[The clinical value of sleep endoscopy in the diagnosis of obstruction sites in patients with obstructive sleep apnea hypopnea syndrome: a systematic review and Meta-analysis].

Objective:To investigate the clinical value of video laryngoscope in localization diagnosis of upper airway obstruction in OSAHS during drug-induced sleep.Method:We searched the MEDLINE (PubMed), EMBASE, CCTR (The Cochrane Controlled Clinical Trials Register Database), CNKI, WAN FANG databases for randomized, blinded studies according Cochrane systematic review. We chose articles published between 1975 and 2016 about the value of sleep endoscopy in localization diagnosis of upper airway obstruction in OSAHS. All the data were analyzed by the software of the Meta-Disc 1.4.Result:Seven qualitative studies and three quantitative studies were included.A total of three studies with 175 patients met the inclusion criteria for Meta-analysis. Meta-analysis results showed that the merger sensitivity degrees, specific degrees, diagnostic odds ratio, positive likelihood ratio, negative likelihood ratio and 95%CI were 1.0(0.96-1.0),0.71(0.59-0.81),212.47(36.07-1 251.56),4.40(1.28-15.16),and 0.02(0-0.11) respectively. The SROC area under the concentration-time curve (AUC) was 0.991 0.Conclusion:Because of its high accuracy, sleep endoscopy can be used as an important auxiliary examination and the sensitive indexes for the surgery procedures and prognosis treatment plan for OSAHS. But more cohort studies are needed for the verification.

Activation of extracellular signal-regulated kinase and c-Jun-NH(2)-terminal kinase but not p38 mitogen-activated protein kinases is required for RRR-alpha-tocopheryl succinate-induced apoptosis of human breast cancer cells.

RRR-alpha-tocopherol succinate (vitamin E succinate, VES) is a potent, selective apoptotic agent for cancer cells but not normal cells. VES has been shown to inhibit the growth of a wide variety of tumor cells in cell culture and animal models. Studies addressing mechanisms of action of VES-induced apoptosis have identified transforming growth factor-beta, Fas/CD95-APO-1, and mitogen-activated protein kinase (MAPK) signaling pathway involvement. Here we show that MAPKs, the extracellular signal-regulated kinases (ERK), and the stress-activated protein kinases, c-Jun NH2-terminal kinases (JNK), but not p38, are critical mediators in VES-induced apoptosis of human breast cancer MDA-MB-435 cells. VES activates ERK1/2 and JNK both in level and duration of kinase activity. Expression of dominant negative mutants of ERK1, MAPK/ERK activator-1, or JNK1 but not p38 blocked phosphorylation of the substrate glutathione S-transferase-c-Jun and inhibited VES-induced apoptosis. Increased phosphorylation and transactivation activity of nuclear transcription factors c-Jun, ATF-2, and Elk-1 are observed after VES treatments; however, only c-Jun and ATF-2 appear to be involved in VES-induced apoptosis based on antisense blockage experiments. Collectively, these results imply a critical role for ERK1 and JNK1 but not p38 in VES-induced apoptosis of human MDA-MB-435 breast cancer cells.

Vitamin E succinate (VES) induces Fas sensitivity in human breast cancer cells: role for Mr 43,000 Fas in VES-triggered apoptosis.

Fas (CD95/APO-1) is an important mediator of apoptosis. We show that Fas-resistant MCF-7, MDA-MB-231, and MDA-MB-435 human breast cancer cells become responsive to anti-Fas (CD95) agonistic antibody-triggered apoptosis after pretreatment or cotreatment with vitamin E succinate (VES; RRR-alpha-tocopheryl succinate). In contrast, no enhancement of anti-Fas agonistic antibody-triggered apoptosis was observed following VES pretreatment or cotreatment with Fas-sensitive primary cultures of human mammary epithelial cells, immortalized MCF-10A cells, or T47D human breast cancer cells. Although VES is itself a potent apoptotic triggering agent, the 6-h pretreatment procedure for Fas sensitization did not initiate VES-mediated apoptosis. The combination of VES plus anti-Fas in pretreatment protocols was synergistic, inducing 2.8-, 3.0-, and 6.3-fold enhanced apoptosis in Fas-resistant MCF-7, MDA-MB-231, and MDA-MB-435 cells, respectively. Likewise, cotreatment of Fas-resistant MCF-7, MDA-MB-231, and MDA-MB-435 cells with VES plus anti-Fas enhanced apoptosis 1.9-, 2.0-, and 2.6-fold, respectively. Functional knockout of Fas-mediated signaling with either Fas-neutralizing antibody (MCF-7-, MDA-MB-231-, and MDA-MB-435-treated cells) or Fas antisense oligomers (MDA-MB-435-treated cells only), reduced VES-triggered apoptosis by approximately 50%. Analyses of whole cell extracts from Fas-sensitive cells revealed high constitutive expression of Mr 43,000 Fas, whereas Fas-resistant cells expressed low levels that were confined to the cytosolic fraction. VES treatment of the Fas-resistant cells caused a depletion of cytosolic Mr 43,000 Fas with a concomitant increase in Mr 43,000 membrane Fas. These data show that VES can convert Fas-resistant human breast cancer cells to a Fas-sensitive phenotype, perhaps by translocation of cytosolic Mr 43,000 Fas to the membrane and show that VES-mediated apoptosis involves Mr 43,000 Fas signaling.

Allelotypic and cytogenetic characterization of chemically induced mouse mammary tumors: high frequency of chromosome 4 loss of heterozygosity at advanced stages of progression.

Loss of heterozygosity (LOH) is one of the most common genetic abnormalities in cancer. To define the role of LOH and chromosomal abnormalities at various stages of mouse mammary cancer progression, we analyzed the allelotypes and karyotypes of primary mammary tumors induced in CD2F, mice by two basic protocols, the classical multiple-dose 7,12-dimethylbenz[a]anthracene (DMBA) protocol and a novel protocol of combined medroxyprogesterone acetate (MPA) and DMBA. The advantage of the latter protocol is that its latency for tumor development is much shorter and its tumor incidence is higher than those of DMBA alone. To study more advanced stages of mammary tumor progression, we also analyzed mouse mammary tumors that had acquired autonomous growth and were transplantable into syngeneic hosts. The allelotypic studies were performed by means of microsatellite length polymorphism analysis with a minimum of two simple-sequence repeat markers per chromosome. We observed that MPA-DMBA-induced mammary adenocarcinomas, which in general arose earlier because of the growth promotion exerted by MPA, did not show any significant LOH and were essentially diploid. Tumors induced by DMBA alone, which on average took longer to develop, showed a higher frequency of allelic losses. LOH on chromosome 11 was observed in 30% of the cases. Chromosomes 4 and 8 were affected in 25% and 20% of the tumors, respectively. Interestingly, advanced stages of mammary tumor progression, represented by transplantable mammary tumors, showed a much higher level of genomic instability, specifically a very high frequency (66%) of LOH on chromosome 4. These findings indicate that chromosome 4 harbors a gene whose inactivation may play a role in the acquisition of more aggressive characteristics such as autonomous growth and transplantation ability.

Medroxyprogesterone acetate accelerates the development and increases the incidence of mouse mammary tumors induced by dimethylbenzanthracene.

Chemical induction of mammary tumors in mice requires usually a long latency period and is often complicated by high non-mammary tumor related mortality. Classically hormone stimulation has been used as the means to increase tumor incidence. The synthetic progestin medroxyprogesterone acetate (MPA) was postulated by some authors to increase mammary tumor incidence in various rodent models. However, controversy exists regarding the role of MPA in experimental and human carcinogenesis. In our study we tested the use of a protocol of combined MPA- and dimethylbenz[a]anthracene (DMBA) treatment for the obtention of mammary tumors with a short latency and with a lower toxicity than the classical multiple dose DMBA protocol. MPA was very effective in accelerating the development and increasing the incidence of mammary tumors induced by DMBA in CD2F1 mice. MPA by itself did not produce any mammary tumors. The mean latency for tumor development from the end of carcinogen treatment was 99 +/- 51 days in the group that received a combination of MPA and four DMBA doses. This group showed significantly earlier mammary tumor incidence (P < 0.0001) and higher tumor numbers than the groups that received only DMBA. Mammary tumors were also analyzed for effects on the mutation rate affecting the Ha-ras and Ki-ras genes. Our data is consistent with MPA probably increasing the number of target cells at risk for mutation by the chemical carcinogen DMBA and possibly promoting the faster development of tumors.