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Background The goal of this study was to review relevant randomized controlled trials in order to determine the efficacy of continuous positive airway pressure (CPAP) versus mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA). Methods Using appropriate keywords, we identified relevant studies using PubMed, the Cochrane Library, and Embase. Key pertinent sources in the literature were also reviewed, and all articles published through October 2019 were considered for inclusion. For each study, we used odds ratios (ORs), mean difference (MD), and 95% confidence interval (95% CI) to assess and synthesize outcomes. Results We included 14 RCTs, for a total of 249 patients in the CPAP group and 247 in the MAD group. Compared with MAD, CPAP significantly decreased apnea hypopnea index (AHI) (WMD: −7.08, 95%CI: −9.06∼-5.10) and the percentage of stage 1 and 2 after therapy (WMD: −3.728, 95%CI: −6.912∼-0.543). However, compared with MAD, CPAP significantly decreased the SF-36-social function score (WMD: −3.381, 95%CI: −6.607∼-0.154).There was no significant difference in Epworth sleepiness scale score after therapy between the two groups. Conclusion CPAP has better therapeutic efficacy in OSA patients than MAD.

BACKGROUND Fine particulate matter (PM2.5) is the air pollutant that most threatens global public health. The purpose of this study was to observe the inflammatory and oxidative stress injury of multiple organs induced by PM2.5 in rats and to explore the tissue-protective effect of erdosteine. MATERIAL AND METHODS We randomly divided 40 male Wistar rats into a blank control group, a saline group, a PM2.5 exposure group, and an erdosteine intervention group. We assessed changes in organs tissue homogenate and biomarkers of inflammation and oxidative stress in serum and bronchoalveolar lavage fluid (BALF). RESULTS (1) The expressions of IL-6, IL-1ß, TNF-alpha, 8-OHdG, 4-HNE, and PCC in serum and BALF of the PM2.5 exposure group increased, but decreased after treatment with erdosteine, suggesting that erdosteine treatment attenuates inflammatory and oxidative stress injury. (2) The expression of γ-GCS in serum and lungs in the PM2.5 exposure group increased, but did not change significantly after treatment with erdosteine. This suggests that PM2.5 upregulates the level of γ-GCS, while erdosteine does not affect this protective response. (3) The expression of T-AOC in serum, lungs, spleens, and kidneys of the PM2.5 exposure group decreased, but increased after treatment with erdosteine. Our results suggest that PM2.5 can cause imbalance of oxidation/anti-oxidation in multiple organs, and erdosteine can alleviate this imbalance. CONCLUSIONS PM2.5 exposure can lead to inflammatory and oxidative stress damage in serum and organ tissues of rats. Erdosteine may be an effective anti-inflammatory and antioxidant that can reduce this injury.

The 6-hole open-irrigated catheter (SHOI) is increasingly used in radiofrequency (RF) ablation of arrhythmias. However, deep transmural lesions are not always achieved, and volume overload caused by irrigated ablation is another problem that should be concerned. The purpose of this study was to analyze and compare the ablation effect and electrical morphology between a novel 18-hole open-irrigated catheter (EHOI) and SHOI.The heart was exposed through a median sternotomy in 12 anesthetized dogs, and the chest cavity was filled with heparinized saline. Bipolar contact pericardial electrograms of both catheters were recorded. Lesions were created under all permutations of the following conditions: RF energy 30 and 40 W for 60 seconds, contact force at 10, 30, and 50 g, electrode orientation horizontal to the tissue, irrigation rate 10 mL/min for EHOI and 17 mL/min for SHOI. The EHOI created deeper lesions than SHOI (5.77 ± 1.37 mm vs 4.98 ± 1.22 mm at power of 30 W, P0.05; 7.16 ± 1.15 mm vs 6.02 ± 1.04 mm at power of 40 W, P0.01), and there was a trend of larger lesion volume for EHOI (312 ± 141 mm(3) vs 259 ± 108 mm(3) at power of 30 W, 536 ± 200 mm(3) vs 451 ± 180 mm(3) at power of 40 W, P0.05). No significant difference in electrogram morphology between 2 catheters was detected.The mapping electrograms of EHOI and SHOI were not significantly different. Compared with SHOI, EHOI more effectively produced deeper lesions at a lower rate of irrigation perfusion.

To observe the relationship between serum and monocyte-derived-macrophages secreted adipocyte fatty acid binding protein (A-FABP), adiponectin (or A-FABP/adiponectin ratio) and coronary artery disease.Three hundred and forty subjects underwent coronary angiography (CAG) were classified into CAD group (n = 211) and non-CAD group (n = 129) according to the CAG results. The severity of coronary artery stenosis was assessed by the numbers of involved coronary artery branches and the sum of the Gensini scores. Fasting venous blood was collected from all subjects and peripheral monocytes were isolated from 20 subjects (10 selected from each group with age-, gender-, and BMI-matched). Peripheral blood monocytes were obtained and stimulated into macrophages with PMA, cell culture supernatant was collected. The concentration of serum/supernatant A-FABP and adiponectin levels were assayed by enzyme-linked immunosorbent assays.(1) A-FABP levels tended to be higher in CAD patients compared to non-CAD subjects [18.3(13.2, 22.8) µg/L vs. 16.4(13.5, 20.4) µg/L, P = 0.088]. The concentration of adiponectin in CAD group was significantly lower than those in non-CAD group [13.9 (9.8, 17.1) mg/L vs. 19.7 (14.5, 27.6) mg/L, P0.05]. (2) The A-FABP levels increased and the adiponectin levels decreased as the number of stenotic vessels increased. Gensini scores were positively correlated with serum A-FABP (r = 0.120, P = 0.043) and inversely correlated with adiponectin (r = -0.405, P = 0.007). (3) The difference in A-FABP/adiponectin ratio was more prominent between subjects with CAD and subjects without CAD [(1.51 ± 0.79) µg/mg vs. (0.89 ± 0.30) µg/mg, P0.01] and there was a stronger positive correlation of Gensini score to A-FABP/adiponectin ratio(r = 0.531, P = 0.000). (4) Monocyte-derived-macrophages from patients with CAD had higher A-FABP/adiponectin ratio than that in patients without CAD [(0.51 ± 0.19) µg/mg vs. (0.36 ± 0.11) µg/mg, P0.05].Increased levels of serum A-FABP and reduced levels of adiponectin in CAD patients serves as a novel biomarker for the severity of the coronary stenosis. A-FABP/adiponectin ratio is superior to A-FABP or adiponectin alone on predicting CAD risks.

Background Adipocyte fatty acid binding protein (A-FABP) and adiponectin have been shown to play important roles in atherosclerosis. We investigated serum A-FABP, adiponectin and A-FABP/adiponectin ratio in patients with coronary artery disease (CAD). Methods A total of 340 subjects who underwent coronary angiography (CAG) were classified into CAD group (n = 211) and non-CAD group (n = 129) according to the CAG. Serum A-FABP and adiponectin concentrations were determined by enzyme-linked immunosorbent assays. Results CAD patients tend to have higher A-FABP concentrations than non-CAD subjects, the difference is significant only between female CAD patients and controls [22.8 (18.6–25.7) ng/ml vs 18.1 (15.6–21.8) ng/ml, P = 0.008]. Serum A-FABP concentration was independently associated with Gensini scores in female subjects (P = 0.018). CAD patients have significant higher serum A-FABP/adiponectin ratio [1.51 ± 0.05 vs 0.89 ± 0.03 ng/μg, P Conclusions Serum A-FABP is associated with CAD more closely in female than in male. The A-FABP/adiponectin ratio may be a more useful indicator for CAD than A-FABP or adiponectin alone.