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Metabolic disturbances in patients with narcolepsy

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Metabolic disturbances in patients with narcolepsy

中国睡眠研究会第十五届全国学术年会

作者： Xinyan ZHANG junying zhou Min WU Sichuan University

Objectives: Narcolepsy is a chronic sleep-wake disorder driven by selective and irreversible orexin neuron *** with narcolepsy also present various metabolic alterations, proven to be with increased susceptibility than the control *** performed a systematic review and meta-analysis to delineate the prevalence rates of respective metabolic disturbances in ***: A meta-analysis was conducted on the prevalence rates of ‘any' metabolic disturbances in patients with *** databases(i.e., PubMed, Web of Science, EBSCO, and Cochrane Library) were searched up to date on 07 September *** effect size(ES) of the prevalence rate was the pooled mean with the random *** age cut-off of 18 years was chosen for sensitive *** the ES with insufficient values to perform meta-analysis, a systematic review was ***: A total of 28 studies(n=15281) were included in this *** studies(n=2351) were on narcoleptic subjects under 18 years old, and the other 18 studies(n=12930) were on older ones(≥ 18y).We found four metabolic disturbances were primarily reported in narcolepsy and the meta-analysis showed the prevalence rates were 31.9%(95%CI: 27.7%-36.1%) in overweight and 27.1%(95%CI: 21.5%-32.7%) in obesity, 28.8%(95%CI: 9.5%-48.1%) in dysglycaemia, 28.7%(95%CI: 16.7%-40.7%) in dyslipidemia, and 43.9%(95%CI: 20.7%-67.2%) in hypertension, ***, the prevalence rate of metabolic syndrome was 36.1%(95%CI: 14.6%-57.6%), which was found to be more prevalent in narcolepsy type *** addition, precocious puberty was also crossly recounted in pediatric narcoleptic studies, with a prevalence rate being 6.9%(95%CI: 12.7%-21.0%).Whilst, Vitamin D(54.8%, 95%CI: 37.1%-72.5%) and Vitamin 12 deficiency were found in adult narcoleptic *** terms of the subgroup analysis of age, the prevalence rate of overweight was increased from underage(<18y: 27.4%, 95%CI: 23.7%-31.1%) to adults(≥18y: 36.0%, 95%CI:

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Mortality and Its Risk Factors in Patients with Rapid Eye Movement Sleep Behavior Disorder

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Mortality and Its Risk Factors in Patients with Rapid Eye Mo...

中国睡眠研究会第九届学术年会

作者： junying zhou Jihui Zhang Yun Kwok Wing Department of Psychiatry The Chinese University of Hong Kong

Study Objectives:To determine the mortality and its risk factors in patients with rapid eye movement（REM） sleep behavior disorder（RBD）.Design:Cohort ***:Clinicbased cohort study of RBD,Hong Kong,***:A total of 205 consecutive patients with video-polysomnography confirmed RBD（mean age = 66.4 ±10.0 years,78.5%males）.Interventions:*** and Results:Medical records and death status were systematically reviewed in the computerized records of the health care *** mortality ratio（SMR） was used to calculate the risk ratio of mortality in RBD with reference to the general ***-three patients（21.0%） died over a mean follow-up period of 7.1 ±*** SMR was not increased in the overall sample（SMR（95%CI） = 1.00（0.73-1.33））.However,SMR（95%CI） increased to 1.80（1.21-2.58） and 1.75（1.11-2.63） for RBD patients who eventually developed neurodegenerative diseases and dementia,*** the Cox regression model,mortality risk was significantly associated with age（HR = 1.05;95%CI,1.01-1.10）,living alone（HR =2.04;95%CI,1.39-2.99）,chronic obstructive pulmonary disease（HR = 3.38;95%CI,1.21-9.46）,cancer（HR = 10.09;95%CI,2.65-38.42）,periodic limb movements during sleep（HR = 3.06;95%CI,1.50-6.24）,and development of neurodegenerative diseases（HR = 2.84;95%CI,1.47-5.45） and dementia（HR = 2.66;95%CI,1.39-5.08）.Conclusions:Patients with RBD have a higher mortality rate than the generalpopulation only if they develop neurodegenerative *** risk factors on clinical and sleep aspects are associated with mortality in RBD *** findings underscore the necessity of timely neuroprotective interventions in the early phase of RBD before the development of neurodegenerative diseases.

关键词： REM sleep behavior disorder Mortality SMR Neurodegenerative disease

伏立康唑联合卡泊芬净成功治疗2例肝功能衰竭合并侵袭性肺曲霉菌病

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中华肝脏病杂志 2014年第3期22卷 239-240页

作者：周俊英孙惠河北医科大学第三医院石家庄050051

一、病例资料病例1：患者男性，46岁，农民，主因发现HBsAg阳性4年，乏力、尿黄22d，发热伴喘憋、痰中带血2d于2012年1月22日人院。4年前查体时发现HBsAg阳性，肝功能正常，2年前开始用阿德福韦酯10mg／d抗病毒治疗，后未定期复查，2个... 详细信息

一、病例资料病例1：患者男性，46岁，农民，主因发现HBsAg阳性4年，乏力、尿黄22d，发热伴喘憋、痰中带血2d于2012年1月22日人院。4年前查体时发现HBsAg阳性，肝功能正常，2年前开始用阿德福韦酯10mg／d抗病毒治疗，后未定期复查，2个月前患者自行停药，并于大量饮酒及劳累后出现乏力、尿黄，于当地给予保肝药物治疗及甲泼尼龙80mg／d，静脉点滴10d，2d前出现发热伴喘憋、咳嗽、咳黏痰，偶有痰中带血，体温最高达38．7℃，伴极度乏力、腹胀人院治疗。既往饮酒史10余年，饮白酒400-500m／d。入院查体：体温38．0℃，脉搏112次／min，呼吸28次／min，血压110／70mmHg（1rnmHg=0．133kPa），身高176cm，体质量102kg，全身皮肤及巩膜重度黄染，口唇紫绀，双肺可闻及湿性哕音。血常规：白细胞计数15．37x109／L，中性粒细胞计数13．48×109／L，血小板计数39．8X109几；血气分析结果显示：血氧分压52mmHg、血二氧化碳分压36mmHg，双肺CT平扫：双肺多发大小不等类圆形高密度影，内部密度不均，边界模糊，肝硬化，腹腔积液。肝功能：白蛋白29．0g／L，球蛋白32．0g／L，AIJT118U／L，AST67U／L，总胆红素409umol／L直接胆红素455．5umol／L；凝血酶原活动度32．080／0lHBV血清学标志物：HBsAg（＋）、HBeAg（4-）、抗-HBc（＋），HBVDNA1．28x1O4IU／ml，入院诊断：1．乙型病毒洼肝炎、肝炎肝硬化（活动陛、失代偿期）；2．慢加急性肝功能衰竭；3．肺部感染，I型呼吸衰竭；4．酒精性肝病。入院后积极护肝、降酶、退黄、抗感染治疗的同时加强免疫支持疗法，给予哌拉西林他唑巴坦、伏立康唑静点，两性霉素B脂质体每2d10mg，雾化吸入，入院第4天患者咳痰增多，痰中带血，体温最高达39．2℃，复查双肺CT平扫：双肺多发大小不等类圆形高密度影，其内可见空洞。3次痰培养均为烟曲霉菌，加用卡泊芬净联合抗曲霉菌治疗，患者体温逐渐恢复正常，咳嗽、咳痰减少，呼吸困难症状消失，肝功能好转，静脉应用卡泊芬净15d后停用，继续静脉应用伏立康唑10d。出院后改为口服伏立康唑抗真菌治疗12周。随访7个月，患者无咳嗽、咳痰，肝功能正常，HBVDNA〈500IU／ml，双肺病变吸收，见图1。

关键词：肝功能衰竭肺曲菌病病例报告

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中国动物园白鹤圈养种群统计学与遗传学分析

四川动物 2013年第4期32卷 492-497页

作者：周军英中国动物园协会北京100037

根据《圈养白鹤中国地区谱系簿2012》提供的数据,应用种群管理软件SPARKSv1.6和PMxv1.0对中国动物园白鹤圈养种群进行统计学和遗传学分析。结果显示该种群面临着许多困难,未知性别比例过高(截止到2012年10月31日,中国动物园白鹤圈养种... 详细信息

根据《圈养白鹤中国地区谱系簿2012》提供的数据,应用种群管理软件SPARKSv1.6和PMxv1.0对中国动物园白鹤圈养种群进行统计学和遗传学分析。结果显示该种群面临着许多困难,未知性别比例过高(截止到2012年10月31日,中国动物园白鹤圈养种群数量达到92只,其中雄性24只,雌性29只,未知性别39只)、年龄结构不合理(育龄个体数量充足,但幼龄个体数量仅有14只,约占现存种群的15.22%)、基因多样性丢失快(野外来源个体数量较多,达到58只,约占总数的63.04%,但是实际参与繁殖的奠基者仅有7只;该群体中某些奠基者的后代数量较多,种群平均亲缘关系值MK=0.15,从而导致现有种群只保留了野生个体85.25%的基因多样性)、种群数量增长乏力(2006～2012年种群的平均增长率λ=0.98)。因此,为了建立一个健康的白鹤圈养种群,应尽快开展性别鉴定工作,改善饲养环境条件,减少创伤引发的死亡,同时采用各种技术(如人工授精)增加潜在奠基者的繁殖机会,从而尽快扩大种群数量,并减少后代过多个体奠基者的繁殖机会。

关键词：白鹤中国动物园圈养种群圈养繁殖遗传管理

泛素特异性蛋白酶18在HBV慢性感染及干扰素抵抗中的作用机制

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中华肝脏病杂志 2014年第5期22卷 386-388页

作者：周俊英杨柳石家庄市河北医科大学第三医院感染科 050051

干扰素（interferon，IFN）α在慢性乙型肝炎（chronic hepatitis B，CHB）抗病毒治疗中的优势为有限疗程和相对较高的HBeAg和HBsAg的血清学转换率，但是其疗效尚不尽人意。在造成IFN应答不佳的众多影响因素中，IFN抗病毒作用信号通路... 详细信息

干扰素（interferon，IFN）α在慢性乙型肝炎（chronic hepatitis B，CHB）抗病毒治疗中的优势为有限疗程和相对较高的HBeAg和HBsAg的血清学转换率，但是其疗效尚不尽人意。在造成IFN应答不佳的众多影响因素中，IFN抗病毒作用信号通路尤其是对IFN刺激基因（interferonstimulatedgene，ISG）的研究逐渐成为热点，

关键词：肝炎病毒乙型干扰素类抵抗泛素特异性蛋白酶18

Association between Sleep and Menstrual Problems in Chinese Female University Students

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Association between Sleep and Menstrual Problems in Chinese ...

中国睡眠研究会第十一届全国学术年会

作者： Xiaocun Xing Pei Xue Xiangdong Tang junying zhou West China College of Medicine Sichuan University Sleep Medicine Center West China Hospital Sichuan University

Objective Menstrual problems are common in women of reproductive age, affecting up to 83% of women. The well-known menstrual problems include irregular periods, abnormal menstrual flow length, abnormal blood volume, period pain, and premenstrual syndrome. Sleep disturbance can impact an individual’s daytime function, emotional well-being and hormonal regulation. Previous studies have found the short sleep duration and rotating shift work can significantly increase the risk of irregular menstrual cycle. The prevalence of sleep disturbance is on the rise in young people, especially in females. A recent study reported that the prevalence of poor sleep quality in young women was 22%. Little is known about the association between sleep and menstruation in young females. Previous studies were limited by a modest sample size and the association between a specific sleep problem and menstrual disorders. In the current study, we aimed to investigate the association of sleep disturbances（eg. poor sleep quality, insomnia and short sleep duration） and menstrual problems in Chinese female university students with a considerable sample *** A total of 1006 female university students aged 15-38 years（mean age = 21.7 ± 2.8 years） participated in this study. Sleep duration, sleep quality and insomnia symptoms were assessed by the Pittsburgh Sleep Quality Index（PSQI） and the Insomnia Severity Index（ISI）. Short sleep duration was defined as total sleep time（TST） ≤ 7 hours. Mood disorders were rated using the Self-Rated Anxiety Scale（SAS） and the Self-Rated Depression Scale（SDS）. A structured questionnaire was used to assess participants’ demographics and menstrual related problems such as menstrual cycle interval, period irregularity, menstrual flow length, menstrual blood volume, and premenstrual syndrome. All statistical analyses were performed using IBM SPSS statistics software（Version 21, Chicago, IL, USA）.Results The prevalences of menstrual irregular, more menstrual blood

关键词：

Association of parameters of nocturnal hypoxemia with diabetic microvascular complications: a cross-sectional study

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Association of parameters of nocturnal hypoxemia with diabet...

中国睡眠研究会第十一届全国学术年会

作者： Pei Xue Yun Gao junying zhou Xiangdong Tang Sleep Medicine Center West China Hospital Sichuan University Department of Endocrinology and Metabolism West China Hospital Sichuan University

Background Diabetic microvascular complications are very common in patients with type 2 diabetes mellitus(T2DM) and contribute significantly to the morbidity and mortality of the condition. A growing body of literature suggests that obstructive sleep apnea(OSA) is a recognized risk factor for T2DM, and may also be a potential risk factor for diabetic microvascular complications. OSA and hyperglycemia share many similar molecular consequences. However, whether OSA defined by apnea-hypopnea index(AHI) or oxygen desaturation index(ODI) is associated with development of diabetic microvascular complications remains controversial. Objective The aim of this study was to examine the association between hypoxemia parameters related to OSA and microvascular complications(i.e., diabetic peripheral neuropathy(DPN), diabetic retinopathy(DR) and diabetic nephropathy(DN)). Methods A total of 468 Chinese patients with type 2 diabetes aged 18-85 years were included in the study. Information on demographic features, lifestyle risk factors, family history of diabetes, history and treatment of comorbidities was collected. All participants underwent one-night polysomnography, followed by the screening of diabetic microvascular complications, which were diagnosed by medical specialists. Parameters of nocturnal hypoxemia including AHI, ODI, mean and lowest oxygen saturation(SpO), and time spent with SpO<90% or <85% were recorded. Student t-test, Wilcoxon rank test and chi-square test were used to analyze data. Logistic regression analysis was used to determine the independent association between various parameters of nocturnal hypoxemia and the odds of diabetic microvascular complications after adjusting for potential confounders. Statistical significance was accepted as a two-sided test with an alpha level of 0.05. Results Patients with diabetic microvascular complications(i.e. DPN, DR or DN) were older and more likely to have long diabetes duration and a history of hypertension compared

关键词： nocturnal hypoxemia obstructive sleep apnea diabetic peripheral neuropathy diabetic retinopathy diabetic nephropathy

SIRT1-FoxO1-AdipoR2信号轴在酒精性脂肪性肝病中的作用机制

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中华肝脏病杂志 2016年第11期24卷 877-880页

作者：孙智周俊英河北医科大学第三医院感染科石家庄050051

长期酒精刺激可抑制肝细胞沉默信息调节因子1的表达，使得插头框蛋白O1的乙酰化水平增高、核内定位减少和DNA序列的结合能力降低，进而致其下游调节的脂联素受体2及微粒体甘油三酯转运蛋白的表达减少，分别通过影响脂联素的信号转导和... 详细信息

长期酒精刺激可抑制肝细胞沉默信息调节因子1的表达，使得插头框蛋白O1的乙酰化水平增高、核内定位减少和DNA序列的结合能力降低，进而致其下游调节的脂联素受体2及微粒体甘油三酯转运蛋白的表达减少，分别通过影响脂联素的信号转导和极低密度脂蛋白的合成导致肝细胞内脂质代谢紊乱和甘油三酯沉积，促进了酒精性脂肪性肝病的发生。

关键词：受体,脂联素脂肪肝,酒精性插头样转录因子1 沉默信息调节因子1

神经酰胺在酒精性脂肪性肝病发病机制中的作用

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中华肝脏病杂志 2015年第3期23卷 238-240页

作者：杨柳周俊英河北医科大学第三医院感染科石家庄市050051

酒精性肝病（ALD）病理改变包括酒精性脂肪肝、酒精性脂肪性肝炎、酒精性肝纤维化及酒精性肝硬化[1].目前乙醇引起肝脏脂肪变性的发病机制尚不十分明确,有研究发现乙醇可激活酸性鞘磷脂酶,使神经酰胺（ceramide）产生增多,通过蛋白磷酸... 详细信息

酒精性肝病（ALD）病理改变包括酒精性脂肪肝、酒精性脂肪性肝炎、酒精性肝纤维化及酒精性肝硬化[1].目前乙醇引起肝脏脂肪变性的发病机制尚不十分明确,有研究发现乙醇可激活酸性鞘磷脂酶,使神经酰胺（ceramide）产生增多,通过蛋白磷酸酶2A （protein phosphatase 2A,PP2A）影响腺苷酸活化蛋白激酶（adenosine monophosphate activated protein kinase,AMPK）,使活化的AMPK去磷酸化,进而影响下游一系列脂代谢调节基因,导致肝细胞内脂肪堆积[2].本研究将详细阐述神经酰胺在酒精性脂肪性肝病（AFLD）发病机制中的作用.

关键词：脂肪肝,酒精性神经酰胺蛋白磷酸酶2A