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Paediatric obstructive sleep apnoea (OSA) is a highly prevalent sleep disorder resulting in chronic intermittent hypoxia (CIH) that has been linked to metabolism and endocrine impairment. Protein acetylation, which is a frequently occurring posttranslational modification, plays pivotal roles in the regulation of hypothalamic processes. However, the effects of CIH-induced global protein acetylation on hypothalamic function and endocrine metabolism remain poorly understood. To bridge this knowledge gap, we conducted a study utilizing liquid chromatography-mass spectrometry to analyse the lysine acetylome and proteome of the hypothalamus in healthy infantile mice exposed to 3 weeks of intermittent hypoxia (as a CIH model) compared to normoxic mice (as controls). Our analysis identified and quantified 2699 Kac sites in 2453 proteins. These acetylated proteins exhibited disruptions primarily in endocrine metabolism, the citrate cycle (TCA cycle), synapse function, and circadian entrainment. Additionally, we observed significant down-regulation of proteins that are known to be involved in endocrine hormone secretion. This study aimed to elucidate the molecular mechanisms underlying CIH-induced alterations in protein acetylation within the hypothalamus. By providing valuable insights into the pathophysiological processes associated with CIH and their impacts on hypothalamic function, our findings contribute to a deeper understanding of the consequences stemming from CIH-induced changes in protein acetylation within the hypothalamus as well as its potential role in endocrine impairment.
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BACKGROUND: Obstructive sleep apnoea (OSA) is a sleep-disordered breathing characterized by intermittent hypoxia (IH) that may cause cognitive dysfunction. However, the impact of IH on molecular processes involved in cognitive function remains unclear. METHODS: C57BL / 6 J mice were exposed to either normoxia (control) or IH for 6 weeks. DNA hydroxymethylation was quantified by hydroxymethylated DNA immunoprecipitation (hMeDIP) sequencing. ten-eleven translocation 1 (Tet1) was knocked down by lentivirus. Specifically, cognitive function was assessed by behavioral experiments, pathological features were assessed by HE staining, the hippocampal DNA hydroxymethylation was examined by DNA dot blot and immunohistochemical staining, while the Wnt signaling pathway and its downstream effects were studied using qRT-PCR, immunofluorescence staining, and Luminex liquid suspension chip analysis. RESULTS: IH mice showed pathological changes and cognitive dysfunction in the hippocampus. Compared with the control group, IH mice exhibited global DNA hydroxylmethylation in the hippocampus, and the expression of three hydroxylmethylases increased significantly. The Wnt signaling pathway was activated, and the mRNA and 5hmC levels of Wnt3a, Ccnd2, and Prickle2 were significantly up-regulated. Further caused downstream neurogenesis abnormalities and neuroinflammatory activation, manifested as increased expression of IBA1 (a marker of microglia), GFAP (a marker of astrocytes), and DCX (a marker of immature neurons), as well as a range of inflammatory cytokines (e.g. TNFa, IL3, IL9, and IL17A). After Tet1 knocked down, the above indicators return to normal. CONCLUSION: Activation of Wnt signaling pathway by hippocampal Tet1 is associated with cognitive dysfunction induced by IH.
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Disfunción Cognitiva , Hipocampo , Ratones Endogámicos C57BL , Proteínas Proto-Oncogénicas , Apnea Obstructiva del Sueño , Vía de Señalización Wnt , Animales , Hipocampo/metabolismo , Hipocampo/patología , Ratones , Proteínas Proto-Oncogénicas/metabolismo , Proteínas Proto-Oncogénicas/genética , Vía de Señalización Wnt/fisiología , Disfunción Cognitiva/metabolismo , Disfunción Cognitiva/patología , Disfunción Cognitiva/etiología , Apnea Obstructiva del Sueño/metabolismo , Apnea Obstructiva del Sueño/complicaciones , Apnea Obstructiva del Sueño/patología , Masculino , Enfermedades Neuroinflamatorias/metabolismo , Enfermedades Neuroinflamatorias/patología , 5-Metilcitosina/análogos & derivados , 5-Metilcitosina/metabolismo , Metilación de ADN , Proteínas de Unión al ADNRESUMEN
BACKGROUND: Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants. METHODS: A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, ß stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson's correlation, multiple linear regression, and analyses of covariance. RESULTS: All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The ß stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 µm/year in women and 5.8 µm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. CONCLUSIONS: The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.
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Grosor Intima-Media Carotídeo , Análisis de la Onda del Pulso , Rigidez Vascular , Humanos , Adulto , Persona de Mediana Edad , Masculino , Femenino , Anciano , Adulto Joven , Rigidez Vascular/fisiología , Adolescente , Valores de Referencia , China , Ultrasonografía/métodos , Pueblo Asiatico , Arterias Carótidas/diagnóstico por imagen , Pueblos del Este de AsiaRESUMEN
Background: Allergic rhinitis (AR) is a complex disease in which gene-environment interactions contribute to its pathogenesis. Epigenetic modifications, such as N6-methyladenosine (m6A) modification of mRNA, play important roles in regulating gene expression in multiple physiological and pathological processes. However, the function of m6A modification in AR and the inflammatory response is poorly understood. Methods: We used the ovalbumin (OVA) and aluminum hydroxide to induce an AR mouse model. Nasal symptoms, histopathology, and serum cytokines were examined. We performed combined m6A and RNA sequencing to analyze changes in m6A modification profiles. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and methylated RNA immunoprecipitation sequencing qPCR (MeRIP-qPCR) were used to verify differential methylation of mRNAs and the m6A methylation level. Knockdown or inhibition of Alkbh5 in nasal mucosa of mice was mediated by lentiviral infection or IOX1 treatment. Results: We showed that m6A was enriched in a group of genes involved in MAPK signaling pathway. Moreover, we identified a MAPK pathway involving Map3k8, Erk2, and Nfκb1 that may play a role in the disrupted inflammatory response associated with nasal inflammation. The m6A eraser, Alkbh5, was highly expressed in the nasal mucosa of AR model mice. Furthermore, knockdown of Alkbh5 expression by lentiviral infection resulted in high MAPK pathway activity and a significant nasal mucosa inflammatory response. Our findings indicate that ALKBH5-mediated m6A dysregulation likely contributes to a nasal inflammatory response via the MAPK pathway. Conclusion: Together, our data show that m6A dysregulation mediated by ALKBH5, is likely to contribute to inflammation of the nasal mucosa via the MAPK signaling pathway, suggesting that ALKBH5 is a potential biomarker for AR treatment.
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Adenosina , Desmetilasa de ARN, Homólogo 5 de AlkB , Modelos Animales de Enfermedad , Sistema de Señalización de MAP Quinasas , Mucosa Nasal , ARN Mensajero , Rinitis Alérgica , Animales , Mucosa Nasal/inmunología , Mucosa Nasal/metabolismo , Mucosa Nasal/patología , Rinitis Alérgica/inmunología , Rinitis Alérgica/metabolismo , Rinitis Alérgica/genética , Ratones , Adenosina/análogos & derivados , Adenosina/metabolismo , Metilación , ARN Mensajero/genética , ARN Mensajero/metabolismo , Desmetilasa de ARN, Homólogo 5 de AlkB/metabolismo , Desmetilasa de ARN, Homólogo 5 de AlkB/genética , Femenino , Ratones Endogámicos BALB C , Inflamación/genética , Inflamación/inmunología , Citocinas/metabolismoRESUMEN
Objective: To evaluate the safety and feasibility of tonsillectomy and/or adenoidectomy (T&A) in pediatric patients with prolonged activated partial thromboplastin time (APTT) and coagulation factor deficiency. Methods: A prospective study was admitted to the children undergoing T&A at our institution between October 2019 and January 2020, specifically focusing on preoperative coagulation function. Within this group, we identified 5 patients exhibiting prolonged APTT and coagulation factor deficiencies, constituting the experimental group, and 10 patients matched by gender and age with normal blood coagulation function were selected as the control group. Comparative analyses between the two groups were conducted, focusing on surgical duration, intraoperative bleeding volume, duration of hospital stay, and postoperative complications such as active bleeding across the groups. At the six-month postoperative mark, a reassessment of coagulation functions and factor assays was conducted within the experimental group. Results: No statistically significant differences were discovered in terms of surgical duration or bleeding volume when comparing the experimental subgroups with their respective control counterparts. Furthermore, there were no incidences of postoperative active bleeding observed in any of the groups. Notably, postoperative APTT values (32.7 ± 1.7s) exhibited a significant disparity compared to preoperative levels (43.7 ± 1.8s, p < 0.01). Coagulation factors demonstrated normalization, evidenced by a significant difference in postoperative Factor XII levels (40.2 ± 5.4%) compared to preoperative levels (63.1 ± 5.9%, p < 0.01). Conclusion: Prolonged APTT with FXII factor deficiency does not show a significant bleeding tendency and is not a contraindication for T&A surgery. Post T&A surgery, children with abnormal coagulation function and deficient clotting factors show significant improvement compared to pre-surgery. It is important to consider that chronic inflammation in adenoids and tonsils may contribute to the prolongation of APTT and the manifestation of Factor XII deficiency.
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Nowadays, it is becoming increasingly urgent to lower the escalating carbon dioxide (CO2) to reduce greenhouse effect. Fortunately, it is an ideal strategy by using the inexhaustible solar energy as the driving force to manipulate the cycloaddition reaction, the atomic efficiency of which is 100 %. This work represents the first attempt on utilization of rare-earth metal Tb with atomic dispersion, and the structure of Tb coordinated with 4 N-atoms and 2B-atoms was constructed on interconnected carbon hollow spheres. The introduction of electron-deficient B reduces the electron density of Tb, thereby boosting Lewis acidity and promoting the occurrence of ring-opening reaction. The mechanism exploration enunciates that TbN4B2/C is a photothermal synergistic catalyst, the combined action of photogenerated electrons and strong Lewis acidic site of Tb reduces the free energy of the rate-determining step, and then improving the yield of cyclic carbonate up to 739 mmol g-1h-1.
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PURPOSE: Chronic rhinosinusitis (CRS) is a common disease that affects patients' quality of life (QoL). We aim to explore which symptoms bothered the patient most. METHODS: This is a cross-sectional study of CRS patients 2 years after endoscopic sinus surgery (ESS). The main observation indicators were SNOT-22 and visual analog scale (VAS) scores. The patients were grouped according to clinical control standard of EPOS 2020. Patients' symptom scores and postoperative medication were used for analysis. RESULTS: A total of 276 patients were included, among them, uncontrolled patients accounted for 23.9%, sense of taste/smell, fatigue, lacking of a good night's sleep, reduced concentration and reduced productivity were the most serious symptoms that troubled them. VAS and SNOT-22 scores were significantly different among all groups (P = 0.000), and had clinical significance for the diagnosis of clinical uncontrolled patients (both P < 0.0001). Furthermore, the duration of corticosteroids use and nasal saline irrigation in uncontrolled patients was significantly longer than that in other patients (P < 0.05). CONCLUSION: There are significant differences in the QoL of CRS patients with different clinical control, sleep and psychological disorders are main symptoms that affect the QoL of CRS patients, and more targeted management of sleep/psychological issues may be needed especially for uncontrolled patients.
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Calidad de Vida , Rinitis , Sinusitis , Trastornos del Sueño-Vigilia , Humanos , Sinusitis/psicología , Sinusitis/cirugía , Sinusitis/complicaciones , Rinitis/psicología , Rinitis/cirugía , Rinitis/complicaciones , Masculino , Femenino , Estudios Transversales , Enfermedad Crónica , Persona de Mediana Edad , Adulto , Trastornos del Sueño-Vigilia/psicología , Trastornos del Sueño-Vigilia/etiología , Endoscopía , Trastornos Mentales/psicología , Trastornos Mentales/epidemiología , Anciano , RinosinusitisRESUMEN
Infantile hemangiomas are relatively common soft tissue tumors in infants and young children, with a prevalence of about 4.5% in full-term newborns. Subglottic Hemangioma ï¼SGHï¼ is a relatively rare type of hemangioma, and its special location often causes respiratory distress and potentially life-threatening conditions in infants. Therefore, it is necessary for clinicians to make an accurate diagnosis and formulate a detailed treatment plan based on the clinical manifestations, the auxiliary examinations, the medical history and the vital signs evaluation of patients.This review describes the pathophysiological mechanism of infantile hemangioma and provides a detailed discussion on commonly used treatment methods in detail.
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Hemangioma Capilar , Hemangioma , Neoplasias Laríngeas , Laringe , Neoplasias de los Tejidos Blandos , Preescolar , Humanos , Lactante , Recién Nacido , Hemangioma/terapia , Hemangioma/diagnóstico , Neoplasias Laríngeas/cirugía , Laringe/patologíaRESUMEN
Various studies have highlighted the important associations between obstructive sleep apnea (OSA) and gut microbiota and related metabolites. Nevertheless, the establishment of causal relationships between these associations remains to be determined. Multiple mendelian randomization (MR) analyses were performed to genetically predict the causative impact of 196 gut microbiota and 83 metabolites on OSA. Two-sample MR was used to assess the potential association, and causality was evaluated using inverse variance weighted (IVW), MR-Egger, and weighted median (WM) methods. Multivariable MR (MVMR) was employed to ascertain the causal independence between gut microbiota and the metabolites linked to OSA. Additionally, Cochran's Q test, the MR Egger intercept test and the MR Steiger test were used for the sensitivity analyses. The analysis of the 196 gut microbiota revealed that genus_Ruminococcaceae (UCG009) (PIVW = 0.010) and genus_Subdoligranulum (PIVW = 0.041) were associated with an increased risk of OSA onset. Conversely, Family_Ruminococcaceae (PIVW = 0.030), genus_Coprococcus2 (PWM = 0.025), genus_Eggerthella (PIVW = 0.011), and genus_Eubacterium (xylanophilum_group) (PIVW = 0.001) were negatively related to the risk of OSA. Among the 83 metabolites evaluated, 3-dehydrocarnitine, epiandrosterone sulfate, and leucine were determined to be potential independent risk factors associated with OSA. Moreover, the reverse MR analysis demonstrated a suggestive association between OSA exposure and six microbiota taxa. This study offers compelling evidence regarding the potential beneficial or detrimental causative impact of the gut microbiota and its associated metabolites on OSA risk, thereby providing new insights into the mechanisms of gut microbiome-mediated OSA development.
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Microbioma Gastrointestinal , Lactobacillales , Microbiota , Apnea Obstructiva del Sueño , Humanos , Microbioma Gastrointestinal/genética , Análisis de la Aleatorización Mendeliana , Causalidad , Clostridiales , Apnea Obstructiva del Sueño/genética , Estudio de Asociación del Genoma CompletoRESUMEN
Disorders of folic acid metabolism during pregnancy lead to fetal neural tube defects (NTDs). However, the mechanisms still require further investigation. Here, we aim to analyze the brain metabolic profiles of 30 NTDs and 30 healthy fetuses. Our results indicated that low-folate diet during early life played a causal role in cerebral metabolism, especially in lipometabolic disturbance, highlighting the importance of folate in modulating brain development and metabolism. Next, we established a mouse model of NTDs. Interestingly, the differential metabolites are mainly involved in glycerophospholipid metabolism and biosynthesis of unsaturated fatty acids both in human and mice fetal brain. Since intestinal microbes could critically regulate neurofunction via the intestinal-brain axis, we further found the abundances of Firmicutes and Bacteroidetes in the gut of pregnant mice were correlated with the abundances of lipid metabolism related metabolites in the fetal brain. This finding probably reflects the intergenerational microbial-metabolism biomarkers of NTDs.
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Purpose: Olfactory dysfunction (OD) is a debilitating symptom frequently reported by patients with chronic rhinosinusitis (CRS) and it is associated with a dysregulated sinonasal inflammation. However, little information is available about the effect of the inflammation-related nasal microbiota and related metabolites on the olfactory function in these patients. Therefore, the current study aimed to investigate the nasal microbiota-metabolites-immune interactions and their role in the pathogenesis of OD in CRS patients. Methods: 23 and 19 CRS patients with and without OD, respectively, were enrolled in the present study. The "Sniffin' Sticks" was used to measure the olfactory function, while the metagenomic shotgun sequencing and the untargeted metabolite profiling were performed to assess the differences in terms of the nasal microbiome and metabolome between the two groups. The levels of nasal mucus inflammatory mediators were investigated by a multiplex flow Cytometric Bead Array (CBA). Results: A decreased diversity in the nasal microbiome from the OD group compared to the NOD group was evidenced. The metagenomic analysis revealed a significant enrichment of Acinetobacter johnsonii in the OD group, while Mycoplasma arginini, Aeromonas dhakensis, and Salmonella enterica were significantly less represented (LDA value > 3, p < 0.05). The nasal metabolome profiles were significantly different between the OD and NOD groups (P < 0.05). The purine metabolism was the most significantly enriched metabolic subpathway in OD patients compared with NOD patients (P < 0.001). The expressions of IL-5, IL-8, MIP-1α, MCP-1, and TNF were statistically and significantly increased in the OD group (P < 0.05). All these data, including the dysregulation of the nasal microbiota, differential metabolites, and elevated inflammatory mediators in OD patients demonstrated a clear interaction relationship. Conclusion: The disturbed nasal microbiota-metabolite-immune interaction networks may be implicated in the pathogenesis of OD in CRS patients and the underlying pathophysiological mechanisms need to be further investigated in future studies.
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Microbiota , Trastornos del Olfato , Rinitis , Sinusitis , Humanos , Rinitis/diagnóstico , Trastornos del Olfato/diagnóstico , Trastornos del Olfato/etiología , Olfato , Sinusitis/diagnóstico , Enfermedad Crónica , Inflamación/complicacionesRESUMEN
Developmental abnormalities and hippocampal aging leads to alteration in cognition. In the brain, N6-methyladenosine (m6A) is a common and reversible mRNA alteration that is essential for both neurodevelopment and neurodegeneration. However, its function in the postnatal hippocampus and the specific mechanisms regulating hippocampus-related neurodegeneration still awaits elucidate. We identified dynamic m6A modifications in postnatal hippocampus at different stages (at 10 days postnatally, and at 11 and 64 weeks of age). m6A shows a definite cell-specific methylation profile and m6A modification displays temporal dynamic during neurodevelopment and aging. Differentially methylated transcripts in the aged (64-week-old) hippocampus were enriched in microglia. The PD-1/PD-L1 pathways was identified that may participate in the cognitive dysfunction associated with an aged hippocampus. Furthermore, Mettl3 was spatiotemporally expressed in the postnatal hippocampus, which was highly expressed at the age of 11 weeks compared with the other two timepoints. Ectopic expression of METTL3 in mice hippocampus mediated by lentiviral infection resulted in high expression of genes related to PD-1/PD-L1 pathway and significant spatial cognitive deficit. Together, our data show that m6A dysregulation, which is mediated by METTL3, most likely contributes to cognitive deficits linked to the hippocampus via the PD-1/PD-L1 pathway.
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Background: Laryngeal carcinoma is one of the most common types of head and neck tumors. The mortality rate in patients with laryngeal cancer has not declined in recent years. Previous studies have shown that laryngeal cancer mortality is related to the extent of laryngeal cancer, the proportion of lymph node metastases, treatment modalities, and postoperative lifestyle habits. Thus, early identifying patients at high risk of laryngeal cancer-specific death is of great clinical importance. However, in the presence of competing risk, the existing survival models based on Cox proportional hazards model may be biased in estimating tumor-specific mortality. In this study, we developed and validated a nomogram based on competitive risk analysis for patients with laryngeal cancer. Methods: We used SEER*Stat (Version 4.6.1) software to identify patients in the Surveillance, Epidemiology, and End Results (SEER) database who were diagnosed with laryngeal cancer between 2000 and 2019 as study subjects. The collected data included demographic data, the primary site of laryngeal cancer, the histological type of tumor, tumor size, and other variables. After excluding cases with missing information, the entire cohort was randomly split into a training cohort and a validation cohort at a 7:3 ratio. The training cohort was used in building the model while the validation cohort was used to validate the model. Univariate and multivariate Fine&Gray regression analyses were used to screen statistically significant variables, and the model performance was measured by establishing a consistency index, receiver operating characteristic curve (ROC), and calibration curves. Results: After excluding cases with missing information, 3,805 patients (2,264 in the training cohort and 1,141 in the validation cohort) were included in the study and followed for a median of 16 months. A total of 411 died of laryngeal cancer, and 2,104 patients died from other causes. Among 3,805 patients, the vast majority was male (80.9%), and Caucasian (77.2%), and aged 60-80 years old (58.4%). Conclusions: Advanced age and keratinized SCC are risk factors for laryngeal cancer-specific death. These high-risk patients should be given more attention and closer monitoring in clinical practice.
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PURPOSE: Obstructive sleep apnea (OSA) is a serious type of obstructive sleep-disordered breathing (SDB) that can cause a series of adverse effects on children's cardiovascular, growth, cognition, etc. The gold standard for diagnosis is polysomnography (PGS), which is used to assess the prevalence of OSA by obtaining the apnea-hypopnea index (AHI), but this diagnosis method is expensive and needs to be performed in a specialized laboratory, making it difficult to be of benefit to children with suspected OSA on a large scale. Our goal was to use a machine learning method to identify children with OSA of varying severity using data on children's nighttime heart rate and blood oxygen data. METHODS: This study included 3139 children who received diagnostic PSG with suspected OSA. Age, sex, BMI, 3 % oxygen depletion index (ODI), average nighttime heart rate and fastest heart rate were used as predictive features. Data sets were established with AHI ≥ 1, AHI ≥ 5, and AHI ≥ 10 as the diagnostic criteria for mild, moderate and severe OSA, and the samples of each data set were randomly divided into a training set and a test set at a ratio of 8:2. An OSA diagnostic model was established based on the XGBoost algorithm, and the ability of the machine learning model to diagnose OSA children with different severities was evaluated through different classification ability evaluation indicators. As a comparison, traditional classifier Logistic Regression was used to perform the same diagnostic task. The SHAP algorithm was used to evaluate the role of these features in the classification task. RESULTS: We established a diagnostic model of OSA in children based on the XGBoost algorithm. On the test set, the AUCs of the model for diagnosing mild, moderate, and severe OSA were 0.95, 0.88, and 0.88, respectively, and the classification accuracy was 90.45 %, 85.67 %, and 89.81 %, respectively, perform better than Logistic Regression classifiers. ODI is the most important feature in all classification tasks, and a higher fastest heart rate and ODI make the model tend to classify samples as positive. A high BMI value caused the model to tend to classify samples as positive in the mild and moderate classification tasks and as negative in the classification task with severe OSA. CONCLUSION: Using heart rate and blood oxygen data as the main features, a machine learning diagnostic model based on the XGBoost algorithm can accurately identify children with OSA at different severities. This diagnostic modality reduces the number of signals and the complexity of the diagnostic process compared to PSG, which could benefit children with suspected OSA who do not have the opportunity to receive a diagnostic PSG and provide a diagnostic priority reference for children awaiting a diagnostic PSG.
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Oxígeno , Apnea Obstructiva del Sueño , Niño , Humanos , Algoritmos , Frecuencia Cardíaca , Polisomnografía/métodosRESUMEN
BACKGROUND: It is unclear about the cardiovascular and metabolic diseases (CMD) among Chinese patients with different clinical subtypes of obstructive sleep apnea (OSA). HYPOTHESIS: The prevalence of CMD varies among OSA patients of different clinical subtypes. METHODS: A total of 1483 Chinese patients with OSA were assessed to evaluate the existence of clinical subtypes of OSA using latent class analysis. We compared the differences in demographic characteristics and prevalence of CMD using ANOVA and χ2 tests. Associations between clinical subtypes and disease prevalence were assessed using adjusted logistic regression. RESULTS: We identified prevalent CMD in Chinese patients with the four subtypes of OSA: excessively sleepy (ES), moderately sleepy with disturbed sleep (ModSwDS), moderately sleepy (ModS), and minimally symptomatic (MinS). The ES subtype had a higher body mass index, average Epworth Sleepiness Scale score, Apnea-hypopnea index, and oxyhemoglobin saturation below 90% compared with the other subtypes (p < .05). The MinS subtype had the lowest mean ESS score (p < .05). We found a significant difference in the prevalence of CMD among the four subtypes, with the highest proportion of cases of CMD in the ES subtype. In adjusted models, significant associations with CMD were also found. ES, ModSwDS, ModS, and MinS subtypes are very high-risk, high-risk, medium-risk, and low-risk in prevalent CMD. CONCLUSIONS: This study identified four clinical subtypes of OSA in Chinese patients. Each clinical subtype corresponds with a different level of prevalence of CMD; this finding is helpful for the more precise treatment of patients with different clinical manifestations.
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Enfermedades Cardiovasculares , Enfermedades Metabólicas , Apnea Obstructiva del Sueño , Humanos , Prevalencia , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/complicaciones , Apnea Obstructiva del Sueño/diagnóstico , Apnea Obstructiva del Sueño/epidemiología , Apnea Obstructiva del Sueño/complicaciones , Enfermedades Metabólicas/complicacionesRESUMEN
Objective:To analyze the etiology and clinical features of patients with olfactory disorders ï¼ODï¼ , and to explore the importance of gustatory testing in patients with OD. Methods:Clinical data of 335 consecutive patients with OD who seek medical consultation in the smell and taste center from the year 2015 to 2021 was retrospectively analyzed. The clinical characteristics of patients with OD were analyzed thorough a structured interview of medical history, otolaryngologic examinations, olfactory testsï¼Sniffin' Sticks testï¼ and gustatory function testï¼whole-mouth taste testï¼. SPSS 17.0 software was used to analyze the clinical characteristics of patients with OD and related factors which have effect on gustatory function. Results:Among the patientsï¼ 36.4% of them caused by head trauma, 22.1% for upper respiratory tract infectionï¼URTIï¼, 15.5% for rhinosinusitis diseasesï¼RSDï¼, 11.9% for idiopathic, 9.6% for congenital anosmia, and 4.5% for other causes, respectively. The features were different in patients with different kinds of OD: most patients with head trauma were anosmicï¼χ²=27.958, P<0.001ï¼, and no difference was found in gender and ageï¼P>0.05 for bothï¼; most patients with URTI were anosmicï¼χ²=21.568, P<0.001ï¼, and female patients were more than maleï¼χ²=5.898, P<0.05ï¼, elder patients were more than youngerï¼χ²=12.963, P<0.001ï¼; most patients with RSD were anosmicï¼χ²=12.106, P<0.05ï¼, and male patients were more than femaleï¼χ²=4.655, P<0.05ï¼; elder patients were more than younger for idiopathic ODï¼χ²=5.284, P<0.05ï¼, but no sex difference was foundï¼P>0.05ï¼; patients with congenital anosmia were all lost their smell since they were born, and no sex difference was found in the diseaseï¼P>0.05ï¼. Fifty-seven of 146ï¼39%ï¼ patients whose gustation was assessed had gustatory dysfunction. Gustatory function was significantly associated with the causes of ODï¼r=0.368, P<0.05ï¼, but not related to olfactory function, age and sexï¼P>0.05 for allï¼. Conclusion:The leading causes of olfactory dysfunction were head trauma, URTI, RSD, and idiopathic causes. Each of OD had its own distinct clinical features. Gustatory dysfunction were common in patients with OD, and gustatory function was related to the causes of OD. High priority should be given to gustatory function evaluation for the patients with OD.
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Traumatismos Craneocerebrales , Trastornos del Olfato , Adulto , Anciano , Traumatismos Craneocerebrales/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Olfato/congénito , Trastornos del Olfato/etiología , Estudios Retrospectivos , Trastornos del Gusto/complicacionesRESUMEN
Background: Olfaction is one of the five basic senses of human beings. As such, olfactory dysfunction seriously affects patients' quality of life and can even endanger them. In recent years, olfactory dysfunction has attracted greater research interest, and numerous studies have been published on olfactory dysfunction. However, there are few studies on olfactory dysfunction through bibliometric analysis. This study aims to describe the current situation and identify the foci and potential new research directions of olfactory dysfunction using a bibliometric approach. Methods: Articles related to olfactory dysfunction published from 2002 to 2021 were located in the Web of Science Core Collection of Clarivate Analytics (London, UK). Bibliometric analyses were conducted with the CiteSpace (Chaomei Chen, Drexel University, Philadelphia, PA, USA) and VOSviewer (Center for Science and Technology Studies, Leiden University, Leiden, Netherlands) software programs. Results: The number of articles published each year showed an upward trend, especially in 2020, where a sharp increase had occurred due to the coronavirus disease 2019 (COVID-19) pandemic. The United States was the country with the most publications and the strongest international cooperation. In terms of institutions, the greatest number of publications from a single institution came from Dresden University of Technology. Thomas Hummel was the author who had contributed the most articles. An analysis of co-citation networks and burst keywords in the field revealed a shift from "gonadotropin-releasing hormone" and "apoptosis" earlier on to "olfactory training," "COVID-19," and "Parkinson's disease" more recently. "Outcome," "COVID-19," "infection," and "pathogenesis" are topics of the research frontier and hotspots. Conclusion: More attention has been paid to olfactory dysfunction as the understanding of it has improved in the past 20 years. This study provides researchers with an objective, systematic, and comprehensive analysis of the literature on olfactory dysfunction. The current frontier areas and hotspots in the field focus on the pathological mechanisms of olfactory dysfunction after infection with COVID-19 and its different prognoses. The pathophysiological mechanism of olfactory dysfunction in neurodegenerative diseases and COVID-19 will be a primary future research direction.
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BACKGROUND: Early detection of left ventricular (LV) subclinical dysfunction is clinically relevant before developing irreversible impairment in obstructive sleep apnea (OSA) patients. Mitral annulus plane systolic excursion (MAPSE) is a fast tool for OSA due to high prevalent obesity; another quick but more comprehensive tool is LV global longitudinal stain (GLS) based on automated function imaging (AFI). We therefore aimed to compare the feasibility and reproducibility of AFI to MAPSE in OSA patients, as a good model in whom obesity is common. METHODS: A comprehensive echocardiographic examination was done in 186 consecutive patients having polysomnography for suspected OSA. MAPSE was measured by using M-mode to calculate excursion of mitral annulus. GLS was derived by offline analysis of three long-axis views that semi-automatically detects LV endocardial boundary, which is adjusted manually as necessary with AFI measurement. Variability of AFI and MAPSE were compared among the different subgroups. RESULTS: Despite a relatively high obesity rate (42.9%), the feasibility of AFI was 94% (175/186) and that of 100% in MAPSE. AFI showed excellent correlation (r = .882) superior to MAPSE (r = .819) between the Expert and Beginner. Intra- and inter- observer variability of AFI and MAPSE in Bland-Altman analysis were 5.5% and 6.5%; 6.2% and 8.8%, respectively. In repeated measurements, AFI showed higher intra-class correlation (ICC = .95) than MAPSE (ICC = .87) (p < 0.05). Furthermore, analysis showed that AFI was feasible even in more obese patients (BMI≥28 kg/m2 ). CONCLUSIONS: Even in obese patients with OSA, AFI-GLS is feasible and more reliable for less expert operators than MAPSE in detecting LV longitudinal dysfunction.
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Apnea Obstructiva del Sueño , Disfunción Ventricular Izquierda , Humanos , Reproducibilidad de los Resultados , Apnea Obstructiva del Sueño/diagnóstico , Apnea Obstructiva del Sueño/diagnóstico por imagen , Sístole , Disfunción Ventricular Izquierda/complicaciones , Disfunción Ventricular Izquierda/diagnóstico por imagen , Función Ventricular IzquierdaRESUMEN
PURPOSE: Obstructive sleep apnea (OSA) increases the risk for olfactory dysfunction. However, the relationship between olfactory function and cognition in OSA patients is unclear. The present study aimed to investigate the relationship between cognition and olfactory dysfunction (OD) in patients with OSA. METHOD: This was a cross-sectional study in which 74 patients with OSA and 22 controls were recruited. All subjects completed polysomnography, Sniffin' Sticks, and -neurocognitive assessments. According to results of Sniffin' Sticks, OSA patients were divided into two groups: OSA with OD (53 cases) and OSA without OD (21 cases). Neurocognitive function was assessed by Montreal Cognitive Assessment (MoCA), Memory and Executive Screening (MES), and Shape Trail Test (STT). Cognition was compared between OSA with and without OD. Correlation between olfactory parameters and respiratory sleep parameters and neurocognitive assessments was analyzed. RESULTS: Compared with OSA without OD, OSA with OD showed significantly decreased neurocognitive scores of MoCA (29-27 vs 27-23, p < 0.01), MES-5R (45-40.1 vs 43-33.5, p < 0.01) and increased consuming time of STT-B (91.66 vs 121.63, p < 0.01). A positive correlation was found between the scores of MoCA and MES-5R and all olfactory parameters. In addition, a negative correlation was present between the time consumed for STT-B and odor thresholds (r = - 0.344, p < 0.01), odor identification (r = - 0.335, p < 0.01), and threshold-discrimination-identification scores (r = - 0.448, p < 0.01). CONCLUSION: Olfactory function is associated cognitive function in patients with OSA and may provide a new direction for early treatment interventions in OSA patients at risk for cognitive impairment.
Asunto(s)
Disfunción Cognitiva , Trastornos del Olfato , Apnea Obstructiva del Sueño , Disfunción Cognitiva/complicaciones , Disfunción Cognitiva/diagnóstico , Estudios Transversales , Humanos , Trastornos del Olfato/complicaciones , Trastornos del Olfato/etiología , PolisomnografíaRESUMEN
BACKGROUND: Difficult-to-treat rhinosinusitis (DTRS) seriously affects the quality of work and life of patients, and the cause is still unclear. We aimed to explore the association between the glucocorticoid receptor (NR3C1) gene polymorphisms and DTRS. METHODS: A nested case-control study was conducted. The exons of NR3C1 gene were sequenced by an ABI 9700 DNA analyzer in 30 DTRS patients and 70 matched chronic rhinosinusitis (CRS) patient with good outcome (non-DTRS). The genotypic and allele frequencies were calculated and linkage disequilibrium was analyzed. RESULTS: The three SNPs showed a significant difference between the DTRS and non-DTRS groups. In allelic model analysis, we found that the allele "C" of rs6196, the allele "A" of rs258751, and the allele "T" of rs6194 were associated with increased the risk of DTRS (all p < 0.05). In addition, the haplotype CAT of the 3 SNPs was detected to be significantly associated with DTRS risk (p = 0.001), while the haplotype TGC was associated with the decreased risk of DTRS (p = 0.008). CONCLUSION: NR3C1 gene polymorphisms are significantly associated with the DTRS.