BackgroundThe objective of the present study was to investigate whether the analysis of magnesium (Mg), high-sensitivity C-reactive protein (hsCRP), and ischemia-modified albumin (IMA) concentrations can be used as a non-invasive and convenient method for diagnosing obstructive sleep apnea syndrome (OSAS).Material/MethodsAfter polysomnography, venous blood was collected from 33 patients with OSAS and 30 control individuals. Serum levels of Mg, hsCRP, and IMA were investigated. The relationship between these factors and apnea–hypopnea index (AHI) was analyzed using the Pearson correlation coefficient. The role of the factors was determined using a receiver operating characteristic (ROC) curve and multivariate logistic regression analysis.ResultsThe levels of hsCRP and IMA were significantly higher in patients with OSAS than in control subjects, while the levels of Mg were lower (P<0.05 for all). A significant correlation was noted between serum IMA (r=0.614; P<0.001) and hsCRP (r=0.453; P<0.001) levels and the AHI. The ROC showed that serum Mg (AUC=0.74(0.62–0.85)), hsCRP (AUC=0.77(0.65–0.87)), and IMA (AUC=0.78(0.66–0.87)) levels could be used as markers to diagnose OSAS. Moreover, our new model, MIh, which is obtained by multivariate analysis, yielded an AUC value of 0.93 (0.83–0.98). Continuous positive airway pressure (CPAP) treatment reversed the changes in the serum levels of Mg, hsCRP, and IMA.ConclusionsPatients with OSAS show reduced serum Mg levels and elevated serum hsCRP and IMA levels. These observed alterations can be reversed by CPAP treatment. A novel model, named MIh, may be a promising tool for OSAS diagnosis.

This study aimed to identify clinical characteristics of cancer patients with incidental pulmonary embolism (IPE) and assess the variables associated with 30-day mortality in cancer patients with PE including symptomatic pulmonary embolism (SPE) and IPE. 6-Month mortality rate in cancer patients with SPE and IPE were also compared. We retrospectively analyzed electronic medical records of cancer patients with newly diagnosed PE between January 2016 and June 2021. We compared clinical and radiological characteristics in cancer patients with IPE and SPE and identified variables associated with the overall 30-day mortality on multivariate analysis. All patients were followed up for 6 months and survival analysis was performed by use of Kaplan–Meier. Five hundred and nine eligible cancer patients with pulmonary embolism were identified during the study period. IPE is associated with lower BMI, colorectal and pancreas cancers, stage III/IV of cancer, recent antiangiogenic therapy, central venous catheter (CVC) and chronic cardiac or respiratory disease compared to SPE. The factors associated with 30-day mortality included poor performance status, lung/pleura or upper gastrointestinal cancers, stage III/IV of cancer, previous VTE, oxygen saturation < 95%, lactic acid > 2 mmol/l and bilateral PE. The overall survival in patients with IPE at 6-month follow-up was similar to those diagnosed with SPE. The present study has allowed the identification of factors associated with 30-day mortality in cancer patients with IPE and SPE. We also found similar mortality rate in cancer patients with IPE compared with patients with SPE at 6-month follow-up.

Objectives. The aim of the paper is to explore the clinical efficacy and prognosis of the modified implantation of atrial septal defect (ASD) closure device to treat bronchopleural fistulas (BPFs). Methods. This paper has reviewed the results of 13 BPF patients implanted with a modified ASD closure device in Shaw Hospital Affiliated with the Medical College of Zhejiang University from October 2018 to November 2021. Anesthesia was selected based on the patient’s condition. Different sizes of ASD closures were selected based on the characteristics of fistulas. The modified implantation of the ASD closure device was applied to treat BPFs. The closure effects, closure time, and Borg score were observed at 4 weeks, 8 weeks, and 12 weeks after the surgery. Results. All 13 BPF patients were successfully implanted with the ASD closure device, and the immediate clinical remission rate was 100%. Follow-up at 4 weeks after the surgery showed that 2 cases were automatically discharged within a few days and 4 cases had closed fistula at 1 day after the surgery; follow-up at 8 weeks after the surgery showed that 1 case with fistula closure was observed at 55 days after the surgery; follow-up at 12 weeks after the surgery showed that 1 case with fistula closure was observed at 82 days after the surgery. T/P values (T = 7.90, 5.99, 7.44, P < 0.05 ) of paired t-tests before surgery and 4 weeks, 8 weeks, and 12 weeks after the surgery were rated by the Borg scale. The data were statistically different, and the clinical symptoms improved significantly. As of publication, the follow-up at 12 weeks after the surgery showed that the clinical remission rate was 9/11, namely, 81.8%, 3 of 11 cases had relieved clinical symptoms but still needed continuous drainage, and 2 cases had fistula closure. The median time of thoracic extubation was 63 (3,120) days. No patients died from surgical complications or BPF recurrence during the prognosis and the follow-up period. Conclusions. The modified implantation method has a high success rate and clinical remission rate, quick and early fistula closure, and simple and noninvasive operation, without the need for a dedicated delivery sheath and rigid endoscopy. Moreover, it has accurate positioning, reliable closure efficiency, and prognosis, and can be completed under local anesthesia. This reduces the operation time, difficulty, and risks of anesthesia.