Meta-analysis of effects of obstructive sleep apnea on the renin-angiotensinaldosterone system

BackgroundObstructive 睡觉呼吸暂停(OSA ) 是抵抗高血压的最普通的原因，它被建议了源于 renin-angiotensin-aldosterone 系统(RAAS ) 的激活。我们分析元 RAAS components.MethodsFull 文章研究的血浆层次上的 OSA 的效果在与 OSA 在成年人分析至少一个 RAAS 部件的 fasting 血浆层次与或没有高血压的 MEDLINE 和 EMBASE 上出版了。OSA 作为一个呼吸暂停呼吸过慢过浅索引或呼吸骚乱索引 ≥ 被诊断；5。学习质量用纽卡斯尔渥太华规模被评估，并且异质用 I 2 统计数值被估计。从单个研究的结果用反的变化被综合并且分享了使用一个随机效果的模型。亚群分析，敏感分析，和元回归被执行，并且出版偏爱的风险是包括的 assessed.ResultsThe 元分析 13 研究， 10 在高血压蛋白原酶上报导了结果( n = 470 个案例和控制)， 7 在血管收缩素 II 上( AngII ， n = 384 )，并且 9 在醛固酮上( n = 439 )。AngII 层次比在控制在 OSA 是显著地更高的[吝啬的差别 = 3.39 ng/L， 95% CI：2.00-4.79， P <；0.00001 ] 当醛固酮层次比 OSA 然而并非与高血压在有高血压的 OSA 是显著地更高的时(吝啬的差别 = 1.32 ng/dL， 95% CI：0.58-2.07， P = 0.0005 ) 。所有研究的元分析没在醛固酮在之间建议重要差别 OSA 和控制，而是一个重要分享的平均数 1.35 ng/mL 的差别(95% CI：0.88-1.82， P <；0.00001 ) 出现在排除一小样品的研究以后。出版偏爱的重要风险都没在所有包括的 studies.ConclusionsOSA 之中被检测与更高的 AngII 和醛固酮层次被联系，特别在高血压的病人。OSA 可以引起高血压，至少部分地，由刺激 RAAS 活动。

Modifying the intensity distribution by assessing the reliability

This article presents an application of a procedure to modify the intensity distribution by assessing the reliability. There are two potential possibilities that may influence the intensity distribution： （1） For the interpolation error, we generate a measured grid across the calculation region. When the point to station spacing is 〈5 km, we consider the results precise; however, some points have less precision because these are farther from the corresponding stations. When the spacing is between 5 and 50 km, we consider the results imprecise and define a reliability factor that correlates with the distance. （2） Some records may have errors that result from local site conditions, equipment problems, or some disturbance such as lightning stroke, which will lead to some grid points having an incorrect intensity. We regress the attenuation relation for sites with abnormal intensities and consider the results to be accurate when the standard deviation （STD） is 〈σ and inaccurate when the STD is 〉 2σ. We then define a reliability factor to correlate with STD between σ and 2σ, such that the intensity distribution is in accord with both wave propagation theory and the investigation intensity.

Rapid estimation of fault rupture extent using envelopes of acceleration

We present a new strategy to estimate the geometry of a rupture on a finite fault for rapid reporting of seismic intensity. We use envelope attenuation relationships which were presented by Huo et al. （Acta Seismol Sin 16：519-525, 1994）. An important base of this work is the fault finiteness theory. We propose a new model to simulate high-frequency motions from earthquakes with large rupture dimension. The envelope of high-frequency ground motion from a large earthquake can be expressed as a rootmean-squared combination of envelope functions from smaller earthquakes. We use simulated envelopes of ground acceleration to estimate the direction and alongstrike length of a rupture. Using the Wenchuan and Jiji （Chi-Chi） earthquake dataset, we parameterize the fault geometry with an epicenter, a fault strike, and along-strike rupture lengths. So this methodology seems quite appropriate for the rapid reporting systems of seismic intensity.

Obstructive Sleep Apnea Hypopnea Syndrome as a Reason for Active Management of Pulmonary Embolism

Background：Obstructive sleep apnea hypopnea syndrome （OSAHS） constitutes an independent factor for high warfarin dose for patients with pulmonary embolism （PE）.The aim of this study was to investigate whether the 6-month anticoagulation treatment by warfarin is enough for patients with PE complicated by OSAHS.Methods：We investigated 97 PE patients,32 of them had OSAHS and 65 non-OSAHS.Warfarin was administered for 6-month if no abnormal circumstances occurred.All patients were followed up for 18 months.Adverse events （AE） included death,major bleeding,hospitalization due to heart failure or pulmonary hypertension,and recurrence or aggravation of PE （including deep vein thrombosis）.Recurrence rate of PE after warfarin cessation was compared between the two groups.Results：OSAHS patients required a significantly higher dose of warfarin than their non-OSAHS counterparts （4.73 mg vs.3.61 mg,P 〈 0.001）.During warfarin treatment,no major bleeding and aggravation of PE occurred among OSAHS patients,and the rates of various AE were not significantly different between the OSAHS and non-OSAHS groups.PE recurrence was higher in OSAHS than non-OSAHS groups after withdrawal of warfarin （21.43% vs.6.78%,P =0.047）.Compared with non-OSAHS patients,OSAHS group had lower international normalized ratio （INR） value but higher plasminogen on baseline and INR resumed to a relatively low level after warfarin discontinuation.Conclusions：OSAHS patients may present with hypercoagulation and relatively high-risk of recurrence of PE after cessation of 6-month warfarin treatment.

Obstructive Sleep Apnea Hypopnea Syndrome： An Incognito Player Contributing to Repeated Pulmonary Embolism？

Thanks for your reading and priceless comments to our recent publication The major concern is that whether OSAHS is an independent risk factor of PE, or just a companion of other diseases which may lead to thrombotic lesions, such as diabetes, hypertension, smoking, obesity, etc. Actually the independent relationship between OSAHS and PE has already been revealed, although the pathophysiological mechanism is far from being determined. As to the repeated PE, yet no literature is available pertaining to its association with OSAHS. Independent prognostic value of OSAHS cannot be concluded from current study because of the limited cases of recurrent PE （n = 10） and thus the statistical irrationality of adjusting for the traditional risk factors mentioned in the above letter as confounding variables in Cox proportional hazards model. Given the high prevalence of OSAHS and the high morbidity and mortality associated with PE, large-scale studies are warranted.

Morphological evaluation using MRI of the olfactory filaments (fila) in a post-traumatic olfactory rat model

Objective: To investigate whether magnetic resonance imaging (MRI) can be used to directly assess olfactory bulb (OB) lesions and quantify the associated morphological changes of olfactory filaments (OF), also known as fila, in an in vivo OB-lesion rat model of the brain. Methods: A surgical group (n = 5) of male Sprague-Dawley rats was subjected to the unilat-eral damage of the OB by a steel needle. The control group (n = 5) did not receive surgery. To assess olfactory system injury in vivo, T2-weighted MRI images were acquired in an oblique plane at a 30° angle from transverse plane one day after surgery. These brain regions were also assessed in the controls. The olfactory function was evaluated using the buried food pellet test (BFPT) 5 days before and after surgery. Results: The OF could be clearly observed on the MRI images from all animals. The left and right OF mean lengths (mm) were similar in the control group (0.81 ± 0.18 vs 0.89 ± 0.17, P > 0.05). In the surgical group, the OB was partially injured in all rats. These rats did not show differences in OF length between left- and right-side (0.83 ± 0.18 vs 0.93 ± 0.24, P > 0.05) at the time of measurement. The time (sec) required to find the food pellets in the BFPT was longer after than before the surgery (83.80 ± 34.37 vs 231.44 ± 53.23, P < 0.05). Conclusions: MicroMRI may be a feasible tool to evaluate the OF and OBs in rat models. The unilateral partial OB lesion model appears to be an effective post-traumatic olfactory dysfunc-tion model.

Preface

Although often taken for granted, odors and tastes signifi-cantly impact our everyday lives, influencing our eating habits, nutrition, and safety. How many of us look forward to the aroma of brewing coffee and sizzling bacon in the morning and a delicious dinner accompanied by a fine wine in the evening?