Objective Measuring the serum concentrations of adrenocorticotropic hormone （ACTH） and cortisol in epileptic seizures during sleep to investigate their link to the EEG changes. Methods Pre-surgical evaluation was pe...Objective Measuring the serum concentrations of adrenocorticotropic hormone （ACTH） and cortisol in epileptic seizures during sleep to investigate their link to the EEG changes. Methods Pre-surgical evaluation was performed by videoEEG monitoring using 24 channel recording. Thirty six epilepsy patients could be attributed to two groups： 28 patients had spontaneous seizures, and the other 8 patients whose seizures were induced by bemegride. Another 11 persons with confirmed psychogenic non-epileptic seizures （PNES） served as control group. Blood samples were obtained at five points： wake （08：00 a.m.）, sleep （00：00 a.m.）, and shortly before, during and after an epileptic seizure. The serum ACTH and cortisol were measured and analyzed by chemiluminescent immunoassay. Results The levels of ACTH and cortisol in serum underwent significant changes： declining below the average sleep-level shortly before seizures, increasing during seizures, and far above the average wake-level after seizures （P 〈 0.001）. Such changes did not occur in the control group （P 〉 0.05）. The ACTH and cortisol levels had no significant difference between spontaneous group and bemegride-induced group （P 〉 0.05）. Conclusion The serum concentrations of ACTH and cortisol during sleep seizures are linked with pre-ictal and ictal EEG changes in epilepsy patients.展开更多
Background Obstructive sleep apnea （OSA） is the most common cause of resistant hypertension, which has been proposed to result from activation of the renin-angiotensin-aldosterone system （RAAS）. We meta-analyzed t...Background Obstructive sleep apnea （OSA） is the most common cause of resistant hypertension, which has been proposed to result from activation of the renin-angiotensin-aldosterone system （RAAS）. We meta-analyzed the effects of OSA on plasma levels of RAAS components. Methods Full-text studies published on MEDL1NE and EMBASE analyzing fasting plasma levels of at least one RAAS component in adults with OSA with or without hypertension. OSA was diagnosed as an apnea-hypopnea index or respiratory disturbance index 〉 5. Study quality was evaluated using the Newcastle-Ottawa Scale, and heterogeneity was assessed using the 12 statistic. Results from individual studies were synthesized using inverse variance and pooled using a random-effects model. Subgroup analysis, sensitivity analysis, and meta-regression were performed, and risk of publication bias was assessed. Results The meta-analysis included 13 studies, of which 10 reported results on renin （n = 470 cases and controls）, 7 on angiotensin II （AnglI, n = 384）, and 9 on aldosterone （n = 439）. AnglI levels were significantly higher in OSA than in controls [mean differences = 3.39 ng/L, 95% CI： 2.00-4.79, P 〈 0.00001], while aldosterone levels were significantly higher in OSA with hypertension than OSA but not with hypertension （mean differences = 1.32 ng/dL, 95% CI： 0.58-2.07, P = 0.0005）. Meta-analysis of all studies suggested no significant differences in aldosterone between OSA and controls, but a significant pooled mean difference of 1.35 ng/mL （95% CI： 0.88-1.82, P 〈 0.00001） emerged after excluding one small-sample study. No significant risk of publication bias was detected among all included studies. Conelusions OSA is associated with higher AnglI and aldosterone levels, espe- cially in hypertensive patients. OSA may cause hypertension, at least in part, by stimulating RAAS activity.展开更多
AIM: To explore the relationship between the level of proinsulin with cardiovascular risk factors and sleep snoring.METHODS: Based on the random stratified sampling principle, 1 193 Chinese residents in Pizhou City, J...AIM: To explore the relationship between the level of proinsulin with cardiovascular risk factors and sleep snoring.METHODS: Based on the random stratified sampling principle, 1 193 Chinese residents in Pizhou City, Jiangsu Province (530 males and 663 females, aged 35-59 years with an average age of 46.69 years) were recruited. Their sleep snoring habits were investigated. Biotin-avidin based double mAbs ELISA was used to detect specific insulin and proinsulin, and a risk factor score was established to evaluate the individuals according to the number of their risk factors.RESULTS: The results of Spearman correlation analysis and covariate ANOVA analysis after age and sex were controlled, indicated that not only the level of proinsulin (r = 0.156, P = 0.000, F= 5.980 P = 0.000), but also cardiovascular risk factors score (r = 0.194, P = 0.000,F= 11.135, P = 0.000) significantly associated with the frequency of sleep snoring, and the significant relationship between true insulin and frequency of sleep snoring was only shown in the covariate ANOVA analysis (F = 2.868,P = 0.022). The result of multivariate stepwise logistic regression after age, sex, body mass index, waist circumference and true insulin were controlled showed that proinsulin (division by interval of quartile) was an independent risk factor for sleep snoring (OR = 1.220,95%CI: 1.085-1.373, P = 0.001).CONCLUSION: The interaction of cardiovascular risk factors clustering, high proinsulin level and sleep breathing disorder may be a syndrome, which has not been recognized in human beings so far.展开更多
Objective:To observe the effect of warm-unblocking acupuncture plus fluticasone propionate nasal spray on the pulmonary ventilation,level of interferon-y(IFN-y)and sleep quality in parents with allergic rhinitis(AR).M...Objective:To observe the effect of warm-unblocking acupuncture plus fluticasone propionate nasal spray on the pulmonary ventilation,level of interferon-y(IFN-y)and sleep quality in parents with allergic rhinitis(AR).Methods:A total of 112 AR patients were enrolled between January 2013 and August 2018 and were divided into an observation group and a control group by the random number table method,with 56 cases in each group.Patients in the observation group received warm-unblocking acupuncture plus fluticasone propionate nasal spray,and patients in the control group only received fluticasone propionate nasal spray.The nasal symptom score,pulmonary function indexes,the levels of IFN-y and interleukin(IL)-4 in serum,and sleep quality in the two groups were compared.Results:After treatment,the total effective rate in the observation group was higher than that in the control group(P<0.05).The nasal symptom score dropped in both groups after treatment(both P<0.05),and the score in the observation group was lower than that in the con trol group(P<0.05).The pulm onary ven tilati on indexes all in creased sign ificantly after treatment in the observation group(all P<0.05);the forced expiratory volume in 1 second(FEV1)to forced vital capacity(FVC)ratio(FEV1/FVC)and the forced expiratory flow at 50%,75%and 25%-75%of the vital capacity(FEF50%,FEF75%,FEF25%-75%)in creased after treatme nt in the control group(all P<0.05);the pulm onary ven tilati on in dexes were higher in the observati on group tha n those in the control group(all P<0.05).The level of IFN-y in creased sign ificantly after t reatment in the two groups(both P<0.05)and the level of IL-4 dropped significantly(both P<0.05);the observation group had a higher IFN-y level(P<0.05)and a lower IL-4 level(P<0.05)compared with the control group.Regarding the Pittsburgh sleep quality index(PSQI),the scores of subjective sleep quality,habitual sleep efficiency and sleep disturbances and the general PSQI score decreased significantly after treatment in both groups(all P<0.05),and the scores in the observation group were significantly lower than those in the control group(all P<0.05).Conclusion:Warm-unblocking acupuncture plus fluticasone propionate nasal spray can effectively control the clinical symptoms and improve pulmonary function in the treatment of AR;this approach can regulate the levels of IFN-y and IL-4 towards the normal range in AR patients;it can also improve patient's sleep quality.This method can produce more significant efficacy than fluticasone propionate nasal spray used alone.展开更多
文摘Objective Measuring the serum concentrations of adrenocorticotropic hormone （ACTH） and cortisol in epileptic seizures during sleep to investigate their link to the EEG changes. Methods Pre-surgical evaluation was performed by videoEEG monitoring using 24 channel recording. Thirty six epilepsy patients could be attributed to two groups： 28 patients had spontaneous seizures, and the other 8 patients whose seizures were induced by bemegride. Another 11 persons with confirmed psychogenic non-epileptic seizures （PNES） served as control group. Blood samples were obtained at five points： wake （08：00 a.m.）, sleep （00：00 a.m.）, and shortly before, during and after an epileptic seizure. The serum ACTH and cortisol were measured and analyzed by chemiluminescent immunoassay. Results The levels of ACTH and cortisol in serum underwent significant changes： declining below the average sleep-level shortly before seizures, increasing during seizures, and far above the average wake-level after seizures （P 〈 0.001）. Such changes did not occur in the control group （P 〉 0.05）. The ACTH and cortisol levels had no significant difference between spontaneous group and bemegride-induced group （P 〉 0.05）. Conclusion The serum concentrations of ACTH and cortisol during sleep seizures are linked with pre-ictal and ictal EEG changes in epilepsy patients.
文摘Background Obstructive sleep apnea （OSA） is the most common cause of resistant hypertension, which has been proposed to result from activation of the renin-angiotensin-aldosterone system （RAAS）. We meta-analyzed the effects of OSA on plasma levels of RAAS components. Methods Full-text studies published on MEDL1NE and EMBASE analyzing fasting plasma levels of at least one RAAS component in adults with OSA with or without hypertension. OSA was diagnosed as an apnea-hypopnea index or respiratory disturbance index 〉 5. Study quality was evaluated using the Newcastle-Ottawa Scale, and heterogeneity was assessed using the 12 statistic. Results from individual studies were synthesized using inverse variance and pooled using a random-effects model. Subgroup analysis, sensitivity analysis, and meta-regression were performed, and risk of publication bias was assessed. Results The meta-analysis included 13 studies, of which 10 reported results on renin （n = 470 cases and controls）, 7 on angiotensin II （AnglI, n = 384）, and 9 on aldosterone （n = 439）. AnglI levels were significantly higher in OSA than in controls [mean differences = 3.39 ng/L, 95% CI： 2.00-4.79, P 〈 0.00001], while aldosterone levels were significantly higher in OSA with hypertension than OSA but not with hypertension （mean differences = 1.32 ng/dL, 95% CI： 0.58-2.07, P = 0.0005）. Meta-analysis of all studies suggested no significant differences in aldosterone between OSA and controls, but a significant pooled mean difference of 1.35 ng/mL （95% CI： 0.88-1.82, P 〈 0.00001） emerged after excluding one small-sample study. No significant risk of publication bias was detected among all included studies. Conelusions OSA is associated with higher AnglI and aldosterone levels, espe- cially in hypertensive patients. OSA may cause hypertension, at least in part, by stimulating RAAS activity.
基金Supported by the National Natural Science Foundation of China,No. 30400173
文摘AIM: To explore the relationship between the level of proinsulin with cardiovascular risk factors and sleep snoring.METHODS: Based on the random stratified sampling principle, 1 193 Chinese residents in Pizhou City, Jiangsu Province (530 males and 663 females, aged 35-59 years with an average age of 46.69 years) were recruited. Their sleep snoring habits were investigated. Biotin-avidin based double mAbs ELISA was used to detect specific insulin and proinsulin, and a risk factor score was established to evaluate the individuals according to the number of their risk factors.RESULTS: The results of Spearman correlation analysis and covariate ANOVA analysis after age and sex were controlled, indicated that not only the level of proinsulin (r = 0.156, P = 0.000, F= 5.980 P = 0.000), but also cardiovascular risk factors score (r = 0.194, P = 0.000,F= 11.135, P = 0.000) significantly associated with the frequency of sleep snoring, and the significant relationship between true insulin and frequency of sleep snoring was only shown in the covariate ANOVA analysis (F = 2.868,P = 0.022). The result of multivariate stepwise logistic regression after age, sex, body mass index, waist circumference and true insulin were controlled showed that proinsulin (division by interval of quartile) was an independent risk factor for sleep snoring (OR = 1.220,95%CI: 1.085-1.373, P = 0.001).CONCLUSION: The interaction of cardiovascular risk factors clustering, high proinsulin level and sleep breathing disorder may be a syndrome, which has not been recognized in human beings so far.
文摘Objective:To observe the effect of warm-unblocking acupuncture plus fluticasone propionate nasal spray on the pulmonary ventilation,level of interferon-y(IFN-y)and sleep quality in parents with allergic rhinitis(AR).Methods:A total of 112 AR patients were enrolled between January 2013 and August 2018 and were divided into an observation group and a control group by the random number table method,with 56 cases in each group.Patients in the observation group received warm-unblocking acupuncture plus fluticasone propionate nasal spray,and patients in the control group only received fluticasone propionate nasal spray.The nasal symptom score,pulmonary function indexes,the levels of IFN-y and interleukin(IL)-4 in serum,and sleep quality in the two groups were compared.Results:After treatment,the total effective rate in the observation group was higher than that in the control group(P<0.05).The nasal symptom score dropped in both groups after treatment(both P<0.05),and the score in the observation group was lower than that in the con trol group(P<0.05).The pulm onary ven tilati on indexes all in creased sign ificantly after treatment in the observation group(all P<0.05);the forced expiratory volume in 1 second(FEV1)to forced vital capacity(FVC)ratio(FEV1/FVC)and the forced expiratory flow at 50%,75%and 25%-75%of the vital capacity(FEF50%,FEF75%,FEF25%-75%)in creased after treatme nt in the control group(all P<0.05);the pulm onary ven tilati on in dexes were higher in the observati on group tha n those in the control group(all P<0.05).The level of IFN-y in creased sign ificantly after t reatment in the two groups(both P<0.05)and the level of IL-4 dropped significantly(both P<0.05);the observation group had a higher IFN-y level(P<0.05)and a lower IL-4 level(P<0.05)compared with the control group.Regarding the Pittsburgh sleep quality index(PSQI),the scores of subjective sleep quality,habitual sleep efficiency and sleep disturbances and the general PSQI score decreased significantly after treatment in both groups(all P<0.05),and the scores in the observation group were significantly lower than those in the control group(all P<0.05).Conclusion:Warm-unblocking acupuncture plus fluticasone propionate nasal spray can effectively control the clinical symptoms and improve pulmonary function in the treatment of AR;this approach can regulate the levels of IFN-y and IL-4 towards the normal range in AR patients;it can also improve patient's sleep quality.This method can produce more significant efficacy than fluticasone propionate nasal spray used alone.
