阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)是由于患者睡眠时上气道完全或部分阻塞,导致呼吸暂停和睡眠结构紊乱、引起夜间反复低氧血症和高碳酸血症.根据其临床症状,归属于中医"鼾症"范畴.隋代巢元方《诸病源候论·鼾眠候》首次将鼾症作为一个独立病证,认为痰湿内生是其重要的发病因素.

Objective To observe the proportion of Treg cells and the expression of related cytokines in peripheral blood of COPD patients, and to analyze their relationship between cardiopulmonary motor function. Methods 30 healthy persons in physical examination were selected as normal group. 30 cases of inpatients with stable COPD were selected in the experimental group.CPET and lung function test were performed respectively. Flow cytometry was used to detect the proportion of Treg cells in peripheral blood,and the expression level of L-17 and TGF-β by ELISA method. The ratio of Treg cells in peripheral blood,IL-17 and TGF-β,cardiopulmonary exercise and pulmonary function changes were compared. Results The expression of TGF-β and IL-17 was increased in the observation group(P<0.05). The peak VO2/ kg,peak power and FVC,FEV1/FVC in the observation group were lower than those in the normal group(P<0.05),and there was a positive correlation between the above indexes and the proportion of Treg cells(P<0.05). There was a negative correlation between IL-17 and TGF-β expression(P<0.05). Conclusion The recurrent occurrence of clinical symptoms is related to the proportion of Treg cells and the changes of related cytokines in COPD patients.

Objective To investigate the effect of ulinastatin (UTI) on acute lung injury induced by underwater explosion in rabbits. Methods Acute lung injury (ALI) was induced by underwater explosion in 40 healthy New Zealand rabbits, and the rabbits were randomly divided into 4 groups with 10 animals in each group: normal control group (N), model group (A), low dose UTI group (B) and high dose UTI group (C). Injection of 2.5, 10 × 104 U/kg UTI was given to group B and C,respectively. Venous blood samples were collected at 0, 4, 12, 24h after ALI, bronchoalveolar lavage fluid (BALF) and lung tissue samples were collected at 24h after ALI. The serum and BALF levels of NF- κB, TNF-α and IL-6 were measured by ELISA method, and the pathological changes of lung tissue were observed under light microscope. Results The serum levels of NF-κB, TNF-α and IL-6 in groups A, B and C were significantly higher than those in group N 4h after ALI (P＜0.05). After treatments with ULT, the NF-κB, TNF-α and IL-6 levels in groups B and C were significantly lower than those in group A at 12h after ALI (P＜0.05) and there were statistical differences between group B and group C (P＜0.05). The levels of NF-κB, TNF- α, IL-6 in BALF, and wet/dry weight of lung tissue (W/D) in groups A, B and C were significantly higher than those in group N (P＜0.05) 24h after ALI; while in groups B and C were lower than those in group A (P＜0.05). The pathological observation showed that compared to group A the lung tissue hemorrhage, edema and inflammatory cell infiltration were attenuated in treatment-groups, and in group C were milder than those in group B.Conclusion UTI can protect lung tissue from ALI caused by the underwater explosion, which is associated with reducing pulmonary edema and inhibiting inflammatory cytokines secretion.

Objective To explore the influencing factors of postoperative fall in elderly patients with general surgery,and to provide a basis for specific anti-fall strategies. Methods With convenience sampling method choosing from February 2016 to February 2018 after general surgery, 18 cases of elderly patients with postoperative fall were investigated and analyzed by using the Falls Risk Assessment Tool. Results Falls between 00∶00 and 08∶00 accounted for 72.2% and 66.7% of toilet breaks. After surgery,patients with physical weakness,taking special drugs,anaesthetic painkillers and other disease factors accounted for the top three risk factors for falls. Falls were also associated with age and deterioration of system function. Conclusion Postoperative falls in elderly patients are closely related to physiological factors,and postoperative factors,environmental factors and other external factors are also important. In order to prevent the elderly patients from falling down after surgery,we should comprehensively analyze the risk factors of falling down after surgery and formulate specific anti-falling strategies.