Could non-HDL-cholesterol be a better marker of atherogenic dyslipidemia in obstructive sleep apnea?

Background/objectiveObstructive sleep apnea (OSA) is independently associated with dyslipidemia, a surrogate marker of atherosclerosis. Low-density lipoprotein (LDL)-cholesterol is accepted as a major independent risk factor for cardiovascular disease. However, non-high-density lipoprotein (HDL)-cholesterol is a better marker of atherogenic dyslipidemia and recommended as a target of lipid lowering therapy. We aimed to assess the prevalence of atherogenic dyslipidemia, and relationship between OSA severity and serum LDL-cholesterol and non-HDL cholesterol levels in OSA patients.MethodsWe retrospectively evaluated treatment naïve 2361 subjects admitted to the sleep laboratory of a university hospital for polysomnography. All subjects’ lipid profile including total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, and non-HDL-cholesterol were measured.ResultsOut of 2361 patients (mean age 49.6 ± 11.9 years; 68.9% male, apnea-hypopnea index 36.6 ± 28.4/h), 185 (7.8%) had no OSA and 2176 (92.2%) had OSA. Atherogenic dyslipidemia prevalence was high (57–66%) in OSA patients, and especially increased in severe OSA compared to other groups (p < 0.05). Though total and LDL-cholesterol did not differ between those with and without OSA, non-HDL-cholesterol (p = 0.020), and triglycerides (p = 0.001) were higher and HDL-cholesterol levels (p = 0.018) were lower in OSA patients than non-OSA. Non-HDL-cholesterol was significantly correlated with OSA severity (p < 0.001) and hypoxia parameters (p < 0.01), whereas LDL-cholesterol showed no correlation.ConclusionsAtherogenic dyslipidemia is highly prevalent and non-HDL-cholesterol levels are significantly increased, predominantly in severe OSA patients. Non-HDL-cholesterol but not LDL-cholesterol, is significantly correlated with OSA severity and hypoxia parameters. Therefore, it could be better to use non-HDL-cholesterol, which is a guideline recommended target of lipid therapy, as a marker of atherosclerotic cardiovascular risk in OSA patients.     

热休克蛋白90对大鼠缺氧心肌细胞丝氨酸苏氨酸蛋白激酶表达的影响

目的探讨内源性热休克蛋白90（HSP90）在缺氧心肌细胞丝氨酸苏氨酸蛋白激酶（AKT）相关信号通路中的作用。方法建立新生Wistar大鼠心肌细胞缺氧模型，将细胞分为正常组、缺氧组、加入HSP90特异性阻断剂格尔德霉素后再缺氧组（格尔德霉素＋缺氧组）。于缺氧后1、3、6、12、24、48h用噻唑蓝法检测心肌细胞的活力；缺氧24h，原位缺口末端标记法检测心肌细胞凋亡指数（AI）；缺氧1、3、6、12、24h，蛋白质印迹法检测大鼠心肌细胞中内源性HSP90及AKT表达水平。结果（1）缺氧24、48h，缺氧组、格尔德霉素＋缺氧组细胞活力均较正常组明显下降（P〈0．05）；格尔德霉素＋缺氧组细胞活力缺氧12h即开始明显下降，缺氧48h时明显低于缺氧组（P〈0．05）。（2）缺氧24h，缺氧组细胞AI为（10．7±1．2）％，明显高于正常组[（1．9±0．3）％．P〈0．05]；格尔德霉素＋缺氧组细胞AI为（26、3±5．3）％，明显高于缺氧组（P〈0．01）。（3）缺氧12h，缺氧组心肌细胞内源性HSP90及AKT表达水平高于正常组与格尔德霉素＋缺氧组；缺氧24h，缺氧组有所下降．格尔德霉素＋缺氧组则下降更明显。结论内源性HSP90对维持心肌细胞的活力有重要作用．缺氧心肌细胞AKT表达水平可受内源性HSP90表达水平的影响。     

Pterygium excision with free conjunctival autograft (FCG) versus postoperative strontium 90 (90Sr) beta-irradiation. A prospective study

In a prospective study the results of a pterygium excision in 54 patients (57 eyes) who underwent a superficial free conjunctival autograft (FCG) were compared to those of patients who were treated with postoperative90Sr-irradiation. In 51 cases the minimum follow-up was six months, the maximum follow-up seven years. We divided the study up into a randomized part and an open part. In the randomized part, surgery of a primary pterygium was performed in 25 eyes, of which 16 were treated with a FCG and compared with 9 eyes with primary pterygium surgery and postoperative90Sr beta-irradiation. In the same period 16eyes were treated because of a recurrent pterygium: 8 with FCG and 8 with90Sr-irradiation. In the open part of the study16 eyes with primary pterygium were successively treated with FCG alone. The results showed in the randomized, as well as in the open study on primary surgery with a minimum follow-up of six month, one recurrence in each of the FCG-groups (2 out of 31 eyes =6.4%), and no recurrences in the 90Sr-group(0%). In the randomized group of patients treated for a recurrent pterygium one recurrence developed in the FCG group (1 out of 8 eyes =12.5%) and one in the 90Sr-group (1 out of 7 =14.6%). Analysis of other clinical parameters showed that postoperative treatment with corticosteroids, nonsteroidal anti-inflammatory drugs, and artificial tears was necessary for a longer period in the FCG group than in the90Sr-group. This revised version was published online in August 2006 with corrections to the Cover Date.     

延长血透机使用寿命的探讨

血液透析是治疗肾功能衰竭的有效方法,应用血液透析机挽救成千上万人的生命,在肾病的保守疗法、透析疗法、肾移植三种可选的治疗方案中,透析疗法是当前治疗肾病的最有效方法。本文对如何延长血透机的使用寿命进行了经验总结和探讨。     

Occurrence and Distribution of Bone Tumors in Beagle Dogs Exposed to 90Sr

Radiation-induced bone tumors in beagle dogs exposed to ⁹⁰Sr have been evaluated in terms of their incidence, time of appearance, occurrence as multiple tumors, anatomic distribution, and the influence of sex on their development. Among dogs fed ⁹⁰Sr during skeletal development, the incidence of bone tumors was dose dependent. Tumors thus appeared in 10 of 19 dogs receiving average skeletal doses of 130 Gy, 15 of 60 receiving 97 Gy, 5 of 61 receiving 61 Gy, 2 of 65 receiving 26 Gy, and 1 of 40 receiving 1.3 Gy. No tumors appeared among 66 dogs who received 8 Gy, 78 who received 0.3 Gy, and 80 non-irradiated controls, all of which have been observed for life. Among dogs given a single intravenous injection of ⁹⁰Sr in early adulthood, tumor production was somewhat higher than among ⁹⁰Sr-fed dogs at the same radiation dose: bone tumors were present in 6 of 25 dogs who received 62 Gy and 1 of 20 dogs who received 7.5 Gy. Bone tumors appeared sooner and were more often multiple in animals receiving the higher doses. Long bones were the sites of most of the tumors appearing after the highest dose level. Bones of the head, particularly the mandible, were the predominant site of tumors in the next highest dose level group.     

川藏线某汽车部队心理教育方法探讨及效果评估

近几年来,军人心理健康在部队建设中的影响和意义越来越受到关注,不少部队已开展了多种形式的心理卫生工作,但对执行高原运输任务汽车部队这一特殊群体的相应调查和探讨,目前尚未见报道。为此我们在川藏线上长期执行高原运输任务的某团,依据可能影响部队官兵心理健康因素的调查     

成人与统招医学生心理健康状况的对照研究

目的 为了研究成人与统招医学生心理健康状况和特点。方法 选用症状自评量表(SCL一90)对146名成人医学生和l58名统招医学生进行测查。结果 统招组除忧郁、焦虑两个因子分以外(P＞0．05)其余各因子分均高于中国正常人常模因子分(P＜0．01)；成人组除躯体．敌对两个因子分以外(P＞0．05)，其余各因子分均高于中国正常人常模因子分(P＜0．01)；两组比较，躯体化、抑郁两个因子分统招组明显低于成人组(P＜0．01)。结论 两组均存在心理健康问题，对医学生应加强心理健康教育和心理咨询工作。     

精神分裂症患者亲属SCL-90评定分析

目的了解精神分裂症患者亲属心理状态与正常人的差异.方法对精神分裂症患者亲属采用SCL-90量表进行评定.结果精神分裂症患者亲属存在明显的紧张、焦虑、恐惧、偏执,SCL-90量表总分明显高于常模,女性对事件的反应态度较男性更强烈.结论精神分裂症患者亲属心理健康较差,必须进行心理教育、咨询和治疗,防止或减少精神疾病的发生.     

心理干预前后药物流产妇女SCL-90测评结果对比分析

目的:探讨心理干预对药物流产妇女心理状态及药物流产效果的影响。方法:将451例药物流产妇女随机分为研究组和对照组,首诊和服用米索前列醇前采用症状自评量表分析系统SCL-90评定心理状态的变化,并对药物流产过程进行效果评价。结果:研究组经心理干预后绝大多数因子分降低(P<0.05),但仍高于全国常模(P<0.05);对照组服用米索前列醇前焦虑、抑郁因子分明显高于首诊(P<0.05),其余因子分无明显变化(P>0.05);研究组的消化道症状、疼痛程度、药物流产时间均低于对照组(P<0.05)。结论:心理干预能明显改善药物流产对妇女心理状态的不良影响,减轻消化道症状、降低疼痛程度,减少流产时间。