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Objective: To investigate the underlying mechanism and effects of transient receptor potential channel 5 (TRPC5) on myocardial damage in rats exposed to intermittent hypoxia. Methods: A total of twelve TRPC5-/- and twelve SD mice were ran- domized to be placed in the chronic intermittent hypoxia (CIH) group and the control group. Echocardiography was utilized to observe structural and functional changes in the rat hearts. To determine the volume fraction of cardiac collagen,masson staining was used.TUNEL labeling was employed to evaluate the apoptosis of cardiac cells. Flow cytometry was employed to measure ROS and Ca2+concentrations in cardiac tissues.Furthermore,Western blot analysis was used to assess the expression levels of TRPC5, Bcl-2,Bax,Caspase-3,CaN,NFAT2,p-NFAT2,NFAT3,p-NFAT4,and p-NFAT4 proteins in the heart tissues. Results: The left ventricular ejection fraction and fractional shortening were higher in the TRPC5-/--CIH group compared to the CIH group,but lower than in the TRPC5-/--Control group,as evidenced by the cardiac color Doppler ultrasound findings. Additionally, the left ven- tricular volume and internal diameter were lower in the CIH group but higher in the TRPC5-/--Control group(P<0.05). Histologi- cal analysis using HE staining showed that the extent of myocardial fiber disarray in the TRPC5-/--CIH group was more prominent compared to the TRPC5-/--Control group, but less severe than in the CIH group. According to Masson staining, the collagen volume fraction was lower in the TRPC5-/--CIH group compared to the CIH group, but higher than the TRPC5-/--Control group. Rat heart tissue stained with TUNEL revealed that the cardiomyocyte apoptotic rate in the TRPC5-/--CIH group was greater than that in the TRPC5-/--Control group, but it was lower than that in the CIH group(P<0.05). The TRPC5-/--CIH group had higher levels of ROS and Ca2+ than the TRPC5-/--Control group, but lower levels than the CIH group, according to the flow cytometry results (P<0.05). Furthermore, Caspase-3, Bax, and CaN expression levels were higher in the TRPC5-/--CIH group compared to the TRPC5-/--Control group,but lower than in the CIH group, according to Western blotting study. In contrast, Bcl-2, p-NFAT2, p-NFAT3, and p-NFAT4 had greater relative expression levels in the TRPC5-/--CIH group than in the CIH group, but lower levels in the TRPC5-/--CIH group. (P<0.05). Conclusion : By koncking out the TRPC5 gene, myocardial damage induced by intermittent hypoxia may be lessened, oxidative stress and calcium overload may be limited, and the CaN/NFAT pathway may play a role in this mechanism. [ABSTRACT FROM AUTHOR]

Abstract Recent empirical investigations reinforce the understanding of a profound interconnection between metabolic functions and Obstructive Sleep Apnea-hypopnea Syndrome (OSAHS). This study identifies distinctive miRNA signatures in OSAHS with Metabolic Syndrome (Mets) patients from healthy subjects, that could serve as diagnostic biomarkers or describe differential molecular mechanisms with potential therapeutic implications. In this study, OSAHS with MetS patients showed significantly higher Apnea Hyponea Index(AHI), but lower oxygen desaturation index(ODI 4/h) and minimum pulse oxygen saturation(SpO2). A total of 33 differentially expressed miRNAs by Limma method, and 31 differentially expressed miRNAs by DEseq2 method were screened. In addition, GO enrichment analysis of target genes associated with differentially expressed miRNAs revealed significant enrichment in metabolic processes, suggesting that the differential expression of OSAHS-induced miRNAs may contribute to the progression of metabolic disorders through the regulation of metabolic pathways. Furthermore, KEGG pathway enrichment analysis revealed significant enrichment in the p53 signaling pathway and several other pathways. Notably, the Wnt signaling pathway, PI3K-Akt signaling pathway, cAMP signaling pathway, and AMPK signaling pathway are implicated in the metabolic processes of glucose dysregulation and lipid homeostasis, as well as the pathogenesis of hypertension associated with OSAHS. We identified IKBKB, PIK3R1, and MAP2K1 as the target genes most associated with Mets pathogenesis in OSAHS, regulated by miR-503-5p, miR-497-5p, and miR-497-5p, respectively. Additionally, the target genes of differentially expressed miRNAs between Tibetan OSAHS patients with MetS and healthy individuals are regulated by transcription factors such as NR2C1, STAT3, STAT5a, HIF1a, ETV4, NANOG, RELA, SP1, E2F1, NFKB1, AR, and MYC. In conlusion, we found differentially expressed miRNAs in Tibetan OSAHS patients with Metabolic Syndrome for the first time. Enrichment analysis results suggest that differentially expressed miRNAs may involved in the development of OSAHS-related metabolic disorders by regulating metabolic pathways. We also revealed that IKBKB, PIK3R1, and MAP2K1 are mostly associated with metabolic disorder in OSAHS, and miR-503-5p and miR-497-5p may regulate the development of MetS associated with OSAHS by modulating IKBKB, PIK3R1, and MAP2K1.

Objective: To analyse the relationships between the expression levels of liver X receptor (LXR), cyclooxygenase-2(COX2) and cholesterol ester transfer protein (CETP) and the severity of obstructive sleep apnoea hypopnoea syndrome (OSAHS) in obese young rats, to obtain information for basic research on OSAHS in obese children. Methods: Twenty-four 3-4-week-old young rats were randomly assigned to the normal control group, obesity group, OSAHS group, obesity and OSAHS group. We used polysomnography to measure the obstructive apnoea hypopnoea index (OAHI) to assess the severity of OSAHS and western blotting to test the expression levels of LXRα, COX2, and CETP in the liver, heart, kidney, and brain tissues. Results: LXR, COX2, and CETP expression levels in the remaining groups were considerably higher than those in the control group (P < 0.05). Compared with those in the obesity group, LXRα, COX2, and CETP expression levels in the obesity and OSAHS group were considerably greater in the liver, kidney, and heart tissues (P < 0.05); the brain tissues of the obesity and OSAHS group showed considerably higher expression levels of COX2 and CETP (P < 0.05). Compared with those in the OSAHS group, LXRα, COX2, and CETP expression levels in the obesity and OSAHS group were significantly greater in all tissues (P < 0.05). The expression levels of LXRα, COX2, and CETP and obesity increased with increasing OSAHS severity (r = 0.777, P < 0.01; r = 0.728, P < 0.01; r = 0.793, P < 0.01; r = 0.786, P < 0.01; and r = 0.698, P < 0.01), and the oxygen concentration increased with decreasing OSAHS severity(r=-0.576, P < 0.01). Conclusions: LXR, COX2, and CETP expression levels were significantly increased in the liver, kidney, heart, and brain tissues of young rats with obesity and OSAHS, and were positively correlated with the severity of OSAHS. [ABSTRACT FROM AUTHOR]

Kai-li Liu,&ast; Shen-jie Xu,&ast; Si-wen Chen, Min-jie Zhang, Ni Ye, Jie Li Department of General Medicine, The First Affiliated Hospital of Soochow University, Suzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jie Li; Ni Ye, Department of General Medicine, The First Affiliated Hospital of Soochow University, No. 899 of Pinghai Road, Gusu District, Suzhou, 215006, People’s Republic of China, Tel: +86 139 6211 6580 ; +86 151 6246 0064, Email lijie_Li01@126.com; yeni0328@126.comObjective: The aim of this study was to analyze the relationship between the characteristics of the intestinal microbiota and cytokine levels in individuals with different degrees of obstructive sleep apnea-hypopnea syndrome (OSAHS) as well as to investigate intestinal microbiota imbalances in patients with OSAHS and the associated mechanisms.Methods: Based on their sleep apnea hypopnea index (AHI), a total of 37 adults were assigned to a control group, a mild OSAHS group, or a moderate-to-severe OSAHS group. Fecal samples were collected to characterize the intestinal microbiota using metagenomic next-generation sequencing (mNGS), while blood samples were collected to detect levels of interleukin-17a (IL-17a), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) in each group.Results: 1. There was no significant difference in the Shannon index among the three groups (P > 0.05). The three groups showed significant difference in the relative abundance of Faecalibacterium prausnitzii and Bifidobacterium adolescentis (with F values of 3.955 and 7.24, respectively, P < 0.05), while showed no significant difference in the relative abundance of B. pseudocatenulatum, Bifidobacterium longum, Klebsiella pneumoniae, and Haemophilus parainfluenzae (P > 0.05). 2. The three groups showed significant difference in the expression of serum IL-17A and TNF-α levels (with F values of 18.119 and 10.691, respectively, P < 0.05), while showed no significant difference in the expression of IL-10, IL-6, and CRP levels (P > 0.05). 3. Multiple linear regression analysis revealed that the relative abundance of F. prausnitzii was correlated with changes in BMI and AHI (with β values of 2.585 and − 0.157, respectively, P < 0.05), while the relative abundance of B. adolescentis was correlated with changes in IL-17a (with β value of − 0.161, P < 0.05).Conclusion: The study revealed a significant correlation between intestinal microbiota abundance and cytokine levels, suggesting that gut microbiota disruption in OSAHS patients may be linked to systemic chronic inflammation.Keywords: chronic inflammation, chronic intermittent hypoxia, cytokines, intestinal microbiota, OSAHS

Background: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is correlated with metabolic deterioration in patients experiencing polycystic ovary syndrome (PCOS). Women diagnosed with PCOS exhibit a heightened prevalence of OSAHS. This meta-analysis aims to assess the morbidity of OSAHS in women affected by PCOS and to examine the differences in metabolismrelated indicators between OSAHS-positive and OSAHS-negative in women with PCOS. Methods: A comprehensive literature analysis of OSAHS morbidity in women with PCOS was conducted, utilizing databases such as CNKI, EMBASE, PubMed, Web of Science, and Wanfang. A comparison was carried out between patients with OSAHS-positive and those with OSAHS-negative in terms of their clinical characteristics and metabolic differences. The search language included English and Chinese. The acquired data were analyzed by employing RevMan 5.2 and Stata 11.0. Continuous variables with the same units were combined and analyzed through weighted mean differences (WMDs) as effect sizes, while continuous variables with different units were combined and analyzed through standardized mean differences (SMDs) as effect sizes. A conjoint analysis was performed on the basis of I² value, using either a fixed effect model (I² = 50%) or a random effect model (I² > 50%). Results: A total of 21 articles met the inclusion criteria for this study. The findings indicated that 20.8% of women with PCOS were found to have comorbid OSAHS. The subjects were categorized into various subgroups for meta-analysis on the basis of race, age, disease severity, body mass index (BMI), and diagnostic criteria of PCOS. The results revealed high morbidity of OSAHS in all subgroups. In addition, most metabolic indicators and parameters of metabolic syndrome were notably worse in women suffering from both PCOS and OSAHS in comparison to their counterparts solely diagnosed with PCOS. Conclusion: The current literature indicates higher morbidity of OSAHS among women with PCOS, linking OSAHS with worse metabolic status and obesity in this population. Consequently, clinicians are advised to prioritize the detection and management of OSAHS in women with PCOS. [ABSTRACT FROM AUTHOR]

Tonsillectomy and/or adenoidectomy can treat children with obstructive sleep apnea/hypopnea syndrome (OSAHS). This study investigated the effects of tonsillectomy and/or adenoidectomy on cognitive function and brain structure in children with OSAHS. This study included 40 obstructive sleep apnea/hypopnea syndrome children and 40 healthy children. The cognitive function and brain structure changes of OSAHS children before and after surgery and 40 healthy children were evaluated by the Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) and the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), as well as brain resting-state fMRI functional magnetic resonance imaging (rs-fMRI). Children with OSAHS showed higher Swanson, Nolan, and Pelham Rating Scale and lower Integrated Visual and Auditory Continuous Performance Test scores than healthy peers, indicating cognitive impairment. Post-surgery, there was a significant improvement in cognitive function, evidenced by decreased Swanson, Nolan, and Pelham Rating Scale and increased Integrated Visual and Auditory Continuous Performance Test scores. Compared to healthy children, OSAHS children displayed altered ReHo values in certain brain regions, such as decreased values in the right angular gyrus, right precuneus, left parahippocampal gyrus, and left middle frontal gyrus, but increased values in the right posterior cerebellum. After surgery, ReHo values increased in regions like the right precuneus, right temporal lobe, right posterior cingulate gyrus, and left limbic lobe, suggesting neurological changes associated with treatment. Children with obstructive sleep apnea/hypopnea syndrome had cognitive impairment and abnormal changes in multiple brain regions. Tonsillectomy and/or adenoidectomy could improve cognitive function and contribute to the reconstruction of brain function and structure in children with obstructive sleep apnea/hypopnea syndrome. [ABSTRACT FROM AUTHOR]

Background: The aim of this research is to achieve the early detection of facial characteristics in patients diagnosed with neurodevelopmental deficits and obstructive sleep apnoea–hypopnea syndrome (OSAHS) through the analysis of the VERT index and Ricketts' cephalometry to minimise the neurocognitive morbidity associated with these disorders. Methods: This clinical study was conducted on 44 patients aged 4 to 15 years. Participants completed an initial questionnaire about sleep disturbances, followed by a polysomnography, a radiographic study, and an oral examination. Results: The maximum variability in the data was obtained in the mandibular plane angle, where we observed that the measurement was higher in patients diagnosed with OSAHS. The relative and normalised indices of facial depth and the mandibular plane showed variations between patients with a clinical picture compatible with OSAHS and the control group without pathology. Conclusions: Our findings indicate that Ricketts' VERT index by itself is unable to provide evidence of a diagnosis compatible with OSAHS in patients with early neurodevelopmental deficits, but, after analysing the results obtained, we observed that for the cephalometric measurements of the mandibular plane angle and facial depth relative to the patient's age, there are sufficiently strong variations for creating a solid method of differential diagnosis, thus preventing complications at the neurocognitive level. [ABSTRACT FROM AUTHOR]

Copyright of Hamidiye Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the effect of TRPC5 on intermittent hypoxia-induced myocardial pyroptosis. Methods TRPC5 knock out (TRPC5-/-) and SD rats were each randomly divided into chronic intermittent hypoxia group (CIH group) and normoxia group (Control group) (n = 6 for each group). The myocardial fibrosis in rats was visualized by Masson staining, the levels of serum inflammatory factors were measured by ELISA and the relative expression levels of TRPC 5 and pyroptosis-related proteins were determined by Western blotting. Results Masson staining showed that the collagen volume fraction in the TRPC5-/--CIH group was higher than that in the TRPC5-/--Control group and lower than that in the WT-CIH group. The ELISA results showed that the serum levels of IL-1, IL-6, and TGF- β in the TRPC5-/--CIH group were higher than those in the TRPC5-/--Control group and lower in the WT-CIH group. Western blotting results showed that the relative expression levels of pyroptosis related proteins caspase-1, NLRP3, GSDMD, and GSDMD-N in the TRPC5-/--CIH group were higher than those in the TRPC5-/--Control group and lower than those in the WT-CIH group. Conclusion TRPC5 deficiency alleviates myocardial pyroptosis and myocardial fibrosis induced by hypoxia. [ABSTRACT FROM AUTHOR]

Objective: This study used latent profile analysis to explore the level of depression among US adults with obstructive sleep apnea hypopnea syndrome (OSAHS) symptoms and to identify different latent categories of depression to gain insight into the characteristic differences between these categories. Methods: The data of this study were obtained from the National Health and Nutrition Examination Survey (NHANES) database, and the subjects with OSAHS symptoms were aged 18 years and older. The latent profile analysis (LPA) method was used to fit the latent depression categories in subjects with OSAHS symptoms. The chi-square test, rank sum test, and binary logistic regression were used to analyze the influencing factors of depression subgroups in subjects with OSAHS symptoms. Results: Three latent profiles were identified: low-level (83.7%), moderate-level (14.5%) and high-level (1.8%) depression. The scores of 9 items in the high-level depression group were higher than those in the other two groups. Among them, item 4 "feeling tired or lack of energy" had the highest score in all categories. Conclusion: Depression in subjects with OSAHS symptoms can be divided into low-level, moderate-level and high-level depression. There are significant differences among different levels of depression in gender, marital status, PIR, BMI, smoking, general health condition, sleep duration and OSAHS symptom severity. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: In France, oral appliances (OAs) are the first-line treatment for moderate and second-line treatment for severe obstructive sleep apnea-hypopnea syndrome. In general, the sleep specialist refers his/her patient to the appliance specialist for the impressions and the fitting. However, is there a relationship between the volume of activity of the appliance specialist and the efficacy of this device? Methods: Our unit includes seven appliance otolaryngology specialists whose activities are highly variable (number of patients varying by a factor of almost 10). Data from a prospective follow-up registry of patients treated with an OA for moderate and severe obstructive sleep apnea-hypopnea syndrome were studied, and differences in outcomes between practitioners in the team were sought. Results: Among 859 patients, OAs significantly reduced the apnea-hypopnea index. Even if the patients were not completely comparable from one practitioner to another, there was a significant heterogeneity in efficacy (complete or partial response of the apnea-hypopnea index and failure of OAs) between practitioners (p = 0.0038; 0.0011; 0.0007 respectively), with better results in practitioners with a higher level of OA activity. Conclusion: The findings suggest that it may be preferable to refer patients to OA practitioners who see a higher volume of patients with moderate or severe obstructive sleep apnea-hypopnea syndrome treated with an OA. [ABSTRACT FROM AUTHOR]

ObjectiveDepression is very common and harmful in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). It is necessary to screen OSAHS patients for depression early. However, there are no validated tools to assess the likelihood of depression in patients with OSAHS. This study used data from the National Health and Nutrition Examination Survey (NHANES) database and machine learning (ML) methods to construct a risk prediction model for depression, aiming to predict the probability of depression in the OSAHS population. Relevant features were analyzed and a nomogram was drawn to visually predict and easily estimate the risk of depression according to the best performing model.Study designThis is a cross-sectional study.MethodsData from three cycles (2005–2006, 2007–2008, and 2015–2016) were selected from the NHANES database, and 16 influencing factors were screened and included. Three prediction models were established by the logistic regression algorithm, least absolute shrinkage and selection operator (LASSO) algorithm, and random forest algorithm, respectively. The receiver operating characteristic (ROC) area under the curve (AUC), specificity, sensitivity, and decision curve analysis (DCA) were used to assess evaluate and compare the different ML models.ResultsThe logistic regression model had lower sensitivity than the lasso model, while the specificity and AUC area were higher than the random forest and lasso models. Moreover, when the threshold probability range was 0.19–0.25 and 0.45–0.82, the net benefit of the logistic regression model was the largest. The logistic regression model clarified the factors contributing to depression, including gender, general health condition, body mass index (BMI), smoking, OSAHS severity, age, education level, ratio of family income to poverty (PIR), and asthma.ConclusionThis study developed three machine learning (ML) models (logistic regression model, lasso model, and random forest model) using the NHANES database to predict depression and identify influencing factors among OSAHS patients. Among them, the logistic regression model was superior to the lasso and random forest models in overall prediction performance. By drawing the nomogram and applying it to the sleep testing center or sleep clinic, sleep technicians and medical staff can quickly and easily identify whether OSAHS patients have depression to carry out the necessary referral and psychological treatment.

Obstructive Sleep Apnea–Hypopnea Syndrome (OSAHS), a severe respiratory sleep disorder, presents a significant threat to human health and even endangers life. As snoring is the most noticeable symptom of OSAHS, identifying OSAHS via snoring sound analysis is vital. This study aims to analyze the time-domain and frequency-domain characteristics of snoring sounds to detect OSAHS and its severity. The snoring sounds are extracted and scrutinized from nighttime acoustic signals, with spectral energy ratio features being applied, calculated via the snore detection frequency division method. A variety of time and frequency-domain features are derived from the snoring sounds. A novel Snore Detection Cepstral Coefficient (SDCC) is proposed, based on Mel Frequency Cepstral Coefficients (MFCCs) and snore detection frequency division. Relief-F feature screening is then applied to SDCC and MFCC. Canonical Correlation Analysis (CCA) is utilized on the fusion features obtained as a result, and the results indicate the highest accuracy (97.8%) with Subspace KNN. The optimal classifier with feature combination is used for the snore model of OSASH early warnings all night, effectively recognizing and assessing OSAHS and reflecting the severity of its disease. This result, achieving high accuracy and low computational complexity, shows that the proposed method holds significant promise for developing portable sleep health detection devices. [ABSTRACT FROM AUTHOR]

In western medicine, obstructive sleep apnea hypopnea syndrome (OSAHS) is an increasingly serious public health hazard, which is exacerbated by the obesity epidemic and an aging population. Ancient medical literature of traditional Chinese medicine (TCM) also recorded OSAHS-like symptoms but described the disease from a completely distinct theoretical perspective. The earliest records of snoring in ancient China can be traced back 2500 years. In TCM, the pathogenesis of OSAHS can be attributed mainly to turbid phlegm and blood stasis. Various TCM prescriptions, herbal medicines, and external therapy have also been proposed for the prevention and therapy of OSAHS. Some of these strategies are still used in current clinical practice. This review highlights historical characterizations of OSAHS and the theory of TCM and also explores its therapy in TCM, which may shed light on future OSAHS research. This is the first systematic English review of the role of TCM in the treatment of OSAHS. [ABSTRACT FROM AUTHOR]

Objective: Obstructive sleep apnea (OSA) and periodontitis share risk factors, such as age, obesity, stress, and cardiovascular events, which have a bidirectional cause-effect relationship through systemic inflammation. Our objective was to determine the relationship between OSA and the periodontal condition and its associated local and systemic risk factors. Material and methods: This was an observational case-control study involving 60 patients. Local oral risk factors and the systemic condition of each patient were evaluated. All patients underwent polysomnography for the diagnosis of OSA. Chi-squared, one-way ANOVA, and Bonferroni's tests were performed. Results: A higher percentage of patients with periodontitis had severe OSA (66.66%); however, no statistically significant association was found between the two pathologies (p = 0.290). In terms of systemic risk factors, an association was found between arterial hypertension and severe OSA (p = 0.038), and in terms of local factors, an association was found between the use of removable prostheses and severe OSA (p = 0.0273). Conclusion: In the general population, patients with periodontitis showed a higher prevalence of severe OSA. Obesity and hypothyroidism were the most prevalent systemic findings in patients with OSA and periodontitis. Arterial hypertension and osteoarthritis were found to be associated with severe OSA. The local risk factors associated with periodontitis and severe OSA were removable partial dentures and misfit resins. Clinical relevance: To study the factors that can facilitate the progression of OSA and periodontitis, physicians and dentists should be advised to provide comprehensive care for patients with both pathologies. [ABSTRACT FROM AUTHOR]

Purpose: Obstructive sleep apnea–hypopnea syndrome (OSAHS) is characterized by recurrent upper airway disturbances during sleep leading to episodes of hypopnea or apnea, followed by hypoxemia and subsequent reoxygenation. It is believed that this reoxygenation/reperfusion stage leads to oxidative stress, which then leads to inflammation and cardiovascular diseases. The treatments of patient with OSAHS include surgical and non-surgical therapies with various side effects and common complaints. Therefore, it is important to develop a new, safe, and effective therapeutic treatment. As a small-molecule multifunctional protein, thioredoxin (TRX) has antioxidant and redox regulatory functions at the active site Cys-Gly-Pro. TRX prevents inflammation by suppressing the production of pro-inflammatory cytokines rather than suppressing the immune response. Methods: We review the papers on the pathophysiological process of OSAHS and the antioxidative and anti-inflammatory effects of TRX. Results: TRX may play a role in OSAHS by scavenging ROS, blocking the production of inflammatory cytokines, inhibiting the migration and activation of neutrophils, and controlling the activation of ROS-dependent inflammatory signals by regulating the redox state of intracellular target particles. Furthermore, TRX regulates the synthesis, stability, and activity of hypoxia-inducible factor 1 (HIF-1). TRX also has an inhibitory effect on endoplasmic reticulum- and mitochondria-induced apoptosis by regulating the expression of BAX, BCL2, p53, and ASK1. Conclusion: Understanding the function of TRX may be useful for the treatment of OSAHS. [ABSTRACT FROM AUTHOR]

The obstructive sleep apnea-hypopnea syndrome(OSAHS) is a sleep disorder caused by upper airway stenosis, and the main clinical manifestations were apnea, hypopnea, and arousal. In recent years, the incidence of OSAHS shows increasing trend, while its clinical diagnosis method is still relatively simple, and the early accurate diagnosis cannot be achieved. Metabolomics has played an important role in many disciplines such as medicine, pharmacy, and toxicology as an emerging subject, even if its research develops relatively short time. In this paper, we systematically reviewed the studies and applications of metabolomics on OSAHS biomarkers and found that OSAHS could cause changes in some special metabolites, including amino acids, lipids, acylcarnitines, intestinal flora, phospholipids, aromatic hydrocarbons, saturated hydrocarbons, acetone and isoprene. These metabolites involved in various metabolic pathways and mechanisms such as amino acid metabolism, lipid metabolism, oxidative stress pathway, phospholipid metabolism and endocannabinoids. The differential metabolites existed in a variety of biological samples in patients, including blood, urine, feces, saliva, and tonsil tissue, and some metabolites could be used in the early diagnosis and differential diagnosis of OSAHS and as the reference for further research on the biomarkers and pathogenesis of OSAHS.

Obstructive sleep apnea is one of the well recognized sleep-related breathing disorders characterized by snoring, episodic cessation (apnea) or reduction (hypopnea) of breathing during sleep and excessive sleepiness during the daytime. The prevalence of sleep apnea shows a rising trend in both developed as well as developing countries. If undiagnosed or untreated, sleep apnea can lead to adverse cardio-pulmonary, metabolic and neurocognitive outcomes including road traffic accidents. Early screening for symptoms and risk factors by the family physician, followed by referral of patients at risk to a sleep centre or specialist for timely diagnosis by polysomnography and effective treatment by positive airway pressure therapy is the standard of care. [ABSTRACT FROM AUTHOR]

Purpose: To aim of the study was to explore the possible mechanisms for the decreased contraction capacity of the palatopharyngeal muscle in cases with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: Palatopharyngeal muscle specimens from patients with OSAHS were taken as the case group. Palatopharyngeal muscle tissue by surgical removal of oropharyngeal malignant tumors was used as a control cohort. The palatopharyngeal muscle contraction capacity was measured by assessing diaphragm peak-twitching force / cross-sectional area (Pt/CSA), fatigue index (FI) twitch tension, and force per cross-sectional area (Force/CSA). Myofibril and sarcoplasmic reticulum (SR) ultra-structures were observed by electron microscopy. The intra-cellular calcium concentration was measured by fluorescence spectrophotometry. DHPRα1s and RyR1 expression profiles were probed through RT-qPCR and Western blot, and the colocalization of them was determined by immunofluorescence. Results: In comparison with the control cohort, the OSAHS cohort demonstrated decreased Pt/CSA (P < 0.01), FI twitch tension (P < 0.01), together with contraction capacity (P < 0.01). This cohort also had lower intra-cellular [Ca2+] of palatopharyngeal muscle cells with abnormal ultrastructure of sarcoplasmic reticulum (SR) (P < 0.01). In addition, transcriptomic (P < 0.01) and proteomic expression (P < 0.01) for RyR1 and DHPRα1s were markedly reduced within OSAHS cohort, although the degree of colocalization of them was not altered. Conclusion: RyR1 and DHPRα1s downregulation may disrupt intra-cellular [Ca2+] homeostasis and subsequently decrease the palatopharyngeal muscle contraction capacity in patients with OSAHS, thus providing a novel insight into the pathogenesis of OSAHS. [ABSTRACT FROM AUTHOR]

Background: Tonsillectomy and/or adenoidectomy can treat children with obstructive sleep apnea/hypopnea syndrome (OSAHS)., Objective: This study investigated the effects of tonsillectomy and/or adenoidectomy on cognitive function and brain structure in children with OSAHS., Methods: This study included 40 obstructive sleep apnea/hypopnea syndrome children and 40 healthy children. The cognitive function and brain structure changes of OSAHS children before and after surgery and 40 healthy children were evaluated by the Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) and the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), as well as brain resting-state fMRI functional magnetic resonance imaging (rs-fMRI)., Results: Children with OSAHS showed higher Swanson, Nolan, and Pelham Rating Scale and lower Integrated Visual and Auditory Continuous Performance Test scores than healthy peers, indicating cognitive impairment. Post-surgery, there was a significant improvement in cognitive function, evidenced by decreased Swanson, Nolan, and Pelham Rating Scale and increased Integrated Visual and Auditory Continuous Performance Test scores. Compared to healthy children, OSAHS children displayed altered ReHo values in certain brain regions, such as decreased values in the right angular gyrus, right precuneus, left parahippocampal gyrus, and left middle frontal gyrus, but increased values in the right posterior cerebellum. After surgery, ReHo values increased in regions like the right precuneus, right temporal lobe, right posterior cingulate gyrus, and left limbic lobe, suggesting neurological changes associated with treatment., Conclusions: Children with obstructive sleep apnea/hypopnea syndrome had cognitive impairment and abnormal changes in multiple brain regions. Tonsillectomy and/or adenoidectomy could improve cognitive function and contribute to the reconstruction of brain function and structure in children with obstructive sleep apnea/hypopnea syndrome.

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a disease marked by apnea, hypopnea, decreased oxygen saturation, and disordered sleep structure, which is a major risk for cardiovascular disease. Recent studies have found that OSAHS patients have an increased risk of hypertension, coronary atherosclerotic heart disease, insulin resistance, type 2 diabetes, metabolic syndrome, non-alcoholic fatty liver disease, etc. And these patients have a high prevalence of obvious glucolipid metabolism disorder (GMD) , which plays an important role in cardiovascular morbidity and mortality in OSAHS. We reviewed the latest advances in the association of GMD and OSAHS, and the potential pathogenesis of OSAHS-induced GMD and insulin resistance, aiming at providing new ideas for clinical treatment of GMD in OSAHS.

Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) has commonly occured in Down syndrome children caused by the abnormalities in upper respiratory tract anatomy and obesity. This study aims to identify the correlation between Mallampati score and obesity and the risk of OSAHS in Down syndrome children. This was an analytical descriptive cross-sectional study. This study was conducted in children with Down syndrome from September until November 2017. All parents filled the Indonesian Pediatric Sleep Questionnaire (PSQ), then all of the children were examined for Mallampati score and BMI. The correlation was analyzed by the Pearson Chi-Square model. Thirty-six subjects were included in this study. The number of male subjects were slightly more (61.1%), the mean age of the subjects was 8.42±4,449 years, with 52.8% (19 subjects) having OSAHS. There were 23 subjects (63.9%) who had Mallampati scores of 3 and 4, with 13 subjects (36.1%) were obese. This study concluded a statistically significant correlation between Mallampati score and obesity and the risk of OSAHS in Down syndrome children (p-value 0.001 and 0.029). Mallampati score and obesity had a significant correlation with the risk of OSAHS in Down syndrome children.

Obstructive sleep apnea hypoventilation syndrome (OSAHS) is a common sleep breathing disorder closely associated with cardiovascular disease. However, the respiratory sleep and related cardiovascular parameters on the apnea and hypopnea index (AHI) and life quality of primary snoring are unclear. We launched a cohort study focused on the association between respiratory sleep and cardiovascular-related parameters and apnea and hypopnea index, incorporating data from 218 patients with primary snoring in our medical center between Jun 1, 2015, and Apr 1, 2016. Thirty patients from Sichuan Cancer Hospital were used for validation. Patients with longer apnea time were more likely to progress to higher AHI (> 30) than controls (OR = 5.66, 95% CI = [2.79, 11.97], p < 0.001). Similarly, if patients have a higher value of diastolic blood pressure, they will also have a higher AHI (> 30) (HR [95% CI] = 3.42 [1.14, 13.65], p = 0.043). According to multivariate analysis, longest apnea time, the mean percentage of SaO2, and neckline length were independent risk factors of overall survival. A predictive model developed based on these factors above yielded a favorable agreement (C-index = 0.872) on the calibration curve. Thirty patients conducted external validation from Sichuan Cancer Hospital, displaying an AUC of 0.833 (0.782–0.884). Increased diastolic blood pressure and apnea time affect AHI level. An AHI prediction model based on these factors above can help clinicians predict the risk of high AHI events. [ABSTRACT FROM AUTHOR]

Background: The purpose of this single-centre prospective clinical study was to evaluate the correction of severe facial deformity and Obstructive sleep apnoea hypopnoea syndrome (OSAHS) in 22 patients aged from 9 to 42 years (mean 20.09) of bilateral Temporomandibular joint ankylosis. Materials and Methodology: Patients underwent multisegment distraction using external bilateral bidirectional distractors. Facial deformity was evaluated clinically in terms of mouth opening and neck chin angle and cephalometrically in terms of corpus length (gonion-pogonion), ramal height (articulare-gonion), chin deficiency (N perpendicular to Pog and SNB). OSAHS was evaluated through Epworth sleepiness scale, Berlin's questionnaire, pharyngeal airway space, apnoeic hypoapnoeic index, oxygen desaturation index, average arterial oxygen saturation and minimal fall in O2 saturation. Patients were followed up for a period of 13–74 months (mean 28.68). Results: Statistically highly significant results were obtained in all parameters. Complications encountered were pin infection (13.63%), loosening of pins (4.5%), wound dehiscence (9.09%), tooth fracture (4.5%) and parotid fistula (9.09%). Intermediate segment necrosis and vector loss were not observed. Conclusion: This study is a large case series using two corticotomy cuts for external bilateral bidirectional distracters with concomitant neo callous moulding in patients both pre- and post-ankylosis release. It is extremely efficient in correcting mandibular corpal and ramal deficiency as well as improving OSAHS. [ABSTRACT FROM AUTHOR]

Objective: To assess efficacy and safety of tonsil reduction with bipolar forceps electrocautery as treatment of paediatric obstructive sleep apnea/hypopnea syndrome (OSAHS). Study design: Prospective interventional study. Methods: Two hundred and sixty-three children aged 4–10 years with OSAHS and an apnea hypopnea index (AHI) > 3 were enrolled from March 2013 to January 2016. Pre-operative evaluation included oropharyngeal clinical examination with fiberoptic nasopharyngoscopy, OSA-18 questionnaire and overnight sleep study. All children were treated with adenoidectomy and tonsillotomy with bipolar forceps. OSA-18 questionnaire and overnight sleep study were performed 30 days after surgery. Results: Pre-operative average of the OSA-18 questionnaires was of 70.3 (SD = 9.7); 30-day post-operative score was 23.15 (SD = 8.2; p = 0.045). Pre-operative average Apnea Hypopnea Index (AHI) score was 9.41 (SD = 4.1); 30-day post-operative average of AHI score was of 1.75 (SD = 0.8; p = 0.012). Oxygen Desaturation Index (ODI) rate changed from 7.39 (SD = 4) to 1.34 (30-day post-operative) (SD = 4.7; p = 0.085). NADIR rate changed from 79% (SD = 6.32) to 90% (30-day post-operative) (SD = 5.18; p = 0.00012). Peri- and post-operative complications in our sample were mainly pain (average 75 doses of paracetamol), while bleeding did not occur (0%). All patients received a follow-up examination 5 years after surgery to evaluate tonsil size; at this time-point, a reduction in tonsil size from 3.6 (3–4; SD = 4.2) to 1.3 (1–2; SD = 5.5) was found, while tonsil regrowth was observed in five children (2%). Conclusion: This study showed that partial tonsillotomy with bipolar forceps electrocautery associated to adenoidectomy is an effective technique in treating OSAHS symptoms in children and ensures less complications in terms of hemorrhage, postoperative pain and infections compared to traditional adenotonsillectomy. The very low tonsillar regrowth rate reported in this study may support the routine use of this technique. [ABSTRACT FROM AUTHOR]

Purpose: Compare awake evaluation (modified Mallampati score—MMs, Müller maneuver—MM) to drug-induced sleep endoscopy (DISE) findings according to NOHL (nose–oropharynx–hypopharynx–larynx) classification in moderate-to-severe OSAHS patients. Methods: 43 moderate-to-severe OSAHS patients referred to our ENT department were enrolled over a 2-year period. In this observational prospective study, each patient was evaluated by the same ENT team both in wakefulness and during pharmacologically induced sleep. Level and severity of the obstruction were described. Results: The comparison of degree of collapsibility was statistically significative only at hypopharyngeal level: 41.8% of the patients showed a hypopharyngeal obstruction in wakefulness whereas 88.3% in DISE (p = 0.000). Laryngeal level was found in 18.6% patients during awake examination, conversely DISE demonstrated laryngeal obstruction in 4.6%. DISE identified significantly higher incidence of multilevel collapses (p = 0.001). However, the incidence of oropharyngeal obstruction in patients classified as MMs I and II was significantly higher in DISE compared to MM (p = 0.021). Conclusion: DISE is the best predictor of hypopharyngeal obstruction, whereas MM underestimates the severity of the collapse at this level. DISE is more reliable than MM to identify the obstruction in patients with MMs score I and II. [ABSTRACT FROM AUTHOR]

Purpose: Obstructive sleep apnea-hypopnea syndrome (OSAHS) may affect cerebrovascular reactivity (CVR), representing cerebrovascular endothelial function, through complex cerebral functional changes. This study aimed to evaluate the change of CVR after 1-month and 6-month mandibular advancement device (MAD) treatment of patients with carotid atherosclerosis (CAS) combined with OSAHS. Methods: Patients with carotid atherosclerosis combined with OSAHS who voluntarily accepted Silensor-IL MAD therapy were prospectively enrolled. All patients underwent polysomnographic (PSG) examinations and CVR evaluation by breath-holding test using transcranial Doppler ultrasound at baseline (T0), 1 month (T1), and 6 months (T2) of MAD treatment. Results: Of 46 patients (mean age 54.4 ± 12.4 years, mean body mass index [BMI] 27.5 ± 4.5 kg/m2), 41 patients (responsive group) responded to the 1-month and 6-month treatment of MAD, an effective treatment rate of 89%. The remaining 5 patients (non-responsive group) were younger (47.4 ± 13.5 years) and had a higher BMI (35.8 ± 1.8 kg/m2). The responsive group had an improvement of apnea-hypopnea index (AHI) (events/h) from 33.0 ± 25.0 (T0) to 12.4 ± 10.4 (T1) and 8.7 ± 8.8 (T2), P < 0.001; minimum arterial oxygen saturation (minSpO2) (%) increased from 79.8 ± 9.1 (T0) to 81.8 ± 9.4 (T1) and 85.2 ± 5.4 (T2), P < 0.01; longest apnea (LA) (s) decreased from 46.5 ± 23.1 (T0) to 33.3 ± 22.7 (T1) and 29.4 ± 18.5 (T2), P < 0.001; T90 (%) decreased from 10.3 ± 14.9 (T0) to 6.1 ± 11.8 (T1) and 3.3 ± 7.5 (T2), P < 0.05. Sleep architecture of these patients also improved significantly. The responsive group had a significant increase in left, right, and mean breath-holding index (BHI): left BHI(/s) from 0.52 ± 0.42 (T0) to 0.94 ± 0.56 (T1) and 1.04 ± 0.64 (T2), P < 0.01; right BHI(/s) from 0.60 ± 0.38 (T0) to 1.01 ± 0.58 (T1) and 1.11 ± 0.60 (T2), P < 0.01; mean BHI(/s) from 0.56 ± 0.38 (T0) to 0.97 ± 0.55 (T1) and 1.07 ± 0.59 (T2), P < 0.01), suggesting improved CVR. Conclusion: Effective MAD therapy is beneficial for restoring cerebrovascular endothelial function in patients with CAS and OSAHS in a short period (1 month and 6 months). Trial registration: Clinical trial registration number: NCT03665818. September 11, 2018. [ABSTRACT FROM AUTHOR]

Background: Obstructive Sleep Apnoea Hypoapnoea Syndrome (OSAHS) is known to be associated with impairment in neuro-cognitive functions. This impairment in cognition is associated with daytime sleepiness that results in occupational deficits and an increased risk of automobile accidents. Objectives: The aim of the study was to assess Neuro-cognition in patients of Obstructive Sleep Apnoea Hypoapnoea Syndrome (OSAHS) Material and methods: Our study was an observational cross-sectional study. Eligible patients (n=205) undergoing polysomnography were categorized into Snoring (n=105), Mild OSA (n=70), Moderate OSA (n=17) and Severe OSA (n=13) groups, based on Apnoea Hypoapnoea Index (AHI). The Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) Questionnaires were administered to assess their cognitive functions and the correlation between Questionnaire scores and severity of OSAS was determined. Results: MMSE Questionnaire detected overall cognitive impairment in 22% of OSA patients while as MoCA Questionnaire detected overall cognitive impairment in 33% of the same OSA patients. The frequency of mild neurocognitive impairment as detected by MMSE Questionnaire increased progressively as the severity of OSA increased from Snoring(6.7%) to Mild OSA(17.1%), Moderate OSA(29.4%) and severe OSA(38.4%). MoCA Questionnaire demonstrated the same pattern except that it was more sensitive. It detected cognitive impairment of 12.4% in Snoring group, 27.1% in Mild OSA group, 41.2% in Moderate OSA group and 53.9% in Severe OSA group. Conclusion: Neurocognitive impairment is common in patients with OSAHS. The MoCA is a more sensitive tool than MMSE for the assessment of mild cognitive impairment in OSAHS patients, whose performance on the MMSE is in the normal range.

Objective: The present study aimed to explore the relationship between young and middle‐aged patients with obstructive sleep apnea‐hypopnea syndrome (OSAHS) and atherosclerotic plaque of the carotid artery and lower extremities. Methods: A total of 110 patients diagnosed with OSAHS by polysomnography in the researchers' hospital from September 2018 to September 2019 were selected as the research objects. The enrolled patients were divided into a mild group (36 cases), a moderate group (38 cases), and a severe group (36 cases). Another 36 healthy subjects were set up as the non‐OSAHS group. All the selected subjects were examined by color Doppler ultrasound of the carotid artery and lower extremity arteries. Results: The detection rate of atherosclerotic plaque of the carotid artery and/or lower extremities in patients with OSAHS was significantly higher than that in the non‐OSAHS group (P < 0.05), and the incidence of plaque tended to increase along with an increase in the degree of OSAHS. Conclusion: The findings indicate that OSAHS might be an independent influencing factor for atherosclerosis. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a widely prevalent problem with many complications, such as hypertension and cerebral vascular diseases. Atherosclerosis, whose most severe outcome is ischemic stroke, is reported being affected by OSAHS. The objective of this article is to investigate the differences of carotid atherosclerosis patients with or without OSAHS by a cross-sectional research. Materials and methods: Patients diagnosed with carotid atherosclerosis by ultrasonography were recruited. They were requested to fill the primary screening OSAHS questionnaire. Patients with high tendency of OSAHS underwent polysomnography (PSG) tests into OSAHS group, and patients without OSAHS were into non-OSAHS group. Blood tests and medical history were collected. Carotid atherosclerosis severity was analyzed by carotid artery intima-media thickness (IMT), carotid plaque, blood flow velocity, etc. Differences between the two groups and subgroups were analyzed. Results: A total of 242 carotid atherosclerosis patients were enrolled including 118 non-OSAHS patients (38 males and 80 females) and 124 OSAHS patients (40 mild, 32 moderate, and 52 severe). Significant differences were found in PSV-ICA and EDV-ICA on both sides (p < 0.05) but no significant differences on IMT and velocity of CCV. CA patients with OSAHS were younger than ones without OSAHS. With the severity of OSAHS increasing, the age of CA patients decreased. The more severity of OSAHS, the younger the patients were. There were no significant differences in comparing cholesterol, triglyceride, HDL, LDL, and glucose. Conclusion: As far as CIMT, carotid plaque, blood flow velocity, and blood lipid are concerned, the severity of CA is not affected by the severity of OSAHS accordantly. The relationship between OSAHS and CA may not be dose dependent. Trial registration: This study has been registered on clinical trials (No. NCT03665818). [ABSTRACT FROM AUTHOR]

Objective　To compare the predictive value of NoSAS score and STOP-Bang questionnaire score， and evaluate the feasibility of NoSAS score screening for OSAHS in physical examination population. Methods　Retrospective analysis of the polysomnography （PSG） monitoring results of 135 patients with suspected OSAHS in our health management center was made from January 2018 to August 2019，including the NOSAS score and the Stop Bang Questionnaire and patient information. Grouped by apnea-hypopnea index （AHI），the sensitivity， specificity， positive predictive value and negative predictive value of NOSAS score and Stop-Bang questionnaire score were calculated， and ROC curves were drawn so as to compare the effectiveness of two scores which screened OSAHS. Result　Of the 135 patients，75.6% were male and 24.4% were female. Using AHI ≥ 5 events/h， AHI ≥ 15 events/h and AHI ≥ 30 events/h as the diagnostic criteria， the sensitivity and specificity of NOSAS scores were： 0.891 and 0.720， 0.910 and 0.587， 0.814， and 0.553； The sensitivity and specificity of STOP-Bang questionnaire were 0.873 and 0.560，0.910 and 0.435，0.949 and 0.329，respectively. When AHI ≥ 5 events/h， AHI ≥ 15 events/h and AHI ≥ 30 events / h were used as diagnostic criteria， the areas under ROC curve of the No SAS score were 0.847，0.773 and 0.693，the difference was statistically significant （ P < 0.001）；the areas under the ROC curve of the STOP-Bang questionnaire were 0.784， 0.711， 0.694 and the differences were statistically significant （P < 0.001）. When AHI is 5 events/h，15 events/h and 30 events/h as the critical points， the area under the NOSAS score ROC curve is greater than or equal to the STOP-Bang questionnaire score. The NOSAS score has good predictive value. Conclusion　As a simple and effective initial screening tool， the NOSAS score can effectively help physicians quickly screen OSAHS patients in physical examination population. [ABSTRACT FROM AUTHOR]

Objective: The purposes of this study were to explore the effect of obstructive sleep apnea-hypopnea syndrome (OSAHS) on the voice by analyzing the acoustic parameters between patients with OSAHS and those without OSAHS and to compare acoustic analyses performed by two software programs (MDVP and Praat). Methods: Patients with OSAHS (n = 75) and normal controls (n = 46) were asked to produce a sustained sound of the vowel /i/ and were analyzed with electroglottography (EGG), MDVP, and Praat software. A self-rated scale (Voice Handicap Index, VHI-10) and acoustic parameters were compared. Results: There were no statistically significant differences in the fundamental frequency (F0), jitter, shimmer, noise/harmonic ratio (NHR), contact quotient perturbation (CQP), or contact index perturbation (CIP) between the patient group and the normal group. The VHI-10 values were significantly increased in patients with OSAHS. The receiver operating characteristic (ROC) analysis suggested that the shimmer obtained from MDVP and Praat possessed relatively high accuracy in differentiating patients with OSAHS from healthy individuals. The results for F0, jitter, shimmer, and NHR were significantly different between MDVP and Praat in OSAHS patients. In normal persons, there was a significant difference in NHR; however, no significant differences were found for F0, jitter, or shimmer between the two software programs. The results demonstrated that high correlations were found between values obtained by both software programs. Conclusions: Patients with OSAHS were prone to vibration irregularity, incomplete glottal closure, hoarseness, and other vocal problems. The two acoustic software programs present different values of acoustic measures. There was a strong correlation and consistency between the parameters calculated by the two software programs. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to explore the clinical characteristics of different sleep perception types of obstructive sleep apnea–hypopnea syndrome (OSAHS) patients and to analyze the correlation between sleep perception and polysomnography (PSG) indicators in OSAHS patients.Methods: We retrospectively analyzed 355 patients diagnosed with OSAHS by PSG at the Sleep Medicine Center of Shengjing Hospital of China Medical University. Patients saw a doctor due to snoring and daytime sleepiness from March 2017 to March 2018. We excluded the patients who are

Abstract Background Obstructive sleep apnea-hypopnea syndrome (OSAHS) is prone to being complicated with various cardiovascular, cerebrovascular and metabolic conditions. OSAHS, due to its multifactorial nature, entails individualized and comprehensive treatment. So far, no well-established diagnostic criteria for the disease are available. In recent years, miRNA has been shown to be a sensitive biomarker suggestive of the progression and prognosis of many diseases. In this study, we examined some serum miRNAs in healthy OSAHS (OSAHS patients without complication) and OSAHS with arterial hypertension, with an attempt to understand the potential effects on the disease, improve the diagnosis of OSAHS and find OSAHS-related diagnostic markers. Methods Against various diagnostic criteria, participants were divided into three groups: healthy OSAHS, OSAHS with arterial hypertension and healthy controls. Their serum miRNA profiles were assessed by microarray technology, and then differentially expressed miRNAs were verified by quantitative real-time PCR (qRT-PCR). The receiver operating characteristic (ROC) curves of miRNAs were constructed and the areas under the curve (AUC) were calculated. Meanwhile, the miRNAs were subjected to logistic regression analysis. The target genes were bioinformatically assessed, their functions and signaling pathways further determined and eventually an miRNA-gene network was established. Results Analysis with the miRNA array exhibited that, compared with the control group, 12 differentially expressed miRNAs were found in healthy OSAHS, and 33 were found in OSAHS with arterial hypertension. The expression of miR-126-3p, let-7d-5p, miR-7641 and miR-1233-5p, miR-320b, miR-145-5p, miR-107, miR-26a-5p were validated by using qRT-PCR. Bioinformatics analysis predicted that the potential target genes of these miRNAs might be involved in metabolism, and the regulation of endothelial cells and nervous system. Moreover, the ROC analysis showed that the using miR-145-5p and let-7d-5p in combination can identify the healthy OSAHS, presence of miR-126-3p, miR-26a-5p and miR-107 was well indicative of OSAHS with arterial hypertension. Conclusions A cluster of dysregulation miRNAs have been found to be involved in the development of OSAHS patients. Moreover, these miRNAs might be used to be potential diagnostic and early warning markers.

Abstract Background To assess the retinal sensitivity in obstructive sleep apnea hypopnea syndrome (OSAHS) patients evaluated with standard automated perimetry (SAP). And to correlate the functional SAP results with structural parameters obtained with optical coherence tomography (OCT). Methods This prospective, observational, case-control study consisted of 63 eyes of 63 OSAHS patients (mean age 51.7 ± 12.7 years, best corrected visual acuity ≥20/25, refractive error less than three spherical or two cylindrical diopters, and intraocular pressure

OBJECTIVE: The aim of this study was to investigate the associations between obstructive sleep apnea hypopnea syndrome (OSAHS) complicated by cerebral infarction and intestinal flora, inflammatory factors, homocysteine, and adiponectin expression. PATIENTS AND METHODS: A total of 30 healthy volunteers (control group), 28 patients with simple cerebral infarction (cerebral infarction group) and 28 patients with OSAHS complicated by cerebral infarction (OSAHS + cerebral infarction group) were enrolled as research objects. The fecal bacterial DNA of research objects was extracted and subject to 16S ribosomal ribonucleic acid sequencing. Furthermore, the levels of inflammatory factors, homocysteine and adiponectin in the peripheral blood were detected. RESULTS: Compared with control group, cerebral infarction group exhibited significantly higher levels of interleukin-4 (IL-4), tumor necrosis factor-beta (TNF-ß), IL-1ß and C-reactive protein (CRP) (p<0.05). However, the levels of TNF-ß, IL-1ß and CRP in OSAHS + cerebral infarction group were notably higher than those in cerebral infarction group (p<0.05). The levels of myeloperoxidase (MPO) and malondialdehyde (MDA) were remarkably higher in cerebral infarction group than those in the control group (p<0.05). However, they were significantly higher in OSAHS + cerebral infarction group than cerebral infarction group (p<0.05). Compared with control group, cerebral infarction group exerted a noticeably higher level of homocysteine (p<0.05). However, homocysteine level was markedly higher in OSAHS + cerebral infarction group than that in cerebral infarction group (p<0.05). Adiponectin level was significantly lower in cerebral infarction group than that in the control group (p<0.05). Meanwhile, it was evidently lower in OSAHS + cerebral infarction group than that in the cerebral infarction group (p<0.05). Control group had the highest abundance of Actinobacteria, and cerebral infarction group exhibited the highest abundance of Coriobacteriales, Vagococcus, Sphingobacteriales and Adlercreutzia. However, OSAHS + cerebral infarction group exhibited the highest abundance of Bifidobacterium, Parascardovia, Metascardovia and Anaerostipes caccae. There was a strong positive correlation between Proteobacterium and Ruminococcus (r=0.9, p=0.000) and between Firmicutes and Bacteroidetes (r=0.72, p=0.004). However, there was a significant negative correlation between Firmicutes and Enterobacteriales (r=-0.45, p=0.009). CONCLUSIONS: OSAHS complicated by cerebral infarction is significantly associated with intestinal flora, inflammatory factors, homocysteine and adiponectin expression. [ABSTRACT FROM AUTHOR]

Background: Preschool children with obstructive sleep apnea-hypopnea syndrome (OSAHS) experience a potentially lethal sleep disorder disease. Early surgical resection of OSAHS is critical for children's growth and development. Tonsil adenoidectomy is an essential treatment technique for OSAHS. However, laryngeal trauma caused by surgery leads to agitation due to pain during recovery, accompanied by other symptoms such as unstable vital signs and postoperative anxiety. Little research has been done on the treatment and care of postoperative agitation and respiratory complications in children with OSAHS. Therefore, exploring a better-personalized care method is essential for reducing the incidence of respiratory complications during anesthesia recovery in children with OSAHS and the smooth recovery of the child. Objectives: The study aimed to investigate the respiratory complications and agitation of childhood OSAHS in the anesthesia recovery period after surgery and suitable nursing care methods. Methods: Atotal of 200children withOSAHSwere randomly divided into the routine care group (Group A, n = 100) and the personalized nursing group (Group B, n = 100). Personalized nursing included postoperative bleeding care, psychological care, infusion care, and pain care. Patients' demographic and clinical data were collected. A CO2 laser-assisted modified uvulopalatopharyngoplasty (UPPP) was performed after the induction of general anesthesia. Children were extubated and transferred to the recovery room after the surgery. The nurses closely monitored the children's agitation, oxygen saturation, and spontaneous breathing every 15 min within one hour in the recovery room. The respiratory frequency and amplitude, ECG changes, blood pressure, hospitalization time, and economic costs were recorded. Results: The incidences of agitation and respiratory obstruction were significantly lower in Group B than in Group A in the recovery room (P < 0.05). Blood pressure and heart rates were significantly higher, and oxygen saturation was lower in Group A at 15 min, 30 min, and 45min (all P < 0.05), but the difference disappeared 60 min after surgery (P > 0.05). The hospitalization time and expenses of Group B were significantly lower than those of Group A (P < 0.05). Conclusions: Personalized nursing care during postoperative anesthesia recovery can reduce the incidence of agitation and respiratory obstruction, lower blood pressure and heart rate, and accelerate postoperative recovery in children with OSAHS. Our study discovered a suitable nursing method for OSAHS children after general anesthesia to improve patients' recovery and reduce economic costs. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea-hypopnea syndrome (OSAHS) can impact multiple organ systems in children. Objectives: To investigate the effects of OSAHS on T-lymphocyte subgroups and natural killer (NK) cell activity in the peripheral blood of affected children. Methods: A total of 85 children with OSAHS were enrolled into an experimental group (OSAHS) and 76 healthy children were placed in a control group (CON) to compare peripheral blood levels of CD3+, CD4+, CD8+, and NK cell activity using flow cytometry. Meanwhile, their polysomnography results were monitored to analyze the correlation between T-lymphocyte subgroups/NK cell activity and lowest pulse oxygen saturation (LSaO2)/apnea-hypopnea index (AHI). Results: Compared to the CON group, the CD3+ percentage in the OSAHS group showed no significant difference (65.98 ± 6.54 vs 64.36 ± 5.32; P > 0.05), but the CD4+ percentage, CD4+/CD8+ ratio, and NK cell activity decreased markedly (33.52 ± 3.04 vs 35.26 ± 3.68, 1.29 ± 0.14 vs 1.43 ± 0.26, and 11.47 ± 4.58 vs 12.69 ± 2.36, respectively; P < 0.05). In addition, the CD8+ percentage increased significantly (26.18 ± 4.76 vs 24.36 ± 2.32; P < 0.05). Linear regression analysis indicated that the CD3+ percentage was not related to LSaO2/AHI (P > 0.05), but the CD4+ and CD8+ percentages, CD4+/CD8+ ratio, and NK cell activity were linearly related to LSaO2 and AHI (P < 0.05). Conclusions: OSAHScan affect the cellularimmunityof children. The AHIandLSaO2maybe involved in cellularimmunityfunction. [ABSTRACT FROM AUTHOR]

Purpose: To explore the relationship between symptomless multi-Variable apnea prediction (sMVAP) index and adverse outcomes of patients with Corona Virus Disease 2019 (COVID-19).Methods: According to the sMVAP quartiles, we divided all patients into four groups. The clinical electronic medical records, nursing records, laboratory findings, and radiological examinations for all patients with laboratory confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection were reviewed. Cox proportional hazard ratio (HR) models were used to determine the risk factors associated with in hospital death.Results: A total of 97 patients were included in this study. The "Quartile 4" group 's ICU transfer rate was significantly higher than the "Quartile 1" group. Coronary heart disease, high d-dimer and sMVAP at admission were associated with increased odds of death.Conclusions: Using the sMVAP index for obstructive sleep apnea hypopnea syndrome (OSAHS) risk assessment, and then predicting the adverse outcomes of COVID-19 patients, is an effective method. Therefore, the use of sMVAP index for OSAHS screening for inpatients with COVID-19 should be vigorously promoted, and high-risk patients should be effectively managed. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to explore the clinical characteristics of different sleep perception types of obstructive sleep apnea–hypopnea syndrome (OSAHS) patients and to analyze the correlation between sleep perception and polysomnography (PSG) indicators in OSAHS patients. Methods: We retrospectively analyzed 355 patients diagnosed with OSAHS by PSG at the Sleep Medicine Center of Shengjing Hospital of China Medical University. Patients saw a doctor due to snoring and daytime sleepiness from March 2017 to March 2018. We excluded the patients who are <18 years old, had a history of OSAHS treatment, had other sleep and psychiatric disorders, and could not provide complete data. According to the patients' explanation, medical history, PSG indicators, and morning questionnaire after PSG, the patients were divided into normal sleep perception (NSP), positive sleep perception abnormality (PSPA), and negative sleep perception abnormality (NSPA). We analyze the demographic characteristics and PSG of the three groups with ANOVA and non-parametric tests. In addition, we conducted correlation analysis between sleep perception and PSG indicators. Results: Of OSAHS patient, 55.5% had sleep perception abnormalities, of which 35.5% were positive-perception abnormalities and 20% were negative-perception abnormalities. From the analysis of PSG indicators, the sleep perception abnormality was related to the frequency of spontaneous arousal of the patient (P = 0.003) and was not related to the slight arousal caused by respiratory events, oxygen desaturations, and limb movement events. OSAHS patients with PSPA had a higher oxygen desaturation index (P = 0.046) but no significant difference in post hoc test. PSPA group had significantly lower rapid eye movement (REM) latency and sleep efficiency and more wake after sleep onset (WASO) than had the other sleep perception groups. Multivariate linear regression analyses after adjusting for age and sex revealed that sleep perception was related to lowest oxygen saturation (LSaO2), TS90%, sleep efficiency, and WASO. Conclusion: Sleep perception abnormality is common in OSAHS patients. OSAHS patients with different sleep perception types have different PSG profiles. The OSAHS patients with PSPA have more severe hypoxia levels at night that require timely personalized treatment. [ABSTRACT FROM AUTHOR]

Purpose: Several studies have reported that serum YKL-40 level was elevated in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). However, most of these studies had relatively small sample sizes and the results were inconsistent. Therefore, a meta-analysis was conducted to determine the potential role of serum YKL-40 level in OSAHS. Methods: A systematic literature search was performed in several databases to identify eligible studies involving the relationship between serum YKL-40 level and OSAHS. The standardized mean difference (SMD) with its 95% confidence interval (CI) was calculated to determine the effect sizes. Results: Five eligible articles were extracted in this meta-analysis. The pooled results demonstrated that the serum YKL-40 level was significantly higher in OSAHS patients compared with their non-OSAHS controls (SMD 1.03, 95% CI 0.46, 1.59, I2 = 87%, P = 0.0004). The subgroup analysis showed that Asian (SMD 1.81, 95% CI 1.41, 2.21, I2 = 0%, P < 0.00001) and Caucasian (SMD 0.67, 95% CI 0.39, 0.96, I2 = 0%, P < 0.00001) patients with OSAHS had higher serum YKL-40 levels than their non-OSAHS controls. YKL-40 level in serum was increased in OSAHS patients with BMI < 28 (SMD 1.81, 95% CI 1.41, 2.21, I2 = 0%, P < 0.00001), as well as in patients with BMI ≥ 28 (SMD 0.57, 95% CI 0.33, 0.81, I2 = 0%, P < 0.00001). In addition, OSAHS patients with cardiac complications had a higher serum YKL-40 level compared with those patients without cardiac complications (SMD 0.80, 95% CI 0.32, 1.28, I2 = 67%, P = 0.001). Conclusions: This study indicates that OSAHS patients have higher serum YKL-40 level, which may serve as a potential biomarker for OSAHS diagnosis and monitoring. [ABSTRACT FROM AUTHOR]