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

OBJECTIVE: To observe the curative efficacy of tyrosine kinase inhibitors (TKIs) in the treatment of e19a2 transcript (P230) CML chronic phase (CML-CP) patients. METHODS: The clinical data of 11 P230 CML-CP patients were collected from July 2008 to December 2019. Blood routine examination, bone marrow cytology, chromosome, and BCR-ABL qualitative and quantitative tests were performed at initial diagnosis. After TKIs treatment, BCR-ABL (P230)/ABL in peripheral blood was regularly detected to evaluate molecular response by real-time quantitative PCR. RESULTS: There were 11 patients (7 males and 4 females) in chronic phase from 6 domestic hospitals enrolled, their median age was 46 years old (range from 19 to 56 years old). Among 4 patients treated with imatinib (400 mg, qd) firstly, 3 cases switched to nilotinib (400 mg, bid) and 1 case switched to dasatinib (100 mg, qd) due to failure to achieve best molecular response at the landmark time or mutation of ABL kinase. Then major molecular response (MMR) was obtained within 1 year. In addition, 5 patients were treated with nilotinib (300 mg, bid) and 2 patients with dasatinib (100 mg, qd) as first-line treatment, all of them got MMR within 6 months. CONCLUSION For intolerance or resistance to imatinib, second-generation TKIs can enable P230 CML patients to achieve deeper molecular response, and MMR in a short time.
Adult ; Dasatinib ; Female ; Fusion Proteins, bcr-abl/genetics* ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy* ; Male ; Middle Aged ; Protein Kinase Inhibitors ; Young Adult

Purpose Analysis of correlation between FOXM1 gene expression levels and clinicopathological features and prognosis of patients with esophageal squamous cancer (ESC). The effect of down-regulation of FOXM1 expression on the proliferation of human ESC cell line KYSE-30 was also inves-tigated. Methods Quantitative real-time PCR (qRT-PCR) and immunohistochemistry ( IHC) methods were used to detect the expression of FOXM1 in ESC tissues and non-cancer tissues in mRNA and protein level. The expression of FOXM1 was down-regulated by RNA interference (RNAi) technique, and the pro-liferation activity of KYSE-30 cells was detected by CCK-8 as-say. Results Compared with the corresponding non-cancer tis-sues, the expression of FOXM1 was significant higher in ESC tis-sues(P＜0. 01). Meanwhile, the expression levels of FOXM1 in poorly differentiated esophageal carcinoma was higher than that in well-differentiated ESC group ( P ＜0. 01 ). The expression of FOXM1 was significantly correlated with poor tumor differentia-tion (P＜0. 001), lymphatic metastasis (P=0. 000), advanced stage (P=0. 004) of ESC patients after surgical resection. High FOXM1 expression was related to shorter overall survival ( OS) (P＜0. 001). After down-regulating FOXM1 expression in KYSE-30 cells, cell proliferation rate was inhibited (P＜0. 01). Conclusion FOXM1 expression is up-regulated in ESC and is closely related to the degree of differentiation, lymph node me-tastasis, clinical stage and prognosis of ESC. FOXM1 may be participated in regulating the proliferation of human esophageal carcinoma cell line KYSE-30.

Objective To develop a rapid,sensitive and specific real time reverse transcription PCR for detecting and identifying human metapneumovirus. Methods The Hmpv-L gene of human metapneumovirus was chosen as target gene,the primers and TaqMan probe were designed,and the PCR reaction was optimized systematically. The total RNA was extracted from respiratory specimens,and reverse transcription was performed through random primer. The cDNA was detected by using real time PCR. The specificity,sensitivity and reproducibility of real time PCR were estimated. The real time PCR was applied to detect 180 clinical respiratory specimens. Results The human metapneumovirus can be detected using real time reverse transcription PCR accurately and quickly,and the sensitivity was 1 copy/μl.The coefficient of variation of intra-assay and inter-assay wasless than 5%. Among those 180 specimens,28(15.56%) were positive for human metapneumovirus,the clinical diagnoses for these 28 patients were pneumonia ( 15.60%,17/109) and bronehiolitis ( 15.49%,11/71 ) .21 positive specimens were from patients under 2 years of age,and 6 positive specimens were from patients between 2 and 5 years of age,only 1 positive specimens was from patients over 5 years. Conclusion It is demonstrated that real time reverse transcription PCR is a reliable,accurate and feasible assay for human metapneumovirus,whieh has become one of the most important pathogens induced acute respiratory infections in pediatric patients.

0.05),but a significant difference at weeks 4,8,and 12 between two groups(P