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*

Objective To comparatively evaluate the clinical efficacy of liposomal bupivacaine and ropiva-caine in transversus abdominis plane(TAP)block combined with intravenous patient-controlled analgesia(PCA)following cesarean section,and to explore the analgesic advantages of liposomal bupivacaine.Methods Eighty parturients scheduled for elective cesarean section were recruited and randomly allocated into two groups via a random number table:the liposomal bupivacaine group and the ropivacaine group.At the conclusion of the surgical procedure,both groups underwent ultrasound-guided bilateral TAP block.In the ropivacaine group,20 mL of 0.5%ropivacaine was administered per side.In the liposomal bupivacaine group,266 mg of liposomal bupivacaine was dissolved in 0.9%normal saline to a total volume of 40 mL,with 20 mL injected per side.The following parameters were compared between the two groups:Visual Analog Scale(VAS)scores at rest and during movement at various postop-erative time points,the overall scores of the 15-item Quality of Recovery(QoR-15)scale,postoperative opioid consumption,the time to first ambulation,the time to first flatus,and the incidence of adverse drug reactions such as nausea,vomiting,constipation,and pruritus.Results In comparison with the ropivacaine group,the liposomal bupivacaine group exhibited significantly lower Visual Analogue Scale(VAS)scores both at rest and during move-ment at 12 hours,24 hours,and 48 hours postoperatively(P<0.001).Significantly higher Quality of Recovery-15(QoR-15)scores were recorded in the liposomal bupivacaine group at 24 hours and during the 24-48-hour period postoperatively(P<0.001).The postoperative opioid consumption within 48 hours was markedly lower in the liposo-mal bupivacaine group(P<0.001).The time to first flatus was significantly shorter in the liposomal bupivacaine group(P<0.001).No significant differences were detected in the incidence of nausea,vomiting,or constipation between the two groups(P>0.05),and no cases of pruritus or other severe adverse reactions were observed.Conclusion Liposomal bupivacaine used for TAP block following cesarean section offers extended analgesia,reduces the need for opioids,enhances the quality of postoperative recovery,promotes gastrointestinal motility,and demonstrates excellent safety.

Objective To comparatively evaluate the clinical efficacy of liposomal bupivacaine and ropiva-caine in transversus abdominis plane(TAP)block combined with intravenous patient-controlled analgesia(PCA)following cesarean section,and to explore the analgesic advantages of liposomal bupivacaine.Methods Eighty parturients scheduled for elective cesarean section were recruited and randomly allocated into two groups via a random number table:the liposomal bupivacaine group and the ropivacaine group.At the conclusion of the surgical procedure,both groups underwent ultrasound-guided bilateral TAP block.In the ropivacaine group,20 mL of 0.5%ropivacaine was administered per side.In the liposomal bupivacaine group,266 mg of liposomal bupivacaine was dissolved in 0.9%normal saline to a total volume of 40 mL,with 20 mL injected per side.The following parameters were compared between the two groups:Visual Analog Scale(VAS)scores at rest and during movement at various postop-erative time points,the overall scores of the 15-item Quality of Recovery(QoR-15)scale,postoperative opioid consumption,the time to first ambulation,the time to first flatus,and the incidence of adverse drug reactions such as nausea,vomiting,constipation,and pruritus.Results In comparison with the ropivacaine group,the liposomal bupivacaine group exhibited significantly lower Visual Analogue Scale(VAS)scores both at rest and during move-ment at 12 hours,24 hours,and 48 hours postoperatively(P<0.001).Significantly higher Quality of Recovery-15(QoR-15)scores were recorded in the liposomal bupivacaine group at 24 hours and during the 24-48-hour period postoperatively(P<0.001).The postoperative opioid consumption within 48 hours was markedly lower in the liposo-mal bupivacaine group(P<0.001).The time to first flatus was significantly shorter in the liposomal bupivacaine group(P<0.001).No significant differences were detected in the incidence of nausea,vomiting,or constipation between the two groups(P>0.05),and no cases of pruritus or other severe adverse reactions were observed.Conclusion Liposomal bupivacaine used for TAP block following cesarean section offers extended analgesia,reduces the need for opioids,enhances the quality of postoperative recovery,promotes gastrointestinal motility,and demonstrates excellent safety.

Objective To compare and analyze the predictive value of different immune-inflammatory parameters for adverse outcomes in severe community-acquired pneumonia(SCAP).Methods A total of 196 severe pneumonia patients admitted to the Second Affiliated Hospital of Zhengzhou University from May 2021 to April 2024.Patients were divided into good prognosis group(n=107)and poor prognosis group(n=89)based on the 28-day hospital outcome.Laboratory indicators were collected and inflammatory indices such as neutrophil-to-lymphocyte ratio(NLR)and NLR to hemoglobin ratio(NLR/Hb)were calculated.Logistic regression analysis was used to identify independent risk factors for poor prognosis in SCAP and to construct a regression model.The diagnostic efficacy of NLR/Hb for adverse outcomes in SCAP was evaluated using the receiver operating characteristic curve.Results NLR during hospitalization in good prognosis group was higher than that in poor prognosis group.Hemoglobin(Hb)in good prognosis group was higher than that in poor prognosis group,and Hb value of admitted patients generally showed a downward trend.platelet(PLT)count in good prognosis group showed an overall upward trend during hospitalization,while poor prognosis group showed a downward trend.NLR/Hb at day 7 showed the most stable significance in multi-model multi-factor Logistic regression analysis(P＜0.001).The indicators with differences were included in multi-factor Logistic regression model.NLR/Hb at day 7,D-dimer,and invasive mechanical ventilation were risk factors for poor prognosis,and platelet count at day 7 was a protective factor for poor prognosis(P＜0.05).Conclusion Dynamic monitoring of blood routine is very necessary in clinical practice,and NLR/Hb is expected to become an effective indicator for judging the poor prognosis of severe pneumonia patients.

Purpose To evaluate the changes of carotid artery elasticity in children with type 1 diabetes mellitus (T1DM) via RF-data based quantitative analysis on vessel stiffness technique (R-VQS),and to detect its correlation with the duration of diabetes mellitus and blood sugar control. Materials and Methods A total of 75 children with T1DM from the Pediatrics Department of Henan Chest Hospital,the Pediatrics Department of Henan People's Hospital,and the Endocrinology,Genetics,and Metabolism Department of Henan Children's Hospital were prospectively collected from September 2019 to November 2021. According to the T1DM duration,all patients were divided into long course group (duration ≥5 years,n=30 cases) and short course group (duration<5 years,n=45 cases). And 30 age and sex matched controls were also collected. The systolic diameter (Diam),vascular displacement (Dist),pulse wave velocity (PWV),stiffness coefficient (HC) and intima-media thickness (IMT) of common carotid artery were measured by R-VQS. Fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),triglyceride (TG),serum total cholesterol (TC),high-density lipoprotein (HDL),low-density lipoprotein cholesterol (LDL) were collected to compared the differences of parameters among the three groups. Results The FBG,HbA1c and IMT of the long and short course groups were all significantly higher than those of control group (all P<0.05). There were statistically significant differences in PWV and HC among the three groups (F=22.854,P<0.001;F=16.811,P<0.001;H=33.214,P<0.001). The course of disease was moderately correlated with PWV and HC (r=0.621,0.517,respectively,P<0.001). HbA1c was moderately correlated with PWV (r=0.562,P<0.001). Conclusion Early onset of T1DM in children may lead to decreased carotid artery elasticity,and prolonged hyperglycemia can aggravate the degree of arterial elasticity damage. R-VQS is a simple,effective,and non-invasive method for assessing arterial elasticity,providing a basis for clinical diagnosis and treatment.

Purpose To evaluate the changes of carotid artery elasticity in children with type 1 diabetes mellitus (T1DM) via RF-data based quantitative analysis on vessel stiffness technique (R-VQS),and to detect its correlation with the duration of diabetes mellitus and blood sugar control. Materials and Methods A total of 75 children with T1DM from the Pediatrics Department of Henan Chest Hospital,the Pediatrics Department of Henan People's Hospital,and the Endocrinology,Genetics,and Metabolism Department of Henan Children's Hospital were prospectively collected from September 2019 to November 2021. According to the T1DM duration,all patients were divided into long course group (duration ≥5 years,n=30 cases) and short course group (duration<5 years,n=45 cases). And 30 age and sex matched controls were also collected. The systolic diameter (Diam),vascular displacement (Dist),pulse wave velocity (PWV),stiffness coefficient (HC) and intima-media thickness (IMT) of common carotid artery were measured by R-VQS. Fasting blood glucose (FBG),glycosylated hemoglobin (HbA1c),triglyceride (TG),serum total cholesterol (TC),high-density lipoprotein (HDL),low-density lipoprotein cholesterol (LDL) were collected to compared the differences of parameters among the three groups. Results The FBG,HbA1c and IMT of the long and short course groups were all significantly higher than those of control group (all P<0.05). There were statistically significant differences in PWV and HC among the three groups (F=22.854,P<0.001;F=16.811,P<0.001;H=33.214,P<0.001). The course of disease was moderately correlated with PWV and HC (r=0.621,0.517,respectively,P<0.001). HbA1c was moderately correlated with PWV (r=0.562,P<0.001). Conclusion Early onset of T1DM in children may lead to decreased carotid artery elasticity,and prolonged hyperglycemia can aggravate the degree of arterial elasticity damage. R-VQS is a simple,effective,and non-invasive method for assessing arterial elasticity,providing a basis for clinical diagnosis and treatment.

Objective To compare and analyze the predictive value of different immune-inflammatory parameters for adverse outcomes in severe community-acquired pneumonia(SCAP).Methods A total of 196 severe pneumonia patients admitted to the Second Affiliated Hospital of Zhengzhou University from May 2021 to April 2024.Patients were divided into good prognosis group(n=107)and poor prognosis group(n=89)based on the 28-day hospital outcome.Laboratory indicators were collected and inflammatory indices such as neutrophil-to-lymphocyte ratio(NLR)and NLR to hemoglobin ratio(NLR/Hb)were calculated.Logistic regression analysis was used to identify independent risk factors for poor prognosis in SCAP and to construct a regression model.The diagnostic efficacy of NLR/Hb for adverse outcomes in SCAP was evaluated using the receiver operating characteristic curve.Results NLR during hospitalization in good prognosis group was higher than that in poor prognosis group.Hemoglobin(Hb)in good prognosis group was higher than that in poor prognosis group,and Hb value of admitted patients generally showed a downward trend.platelet(PLT)count in good prognosis group showed an overall upward trend during hospitalization,while poor prognosis group showed a downward trend.NLR/Hb at day 7 showed the most stable significance in multi-model multi-factor Logistic regression analysis(P＜0.001).The indicators with differences were included in multi-factor Logistic regression model.NLR/Hb at day 7,D-dimer,and invasive mechanical ventilation were risk factors for poor prognosis,and platelet count at day 7 was a protective factor for poor prognosis(P＜0.05).Conclusion Dynamic monitoring of blood routine is very necessary in clinical practice,and NLR/Hb is expected to become an effective indicator for judging the poor prognosis of severe pneumonia patients.

Objective    To evaluate the feasibility, safety, and short-term effect of minimally invasive ascending aorta surgery through a right anterior thoracotomy via the second intercostal incision. Methods    The clinical data of 13 patients who underwent minimally invasive ascending aorta surgery (including minimally invasive Bentall operation in 7 patients, minimally invasive Wheat operation in 2 patients, and minimally invasive ascending aorta replacement in 4 patients) through a right anterior thoracotomy via the second intercostal incision in our center from October, 2019 to September, 2020 were retrospectively analyzed. There were 12 males and 1 female at age of 19-69 (52.4±13.7) years. Results    The aortic cross-clamping time was 84.3±18.3 min. Three patients received blood transfusion, with the rate of 23.1%. The drainage volume in the first 24 hours after operation was 214.5±146.3 mL, with no redo for bleeding. The duration of mechanical ventilation was 19.0±11.3 hours and the length of intensive care unit stay was 1.8±1.3 days. The drainage tube was removed 2.5±1.0 days after operation. All the 13 patients recovered and discharged 6.4±2.0 days after operation, with no dead patients found. All patients survived with New York Heart Association (NYHA) functional classⅠandⅡduring a median follow-up of 8 months. Conclusion    Minimally invasive ascending aorta surgery through a right anterior thoracotomy via the second intercostal incision may be a safe and effective method with less injury and quick recovery.

The unicellular green alga Haematococcus pluvialis is the best source of natural astaxanthin (AST) in the world due to its high content under stress conditions. Although high light (HL) can effectively induce AST biosynthesis, the specific mechanisms of light signal perception and transduction are unclear. In the current study, we used transcriptomic data of normal (N), high white light (W), and high blue light (B) to study the mechanisms of light inducing AST accumulation from the point of photoreceptors. The original data of 4.0 G, 3.8 G, and 3.6 G for N, W, and B were obtained, respectively, by the Illumina Hi-seq 2000 sequencing technology. Totally, 51 954 unigenes (at least 200 bp in length) were generated, of which, 20 537 unigenes were annotated into at least one database (NR, NT, KO, SwissProt, Pfam, GO, or KOG). There were 1 255 DEGs in the W vs N, 1 494 DEGs in the B vs N, and 1 008 DEGs in the both W vs N and B vs N. KEGG enrichment analysis revealed that photosynthesis, oxidative phosphorylation, carotenoid biosynthesis, fatty acids biosynthesis, DNA replication, nitrogen metabolism, and carbon metabolism were the significantly enriched pathways. Moreover, a large number of genes encoding photoreceptors and predicted interacting proteins were predicted in Haematococcus transcriptome data. These genes showed significant differences at transcriptional expression levels. In addition, 15 related DEGs were selected and tested by qRT-PCR and the results were significantly correlated with the transcriptome data. The above results indicate that the signal transduction pathway of "light signal - photoreceptors - interaction proteins - (interaction proteins - transcription factor/transcriptional regulator) - gene expression - AST accumulation" might play important roles in the regulation process, and provide reference for further understanding the transcriptional regulation mechanisms of AST accumulation under HL stress.
Chlorophyta/genetics* ; Gene Expression Profiling ; Signal Transduction/genetics* ; Transcriptome/genetics* ; Xanthophylls