Effects of low-temperature plasma treatment on pulmonary function in children with obstructive sleep apnea-hypopnea syndrome

Endoscopic mucosal resection of gastrointestinal polyps with a novel low-temperature plasma radio frequency generator: a non-inferiority multi-center randomized control study

BACKGROUND

To evaluate the efficacy and safety of novel plasma radio frequency generator and its single-use polypectomy snares for endoscopic mucosal resection (EMR) of gastrointestinal (GI) polyps.

METHODS

A total of 217 patients with 413 GI polyps were recruited from four centers in China. Patients were assigned to experimental or control groups using a central randomization method. The experimental group used the novel plasma radio frequency generator and its matched single-use polypectomy snares (Neowing, Shanghai), while the control group used the high-frequency electrosurgical unit (Erbe, Germany) and disposable electrosurgical snares (Olympus, Japan). The primary endpoint was the en bloc resection rate, and the non-inferiority margin was set at 10%. Secondary endpoint included operation time, coagulation success rate, intraoperative and postoperative bleeding rate, and perforation rate.

RESULTS

The en bloc resection rate was 97.20% (104/107) in the experimental group and 95.45% (105/110) in the control group (P = 0.496). The operation time was 29.14 ± 20.21 min in the experimental group and 30.26 ± 18.74 min in the control group (P = 0.671). The average removal time of a single polyp in the experimental group was 7.52 ± 4.45 min, which was slightly shorter than that in the control group 8.90 ± 6.67 min, with no statistical difference (P = 0.076). The intraoperative bleeding rates of the experimental group and control group were 8.41% (9/107) and 10.00% (11/110), respectively (P = 0.686). No intraoperative perforation occurred in either group. The postoperative bleeding rates of the experimental group and the control group were 1.87% (2/107) and 4.55% (5/110), respectively (P = 0.465). No postoperative perforation occurred in the experimental group (0/107), while one case of delayed perforation occurred in the control group (1/110, 0.91%). There was no statistical difference between the two groups.

CONCLUSIONS

Endoscopic mucosal resection of GI polyps with the novel plasma radio frequency generator is safe and effective, and non-inferior to the conventional high-frequency electrosurgical system.

Expression Profile Analysis and Image Observation of miRNA in Serum of Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

The expression profile and image observation of miRNA in serum of patients with obstructive sleep apnea-hypopnea syndrome were investigated. Bioinformatics methods were used to explore the molecular mechanism of obstructive sleep apnea-hypopnea syndrome (OSAHS)-related hypertension and explore the differentially expressed core miRNAs and regulatory factors, providing a theoretical basis for seeking molecular targets for clinical diagnosis and treatment. The miRNA datasets of patients with OSAHS and those with hypertension were downloaded from the public database to obtain differentially expressed miRNAs and explore the biological processes and pathways involved in the target genes. The core miRNAs and competitive endogenous RNA (ceRNA) transcription factors (TFs) were obtained by database mining and Cytoscape network analysis. The results showed that 2,579 differentially expressed miRNAs were obtained from the GSE112093 dataset. Seven upregulated miRNAs (hsa-miR-7107-5p, hsa-miR-7110-5p, hsa-miR-595, hsa-miR-1268b, hsa-miR-3064-5p, hsa-miR-68565p, and hsa-miR-1180-3p) and one downregulated miRNA (hsa-miR-22-3p) were obtained from the GSE112093 dataset. It is proved that hsa-miR-22-3p, hsa-miR-595, hsa-miR-6856-5pKcnq1ot1, neat1, Tsix, ERG, kdm2b, and Runx1 may be involved in the pathogenesis of OSAHS-related hypertension, which provided a theoretical basis for the mechanism research and clinical treatment of OSAHS.

Efficacy of Low-Temperature Plasma-Assisted Unilateral/Bilateral Tonsillectomy and Adenoidectomy in Children with Obstructive Sleep Apnea Hypopnea Syndrome

Background

The aim of this study was to investigate the efficacy of low-temperature plasma-assisted bilateral or unilateral tonsillectomy (LTPABT or LTPAUT) and adenoidectomy in treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS).

Material/Methods

The present observational cohort study included a total of 244 children with OSAHS during December 2017 to December 2018. The patients were divided into the LTPABT group, the LTPAUT group, and the control group that received traditional bilateral tonsillectomy and adenoidectomy. The apnea hypopnea index (AHI) and the lowest oxygen saturation (LSaO₂) were measured. The patients’ pain condition was determined using the Visual Analog Score (VAS) and intraoperative indices were collected. Patients’ quality of life was assessed by OSA-18 scale and patients’ immune function was determined.

Results

The postoperative VAS scores were remarkably lower in the LTPABT and LTPAUT groups. At 6 months after surgery, the AHI significantly had decreased and LSaO₂ levels were significantly enhanced for all groups, and the AHI was significantly lower and LSaO₂ was markedly higher in the LTPABT group. The ratio of patients with efficacy of cured and remarkably effective was remarkably higher in the LTPABT group. The rates of postoperative hemorrhage and infection were significantly lower in the LTPABT and LTPAUT groups, and 4 cases showed tonsillar hyperplasia. OSA-18 scores were lowest in the LTPABT group. No significant difference was found in levels of IgM, IgA and IgG, and T lymphocyte subtypes.

Conclusions

The low-temperature plasma-assisted bilateral tonsillectomy combined with adenoidectomy had the best efficacy. None of the surgery methods influenced the patients’ immune function.