Objective: To evaluate systematically the effects of continuous positive airway pressure (CPAP) on blood pressure in patients with resistant hypertension and obstructive sleep apnea (OSA). Methods: The Cochrane Library, PubMed, ScienceDirect, and the Web of Science were searched for studies investigating the effects of CPAP on blood pressure in patients with resistant hypertension and OSA. The selected studies underwent quality assessment and meta-analysis, as well as being tested for heterogeneity. Results: Six randomized controlled trials were included in the meta-analysis. The pooled estimates of the changes in mean systolic blood pressure and mean diastolic blood pressure (as assessed by 24-h ambulatory blood pressure monitoring) were −5.40 mmHg (95% CI: −9.17 to −1.64; p = 0.001; I2 = 74%) and −3.86 mmHg (95% CI: −6.41 to −1.30; p = 0.00001; I2 = 79%), respectively. Conclusions: CPAP therapy can significantly reduce blood pressure in patients with resistant hypertension and OSA.

Study Objectives Increased incidence of narcolepsy was reported in children during the 2009 H1N1 pandemic following Pandemrix®, a H1N1 flu vaccine. A link with A(H1N1)pdm09 infections remains controversial. Using nationwide surveillance data from China (1990 to 2017), the epidemiology of narcolepsy was analyzed. Methods Individual records of narcolepsy patients were collected from 15 of 42 hospitals across China known to diagnose cases. Incidence was estimated assuming representativeness of these hospitals. Age-specific incidence, epidemiological and clinical characteristics of patients were evaluated before, during, and after the 2009 H1N1 pandemic. Sensitivity analyses were conducted by including NT1 cases only and to exclude the effect of 2009 H1N1 vaccination. Results Average annual incidence was 0.79 per 100,000 person-years (PY) from 1990 to 2017 and 1.08 per 100,000 PY from 2003 to 2017. Incidence increased 4.17 (95%CI 4.12, 4.22) and 1.42 (95%CI 1.41, 1.44) fold during and after the 2009 H1N1 pandemic when compared to baseline. These results were robust in sensitivity analyses. Patients with onset of narcolepsy during the pandemic period were younger (notably in 5-9-year-old strata), and age shift toward younger children reversed to baseline following the pandemic. Conclusions Increased incidence of narcolepsy was observed during the 2009 H1N1 pandemic period. This is likely to be associated with the circulation of the wild-type A(H1N1)pdm09 virus. This observation should be considered for future influenza pandemic preparedness plans.

Obstructive Sleep Apnoea (OSA) is a chronic respiratory condition leading to intermittent hypoxia and disturbances of sleep structure, resulting in partial or complete obstruction of the upper airways. 1,2 Epidemiological surveys show that approximately 3%-9% of women and 10%-17% of men have OSA in the United States, 3 and around 4.1% people who aged 14 or over have OSA in Guangxi province, China. 4 OSA is an important predisposing risk factor for primary hypertension, atherosclerosis, myocardial infarction, cerebral infarction and stroke. It also significantly affects the quality of life due to its

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Background Anxiety and sleep problems are common comorbidities among outpatients living in high-altitude areas. Network analysis is a novel method to investigate the interaction and the association between symptoms across diverse disorders. This study used network analysis to investigate the network structure symptoms of anxiety and sleep problems among outpatients in high-altitude areas, and to explore the differences in symptom associations in various sex, age, educational levels and employment groups. Methods The data was collected from the Sleep Medicine Center of The First People’s Hospital of Yunnan Province from November 2017 to January 2021 with consecutive recruitment (N = 11,194). Anxiety and sleep problems were measured by the Chinese version of the seven-item Generalized Anxiety Disorder Scale (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI) respectively. Central symptoms were identified based on centrality indices and bridge symptoms were identified with bridge indices. The difference of network structures in various sex, age, educational levels and employment groups were also explored. Results Among all the cases, 6,534 (58.37%; 95% CI: 57.45-59.29%) reported experiencing anxiety (GAD-7 total scores ≥ 5), and 7,718 (68.94%; 95% CI: 68.08-69.80%) reported experiencing sleep problems (PSQI total scores ≥ 10). Based on the results of network analysis, among participants, “Nervousness”, “Trouble relaxing”, “Uncontrollable worry” were the most critical central symptoms and bridge symptoms within the anxiety and sleep problems network structure. The adjusted network model after controlling for covariates was significantly correlated with the original (r = 0.75, P = 0.46). Additionally, there were significant differences in edge weights in the comparisons between sex, age and educational levels groups (P < 0.001), while the employed and unemployed groups did not show significant differences in edge weights (P > 0.05). Conclusions In the anxiety and sleep problems network model, among outpatients living in high-altitude areas, nervousness, uncontrollable worry, and trouble relaxing were the most central symptoms and bridge symptoms. Moreover, there were significant differences between various sex, age and educational levels. These findings can be used to provide clinical suggestions for psychological interventions and measures targeting to reduce symptoms that exacerbate mental health.

BackgroundDanlou tablets exert auxiliary advantages in treating coronary heart disease (CHD), but a summary of evidence-based proof is lacking. This study aims to systematically evaluate Danlou tablets in treating CHD from two aspects, including efficacy and safety.MethodsBy a thorough retrieval of the four English databases, namely, PubMed, The Cochrane Library, Embase, and Web of Science, and the four Chinese databases, namely, CNKI, Wanfang, VIP database, and China Biomedical Literature Service System, we found all randomized controlled trials (RCTs) related to Danlou tablets in treating CHD. The retrieval time was from the construction of the database to April 2022. We engaged two researchers to screen the studies, extract the required data, and assess the risk of bias. We then used RevMan5.3 and STATA.14 software to conduct a meta-analysis. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of outcome indicators.ResultsSeventeen RCTs involving 1,588 patients were included. The meta-analysis results are displayed as follows: clinical treatment effect [risk ratio (RR) = 1.22, 95% confidence interval (CI): 1.16, 1.28, P &lt; 0.00001], angina pectoris duration [MD = −0.2.15, 95% CI: −2.91, −1.04, P &lt; 0.00001], angina pectoris frequency [standard mean difference (SMD) = −2.48, 95% CI: −3.42, −1.54, P &lt; 0.00001], angina pectoris degree [SMD = −0.96, 95% CI: −1.39, −0.53, P &lt; 0.0001], TC [MD = −0.71, 95% CI: −0.92, −0.51, P &lt; 0.00001], TG [MD = −0.38, 95% CI: −0.53, −0.22, P &lt; 0.00001], low-density lipoprotein cholesterol [MD = −0.64, 95% CI: −0.76, −0.51, P &lt; 0.00001], high-density lipoprotein cholesterol [MD = 0.16, 95% CI: 0.11, 0.21, P &lt; 0.00001], and adverse events [RR = 0.46, 95% CI: 0.24, 0.88, P = 0.02].ConclusionThe current evidence suggests that the combination of Danlou tablets and Western medicine can enhance the efficacy of CHD and does not increase adverse events. However, because of the limited number and quality of the included studies, the results of our study should be treated with caution. Further large-scale RCTs are necessary to verify the benefits of this approach.