing velopharyngeal surgery for treatment of patients with P-OSAHS, defined as the apnea hypopnea index (AHI) in different body postures (supine AHI ≥2*nonsupine AHI). MATERIALS AND METHODS: A total of 44 patients with P-OSAHS who underwent velopharyngeal surgery were retrospectively studied. The clinical data of these patients, including polysomnography (PSG), physical examination, and surgical information, were collected for analysis. All patients underwent a PSG about 6 months after surgery to determine the treatment outcomes. RESULTS: The overall AHI of the 44 patients decreased from 40.2 ± 18.7 events/h to 18.5 ± 17.5 events/h after surgery (P < .001). There were 29 responders (65.9%) according to the classical definition of surgical success. The percentage of sleep time with oxygen saturation below 90% (CT90) was the only predictive parameter for surgical success (P = .014, odds ratio value = 0.894). There was no significant difference between the change in supine AHI (-55.9 ± 35.2%) and the change in nonsupine AHI (-43.4 ± 74.1%; P = .167), and these 2 parameters were significantly correlated (r = 0.616, P < .001). Among the 38 patients with residual OSAHS (residual AHI ≥5), 28 had persistent P-OSAHS, and the percentage was as high as 82.4%. CONCLUSIONS AND SIGNIFICANCE: Patients with P-OSAHS with a lower CT90 value are more likely to benefit from velopharyngeal surgery. Positional therapy could be indicated for most of the patients who are not cured by such surgery.

[Analysis of genetic and environmental risk factors in pediatric OSA].

Objective:To investigate the genetic and family environmental risk factors of obstructive sleep apnea（OSA） in children with habitual snoring. Method:Children with habitual snoring who underwent overnight PSG were recruited. Subjects were divided into the snoring group and OSA group according to the criteria of the International Classification of Sleep Disorder（ICSD-3）. The demographic data, symptoms, signs and family environmental factors of the two groups were compared. Result:One hundred and fifty-five families were included（including children with habitual snoring and their parents）. Children were 3 to 13 years old, including 88 cases in the snoring group and 67 cases in the OSA group. Using binary logistic regression analysis, existence of apnea, higher BMI z score and mother's medical history of repeated tonsillitis and/or adenotonsillectomy in childhood were risk factors for OSA in children with habitual snoring, and the odds ratio（95%CI） was 4.081（1.835, 9.073）, 1.347（1.071, 1.694）, 3.897（1.400, 10.849） respectively. There were no significant differences in the distribution of environmental factors such as family residence, per capita household income, and parental smoking history. Conclusion:The risk factors of OSA in habitual snoring children are symptom of apnea, higher BMI z score and mother's medical history of repeated tonsillitis and/or adenotonsillectomy in childhood.

[Feasibility analysis of new dry electrode EEG sleep monitoring].

Objective:To evaluate the accuracy of the new carbon black polyurethane dry electrode electroencephalogram and clarify the value of the new dry electrode electroencephalogram. Method:Forty-three male-adult patients in the group were wearing both Ag/AgCl wet electrode and new dry electrode for sleep monitoring. The wet electrode recording was used as the gold standard for diagnostic accuracy analysis of dry electrode monitoring results. Result:The overall accuracy of the new type of dry electrode EEG was 74.53%, and the diagnostic efficiency of the dry electrode was significantly different among different stages. The sensitivity of WK, N1, N2, N3 and REM is 85.75%, 61.92%, 74.22%, 79.70% and 74.50%, and the specificity is 95.54%, 88.46%, 88.15%, 95.07%, 98.55%, respectively. Conclusion:The dry electrode EEG acquisition accuracy is good, especially for the WK, which is beneficial to improve the accuracy of the portable sleep monitoring equipment for the diagnosis of OSA disease.

Inhibition of Specificity Protein 1 Is Involved in Phloretin-Induced Suppression of Prostate Cancer.

Phloretin is a flavonoid existed in various plants and has been reported to possess anticarcinogenic activity. However, the anticancer mechanism of phloretin in prostate cancer (PCa) remains unclear. Here, our in vitro and in vivo experimental data demonstrate that phloretin inhibits the phosphorylation and the activation of EGFR and then inhibits its downstream PI3K/AKT and MEK/ERK1/2 pathways in PCa cells. Inhibition of these two pathways further decreases expression of Sp1 by inhibiting Sp1 gene transcription, induces degradation of Sp1 protein by inhibiting GSK3ß phosphorylation, suppresses nucleolin-enhanced translation of Sp1 mRNA by inhibiting nucleolin phosphorylation, and directly inactivates transcription activity of Sp1. Inhibition of Sp1 subsequently decreases the expression of Sp3/4, VEGF, and Survivin and then upregulates apoptosis-related proteins and downregulates cell cycle-related proteins in PCa cells. Finally, phloretin treatment in PCa cells induces cell growth inhibition and apoptosis, suggesting that phloretin may be an effective therapy compound in the treatment of prostate cancer.

Five-Year Objective and Subjective Outcomes of Velopharyngeal Surgery for Patients with Obstructive Sleep Apnea.

OBJECTIVE: To assess the long-term effects of velopharyngeal surgery on objective and subjective symptoms in patients with obstructive sleep apnea (OSA). STUDY DESIGN: Prospective cohort study. SETTING: University medical center. SUBJECTS AND METHODS: Eighty-six patients with OSA underwent velopharyngeal surgery, which consisted of revised uvulopalatopharyngoplasty with uvula preservation, with or without concomitant transpalatal advancement pharyngoplasty. The results from polysomnography and the Epworth Sleep Scale after 6 months and 5 years were compared with baseline. Baseline variables were compared between responders and nonresponders. RESULTS: Sixty-three patients were successfully followed up at the end of study. The surgical success rate after 6 months and 5 years was 66.67% (42 of 63) and 60.32% (38 of 63), respectively, with no significant difference (P = .459). The apnea-hypopnea index and Epworth Sleep Scale dramatically decreased from baseline after 6 months and 5 years in responders and nonresponders (P < .001 for all). As compared with nonresponders, the responders exhibited larger tonsil size, higher nocturnal lowest oxygen desaturation, lower CT90 (percentage of time with oxygen saturation <90%), and shorter MH (vertical distance between the lower edge of the mandible and hyoid in the midsagittal plane of computed tomography). Tonsil size and CT90 showed significant predictive value for surgery success (P < .001 for both). CONCLUSION: Velopharyngeal surgery was effective in improving nocturnal respiration and excessive daytime sleepiness in patients with OSA at 6-month and 5-year follow-up. Tonsil size and CT90 could be predictors for surgery responders.

EGFR­associated pathways involved in traditional Chinese medicine (TCM)­1­induced cell growth inhibition, autophagy and apoptosis in prostate cancer.

Traditional Chinese medicine (TCM) has the synergistic effect of the combination of a single ingredient and a monomer, and systemic and local therapeutic effects in cancer treatment, through which TCM is able to enhance the curative effect and reduce the side effects. The present study analyzed the effect of TCM­1 (an anti­cancer TCM) on prostate cancer (PCa) cell lines, and studied in detail the mechanism of cell death induced by TCM­1 in vitro and in vivo. From the present results, it was identified for the first time, to the best of our knowledge, that TCM­1 arrested the cell cycle at the G1 phase, decreased cell viability and increased nuclear rupture in a dose­dependent manner; these effects finally resulted in apoptosis in PCa cells. At the molecular level, the data demonstrated that TCM­1 competitively acted on epidermal growth factor receptor (EGFR) with EGF, and suppressed the auto­phosphorylation and activity of EGFR. Inhibition of EGFR further suppressed the downstream phosphatidylinositol 3­kinase (PI3K)/RAC­α serine/threonine­protein kinase (AKT) and RAF proto­oncogene serine/threonine­protein kinase/extracellular signal regulated kinase signaling pathways and resulted in a decrease in the phosphorylated­forkhead box protein O1 (at Ser256, Thr24 and Ser319) expression level, and induced cell growth inhibition and apoptosis by regulating the expression of apoptosis­and cell cycle­associated genes. In addition, TCM­1 markedly inhibited the PI3K/AKT/serine/threonine­protein kinase mTOR signaling pathway and induced cell autophagy by downregulating the phosphorylation of p70S6K and upregulating the levels of Beclin­1 and microtubule­associated protein light chain­3II. In vivo, the TCM­1­treated group exhibited a significant decrease in tumor volume compared with the negative control group in subcutaneous xenograft nude mice by inhibiting EGFR­associated signaling pathways. Therefore, the bio­functions of Chinese medicine TCM­1 in inducing PCa cell growth inhibition, autophagy and apoptosis suggested that TCM­1 may have clinical potential for the treatment of patients with PCa.

Traditional Chinese Medicine CFF-1 induced cell growth inhibition, autophagy, and apoptosis via inhibiting EGFR-related pathways in prostate cancer.

Traditional Chinese medicine (TCM) has a combined therapeutic result in cancer treatment by integrating holistic and local therapeutical effects, by which TCM can enhance the curative effect and reduce the side effect. In this study, we analyzed the effect of CFF-1 (alcohol extract from an anticancer compound Chinese medicine) on prostate cancer (PCa) cell lines and studied in detail the mechanism of cell death induced by CFF-1 in vitro and in vivo. From our data, we found for the first time that CFF-1 obviously arrested cell cycle in G1 phase, decreased cell viability and then increased nuclear rupture in a dose-dependent manner and finally resulted in apoptosis in prostate cancer cells. In molecular level, our data showed that CFF-1 induced inhibition of EGFR auto-phosphorylation and inactivation of EGFR. Disruption of EGFR activity in turn suppressed downstream PI3K/AKT and Raf/Erk signal pathways, resulted in the decrease of p-FOXO1 (Ser256) and regulated the expression of apoptosis-related and cycle-related genes. Moreover, CFF-1 markedly induced cell autophagy through inhibiting PI3K/AKT/mTOR pathway and then up-regulating Beclin-1 and LC-3II and down-regulating phosphorylation of p70S6K. In vivo, CFF-1-treated group exhibited a significant decrease in tumor volume compared with the negative control group in subcutaneous xenograft tumor in nude mice via inhibiting EGFR-related signal pathways. Thus, bio-functions of Chinese medicine CFF-1 in inducing PCa cell growth inhibition, autophagy, and apoptosis suggested that CFF-1 had the clinical potential to treat patients with prostate cancer.

Isorhapontigenin induced cell growth inhibition and apoptosis by targeting EGFR-related pathways in prostate cancer.

Isorhapontigenin (ISO), a naturally phytopolyphenol compound existing in Chinese herb, apples, and various vegetables, has attracted extensive interest in recent years for its diverse pharmacological characteristics. Increasing evidences reveal that ISO can inhibit cancer cell growth by induced apoptosis, however, the molecular mechanisms is not fully understood. In this study, we found for the first time that ISO apparently induced cell growth inhibition and apoptosis by targeting EGFR and its downstream signal pathways in prostate cancer (PCa) cells both in vitro and in vivo, whereas no obviously effect on normal prostate cells. From the results, we found that ISO competitively targeted EGFR with EGF and inhibited EGFR auto-phosphorylation, and then decreased the levels of p-Erk1/2, p-PI3 K, and p-AKT, and further induced down-regulation of p-FOXO1 and promoted FOXO1 nuclear translocation; and finally resulted in a significantly up-regulation of Bim/p21/27/Bax/cleaved Caspase-3/cleaved PARP-1 and a markedly down-regulation of Sp1/Bcl-2/XIAP/Cyclin D1. Moreover, our experimental data demonstrated that treatment of ISO decreased protein level of AR via both inhibiting the expression of AR gene and promoting the ubiquitination/degradation of AR proteins in proteasome. In vivo, we also found that ISO inhibited the growth of subcutaneous xenotransplanted tumor in nude mice by inducing PCa cell growth inhibition and apoptosis. Taken together, all findings here clearly implicated that EGFR-related signal pathways, including EGFR-PI3K-Akt and EGFR-Erk1/2 pathways, were involved in ISO-induced cell growth inhibition and apoptosis in PCa cells, providing a more solid theoretical basis for the application of ISO to treat patients with prostate cancer in clinic.

Differential Proteomic Analysis Reveals Protein Networks and Pathways that May Contribute to Helicobacter pylori FKBP-Type PPIase-Associated Gastric Diseases.

PURPOSE: Though Helicobacter pylori (H. pylori) has been classified as class I carcinogen, key virulence factor generated by H. pylori that causes gastric cancer remains to be fully determined. Recently, we identified a gastric cancer-associated H. pylori gene, peptidylprolyl isomerase-FK506 binding protein (PPIase-FKBP), and showed that PPIase-FKBP was capable of inducing oncogenic transformation of gastric epithelial cells. But its mechanism was unclear. EXPERIMENTAL DESIGN: We carried out a comparative proteomic analysis of human gastric epithelial cells that either express PPIase-FKBP or green fluorescent protein using 2-DE and then MALDI-TOF-MS/MS. RESULTS: Our results identified 28 differentially expressed proteins induced by PPIase-FKBP. These proteins participate in some cellular biological processes, such as cell proliferation, cell apoptosis and DNA replication, mRNA splicing, and protein biosynthesis. Ingenuity Pathway Analysis categorized the 28 proteins into two molecular interaction networks, involved primarily in cancer and gastrointestinal diseases. CONCLUSIONS AND CLINICAL RELEVANCE: Our results provided insight on the protein interaction networks and signaling pathways that may contribute to PPIase-FKBP-associated gastric diseases and may lead to a better understanding of the mechanisms indicating the oncogenic effects of H. pylori PPIase-FKBP.

[Relationship among the Oxygen Concentration, Reactive Oxygen Species and the Biological Characteristics of Mouse Bone Marrow Hematopoietic Stem Cells].

OBJECTIVE: To investigate the effects of oxygen concentration and reactive oxygen species (ROS) on the biological characteristics of hematopoietic stem cells (HSC) and to analyzed the relationship among the oxygen concentration, ROS and the biological characteristics of mouse HSC through simulation of oxygen environment experienced by PB HSC during transplantation. METHODS: The detection of reactive oxygen species (ROS), in vitro amplification, directional differentiation (BFU-E, CFU-GM, CFU-Mix), homing of adhesion molecules (CXCR4, CD44, VLA4, VLA5, P-selectin), migration rate, CFU-S of NOD/SCID mice irradiated with sublethal dose were performed to study the effect of oxgen concentration and reactive oxygen species on the biological characteristics of mouse BM-HSC and the relationship among them. RESULTS: The oxygen concentrations lower than normal oxygen concentration (especially hypoxic oxygen environment) could reduce ROS level and amplify more Lin(-) c-kit(+) Sca-1(+) BM HSC, which was more helpful to the growth of various colonies (BFU-E, CFU-GM, CFU-Mix) and to maintain the migratory ability of HSC, thus promoting CFU-S growth significantly after the transplantation of HSC in NOD/SCID mice irradiated by a sublethal dose. BM HSC exposed to oxygen environments of normal, inconstant oxygen level and strenuously thanging of oxygen concentration could result in higher level of ROS, at the same time, the above-mentioned features and functional indicators were relatively lower. CONCLUSION: The ROS levels of BM HSC in PB HSCT are closely related to the concentrations and stability of oxygen surrounding the cells. High oxygen concentration results in an high level of ROS, which is not helpful to maintain the biological characteristics of BM HSC. Before transplantation and in vitro amplification, the application of antioxidancs and constant oxygen level environments may be beneficial for transplantation of BMMSC.

The Role of Obstruction Length and Height in Predicting Outcome of Velopharyngeal Surgery.

OBJECTIVE: To measure obstruction length and height using drug-induced sleep endoscopy (DISE) in obstructive sleep apnea (OSA) patients and to evaluate their association with outcomes of velopharyngeal surgery. STUDY DESIGN: Prospective cohort study. SETTING: University medical center. METHODS: Forty-three consecutive patients with OSA were evaluated by DISE using dexmedetomidine. The 2 new parameters, obstruction length (defined as the distance from the most superior point of the collapse to the most inferior point of the collapse) and obstruction height (the distance from the posterior border of the nasal septum to the most proximal point of the collapse), were measured by both DISE and a pressure transducer catheter method before surgery. All of the patients received velopharyngeal surgery, including revised uvulopalatopharyngoplasty with uvula preservation and transpalatal advancement pharyngoplasty. We followed up with all of the patients using polysomnography at least 3 months after surgery. RESULTS: Twenty-six (60.5%) patients were responders, and 17 (39.5%) were nonresponders. The mean obstruction length and obstruction height were 1.3 ± 0.5 cm (range, 0.4-2.2 cm) and 3.4 ± 0.9 cm (range, 1.1-5.0 cm), respectively. Nonresponders had a longer obstruction length and a shorter obstruction value. Multivariate logistic regression analysis revealed that obstruction length >1.4 cm (odds ratio [OR], 0.21; 95% confidence interval [CI], 0.04-0.98; P = .048) and obstruction height ≥3.2 cm (OR, 9.35; 95% CI, 1.79-48.80; P = .008) were the only independent predictors of velopharyngeal surgery success. CONCLUSIONS: Accurate measurement of obstruction length and height can be performed with both DISE and a pressure transducer catheter method. The 2 parameters can predict the outcome of velopharyngeal surgery.

Helicobacter pylori FKBP-type PPIase promotes gastric epithelial cell proliferation and anchorage-independent growth through activation of ERK-mediated mitogenic signaling pathway.

Though Helicobacter pylori (H. pylori) has been classified as class I carcinogen, key virulence factor(s) generated by H. pylori that causes gastric cancer remains to be fully determined. Here, we show that deletion of peptidyl-prolyl cis-trans isomerase (PPIase) prevented H. pylori from stimulating human gastric epithelial cell (AGS) proliferation. Consistent with this observation, ectopic expression of H. pylori PPIase promoted AGS cell proliferation and anchorage-independent growth. To gain insight into the biochemical mechanism of PPIase-induced effect, early signal events involved in mitogenic signaling pathways were evaluated. Expression of H. pylori PPIase caused an increase in basal as well as EGF-stimulated phosphorylation of ERK and EGF receptor at Tyr1086. Treatment with MEK inhibitor completely blocked PPIase-induced cell proliferation. Our results suggest that H. pylori PPIase has the potential to activate mitogenic signaling pathway and to promote transformation of gastric epithelial cells. H. pylori PPIase may represent a novel target for therapeutic management of gastric cancer patients.

Comparison of drug-induced sleep endoscopy and upper airway computed tomography in obstructive sleep apnea patients.

The purpose of the present study was to evaluate the associations between the findings of drug-induced sleep endoscopy (DISE) and upper airway computed tomography (UACT) in obstructive sleep apnea (OSA) patients. This study was a non-randomized, prospective, clinical trial. We used DISE to identify the obstruction pattern according to VOTE classification. All 62 study subjects (all men) showed velum-related obstruction; 47 (75.8%) had lateral oropharyngeal obstruction, 45 (72.6%) had tongue-base-related obstruction, and 6 (9.7%) had epiglottal obstruction. The following UACT measurements significantly differed between subjects with and without lateral oropharyngeal obstruction (P < 0.05): airway length, laryngopharynx length, mandibular plane to hyoid distance, minimum lateral dimension of the retroglossal airway, retropalatal anteroposterior/lateral dimension, and retroglossal anteroposterior/lateral dimension. None of the UACT measurements significantly differed between subjects with and without tongue-base-related or epiglottal obstruction. These results indicate that in OSA patients, obstruction related to the lateral oropharyngeal walls can be identified using these UACT measurements. Thus, UACT, which is performed during wakefulness, can partially replace DISE, which is both time consuming and costly.

[Comparison of different continuous positive airway pressure titration methods for obstructive sleep apnea hypopnea syndrome].

OBJECTIVE: To explore whether there were differences between the results of automatic titration and the results of manual titration for positive airway pressure treatment in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and its influencing factors, the results might provide a theoretical basis for the rational use of two pressure titration methods. METHODS: Sixty one patients with OSAHS were included in this study. All patients underwent a manual titration and an automatic titration within one week. The clinical informations, polysomnography data, and the results of both two titration of all patients were obtained for analysis. RESULTS: The overall apnea/hypopnea index was (63.1 ± 17.7)/h, with a range of 14.9/h to 110.4/h. The treatment pressure of manual titration was (8.4 ± 2.1) cmH(2)O, which was significantly lower than the treatment pressure of automatic titration, (11.5 ± 2.7) cmH(2)O (t = -9.797, P < 0.001). After using a ΔP of 3 cmH(2)O for the cutoff value (ΔP was defined as the difference of automatic titration and manual titration), it was found that the pressure of automatic titration was significantly higher in patients with a ΔP > 3 cmH(2)O than in patients with a ΔP ≤ 3 cmH(2)O, which was (13.3 ± 2.3) cmH(2)O vs (10.0 ± 2.0) cmH(2)O (t = -6.159, P < 0.001). However, there were no differences for the pressure of manual titration between these two groups, which was (8.6 ± 2.4) cmH(2)O vs (8.3 ± 2.0)cmH(2)O (P > 0.05). There was no significant difference in age, body mass index, neck circumference, abdomen circumference, apnea hypopnea index, and arterial oxygen saturation between these two groups. CONCLUSIONS: The treatment pressure of automatic titration is usually higher than that of manual titration. For patients with a high treatment pressure which is derived from automatic titration, a suggestion about manual titration could be given to decrease the potential treatment pressure of continuous positive airway pressure, which may be helpful in improving the comfortableness and the compliance of this treatment.

The biological activity of H. pylori SlyD in vitro.

AIM: To investigate the biological activity of the H. pylori SlyD in vitro. METHODS: Helicobacter pylori (H.pylori) slyD prokaryotic expression vector was carried out in Escherichia coli (E.coli), and recombination SlyD (rSlyD) was purified by immobilized metal affinity chromatography. The proliferation, apoptosis, invasion, transformation effects of rSlyD on AGS cells was detected by CCK-8, cell cycle, caspase-3 activity, matrigel invasion assay, and double-deck soft agar colony forming efficiency. In addition, the expressions of PCNA, KI-67, caspase-3, and MMP-9 were detected by western blot and immunofluorescence assay, respectively. RESULTS: The CCK-8 assay revealed that cell proliferation was increased in a time and dose-dependent manner in AGS + rSlyD group compared with that of AGS or AGS + PBS group (p < .05). There are significant difference of PCNA and KI67 expressions among AGS, AGS + PBS, AGS + rSlyD groups (p < .05). Soft agar colony formation assay revealed the colony number (foci>100 µm) in AGS + rSlyD group was 26.3 ± 7.09, whereas 5.6 ± 1.15 in AGS and 5.0 ± 1.0 in AGS + PBS groups, respectively (p < .01). Colorimetric enzyme assay revealed the activity of caspase-3 was decreased to 31.45 ± 0.49 after treatment with rSlyD, whereas 55.5 ± 0.43 in AGS and 55.1 ± 0.25 in AGS + PBS group, respectively (p < .001). Similar caspase-3 expression also was confirmed by Western blot. The number of invasive cells in transwell chambers assay is 196.66 ± 40.41 in AGS + rSlyD group higher than 85 ± 22.9 in AGS or 81.66 ± 15.27 in AGS + PBS group, respectively (p < .001). The MMP-9 expression in AGS + rSlyD group was also higher than that of AGS or AGS + PBS group. CONCLUSION: These results suggest that the HpSlyD may play an important role in disturbing cell proliferation, apoptosis, and enhancing cell transformation and invasion in the AGS cell line. HpSlyD might contribute to gastric pathogenicity in H.pylori-associated diseases.

[Evaluation of Watch PAT as a diagnosing test for patients with obstructive sleep apnea hypopnea syndrome].

OBJECTIVE: This study aimed to test the accuracy of the watch peripheral arterial tone (Watch PAT) in diagnosing the obstructive sleep apnea hypopnea syndrome (OSAHS) and its influencing factors. METHODS: Thirty five outpatients who had a chief complaining of sleep snoring were recruited to receive Watch PAT test and polysomnography (PSG) simultaneously. The results of PSG were manually analyzed by an experienced technician, while the results of Watch PAT were automatically analyzed by software. RESULTS: There was a trend that the apnea hypopnea index (AHI) of PSG was significantly higher than that of Watch PAT (P = 0.06) in the 35 patients studied, however, these two variables were significantly correlated (P < 0.001), and the correlation coefficient was as high as 0.955. A linear regression analysis which used the AHI of Watch PAT to predict the AHI of PSG also concluded same result and the equation was AHI (PSG) = 0.944 + 1.030AHI (Watch PAT), P < 0.001. The analysis which used ROC curve to test the diagnostic efficiency of Watch PAT concluded that the area under the curve could reach to 0.953 (P < 0.001), and if an AHI (Watch PAT) threshold of ≥ 8.65 was used as the cut-off point in this study, the sensitivity and specificity could reach to 92.3% and 100.0%. The absolute values of the differences (AVD) between the AHI of Watch PAT and the AHI of PSG were also calculated as a criterion for grouping the 35 patients studied, then it could be found that there was a trend that the BMI of patients who had an AVD ≥ 5 were higher than that of patients who had an AVD < 5 (P = 0.077). CONCLUSIONS: The Watch PAT is highly sensitive in the diagnosis of OSAHS, it can be used as a simple and reliable method for screening people with suspicious OSAHS. However, the accuracy of diagnosis may be relatively low in patients who have a great BMI.