The aim of this study was to investigate the changes in insular cortex metabolites and the correlation with clinical manifestations in patients with obstructive sleep apnea syndrome (OSA). Lateral insular metabolite levels were measured and relevant ratios were calculated in OSA patients and healthy individuals, including N-acetyl aspartate/creatine (NAA/Cr), choline/creatine (Cho/Cr), inositol/creatine (Ins/Cr), glutamate compound/creatine (Glx/Cr), N-acetyl aspartate/choline (NAA/Cho), and lactic acid (Lac). Participants' scores on the Hamilton Anxiety Scale (HAMA), the Hamilton Depression Scale (HAMD), the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS) were also evaluated. Apnea-Hypopnea Index, the lowest arterial oxygen saturation, and the mean arterial oxygen saturation (MSaO2) values were monitored by polysomnography. NAA/Cr, Glx/Cr, and NAA/Cho values in the insular cortex were significantly decreased, whereas HAMA, HAMD, PSQI, and ESS scores were significantly higher in OSA patients compared with the control participants. HAMA and HAMD scores showed a significant negative correlation with the NAA/Cho value in the insular cortex and a positive correlation with PSQI and ESS scores. PSQI scores were correlated positively with the Cho/Cr and Ins/Cr ratios in the left insular cortex, but correlated negatively with the NAA/Cho ratio. The symptoms of anxiety and depression in OSA patients may be associated with insular neuron damage or dysfunction; proton magnetic resonance spectroscopy can provide an objective imaging basis for the early diagnosis and treatment of OSA in clinical practice.
Purpose Previous studies have confirmed that patients with obstructive sleep apnea (OSA) have higher systemic inflammatory markers, including intercellular adhesion molecule-1(ICAM-1), vascular cell adhesion molecule-1(VCAM-1), and E-selectin compared to control subjects. However, the effects of continuous positive airway pressure (CPAP) therapy on circulating levels of ICAM-1, VCAM-1, and E-selectin in OSA patients remain inconsistent. Therefore, the primary purpose of the present meta-analysis is to estimate the effect of CPAP therapy on these cell adhesion molecules (CAMs) in patients with OSA. Methods The PubMed, Scopus, Embase, and Cochrane Library databases were searched. The overall effects were measured by the standardized mean difference (SMD) with a 95% confidence interval (CI). A random effects model or a fixed-effects model was used, depending on the heterogeneity of the studies. Results A total of 11 studies were included, comprising 650 OSA patients. The pooled results showed that CPAP therapy significantly decreased ICAM-1 (SMD = − 0.283, 95% CI − 0.464 to − 0.101, p = 0.002) and E-selectin levels (SMD = − 0.349, 95% CI − 0.566 to − 0.133, p = 0.002). In contrast, there was no significant improvement of VCAM-1 levels after CPAP treatment (SMD = − 0.160, 95% CI − 0.641 to 0.320, p = 0.513). Conclusions Our meta-analysis demonstrated that CPAP treatment significantly decreased the circulating levels of ICAM-1 and E-selectin in OSA patients. Thus, ICAM-1 and E-selectin may be effective markers to evaluate CPAP therapy for reducing OSA cardiovascular risk in clinical practice.
Review question / Objective: Population: histologically confirmed advanced NSCLC patients; Intervention: received immune-checkpoint inhibitor plus chemotherapy; Comparison:received chemotherapy; Outcome: reported OS, PFS, ORR and TRAEs; Study design: RCT. Condition being studied: Lung cancer is the primary cause of cancer-related deaths, with an estimated 2.20 million new cases and 1.79 million deaths every year, and 85% of all primary lung cancers are non-small cell lung cancer. Eligibility criteria: Studies were considered eligible if they met the following criteria: (1) being an randomized controlled trial published in English, (2) histologically confirmed advanced NSCLC patients, (3) reported OS, PFS, ORR and TRAEs, (4) the intervention group received immune-checkpoint inhibitor plus chemotherapy, while the control group received chemotherapy, (5) When numerous papers reporting the same trial were found, the most current or most complete publications were chosen. The following were the exclusion criteria: (1) duplicate articles, (2) reviews, meta-analyses, case reports, editorials and letters, (3) molecular biology or animal research, (4) retrospective or prospective observational cohort studies.
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