Value of pulse oxygen saturation monitoring in predicting the moderate-to-severe obstructive sleep apnea in children / 中华实用儿科临床杂志

Objective:To investigate the value of pulse oxygen saturation (SpO 2) monitoring in predicting children with moderate-to-severe obstructive sleep apnea (OSA). Methods:It was a retrospective study involving 341 children with snoring during nighttime sleep who had visited the Children′s Hospital of Soochow University from June 2017 to November 2020 and monitored for polysomnography (PSG) and SpO 2.The SpO 2 parameters mainly included oxygen desaturation index (ODI), oxygen desaturation index ≥3% (ODI3), oxygen desaturation index ≥4% (ODI4), mean pulse blood oxygen saturation (MSpO 2), lowest pulse blood oxygen saturation (LSpO 2), cumulative time spent with blood oxygen saturation below 95%, 92% and 90%(T95, T92 and T90). According to obstructive sleep apnea hypopnea index (OAHI), patients were divided into the snoring and mild OSA group (OAHI≤5 times/h) and moderate-to-severe OSA group (OAHI>5 times/h). Differences in SpO 2 parameters were compared between groups using the Chi- square test and Mann- Whitney U test. Spearman correlation analysis was used to analyze the correlation between SpO 2 parameters and OAHI in all children.The SpO 2 parameters were included in the Logistic regression model.Receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of SpO 2 parameters on moderate-to-severe OSA. Results:A total of 341 patients were recruited, including 206 male and 135 female patients with the mean age, body mass index (BMI) and OAHI of 6.0 (4.0, 7.5) years, 16.2 (15.1, 18.0) kg/m 2 and 0.6 (0.1, 3.0) times /h, respectively.There were 283(83.0%) and 58 (17.0%) patients in the snoring and mild OSA group and moderate-to-severe OSA group.The ODI3[0.7 (0.3, 1.4) times/h vs.7.7 (4.4, 12.8) times/h], ODI4[0.4 (0.1, 0.8) times/h vs.5.3 (2.7, 9.1) times/h], T95[1.4 (0.3, 5.3) min vs.13.7 (7.0, 33.5) min], T92[0.1 (0, 0.5) min vs.1.8 (0.9, 6.0) min] and T90[0 (0, 0.1) min vs.0.6 (0.2, 2.2) min] were significantly lower in the snoring and mild OSA group than those of moderate-to-severe group, while LSpO 2[91.0 (89.0, 93.0)% vs.86.5 (82.0, 88.0)%] and MSpO 2[ 97.0 (97.0, 98.0)% vs.96.0 (96.0, 97.0)%] were significantly higher(all P<0.001). All SpO 2 parameters were significantly correlated with OAHI (all P<0.001), and the correlation coefficient between ODI3 and OAHI was 0.660.ODI3 was an independent predictor of moderate-to-severe OSA ( OR=3.117, 95% CI: 1.635-5.945, P=0.001). The area under the ROC curve of ODI3 in predicting the moderate-to-severe OSA was 0.957, and the cut-off value of 3.45 times/h and specificity of 95.4%.MSpO 2 was an independent predictor of moderate-to-severe OSA ( OR=2.917, 95% CI: 1.589-5.354, P=0.001). Conclusions:ODI3 can be used to predict the moderate-to-severe OSA in children.

Prognostic significance of carbonic anhydrase IX expression in clear cell renal cell carcinoma / 中华泌尿外科杂志

Objective To evaluate the prognostic significance of carbonic anhydrase IX (CA IX) expression in patients with clear cell renal cell carcinoma (ccRCC). Methods CA IX expression in a cohort of 120 patients with ccRCC was evaluated by P-V immunohistochemistry with a rabbit CA IX polyclonal antibody. Twenty-five normal kidney tissues were used as a control. The relationship between CA IX expression and prognosis was analyzed by univariate and multiple-factor analysis (Cox regression model). The primary end point was cancer specific survival. Results One hundred and twelve (93.3%) patients were followed up with the median follow-up time of 45 months (range, 6 to 94 months). Seventy-five patients survived without evidence of tumor recurrence, 3 patients survived with tumor recurrence, and 34 patients died, 28 of the 34 died of cancer. CA IX expression was negative in all normal renal tissue. High CA IX expression was observed in 89 (74.2%) patients, among which 82 patients were followed up, and the disease free survival was 75.6% (62/82). Two (2.4%) patients survived with tumor recurrence, and 18 (22.0%) patients died, of which 13 (15.9%) died of cancer. Tumor recurrence and (or) metastasis occurred in 9 (11.0%) patients, with a median survival of 92 months in this high expression group. Low CA IX expression was observed in 31 (25.8%) patients, among which 30 patients were followed up, and the disease free survival was 43.3% (13/30). One (3.3%) patient survived with tumor recurrence, and 16 (53.3%) patients died, of which 15 (50.0%) died of cancer. Tumor recurrence and (or) metastasis occurred in 8 (26.7%) patients with a median survival of 53 months in this low expression group. Cancer specific survival between CA IX high expression group and low expression group was significantly different (P=0.000, χ2=15.950), and tumor relapse and (or) metastasis rates were significantly different (P=0.040, χ2=4.200). The 1, 3, 5 and 7 year cancer specific survival rates were 95.2%, 83.9%, 81.2% and 78.2% respectively in the high CA IX expression group, and 89.5%, 63.9%, 46.8% and 40.1% respectively in the low expression group. Multivariate analysis with Cox regression model showed that CA IX expression was a prognostic factor (RR=0.186). Conclusions High CA IX expression is negatively correlated with postoperative mortality, relapse and (or) metastasis in ccRCC. CA IX expression could be used as a prognostic biomarker in ccRCC.

Cloning of foot-and-mouth disease virus integrin receptor beta1 subunit and antibody production to its ligand-binding domain / 生物工程学报

We produced beta1 gene which is about 2400 bp by reverse transcription polymerase chain reaction (RT-PCR) from bovine trachea, reclaimed and purified, then cloned the amplified fragment to pGEM-T easy vector, confirmed by sequencing. The immune-dominant epitope of beta1 gene was chosen by computer analysis and then syncretized ligand-binding domain from 346 bp to 843 bp of ecytoplasm with six histidine, expressed LBD protein massly in E. coli BL21 (DE3), and identified by SDS-PAGE. The fusion protein was purified with Ni-NTA affinity chromatography and immunized New Zealand rabbits preparing of its polyclonal antibody, the specific antibody titer was above 1:12,800 detected by indirect ELISA, the result of Western blot showed that this antibody could be recognized by LBD fusion protein.

Bilateral multiple renal angiomyolipomas associated with tuberous sclerosis (report of 4 cases) / 中华泌尿外科杂志

Objective To study the clinical features of renal angiomyolipomas with tuberous sclerosis and to improve the recognization of this disease. Methods The diagnosis and treatment of 4 cases of tuberous sclerosis with bilateral and multiple renal angiomyolipomas were reviewed.The age range was 17 to 44 years,two of them were men.One patient presented with the classic triad:facial angiofibroma,seizures,and mental retardation.Facial angiofibroma occurred in three and seizures were found in two,three patients showed multiple extrarenal organ involvement including liver,spleen and bone.Brain CT revealed classical calcified cortical tuber and(or) subependymal nodule in three cases. Results The diagnosis of renal angiomyolipomas in three cases was affirmed on CT scan.However,the giant renal angiomyolipomas in one case can not be diagnosed from renal CT scan which did not demonstrate characteristic fatty tissue whereas the diagonsis was confirmed by ultrasound-guided right renal tumor biopsy and subsequent right nephrectomy for the large leisions.Regular monitoring of one patient was adopted for his mild symptomatic small renal leisions,the other two with hemorrhage in renal angiomyolipomas were reluctant to aggressive treatment and underwent conservative therapy.Follow-up ranged 6 to 36 months, none had recurrent symptoms and no significant growth of renal lesions was observed. Conclusions CT may not be pathognomonic for renal angiomyolipomas associated with tuberous sclerosis,needle biopsy may be needed to exclude renal carcinoma.The choice of treatment is based on tumor size distribution pattern,progression,and associated symptoms.

The use of flutamide before transurethral resection of the middle-or large-sized hyperplastic prostate / 中华泌尿外科杂志

0.05).In groups A and B,the intraoperative blood loss was(94.4?51.6)ml and(155.8?84.3)ml;the 4% mannitol solution used for intraoperative irrigation was(18.4?6.2)L and(25.4?8.8)L;the operative time was(65.0?16.4)min and((86.8?)25.0)min;the time for postoperative bladder infusion was(46.5?9.1)h and(57.8?17.4)h;the infused saline volume was(19.2?4.2)L and(26.7?10.2)L;the degree of satisfaction of the surgeons with the TURP field was 75.0%(36/48) and 41.9%(26/62);the cases who needed to increase the perfusion pressure during TURP accounted for 22.9%(11/48) and 45.2%(28/62);the blood transfusion rates were 6.2%(3/48) and 22.6%(14/62);and the incidence rates of secondary prostatic bleeding were(10.4)%(5/48) and 25.8%(16/62),respectively.The differences in all these parameters were statistically significant between the 2 groups(P