ABSTRACT BACKGROUND: The cardiopulmonary function of patients with obstructive sleep apnea (OSA) is significantly lower than that of patients with simple snoring and is significantly related to the severity of OSA. Currently, only a few studies have been conducted on cardiopulmonary exercise testing in overweight patients with OSA. OBJECTIVE: To analyze the correlation between cardiopulmonary exercise test (CPET) indices and the condition of overweight patients with OSA. DESIGN AND SETTING: Retrospective study in Guangdong Provincial Hospital of Chinese Medicine. METHODS: This study included 73 hospitalized overweight patients. The patients were divided into no, mild, moderate, and severe OSA groups. Differences in the CPET indices among the four groups were compared. The correlation between the CPET indices and conditions was analyzed. RESULTS: No, mild, moderate, and severe OSA groups had 18 men and 5 women, 11 men and 3 women, 12 men and 2 women, and 21 men and 1 woman, respectively (P > 0.05). No significant difference was observed in resting pulmonary function among the four groups (P > 0.05). In the CPET, the anaerobic threshold, maximum oxygen uptake, and oxygen pulse were significantly lower in the severe OSA group than those in the normal OSA group (P < 0.05). Moreover, CPET indices negatively correlated with the apnea-hypopnea index. CONCLUSION: Changes in CPET indices occurred earlier than changes in resting pulmonary function in patients with OSA. CPET might be a potential method for evaluating the severity of OSA combined with overweight status. BACKGROUND (OSA Currently OBJECTIVE (CPET SETTING Medicine METHODS 7 no mild moderate compared analyzed RESULTS women woman P 0.05. 005 0.05 . 0 05 0.05) threshold uptake Moreover apneahypopnea hypopnea index CONCLUSION status 00 0.0 0.

Abstract Objectives Metabolic Syndrome (MetS) has been established as a significant factor in the pathogenesis of numerous chronic inflammatory conditions. However, its role in Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) is unknown. This study aims to investigate the association between MetS, its components, and the risk of postoperative recurrence in Chinese patients with CRSwNP. Methods A retrospective cohort study was conducted on CRSwNP patients who underwent endoscopic sinus surgery in our hospital. Patients were divided into MetS and non-MetS groups, and the clinical characteristics and recurrence rates were compared. All CRSwNP patients were followed up for more than 2-years and further categorized into non-recurrent and recurrent groups. Binary logistic regression analyses were performed to examine the effects of MetS and its components on the risk of postoperative recurrence. Results A total of 555 CRSwNP patients were enrolled in the present study, 157 patients were included in the MetS group and 398 patients were categorized into the non-MetS group. The recurrence rate in the MetS group was significantly higher compared to the non-MetS group (p< 0.05). The rate of MetS, overweight or obesity, hyperglycemia and dyslipidemia were higher in the recurrent group in comparison with the non-recurrent group (p< 0.05). Multivariate logistic regression analysis suggested that MetS, overweight or obesity, hyperglycemia, dyslipidemia, and accompanying allergic rhinitis were associated with the risk of postoperative recurrence of CRSwNP (p< 0.05). Moreover, adjusted and unadjusted regression models showed that MetS was an independent risk factor for postoperative recurrence of CRSwNP, and the risk increased with more components of MetS included (p< 0.05). Conclusion Our findings revealed that MetS independently increased the risk of postoperative recurrence in patients with CRSwNP, with the risk escalating as the number of MetS components increased. Moreover, accompanying allergic rhinitis was also demonstrated to be a potential risk factor for CRSwNP recurrence. Level of evidence: Level 4. (MetS conditions However (CRSwNP unknown hospital nonMetS non groups 2years years 2 nonrecurrent 55 15 39 p< p (p 0.05. 005 0.05 . 0 05 0.05) obesity Moreover evidence 4 5 1 3 00 0.0 0.

ABSTRACT Introduction: According to the American Heart Association guideline for coronary artery bypass grafting (CABG), female patients undergoing on-pump CABG (ONCAB) are at higher risk of short-term adverse outcomes than male patients. However, whether off-pump CABG (OPCAB) can improve the short-term outcome of female patients compared to ONCAB remains unclear. Methods: We conducted a meta-analysis to study the effect of the female sex on short-term outcomes of OPCAB vs. ONCAB. A total of 31,115 patients were enrolled in 12 studies, including 20,245 females who underwent ONCAB and 10,910 females who underwent OPCAB. Results: The in-hospital mortality in female patients who underwent OPCAB was significantly lower than in those in the ONCAB group with (2.7% vs. 3.4%; odds ratio [OR] 0.76; 95% confidence interval [CI] 0.65-0.89) and without (OR 0.68; 95% CI 0.52-0.89) adjustment for cardiovascular risk factor. The incidence of postoperative stroke in female patients who underwent OPCAB was lower than in those in the ONCAB group (1.2% vs. 2.1%; OR 0.59; 95% CI 0.48-0.73) before cardiovascular risk factor adjustment but was not significant (OR 0.87; 95% CI 0,66-1.16) after adjustment. There was no significant difference in the incidence of postoperative myocardial infarction between women who underwent OPCAB and those in the ONCAB group (1.3% vs. 2.3%; OR 0.88; 95% CI 0.54-1.43). Conclusion: In contrast to the American Heart Association CABG guideline, female patients who had OPCAB don’t have unfavorable outcomes compared with the ONCAB group. Introduction CABG, , (CABG) onpump pump (ONCAB shortterm short term However offpump off (OPCAB unclear Methods metaanalysis meta analysis vs 31115 31 115 31,11 1 studies 20245 20 245 20,24 10910 10 910 10,91 Results inhospital hospital 2.7% 27 2 7 (2.7 3.4% 34 3 4 [OR 0.76 076 0 76 95 [CI 0.650.89 065089 0.65 0.89 65 89 0.65-0.89 0.68 068 68 0.520.89 052089 0.52 52 0.52-0.89 1.2% (1.2 2.1% 21 0.59 059 59 0.480.73 048073 0.48 0.73 48 73 0.48-0.73 0.87 087 87 0,661.16 066116 0,66 1.16 66 16 0,66-1.16 1.3% 13 (1.3 2.3% 23 0.88 088 88 0.541.43. 054143 0.54 1.43 . 54 43 0.54-1.43) Conclusion dont don t (CABG 3111 11 31,1 2024 24 20,2 1091 91 10,9 2.7 (2. 3.4 0.7 07 9 650 0.650.8 06508 065 0.6 089 0.8 6 8 0.65-0.8 06 520 0.520.8 05208 052 0.5 5 0.52-0.8 1.2 (1. 2.1 05 480 0.480.7 04807 048 0.4 073 0.48-0.7 08 661 0,661.1 06611 066 0,6 116 1.1 0,66-1.1 1.3 2.3 541 0.541.43 05414 054 143 1.4 0.54-1.43 311 31, 202 20, 109 10, 2. (2 3. 0. 0.650. 0650 0.65-0. 0.520. 0520 0.52-0. 1. (1 0.480. 0480 04 0.48-0. 0,661. 0661 0, 0,66-1. 0.541.4 0541 14 0.54-1.4 ( 0.650 0.65-0 0.520 0.52-0 0.480 0.48-0 0,661 0,66-1 0.541. 0.54-1. 0.65- 0.52- 0.48- 0,66- 0.541 0.54-1 0.54-

Resumen La nefropatía obstructiva se considera una manifestación inusual en las vasculitis ANCA. Se presenta el caso de un masculino de 38 años, con granulomatosis con poliangitis e hidronefrosis unilateral, y revisión de la literatura. Masculino de 38 años, sano, quien consulta por cuadro subagudo de odinofagia, síntomas constitucionales y lesión renal aguda anúrica. Inicialmente con hallazgo de hidronefrosis izquierda, manejado como nefropatía obstructiva, que eventualmente desarrolla hemorragia alveolar difusa, distrés respiratorio y fallece debido a un síndrome de distrés respiratorio agudo severo refractario asociado a su granulomatosis con poliangitis. La nefropatía obstructiva es una manifestación inusual de las vasculitis ANCA asociadas. Es importante la sospecha diagnóstica en estos cuadros multisistémicos para no dilatar el tratamiento inmunosupresor conjunto con el resto de las terapias requeridas.

Abstract Obstructive nephropathy is considered an unusual presentation in ANCA-associated vasculitis. The following case describes a 38-year-old male with granulomatosis with polyangiitis and unilateral hydronephrosis, as well as a literature review. A 38-year-old male with an unremarkable medical background presents with a 3-week history of odynophagia, constitutional symptoms and anuric kidney injury. Initially managed as an obstructive nephropathy due to a left hydronephrosis finding, the patient eventually develops a diffuse alveolar hemorrhage, acute respiratory distress and perishes due to granulomatosis with polyangiitis. Obstructive nephropathy is an unusual manifestation of ANCA-associated vasculitis. Diagnostic suspicion is important in these multisystem pictures so as not to delay immunosuppressive treatment together with the rest of the required therapies.

ABSTRACT While excavation activities in mountain terrain regions, the exposure of carbonaceous mudstone could deteriorate the strength under the water-rock interaction, which impacts slope stability and affects the safety of the engineering project. The present study conducted the Point Loading Test (PLT), Acoustic Emission (AE), and Scanning Electron Microscope (SEM) to investigate the degradation of its mechanical properties under the water-rock interaction. The results reveal that: (1) The Total Organic Carbon (TOC) content and water content correspond to a negative correlation, and the carbonaceous mudstone possesses a softening boundary which makes the mudstone strength decay rapidly resulting in the strength decrease by 80% once the water content exceeds the boundary value; (2) Water-rock interaction weakens the acoustic emission capacity and the acoustic emission characteristic in the failure process of carbonaceous mudstone with different TOC can reflect the influence of water-rock interaction on its macroscopic strength and fracture structure deterioration, and the damage degree under immersion is over 50%; (3) The inhomogeneity of water-rock interaction causes unbalanced forces in the rock, as dissolved soluble minerals and oxidation-reduction of organic matter accelerate the deterioration of carbonaceous mudstone making the water-rock interaction is slowed down by the water-swelling filling of minerals in a time period. Therefore, this study has investigated the strength deterioration of carbonaceous mudstone subjected to water-rock interaction from macro-scale and micro-scale perspectives, which provides a reference for preventing and controlling carbonaceous mudstone deterioration resulting from catastrophes. regions waterrock rock project PLT, PLT , (PLT) AE, AE (AE) SEM (SEM that 1 (1 (TOC correlation 80 value 2 (2 Waterrock Water 50% 50 3 (3 oxidationreduction oxidation reduction waterswelling swelling period Therefore macroscale macro scale microscale micro perspectives catastrophes (PLT (AE ( 8 5

PURPOSE: This research aims to investigate whether increasing the pension contributions of a firm leads to inefficient investments DESIGN/METHODOLOGY/APPROACH: Based on the 26 135 observations of the Chinese listed firms, this study employs ordinary least squares models to investigate the relationship between pension costs and inefficient investments FINDINGS/RESULTS: This study shows that Chinese listed firms' pension contribution increments result in fewer investment opportunities and a decreased in investment efficiency. This is insignificant for the more profitable firms and state-owned enterprises. It suggests further that a firm's pension cost is significantly associated with its investment inefficiency, particularly for cash flow dominated and financing-restricted firms. This indicates a negative association between pension contributions and cash flows, and several pension contributions may lead to a cash flow shortage in the firms PRACTICAL IMPLICATIONS: For managers, they should improve their investment efficiency within an affordable pension plan; for investors, increasing pension costs potentially decrease their investment returns ORIGINALITY/VALUE: Some findings have reference values for some developing countries

Naringin (Nar) has been reported to exert potential hepatoprotective effects against acetaminophen (APAP)-induced injury. Mitochondrial dysfunction plays an important role in APAP-induced liver injury. However, the protective mechanism of Nar against mitochondrial damage has not been elucidated. Therefore, the aim of this study was to investigate the hepatoprotective effects of Nar against APAP and the possible mechanisms of actions. Primary rat hepatocytes and HepG2 cells were utilized to establish an in vitro model of APAP-induced hepatotoxicity. The effect of APAP and Nar on cell viability was evaluated by a CCK8 assay and detection of the concentrations of alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase. The cellular concentrations of biomarkers of oxidative stress were measured by ELISA. The mRNA expression levels of APAP-related phase II enzymes were determined by real-time PCR. The protein levels of Nrf2, phospho (p)-AMPK/AMPK, and biomarkers of mitochondrial dynamics were determined by western blot analysis. The mitochondrial membrane potential (MMP) was measured by high-content analysis and confocal microscopy. JC-1 staining was performed to evaluate mitochondrial depolarization. Nar pretreatment notably prevented the marked APAP-induced hepatocyte injury, increases in oxidative stress marker expression, reductions in the expression of phase II enzymes, significant loss of MMP, mitochondrial depolarization, and mitochondrial fission in vitro. In conclusion, Nar alleviated APAP-induced hepatocyte and mitochondrial injury by activating the AMPK/Nrf2 pathway to reduce oxidative stress in vitro. Applying Nar for the treatment of APAP-induced liver injury might be promising.

Abstract To investigate the value of edible horticultural therapy (EHT) for long-term-hospitalized (LTH) female patients who suffered from schizophrenia. 60 female schizophrenic patients hospitalized in our hospital were randomly divided into EHT group and control group, with 30 cases in each group. The EHT group was combined with EHT on the basis of drug treatment, and the control group was only treated with drug treatment. The Brief Psychiatric Rating Scale (BPRS), the Chinese version Scale of Social Functioning for Psychotic Inpatients (SSFPI), and the Life Satisfaction Index A (LSIA) were compared and analyzed between two groups. After 6 weeks of treatment, the SSFPI score of EHT group increased and was significantly higher than that of the control group. After treatment, the LSIA index of EHT group was higher than that of the control group, and the difference between the two groups was statistically significant (P < 0.05). The BPRS index of EHT group was significantly lower than that before treatment, but there was little change in the control group. There was significant difference between the two groups (P < 0.05). EHT maybe valuable for improving clinical symptoms of schizophrenia and recovery of social function. Clinical registration number:researchregistry7590

Abstract Background: G protein coupled receptor kinase 2 (GRK2) has been demonstrated to play a crucial role in the development of chronic pain. Acupuncture is an alternative therapy widely used for pain management. In this study, we investigated the role of spinal neuronal GRK2 in electroacupuncture (EA) analgesia. Methods: The mice model of inflammatory pain was built by subcutaneous injection of Complete Freund's Adjuvant (CFA) into the plantar surface of the hind paws. The mechanical allodynia of mice was examined by von Frey test. The mice were subjected to EA treatment (BL60 and ST36 acupuncture points) for 1 week. Overexpression and down-regulation of spinal neuronal GRK2 were achieved by intraspinal injection of adeno associated virus (AAV) containing neuron–specific promoters, and microglial activation and neuroinflammation were evaluated by real–time PCR. Results: Intraplantar injection with CFA in mice induced the decrease of GRK2 and microglial activation along with neuroinflammation in spinal cord. EA treatment increased the spinal GRK2, reduced neuroinflammation, and significantly decreased CFA–induced mechanical allodynia. The effects of EA were markedly weakened by non–cell–specific downregulation of spinal GRK2. Further, intraspinal injection of AAV containing neuron–specific promoters specifically downregulated neuronal GRK2, and weakened the regulatory effect of EA on CFA–induced mechanical allodynia and microglial activation. Meanwhile, overexpression of spinal neuronal GRK2 decreased mechanical allodynia. All these indicated that the neuronal GRK2 mediated microglial activation and neuroinflammation, and subsequently contributed to CFA–induced inflammatory pain. Conclusion: The restoration of the spinal GRK2 and subsequent suppression of microglial activation and neuroinflammation might be an important mechanism for EA analgesia. Our findings further suggested that the spinal GRK2, especially neuronal GRK2, might be the potential target for EA analgesia and pain management, and we provided a new experimental basis for the EA treatment of pain.

ABSTRACT Purpose: To explore the mechanism and investigate the protective effect of hydroxysafflor yellow A (HSYA) on renal oxidative stress, which cyclosporine A (CsA) induces. Methods: HK-2 cells were treated with CsA to get CsA-induced oxidative stress. The effects on oxidative stress and apoptosis of HK-2 cells were detected. The contents of SOD, MDA, GSH-Px, ROS, and CAT in serum were measured, and the expression of apoptosis-related proteins was detected by western blot. Then, established the renal oxidative stress injury rats to verify the efficacy of HSYA. Results: HSYA could reduce the ROS and MDA contents induced by CsA. Compared with the CsA group, the activities of SOD, CAT, and GSH-Px increased significantly when treated with HSYA. HSYA could inhibit CsA-induced apoptosis in HK-2 cells, and promote the protein of Bcl-2 and inhibit the expression of Bax. Animal experiments showed that HSYA could reduce CsA-induced renal cell injury by reducing glomerular cell vacuoles and inflammatory factors in tissues. It also decreased serum creatinine (Crea) and blood urea nitrogen, increased Crea clearance significantly. Conclusions: HSYA could significantly improve the antioxidant capacity of the kidney cells and inhibit cell apoptosis, thereby effectively ameliorating CsA-induced oxidative stress in vitro and in vivo.

Abstract Objectives The aim of the present study was to evaluate the associations of parental bonding and adolescents’ Internet addiction symptoms with depression and anxiety in parents of adolescents with attention deficit/hyperactivity disorder (ADHD). Methods Parental depression and anxiety symptoms, parental bonding, and adolescents’ Internet addiction symptoms were assessed in 46 parent-child dyads using the Center for Epidemiological Studies Depression Scale, State-Trait Anxiety Inventory, Parental Bonding Instrument (PBI), and Chen Internet Addiction Scale, respectively. Forward stepwise multiple regression analysis was used to examine the associations of parental bonding and adolescents’ Internet addiction symptoms with parental depression and anxiety. Results Low care/affection on the PBI was significantly associated with parental depression, and overprotection on the PBI and adolescents’ Internet addiction were significantly associated with parental anxiety. Discussion Parental bonding and adolescents’ Internet addiction are related to depression and anxiety in parents of adolescents with ADHD.

RESUMO OBJETIVO: O objetivo deste estudo é investigar a expressão de Id-1 em tecidos de adenocarcinoma colorretal em humanos e investigar sua correlação com os parâmetros patológicos clínicos de câncer colorretal. MÉTODOS: Os níveis de expressão de proteína e mRNA Id-1 em 50 amostras de tecido colorretal normal e 50 amostras de tecido de adenocarcinoma colorretal foram detectados através de reação em cadeia de polimerase precedida de transcrição reversa e western blot. Além disso, a proteína Id-1 foi detectada através de imuno-histoquímica. A correlação entre a expressão de Id-1 e características clínico-patológicas foi analisada. RESULTADOS: O nível de expressão de mRNA Id-1 em tecidos de adenocarcinoma colorretal e tecidos colorretais normais foi de 0,96 ± 0,03 versus 0,20 ± 0,04, respectivamente; a diferença foi estatisticamente significativa (P= 0,011). Além disso, a expressão da proteína Id-1 foi maior em tecidos de adenocarcinoma colorretal do que em tecidos colorretais normais (0,82 ± 0,04 versus 0,31 ± 0,02, P= 0,020). Além disso, a taxa de expressão positiva de proteínas Id-1 foi maior em tecidos de adenocarcinoma colorretal do que em tecidos colorretais normais (72,00% vs. 24,00%, X2=23,431, p=0,000). A expressão de Id-1 foi correlacionada com a profundidade da invasão tumoral, estágio TNM, metástases linfonodais, invasão vascular e metástase hepática (P<0,01). Todavia, essa expressão não se correlacionou com o tamanho do tumor e graus de diferenciação (P>0,05). CONCLUSÃO: A alta expressão de Id-1 em tecidos de adenocarcinoma colorretal desempenham um importante papel no processo do câncer, e é esperado que se torne um novo indicador de monitoramento de tumores para o diagnóstico clínico, tratamento e estimativa de prognóstico.

SUMMARY BACKGROUND: This study aims to investigate the expression of Id-1 in human colorectal adenocarcinoma tissues and explore its correlation with the clinical pathological parameters of colorectal cancer. METHODS: The Id-1 mRNA and protein expression levels of 50 specimens of normal colorectal tissues and 50 specimens of colorectal adenocarcinoma tissues were detected using reverse-transcription polymerase chain reaction and western blot. Furthermore, Id-1 protein was detected using immunohistochemistry. The correlation between the expression of Id-1 and clinicopathologic features was analyzed. RESULTS: The mRNA expression level of Id-1 in colorectal adenocarcinoma tissues and normal colorectal tissues was 0.96 ± 0.03 vs. 0.20 ± 0.04, respectively; and the difference was statistically significant (P=0.011). Furthermore, Id-1 protein expression was higher in colorectal adenocarcinoma tissues than in normal colorectal tissues (0.82 ± 0.04 vs. 0.31 ± 0.02, P=0.020). In addition, the positive protein expression rate of Id-1 was higher in colorectal adenocarcinoma tissues than in normal colorectal tissues (72.00% vs. 24.00%, X2=23.431, P=0.000). The expression of Id-1 was correlated with the depth of tumor invasion, TNM stage, lymph node metastasis, vessel invasion, and liver metastasis (P<0.01). However, this expression was not correlated with tumor size and differentiation degrees (P>0.05). CONCLUSIONS: The high Id-1 expression in colorectal adenocarcinoma tissues play an important role in the process of cancer, and is expected to become a new tumor monitoring indicator for clinical diagnosis, treatment, and prognosis judgment.

Abstract Background: Light exposure is a common stress factor in in vitro manipulation of embryos in the reproductive center. Many studies have shown the deleterious effects of high-intensity light exposure in different animal embryos. However, no transcriptomic studies have explored the light-induced injury and response in preimplantation embryos. Results: Here, we adopt different time-courses and illumination intensities to treat mouse embryos at the 2-cell stage and evaluate their effects on blastulation. Meanwhile, single-cell transcriptomes from the 2-cell to blastocyst stage were analyzed after high-intensity light exposure. These data show that cells at each embryonic stage can be categorized into different light conditions. Further analyses of differentially expressed genes and GO terms revealed the light-induced injury as well as the potential repair response after high-intensity lighting. Maternal-to-zygote transition is also affected by the failure to remove maternal RNAs and deactivate zygotic genome expression. Conclusion: Our work revealed an integrated response to high-intensity lighting, involving morphological changes, long-lasting injury effects, and intracellular damage repair mechanisms.

ABSTRACT Objectives: Previous studies have compared infectious outcomes on the basis of whether rectal preparation was performed; however, they failed to evaluate the quality of each rectal preparation, which may have led to confounding results. This study aimed to compare hospitalizations for urosepsis within 1 month after transrectal ultrasound-guided prostate biopsy between patients with adequate and traditional rectal preparations. Materials and Methods: Between January 2011 and December 2016, a total of 510 patients who underwent transrectal ultrasound - guided prostate biopsy at our institutions and were orally administered prophylactic antibiotics (levofloxacin) were included. Two rectal preparations were performed: (1) adequate rectal preparation confirmed by digital rectal examination and transrectal ultrasound (Group A, n = 310) and (2) traditional rectal preparation (Group B, n = 200). All patient characteristics were recorded. A logistic regression model was used to assess the effects of the two different rectal preparations on urosepsis, adjusted by patient characteristics. Results: There were a total of three and nine hospitalizations for urosepsis in Groups A and B, respectively. Differences in the demographic data between the two groups were insignificant. Logistic regression showed that adequate rectal preparation before biopsy significantly decreased the risk for urosepsis after biopsy (adjusted odds ratio: 0.2; 95% confidence interval: 0.05 – 0.78; P = 0.021). Conclusions: Adequate rectal preparation could significantly reduce hospitalizations for urosepsis within 1 month after transrectal ultrasound-guided prostate biopsy. The quality of rectal preparation should be evaluated before biopsy. If adequate rectal preparation is not achieved, postponing the biopsy and adjusting the rectal preparation regimen are suggested.