Mesenchymal stem cells(MSCs)are self-regenerating,rapidly proliferating pluripotent stem cells that depend primarily on their derived pro-angiogenic,inflammatory regulatory,and tro-phic factors to exert beneficial effects that attenu-ate deleterious inflammatory responses,reduce vascular damage,and promote tissue repair and re-generation.Obstructive sleep apnea hypoventila-tion syndrome(OSAHS)is a chronic disorder marked by oropharyngeal collapse during sleep,re-sulting in transient reduced airflow,large fluctua-tions in intrathoracic pressure,and intermittent hy-poxia and hypercapnia.OSAHS subsequently cyto-kine-mediated inflammatory cascades,oxidative stress,and ischemia,recruit MSCs from inflamed and damaged tissues through MSCs-derived of anti-inflammatory and pro-angiogenic factor activity,re-duce hypoxia,suppress inflammation,promote re-generation,and prevent fibrosis in OSAHS-injured tissues.In this paper,we will describe the patho-genesis of inflammation,oxidative stress,fibrosis and ischemia from the perspective of OSAHS,high-lighting the current research progress on MSCs-de-pendent regulation of OSAHS-related pathology.

Obstructive sleep apnea (OSA) is a common sleep disordered breathing disorder. As a major global public health problem, untreated OSA can lead to a variety of adverse health outcomes, including various cardiovascular and cerebrovascular diseases, metabolic disorders, and psychiatric disorders such as anxiety and depression. Traditional OSA therapies such as positive airway pressure (PAP), weight loss, oral appliance, upper airway surgery, and postural therapy focus on the anatomical factors of OSA. However, the pathogenesis of OSA is heterogeneous, and non-anatomical factors also play an important role in most patients. Although there is no drug with exact efficacy for the treatment of OSA, with the deepening understanding of the pathophysiological mechanism of OSA, more and more clinical studies are devoted to the study of drug treatment of OSA and its complications, and a series of results have been achieved. The following is a review of the relevant studies on drug treatment of OSA in recent years, hoping to provide literature support and theoretical basis for future research on drug treatment of OSA.

Chronic obstructive pulmonary disease (COPD), a respiratory disease characterized by inflammation due to neutrophil infiltration, has become the third leading cause of death worldwide. After the occurrence of COPD, the persistent accumulation of neutrophils can promote the excessive formation of neutrophil extracellular traps (NETs), which plays an important role in local capture and clearance of pathogens, rapid control of infection, and immune regulation. This article mainly introduces the mechanism of COPD occurrence and NETs formation as well as the research progress of NETs in COPD, and summarizes the relevant drug targets for COPD treatment based on NETs, aiming to provide a reference for further research.

Ischemic stroke, a cerebrovascular disease with high incidence, high mortality, high disability rate and high recurrence rate, is an important cause of death and disability of middle-aged and elderly people in China, and imposes a huge burden to society and families. Therefore, it is essential to identify the risk factors associated with ischemic stroke and effectively prevent them. Studies have shown that obstructive sleep apnea is an independent risk factor for ischemic stroke. However, the exact pathological mechanism of their association has not been clarified. With the development of next-generation sequencing technology, more and more studies have focused on intestinal microbiota. They have found that obstructive sleep apnea can cause intestinal microbiota changes, and intestinal microbiota may be closely related to ischemic stroke. Therefore, this paper attempts to investigate the relationship between intestinal flora and ischemic stroke, so as to reveal the potential pathological mechanism of ischemic stroke caused by obstructive sleep apnea.

Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible and typical chronic fibrotic lung disease. In recent years, significant progress has been made in the pathophysiology, clinical diagnosis and treatment of IPF. However, to date, there is still no cure for IPF. The second messenger cyclic adenosine monophosphate (cAMP) inhibits fibroblast proliferation or differentiation into myofibroblasts during the development of IPF. Phosphodiesterase 4 (PDE4) is a major camp-degrading enzyme in lung fibroblasts, which is up-regulated during the progression of fibrosis. PDE4 inhibitors have anti-fibrosis effects in vivo and in vitro in IPF models. In addition, PDE4 is widely involved in inflammatory processes, which are also active in the pathogenesis of IPF. Thus, PDE4 inhibition is a potential therapeutic approach for IPF. This article reviews the pathogenesis of IPF and the physiological function of PDE subtype 4 inhibitors in the treatment of IPF.

Mammalian cell defense mechanisms are constantly evolving in response to increasing endogenous and exogenous oxidative stress factors. In recent years, as research has deepened, nuclear factor E2-related factor 2 (Nrf2) has been hailed as a "star" molecule in antioxidant damage defense. Billions of dollars have been spent internationally on developing targeted activators or inhibitors. Obstructive sleep apnea (OSA) is the most common form of sleep breathing disorder in clinical practice. Oxidative stress is one of its main pathological mechanisms and is closely related to target organ damage in the heart, brain, lungs, kidneys, and other systems. Recent research has revealed the mechanistic relationship of the Nrf2 pathway in OSA complications, and some natural Nrf2 activators have demonstrated emerging therapeutic effects in animal experiments. However, the activation mode and effect pathway of Nrf2 in different target organs of OSA have not been clarified. Therefore, this article reviews the research progress of the Nrf2 pathway in OSA and its complications, to deepen understanding of the mechanism of OSA complications and provide a potential treatment strategy.

Obstructive sleep apnea(OSA)can lead to complications in various systems and or-gans of the body.Dry eye(DE),the most common ocular surface disease in clinical practice,affects visual-related daily activities and work in varying degrees.Recent studies have revealed a potential re-lationship between OSA and DE.OSA can induce DE through a series of mechanisms such as oxidative stress,inflammation,rhythm disorder and so on,and the combination of OSA and DE may profoundly affect the sleep health,mood disorders,and quality of life of patients in a new form overall.However,there is still a lack of systematic understanding of the comorbidity of OSA and DE,resulting in insuffi-cient screening,diagnosis and treatment of OSA related DE in clinical practice.This paper provided a review of the relationship between OSA and DE to raise awareness among clinicians of the diagnosis and management of DE during OSA treatment.

Obstructive sleep apnea(OSA)can lead to complications in various systems and or-gans of the body.Dry eye(DE),the most common ocular surface disease in clinical practice,affects visual-related daily activities and work in varying degrees.Recent studies have revealed a potential re-lationship between OSA and DE.OSA can induce DE through a series of mechanisms such as oxidative stress,inflammation,rhythm disorder and so on,and the combination of OSA and DE may profoundly affect the sleep health,mood disorders,and quality of life of patients in a new form overall.However,there is still a lack of systematic understanding of the comorbidity of OSA and DE,resulting in insuffi-cient screening,diagnosis and treatment of OSA related DE in clinical practice.This paper provided a review of the relationship between OSA and DE to raise awareness among clinicians of the diagnosis and management of DE during OSA treatment.

Objective:To observe the local reactions and efficacy of CD19 CAR-T therapy in recurrence/refractory B-cell non-Hodgkin's lymphoma (R/R NHL) patients with >7.5 cm lesions.Methods:32 R/R NHL patients with >7.5 cm lesions were enrolled and injected with CD19 CAR-T cells. Flow cytometry was used to detect and observe the amplification of CD19 CAR-T cells in vivo. Enzyme-linked immunosorbent assay (ELISA) was used to detect cytokines in peripheral blood of patients. The side effects of CD19 CAR-T cell therapy included systemic side effects and local reactions of tumor. The local side effects were observed by Ultrasound, Computed tomography and Magnetic resonance imaging. Treatment options included glucocorticoid, interleukin-6 antibody and drainage of exudate. Overall response rate (ORR) and overall survival rate (OS) were observed.Results:①Among the 32 patients, CR (40.63%) , PR (31.25%) and ORR (71.88%) were 13, 10 and 23, respectively. ②In all 23 patients received ORR, 13 patients had grade 1-2 CRS, while 10 patients had grade 3-4 CRS. All the 9 patients in the SD+PD group had grade 1-2 CRS ( P=0.030) . ③A total of 15 patients with tumor local reactions, included 9 patients with CR, 5 patients with PR and 1 patient with SD. The local reactions of the tumor included that the diameter of the superficial lesions increased with redness, swelling and heat pain. The deep lesions presented abdominal pain, abdominal distension, suffocation and local pain, and burning of the tumor. The deep lesions were enlarged or accompanied by local edema. The local exudative lesions were found in the abdominal cavity and pleural cavity. ④ Peak proportion of CD19 CAR-T cells in ORR group was higher than that of in SD+PD group[16.8% (5.3%-48.2%) vs 2.9% (1.5%-5.7%) , z=-4.297, P<0.001]. The peak proportion of CD19 CAR-T cells in ORR group with local reactions was higher than that of in patients without local reactions [22.2% (10.5%-48.2%) vs 12.6% (5.3%-21.6%) , z=-3.213, P=0.001]. The peak proportion of CD19 CAR-T cells in multiple lesion group was higher than that of in single lesion group [35.8% (1.5%-48.2%) vs 16.8% (10.5%-18.5%) , z=-2.023, P=0.040]. ⑤Occurrence of local reactions and tumor shrinkage time were both delayed compared with systemic side effects. ⑥In the ORR group, the OS of patients with tumor local reactions was longer than that of patients without tumor local reactions, but there was no difference in the two groups (75% vs 34.6%, P=0.169) . Conclusions:CD19 CAR-T cell therapy in R/R NHL patients with >7.5 cm lesions might cause tumor local reactions later than systemic side effects.Clinicaltrial::ChiCTR1800018059

Objective:To explore the effects of bridge in, objective, pre-assessment, participatory learning, post-assessment and summary (BOPPPS) on internal nursing teaching.Methods:Totally 220 nursing students enrolled into Zhengzhou University in 2017 were selected by convenient sampling and divided into the observation group and the control group according to the teaching mode, with 110 nursing students in each group. Nursing students in the control group receiving traditional teaching, while nursing students in the control group receiving BOPPPS teaching. The effect of the two teaching modes was compared.Results:The satisfaction rate of the observation group (98.2%) was higher than that of the control group (90.0%) , and the difference was statistically significant ( P<0.05) . The assessment results of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . The total score of self-evaluation of learning effect and the score of each dimension in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The BOPPPS model shows satisfying effects in internal nursing teaching, which can increase the satisfaction of students with the teaching mode, and enhance their interest in learning, academic performance, and learning evaluation.