Obstructive sleep apnea (OSA) is a global public health concern characterized by repeated upper airway collapse during sleep. Research indicates that OSA is a risk factor for the development of various diseases, including cardiovascular disease, metabolic disorders, respiratory diseases, neurodegenerative diseases, and cancer. Exosomes, extracellular vesicles released by most cell types, play a key role in intercellular communication by transporting their contents-such as microRNA, messenger RNA, DNA, proteins, and lipids-to target cells. Intermittent hypoxia associated with OSA alters circulating exosomes and promotes a range of cellular structural and functional disturbances involved in the pathogenesis of OSA-related diseases. This review discusses the potential roles of exosomes and exosome-derived molecules in the onset and progression of OSA-associated diseases, explores the possible underlying mechanisms, and highlights novel strategies for developing exosome-based therapies for these conditions.
Humans ; Exosomes/physiology* ; Sleep Apnea, Obstructive/metabolism* ; Animals ; MicroRNAs/metabolism*

ObjectiveTo analyze the on-site technical evaluation results of the provincial-level health enterprises in Shandong Province. Methods A total of 88 provincial-level health enterprises in Shandong Province in 2021 were selected as the research subjects using the convenient sampling method. The scores of on-site technical assessments were analyzed. Results The total score of on-site technical evaluations for the 88 provincial health enterprises was (942.1±21.8) points. The scores for the first-level indicators, including management system, health environment, health management and services, and health culture, were (193.7±4.7), (191.6±5.2), (414.4±16.4), and (142.3±6.7) points, respectively. The score for health culture in large-sized enterprises was higher than that in medium-sized and below enterprises (P<0.05). State-owned enterprises had higher total scores than private enterprises and joint-stock enterprises (both P<0.05). The score for health management and services in the mining industry was higher than that in the manufacturing industry (P<0.05). Enterprises with high total investment in health promotion had higher scores for health culture than those with low investment (P<0.05). There were no significant differences in the scores for indicators of management system and health environment among enterprises of different sizes, natures, industries, and total investments in health promotion (all P>0.05). Conclusion The overall score of these 88 enterprises was higher than the standard for provincial health enterprises. Except for management systems and general environment, there were some differences in the scores for health management and services, and health culture assessments among enterprises of different sizes, natures, industries, and total investments in health promotion.

Objective:To explore the application of COVID-19-specific IgG antibody in identifying epidemic Omicron BA.5 strain infection.Method:Omicron BF.7/BA.5 naturally infected population, healthy population vaccinated with the COVID-19 vaccine, and Omicron BF.7/BA.5 breakthrough cases were enrolled into this study. The serum WT-S-IgG and BA.5-S-IgG were detected by indirect ELISA, and the serum-specific IgG antibody levels of different populations were compared. The application value of the two antibody titers and the ratio of the two antibodies in identifying Omicron BA.5 epidemic strain infection were explored by the ROC curve, aiming to provide technical support for pathogen diagnosis.Results:The antibody titers of WT-S-IgG and BA.5-S-IgG in the breakthrough cases were higher than those in the naturally infected population and the healthy population ( P<0.05). The area under the curve (AUC) of WT-S-IgG and BA.5-S-IgG in identifying epidemic Omicron BA.5 strain infection was 0.947 and 0.961, respectively. The AUC of BA.5-S-IgG and WT-S-IgG antibody titer ratio was 0.873. When the antibody titer ratio was 0.855, the sensitivity and specificity were 80.00% and 90.00%, respectively. According to the interval since the last infection, the AUC of the ratio of BA.5-S-IgG to WT-S-IgG antibody titer to identify the infection of epidemic strains less than 30 days and more than 30 days was 0.887 and 0.863, respectively, and the sensitivity and specificity were both above 80%. Conclusion:Both BA.5-S-IgG and WT-S-IgG, as well as the combination of these two antibodies, are of high value in the identification of epidemic strains.

Objective To investigate the changes in blood microbiota in patients with high altitude polycythemia(HAPC)and the correlation with the risk of HAPC.Methods A cross-sectional trial was carried out among 41 HAPC patients(HAPC group)and 41 healthy plateau individuals(control group)who took physical examination in the Health Management Department of No.953 Hospital of PLA Army in 2021.High-throughput sequencing technology was used to detect the V3-V4 variable region of the 16S ribosomal RNA(16S rRNA)gene in the blood smaples,and the composition and difference of the blood microbiota were compared and analyzed between the 2 groups.Results All the participants were male and Han people,and there were no significant differences in baseline data such as age,body mass index and plateau migration time between the 2 groups(P＞0.05).The α-diversity of blood microbiota in the HAPC group,including the Simpson index(0.931±0.005 vs 0.907±0.008,P＜0.05),Goods Coverage index(0.998±0.001 vs 0.997±0.001,P＜0.001)and Pielou index(0.597±0.011 vs 0.567±0.009,P＜0.05)were significantly higher than those in the control group.Meanwhile,obvious difference was observed in the β diversity between the 2 groups(P＜0.01).The relative abundance analysis of bacteria showed that Pelomonas(0.046±0.004 vs 0.033±0.003,P＜0.05),Azospirillum(0.046±0.006 vs 0.021±0.003,P＜0.01),Acidovorax(0.032± 0.003 vs 0.019±0.002,Azospirillum(0.046±0.006 vs 0.021±0.003,P＜0.01)and Acidovorax(0.032± 0.003 vs 0.019±0.002,P＜0.05)were statistically higher in the HAPC group than the control group.LEfSe analysis showed that the characteristic blood microbiota of the HAPC group were α-Proteobacteria,and those of control group were Trichospiridae.Conclusion Significant changes are found in diversity,relative abundance and characteristic bacteria of the blood microbiota between the HAPC patients and healthy people at the high altitude,which might be closely associated with the occurrence and development of HAPC.

Objective:To explore the application of COVID-19-specific IgG antibody in identifying epidemic Omicron BA.5 strain infection.Method:Omicron BF.7/BA.5 naturally infected population, healthy population vaccinated with the COVID-19 vaccine, and Omicron BF.7/BA.5 breakthrough cases were enrolled into this study. The serum WT-S-IgG and BA.5-S-IgG were detected by indirect ELISA, and the serum-specific IgG antibody levels of different populations were compared. The application value of the two antibody titers and the ratio of the two antibodies in identifying Omicron BA.5 epidemic strain infection were explored by the ROC curve, aiming to provide technical support for pathogen diagnosis.Results:The antibody titers of WT-S-IgG and BA.5-S-IgG in the breakthrough cases were higher than those in the naturally infected population and the healthy population ( P<0.05). The area under the curve (AUC) of WT-S-IgG and BA.5-S-IgG in identifying epidemic Omicron BA.5 strain infection was 0.947 and 0.961, respectively. The AUC of BA.5-S-IgG and WT-S-IgG antibody titer ratio was 0.873. When the antibody titer ratio was 0.855, the sensitivity and specificity were 80.00% and 90.00%, respectively. According to the interval since the last infection, the AUC of the ratio of BA.5-S-IgG to WT-S-IgG antibody titer to identify the infection of epidemic strains less than 30 days and more than 30 days was 0.887 and 0.863, respectively, and the sensitivity and specificity were both above 80%. Conclusion:Both BA.5-S-IgG and WT-S-IgG, as well as the combination of these two antibodies, are of high value in the identification of epidemic strains.

High Altitude Military Hygiene is the professional core course of high-altitude medicine, which is significant to the cultivation of military medical talents urgently needed by plateau troops. Under the background of "golden course" construction and army curriculum reform, aiming at the problems such as outdated content of course materials, single teaching mode and insufficient capacity of practical courses, we actively explored the effective path of "golden course" construction, including the renovation of the curriculum-construction concept, the optimization and reorganization of the teaching content, the expansion of case teaching and equipment teaching methods, and the implementation of curriculum ideological and political education and examination reforms. The reform has further improved the learning effect of students and the level of curriculum construction, and also provided beneficial reference for the construction of similar courses in military colleges and universities.

At present, domestic scholars in China have conducted research on the implementation and process of doctor-patient joint decision-making, but they are facing difficulties in localization of decision-making theory, human resources of decision-making and transformation of decision-making results. Social work involved in doctor-patient joint decision-making can unlock channels of communication between doctors and patients, make full use of existing resources, and promote the physical and mental health of patients. From the perspective of social work, the involvement of doctor-patient joint decision-making will face the challenges of ambiguous decision-making authority, "non counterpart" social work talents, and the reluctance of doctors and patients to take responsibility for decision-making, makes it difficult for social workers to build a bridge of communication, cooperation, and trust in the intervention process. Therefore, this paper proposed to explore the platform of standardization, diversification and symmetry by establishing an "embedded" intervention process, a "patient-centered" multidisciplinary team, and a "Gong" communication model.

Hyperlipidemia pancreatitis in children is mostly genetic metabolic disease.The incidence of acute pancreatitis in children is only (3-13)/100 000, and pancreatitis caused by hyperlipidemia accounts for 9% of acute pancreatitis.A child suffering from V-type hyperlipidemia pancreatitis was admitted to the Children′s Hospital Affiliated to Nanjing Medical University in July 2019.The missense mutation at position c. 2770G>A of CFTR gene (nucleotide 2770 in coding region changed from guanine to adenine) in children was detected by gene sequencing, thus resulting in amino acid change p. D924N.It is extremely rare to report that CFTR gene mutation causes hereditary pancreatitis, and there is no literature report on c. 2770G>A site.This case is reported as follows, hoping to provide reference and inspiration for pediatricians.

Objective:To investigate the current status of satisfaction with training program and loyalty to the university among professional postgraduate students majoring in clinical medicine, as well as the association between satisfaction with training program and loyalty to the university.Methods:The 2017 National Medical Student Satisfaction Survey Database was used. A total of 1 944 professional postgraduate students in the second or third year, as well as those with delayed graduation, from 59 postgraduate training colleges and universities who participated in clinical internship were selected. SPSS 20.0 software was used for analysis; descriptive analysis was used to describe satisfaction with training program and loyalty to the university; factor analysis was adopted to calculate comprehensive satisfaction score to reduce the number of variables; logistic regression analysis was applied to investigate the association of general information and satisfaction with training program with loyalty to the university.Results:The professional postgraduate students majoring in clinical medicine had a degree of 60.44% of loyalty to the university. Satisfaction with training program reflected low satisfaction at each link of the training program. For every 1-point increase in the comprehensive satisfaction scores of the four links of courses, research training, college support, and practice, the loyalty to the university was increased to 2.11, 1.83, 1.77, and 1.75 times as the original, respectively, of the baseline scores.Conclusion:There is still room for further improvement in the satisfaction with training program and the loyalty to the university among professional postgraduate students majoring in clinical medicine, and the satisfaction with training program is closely associated with the loyalty to the university. Colleges and universities need to take measures for courses, practice, research training, and college support, so as to improve satisfaction and thus enhance loyalty to the university.

【Objective】 To eliminate the insoluble particles in the drug and the particles produced by breaking the glass during intravenous or intramuscular injection. 【Methods】 We established a type of liquid medicine filter for preventing insoluble particles in this study. The front end of the filter body was conical and the back end was a filtering one. The filter body consisted of a filter block and a floating plug arranged inside the filter block. A filter chamber was formed inside the filter block， and a ring-shaped filter membrane was set in the filter chamber. When the injector pumped liquid， the float plug moved to the top of the float plug channel of the filter block， and the liquid entered the filter cavity from the blind hole of the float plug. When the syringe discharged liquid， the float plug was far away from the top of the float plug channel of the filter block， and the liquid in the filter cavity entered the blind hole of the float plug through the annular filter membrane and the peripheral channel of the filter block. 【Results】 The filtration rates of 5‒6 μm particles in standard solution of 5 μm latex particles by nuclear pore membrane， polyethersulfone membrane and nylon membrane were 96.9%， 97.1% and 96.2%， respectively. The filtration rate of 3‒4 μm particles in the standard solution of 3 μm latex particles could reach 98.1%. 【Conclusion】 The filter can filter the particles， which precipitate in the drug， thus achieving the effect of filtration and ensuring the safety of patients.