Objective:To investigate the effect of elevated low-density lipoprotein(LDL)cholesterol on the release of endothelial microvesicles into the circulatory system in elderly patients with obstructive sleep apnea(OSA).Methods:This was a case-control study.A total of 69 elderly inpatients aged ≥ 60 years were divided into the OSA group(n=48)and the normal control group(n=21)based on the apnea/hypopnea index(AHI). Sleep monitoring was carried out in the two groups, and venous blood samples were taken after the monitoring.Density gradient centrifugation was used to extract microparticles and flow cytometry was used to analyze patients' blood levels of endothelial microvesicles.Blood lipid levels of patients were measured by biochemical analysis methods.The correlation between LDL cholesterol levels and endothelial microvesicles in OSA patients was analyzed.Results:LDL cholesterol levels were higher in OSA patients than in normal controls(2.6±0.6 mmol/L vs.2.2±0.7 mmol/L, t=2.089, P=0.041). Endothelial microvesicle levels were elevated in OSA patients compared with the normal controls[(28.2±12.2)×10 -6events/L vs.(19.6±7.8)×10 -6 events/L, t=-3.164, P=0.003]. Endothelial microvesicle levels increased in OSA patients with elevated LDL cholesterol compared with OSA patients with normal LDL cholesterol[(39.3±12.6)×10 -6 events/L vs.(28.2±12.2)×10 -6 events/L, t=2.899, P=0.006]. There was a significant correlation between LDL cholesterol levels and endothelial microvesicle levels in OSA patients( r=0.497, P=0.032), while levels of HDL, total cholesterol, triglycerides, blood pressure and blood glucose had no significant correlation with endothelial microvesicle levels. Conclusions:The level of endothelial microvesicles released into the circulation is higher in elderly OSA patients than in normal elderly people, and the elevated concentration of LDL can further promote the release of endothelial microvesicles in OSA patients.

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.