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 develop an expert consensus on subcutaneous injection nursing for allergic asthma in children,standardize nursing practice to reduce the occurrence of related adverse reactions.Methods The clinical guideline,expert consensus,systematic review,evidence summary and original research on subcutaneous injection of monoclonal antibody drug for children with allergic asthma were comprehensively searched in domestic and foreign databases.The time limit for retrieval was from the establishment of databases until August 2023.Combined with clinical practice experience,the first draft of the consensus was formed.From December 2023 to February 2024,27 experts were invited to conduct 2 rounds of expert letter consultation,revise and improve the contents of the first draft,and expert demonstration was conducted,and finally a consensus final draft was formed.Results The effective recovery rate of the 2 rounds of letter consultation questionnaires was 100％;the authority coefficient of experts was 0.88;the judging basis coefficient was 0.93;the familiarity coefficient was 0.83.In the 2 rounds of correspondence,the Kendall concordant coefficients of expert opinions were 0.241 and 0.252,respectively(P＜0.001 for both).The consensus includes 6 parts,including personnel management,environmental layout,indications and contraindications,subcutaneous injection operation norms,identification and treatment of adverse reactions,and health education.Conclusion The consensus is strongly scientific and practical,and can provide guidance for nursing practice of subcutaneous injection of monoclonal antibodies in children with allergic asthma.

【Objective】 To explore the relationship between changes in the entorhinal cortex （EC） of traumatic brain injury （TBI） and cognitive function based on structural magnetic resonance imaging. 【Methods】 MRI was performed in 26 patients with clinically confirmed TBI after admission， and the Mini-mental State Examination （MMSE） was followed up 6 months later. The TBI patients were classified as mild TBI and moderate to severe TBI according to the post-traumatic Glasgow coma scale （GCS）. We compared the differences in age， gender， education level， hypertension， diabetes， TBI operation history， and follow-up MMSE between the two groups. Then the morphology， surface area， volume and thickness of the patient’s EC were evaluated using the visual score and Freesurfer software， and finally the correlation between EC parameters and MMSE was analyzed. 【Results】 The study included 12 cases of mild TBI and 14 cases of moderate to severe TBI. There were no statistical differences in age， gender， years of education， hypertension， diabetes or TBI operation history. However， the two groups differed significantly in follow-up MMSE. Visual evaluation showed statistical difference in the left EC scores. Structural MRI showed that the volume and thickness of left EC were statistically different between the two groups. The correlation analysis showed that there was a positive correlation between the thickness of left EC and MMSE （r=0.430， P<0.05）. 【Conclusion】 Entorhinal cortex atrophy after TBI is related to the severity of trauma， and it can reflect the long-term cognitive level of patients， which can be used as a noninvasive and reliable imaging marker for evaluating cognitive impairment after TBI.

Objective:To establish a disease risk prediction model for the newborn screening system of inherited metabolic diseases by artificial intelligence technology.Methods:This was a retrospectively study. Newborn screening data ( n=5 907 547) from February 2010 to May 2019 from 31 hospitals in China and verified data ( n=3 028) from 34 hospitals of the same period were collected to establish the artificial intelligence model for the prediction of inherited metabolic diseases in neonates. The validity of the artificial intelligence disease risk prediction model was verified by 360 814 newborns ' screening data from January 2018 to September 2018 through a single-blind experiment. The effectiveness of the artificial intelligence disease risk prediction model was verified by comparing the detection rate of clinically confirmed cases, the positive rate of initial screening and the positive predictive value between the clinicians and the artificial intelligence prediction model of inherited metabolic diseases. Results:A total of 3 665 697 newborns ' screening data were collected including 3 019 cases ' positive data to establish the 16 artificial intelligence models for 32 inherited metabolic diseases. The single-blind experiment ( n=360 814) showed that 45 clinically diagnosed infants were detected by both artificial intelligence model and clinicians. A total of 2 684 cases were positive in tandem mass spectrometry screening and 1 694 cases were with high risk in artificial intelligence prediction model of inherited metabolic diseases, with the positive rates of tandem 0.74% (2 684/360 814)and 0.46% (1 694/360 814), respectively. Compared to clinicians, the positive rate of newborns was reduced by 36.89% (990/2 684) after the application of the artificial intelligence model, and the positive predictive values of clinicians and artificial intelligence prediction model of inherited metabolic diseases were 1.68% (45/2 684) and 2.66% (45/1 694) respectively. Conclusion:An accurate, fast, and the lower false positive rate auxiliary diagnosis system for neonatal inherited metabolic diseases by artificial intelligence technology has been established, which may have an important clinical value.

Objective To treat hematospermia by ureteroscopy and investigate its application value for the treatment of hematospermia.Methods Nineteen patients with persistent hematospermia, TRUS,seminal vesicle MRI or CT were examined to exclude seminal vesicle tumor, tuberculosis, prostatic occupancy and preoperative prostatic fluid and drug sensitivity.Transurethral 4.5 - 6 F ureteroscopy entered through the microscopic seminal vesicle, wash of the old blood, reserved perfusion with Quinolones, and the lithoclasty on the seminal stones by holmium laser, resection of small polypi.Results The ureteroscopy was successful in 18 (95%) cases for bilateral seminal vesicle, wash and drug reserved perfusion, and one case was also successful seminal vesicle microscopy on the affected side; five cases with the seminal stones by olmium laser, three cases with small polypi by resection.The averse duration of the procedure was 35 10 -75) min.There were no compliocations during or after the operation.In 18 cases at 6 - 12 months follow-up the hematospermia and symptoms of hematospermia disappeared fully after 90 d.There was recurrence in one case which improved with anti-inflammaotry treatment.Conclusions Ureteroscopic treatment for persistent hematospermia by 4.5 - 6 F ureteroscopy through the seminal vesicle is effective and safe method and results in a micro-wound.

Objective To explore induced eruption techniques of the impacted maxillary canine with labial medial inclination. Methods A total of 38 cases with upper impacted canines with labial medial inclination were selected. The impacted canine was connected to the buccal hook of the upper first molar band, moved distantly and uprightly and then drawn to the dental arch after the pressure to the adjacent teeth was removed. Results After average 18 months treatment, 38 patients had good functions. The deeper impacted canines in 5 patients were extracted, and then the dental arch spaces closed. The lateral incisors of root resorption in 4 patients were extracted. The premolars in 19 patients were removed, and 10 patients without extractions. Then the impacted canines were moved into dental arch. There was no aggravated root resorption during the treatment process. Conclusion When the maxillary canine with labial medial inclination is impacted, it is moved distantly and uprightly by elastic line connected to the buccal hook of the maxillary first molar band, and then drawn to the dental arch. The process is smoothly and the neighbor teeth are protected.