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*

OBJECTIVES: To assess the effectiveness of the comparison between pit and fissure sealants and fluoride varnishes, as well as various types of sealants, in preventing caries on the occlusal surface of children's first permanent molars (FPM). METHODS: Conduct a comprehensive search of literature published between January 1, 1988, and May 30, 2024, in the following databases: China National Knowledge Infrastructure, Web of Science, Cochrane Library, Embase, PubMed, China Science Periodical Database and China Biology Medicine database. Meta-analysis and subgroup analyses were performed on the literature that met the inclusion criteria. RESULTS: A total of 5 618 pieces of literature were retrieved, resulting in the inclusion of 14 in the study. Meta-analysis showed that there was no statistically significant difference in the efficacy between varies pit and fissure sealants compared to fluoride varnishes, and between varies types of sealants in preventing caries on the occlusal surface of children's first permanent molars within 24 months post-surgery (P>0.05). CONCLUSIONS Within 24 months, there was no significant difference in the effectiveness of using resin-based or glass iomomer pit and fissure sealants compared with fluoride varnishes in preventing occlusal caries in FPM in children; within 24 months, there was no significant difference in the effectiveness of using resin-based sealants compared with ART sealants in preventing occlusal caries in FPM in children. ART sealants are recommended over resin-based sealers for children who have no conditions for chair-side manipulation or who are poorly co-operative.
Humans ; Pit and Fissure Sealants/therapeutic use* ; Dental Caries/prevention & control* ; Molar ; Child ; Fluorides, Topical/therapeutic use* ; Dentition, Permanent

Objective:To develop a novel, flexible, dual-arm, master-slave digestive endoscopic minimally invasive surgical robot system named dual-arm robotic endoscopic assistant for minimally invasive surgery (DREAMS) and to evaluate its feasibility for endoscopic submucosal dissection (ESD) by using ex vivo porcine stomachs.Methods:A novel endoscopic robot (DREAMS) system was developed which was composed of a flexible two-channel endoscope, two flexible robotic manipulators, a master controller, a robotic arm, and a control system. A total of 10 artificial round-like lesions with diameters ranging from 15 to 25 mm were created (5 in gastric antrum and 5 in gastric body) by using fresh peeled stomach of healthy pigs as the model. Submucosal dissection was performed with the assistance of the DREAMS system by two operators. The main outcome was submucosal dissection speed, and the secondary outcomes included muscular injury rate, perforation rate, and grasping efficiency of the robot.Results:All 10 lesions were successfully dissected en bloc by using the DREAMS system. The diameter of the artificial lesions was 22.34±2.39 mm, dissection time was 15.00±8.90 min, submucosal dissection speed was 141.79±79.12 mm 2/min, and the number of tractions required by each ESD was 4.2 times. Muscular injury occurred in 4/10 cases of ESD. No perforation occurred. Conclusion:The initial animal experiment shows the DREAMS system is safe and effective.

Objective To investigate the difference of matrix stiffness in different regions of tibial plateau in osteoarthritis (OA) and its effects on morphology of the cartilage and mitochondria. Methods The tibial plateau cartilage specimens of OA were obtained for nanoindentation test, transmission electron microscopy and histological analysis. The stiffness of cartilage matrix in different regions of OA tibial plateau was detected by nano-indentation. The morphology of cartilage mitochondria in different regions was observed by transmission electron microscopy, and the changes of mitochondrial plane area, shape and ridge volume density were quantitatively analyzed. Cartilage injury in different regions of OA tibial plateau was observed by histological staining. Results The cartilage of OA tibial plateau showed regional heterogeneity, and the cartilage and mitochondria on medial side of varus knee OA were more severe, and the matrix stiffness was higher. The OA scores were positively correlated with matrix stiffness. There was also a significant correlation between OA scores and mitochondrial morphology: the higher OA scores, the larger and rounder mitochondrial plane area, and the lower cristae volume density. Conclusions The differences of tibial plateau revealed the correlation between cartilage matrix stiffness, OA scores and mitochondrial morphological parameters. The increased cartilage matrix stiffness may be the main cause of chondrocyte mitochondrial injury, and further aggravate the progression of OA.

With global warming and frequent heat waves, the incidence of heat-related-illness has gradually increased, and heatstroke is the most serious clinical syndrome, with high mortality and incidence of sequelae. Effective heatstroke warning aims to reduce the incidence and the harm of heatstroke by monitoring certain parameters and forecasting the possibility of suffering heat illness, however, there is no unified summary of the heatstroke early warning system at present. The occurrence of heatstroke involves two key aspects: climate environment and individual susceptibility, and individual susceptibility is manifested as the difference in heat tolerance ability. This article represents the current early warning system of heatstroke from climate environment, such as effective temperature, heat index, wet bulb globe temperature (WBGT) index, somatosensory temperature, etc., and individual susceptibility, for the reference of research and development in this field.

【Objective】 To eliminate the insoluble particles in the drug and the particles produced by breaking the glass during intravenous or intramuscular injection. 【Methods】 We established a type of liquid medicine filter for preventing insoluble particles in this study. The front end of the filter body was conical and the back end was a filtering one. The filter body consisted of a filter block and a floating plug arranged inside the filter block. A filter chamber was formed inside the filter block， and a ring-shaped filter membrane was set in the filter chamber. When the injector pumped liquid， the float plug moved to the top of the float plug channel of the filter block， and the liquid entered the filter cavity from the blind hole of the float plug. When the syringe discharged liquid， the float plug was far away from the top of the float plug channel of the filter block， and the liquid in the filter cavity entered the blind hole of the float plug through the annular filter membrane and the peripheral channel of the filter block. 【Results】 The filtration rates of 5‒6 μm particles in standard solution of 5 μm latex particles by nuclear pore membrane， polyethersulfone membrane and nylon membrane were 96.9%， 97.1% and 96.2%， respectively. The filtration rate of 3‒4 μm particles in the standard solution of 3 μm latex particles could reach 98.1%. 【Conclusion】 The filter can filter the particles， which precipitate in the drug， thus achieving the effect of filtration and ensuring the safety of patients.

Objective To observe the therapeutic effects and adverse effect of different lipid-lowering regimens in Atherosclerosis renal artery stenosis (ARAS) rat model and select the optimal treatment.Methods 90 Wister rats were randomly divided into sham operation group (group F) and operation group.The operation group was divided into normal feed group (group N) and high-fat feed group (group T).We established the rat model in operatino group by narrowing the renal artery with acupuncture needle and 8 weeks of high-fat feeding.According to the different lipid-lowing therapeutic schedules,the T group rats were randomly divided into five groups:the blank group (T0 group),the Xuezhikang group (T1 group),the rosuvastatin group (T2 group),the regular dose of rosuvastatin combined with Xuezhikang (T3 group),the low dose of rosuvastatin combined with Xuezhikang (T4 group).Mter 6 weeks of intervention,the serum lipids [total cholesterol (TC),triglyceride (TG),high density lipoprotein-cholesterol (HDL-C),low density lipoproteincholesterol (LDL-C)],liver function [alanine aminotransferase (ALT),aspartate aminotransferase (AST)],kidney function [blood urea nitrogen (BUN),serum creatinine (Scr)] and pathological changes of aorta and kidney were detected before and after treatment.Results (1) The blood pressure,BUN and Scr were significantly increased in N group and T group compared with F group (P ＜ 0.05).TC,TG,LDL-C were significantly increased (P ＜ 0.05) and HDL-C were significantly decreased (P ＜ 0.05) in T group compared with N,T group.According to the pathological section,the aorta in T group had visible atherosclerosis change,the renal tubules were atrophied and decreased.All above,the rat model of ARAS was successfully established.(2) After 6 weeks of drug intervention,compared with prior treatment,TC,TG,LDL-C,BUN and Scr were significant decrease (P ＜ 0.05),while HDL-C was significantly increased (P ＜ 0.05) in all treatment groups,and the most remarkable change was in T3,T4 group,T3 group was better than T4 group but with no significant difference between T3 and T4 group (P ＞ 0.05).We found that ALT and AST were significantly increased in T2 and T3 group (P ＜ 0.05) after treatment.Compared with T0 group,pathological lesions of aorta and kidney were reduced best in T3 and T4 group.Conclusions Low dose of rosuvastatin combined with Xuezhikang can achieve ideal lipid-lowing effects.At the same time,it has a protective effect on kidney,and has little damage to liver function.

OBJECTIVE: To investigate the effects of Kangfuxin solution combined with Chuangyangling and gelatin sponge on dry socket disease in patients with type 2 diabetes mellitus after the extraction of impacted teeth. METHODS: A total of 85 patients with impacted teeth and type 2 diabetes mellitus during Jan. 2016-Jan. 2017 were divided into group A (29 cases), B (25 cases), C (31 cases) according to random number table. All patients were treated with turbine drill method; in group A, Kangfuxin solution + Absorbable gelatin sponge was used to fill the wound site; in group B, Chuangyangling+compound preparation of Kangfuxin solution and gelatin sponge were used to fill the wound site; in group C, the wounds were filled with gauze but without any drugs. All patients received routine anti-infective treatment after surgery for 5-7 d. The time of impacted teeth extraction was observed in 3 groups; granulation tissue coverage integrity rate of tooth socket and the incidence of dry socket disease 7 d after surgery, the incidence of other postoperative complications, treatment cost, satisfaction scores were also comparod. RESULTS: There was no statistical significance in the time of impacted teeth extraction or treatment cost among 3 groups (P＞0. 05). Seven days after surgery, granulation tissue coverage integrity of tooth socket and satisfaction scores were in descending order: group B＞group A＞group C; the incidence of dry sockets were in ascending order: group B＜group A＜group C, with statistical significance (P＜0. 05). The incidence of other postoperative complications as bleeding, pain, swelling, limitation of mouth opening in group A and B were significantly lower than group C, with statistical significance (尸＜0. 05). There were no statistical significance between group A and B (P＞0. 05). CONCLUSIONS: Kangfuxin solution combined with Chuangyangling and gelatin sponge can effectively increase granulation tissue coverage integrity of tooth socket, and reduce the incidence of dry socket disease and other postoperative complications in patients with type 2 diabetes mellitus, but do not increase economic burden of patients and obtain high patient satisfaction.

Objective To examine the effects ofulinastatin (UTI) on cardiac dysfunction in mice with heat stroke and its possible mechanism.Methods 20 mice were divided into four groups randomly:room temperature plus normal saline (Sham+NS),room temperature plus UTI (Sham+UTI),heat stress plus normal saline (HS+NS),heat stress plus UTI (HS+UTI),5 each.105U/kg UTI was delivered by intraperitoneal injection before the onset of the heat stress.Room temperature groups were housed at room temperature (23.0 ± 0.5 ℃),while heat stress groups were kept in an incubator at 36.5 ± 0.5 ℃ and humidity of 65.0％ ± 2.0％.The rectal temperature (Tr) reaching 42℃ was taken as severe heat stroke,and the time in two heat stress groups was recorded.The mice were transferred to the room temperature (23.0 ± 0.5 ℃) for natural cooling after the heat stroke onset.6 hours after the treatment,cardiac output (CO) was ultrasonographically detected,the myocardium was separated for histopathological examination and the expression of total p38 and phosphorylated p38 (p-p38) was determined by Western blotting.Results The time to reach 42℃ in HS+UTI group was significantly prolonged (P=0.044).Compared with the Sham+NS group,the CO in HS+NS and HS+UTI group decreased significantly (P=0.017),and the score of myocardial inflammation (P＜0.001) and p-p38/p38 ratio (P＜0.001) increased.The CO was significantly higher in HS+UTI group than in HS+NS group (P=0.030),and the score of myocardial inflammation (P＜0.001) and p-p38/p38 ratio (P=0.001) were significantly lower.Conclusion Ulinastatin might improve the cardiac function in mice with heat stroke by decreasing the p-p38 and alleviating the inflammation response.

Objective To investigate the eftect of radiation dose of dual-source computed tomography (CT) dual energy single-phase enhanced scan in patients with esophageal cancer.Methods The prospective study was conducted.The clinicopathological data of 56 patients with esophageal cancer who were admitted to the Lishui Hospital of Zhejiang University between January 2015 and December 2016 were collected.All the patients were divided into the experimental group (undergoing dual-source CT dual energy single-phase enhanced scan) and control group (undergoing dual-phase CT enhanced scan) bv randomised block method.TNM classification of esophageal cancer (Seventh Edition) published by American Joint Committee on Cancer (AJCC) was used as a standard TNM staging.Two observers independently read films.All the patients underwent radical resection of esophageal cancer or palliative surgery,and then received adjuvant radiochemotherapy.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients up to March 2017.Observation indicators:(1) consistencies of T staging,N staging and M staging;(2) accuracies of T staging,N staging and M staging (pathological results as a gold standard);(3) radiation dose of CT scan;(4) treatment and follow-up situations.The Kappa test was used for evaluating the consistency,κ≥0.75 as a good consistency,0.40≤κ＜0.75 as a normal consistency and κ＜0.40 as a poor consistency.Comparisons of count data and ratio were done by the chi-square test.Comparisons of measurement data were analyzed by the t test.Results A total of 50 patients were enrolled in the study,including 25 in the experimental group and 25 in the control group.(1) Consistencies of T staging,N staging and M staging:all the 50 patients finished successfully CT scans.Two observers considered that consistencies of T staging,N staging and M staging in the 2 groups were normal (κ =0.452,0.618,0.729,P＜0.05).Consistencies of N staging and M staging were superior to T staging.(2) The pathological results were used as a gold standard.Accuracies of T staging,N staging and M staging in the experimental and control groups were 72％,76％ and 88％,84％ and 92％,88％,respectively,with no statistically significant difference between the 2 groups (x2 =0.10,0.37,0.50,P＞0.05).(3) Radiation dose of CT scan:volume CT dose index (CTDIvol),dose length production (DLP) and effective radiation dose (E) were (10.35±2.01) mGy,(400.63± 34.13) mGy · cm,(5.61 ± 0.47) mSv in the experimental group and (3.55 ± 0.60)mGy,(140.66± 10.89) mGy · cm,(1.98±0.17) mSv in the control group,respectively.There were statistically significant differences in CTDIvol and E between the 2 groups (t =16.23,36.30,P＜0.05).(4) Treatment and follow-up situations:of 50 patients,43 patients received treatments,including 32 undergoing radical resection (11 receiving postoperative adjuvant chemotherapy),6 undergoing palliative surgery,3 receiving single radiotherapy and 2 receiving single chemotherapy.Thirty-six of 43 patients were followed up for 3-18 months,with a median time of 6 months.During follow-up,1-year survival rate was 61.1％.Conclusion Dual-source CT dual energy single-phase enhanced scan in patients with esophageal cancer cannot reduce accuracy of TNM staging,but decreased effectively radiation dose.