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Effects of CPAP on blood pressure in patients with resistant hypertension and OSA:A Systematic Review and meta-analysis of 7 Randomized Controlled Trials

Effects of CPAP on blood pressure in patients with resistant...

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2016中华医学会呼吸病学年会暨第十七次全国呼吸病学学术会议

作者： qiangLei 昆明理工大学信息工程与自动化学院

目的 To systematically evaluate the impact of continuous positive airway pressure(CPAP)on blood pressure in patients with resistant hypertension and obstructive sleep apnea(OSA).方法 The related RCT literature of CPAP on blood pressure in patients with resistant hypertension and OSA have been searched by computer from Cochrane Library,PubMed,ScienceDirect,Web of Science,and the relevant journals have been retrieved *** clinic randomized controlled trials of the treatment effect to resistant hypertension and OSA by CPAP were *** conformed to the condition were extracted to the quality of research and to be extracted in *** RevMan5.3 and R3.2.2 software was applied to carry out meta-analysis.结果 7 studies of the randomized controlled trials(RCT)are included,meta-analysis shows The pooled estimate of mean change and the corresponding 95％CIs were-5.36mmHg(95％CI;-8.60 to-2.11;P=0.001;I2 70％)and-4.21mmHg(95％CI：-6.39 to-2.04;P=0.00001;I2 79％)in 24-h mean systolic blood pressure(SBP)and 24-h mean diastolic blood pressure(DBP)respectively.结论 CPAP therapy can significant reduce blood pressure in patients with resistant hypertension and OSA.

关键词： Obstructive sleep apnea Continuous positive airway pressure Resistant hypertension Meta-analysi

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7years follow-up:the correlation among sleep apnea syndrome and Hypertension,Diabetes disease

7years follow-up:the correlation among sleep apnea syndrome ...

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2016中华医学会呼吸病学年会暨第十七次全国呼吸病学学术会议

作者： ZhongmingHE karamay central hospital

目的 To explore the correlation between obstructive sleep apnea syndrome(OSAS)and hypertension and diabetes mellitus(DM).方法 A cohort of 1331 people Was screened for OSAS,and followed from October 2007 to October *** medical examinations including blood pressure,blood fat and blood *** end point of the study when hypertension or DM were *** patients were diagnosed as SAHS with fasting plasma lipids(include total cholesterol,triglyceride,high density lipoprotein and low density lipoprotein).结果 Among the 1331 elderly people,734(55.2％)were confirmed to have OSAS,including 396(54.0％)males and 338(46.0％)*** other 597 people as control ***：Compared with the non—OSAS group,patients with OSAS had higher morbidity rate of hypertension(7.8％vs 4.4％)(P＜0.05).the morbidity rate of diabetes patients with OSAS was higher than non— OSAS group(6.0％vs 3.2％)(P＜0.05).During the 7 year follow-up,94 people died for complication of hypertension,diabetes and other diseases.9.3％(68/734)in the OSAS group.4.4％(26/597)in the non-OSAS group(P＜0.05).the total cholesterol[(4.8±1.2)mmol/L vs(4.5±1.1)mmol/L],triglyceride[(2.2±1.6)mmol/L vs(1.9±1.2)mmol/L]were difference between SAHS and no SAHS groups(P＜0.05).结论 Patients with OSAS have more likely to suffer from hypertension and *** may be an independent risk factor for hypertension and *** sleep apnea can cause lipid metabolism disorder.

关键词： obstructive sleep apnea hypertension diabetes mellitus

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Bcl-2Inhibitors Reduce Steroid-insensitive Airway Inflammation and Airway Hyperresponsiveness

Bcl-2Inhibitors Reduce Steroid-insensitive Airway Inflammati...

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2016中华医学会呼吸病学年会暨第十七次全国呼吸病学学术会议

作者： BaopingTian Li-xiaXia Song-min Ying Hua-haoShen Department of Respiratory and Critical Care Medicine Second Affiliated HospitalZhejiang University School of Medicine

目的 We thought to explore the underlying mechanisms of airway inflammation persistence as well as corticosteroid resistance,and to investigate a new strategy of effective treatment against corticosteroid-insensitive neutrophilic asthma.方法 Mouse models of either eosinophil-dominated or neutrophil-dominated airway inflammation were used in this study to test corticosteroid sensitivity in vivo and in *** also used vav-Bcl-2 transgenic mice to confirm the importance of granulocytes apoptosis in the clearance of airway ***,Bcl-2 inhibitors ABT-737 or ABT-199 was tested for their therapeutic effects against eosinophilic or neutrophilic airway inflammation and airway hyperresponsiveness.结果 Overexpression of Bcl-2 protein was found to be responsible for persistence of granulocytes in bronchoalveolar lavage fluid following allergic *** was important as allergen-induced airway inflammation aggravated and persisted in vav-Bcl-2 transgenic mice,where nucleated hematopoietic cells were over-expressed with Bcl-2 and resistant to ***-2 inhibitors,ABT-737 or ABT-199,play efficient roles in alleviation of either eosinophilic or corticosteroid resistant-neutrophilic airway inflammation,by inducing granulocytes ***,these inhibitors were found to be more efficient than steroid to induce granulocytes apoptosis ex vivo from severe asthma patients.结论 Apoptosis of granulocytes is essential for the clearance of allergen-induced airway ***-2 inhibitors ABT-737 or ABT-199 may be promising drugs for the treatment against airway inflammation,especially for corticosteroid-insensitive neutrophilic airway inflammation.

关键词： Airway inflammation Eosinophil Neutrophil Apoptosis Bcl-2 Steroid-insensitive

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Efficacy of nasal CPAP on OSAHS patients with erectile dysfunction and lower levers of sexual hormone

Efficacy of nasal CPAP on OSAHS patients with erectile dysfu...

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2016中华医学会呼吸病学年会暨第十七次全国呼吸病学学术会议

作者： zhijunLi WenjuanWu JianzongDu TianZhao XiaoxiZhou GuangyueQin 浙江医院

目的 The aim of study was to test the hypothesis that erectile dysfunction (ED) was common in men obstructive sleep apnea hypopnea syndrome (OSAHS) *** addition, the efficacy of continuous positive airway pressure (CPAP) treatment for ED and sexual hormone levels was evaluated in severe OSAHS patients with ED.方法 In total, 153 OSAHS patients and 60 controls were enrolled into the research, and OSAHS patients were divided into mildmoderate groups and severe *** International Index of Erectile Dysfunction-5 (IIEF-5) scores were obtained from each subject, and blood samples were drawn for the analysis of sexual hormones after *** IIEF-5 scores, sexual hormone levels, and polysomnographic parameters were reevaluated in 32 severe OSAHS patients with ED after 1 month of CPAP treatment.结果 The prevalence of ED was 47.1％ in all OSAHS patients, 39.5％ in those with mild-moderate OSAHS and 56.7％ of ED in severe *** with ED was more older, and had a lower follicle stimulating hormone (FSH) and testosterone levels than without ED (P＜0.05).There was a significant increase in IIEF-5 scores after CPAP intervention, and improvement was observed in serum levels of FSH, luteinizing hormone (LH), progesterone and testosterone, comparing with baseline levels (all P＜0.05).结论 OSAHS patients had more lower sexual hormone levels and higher prevalence of ED than control *** treatment did ameliorate the symptom of ED and elevate serum levels of sexual hormone, such as FSH, LH, progesterone and testosterone.

关键词： Obstructive sleep apnea hypopnea syndrome Erectile dysfunction Sexual hormone International Index

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Vascular endothelial growth factor levels in patients with obstructive sleep apnea: a meta-analysis

Vascular endothelial growth factor levels in patients with o...

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2016中华医学会呼吸病学年会暨第十七次全国呼吸病学学术会议

作者： Xiao-BinZhang Xing-TangJiang Fang-RongCai MiaoWang Feng-FuZhan Zhongshan Hospital Xiamen UniversityFujianChina

目的 Published articles regarding the blood levels of vascular endothelial growth factor (VEGF) in obstructive sleep apnea(OSA) patients are *** objective of the current study was to explore whether VEGF levels is high or not in OSA subjects via quantitatively statistical analysis.方法 The electronic databases of Pubmed, Web of Science, EMBASE were systematic *** VEGF levels, clinical characteristics of participants between OSA group and control group were extracted for *** mean difference (WMD) or standard mean difference (SMD) with 95％ confidence interval (CI) was calculated by fixed effects or random effects *** statistical software was employed for data synthesis.结果 Totaling 15 articles with 697 participants were included in the current *** meta-analysis showed that blood VEGF concentration was significantly higher in OSA patients than in control subjects (SMD 1.89, 95％CI 0.92 to 2.87, p=0.000).Subgroup analysis demonstrated that when compared with control group, OSA patients with age≥50 years (SMD 3.55, 95％CI 1.82 to 5.28, p=0.000), apnea hypopnea index≥30events/hour (SMD 2.47, 95％CI 1.20 to 3.73, p=0.000) had higher VEGF *** with control subjects, OSA patients had an elevated VEGF in serum (SMD 3.55, 95％CI 1.82 to 5.28, p=0.000) rather than in plasma.结论 High blood VEGF concentration was observed in OSA patients, particularly in the older and more serious patients.

关键词： Sleep apnea Vascular endothelial growth factor Meta-analysis

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Role of oxidative stress in the neurocognitive dysfunction of obstructive sleep apnea syndrome

Role of oxidative stress in the neurocognitive dysfunction o...

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2016中华医学会呼吸病学年会暨第十七次全国呼吸病学学术会议

作者： LiZhou RuoyunOuyang PingChen YatingPeng The Second Xiangya Hospital Central-South University

Obstructive sleep apnea syndrome (OSAS) is characterized by chronic nocturnal intermittent hypoxia and sleep *** dysfunction, a significant and extraordinary complication of OSAS, seriously influences the patients' work, family and social life and reduces quality of *** impairment in OSAS could be involved in a series of cognitive domain, such as attention/vigilance, memory, global cognitive function, executive *** importantly, evidence, which accumulated in recentyears, has demonstrated that oxidative stress (OS) that results from chronic recurrent hypoxia and reoxygenation, an extraordinary characteristic of OSAS, is one of important mechanisms leading to neurocognitive *** episodes of obstruction of the upper airway induces chronic intermittent hypoxia(CIH), then causes dysfunction of mitochondria, endoplasmic reticulum,energy metabolism and endothelium , activation of NADPH oxidase, xanthine oxidase and a series of inflammation reaction,consequently contributes to overproduction of reactive oxygen species(ROS) and imbalance of oxidation-antioxidation, that is state of oxidative stress, which produces protein, lipid and DNA peroxidation ***, cerebral neural cells, especially in the region of hippocampus and cerebral cortex, are susceptible to ***-induced OS could lead to the necrosis and apoptosis of nerve cell, which results in neurocognitive dysfunction of OSAS gradually, presenting near-term declined attention and vigilance and long-term degeneration of memory, executive *** addition to continue positive airway pressure(CPAP) treatment, animal experiments of OSAS demonstrate that administration of antioxidant, erythropoietin, growth hormone, growth hormone releasing hormone (GHRH) agonist JI-34 and telmisartan might provide an available measure to protect IHvulnerable brain regions from OSAS-associated neuronal damage and associated neurocognitive ***

关键词： obstructive sleep apnea-hypopnea syndrome oxidative stress cognitive dysfunction

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A Correlative Study of Carbon Dioxide Monitoring in End-tidal in OSAHS

A Correlative Study of Carbon Dioxide Monitoring in End-tida...

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2016中华医学会呼吸病学年会暨第十七次全国呼吸病学学术会议

作者： XianwenSun QingyunLi HaiyangShi Ruijin Hospital Shanghai Jiao Tong University School of Medicine

目的 Obstructive sleep apnea hypopnea syndrome (OSAHS) is a chronic sleep respiratory disease with nocturnal hypoxemia and continuous *** key determinants of hypercapnia in OSAHS are unclear. 方法 70 OSAHS patients were measured by overnight polysomnography (PSG), Epworth Sleepiness Scale (ESS), carbon dioxide monitoring in end-tidal (PETC02Q) and prolonged expiration (more than 5 seconds) (PETC02P) at bedtime and in the *** patients were divided equally into 4 groups according to PSG results： control group with an apnea-hypopnea index (AHI) ＜5 (n=17), mild group (5 ≤ AHI ＜15) (n=17), moderate group (15 ≤ AHI ＜30) (n=18) and severe group (AHI ≥30) (n=18).结果 There were no significant differences between PETC02Q and PETC02P at bedtime and in the morning *** PETC02P levels were higher than *** difference of PETC02P and PETC02Q (△PETC02) had no relationships with AHI, lowest oxygen saturation (LSaO2), sex, age and *** △PETC02 had positive relationships with the percent of SaO2＜90％ in one night sleep (SIT90), Body Mass Index (BMI), Neck circumference, waist circumference and ESS (r=0.625,r=0.429,r=0.424,r=0.335,r=0.387,p＜0.05).结论 Hypercapnia occurs in a large part of patients with *** hypoxemia and obesity are all contributed to the development of daytime CO2 retention in OSAHS.

关键词： OSAHS carbon dioxide end-tidal

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Role of the endogenous cannabinoid receptor1in brain injury induced by chronic intermittent hypoxia in rats

Role of the endogenous cannabinoid receptor1in brain injury ...

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2016中华医学会呼吸病学年会暨第十七次全国呼吸病学学术会议

作者： beiwang The second Hospital of Shanxi Medical University

目的 This study investigated the effect of rimonabant,a cannabinoid receptor type 1(CB1)antagonist,on calcium/calmodulin dependent protein kinase Ⅱ(CaMKⅡ)and CB1 during the course of brain injury by chronic intermittent hypoxia(CIH)in a rat model.方法 Healthy male rats were divided into the following treatment groups(n=10/group)：control group(CG),intermittent hypoxia group(IH)for 4 or 6 weeks,hypoxic intervention group(HI)that received a daily intraperitoneal injection of 1 mg/kg/d rimonabant prior to exposure to hypoxia and for 4 or 6 weeks *** groups Morphological changes in the brain tissue were observed by hematoxylin-eosin staining(HE).The expression of CaMKⅡ and CB1 in cerebral hippocampus cells was determined by immunohistochemistry.结果 HE staining revealed that the hippocampal cells in the disorganized with decreased *** contrast,the hippocampal cells of the HI group were neatly arranged at 4 *** six weeks,the cells in the HI group were larger with scarce cytoplasm and nuclear changes indicative of cell *** compared with control groups,the expression of CaMKⅡ and CB1 in the cerebral hippocampus were elevated in the IH group at 4 weeks;even greater expression was observed at 6 *** CB1 expression was reduced in the HI group as compared to the IH *** analysis revealed that the expression levels of CaMKⅡ and CB1 were positively correlated significantly in the IH group.结论 CIH induced structural damage in the hippocampus and dysregulation of the endocannabinoid system(ECS),increasing CB1 and CaMKⅡ expression,which may mediate the cognitive impairment associated with *** had a protective effect against CIH.

关键词： obstructive sleep apnea-hypopnea syndrome(OSAS) chronic intermittent yypoxia(CIH)

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Induction of Regulatory T cells inhibit ImmTac-redirected lung cancer cell killing and how to resolve the problem

Induction of Regulatory T cells inhibit ImmTac-redirected lu...

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2016中华医学会呼吸病学年会暨第十七次全国呼吸病学学术会议

作者： huanling zhangyili Guangzhou Institute of Biomedicine and Health Chinese Academy of science

目的 Immune-mobilizing monoclonal TCRs against cancer(ImmTacs)can activate T cell to kill lung cancer cells efficitively,but it may not overcome immunosuppressive mechanisms,such as *** we want to know whether iTregs impede the efficiency of ImmTacs,and if it does,what is the mechanism and how to deal with this ***,the study is focused on iTregs inhibit the ImmTacs-redirected lung cancer cells lysis,in an effort to implement the immunotherapy *** also demonstrated that iTregs through a series of mechanisms to suppress ImmTacs-redirected lung cancer cell killing and anti-PD1mAb can reverse the suppression function of *** is to say,combing ImmTacs with anti-PD-1 mAbs can produce a synergistic antitumor efficacy and this efficacy can resist the inhibition of iTregs.方法 *** of iTreg by TGFb in *** and purification of *** assays were used to detect the function of ImmTacs and *** was used to detect the mechanism of iTreg inhibited ImmTacs-redirected Lung cancer cells lysis.结果 *** can be induced in vitro *** can redirect T cells to lyse lung *** inhibit the function of *** may be throgh inhibiting the expression of granzymeB,perforin,CD25,CD107a and proliferation of CD8+T cell to inhibit the function of ***-PD1 mAb reverse the inhibition of iTregs on ImmTacs结论 Anti-PD-1 mAb can help ImmTacs play a better role in activated PBMC to lyse tumor cells and the combined efficacy could boycott the inhibition of *** findings provide proof-of-concept evidence for combined ImmTacs/αnti-PD-1 mAb treatment of advanced lung cancer.

关键词： ImmTacs anti-PD-1mAb iTreg immunotherapy cancer

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OPG may protect bleomycin-induced pulmonary fibrosis by inhibiting SMAD2/3 dependent TGF-β1 activation

OPG may protect bleomycin-induced pulmonary fibrosis by inhi...

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2016中华医学会呼吸病学年会暨第十七次全国呼吸病学学术会议

作者： DongWeng HuipingLi BaoxueGe Shanghai Pulmonary Hospital Tongji University School of Medicine

目的 Idiopathic pulmonary fibrosis (IPF) is a highly heterogeneous and lethal pathological process with limited therapeutic options, which is the most common and severe of the idiopathic interstitial pneumonias (IIPs).The pathogenesis of IPF is a complex process with continual injury, chronic inflammation and wound healing *** found OPG (osteoprotegrin) were significantly increased in IPF patients than that in healthy controls.方法 To investigate the role of OPG in the pathogenesis of IPF, we used WT and OPG-/- mouse to establish the model of pulmonary fibrosis by *** analyzed the histopathology and evaluated expression of various key *** also investigate the adaptive immune response by flow ***, important signaling pathway was determined by western blotting.结果 We found that OPG-deficiency led to exacerbation of inflammation and fibrosis during ***-/- mice showed increased Th1, Th17, Th2 and decreased Tregs at early stage of BLM-induced ***-/- mice showed increased inflammatory cytokines at early stage of BLM-induced ***-/- mice have decreased Th1, Th17 and Bregs at late stage of BLM-induced ***-/- KO mice showed increased inflammatory cytokines, TGF- β and decreased IL-17A at late stage of BLM-induced *** may inhibit TGF-β1-dependent activation of SMAD2/3 signaling in pulmonary fibrosis.结论 Our data provided clear evidences that OPG might play a critical role in the pathogenesis of idiopathic pulmonary *** may protect mice from bleomycin-induced pulmonary fibrosis by inhibiting SMAD2/3 dependent TGF-β1 activation.

关键词： OPG pulmonary fibrosis SMAD2/3 TGF-β1

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