Search

Uncaria, a perennial vine from the Rubiaceae family, is a typical Chinese traditional medicine. Currently, uncertainty exists over the Uncaria genus' evolutionary relationships and germplasm identification. The complete chloroplast genomes of four Uncaria species mentioned in the Chinese Pharmacopoeia and Uncaria scandens (an easily confused counterfeit) were sequenced and annotated. The findings demonstrated that the whole chloroplast genome of Uncaria genus is 153,780–155,138 bp in full length, encoding a total of 128–131 genes, containing 83–86 protein-coding genes, eight rRNAs and 37 tRNAs. These regions, which include eleven highly variable loci and 31–49 SSRs, can be used to create significant molecular markers for the Uncaria genus. The phylogenetic tree was constructed according to protein-coding genes and the whole chloroplast genome sequences of five Uncaria species using four methods. The topology of the two phylogenetic trees showed no difference. The sequences of U. rhynchophylla and U. scandens are clustered in one group, while the U. hirsuta and U. macrophylla are clustered in another group. U. sessilifructus is clustered together with the above two small clades. New insights on the relationship were revealed via phylogenetic research in five Uncaria species. This study will provide a theoretical basis for identifying U. rhynchophylla and its counterfeits, as well as the species of the Uncaria genus. This research provides the initial chloroplast genome report of Uncaria, contributes to elucidating the chloroplast genome evolution of Uncaria in China. [ABSTRACT FROM AUTHOR]

The newly emerged lineage 1 porcine reproductive and respiratory syndrome viruses (PRRSVs) (especially the NADC30‐like and NADC34‐like viruses) have posed a direct threat to the Chinese pig industry since 2013. The phylogenetic, epidemic, and recombinant properties of these viruses have not yet systematically analysed in China. This report presents regular surveillance and field epidemiological studies for PRRSV across China from 2007 to 2019. From over 4,000 detected clinical samples, 70 open reading frame five sequences and four complete genomes of lineage 1 viruses were successfully obtained. Combined with global data, we conducted an extensive and systematic molecular phylogeny analysis using a maximum likelihood tree. The Chinese lineage 1 viruses were clustered, and their temporal and spatial distribution was further explored. Multiple viral introductions of lineage 1 virus from the United States to China were detected, and some became endemic in China. There are three sub‐lineage 1 clusters: lineage 1.5 (NADC34‐like), lineage 1.6 and New Intro cluster (NADC30‐like). These viruses show high genetic diversity and a wide distribution in China, with Henan Province showing the highest diversity. Moreover, Chinese lineage 1 viruses have developed an endemic NADC30‐like cluster. The demographic feature of this cluster showed a more or less constant population expansion history with a recent decreasing trend. Moreover, the genome recombination of Chinese lineage 1 with two dominant clusters (Chinese HP‐PRRSVs: lineage 8.7 and VR2332‐like: lineage 5.1) was frequently detected, both of which have commercial vaccine strains available. Furthermore, recombination hotspots were discovered near NSP9 and ORF2‐4 regions of the genome. Overall, these findings provide important insights into the evolution and geographical diversity of Chinese lineage 1 PRRSV. These results will facilitate the development of programmes for the control and prevention of the emerging lineage 1 viruses in China. [ABSTRACT FROM AUTHOR]

Background: The molecular and genetic research showed the association between DFNA11 and mutations in MYO7A. This research aimed to identify a MYO7A mutation in a family with nonsyndromic autosomal dominant hearing loss. Methods: We have ascertained one large multigenerational Chinese family (Z029) with autosomal dominant late-onset progressive non-syndromic sensorineural hearing loss. Genome-wide linkage analysis of the family mapped the disease locus to the DFNA11 interval, where the MYO7A was considered as a candidate gene. Sequencing of the PCR products was carried out for each sample. One hundred and fifty one control subjects with normal hearing functions were also evaluated. Results: The pathogenic mutation (c.2011G>A) was identified in the family. This mutation co-segregated with hearing loss in this family. No mutation of MYO7A gene was found in the 151 controls. Conclusions: The missense mutation of MYO7A is identified in the family displaying the pedigree consistent with DFNA11. We not only examined the clinical and genetic characteristics of the family, but also provided a basis for genetic counseling. We also summarized and analyzed the phenotypes and genotypes of all DFNA11 families, four of nine are Chinese families, suggesting that MYO7A mutations are not rare. Therefore, we should pay more attention to Chinese patients. [ABSTRACT FROM AUTHOR]

Background: Sedation and/or analgesia can relieve the patient-ventilator asynchrony. However, whether sedation and/or analgesia can benefit the clinical outcome of the patients with interface intolerance is still unclear.Methods: A retrospective study was performed on patients with interface intolerance who received noninvasive positive pressure ventilation (NIPPV) after extubation in seven intensive care units (ICU) of West China Hospital, Sichuan University. The primary outcome was rate of NIPPV failure (defined as need for reintubation and mechanical ventilation); Secondary outcomes were hospital mortality rate and length of ICU stay after extubation.Results: A total of 80 patients with oral-nasal mask (90%) and facial mask (10%) were included in the analysis. 41 out of 80 patients received sedation and/or analgesia treatment (17 used analgesia, 11 used sedation and 13 used both) at some time during NIPPV. They showed a decrease of NIPPV failure rate, (15% vs. 38%, P = 0.015; adjusted odd ratio [OR] 0.29, 95% confidence interval [CI] 0.10-0.86, P = 0.025), mortality rate (7% vs. 33%, P = 0.004; adjusted OR 0.14, 95% CI 0.03-0.60, P = 0.008), and the length of ICU stay after extubation.Conclusion: This clinical study suggests that sedation and/or analgesia treatment can decrease the rate of NIPPV failure, hospital mortality rate and ICU LOS in patients with interface intolerance after extubution during NIPPV. [ABSTRACT FROM AUTHOR]

Biotransformation mediated by microbes can affect the biogeochemical cycle of arsenic. However, arsenic biotransformation mediated by earthworm-related microorganisms has not been well explored, especially the role played by earthworm skin microbiota. Herein, we reveal the profiles of arsenic biotransformation genes (ABGs) and elucidate the microbial communities of the earthworm gut, skin, and surrounding soil from five different soil environments in China. The relative abundance of ABGs in the earthworm skin microbiota, which were dominated by genes associated with arsenate reduction and transport, was approximately three times higher than that in the surrounding soil and earthworm gut microbiota. The composition and diversity of earthworm skin microbiota differed significantly from those of the soil and earthworm gut, comprising a core bacterial community with a relative abundance of 96% Firmicutes and a fungal community with relative abundances of 50% Ascomycota and 13% Mucoromycota. In addition, stochastic processes mainly contributed to the microbial community assembly across all samples. Moreover, fungal genera such as Vishniacozyma and Oomyces were important mediators of ABGs involved in the biogeochemical cycle of arsenic. This is the first study to investigate earthworm skin as a reservoir of microbial diversity in arsenic biotransformation. Our findings broaden the current scientific knowledge of the involvement of earthworms in the arsenic biogeochemical cycle. [Display omitted] • Profiles of ABG in the earthworm skin dominated by arsenate reduction and transport were observed. • The earthworm skin microbiota differed significantly from those of the soil and earthworm gut. • Stochastic processes strongly shaped the microbial community assembly of earthworm gut and skin. • The earthworm skin as a reservoir of microbial diversity played a vital role in arsenic biotransformation. [ABSTRACT FROM AUTHOR]

Abstract: Technique for Order Performance by Similarity to Ideal Solution (TOPSIS) method was used to comprehensively evaluate total natural antioxidants and antioxidant activities in Ziziphus jujuba Mill. var. spinosa (Bunge) Hu ex H. F. Chou fruits based on geographical origin. Correlations between natural antioxidants, antioxidant activities and geographical conditions were investigated. TOPSIS evaluation showed that the fruits from Ningxia possess the largest amount of natural antioxidants and antioxidant activities among other samples. Correlation analyses indicated that both altitude and annual precipitation exert profound effects on natural antioxidant levels. Moreover, the fruits exhibited significant DNA damage protection activity and in vitro antiradical potentials. In particular, the fruits from Ningxia, Gansu and Shaanbei which were grown in the semi-arid regions of loess plateaus showed fairly higher antioxidant activities. To a certain degree, this study concludes that the fruits in arid harsh and high-altitude areas can accumulate higher levels of natural antioxidants and display stronger antioxidant activities. [ABSTRACT FROM AUTHOR]

Abstract: Carbon isotope discrimination (Δ) has been repeatedly reported to positively correlate with grain yield in wheat grown under post-anthesis stress environments. Several hypotheses have been put forward to explain this association. However, there is few reported direct evidence clarified the relationship between Δ and grain yield, which is the objective of the present work. The relationships between Δ and grain yield (GY), harvest index (HI), ash content (m a), specific stem dry weight (SSDW) and carbohydrate in stem, were studied in a collection of 20 bread wheat cultivars (landraces, released cultivars and advanced lines) in Yinchuan of the Ningxia region (Northwest of China) in three successive years (2006, 2007 and 2008). Relationships between GY, HI, stem specific dry weight, accumulation and mobilization of stem reserved carbohydrate and Δ were analyzed. The effects of year, sampling time and genotypes on measured traits were significant. Positive correlations between grain yield and Δ were noted in 2007 and 2008 when stress occurred after anthesis, but not in 2006 when soil water condition was nearly optimal. Significant and positive correlations among m a L m, grain Δ and harvest index were found. Stem water-soluble carbohydrate content (SWSCC) and specific dry weight 7 days after anthesis was positively associated with Δ. Remobilization efficiency of stem water-soluble carbohydrate and total carbohydrate (the sum of water-soluble carbohydrate and starch) was also found to be significantly and positively correlated to Δ. There were negative relationships between ΔG m, ΔS m, and SSDW at maturity. In conclusion, Δ may predict yield when irrigation does not meet crop''s water requirement and wheat experiences a slight water stress after anthesis in central region of Ningxia. Δ or m a L m is related to the efficiency of carbon partitioning to the grain. Basal mature stem Δ seems to be an integrated character reflecting both early carbohydrate assimilation and dry matter remobilization to grain during grain-filling. [Copyright &y& Elsevier]

Abstract: Hydrodistillation of the flower of seven populations of Salvia miltiorrhiza Bge. collected in different locations in China afforded a pale yellowish oil in a yield of approximately 0.2%. A total of 82 compounds were identified across all the samples, accounting for 98–100% of the total compositions of each sample. Components were mainly monoterpenes, sesquiterpenes, fatty acids and alkanes. GC and GC–MS analysis indicated that the predominant components of the essential oils are β-caryophyllene (12.2–31.7%), β-caryophyllene oxide (1.4–11.6%), α-caryophyllene (4.8–10.6%), cadinadiene (7.4–29.3%), and hexadecanoic acid (3.9–18.8%). [Copyright &y& Elsevier]

Phytogeographical variation has an impact on up/down regulation of secondary metabolites in medicinal plants. In this context, present study analyzed the influence of environmental factors on secondary metabolites in Salvia miltiorrhiza from natural habitat of China with different topographical conditions. The chemotypic variation was further correlated with climatic factors than micronutrients in the soil. The data revealed that tanshinones were more likely to be influenced by changes in ecological factors compared with phenolic acids. Tanshinone content was positively correlated with annual sunshine duration (correlation coefficients ranged from 0.379 to 0.730, P <  0.01 or 0.05), but negatively correlated with annual mean temperature (correlation coefficients ranged from −0.358 to −0.718, P <  0.01 or 0.05) and annual average precipitation (correlation coefficients ranged from −0.425 to −0.679, P <  0.01); the opposite situation was found in salvianolic acid B (correlation coefficients were −0.137, 0.084, 0.19), caffeic acid (correlation coefficients were −0.336, 0.246, 0.216, P <  0.05) and rosmarinic acid (correlation coefficients were −0.518, 0.475, 0.493, P <  0.01). Among the micronutrients, soil concentrations of Ba, Al and Mg exhibit the positive correlation with tanshinone content, but Pb exhibit the negative correlation with tanshinone content. Total N and K presented positive effects on most of phenolic acids. Ba showed significant negative and direct effects on salvianolic acid B (correlation coefficient was −0.281) and Rosmarinic acid (correlation coefficient was −0.367, P <  0.05). Therefore, the elite chemotype of S. miltiorrhiza identified among the collected samples express the correlation of phyto-geographical condition on the quantity of industrially viable metabolites, tashinones and phenolic acids. This aids in site specific exploration of high metabolite yielding samples to meet out the commercial demands and, promote the agriculture practices of this industrial crop for societal upliftment in area having similar phytogeographical locations. [ABSTRACT FROM AUTHOR]

The article examines the importance of precision medicine implementation in gastric cancer in China. Topics discussed include factors contributing to the decline in cancer deaths in China, anatomic, histologic and molecular classifications of gastric cancer, and challenges for precision medicine in the country.

Abstract: Ethnopharmacological relevance: The leaves of Taxus chinensis var. mairei (Taxaceae) is used traditionally to fill pillows in some rural areas of China. Its volatile substances have been speculated to be capable of improving sleep quality, making blood pressure stable, and having diuretic capacity as recorded in Ancient Chinese Materia Medica. Using animal models and new technologies, we confirmed the hypotensive potential of volatile components from leaves of Taxus chinensis var. mairei (VCLT). Materials and methods: VCLT was obtained by supercritical CO2 extraction equipment from Taxus chinensis var. mairei fresh leaves. Hypertensive rats were pre-induced by intraperitoneal (i,p.) injection of Nω-Nitro-l-Ariginine (l-NNA) for 15 days (15mg/kg, twice a day), then divided into 5 groups and subjected to the following treatments. l-NNA group (group 1) receiving l-NNA alone (15mg/kg, i.p., twice per day for 6 weeks); in addition to receiving l-NNA same as group 1, Hydrochlorothiazide (HDZ) group (group 2) receiving HDZ (orally administration, 5mg/kg, once per day for 6 weeks); VCLT groups (groups 3–5), including VCLT1, VCLT2, VCLT3. The VCLT rats were housed in an enclosed cage (2 rats/0.064m3). VCLT was mixed well and sprayed on fresh leaves surface of Taxus chinensis var. mairei (100ml/kg) with three dosages: 167g/kg (VCLT1), 233g/kg (VCLT2) and 333g/kg (VCLT3), respectively. Systolic Blood Pressure (SBP), plasma nitric oxide (NO), plasma angiotensin II, postprandial blood glucose, fasting blood glucose and blood lipids were determined. Results: VCLT prevented the increase of SBP and plasma angiotensin II in l-NNA treated rats. Although VCLT does not significantly reduce blood triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C), it decreases total cholesterol (TC) while increasing plasma NO levels in a dose-dependent manner. Conclusion: VCLT can be used as a natural and supplementary reagents for the treatment of hypertension. [Copyright &y& Elsevier]

Abstract: One thousand and thirty Escherichia coli isolates from food animals, animals-derived foods, and companion animals between 2007 and 2008 in Southern China were used to investigate their antimicrobial susceptibility to 14 different antimicrobials by the standard agar dilution method. More than 70% of isolates showed resistance to tetracycline, trimethoprim–sulphamethoxazole, nalidixic acid, and ampicillin. In general, resistance was less frequent in companion animal isolates vs food animals isolates, but cephalosporin and amikacin resistance was more frequent in companion animal isolates, 42.6% to 56.2% vs 14.1% to 24.3%, and 28.5% vs 18.8%, respectively, which was most likely due to the common use of these antimicrobials as treatment in pet animals. Fluroquinolones resistance was high in all animal isolates (>50%). Food products showed lowest resistance among isolates from these three resources. PFGE analysis indicated that a majority of multidrug-resistant E. coli isolates showed unique, unrelated PFGE profiles and were unlikely to be the spread of a specific clone. This study provides useful information about the prevalence of antimicrobial resistance in E. coli isolated from animals and food products in China and provided evidence of the linkage of the use of antimicrobials in animals and its selection of antimicrobial resistance in bacterial isolates. The data from this study further warns the prudent use of antimicrobials in food and pet animals to reduce the risks of transmission of antimicrobial resistance zoonotic pathogen to humans. [Copyright &y& Elsevier]

Background: The first case of 2009 pandemic influenza A (H1N1) virus infection in China was documented on May 10. Subsequently, persons with suspected cases of infection and contacts of those with suspected infection were tested. Persons in whom infection was confirmed were hospitalized and quarantined, and some of them were closely observed for the purpose of investigating the nature and duration of the disease. Methods: During May and June 2009, we observed 426 persons infected with the 2009 pandemic influenza A (H1N1) virus who were quarantined in 61 hospitals in 20 provinces. Real-time reverse-transcriptase–polymerase-chain-reaction (RT-PCR) testing was used to confirm infection, the clinical features of the disease were closely monitored, and 254 patients were treated with oseltamivir within 48 hours after the onset of disease. Results: The mean age of the 426 patients was 23.4 years, and 53.8% were male. The diagnosis was made at ports of entry (in 32.9% of the patients), during quarantine (20.2%), and in the hospital (46.9%). The median incubation period of the virus was 2 days (range, 1 to 7). The most common symptoms were fever (in 67.4% of the patients) and cough (69.5%). The incidence of diarrhea was 2.8%, and the incidence of nausea and vomiting was 1.9%. Lymphopenia, which was common in both adults (68.1%) and children (92.3%), typically occurred on day 2 (range, 1 to 3) and resolved by day 7 (range, 6 to 9). Hypokalemia was observed in 25.4% of the patients. Duration of fever was typically 3 days (range, 1 to 11). The median length of time during which patients had positive real-time RT-PCR test results was 6 days (range, 1 to 17). Independent risk factors for prolonged real-time RT-PCR positivity included an age of less than 14 years, male sex, and a delay from the onset of symptoms to treatment with oseltamivir of more than 48 hours. Conclusions: Surveillance of the 2009 H1N1 virus in China shows that the majority of those infected have a mild illness. The typical period during which the virus can be detected with the use of real-time RT-PCR is 6 days (whether or not fever is present). The duration of infection may be shortened if oseltamivir is administered. N Engl J Med 2009;361:2507-17. [ABSTRACT FROM AUTHOR]

Background: There is limited information on the difference in epidemiology, clinical characteristics and outcomes of the initial outbreak of the coronavirus disease (COVID-19) in Wuhan (the epicenter) and Sichuan (the peripheral area) in the early phase of the COVID-19 pandemic. This study was conducted to investigate the differences in the epidemiological and clinical characteristics of patients with COVID-19 between the epicenter and peripheral areas of pandemic and thereby generate information that would be potentially helpful in formulating clinical practice recommendations to tackle the COVID-19 pandemic., Methods: The Sichuan & Wuhan Collaboration Research Group for COVID-19 established two retrospective cohorts that separately reflect the epicenter and peripheral area during the early pandemic. The epidemiology, clinical characteristics and outcomes of patients in the two groups were compared. Multivariate regression analyses were used to estimate the adjusted odds ratios (aOR) with regard to the outcomes., Results: The Wuhan (epicenter) cohort included 710 randomly selected patients, and the peripheral (Sichuan) cohort included 474 consecutive patients. A higher proportion of patients from the periphery had upper airway symptoms, whereas a lower proportion of patients in the epicenter had lower airway symptoms and comorbidities. Patients in the epicenter had a higher risk of death (aOR=7.64), intensive care unit (ICU) admission (aOR=1.66), delayed time from illness onset to hospital and ICU admission (aOR=6.29 and aOR=8.03, respectively), and prolonged duration of viral shedding (aOR=1.64)., Conclusions: The worse outcomes in the epicenter could be explained by the prolonged time from illness onset to hospital and ICU admission. This could potentially have been associated with elevated systemic inflammation secondary to organ dysfunction and prolonged duration of virus shedding independent of age and comorbidities. Thus, early supportive care could achieve better clinical outcomes.

Background: The number of hospitalized young coronavirus disease 2019 (COVID-19) patients has increased significantly. However, specific data about COVID-19 patients under 65 years old who are admitted to the hospital are scarce., Methods: The COVID-19 patients under 65 years old who were admitted to the hospital in Sichuan Province, Renmin Hospital of Wuhan University, and Wuhan Red Cross Hospital were included in this study. Demographic information, laboratory data and clinical treatment courses were extracted from electronic medical records. Risk factors associated with oxygen therapy were explored., Results: Eight hundred thirty-three COVID-19 patients under 65 years old were included. Of the included patients, 29.4% had one or more comorbidities. Oxygen therapy was required in 63.1% of these patients, and the mortality was 2.9% among the oxygen therapy patients. Fever (odds ratio [OR] 2.072, 95% confidence interval [CI] 1.312-3.271, p = 0.002), dyspnea (OR 2.522, 95% CI 1.213-5.243, p = 0.013), chest distress (OR 2.278, 95% CI 1.160-4.473, p = 0.017), elevated respiratory rate (OR 1.114, 95% CI 1.010-1.228, p = 0.031), and decreased albumin (OR 0.932, 95% CI 0.880-0.987, p = 0.016) and globulin levels (OR 0.929, 95% 0.881-0.980, p = 0.007) were independent factors related to oxygen therapy., Conclusions: Oxygen therapy is highly required in COVID-19 patients under 65 years old who are admitted to the hospital, but the success rate is high. Respiratory failure-related symptoms, elevated respiratory rate, low albumin and globulin levels, and fever at admission are independent risk factors related to the requirement of oxygen., Competing Interests: None of all authors have any financial or non-financial competing interests in this manuscript.

Objective: We sought to explore the prevalence and immediate clinical implications of acute myocardial injury in a cohort of patients with COVID-19 in a region of China where medical resources are less stressed than in Wuhan (the epicentre of the pandemic)., Methods: We prospectively assessed the medical records, laboratory results, chest CT images and use of medication in a cohort of patients presenting to two designated covid-19 treatment centres in Sichuan, China. Outcomes of interest included death, admission to an intensive care unit (ICU), need for mechanical ventilation, treatment with vasoactive agents and classification of disease severity. Acute myocardial injury was defined by a value of high-sensitivity troponin T (hs-TnT) greater than the normal upper limit., Results: A total of 101 cases were enrolled from January to 10 March 2020 (average age 49 years, IQR 34-62 years). Acute myocardial injury was present in 15.8% of patients, nearly half of whom had a hs-TnT value fivefold greater than the normal upper limit. Patients with acute myocardial injury were older, with a higher prevalence of pre-existing cardiovascular disease and more likely to require ICU admission (62.5% vs 24.7%, p=0.003), mechanical ventilation (43.5% vs 4.7%, p<0.001) and treatment with vasoactive agents (31.2% vs 0%, p<0.001). Log hs-TnT was associated with disease severity (OR 6.63, 95% CI 2.24 to 19.65), and all of the three deaths occurred in patients with acute myocardial injury., Conclusion: Acute myocardial injury is common in patients with COVID-19 and is associated with adverse prognosis., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: We aimed to further determine the relationship between the areas of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and the ratio of VAT to SAT (VAT/SAT) with the outcomes of acute respiratory distress syndrome (ARDS) patients., Methods: A retrospective study was performed on patients with ARDS in 7 intensive care units (ICU) of West China Hospital, Sichuan University., Results: A total of 169 patients were included in the analysis. Abdominal computed tomography scans of each patient within 24 hours of being admitted to the ICU were assessed by at least 2 investigators. Higher VAT/SAT was related with higher hospital mortality (22% vs. 44%, P = 0.003; adjusted odds ratio [aOR] 0.699, 95% CI 0.530-0.922 ([P = 0.011]). On the contrary, higher SAT and VAT were related to lower hospital mortality in ARDS (aOR 1.077, 95% CI 1.037-1.119 [P < 0.001]; aOR 1.017, 95% CI 1.004-1.030 [P = 0.011], respectively). Patients with higher SAT and VAT had shorter length of ICU stay (ICU LOS) (26.26 vs. 15.83 days, P = 0.031; 25.16 vs. 14.19 days, P = 0.007, respectively), while VAT/SAT was not related with ICU LOS. Moreover, we did not find any significant relationship either between VAT/SAT and mechanical ventilation-free days or between SAT and mechanical ventilation-free days., Conclusions: This study suggests that VAT/SAT can contribute to adverse outcomes of patients with ARDS. However, higher SAT and VAT were related to better prognosis of ARDS patients., (Copyright © 2018. Published by Elsevier Inc.)

Objective: To identify risk factors of obstructive sleep apnea hypopnea syndrome (OSAHS) in female patients, and assess its treatment and health-related quality of life (HRQoL) of the patients., Methods: One hundred and ninety three female patients undergoing polysomnography whith sleep breath disorders were recruited and divided into non-OSAHS group and OSAHS group. Age, body mass index (BMI), and prevalence of menopause and hypertension were compared between the two groups. The associations of those variables with apnea hypopnea index (AHI) and lowest pulse oxygen saturation (LSpO2) were analysed. The treatment of OSAHS and its impact on HRQoL assessed by the Calgary quality of life index (SAQLI) were evaluated., Results: The OSAHS group had greater mean age, BMI, and prevalence of menopause and hypertension than the non-OSAHS group (P<0.05). Those variables were significantly correlated with AHI and LSpO2 (P<0.05). Weight control and positional therapy were the most common treatment for sleep breath disorders. Weight loss and continuous positive airway pressure improved the Epworth sleep scale (ESS) of the patients with OSAHS significantly (P<0.05). But positional therapy made no difference (P>0.05). The ESS of the 32.5% of patients who did not undergo any treatment was worsened during the same period of time (P<0.05). No differences were found in the scores of the four domains of SAQLI between the two groups (P>0.05). The stepwise multiple regression analysis identified Pittsburgh sleep quality index (PSQI), ESS and AHI as independent predictors for the total score of SAQLI (P<0.05)., Conclusion: Older age, greater BMI, menopause and hypertension are risk factors of OSAHS in female patients. OSAHS was not well managed in female patients. PSQI, ESS and AHI can be used as predictors for HRQoL.

Background: Epidemiologic studies have shown an independent and definite association between obstructive sleep apnea (OSA) and hypertension. This study aimed to define the association between daytime blood pressure and severity of OSA in Chinese population in mainland of China., Methods: Twenty university hospital sleep centers in mainland of China were invited by the Chinese Medical Association (CMA) to participate in this epidemiologic study and 2297 consecutive patients (aged 18 - 85 years; 1981 males and 316 females) referred to these twenty sleep centers for evaluation of OSA between January 2004 and April 2006 were prospectively enrolled. Nocturnal polysomnography was performed in each patient, and disease severity was assessed based on the apneahypopnea index (AHI). These patients were classfied into four groups: nonapneic control (control, n = 257) with AHI < or = 5 episodes/hour; mild sleep apnea (mild, n = 402) with AHI > 5 and < or = 15 episodes/hour; moderate sleep apnea (moderate, n = 460) with AHI > 15 and < or = 30 episodes/hour and severe sleep apnea (severe, n = 1178) with AHI > 30 episodes/hour. Daytime blood pressure measurements were performed under standardized conditions in each patient at 10 a.m. in office on the day of referring to sleep centers for getting average value. All the patients were requested to quit medications related to blood pressure for three days before the day of assessing., Results: Both daytime systolic blood pressure and diastolic blood pressure values were significantly related to AHI positively (r = 0.201 and 0.276, respectively; both P values < 0.001) and to nadir nocturnal oxygen saturation negatively (r = -0.215 and -0.277, respectively; both P values < 0.001), which were the parameters of OSA severity. In two special designed mean plots, means of daytime systolic and diastolic blood pressure increased gradually with increasing AHI. Beyond AHI of 61 - 65, this increasing trend reached a plateau., Conclusions: The results showed that OSA severity was associated with daytime blood pressure until AHI of 61 - 65, providing evidence for early OSA management, especially in OSA patients with concomitant hypertension.

Objective: To investigate the relationship between clinical features of patients with A/H5N1 infection and their prognosis in mainland China., Methods: This study included 28 human cases with A/H5N1 infection in mainland China from October 2005 to May 2008. Data were collected and reviewed from hospital medical records and publishied papers. A database was built by EPIDATA 3.02 and statistical analyses were performed with SPSS 13.0., Results: The median age of the 28 cases was 29 years (range 6-62), and 15 were females. Ten patients survived, and 18 died. The typically clinical manifestations of human influenza A/H5N1 infection included fever and lower respiratory infection. The numbers of peripheral white blood cells, lymphocytes and platelets in the survival and non-survival groups were (4.01 +/- 1.86) x 10(9)/L vs (5.1 +/- 2.9) x 10(9)/L, (1.09 +/- 0.49) x 10(9)/L vs (0.98 +/- 0.44) x 10(9)/L, and (116 +/- 39) x 10(9)/L vs (101 +/- 40) x 10(9)/L, respectively; the differences were not statistically significant between the 2 groups (P>0.05). There was also no statistically significant difference in the increased serum enzymes, such as aspartate aminotransferase [(173 +/- 246) U/L vs (272 +/- 263) U/L], lactate dehydrogenase [(1016 +/- 568) U/L vs (1512 +/- 1052) U/L], creatine kinase [(1099 +/- 1590) U/L vs (2534 +/- 4281) U/L] and MB isoenzyme of creatine kinase [(28 +/- 30) U/L vs (125 +/- 197) U/L] (P>0.05) between the survival and the non-survival groups. However, there was a statistically significant difference in the number of patients with an initial LDH level more than 8 fold of the normal value between the survival and the non-survival groups (none vs 6, P<0.05). All of the 28 cases developed bilateral multiple infiltrates and consolidation in chest radiographs. Acute respiratory distress syndrome occurred in 22 cases, 17 of them died. All the 9 patients with acute kidney injury died. Ten patients received antiviral treatment with oseltamivir, and 6 of them survived. There was a statistical difference in the time of initiating oseltamivir treatment between the survival and the non-survival cases [(6.5 +/- 3.0) d vs (11.8 +/- 3.3) d, Z = 3.70, P<0.05]. Broad spectrum antibiotics and corticosteroids were administered in all of the 28 cases. There was no statistical difference between the survival and the non-survival groups regarding to the corticosteroid treatment (P>0.05)., Conclusions: Initial LDH level reaching more than 8 fold of the normal value suggests a poor prognosis for human H5N1 infection. Patients complicated with either ARDS or acute kidney injury had a higher risk of death. Early administration of effective antiviral agents might improve the prognosis and decrease case fatality.

Objective: To assess the impact of chronic obstructive pulmonary disease (COPD) on the quality of life and economic burden in Chinese urban areas., Methods: COPD patients (n = 723) were interviewed face-to-face in outpatient departments in 6 large cities in China. The questionnaire included social and demographic information, current health status, quality of life (SGRQ), and medical expenditure on outpatient visit, hospitalization, medicine purchasing in medicine stores in the last 12 months, and other expenditures related with COPD were also collected. All the data were analyzed using descriptive method., Results: Of the 723 COPD patients interviewed, 73% were male and the average age was 67 years old. The average symptom score of SGRQ was 49 +/- 24, activity score 57 +/- 23, impact score 46 +/- 23 and total score 50 +/- 21, which were all higher than scores of the healthy populations. The average direct medical cost (including outpatient cost, inpatient cost, and medicine purchasing cost) was 11 744 RMB yuan annually. The direct non-medical cost (including transportation fee, nutrition fee, and nursing fee) was 1570 RMB yuan. 36% of the patients in work had an average of 17 working days lost in the last 12 months because of COPD, while 17% of their relatives had an average of 14 working days lost for caring the patients., Conclusions: COPD has a serious impact on the quality of life of Chinese urban patients and places a heavy economic burden on their family and the society. Management of COPD should be improved for patients at stable conditions, so as to reduce the incidence and exacerbation of COPD.

Aim: This paper is a report of a study to identify the common symptoms and demographic and physiological factors of obstructive sleep apnoea that are predictive of health-related quality of life in a Chinese population., Background: Health-related quality of life impairment in obstructive sleep apnoea is an increasingly important consideration, but little is known about the factors that influence quality of life in this population., Method: A total of 108 Chinese patients with newly diagnosed obstructive sleep apnoea were recruited in 2003 and assessed for health-related quality of life, daytime sleepiness, depression and anxiety. Associations between symptoms, demographic and physiological factors and quality of life were examined by Pearson linear correlation. Hierarchical multiple regression were used to determine predictors of overall quality of life and its dimensions., Results: Forty-six patients (42.6%) had depressed mood and 21 (19.4%) were anxious. Fifty-nine (54.6%) were hypersomnolent. The severity of symptoms of sleepiness, depression, and anxiety was statistically significantly inversely correlated with each domain and the total score for health-related quality of life. No statistically significant correlation was observed between disease severity and quality of life. Controlling for age and gender, anxiety and sleepiness predicted 45.2% of the variance of overall quality of life (R(2) = 0.452, P < 0.001). Anxiety was the strongest predictor of overall and each domain of health-related quality of life., Conclusion: Assessment of mood in patients with obstructive sleep apnoea should be an essential part of nursing practice. Comprehensive evaluation of symptoms, especially mood disturbance, is important for improving quality of life for these patients.