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*

The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine. Despite their reliability, traditional laboratories often lag in terms of rapid diagnosis. Point-of-care testing (POCT) has emerged as a promising alternative, which is awaiting rigorous validation. We assessed 226 samples from patients at the First Affiliated Hospital of Guangzhou Medical University using a Beckman Coulter AU5821 and a PUSHKANG POCT Biochemistry Analyzer MS100. Furthermore, 350 samples were evaluated with a Stago coagulation analyzer STAR MAX and a PUSHKANG POCT Coagulation Analyzer MC100. Metrics included thirteen biochemical indexes, such as albumin, and five coagulation indices, such as prothrombin time. Comparisons were drawn against the PUSHKANG POCT analyzer. Bland-Altman plots (MS100: 0.8206‒0.9995; MC100: 0.8318‒0.9911) evinced significant consistency between methodologies. Spearman correlation pinpointed a potent linear association between conventional devices and the PUSHKANG POCT analyzer, further underscored by a robust correlation coefficient (MS100: 0.713‒0.949; MC100: 0.593‒0.950). The PUSHKANG POCT was validated as a dependable tool for serum and whole blood biochemical and coagulation diagnostics. This emphasizes its prospective clinical efficacy, offering clinicians a swift diagnostic tool and heralding a new era of enhanced patient care outcomes.
Humans ; Point-of-Care Testing ; Critical Care ; Blood Coagulation Tests/methods* ; Male ; Blood Coagulation ; Female ; Middle Aged ; Reproducibility of Results ; Prothrombin Time ; Aged ; Adult ; Point-of-Care Systems

Objective To analyze the trends in the disease burden of pertussis in China from 1990 to 2021, and to provide a basis for the development of effective prevention and control strategies. Methods Using the 2021 Global Burden of Disease Study (GBD) database, the incidence, mortality, and disability-adjusted life years (DALYs), as well as the age-standardized rates of pertussis in China from 1990 to 2021 were analyzed. Descriptive statistical methods were employed to analyze the characteristics of the pertussis disease burden, and the Joinpoint regression model was used to analyze the trends in pertussis disease burden. Results From 1990 to 2021, the incidence, mortality, and DALYs of pertussis in China decreased from 1 503 800 cases, 10 951 deaths, and 954 900 person-years to 65 400 cases, 548 deaths, and 46 500 person-years, representing a decrease of 95.65%, 95.00%, and 95.13%, respectively. The corresponding age-standardized rates also decreased by 93.58%, 92.47%, and 92.53%, respectively. The Joinpoint regression model revealed a significant downward trend in the age-standardized incidence, mortality, and DALYs rates for pertussis (AAPCs were -8.32%, -9.65%, and -9.58%, respectively, P<0.001). The disease burden was slightly higher in females than in males, with the majority of cases occurring in children under 10 years old, particularly in infants under 1 year old, where the burden was the heaviest. As age increased, the disease burden decreased. Conclusion Between 1990 and 2021, the overall disease burden of pertussis in China showed a significant downward trend, with gender and age differences. Special attention should be given on the prevention and control of pertussis in children under 10 years old, especially in infants under 1 year old.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To observe the value of machine learning(ML)models based on brain functional network features combining clinical indicators for predicting postoperative outcomes of patients with drug-resistant mesial temporal lobe epilepsy(DR-mTLE).Methods Totally 84 patients with unilateral DR-mTLE who underwent surgery were retrospectively enrolled and classified into seizure free(SF)group(n=55)and non-seizure free(NSF)group(n=29)according to one-year postoperative follow-up.Clinical data were analyzed to screen independent predictors of postoperative outcomes.Based on brain preoperative resting-state functional MRI,brain functional networks were constructed using graph theory analysis,and 587 features were extracted.Five-fold cross validation was used to divide the data into training set and test set,then the optimal brain functional network features related to postoperative outcomes of DR-mTLE patients were selected.Combining with clinically relevant independent predictors,ML models were constructed using classifiers including Gaussian process(GP),logistic regression(LR),support vector machine(SVM)and quadratic discriminant analysis(QDA),respectively,and the prediction efficacy,calibration and clinical value of each ML model were evaluated.Results Both course of disease and lesion location were clinically relevant independent predictors of postoperative outcome of DR-mTLE patients(OR=0.928,5.710,P=0.010,0.016).Four optimal brain function network features were selected,including betweenness centrality of the third zone of cerebellar vermis,degree centrality of right globus pallidus,nodal efficiency of temporal left inferior temporal gyrus and nodal clustering coefficient of left inferior parietal lobule.The average area under the curve(AUC)of GP,LR,SVM and QDA models in test set was 0.868,0.864,0.875 and 0.870,respectively.Calibration curves and decision curve analysis indicated that each ML model had good calibration and high clinical net benefit.Conclusion ML models based on brain functional network features combining with clinical indicators could be used to effectively predict postoperative outcomes in DR-mTLE patients.

Objective: To investigate the effects of “Three Methods and Three Acupoints” (TMTP) Tuina therapy on spinal microcirculation in sciatic nerve injury (SNI). Methods: Thirty-six Sprague–Dawley rats were randomly assigned to four groups: normal, sham operation, model, and TMTP Tuina. Successful model induction was confirmed by observable hind limb lameness. After 20 sessions, hind limb grip strength and motor nerve conduction velocity (MNCV) were measured at baseline and following the 10th and 20th intervention. CD31 and α-SMA in the ventral horn of SNI model rats were detected using immunofluorescence. Motor neurons in the ventral horn were detected by Nissl staining. PTEN levels in the ventral horn were measured by ELISA, and PI3K, Akt, BDNF, VEGF, and HIF-1α expression was determined by RT-PCR. Spinal cord microcirculation was evaluated by western blotting analysis of the levels of Akt, p-Akt, BDNF, and VEGF. Results: Hind limb grip strength and MNCV significantly improved in the TMTP Tuina group compared to the model group (both P < .001). Morphology of ventral horn motor neurons in the TMTP Tuina group improved compared to the model group, with increased expressions of α-SMA (P = .002) and CD31 (P = .006). Western blot analysis indicated increased expression of VEGF (P = .005), p-Akt (P < .001), and BDNF (P = .008) in the ventral horn following Tuina treatment. RT-PCR analysis revealed increased expression of PI3K, Akt, BDNF, VEGF and HIF-1α (all P < .05). In contrast, expression of PTEN decreased compared to the model group (P < .001). Conclusion TMTP Tuina therapy may restore motor function in rats, enhance ventral horn motor neuron morphology, and promote angiogenesis and vascular smooth muscle proliferation. The mechanism may involve the activation of the PI3K/Akt signaling pathway.

BACKGROUND:Developmental dysplasia of hip causes groin pain in patients with prolonged activity or standing due to the presence of deformities of the acetabulum and femoral head in terms of structure,size and orientation,and if not effectively treated,patients' normal activities will be severely limited.OBJECTIVE:Finite element model of the hip joint of solid-liquid biphase fiber reinforced cartilage based on FEBio was established to explore the biomechanical properties of the cartilage for patients with developmental dysplasia of hip and the normal hip joint.METHODS:A patient with developmental dysplasia of hip and a normal volunteer were chosen to build their left hip models including left pelvis,left femur,and cartilage attached thereto. The solid-liquid biphase fiber reinforced cartilage of normal hip was verified to be effective. The cartilage equal contact stress,fluid pressure,solid effective stress,and fluid support rate differences between the developmental dysplasia of hip patients hip and the normal one in the case of one leg of static load (2130 N) were compared after establishing finite element models of developmental dysplasia of hip patients.RESULTS AND CONCLUSION:(1) Compared with the finite element results of the normal hip model,the cartilage contact position of developmental hip dysplasia patient hip showed obvious edge contact,the peak contact stress (3.86 Mpa) and peak fluid pressure (3.76 Mpa) were both higher than normal hip model. (2) After 1500 s (stable load-bearing capacity),peak contact stress and peak fluid pressure in both models decreased,but the cartilage contact position of developmental hip dysplasia patient hip moved from the edge of cartilage to the center,and fluid support rate decreased from 97.41％ to 91.08％. The fluid support rate in normal hip was decreased by 0.58％ from 95.24％ to 94.66％. (3) It is indicated that under the physiological load of standing on one leg,the cartilage of developmental dysplasia of hip patients showed obvious edge load,and the decrease of peak contact stress,fluid pressure,and fluid formation rate was greater than that of normal cartilage. Considering the solid-liquid biphasic fiber reinforcement characteristics of cartilage,it is of great clinical significance to evaluate the biomechanical properties of hip cartilage in developmental dysplasia of hip patients,to understand the pathophysiological mechanism of developmental dysplasia of hip,and make preoperative plan.

Objective:To investigate the role of inhibitor of differentiation 2(Id2)in inducing the generation of central memory T(Tcm)cells and enhancing the anti-tumor persistence of T cells.Methods:CD8+na?ve T cells were sorted with magnetic beads and then co-cultured with carcinoembryonic antigen(CEA)-loaded dendritic cells(DCs).These cells were induced into effector T(Teff)or Tcm cells by interleukin-2(IL-2)or IL-7/15/21/23,respectively.The mRNA and protein expression of Id2 and Id3 in T cells were detected using qPCR and WB,respectively.Id2 gene in T cells was knocked down using lentivirus,and the T cell memory phenotype was analyzed by flow cytometry.The expression of PI3K/AKT pathway-related proteins was examined by WB.The extracellular acidification rate(ECAR)and oxygen consumption rate(OCR)were assessed using a Seahorse extracellular flux analyzer.A zebrafish colorectal cancer HCT116 xenograft model was employed to analyze the anti-tumor differences between Teff and Tcm cells.The effect of Id2 gene knockdown in Tcm cells(Tcm-shId2)on the growth inhibition of secondary xenografts was also observed.Results:Tcm cells exhibited high expression of Id3 mRNA(P<0.05),whereas Teff cells showed high expression of Id2 mRNA(P<0.001).Tcm cells with Id2 knockdown(Tcm-shId2)were successfully constructed,showing significantly upregulated Id3 expression.Knockdown of Id2 promoted the formation of Tcm cell(P<0.05).Tcm-shId2 cells underwent metabolic reprogramming via the PI3K/AKT pathway,which effectively suppressed the growth of colorectal cancer xenografts in zebrafish and also produced significant inhibitory effects on secondary tumor growth(P<0.01).Conclusion:Id2 gene may regulate T cell metabolism through the PI3K/AKT signaling pathway,promoting the differentiation of CD8+T cells into Tcm cells and effectively inhibiting the growth of colorectal cancer xenografts.

Objective To investigate the correlation between serum levels of microRNA(miR)-489-3p and miR-214-3p in patients with Psoriasis and the severity of disease.Methods From March 2022 to January 2024,138 Psoriasis patients who visited Zhangjiakou First Hospital were regarded as the study subjects(disease group).According to the psoriasis area and severity index(PASI)score,the 138 Psoriasis patients were separated into mild group(n=46),moderate group(n=54)and severe group(n=38).112 healthy individuals who underwent physical examinations in Zhangjiakou First Hospital during the same period were included in the control group.Real-time fluorescence quantitative PCR(RT-qPCR)method was applied to determine the serum levels of miR-489-3p and miR-214-3p in the subjects.The serum levels of miR-489-3p and miR-214-3p were compared between the disease group and the control group,and among patients with different degrees of disease.Spearman correlation analysis was applied to explore the relationship between serum miR-489-3p,miR-214-3p levels and disease severity in Psoriasis patients.Logistic regression analysis was performed to analyze the related factors affecting the severity of Psoriasis.Receiver operating characteristic(ROC)curve was applied to investigate the diagnostic value of serum miR-489-3p and miR-214-3p levels for severe Psoriasis.Results The serum levels of miR-489-3p(0.81±0.23)and miR-214-3p(0.79±0.22)in the disease group were lower than those in the control group(1.05±0.28,1.02±0.25),and the differences were statistically significant(t=7.441,7.732,all P<0.05).Serum miR-489-3p in mild,moderate and severe Psoriasis groups(0.93±0.24,0.80±0.23,0.69±0.22),miR-214-3p levels(0.91±0.24,0.77±0.22,0.66±0.21)decreased gradually,and the differences were statistically significant(F=12.423,13.168,all P<0.05).Spearman's results showed that serum levels of miR-489-3p and miR-214-3p were negatively correlated with the severity of Psoriasis in patients(r=-0.490,-0.463,all P<0.05).Serum miR-489-3p and miR-214-3p were independent protective factors for the severity of Psoriasis patients(Wald χ2=5.751,8.753,all P<0.05).ROC curve results showed that the area under the curve(AUC)of serum miR-489-3p and miR-214-3p for diagnosing severe Psoriasis alone was 0.785 and 0.792,with sensitivity of 78.9%and 73.7%,specificity of 49.9%and 54.7%,respectively.The AUC of the combined diagnosis for severe Psoriasis was 0.931,the sensitivity and specificity were 71.7%,71.1%,respectively,and the combined diagnostic efficacy of the two was better than that of miR-489-3p and miR-214-3p alone,and the differences were statistically significant(Z=3.018,2.773,all P<0.05).Conclusion The serum levels of miR-489-3p and miR-214-3p in patients with Psoriasis are both reduced,and both are negatively correlated with the severity of the disease in Psoriasis patients.The combined determination of the two has high efficacy in the diagnosis of severe Psoriasis.