MrERF039 transcription factor plays an active role in the cold response of Medicago ruthenica as a sugar molecular switch.

Cold stress severely restricts plant development, causing significant agricultural losses. We found a critical transcription factor network in Medicago ruthenica was involved in plant adaptation to low-temperature. APETALA2/ethylene responsive factor (AP2/ERF) transcription factor MrERF039 was transcriptionally induced by cold stress in M. ruthenica. Overexpression of MrERF039 significantly increased the glucose and maltose content, thereby improving the tolerance of M. ruthenica. MrERF039 could bind to the DRE cis-acting element in the MrCAS15A promoter. Additionally, the methyl group of the 14th amino acid in MrERF039 was required for binding. Transcriptome analysis showed that MrERF039 acted as a sugar molecular switch, regulating numerous sugar transporters and sugar metabolism-related genes. In addition, we found that MrERF039 could directly regulate ß-amylase gene, UDP glycosyltransferase gene, and C2H2 zinc finger protein gene expression. In conclusion, these findings suggest that high expression of MrERF039 can significantly improve the cold tolerance of M. ruthenica root tissues during cold acclimation. Our results provide a new theoretical basis and candidate genes for breeding new legume forage varieties with high resistance.

Case report: A girl with witnessed sleep apnea.

Introduction: Pfeiffer syndrome is a rare genetic disorder characterized by craniosynostosis, broad thumbs and big toes, and partial syndactyly of the hands and feet. This case report presents the case of a girl diagnosed with type 2 Pfeiffer syndrome who experienced severe obstructive sleep apnea (OSA). Case report: The patient had been using an oropharyngeal airway since the age of 4 months due to snoring and witnessed apnea during sleep. At 11 months old, she was referred to our sleep clinic because of growth limitation and gross motor ability issues. Polysomnography (PSG) showed severe obstructive hypopnea before any treatment, and revealed severe central sleep apnea with the oropharyngeal airway in place. Positive airway pressure (PAP) therapy was initiated, which improved both her sleep and gross motor ability. Conclusion: This case report emphasizes the importance of thorough sleep studies for diagnosing sleep and breathing disorders in Pfeiffer syndrome patients and highlights the effectiveness of PAP therapy in managing these conditions.

A case report of REM sleep behavior disorder, Behcet's disease, Sjogren's syndrome and cognitive dysfunction.

BACKGROUND: Behcet's disease and Sjogren's syndrome is an autoimmune disorder from which many systems of the body can suffer. Here we reported a patient with a history of Behcet's disease and Sjogren's syndrome in which REM sleep behavior disorder (RBD) was then detected by polysomnographic (PSG) monitoring. CASE PRESENTATION: A 68-year-old male patient with a history of Behcet's disease and Sjogren's syndrome was diagnosed with RBD by clinical examination and video-PSG, and he also underwent a multiple sleep latency test and cerebral magnetic resonance imaging. The patient had a history of Behcet's disease for 20 years and Sjogren's syndrome for 2 years. The cerebral magnetic resonance imaging also suggested cerebral demyelination and mild cortical atrophy, with cognitive dysfunction by a score of 28 on the mini-mental state examination (MMSE) and a score of 22 on the Montreal cognitive assessment (MoCA). CONCLUSION: RBD is common in the elderly population and is significantly related to α-synucleinopathy. Combining the decline in neuro-cognition and mild cortical atrophy, presentation of RBD in this patient could indicate an underlying α-synucleinopathy neurodegenerative disorder in the future. Considering the role of inflammation in the pathogenesis of α-synucleinopathy and a common shared HLA allelic genes in RBD and Sjogren's syndrome, it is suggested that a physiological process which is related to neuroinflammation may be involved in the pathogenesis of RBD.

[The prevalence of snoring in male pilots].

OBJECTIVE: To investigate and analysis the prevalence and risk factors of snoring and excessive daytime sleepiness among male pilots. METHODS: 1108 subjects were derived from a random sample of pilots. They were asked to answer the questions from a questionnaire concerning their snoring and daytime sleepiness, etc. 1054 questionnaire were available for evaluation. RESULTS: The overall prevalence of snoring among male pilots was 51.04% (538/1054), while moderate and severe snorers accounted for 26.28% (227/1054). The prevalence of snoring among male pilots aged over 30 yr was 63.68% (426/669). The prevalence and severity of snoring increase with age and BMI. Age, overweight and obesity, alcohol ingestion and family history of snoring were associated with the prevalence and severity of snoring. There was significant difference in Epworth sleepiness scale scores among without snoring group and various severity of snoring groups (chi2 = 16.948, P < 0.05). CONCLUSION: The prevalence of snoring is high in male pilots. The Epworth sleepiness scale score increase with increasing degree of snoring. Doctors should pay more attention to snoring in male pilot.

[Value of oxygen saturation combined airflow in diagnosis of obstructive sleep apnea hypopnea syndrome].

OBJECTIVE: To assess the diagnostic value of oxygen saturation combined with airflow (OF) monitoring for diagnosis of obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS: Sixty-two subjects including suspected OSAHS and non-snorers underwent overnight polysomnography (PSG) and OF monitoring simultaneously in sleep laboratory. The apnea-hypopnea index (AHI), lowest oxygen saturation (LSaO(2)), and oxygen desaturation index (ODI) recorded by OF were compared with those recorded by PSG. The AHI and ODI data that showed skew distribution underwent square root transformation to approximate to normal distribution. Pair t test was used for difference hypothesis test. The agreement between the two measures was analyzed using Bland-Altman plot. RESULTS: Forty-five of the 62 subjects were diagnosed as with OSAHS based on PSG with the mean AHI value of (40 +/- 27) events per hour. The mean AHI values derived from OF (OF-AHI) and PSG (PSG-AHI) according to total sleep time were (28 +/- 26) and (29 +/- 28) times per hour respectively, and those after square root transformation were (4.6 +/- 2.7) and (4.7 +/- 2.7) times per hour respectively (P = 0.08). The mean LSaO(2) derived from OF (OF-LSaO(2)) was (82 +/- 11)%, not significantly different from that derived from PSG (PSG-LSaO(2)) [(82 +/- 10)%, P = 0.65]. The ODI derived from OF (OF-ODI) after square root transformation was (3.0 +/- 2.4) times/h, significantly lower than that derived from PSG (PSG-ODI) after square root transformation [(4.0 +/- 2.9) times/h, P = 0.00]. The Bland-Altman plot revealed a good agreement between the OF-AHI and PSG-AHI in non-OSAHS people and patients with mild OSAHS (P = 0.28), however, the OF-AHI was lower than PSG-AHI (P = 0.00) in the patients with moderate to severe OSAHS. There was no significant difference between OF-LSaO(2) and PSG-LSaO2 (P = 0.65). CONCLUSIONS: There is a good agreement between OF and PSG for AHI and LSaO(2). OF can be used to screen patients with suspected OSAHS in high risk population. However, OF tends to underestimate the AHI in moderate to severe OSAHS so additional manual analysis is necessary to confirm the diagnosis.