A case-control study of obstructive sleep apnea-hypopnea syndrome in obese and nonobese chinese children

BACKGROUND: Obesity is a risk factor for obstructive sleep apnea-hypopnea syndrome (OSAHS) in adults. However, the prevalence of OSAHS in children is not clear, and the relationship between obesity and OSAHS remains controversial. METHODS: Obese children were recruited from the endocrinology, respiratory, and ear, nose, and throat clinics. Weight-matched, age-matched, and sex-matched children were recruited as control subjects. Standard questionnaires were administered, and a standardized physical examination was carried out. Lateral neck roentgenography, sleep polysomnography, full blood count, and arterial blood gas analysis were also performed. Children with body mass index z-scores of > 1.96 were considered to be obese. An adenoidal/nasopharygeal ratio of > 0.67 was considered to constitute adenotonsillar hypertrophy (ATH). OSAHS was defined as an apnea-hypopnea index (AHI) score of > 5 or obstructive apnea index (OAI) score of > 1. RESULTS: Ninety-nine obese children and 99 control subjects were recruited into the study. Obese patients had significantly higher AHI and OAI scores, and lower sleep efficiency and minimum arterial oxygen saturation (MinSao(2)) than control subjects. The prevalence of OSAHS was significantly higher in obese children with or without the ATH groups than their nonobese counterparts (odds ratio, 1.9 vs 108, respectively; 95% confidence interval, 1.21 to 4.7 vs 6.2 to 191, respectively). Obesity, tonsillar hypertrophy, and adenoid hypertrophy were independent risk factors for OSAHS (p < 0.001, p = 0.042, and p = 0.004, respectively). There was a positive correlation between the degree of obesity and AHI (r = 0.535; p < 0.001), and an inverse correlation between obesity and MinSao(2) (r = -0.507; p < 0.001). End-tidal CO(2), Paco(2), and bicarbonate levels were within the normal range. CONCLUSIONS: Obesity is a risk factor for OSAHS, and the degree of obesity is positively correlated with the severity of OSAHS.     

IOl-master700和Pentacam测量Kappa角一致性分析

目的探讨Pentacam眼前节分析系统与IOL-master 700测量Kappa角的差异性和一致性。方法横断面研究。选取2019年03月01-04月01在乐山市眼科中心性白内障术前检查患者71例(121只眼)。其中男性40例,女性31例;年龄(62±17岁)。分别用Pentacam、IOLMaster 700进行X值及Y值测量,采用方差分析及LSD-t比较组间差异性,组内相关系数(ICC)及Bland-Altman法评价仪器的一致性。结果方差分析显示,两种仪器测量X值无统计学意义(F=0.496,P>0.05),Y值无统计学意义(F=0.030,P>0.05),两种仪器各测量值间ICC为0.667、0.689,Cronbach’s Alpha为0.79、0.816,显示两种仪器测量结果可信度好。Bland-Altman分析显示Pentacam与IOLMaster 700测量X值比较,有7/121(5.8%)个点位于95%LoA外,一致性好,差值范围为(-0.19~0.22);Y值测量,有8/121(6.7%)个点位于95%LoA外,一致性好,差值范围为(-0.14~0.15),一致性好。结论两种仪器测量KAPPA角的差异性小,一致性均较好。     

Microstructure and Texture Evolution during Superplastic Deformation of SP700 Titanium Alloy

The superplastic tensile test was carried out on SP700 (Ti-4.5Al-3V-2Mo-2Fe) titanium alloy sheet at 760 °C by the method of maximum m value, and the microstructure characteristics were investigated to understand the deformation mechanism. The results indicated that the examined alloy showed an extremely fine grain size of ~1.3 μm and an excellent superplasticity with fracture elongation of up to 3000%. The grain size and the volume fraction of the β phase increased as the strain increased, accompanied by the elements’ diffusion. The β-stabilizing elements (Mo, Fe, and V) were mainly dissolved within the β phase and diffused from α to β phase furthermore during deformation. The increase in strain leads to the accumulation of dislocations, which results in the increase in the proportion of low angle grain boundaries by 15%. As the deformation process, the crystal of α grains rotated, and the texture changed, accompanied by the accumulation of dislocations. The phase boundary (α/β) sliding accommodated by dislocation slip was the predominant mechanism for SP700 alloy during superplastic deformation.     

Stimulus probability affects the visual N700 component of the event-related potential

ObjectiveTo examine whether the occipito-temporal visual N700 component of the event-related potential is sensitive to stimulus probabilities.MethodsP1, N1, P3, and, in particular, the occipito-temporal N700 component of the event-related potential were analysed in response to frequent and rare non-target letters of a continuous performance task in 200 healthy adolescents. Additionally, amplitude habituation with time was examined for the occipito-temporal N700 and N1 components.ResultsThe visual P1, N1, and occipito-temporal N700 components were significantly larger in response to rare letters than to frequent letters, whereas the P3 component demonstrated no amplitude difference. Over time, the occipito-temporal N700 amplitude decreased in response to the rare letters, while the N1 amplitude increased, to both, frequent and rare letters.ConclusionsThis study provides first evidence that the visual occipito-temporal N700 is sensitive to stimulus probabilities, suggesting an enhanced post-processing of rare stimuli in secondary visual areas. The distinct habituation patterns of occipito-temporal N700 and N1 amplitudes distinguish repetition effects on stimulus post-processing (N700) from those on perception (N1).SignificanceThe enhanced N700 component to rare stimuli might reflect an orienting response and underlying attentional processes. The N700 sensitivity to stimulus probabilities should be examined in patient groups with attentional deficits.     

Guidelines for hospital privileges in vascular surgery and endovascular interventions: Recommendations of the Society for Vascular Surgery

The Hospital Privileges Practice Guideline Writing Group of the Society for Vascular Surgery is making the following five recommendations concerning guidelines for hospital privileges for vascular surgery and endovascular therapy. Advanced endovascular procedures are currently entrenched in the everyday practice of specialized vascular interventionalists, including vascular surgeons, but open vascular surgery remains uniquely essential to the specialty. First, we endorse the Residency Review Committee for Surgery recommendations regarding open and endovascular cases during vascular residency and fellowship training. Second, applicants for new hospital privileges wishing to perform vascular surgery should have completed an Accreditation Council for Graduate Medical Education-accredited vascular surgery residency or fellowship or American Osteopathic Association-accredited training program before 2020 and should obtain American Board of Surgery certification in vascular surgery or American Osteopathic Association certification within 7 years of completion of their training. Third, we recommend that applicants for renewal of hospital privileges in vascular surgery include physicians who are board certified in vascular surgery, general surgery, or cardiothoracic surgery. These physicians with an established practice in vascular surgery should participate in Maintenance of Certification programs as established by the American Board of Surgery and maintain their respective board certification. Fourth, we provide recommendations concerning guidelines for endovascular procedures for vascular surgeons and other vascular interventionalists who are applying for new or renewed hospital privileges. All physicians performing open or endovascular procedures should track outcomes using nationally validated registries, ideally by the Vascular Quality Initiative. Fifth, we endorse the Intersocietal Accreditation Commission recommendations for noninvasive vascular laboratory interpretations and examinations to become a Registered Physician in Vascular Interpretation, which is included in the requirements for board eligibility in vascular surgery, but recommend that only physicians with demonstrated clinical experience in the diagnosis and management of vascular disease be allowed to interpret these studies.     

Broviac catheter-related Malassezia furfur sepsis in five infants receiving intravenous fat emulsions

Malassezia furfur, a lipophilic fungus commonly found on the skin of healthy adult, was isolated from Broviac catheter blood cultures in five sick infants who were receiving fat emulsions intravenously. The most common manifestations of sepsis included apnea and bradycardia, low-grade fever, interstitial pneumonia, elevated neutrophil band counts, and thrombocytopenia. All infants recovered without antifungal therapy after removal of the Broviac catheters. Early onset of fungemia after catheter placement in these five infants and the recovery of M. furfur from the skin of nearly 33% of hospitalized premature neonates indicate that contamination of the Broviac catheter at time of placement may be the most likely origin of infection.     

Altered proteasomal function in sporadic Parkinson's disease

Parkinson's disease (PD) is characterized pathologically by preferential degeneration of the dopaminergic neurons in the substantia nigra pars compacta (SNc). Nigral cell death is accompanied by the accumulation of a wide range of poorly degraded proteins and the formation of proteinaceous inclusions (Lewy bodies) in dopaminergic neurons. Mutations in the genes encoding alpha-synuclein and two enzymes of the ubiquitin-proteasome system, parkin and ubiquitin C-terminal hydrolase L1, are associated with neurodegeneration in some familial forms of PD. We now show that, in comparison to age-matched controls, alpha-subunits (but not beta-subunits) of 26/20S proteasomes are lost within dopaminergic neurons and 20S proteasomal enzymatic activities are impaired in the SNc in sporadic PD. In addition, while the levels of the PA700 proteasome activator are reduced in the SNc in PD, PA700 expression is increased in other brain regions such as the frontal cortex and striatum. We also found that levels of the PA28 proteasome activator are very low to almost undetectable in the SNc compared to other brain areas in both normal and PD subjects. These findings suggest that failure of the ubiquitin-proteasome system to adequately clear unwanted proteins may underlie vulnerability and degeneration of the SNc in both sporadic and familial PD.     

Mechanisms of photosystem I activity stimulation in trypsin-treated pea chloroplast membranes

Trypsin-induced effects on the PSI-photochemical activity of pea chloroplast membranes have been measured under saturating light conditions. It was found that incubation of isolated chloroplasts with trypsin in concentration range of 20–60 μg trypsin per mg Chl leads to a linear increase of the rate of PSI-mediated electron transport, measured by O₂-uptake with methyl viologen as an electron acceptor and DCPIP·H₂ as electron donor. Low temperature (77 K) chlorophyll fluorescence measurements have indicated that a remarkable redistribution of excitation light energy in favor of PSI occurs under these conditions. The results are interpreted in terms of trypsin-induced lateral reorganization of the chlorophyll—protein complexes within the thylakoid membranes and specific alteration at the level of LHC a/b-PSII supramolecular organization.     

Initial experience with the polytetrafluoroethylene graft for limb salvage. A report on twenty patients

The early results of the bypass procedures for limb salvage using the new polytetrafluoroethylene (PTFE) graft are analyzed. Of twenty patients presenting with either severe rest pain or gangrene, patency has been maintained in fourteen for a mean period of thirteen months to date. Particularly satisfying results have been achieved when bypassing into single dominant arteries below the knee where limb salvage and graft patency was obtained in all cases.     

Hyperglycemia in stressed small premature neonates.

The metabolic responses to a constant glucose infusion were measured in 30 premature infants, 700 to 1,550 gm. The study included 18 stressed premature infants who needed assisted ventilation, and 12 control premature infants. Metabolic measurements were similar in both groups in the cord and preinfusion samples. In the first postinfusion sample, glucose, cortisol, and glycerol values were higher in stressed than in control premature infants. Hyperglycemia was seen in 13 of stressed and in only one of control premature infants. Stressed infants who became hyperglycemic in the first postinfusion sample were then compared to stressed euglycemic infants. Insulin levels were higher, glycerol levels similar, but cortisol levels lower in stressed hyperglycemic than in stressed euglycemic premature infants. The etiology of hyperglycemia in stressed premature infants cannot be attributed to hypoinsulinemia or to hypercortisolemia, and is not associated with increased glycerol levels. There was no difference in mortality between stressed hyperglycemia and stressed euglycemic infants; stress, rather than hyperglycemia, was related to mortality.