Effect of nocturia in patients with different severity of obstructive sleep apnea on polysomnography: A retrospective observational study

Patients with suspected OSA were examined using PSG.They were divided into two groups based on the presence of nocturia.Nocturia was defined as a patient who needed to void at least once.Apneaehypopnea index(AHI)was employed to classify patients according to degrees of severity:AHI<5 events/h,5 events/hAHI<15 events/h,15 events/hAHI<30 events/h,and AHI30 events/h,defined as normal,mild OSA,moderate OSA,and severe OSA,respectively.Demographic variables,PSG parameters,International Prostate Symptom Scores(IPSSs),and quality of life scores due to urinary symptoms were analyzed.Results:In total 140 patients,114 patients had OSA(48 had mild OSA;34 had moderate OSA;and 32 had severe OSA)and 107 patients had nocturia.The total IPSS was significantly higher in nocturia patients in all groups except the group of severe OSA patients.With the increasing severity of OSA,more correlated factors related to nocturia were determined.In mild OSA patients,nocturia related to increased age(p=0.025),minimum arterial blood oxygenation saturation(p=0.046),and decreased AHI of non-rapid eye movement(p=0.047),AHI of total sleep time(p=0.010),and desaturation index(p=0.012).In moderate OSA patients,nocturia related to increased age(p<0.001),awake time(p=0.025),stage 1 sleep(p=0.033),and sleep latency(p=0.033),and decreased height(p=0.044),weight(p=0.025),and sleep efficiency(p=0.003).In severe OSA patients,nocturia related to increased weight(p=0.011),body mass index(p=0.009),awake time(p=0.008),stage 1 sleep(p=0.040),arousal number(p=0.030),arousal index(p=0.013),periodic limb movement number(p=0.013),and periodic limb movement index(p=0.004),and decreased baseline arterial blood oxygenation saturation(p=0.046).Conclusion:Our study revealed that there were more correlated factors related to nocturia with increasing severity of OSA.This study helps in clinical education and treatment for OSA patients with different severity.

Thymoquinone suppresses migration of Lo Vo human colon cancer cells by reducing prostaglandin E2 induced COX-2 activation

AIM To identify potential anti-cancer constituents in natural extracts that inhibit cancer cell growth and migration. METHODS Our experiments used high dose thymoquinone (TQ) as an inhibitor to arrest LoVo (a human colon adenocarcinoma cell line) cancer cell growth, which was detected by cell proliferation assay and immunoblotting assay. Low dose TQ did not significantly reduce LoVo cancer cell growth. Cyclooxygenase 2 (COX-2) is an enzyme that is involved in the conversion of arachidonic acid into prostaglandin E2 (PGE2) in humans. PGE2 can promote COX-2 protein expression and tumor cell proliferation and was used as a control. RESULTS Our results showed that 20 mu mol/L TQ significantly reduced human LoVo colon cancer cell proliferation. TQ treatment reduced the levels of p-PI3K, p-Akt, p-GSK3 beta, and beta-catenin and thereby inhibited the downstream COX-2 expression. Results also showed that the reduction in COX-2 expression resulted in a reduction in PGE2 levels and the suppression of EP2 and EP4 activation. Further analysis showed that TG treatment inhibited the nuclear translocation of beta-catenin in LoVo cancer cells. The levels of the cofactors LEF-1 and TCF-4 were also decreased in the nucleus following TQ treatment in a dose-dependent manner. Treatment with low dose TQ inhibited the COX-2 expression at the transcriptional level and the regulation of COX-2 expression efficiently reduced LoVo cell migration. The results were further verified in vivo by confirming the effects of TQ and/or PGE2 using tumor xenografts in nude mice. CONCLUSION TQ inhibits LoVo cancer cell growth and migration, and this result highlights the therapeutic advantage of using TQ in combination therapy against colorectal cancer.

Health disparities are associated with gastric cancer mortality-to-incidence ratios in 57 countries

AIM To evaluate the association between mortality-to-incidence ratios(MIRs) and health disparities.METHODS In this study, we used the GLOBOCAN 2012 database to obtain the cancer incidence and mortality data for 57 countries, and combined this information with the World Health Organization(WHO) rankings and total expenditures on health/gross domestic product(e/GDP). The associations between variables and MIRs were analyzed by linear regression analyses and the 57 countries were selected according to their data quality. RESULTS The more developed regions showed high gastric cancer incidence and mortality crude rates, but lower MIR values than the less developed regions(0.64 vs 0.80, respectively). Among six continents, Oceania had the lowest(0.60) and Africa had the highest(0.91) MIR. A good WHO ranking and a high e/GDP were significantly associated with low MIRs(P = 0.001 and P = 0.001, respectively).CONCLUSION The MIR variation for gastric cancer would predict regional health disparities.

Altered heart rate variability and pulse-wave velocity after spinal cord injury

BACKGROUND Heart rate variability(HRV) and pulse-wave velocity(PWV),indicators of cardiac function,are altered in patients with spinal cord injury(SCI),suggesting that autonomic cardiac function and arterial stiffness may underlie the high risk of cardiovascular complications in these patients.No study has simultaneously investigated HRV and PWV in the same patients.AIM To evaluate cardiovascular complications in SCI patients by comparing HRV and PWV between patients with and without SCI.METHODS In this cross-sectional pilot study,patients with(n = 60) and without SCI(n = 60) were recruited from December 7,2019 to January 21,2020.Each participant received a five-minute assessment of HRV and the cardiovascular system using the Medicore HRV Analyzer SA-3000 P.Differences in HRV and PWV parameters between participants with and without SCI were statistically examined.RESULTS We observed a significant difference between participants with and without SCI with respect to the standard deviation of all normal-to-normal intervals,square root of the mean sum of squared successive risk ratio interval differences,physical stress index,total power,very-low frequency,low frequency,high frequency,and arterial elasticity.CONCLUSION Patients with SCI have weaker sympathetic and parasympathetic activity as well as lower arterial elasticity compared to those without,suggesting that SCI may increase cardiac function loading.

Severe heterotopic ossification in a seronegative spondyloarthritis patient after cervical Bryan disc arthroplasty: A case report

BACKGROUND Cervical disc arthroplasty(CDA)is an alternative treatment to traditional interbody fusion that maintains postoperative cervical spine mobility.However,the CDA postoperative period is impacted by osteolysis,subsidence,metallosis,or heterotopic ossification(HO).We report a case of severe HO in a seronegative spondyloarthritis patient after cervical Bryan disc arthroplasty.CASE SUMMARY A 34-year-old man received hybrid surgery for C4-C5 and C5-C6 arthroplasty with Bryan discs and C6-C7 arthrodesis with polyetheretherketone cage due to traumatic herniation of the intervertebral disc(HIVD).After four years,cervical spine radiographs revealed severe HO around the Bryan discs over the C4-C5 and C5-C6 levels.The magnetic resonance image revealed HIVD over the C3-C4 level with spinal cord compression.Seronegative spondyloarthritis was diagnosed after consultation with a rheumatologist.A second CDA for the adjacent segment disease HIVD with Baguera C disc over the C3-C4 level achieved an excellent outcome.CONCLUSION Minimizing intraoperative tissue trauma and achieving postoperative interbody stability avoid soft tissue traction to prevent HO formation after CDA.

Exosomes as promising frontier approaches in future cancer therapy

In this editorial,we will discuss the article by Tang et al published in the recent issue of the World Journal of Gastrointestinal Oncology.They explored an innovative approach to enhancing gemcitabine(GEM)delivery and efficacy using human bone marrow mesenchymal stem cells(HU-BMSCs)-derived exosomes.The manufacture of GEM-loaded HU-BMSCs-derived exosomes(Exo-GEM)has been optimized.The Tang et al’s study demonstrated that Exo-GEM exhibits enhanced cytotoxicity and apoptosis-inducing effects compared to free GEM,highlighting the potential of exosome-based drug delivery systems as a more effective and targeted approach to chemotherapy in pancreatic cancer.Additional in vivo studies are required to confirm the safety and effectiveness of Exo-GEM before it can be considered for clinical use.