INTRODUCTION: Obstructive sleep apnoea (OSA) is common in Singapore, with moderate to severe OSA affecting around 30% of residents. These consensus statements aim to provide scientifically grounded recommendations for the management of OSA, standar-dise the management of OSA in Singapore and promote multidisciplinary collaboration. METHOD: An expert panel, which was convened in 2024, identified several areas of OSA management that require guidance. The expert panel reviewed the current literature and developed consensus statements, which were later independently voted on using a 3-point Likert scale (agree, neutral or disagree). Consensus (total ratings of agree and neutral) was set a priori at ≥80% agreement. Any statement not reaching consensus was excluded. RESULTS: The final consensus included 49 statements that provide guidance on the screening, diagnosis and management of adults with OSA. Additionally, 23 statements on the screening, diagnosis and management of paediatric OSA achieved consensus. These 72 consensus statements considered not only the latest clinical evidence but also the benefits and harms, resource implications, feasibility, acceptability and equity impact of the recommendations. CONCLUSION The statements presented in this paper aim to guide clinicians based on the most updated evidence and collective expert opinion from sleep specialists in Singapore. These recommendations should augment clinical judgement rather than replace it. Management decisions should be individualised, taking into account the patient's clinical characteristics, as well as patient and caregiver concerns and preferences.
Humans ; Sleep Apnea, Obstructive/diagnosis* ; Singapore ; Consensus ; Adult

Transanal total mesorectal excision (TaTME) was introduced as a novel technique to deal with rectal cancers. Its transanal approach offered the shortest distance to approach a challenging location, allowing an excellent visualization of the distal resection margin. Since its introduction in 2010, a significant amount of research has been put in to measure its development. In this review, we look at its ancestry, the genesis for its introduction and continued evolution as well as some of the important outcomes in its journey thus far. The importance of a structured and proctored learning journey is also stressed to enable the safe application and development of this technique. Beyond this, the TaTME movement has progressed relentlessly and its utility has been expanded to the management of benign conditions such as inflammatory bowel disease, Hartman reversals, and anastomotic strictures. We believe that the continued development and adoption of TaTME worldwide is here to stay.

Objective To find a suitable cell line for hepatitis A antigen expressed by vaccinia virus vector and to find a way of inactivation and preservation of the HAV recombinant antigen.Methods Series of cell lines such as K4,143,HEL,Hep-2 and Vero were inoculated with vaccinia virus that can express HAV recombinant antigen.ELISA was used to determine the contents of expression antigen.The chracteration of the HAV antigen expressed by vaccinia virus was then analyzed after it was treated with different methods.Results The expression of HAV recombinant antigen in K4,143 and HEL cell lines was a little more than expression in Hep-2 and Vero cell lines.The antigenicity is obviously higher when HAV recombinant antigen was inactivated by β-propiolactone other than it was inactivated by formalin.It was best to preserve the prepared HAV recombinant antigen under -40℃ condition.Conclusions The application of vaccinia virus vector in hepatitis A antigen preparation was very useful and promising.

Objective To study the affect of psychological intervention to anxiety-depression emotion and T Lvmlcih cells in breast cancer patients during the peri-operation. Methods We divided 60 cases into two groups at random. the experiment group(30) and the control group(30).The psychological situation Was evaluated according to the scores of Self-Rating Anxiety Status Inventory(SAS)and Depression Status Inventory (SDS).2 ml of venous blood Was taken to measure the level of T lymph cells. Then the experiment group Was given the specific and generalized psychological interventions. while the control group was given only the common nursing care. Results The scores of anxiety(8.65±3.69)and depression(31.70±5.79)after the intervention in the experiment group were lower than those before the intervention。and had significant difference (P<0.05).After the operation，the average value of CD3，CD4，CD4／CD8 in the experiment group was higber than that of the control group，and the values of CD3 and CD4 had statistical meaning(P<0.05).After the intervention，the vatues of CD3,CD4，CD4／CD8 of the experiment group were higher than those before the intervention. and the values of CD3 and CD4 had obvious difference(P<0.05).Conclusions In this study, a suitable and effective psychological intervention can improve the status of anxiety and depression of patients with breast cancer during the peri-operative period, and at the same time can modulate the immune status.

Objective:To study the feasibility of using the bionic technology to construct small-caliber vascular prostheses with modified SIS.Methods: The vascular endothelial cells and smooth muscle cells were separated from canine saphenous artery,the cells blended with collagen gel,which were planted respectively on the SIS films,these films were rolled into the biologic three-layer prostheses around a 3mm diameter polyethylene tube;one-layer prostheses without these cells and collagen gel served as control.These 2 types of prostheses were implanted into the defect of bilateral canine femoral by anastomosis in 15 dogs.doppler colour ultrasonic,histology detection and electron microscope examination were done postoperatively.Results: By 12 weeks postoperatively,14 biologic vascular prostheses had kept well patency,the patency rate being 93.3%,the biologic structure like blood vessels had formed,the inner surface of the vessels had been covered with full endothelial cells,a lot of smooth muscle cells had been found in the media of vascular walls in regular line;the patency rate in control group was 60.0%,the endothelial cell coverage was incomplete.Conclusions: The bionic vascular prostheses showed potent blood compatibility,which could keep long-term patency in vivo.Curative effect of repairing the small-caliber vessel defect was well satisfactory.

Abdominal Pain ; etiology ; Acute Disease ; Adult ; Atropine ; therapeutic use ; Chemical and Drug Induced Liver Injury ; etiology ; therapy ; Diarrhea ; etiology ; Fatal Outcome ; Female ; Humans ; Male ; Middle Aged ; Multiple Organ Failure ; etiology ; Muscarinic Antagonists ; therapeutic use ; Mushroom Poisoning ; complications ; therapy

Objective A new Continous-monitoring. Methods Determinating adenosine desaminase was established,and its experiment conditions including pH,substract concentration et al,and methodological performance were investigated.In this study,Two reagents were used,reagent one including 6 mmol/L α-ketoglutarate acid,0.35 mmol/L NADH,0.8 mmol/L ADP,0.1 mmol/L EDTA-Na2,1000U/L glutaic dehydrogenase.Reagent two including 12 mmol/L adenosine.Results The linearity range of this method can reach 97 U/L,the variance within batch and between batch were 4.9% and 6.53% respectively.Correlation analysis showed there was significant correlation between ours and Berthelot′s method.Conclusion The continous-monitoring method is accurate,simple and easy to be used in clinic.

Objective To investigate the clinical and pathological features of lymphomatoid granulomatosis(LG).Methods The data of clinic and the results of pathological study of brain biopsy which stained by immunohistochemical method were reviewed in one case with LG.Results The patient was presented with headache,dizzy,slurred speech and myasthenia of limbs.MRI showed abnormal signals on bilateral cerebral white matter,pons,cerebellum and cervical-thoracic spinal cord.Gd-enhanced imaging showed punctiform enhancement.The protein and IgG in cerebrospinal fluid elevated slightly.Brain biopsy showed angiocentric,angiodestructive granuloma formation combined with infiltration of multiple cells.The infiltrated cells confirmed immunohistochemically were lymphocytes and mononuclear phagocytes.In situ hybridization technique showed EBV positive.The status of this patient improved after radiotherapy and glucocorticosteroid treatment.Conclusion LG lacks characteristic features in clinic,laboratory and radiological examinations,so the pathological examination is important for diagnosis of this disease.