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Chronic intermittent hypoxia aggravates cardiomyocyte apoptosis in rat ovariectomized model

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Chinese Medical Journal 2012年第17期125卷 3087-3092页

作者： GAO Ying-hui CHEN Lin MA Yan-liang HE Quan-ying department of pneumology Peking University People's HospitalBeijing 100044China

Background The prevalence of obstructive sleep apnea （OSA） increases after menopause in women, but remains under diagnosed because of social or lifestyle factors. It is important to evaluate the hazards of OSA on cardiovascular disease in menopausal women. We tested the hypothesis that chronic intermittent hypoxia （CIH） may aggravate cardiomyocyte apoptosis in ovariectomized （OVX） Sprague Dawley （SD） rats; the changes of anti-oxidation ability in cardiac muscles may be one of the reasons for cardiomyocyte apoptosis. Methods Forty-eight 60-day old female SD rats were randomly divided into a CIH group, OVX group, OVX±CIH （OC） group, and handled control （HC） group, and the rats were exposed either to CIH （nadir 02 6%） or handled normoxic controls. The changes of body weight and whole heart weight were measured. Super oxide dismutase （SOD） and malonaldehyde （MDA） were used to evaluate the level of oxidative stress. TdT-mediated dUTP nick end labeling （TUNEL） was used to measure apoptosis in each rat. Western blotting was used to measure apoptosis associated proteins in cardiac muscle samples from each rat. Results When compared with the HC and CIH groups, the levels of oxidative stress in the OC and OVX groups were significantly higher. The levels of SOD in the HC, CIH, OC, and OVX groups were （47.99±4.89）, （53.60±4.47）, （20.99±2.72）, and （30.64±3.79） mmol/mg protein; significantly increased in the CIH group （P 〈0.05） and significantly decreased in the OC （P 〈0.01） and OVX （P 〈0.05） groups. The levels of MDA in the HC, CIH, OVX, and OC groups were （1.63±0.20）, （1.93±0.77）, （3.30±0.39）, and （1.95_±0.20） mmol/mg protein; it significantly increased in the CIH （P 〈0.05）, OC （P 〈0.01）, and OVX （P 〈0.05） groups compared with the HC group. Bax protein expression was significantly increased and bcl-2 protein expression was significantly reduced after CIH compared with HC rats （P 〈0.05）. The protein expression of bax and bcl-2 in the OC group was not significantly different from the CIH group, but the ratio of bax/bcl-2 was s

关键词： sleep apnea obstructive chronic intermittent hypoxia apoptosis myocardium ovariectomy

Chronic intermittent hypoxia from pedo-stage decreases glucose transporter 4 expression in adipose tissue and causes insulin resistance

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Chinese Medical Journal 2010年第4期123卷 463-470页

作者： CHEN Lin CAO Zhao-long HAN Fang GAO Zhan-cheng HE Quan-ying department of pneumology Peking University People's Hospital Beijing 100044 China

Background The persistence of sleep disordered breathing （SDB） symptoms after tonsil and/or adenoid （T＆A） surgery are common in children with obstructive sleep apnea （OSA）. We tested the hypothesis that disturbances of glucose transporters （GLUTs） in intraabdominal adipose tissue caused by chronic intermittent hypoxia （CIH） from the pedo-period could facilitate the appearance of periphery insulin resistance in Sprague-Dawley （SD） rats. We tested the hypothesis that the changes of GLUTs in adipose tissue may be one of the reasons for persistent SDB among clinical OSA children after T＆A surgery. Methods Thirty 21-day-old SD rats were randomly divided into a CIH group, a chronic continuous hypoxia （CCH） group and a normal oxygen group （control group） and exposed for 40 days. The changes of weight, fasting blood glucose and fasting blood insulin levels were measured. Hyperinsulinemic-euglycemic clamp techniques were used to measure insulin resistance in each animal. Real-time quantitative PCR and Western blotting were used to measure GLUT mRNA and proteins in intraabdominal adipose tissue. Additional intraabdomial white adipose tissue （WAT） was also processed into paraffin sections and directly observed for GLUTs1-4 expression. Results When compared with control group, CIH increased blood fasting insulin levels, （245.07±53.89） pg/ml vs. （168.63±38.70） pg/ml, P=-0.038, and decreased the mean glucose infusion rate （GIR）, （7.25±1.29） mg·kg^-1·min^-1 vs. （13.34±1.54） mg·kg^-1·min^-1, P 〈0.001. GLUT-4 mRNA and protein expression was significantly reduced after CIH compared with CCH or normal oxygen rats, 0.002±0.002 vs. 0.039±0.009, P 〈0.001; 0.642±0.073 vs. 1.000±0.103, P=0.035. Conclusions CIH in young rats could induce insulin resistance via adverse effects on glycometabolism. These findings emphasize the importance of early detection and treatment of insulin insensitivity in obese childhood OSA.

关键词： sleep apnea syndrome insulin resistance glucose transporters hypoxia childhood

Gastrointestinal lesions associated with spondyloarthropathies

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World Journal of Gastroenterology 2009年第20期15卷 2443-2448页

作者： Ambrogio Orlando Sara Renna Giovanni Perricone Mario Cottone department of General Medicine Pneumology and Nutrition Clinic "V. Cervello" Hospital Palermo University department of General Medicine Pneumology and Nutrition Clinic"V. Cervello" Hospital Palermo University

Subclinical gut inflammation has been described in up to twothirds of patients with spondyloarthropathies(SpA).Arthritis represents an extraintestinal manifestation of several gastrointestinal diseases, including inflammatory bowel disease(IBD), Whipple's disease, Behcet's disease, celiac disease, intestinal bypass surgery, parasitic infections of the gut and pseudomembranous colitis.Moreover about two thirds of nonsteroidal antiinflammatory drug users demonstrate intestinal inflammation.Arthritis may manifest as a peripheral or axial arthritis.The spondyloarthropathy family consists of the following entities:ankylosing spondylitis, undifferentiated spondyloarthritis, reactive arthritis, psoriatic arthritis, spondyloarthritis associated with IBD, juvenile onset spondyloarthritis.This topic reviews the major gastrointestinal manifestations that can occur in patients with SpA and in nonsteroidal anti inflammatory drugs users.

关键词：胃肠道疾病鸡传染性法氏囊病非甾体抗炎药评价病变关节炎寄生虫感染脊柱

Medically unexplained dyspnea:psychophysiological characteristics and role of breathing therapy

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Chinese Medical Journal 2004年第1期117卷 6-13页

作者：韩江娜朱元珏李舜伟雒冬梅胡征 Van Diest I De Peuter S Van de Woestijne KP Van den Bergh O Laboratory of Respiratory Psychophysiology Department of PneumologyPeking Union Medical College HospitalChinese Academy of Medical Sciences department of Psychology University of Leuven department of pneumology UZ Gasthuisberg

Background Medically unexplained dyspnea occurs commonly in medical settings and remains poorly understood. This study was conducted to investigate the psychophysiological characteristics of medically unexplained dyspnea and the efficacy of breathing retraining for these patients. Methods A group of patients with medically unexplained dyspnea were compared to patients with a variety of organic lung diseases and healthy subjects. In another group of patients,the influence of breathing therapy on complaints,anxiety, and breath-holding was evaluated for an average of 1.5 years. Results Patients with medically unexplained dyspnea reported more intense dyspnea than patients with a variety of organic lung diseases. Additionally,they were anxious and presented a broad range of symptoms in daily life and under challenge,for instance voluntary hyperventilation. More than one third of them qualified for panic disorder. They had shorter breath-holding time at rest,less increase in breath-holding time and higher chances of showing a “paradoxical” decrease of breath-holding time after hyperventilation. A combination of PaO2,forced expiratory volume in one second (FEV_1),and anxiety measures distinguished them from organic dyspnea. Breathing retraining profoundly improved their symptoms and decreased the level of state and trait anxiety. Moreover,they better tolerated the voluntary hyperventilation and the symptoms induced were also markedly decreased after therapy. Breath-holding time was prolonged and PetCO2 in a representative group of patients increased. Conclusions Patients with medically unexplained dyspnea appear to have the feature of a “psychosomatic” patient: an anxious patient with a wide variety of symptoms of different organ systems that do not have an organic basis. They can be distinguished from organic dyspnea using a small set of physiological and psychological measures. Breathing retraining turns out to be an effective therapy for those “difficult to treat patients”.

关键词： dyspnea·somatization·anxiety·hyperventilation·breathing therapy

Cerebral Abscesses Revealing Pulmonary Arteriovenous Malformations

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Chinese Medical Journal 2016年第18期129卷 2253-2255页

作者： Issoufou Ibrahim Sani Rabiou Belliraj Laila Ammor Fatima Zahra Ghalimi Jamal Lakranbi Marouane Serraj Mounia Ouadnouni Yassine Smahi Mohamed department of Thoracic Surgery Teaching Hospital Hassan II Fez 30000 Morocco department of pneumology Teaching Hospital Hassan II Fez 30000 Morocco

Pulmonary arteriovenous malformations （AVM） lung is defined by an abnormal communication between pulmonary artery（ies） and vein（s） responsible for a right-left shunt. Congenital forms are most common and usually associated with Rendu-Osler disease （ROD）. Inversely, 15-45% of patients with ROD present lung AVM Nowadays, embolization is preferred to surgical resection in the majority of cases. Except for certain cases where surgery is indicated. This paper shows the role of surgery in AVMs.

关键词： Brain Abscess Lobectomy Osler-Rendu Disease Pulmonary Arteriovenous Malformation Thoracotomy

Fearful imagery induces hyperventilation and dyspnea in medically unexplained dyspnea

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Chinese Medical Journal 2008年第1期121卷 56-62页

作者： HAN Jiang-na ZHU Yuan-jue LUO Dong-mei LI Shun-wei Ilse Van Diest Omer Van den Bergh KarelP Van de Woestijne department of pneumology Peking Union Medical CollegeHospital Chinese Academy of Medical Sciences Beijing 100730China department of Psychology University of Leuven B-3000 LeuvenBelgium department of pneumology U Z Gasthuisberg B-3000 LeuvenBelgium

Background Medically unexplained dyspnea refers to a condition characterized by a sensation of dyspnea and is typically applied to patients presenting with anxiety and hyperventilation without underlying cardiopulmonary pathology. We were interested to know how anxiety triggers hyperventilation and elicits subjective symptoms in those patients. Using an imagery paradigm, we investigated the role of fearful imagery in provoking hyperventilation and in eliciting symptoms, specifically dyspnea. Methods Forty patients with medically unexplained dyspnea and 40 normal subjects matched for age and gender were exposed to scripts and asked to imagine both fearful and restful scenarios, while end-tidal PCO2 （PetCO2） and breathing frequency were recorded and subjective symptoms evaluated. The subject who had PetCO2 falling more than 5 mmHg from baseline and persisting at this low level for more than 15 seconds in the imagination was regarded as a hyperventilation responder. Results In patients with medically unexplained dyspnea, imagination of fearful scenarios, being blocked in an elevator in particular, induced anxious feelings, and provoked a significant fall in PetCO2 （P〈0.05）. Breathing frequency tended to increase. Eighteen out of 40 patients were identified as hyperventilation responders compared to 5 out of 40 normal subjects （P〈0.01）. The patients reported symptoms of dyspnea, palpitation or fast heart beat in the same fearful script imagery. Additionally, PetCO2 fall was significantly correlated with the intensity of dyspnea and palpitation experienced during the mental imagery on one hand, and with anxiety symptoms on the other. Conclusions Fearful imagery provokes hyperventilation and induces subjective symptoms of dyspnea and palpitation in patients with medically unexplained dyspnea.

关键词： medically unexplained dyspnea hyperventilation anxiety dyspnea mental imagery

Thoracic splenosis: Case report of a symptomatic case

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Chinese Journal of Traumatology 2020年第3期23卷 185-186页

作者： Florent Le Bars Remy Pascot Charles Ricordel Herve Corbineau Jean Philippe Verhoye Bertrand Richard De Latour Simon Rouze department of Cardiothoracic Surgery University Hospital CentreRennesFrance department of Vascular Surgery University Hospital CentreRennesFrance department of pneumology University Hospital CentreRennesFrance

Thoracic splenosis is the autotransplantation of splenic tissue in the left thoracic cavity as a result of a splenic injury. This rare pathology is usually asymptomatic and may be discovered on incidental imaging, but the diagnosis often requires invasive procedures such as surgery in order to eliminate a neoplasic origin. We report a rare symptomatic case of a 39-year-old man presenting with chest pain and multiple nodules revealed on a computed tomography scan. The patient underwent a surgical exploration and the pathological studies concluded to a thoracic splenosis. Indeed, the previous medical history of the patient revealed a left thoraco-abdominal traumatism during childhood. The aim of this paper is to emphasize that the diagnosis can now be performed using only imaging techniques such as technetium-99 sulfur colloid or labelled heat-denatured red blood cell scintigraphy to avoid unnecessary invasive procedures including thoracotomy.

关键词： Splenectomy Thoracic splenosis Splenic injury Diaphragmatic injury Pleural nodule

Fibroblasts weaken the anti-tumor effect of gefitinib on co-cultured non-small cell lung cancer cells

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Chinese Medical Journal 2014年第11期127卷 2091-2096页

作者： Yong Xiao Wang Peiqin Jiang Tao Yu Wenchen Shang Yan Han Yiping Zhang Pingping Li Qiang department of pneumology Changhai Hospital Second Military Medical University Shanghai 200433 China department of Gastroenterology Changzheng Hospital Second Military Medical University Shanghai 200003 China department of Emergency Affiliated Hospital of Medical College Qingdao UniversityQingdao Shandong 266000 China department of pneumology Affiliated Hospital of Medical College Qingdao UniversityQingdao Shandong 266000 China

Background Non-small cell lung cancer （NSCLC） is the most common lung malignancy worldwide.The metastatic potential of NSCLC cells has been shown to be associated with the tumor microenvironment,which consists of tumor cells,stroma,blood vessels,immune infiltrates and the extracellular matrix.Fibroblasts can produce numerous extraceilular matrix molecules and growth factors.Gefitinib has been evaluated as a first-line treatment in selected patients,and it has shown favorable efficacy especially in NSCLC,but it is not effective for everyone.Methods In this study,we examined the antitumor activity of gefitinib on lung fibroblasts co-cultured of lung cancer cells.A series of co-culture experiments that employed cell counting kit-8 （CCK8）,transwells,real-time polymerase chain reaction （RT-PCR） and Western blotting with HFL-1 fibroblasts and A549 human lung carcinoma cells were performed to learn more about tumor cell proliferation,migration and invasion; and to determine any change of epithelial mesenchymal transition （EMT）-associated tumor markers vimentin,matrix metallopro-teinase 2 （MMP2） and chemotaxis cytokines receptor 4 （CXCR4） mRNA levels.Results A549 cell proliferation in the presence of HFL-1 cells was not significantly increased compared with A549 cells alone,but A549 cell spheroid body formation was increased after co-culture,and treatment with gefitinib increased further.Our study also revealed that fibroblasts attenuated the lung cancer cell inhibition ratio of migration and invasion after gefitinib treatment in vitro.To further study this mechanism,RT-PCR analysis showed that vimentin,MMP2 and CXCR4 mRNA levels were more highly expressed in the lung cancer cells after co-culture,but did not obviously decrease compared with the control cells following gefitinib treatment.This suggests the mechanism by which fibroblasts attenuate gefitinib-induced expression of EMT-associated tumor markers.Finally,our results demonstrated that co-culture with A549 lung cancer cells does not alter the cell cycle distribut

关键词： gefitinib cancer-associated fibroblasts lung cancer co-culture epithelial mesenchymal transition proliferation

How does negative affectivity contribute to medically unexplained dyspnea?

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Chinese Medical Journal 2004年第1期117卷 3-3页

作者： Karel P. Van de Woestijne department of pneumology UZ Gasthuisberg

Typical for medically unexplained dyspnea is the combination of respiratory complaints, specifically dyspnea, the absence of any disability that might explain these complaints, and, in addition, a high level of anxiety. When the latter is quantified by the STAI-state and trait anxiety inventory,1 the resulting scores are significantly higher than those observed in organic pulmonary disorders.

关键词： Personality Anxiety Dyspnea Humans