Comparison of oral sodium phosphate tablets and polyethylene glycol lavage solution for colonoscopy preparation: a systematic review and meta-analysis of randomized clinical trials.

Objective: To systematically compare the bowel cleaning ability, patient tolerance and safety of oral sodium phosphate tablets (NaPTab) and oral polyethylene glycol electrolyte lavage solution (PEGL) to inform clinical decision making. Methods: PubMed, Embase, CBM, WanFang Data, CNKI, and VIP databases were searched for studies that used randomized controlled trials (RCTs) to compare the roles of NaPTab and PEGL in bowel preparation before colonoscopy. Two reviewers independently screened the studies, extracted data, and assessed the risk of bias in the included papers. A meta-analysis was performed using RevMan 5.3 software. Results: A total of 13 RCTs were eligible for inclusion, including 2,773 patients (1,378 and 1,395 cases in the NaPTab and PEGL groups, respectively). Meta-analysis revealed no significant difference in the cleansing quality of the NaPTab and PEGL groups [RR 1.02, 95% CI (0.96-1.08), P = 0.46]. The incidence of nausea was lower in the NaPTab group than in the PEGL group [RR 0.67, 95% CI (0.58-0.76), p < 0.00001]. Patients rated the taste of NaPTab higher than PEGL [RR 1.33, 95% CI (1.26-1.40), P < 0.00001]. Willingness to repeat the treatment was also higher in the NaPTab group than in the PEGL group [RR 1.52, 95% CI (1.28-1.80), P < 0.00001]. Both serum potassium and serum calcium decreased in both groups after the preparation; however, meta-analysis revealed that both minerals decreased more in the NaPTab group than in the PEGL group [MD = 0.38, 95% CI (0.13-0.62), P = 0.006 for serum potassium and MD = 0.41, 95% CI (0.04-0.77), P = 0.03 for serum calcium]. Meanwhile, serum phosphorus increased in both groups after the preparation; however, levels increased more in the NaPTab group than in the PEGL group [MD 4.51, (95% CI 2.9-6.11), P < 0.00001]. Conclusions: While NaP tablets and PEGL were shown to have a similar cleaning effect before colonoscopy, NaP tablets had improved patient tolerance. However, NaP tablets had a strong effect on serum potassium, calcium, and phosphorus levels. For patients with low potassium, low calcium, and renal insufficiency, NaP tablets should be prescribed with caution. For those at high-risk for acute phosphate nephropathy, NaP tablets should be avoided. Given the low number and quality of included studies, these conclusions will require additional verification by large high-quality studies. Systematic review registration: 10.37766/inplasy2023.5.0013, identifier: NPLASY202350013.

Serum sex hormone levels in different severity of male adult obstructive sleep apnea-hypopnea syndrome in East Asians / 华中科技大学学报（医学）（英德文版）

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a serious health issue, which can impact the hormone secretion. The aim of this study is to analyze the relationship between serum sex hormone concentrations and different severity degree of OSAHS, and to evaluate the influence of OSAHS on sex hormone levels. We enrolled 116 subjects who were subjected to polysomnography (PSG). They were divided into three groups: control group (n=10) [apnea hypopnea index (AHI) <5/h], mild-moderate OSAHS group (n=15) (5≤AHI<30/h), and severe OSAHS group (n=91) (AHI≥30/h). The patients in OSAHS group were subdivided into obesity and non-obesity subgroups. The parameters such as AHI, body mass index (BMI), lowest oxygen saturation (LSaO2), and mean oxygen saturation (MSaO2) were recorded. Serum levels of testosterone, polactin, estradiol, follicle stimulating hormone (FSH) and luteinizing hormone (LH) were determined in the morning immediately after waking up. Mean levels of hormones were compared among groups. The correlation between hormone levels and sleep-breathing parameters was analyzed. No significant differences in serum sex hormone levels were found among control, mild-moderate OSAHS, and severe OSAHS groups (P>0.05). There was no correlation between AHI and sex hormone levels (P>0.05). Testosterone was significantly negatively correlated with BMI (P<0.05). These results suggested that BMI might have a direct effect on testosterone level, and it might be an important factor affecting testosterone level in male OSAHS patients, and there may be no correlation between severity of OSAHS and sex hormones levels.

Comparation between modified coblation assisted uvulopalatopharyngoplasty and conventional uvulopalatopharyngoplasty in operative complication / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To compare the operative effectivity and incidence of postoperative complication between conventional uvulopalatopharyngoplasty (UPPP) and modified coblation assisted UPPP (M-CAUP) in treating patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). And to explore the more effective, safer and minimally invasive operative method in surgical therapy of OSAHS.</p><p><b>METHODS</b>It was a controlled trial. A retrospective analysis was made on surgical complications of conventional UPPP and of M-CAUP performed on OSAHS patients from 1995 to 2010. There were 451 patients in UPPP group and 323 patients in M-CAUP group. χ(2) test and Fisher's Exact test were used in statistical analysis.</p><p><b>RESULTS</b>The incidence of serious surgical complications was higher in conventional UPPP group (3.77%, 17/451) than that in M-CAUP group (0.62%, 2/323), χ(2) = 7.800, P < 0.01, while the incidence of short-term complications was higher in M-CAUP group (90.40%, 292/323) than that in conventional UPPP group (60.98%, 275/451), χ(2) = 83.186, P < 0.01. The difference of long-term complications was not statistically significant between M-CAUP group and conventional UPPP group (P = 0.1331, Fisher Exact test). There was no significant difference in incidence of asphyxia between M-CAUP group and conventional UPPP group (P < 0.01, Fisher Exact test). However, the incidence of post-operative primary hemorrhage was obviously lower in M-CAUP group than that in conventional UPPP group (3.99%, 18/451), χ(2) = 12.133, P < 0.01. While the incidence of delayed hemorrhage, temporal velopharyngeal insufficiency, and foreign body sensation at pharynx were higher in M-CAUP group (8.05%, 12.69%, 68.42%, respectively) than that in conventional UPPP group (3.77%, 3.33%, 51.00%, respectively) P < 0.01, respectively. There was no significant difference in incidence of permanent velopharyngeal insufficiency, stenosis of nasopharynx and nasopharyngeal atresia, alteration of taste, throat itch and coughing.</p><p><b>CONCLUSION</b>Compared to the conventional UPPP, M-CAUP was more effective and safer in treating OSAHS with less severe complications during and after the operation.</p>