m6A reader YTHDF3 is associated with clinical prognosis, related RNA signatures and immunosuppression in gastric cancer.

BACKGROUND: YTHDF3 as a N6-methyladenosine (m6A) reader participates in the development and progression of multiple cancer types, however, the prognosis, molecular biology and immune infiltration of YTHDF3 in gastric cancer (GC) have not been investigated. METHODS: The YTHDF3 expression profile and clinicopathological parameters of stomach adenocarcinoma (STAD) were downloaded from TCGA. The online websites and databases such as GEPIA2, cBioPortal, UALCAN, ImmuCellAl, xCell, TISIDB, GSCA were utilized for analysis of the association of YTHDF3 with STAD, including clinical prognosis, WGCNA and LASSO Cox regression analysis. Further functional assays such as RT-qPCR, Western blot, immunohistochemistry (IHC), immunofluorescence (IF), CCK-8, colony formation, EdU and Transwell assays were performed to determine the role of YTHDF3 in GC. RESULTS: We found that YTHDF3 was upregulated in STAD tissue samples ascribed to its copy number amplification and associated with poor prognosis in patients with STAD. GO and KEGG analyses showed that YTHDF3-related differential genes were predominantly enriched in the proliferation, metabolism and immune signaling pathways. Knockdown of YTHDF3 repressed the growth and invasion of GC cells by inhibition of PI3K/AKT signaling. We then identified YTHDF3-related lncRNAs, miRNAs and mRNAs, and constructed their prognostic signatures in patients with STAD. Moreover, YTHDF3 associated with tumor immune infiltration such as CD8+ T cells, macrophages, Tregs, MHC molecules and chemokines, upregulated PD-L1 and CXCL1 and exerted a response to the immunotherapy in GC. CONCLUSIONS: YTHDF3 upregulation indicates poor prognosis and promotes GC cell growth and invasion by activating PI3K/AKT pathway and regulating immune microenvironment. The established YTHDF3-related signatures highlight the association of YTHDF3 with the clinical prognosis and immune cell infiltration in GC.

DDX54 Plays a Cancerous Role Through Activating P65 and AKT Signaling Pathway in Colorectal Cancer.

Colorectal cancer (CRC) is one of the most malignant cancers, and its incidence is still steadily increasing. The DDX RNA helicase family members have been found to play a role in various cancers; however, the role of DDX54 in colorectal cancer is still unclear and needed to be defined. Here, we found DDX54 was overexpressed in CRC tissues by the label-free mass spectrum, which was also verified in tissue microarray of colon cancer, as well as the CRC cell lines and TCGA database. High DDX54 level was correlated with tumor stage and distant metastasis, which always indicated a poor prognosis to the CRC patients. DDX54 could promote the proliferation and mobility of CRC cells through increasing the phosphorylation level p65 and AKT leading to the tumorigenesis. Here, we have preliminarily studied the function of DDX54 in CRC, which would improve our understanding of the underlying biology of CRC and provide the new insight that could be translated into novel therapeutic approaches.

Application of Upper Arm Circumference and Calf Circumference in Screening and Diagnosis of Sarcopenia for Old Adults in Community / 中国康复理论与实践

Objective:To explore the correlation of upper arm circumference and calf circumference with muscle mass, and the screening effect and the cut-off values for low muscle mass and sarcopenia. Methods:From March to August, 2020, a total of 831 community-dwelling old people (≥ 60 years old) were recruited by using convenience sampling. Muscle mass and other body composition indicators were tested by body composition tester. The upper arm circumference, calf circumference, grip strength and gait speed were measured at the same day. Pearson cofficient was used to analyze the correlation of upper arm circumference and calf circumference with muscle mass, and receiver operation characteristic (ROC) curve was used to analyze the diagnostic effect of upper arm circumference and calf circumference on low muscle mass and sarcopenia, and the Youden index (YI) was used to determine the cut-off values. Results:Upper arm circumference and calf circumference were positively correlated with appendicular skeletal muscle mass (ASM) and skeletal mass index (SMI) (r = 0.6 to 0.8, P < 0.001). For diagnosing low muscle mass, the areas under the ROC curve (AUC) of upper arm circumference were 0.888 for male, 0.787 for female; and that of calf circumference were 0.933 for male, 0.854 for female, respectively. The cut-off values of upper arm circumference for low muscle mass were 26 cm for both male and female; and that of calf circumference were 34 cm for male and 33 cm for female, respectively. For diagnosing sarcopenia, the AUC of upper arm circumference was 0.902 for male, 0.744 for female; and that of calf circumference was 0.923 for male, 0.832 for female, respectively. The cut-off values of upper arm circumference and calf circumference for sarcopenia were 26 cm and 33 cm for both male and female. The AUC of combined diagnosis with age, upper arm circumference, calf circumference, grip strength and gait speed for low muscle mass and sarcopenia in males and females was all greater than 0.85. Conclusion:In the community old adults, upper arm circumference and calf circumference are positively correlated with muscle mass, and both indices can be used to diagnose low muscle mass and sarcopenia. multi-indices combination can improve the diagnosis effect of upper arm circumference in females.

Low serum gastrin associated with ER+ breast cancer development via inactivation of CCKBR/ERK/P65 signaling.

BACKGROUND: Gastrin is an important gastrointestinal hormone produced primarily by G-cells in the antrum of the stomach. It normally regulates gastric acid secretion and is implicated in a number of human disease states, but how its function affects breast cancer (BC) development is not documented. The current study investigated the suppressive effects of gastrin on BC and its underlying mechanisms. METHODS: Serum levels of gastrin were measured by enzyme-linked immunosorbent assay (ELISA) and correlation between gastrin level and development of BC was analyzed by chi-square test. Inhibitory effects of gastrin on BC were investigated by CCK-8 assay and nude mice models. Expressions of CCKBR/ERK/P65 in BC patients were determined through immunohistochemistry (IHC) and Western blot. Survival analysis was performed using the log-rank test. RESULTS: The results indicated that the serum level of gastrin in BC patients was lower compared with normal control. Cellular and molecular experiments indicated that reduction of gastrin is associated with inactivation of cholecystokinin B receptor (CCKBR)/ERK/P65 signaling in BC cells which is corresponding to molecular type of estrogen receptor (ER) positive BC. Furthermore, we found that low expression of gastrin/CCKBR/ERK /P65 was correlated to worse prognosis in BC patients. Gastrin or ERK/P65 activators inhibited ER+ BC through CCKBR-mediated activation of ERK/P65. Moreover, combination treatment with gastrin and tamoxifen more efficiently inhibited ER+ BC than tamoxifen alone. CONCLUSIONS: We concluded that low serum gastrin is related to increased risk of ER+ BC development. The results also established that CCKBR/ERK/P65 signaling function is generally tumor suppressive in ER+ BC, indicating therapies should focus on restoring, not inhibiting, CCKBR/ERK/P65 pathway activity.

Overexpression of dedicator of cytokinesis 2 correlates with good prognosis in colorectal cancer associated with more prominent CD8+ lymphocytes infiltration: a colorectal cancer analysis.

Recently, dedicator of cytokinesis 2 (DOCK2) has been reportedly exhibited high mutation prevalence in the Asian colorectal cancer (CRC) cohort. However, the expression pattern of DOCK2 and its clinical significance in CRC were still unknown. To characterize the role of DOCK2, a tissue microarray (TMA) containing 481 archived paraffin-embedded CRC specimens was performed by immunohistochemistry. Among which, 54 primary CRC tissues showed high expression of DOCK2 protein, while others were negative. Moreover, DOCK2 expression was positively associated with invasion depth (P < .001) and tumor size (P = .016). Significantly, Kaplan-Meier survival analysis revealed that patients with higher DOCK2 expression had a longer overall survival time (P = .017). Furthermore, univariate and multivariate Cox regression analysis confirmed that DOCK2 is an independent prognostic marker in CRC (P = .049,; HR, 0.519; 95% CI, 0.270 to 0.997). In addition, we observed a strong correlation between the infiltration of CD8+ T lymphocytes and DOCK2 expression (P = .0119). Our findings demonstrated that overexpressed DOCK2 might involve in recruiting CD8+ T lymphocytes and serve as a novel prognostic indicator and indicated a potential therapeutic strategy by restoring DOCK2 for CRC.

Gastrin inhibits gastric cancer progression through activating the ERK-P65-miR23a/27a/24 axis.

BACKGROUND: To test the hypothesis that activated extracellular signal-regulated kinase (ERK) regulates P65-miR23a/27a/24 axis in gastric cancer (GC) and the ERK-P65-miR23a/27a/24 axis plays an important role in the development of GC, and to evaluate the role of gastrin in GC progression and ERK-P65-miR23a/27a/24 axis. METHODS: The component levels of the ERK-P65-miR23a/27a/24 axis in four fresh GC tissues, 101 paraffin-embedded GC tissues and four GC cell lines were determined by Western blotting, immunohistochemistry (IHC) or qRT-PCR. The effects of gastrin on GC were first evaluated by measuring gastrin serum levels in 30 healthy and 70 GC patients and performing a correlation analysis between gastrin levels and survival time in 27 GC patients after eight years of follow-up, then evaluated on GC cell lines, GC cell xenograft models, and patient-derived xenografts (PDX) mouse models. The roles of ERK-P65-miR23a/27a/24 axis in GC progression and in the effects of gastrin on GC were examined. RESULTS: ERK- P65-miR23a/27a/24 axis was proved to be present in GC cells. The levels of components of ERK-P65-miR23a/27a/24 axis were decreased in GC tissue samples and PGC cells. The decreased levels of components of ERK-P65-miR23a/27a/24 axis were associated with poor prognosis of GC, and ERK-P65-miR23a/27a/24 axis played a suppressive role in GC progression. Low blood gastrin was correlated with poor prognosis of the GC patients and decreased expression of p-ERK and p-P65 in GC tissues. Gastrin inhibited proliferation of poorly-differentiated GC (PGC) cells through activating the ERK-P65-miR23a/27a/24 axis. Gastrin inhibited GC growth and enhanced the suppression of GC by cisplatin in mice or PGC cell culture models through activating the ERK-P65-miR23a/27a/24 axis or its components. CONCLUSIONS: ERK-P65-miR23a/27a/24 axis is down-regulated, leading to excess GC growth and poor prognosis of GC. Low gastrin promoted excess GC growth and contributed to the poor prognosis of the GC patients by down-regulating ERK-P65-miR23a/27a/24 axis. Gastrin inhibits gastric cancer growth through activating the ERK-P65-miR23a/27a/24 axis.

Novel immunochromatographic assay on cotton thread based on carbon nanotubes reporter probe.

In this article, a novel immunochromatographic assay method on cotton thread based on carbon nanotubes (CNTs) as reporter probe was successfully prepared for visual and rapid detection of a lung cancer related biomarker, human ferritin antigen. A model system comprising ferritin as an analyte was used to demonstrate the protocol of the cotton thread immunoassay device. The device can detect at least 50ng/mL human ferritin antigen, which improved the sensitivity approximately by 500 folds comparing with previous point-of-care test report based on carbon nanotubes as reporter probe. The CNTs reporter probe combined with cotton thread device based biosensor provided an alternative path for clinical diagnosis of other protein or nucleic acid biomarkers.

Methylation of the suppressor of cytokine signaling 3 gene (SOCS3) in bladder cancer.

BACKGROUND: It has been identified consequences of dysregulation of JAK-STAT signalling, particularly in regard to JAK-STAT signalling that has been shown to have roles in the oncogenesis of several cell types. SOCS3 protein, the negative regulatory protein of JAK-STAT signaling pathway, may also plays critical regulatory roles in cancer initiation and progression. SOCS3 promoter hypermethylation has often been identified in human cancers; however, the precise role of SOCS3 in bladder cancer is unclear. METHODS: The methylation status of the SOCS3 was analyzed in an age (±5 years) and sex-matched case-control study, including 112 bladder cancer cases and 118 normal controls, using the MassARRAY EpiTYPER system. RESULTS: Methylation rate of JAK2, SOCS3 and STAT3 gene were shown to vary among different CpG island. The methylation rate of SOCS3 gene was also much higher in BCa than in normal control participants, but the methylation rate of JAK2, STAT3 gene weren't different in Bca and normal control participants. CONCLUSIONS: Our study demonstrates that promoter hypermethylation of SOCS3 gene is associated with BCa and thus, may serve as an independent prognostic biomarker.

Importance of activated hepatic stellate cells and angiopoietin-1 in the pathogenesis of hepatocellular carcinoma.

Previous studies have determined that activated hepatic stellate cells (aHSCs) promote the progression of hepatocellular carcinoma (HCC) by increasing angiogenesis in cancerous tissues. In addition, angiopoietin 1 (Ang­1) has been reported to be involved in tumor growth and metastasis via the promotion of angiogenesis. It remains unclear whether aHSCs and Ang­1 are involved in the angiogenesis in HCC. A total of 25 HCC and tumor­adjacent tissues, and 21 normal liver tissues were used in the present study. Immunohistochemistry (IHC) was used to detect the expression of Ang­1 and α smooth muscle actin (α­SMA). The expression of CD34 was also analyzed using IHC to evaluate the microvessel density (MVD). The protein expression levels of Ang­1 were evaluated using western blot analysis. The association between aHSC, Ang­1 and angiogenesis was determined using Spearman's rank correlation coefficient. The present study determined that the expression of α­SMA, Ang­1 and MVD (CD34) was significantly higher in the HCC tissues when compared with tumor­adjacent tissues and normal liver tissues. Spearman's rank analysis identified a positive correlation between the expression of α­SMA, Ang­1 and CD34. This suggests that α­SMA­positive aHSCs promoted angiogenesis by expressing Ang­1, resulting in the proliferation and metastasis of HCC.

Association between the polymorphisms of urokinase plasminogen activation system and cancer risk: a meta-analysis.

PURPOSE: The present study aimed to investigate the potential association between the urokinase plasminogen activation (uPA) system polymorphisms (rs4065, rs2227564, and rs344781) and cancer risk. METHODS: An extensive search was performed to identify published case-control studies on the association between the uPA system polymorphisms and cancer risk. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the relationship between the uPA system polymorphisms and cancer risk. RESULTS: A total of 20 studies comprising 7,037 cancer cases and 10,094 controls were identified and included in the present meta-analysis. Overall, significantly increased cancer risk was associated with the uPA polymorphism rs4065 (T vs C: OR 1.50, 95% CI: 1.19-1.89; TT vs CC: OR 4.63, 95% CI: 3.10-6.91; dominant model: OR 1.93, 95% CI: 1.60-2.33; recessive model: OR 3.02, 95% CI: 1.26-7.25) and the uPA receptor polymorphism rs344781 (T vs C: OR 1.13, 95% CI: 1.04-1.23; TC vs CC: OR 1.26, 95% CI: 1.06-1.49; TT vs CC: OR 1.35, 95% CI: 1.13-1.63; dominant model: OR 1.29, 95% CI: 1.10-1.52). No significant association was found between the uPA polymorphism rs2227564 and cancer risk. Subgroup analysis suggests that the T allele of the rs4065 (T allele vs C allele: OR 1.50, 95% CI: 1.19-1.89) and rs344781 polymorphisms (T allele vs C allele: OR 1.13, 95% CI: 1.04-1.23) was associated with increased cancer risk in Asians. CONCLUSION: Our results suggest that the uPA polymorphism rs4065 and the uPA receptor polymorphism rs344781 are associated with increased cancer risk.

Acute effects of Rho-kinase inhibitor fasudil on pulmonary arterial hypertension in patients with congenital heart defects.

BACKGROUND: We investigated the acute vasodilator effects of i.v. fasudil, a specific Rho-kinase inhibitor, on pulmonary circulation in patients with congenital heart defects (CHD) and severe pulmonary arterial hypertension (PAH). METHODS AND RESULTS: Thirty-five patients (34.23±12.10 years old) with CHD and severe PAH were consecutively enrolled. All patients underwent heart catheterization. At baseline and 30 min after initiation of i.v. fasudil, the following hemodynamic parameters were measured and calculated: right atrial pressure, pulmonary and systemic artery pressure (PAP and SAP), pulmonary and systemic vascular resistance, pulmonary-to-systemic blood pressure ratio (Pp/Ps), pulmonary-to-systemic blood flow ratio (Qp/Qs), cardiac index (CI) and artery oxygen saturation (SaO2). After fasudil treatment, marked decrease in mean PAP (mPAP), pulmonary vascular resistance (PVR), total pulmonary resistance, pulmonary-to-systemic vascular resistance ratio (Rp/Rs) and mean Pp/Ps (mPp/Ps) was found, while Qp/Qs increased significantly without affecting CI and SAP. mPAP, PVR, Rp/Rs and Qp/Qs tended to be improved more significantly in the post-tricuspid shunt group compared with the pre-tricuspid shunt group. CONCLUSIONS: Fasudil was well tolerated in patients with CHD and severe PAH, and significantly reduced PAP and PVR without affecting CI, SAP or SaO2.

Association of selenoprotein S gene polymorphism with ischemic stroke in a Chinese case-control study.

Previous studies showed that selenoprotein S (SELS) was associated with a range of inflammatory markers, and its gene expression was influenced by a polymorphism in the promoter region. The genetic basis of the ischemic stroke has now been largely determined, so the aim of the study was to examine the role of SELS genetic variants in the ischemic stroke risk in a Chinese population. We conducted a case-control study with 239 ischemic stroke patients and 240 controls. Two single-nucleotide polymorphisms (SNPs) in SELS genes were analyzed for association with the risk of ischemic stroke in the Chinese Han population. No evidence of ischemic stroke association was observed with the SNP rs34713741. Interestingly, the strongest evidence showed that SELS SNP rs4965814 was associated with ischemic stroke (P < 0.05). We found a significant association with increased ischemic stroke risk in women carrying the CC genotype of rs4965814 [hazard ratio: 2.43(1.03-5.75)]; a similar trend was also found in men carrying the TC genotype of rs4965814 [hazard ratio: 1.81(1.06-3.08)]. SNP rs4965814 of SELS may affect the susceptibility to ischemic stroke. Understanding the inflammatory mechanisms of ischemic stroke may give new therapeutic targets to pharmacologists.

[Coagulation and prothrombotic state parameters: clinical analysis in early pregnancy].

OBJECTIVE: To assess the changes in coagulation, thrombosis, anti-coagulation and fibrinolysis during early pregnancy. METHODS: A total of 105 gravidas with monocytic pregnancies between 10 and 12 weeks gestational age at Sun Yat-sen Memorial Hospital, Sun Yat-sen University during April 2005 to June 2009 were recruited for study group and another 82 non-pregnant women as control group. Coagulation parameters, including thrombin time (TT), activated partial thromboplastin time (APTT), prothrombin (PT) and fibrinogen (Fg), were measured. We also tested the prothrombotic state parameters, including prothrombin fragment 1+2 (F1+2), thrombomodulin (TM), thrombin-antithrombin complex (TAT), antithrombin III(AT-III), GMP140, thromboxane B2 (TXB2), plasminogen activator inhibitor (PAI-2; performed by enzyme-linked immunosorbent assay) and D-dimer (D2; tested by latex turbidimetric immunoassay). RESULTS: Fg (4.00 vs 2.52 g/L), F1+2 (0.66 vs 0.31 nmol/L), TAT (179.95 vs 39.46 µg/L), GMP140 (9.42 vs 19.13 µg/L), D2 (201.51 vs 125.02 µg/L) and PAI-2 (0.047 vs 0.006 g/L) were statistically different between the study and control groups (P < 0.01). CONCLUSIONS: The coagulation, fibrinolysis and anti-fibrinolysis functions of healthy pregnant women become enhanced during early pregnancy while anti-coagulation function slightly increases. These four basic functions are balanced at a higher level so that the activation of platelets stays at a lower level.

Associated predictors of therapeutic response to uvulopharyngopalatoplasty for severe obstructive sleep apnea hypopnea syndrome.

The aim of this study was to determine the associated factors affecting the outcome of uvulopharyngopalatoplasty (UPPP) in patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS), and to investigate whether cephalometric measurements were predictive of the therapeutic response to UPPP in patients with severe OSAHS. We retrospectively studied 51 consecutive patients who underwent revised UPPP with uvula preservation (H-UPPP), or Z-palatopharyngoplasty (ZPPP) for severe OSAHS [apnea-hypopnea index (AHI) >30]. All patients were evaluated using physical examination, Epworth Sleepiness Scale (ESS), cephalometry, and nocturnal polysomnography (PSG) before surgery and at 6-12 months after surgery. Based on the success criteria defined as an AHI of <20 and a decrease >50 %, the overall success rate was 45.1 %. The preoperative distance from the posterior border of the uvula to the middle pharyngeal wall (U-MPW) was significantly longer in the responder group than in the nonresponder group, when considering the whole group or the H-UPPP group alone. Among all study subjects, U-MPW and change in body mass index (△BMI) were the significant predictors of surgical success. U-MPW was the key predictor for H-UPPP surgical success, whereas mandibular plane angle (MPA) and Friedman stage were the key predictors for ZPPP surgical success. In conclusion, U-MPW was a significant predictor of UPPP surgical success. Patients with U-MPW >10 mm who are unwilling to receive nasal continuous positive airway pressure (CPAP) therapy might be suitable candidates for UPPP surgery.

Primary maxillomandibular advancement with concomitant revised uvulopalatopharyngoplasty with uvula preservation for severe obstructive sleep apnea-hypopnea syndrome.

BACKGROUND: This study aimed to evaluate the efficacy and safety of primary maxillomandibular advancement (MMA) with concomitant adjunctive revised uvulopalatopharyngoplasty with uvula preservation (H-UPPP) in selected patients with severe obstructive sleep apnea-hypopnea syndrome (OSASH). METHODS: Eleven consecutive male patients with velo-orohypopharyngeal and hypopharyngeal narrowing underwent MMA with concomitant H-UPPP for severe OSAHS. All patients underwent a physical examination, Epworth Sleepiness Scale evaluation, cephalometry, nocturnal polysomnogram, and velopharyngeal insufficiency questionnaire survey before and at 6 to 12 months after surgery. RESULTS: On the basis of the success criteria, defined as an apnea-hypopnea index less than 20 and a decrease greater than 50%, the success rate was 91%. The apnea-hypopnea index decreased from 67.44 (13.30) to 9.41 (7.20) events per hour (P < 0.001) and the lowest oxygen saturation increased from 63.0% (10.70%) to 88.55% (4.59%) (P < 0.001) after surgery. All patients showed a significant decrease in mandibular plane to hyoid bone and increase in PAS after surgery. One patient reported regurgitation of liquids when drinking hastily after surgery. Two patients reported regurgitation as occasional occurrences. Half a year later, 2 patients reported complete resolution of the symptoms. One patient still complained of rare regurgitation of liquids when drinking quickly. Five patients had paresthesia of the lower lip; in 4 patients, the paresthesia had resolved by 12 months after surgery. One patient still complained of paresthesia of the lower lip after 2 years of follow-up. No major complication (eg, upper airway obstruction) occurred. CONCLUSIONS: Primary MMA with concomitant adjunctive H-UPPP is effective in selected patients with severe OSAHS without major complications.

The application of CT to localize the upper airway obstruction plane in patients with OSAHS.

OBJECTIVE: To identify a correlation in terms of airway obstruction between awake and sleep apnea using spiral computed tomography (CT). STUDY DESIGN: Case series with planned data collection. SETTING: College medical center. METHODS: Sixty-one patients diagnosed with obstructive sleep apnea/hypopnea syndrome (OSAHS) underwent CT scans under 3 conditions: quiet breathing while awake, the end of deep inspiration during wakefulness, and apnea while asleep. The upper airway morphology under the 3 conditions was compared, and the accuracy of the obstructive planes as determined by CT scans under the 2 awake conditions was analyzed while considering the obstructive planes that occurred during apnea as a reference. RESULTS: The differences in the anteroposterior diameter, lateral dimension, and cross-sectional area of the retropalatal and retroglossal regions among the 3 states were statistically significant. Obstruction of the retropalatal region occurred in 100%, whereas retroglossal obstruction occurred in 44.3% of the 61 cases during sleep apnea. The coincidence rate between the awake quiet breathing and the sleep apnea was 85.2% in the retropalatal obstruction and 52.5% in the retroglossal obstruction. The coincidence rate between the awake deep inspiration and the sleep apnea was 82.0% in the retropalatal obstruction and 54.1% in the retroglossal obstruction. CONCLUSION: The main obstructive plane in patients with OSAHS was the retropalatal region. An awake upper airway CT scan can properly diagnose palatopharyngeal obstruction; however, it is not suitable for detecting retroglossal obstruction.

Predictors of surgical outcomes of uvulopalatopharyngoplasty for obstructive sleep apnea hypopnea syndrome.

OBJECTIVES: To investigate predictors of surgical outcomes of uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea hypopnea syndrome (OSAHS). STUDY DESIGN: Case series with planned data collection. SETTING: A university medical center. SUBJECTS AND METHODS: Thirty-nine patients with OSAHS received Z-palatopharyngoplasty (ZPPP) or Han-uvulopalatopharyngoplasty (H-UPPP). All patients were evaluated within 3 months before surgery and at 6 to 12 months after surgery. Statistical analyses were conducted on preoperative parameters that could have affected surgical efficacy and outcome. Success was defined as an apnea-hypopnea index (AHI) fewer than 20 times per hour and a decrease of more than 50%. RESULTS: The success rate was 56.4% (22/39 patients). There were statistically significant differences in AHI, lowest oxygen saturation (L-Sao(2)), time with oxygen saturation less than 90% (CT90), percentage of time with oxygen saturation less than 90% (CT90%), microarousal index (MI), apolipoprotein E (ApoE), high-density lipoprotein (HDL), fasting blood glucose (FBG), and Friedman OSA stage between the treatment success and failure groups. Higher success rate was predicted by lower severity, as indicated by lower AHI, CT90, CT90%, and MI; higher L-Sao(2); and fewer glucose and lipid metabolism abnormalities, shown by lower ApoE and FBG and higher HDL. CONCLUSIONS: Disease severity, glucose and lipid metabolism, and Friedman OSA stage may be important predictors of surgical outcome of UPPP for OSAHS.

Evaluation of etiological characteristics of Chinese women with recurrent spontaneous abortions: a single-centre study.

BACKGROUND: Various etiologies that contribute to the loss of pregnancy have been proposed. Despite the lack of established and uniform screening methods for recurrent pregnancy loss (RPL), there are several factors considered to be definite (or probable) causes of RPL. Data describing the etiological characteristics of RPL consist almost entirely of Caucasian populations. As we were interested in the Chinese population, the goal of this study was to determine the etiological characteristics of RPL in the Chinese patients. METHODS: The study was performed retrospectively by analyzing 1122 women with RPL. Patients were divided into three groups according to their number of pregnancy losses. Diagnostic tests included the following 9 critiria: parental genetics, uterine anatomy, autoimmune factors, alloimmune factors, thrombophilic factors, endocrine parameters, genital infection, toxoplasma, rubella, cytomegalovirus, herpes (TORCH) titers and RH blood groups. The criteria for abnormal results were defined before diagnosis. RESULTS: We found that 87.1% (977/1122) patients had no more than 3 abnormal aspects, and the proportion of total abnormal results was similar among groups. The prevalence of abnormal results for each test did not differ among groups, except in the cases of parental genetics, uterine anatomy and presence of mixed lymphocyte reaction blocking antibodies (MLR-Bf). Absence of MLR-Bf, as well as abnormally increased levels of CD3⁺CD19⁺ and CD56⁺CD16⁺ cells, was commonly detected in Chinese RPL patients. CONCLUSION: Immunological disorders play an important role in RPL among Chinese patients.

Z-palatopharyngoplasty plus genioglossus advancement and hyoid suspension for obstructive sleep apnea hypopnea syndrome.

OBJECTIVE: To explore the feasibility and efficiency of Z-palato-pharyngoplasty (ZPPP) plus genioglossus advancement and hyoid suspension (GAHM) for severe obstructive sleep apnea hypopnea syndrome (OSAHS). STUDY DESIGN: Case series with planned data collection. SETTING: A university medical center. SUBJECTS AND METHODS: Twenty-six patients who had OSAHS with Friedman obstructive sleep apnea stage II/III and posterior airway space <11 mm received GAHM and ZPPP. All patients were reevaluated 6 months after surgery using the preoperative methods. RESULTS: Based on success criteria, defined as an apnea-hypopnea index (AHI) of <20 and a decrease >50%, the success rate was 46.2% at 6 months postoperatively. The AHI showed a significant reduction from 65.6 ± 17.6 preoperatively to 30.1 ± 23.1 postoperatively. The percentage of time with oxyhemoglobin saturation below 90% (CT(90)) decreased from 30.9% ± 28.1% preoperatively to 15.5% ± 25.6% postoperatively (P < .01). Sleep architecture was effectively changed. The S3 + S4 percentage of total sleep time increased from 3.6% ± 4.4% to 8.7% ± 5.0% (P < .05). The success rates were 100% (8/8) and 22.2% (4/18) in patients with Friedman obstructive sleep apnea stage II and III, respectively. CONCLUSION: The success rate of ZPPP plus GAHM for patients with severe OSAHS who suffer from oropharyngeal and hypopharyngeal obstruction was limited. Friedman stage was a predictor of ZPPP plus GAHM surgical success.