Objective To evaluate the association between metabolic profiles and obstructive sleep apnea (OSA) during rapid eye movement (REM) and non-REM (NREM) sleep in children. Methods A total of 514 children underwent overnight polysomnography (PSG) and biochemical testing. Obstructive apnea hypopnea indices (OAHI) and oxygen desaturation indices (ODI) were recorded for total sleep time (TST), REM, and NREM. A multivariate analysis of covariance model assessed the associations of OAHITST, OAHINREM, and OAHIREM with overall metabolic parameters, adjusting for body mass index (BMI) z-score and other covariates. Then, multivariable linear regression models were used to quantify the independent effects of sleep variables on metabolic profiles during REM and NREM sleep. Results When stratified by OAHI-defined severity of OSA, TP, TCH, TG, HDL-C, LDL-C, LDL-C/HDL-C, TyG, and ALT levels were significantly different during TST and NREM (all P < 0.05). In fully adjusted multivariable linear regression models, both OAHITST, OAHINREM and OAHIREM were independently associated with these metabolic parameters. When stratified by ODI-defined severity of OSA, HDL-C, LDL-C, LDL-C/HDL-C, and TyG levels differed significantly during NREM (all P < 0.05) and were independently related to ODINREM. ODIREM was independently associated with TP, TCH, TG, HDL-C, LDL-C, LDL-C/HDL-C, and TyG levels. And in fully adjusted multivariable linear regression models, associations between ODI and TG, LDL-C, and TCH were evident during REM sleep but not during NREM sleep. Conclusions In pediatric OSA, OAHI was associated with metabolic alterations throughout sleep stages. ODI showed more pronounced metabolic effects during REM sleep, where the associations of TG, LDL-C, and TCH varied across ODI severity categories.

Chronic intermittent hypoxia (CIH), a key feature of obstructive sleep apnea, impairs central nervous system function, but its effects on olfactory bulb (OB) and epigenetic mechanisms are unclear. We show that CIH causes olfactory behavioral deficits in mice with structural and molecular OB changes. CIH disrupted adult OB neurogenesis, increasing the immature neuron marker doublecortin (DCX) and reducing mature NeuN expression, and activated microglia. At the molecular level, CIH markedly upregulated the DNA demethylation enzyme Tet1 and global 5-hydroxymethylcytosine (5hmC) levels, which were accompanied by aberrant activation of the PI3K-Akt pathway. Importantly, Tet1 knockdown in the OB partially normalized PI3K-Akt signaling, was associated with improved neurogenesis markers, and alleviated CIH-induced olfactory dysfunction. These results suggest that Tet1-dependent epigenetic remodeling represents an important molecular mechanism linking CIH to OB dysfunction, and that Tet1 may serve as a potential therapeutic target for CIH-related sensory impairment.

Olfactory dysfunction not only diminishes quality of life but also serves as an early biomarker for neurodegenerative diseases. However, the molecular mechanisms underlying age-related olfactory dysfunction remain poorly understood. In this study, we profiled the dynamics of m6A epitranscriptomics in mouse olfactory bulbs (OBs) throughout postnatal development, adulthood, and aging, revealing the dynamic remodeling of m6A methylation during the aging process. Our findings indicate that m6A modifications regulate various physiological processes in a stage-specific manner. Notably, in aged OBs, m6A methylation is enriched in genes associated with the Wnt signaling pathway. Furthermore, we identified a Wnt pathway involving Wnt, Ror2, and Nkd1 that may contribute to disrupted glutamate metabolism responses linked to age-related alterations in glutamatergic neuron function. This disruption is accompanied by significant reductions in glutamate and its related metabolites, suggesting an imbalance in neurotransmitter levels and impaired mitochondrial function—factors that may lead to olfactory dysfunction. Additionally, we identified METTL3 as a key m6A methyltransferase that drives age-related declines in olfactory function. Conditional knockdown of Mettl3 in aged OBs restores both olfactory function and activity within glutamatergic neurons. Our study provides valuable insights into the m6A-mediated mechanisms governing OB aging and highlights potential therapeutic targets for mitigating neur odegenerative-associated olfactory deficits.

Objective: Obstructive Sleep Apnea (OSA) is a common sleep-disordered breathing condition in children. Moderate/severe OSA can lead to a series of complications, including growth restriction and neurocognitive impairment, severely impacting children's physical and mental health. The gold standard for diagnosing OSA is polysomnography (PSG). Given the limitations of PSG in large-scale screening and the insufficient accuracy and compliance of existing screening tools, exploring simple and reliable screening tools for moderate/severe OSA holds significant clinical importance. This study aims to systematically compare the predictive efficacy of neckto-height ratio (NHR), waist-to-height ratio (WHtR), hip-to-height ratio (HHR), and BMI Z-score for moderate/severe pediatric OSA, providing more accurate and convenient indicators for clinical screening. Methods: We retrospectively analyzed data from 685 children aged 3-16 years who underwent PSG. Using age, gender, tonsil size, and adenoid size as covariates, receiver operating characteristic (ROC) analysis was used to assess the discriminatory ability of NHR, WHtR, HHR, and BMI Z-score in the overall cohort and within age and gender subgroups. Results: NHR demonstrated the highest predictive efficacy in the overall cohort (AUC=0.781), significantly outperforming other indices. Subgroup analysis revealed that NHR maintained excellent predictive performance in children above 10 years, with AUC values of 0.777 in boys and 0.913 in girls. Conclusion: The NHR may serve as a useful adjunctive screening tool for moderate/severe OSA in children above 10 years, showing moderate predictive value and outperforming traditional indices such as WHtR, HHR, and BMI Z-score.

OBJECTIVES:To propose a new method for grading adenoids under fiberoptic nasopharyngoscopy and discuss its relationship with related clinical symptoms. METHODS:The participants underwent fiberoptic nasopharyngoscopy performed by an experienced technician, and several clear images were obtained. The images had to include the nasopharynx from both nostrils and clearly expose the relevant anatomical structures. Two otolaryngologists, one senior and one junior, who were unaware of the children's conditions, graded the adenoid hypertrophy from the images using both the new anatomical adenoid grading method (NAAGM) and the traditional percentage 4°-grading method. Six months later, the same two physicians reassessed the cases. Inter-observer and intra-observer consistency and the relationship between the grading methods and relevant clinical symptoms were observed. RESULTS:A total of 285 children were evaluated by clinical physicians. The inter-observer and intra-observer consistency of the NAAGM was higher than that of the traditional percentage 4°-grading method. Additionally, the NAAGM demonstrated significantly better predictive ability for moderate-severe obstructive sleep apnea (OSA), otitis media with effusion (OME), and nighttime minimum oxygen saturation compared to the percentage 4°-grading method. CONCLUSION:The NAAGM proposed in this study is more straightforward, more reliable, and easier to use. It clearly describes the relationship between adenoids and anatomical structures and better predicts related clinical symptoms. Consequently, it may serve as a more suitable method for evaluating adenoid size. LEVEL OF EVIDENCE: 3:

The aim of this study was to develop a method based on multiple cross displacement amplification (MCDA) and real-time fluorescence technique for rapid, highly sensitive and specific detection of Streptococcus pyogenes (Group A Streptococcus, GAS). A set of 10 primers targeting the speB gene of GAS was designed for the MCDA reaction. According to the principle of real-time MCDA detection, the core primer was further modified with a restriction endonuclease recognition sequence, a fluorophore, and a quencher. The optimal reaction temperature for the assay was determined based on the performance of the MCDA amplification products. The detection limit was evaluated using tenfold serial dilutions of GAS genomic DNA templates. To assess specificity, the assay was tested using genomic DNA from 3 GAS strains and 29 non-GAS strains. To evaluate clinical application of the GAS real-time MCDA assay, 56 clinical samples were analyzed and compared with the lateral flow biosensors (LFB) method and PCR. The GAS real-time MCDA method was performed using a fluorescence instrument at 63℃ for 40 min. The method demonstrated high sensitivity, with a detection limit of 50 fg, and showed no cross-reactivity with other pathogens. The GAS real-time MCDA assay described here offers a new and valuable diagnostic tool for the reliable and rapid detection of GAS.

OBJECTIVE:Duration of disease plays an important role in the relationship of adenoid hypertrophy and craniofacial morphology. This study aimed to analyse the association of adenoid hypertrophy with craniofacial features in different duration groups. METHODS:Cephalograms were obtained from 216 participants aged 3-14 years. The effects of varying durations of snoring and oral breathing, as well as the risk of OSA, on craniofacial development were compared. Associations between craniofacial development and relevant clinical factors were evaluated using logistic regression analysis. RESULTS:Compared with the Ad/Np ≤ 0.7 group, children in the Ad/Np > 0.7 group had significantly reduced SNA and SNB angles, increased nose length, and alterations in vertical and soft tissue parameters (all p < 0.05). Snoring >1 year correlated with decreased lip protrusion angle and increased mandibular angle/facial width (p < 0.05). Oral breathing >3 months in Ad/Np > 0.7 children reduced ANB angle (p = 0.02) but increased upper lip thickness (D-C, p = 0.038). Multivariate regression analysis identified that the Ad/Np ratio was associated with changes in SNA and SNB. Snoring duration and oral breathing were determined as influencing factors for dentofacial protrusion and alterations in upper lip soft tissue morphology. CONCLUSION:Children with adenoid hypertrophy are independently associated with sagittal skeletal discrepancies and show altered craniofacial growth patterns. Prolonged snoring (>1 year) and oral breathing (>3 months) exacerbate dentofacial protrusion and upper lip (soft tissue) morphological changes.

Adenoid hypertrophy is one of the most common upper respiratory tract disorders during childhood, leading to a range of symptoms such as nasal congestion, mouth breathing and obstructive sleep apnea. Current diagnostic methods, including computerized tomography scans and nasal endoscopy, are invasive or involve ionizing radiation, rendering them unsuitable for long-term assessments. To address these clinical challenges, this paper proposes a novel deep learning approach for the non-invasive detection of adenoid hypertrophy using heartlung sounds. Firstly, we established a heart-lung sound database with corresponding labels indicating adenoid size. Subsequently, we employed three different deep learning tasks to explore the association between heart-lung sounds and adenoid size. In particular, it includes binary classification to distinguish between normal and abnormal cases, four-grade classification to assess the severity of adenoid hypertrophy, and regression models to predict the actual size of the adenoids. The experimental results demonstrate that the deep learning models can effectively predict the condition of adenoid hypertrophy based on heart-lung sounds. In resource-constrained clinical environments, the proposed methods for adenoid hypertrophy automatic detection provide a simple and non-invasive approach, which can reduce healthcare costs and facilitate remote self-screening.

Sleep disturbances are associated with poor health outcomes in children. However, the sleep problems that occur in children’s growth and metabolism need to be further studied. The aim of the present study was to assess the effects of sleep habits on the growth and metabolism in school-aged children. This cross-sectional study included 5832 children and adolescents aged 6–18 years from 10 primary and secondary schools in a district in Beijing between 2022 and 2023. Children’s sleep characteristics were evaluated using the Children’s Sleep Habits Questionnaire (CSHQ). Body composition, body mass index (BMI), blood pressure, fasting plasma glucose, and blood lipid levels were assessed. Girls had a greater rate of sleep anxiety, while boys had a greater rate of sleep-disordered breathing (SDB) across all age groups. Linear regression analysis showed that poor sleep habits were negatively correlated with height for age (HAZ) and systolic blood pressure (SBP) (β = −0.111 and − 0.459, respectively; p < 0.05). SDB was significantly associated with BMI, fat mass percentage (FMP), waist-to-height ratio (WHtR), SBP, triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) across all age groups (p < 0.05), while SDB was positively correlated with HAZ only in children aged 6–11 years (β = 0.240, p < 0.05). Logistic regression analysis showed that insufficient sleep was associated with FMP, WHtR, and overweight/obesity in children aged 6–11 years (p < 0.05). SDB was a risk factor for hypertension in children aged 12–18 years (OR = 1.847, p < 0.05). Evaluating the multiple aspects of childhood sleep habits is crucial for improving sleep-related children’s growth and metabolism. Age differences in sleep-related growth and cardiometabolic abnormalities should be considered in preventive interventions. Our study provides new insights into age differences in the influence of sleep habits on the growth and metabolism of children. Our results indicate that sleep habits are significantly associated with growth and cardiometabolic risk factors in children and adolescents and that there are age differences in these relationships. This finding suggests that age differences in sleep-related cardiometabolic abnormalities should be considered in preventive interventions.

Background: Human adenovirus type 3 (HAdV-3) and 7 (HAdV-7) are significant causative agents of acute respiratory tract infections that are prevalent among school-based outbreaks across China. Rapid and accurate diagnosis is crucial for effective control and treatment of HAdV infection. Methods: Here, we developed a novel diagnostic assay combining multiple cross displacement amplification (MCDA) with CRISPR-Cas12b technology, designated HAdV-MCDA-CRISPR, to rapidly detect HAdV-3 and HAdV-7. The assay targets a highly conserved region of the hexon gene, enabling broad detection of these serotypes. The protocol includes DNA extraction (15 minutes), MCDA amplification (40 minutes), and CRISPR detection (5 minutes), and is completed within one hour. Specificity was validated by testing against non-HAdV pathogens, while sensitivity was assessed using serial dilutions of hexon-containing plasmid DNA. Clinical performance was evaluated using 88 patient samples. Results: The HAdV-MCDA-CRISPR assay demonstrated high sensitivity, detecting as little as 5 fg HAdV plasmid DNA per reaction, and showed no cross-reactivity with other common respiratory pathogens. Clinical validation using 88 patient samples further demonstrated the diagnostic accuracy of HAdV-MCDA-CRISPR. Conclusions: HAdV-MCDA-CRISPR is a rapid, sensitive, and specific tool for diagnosing HAdV-3 and HAdV-7 infections, offering potential for timely clinical intervention and enhanced epidemiological surveillance.

BACKGROUND:Vocal fold nodules are a common pediatric voice disorder that can adversely affect both phonation and psychosocial development. Currently, diagnosis primarily relies on invasive laryngoscopy evaluation, which limits routine application in young children. Acoustic analysis offers a promising, noninvasive alternative for identifying and monitoring vocal fold nodules. This study aimed to evaluate the feasibility of using mel-frequency cepstral coefficient (MFCC)-derived features for the objective, automated detection of vocal fold nodules in children. METHODS:A total of 100 children were included, comprising 50 patients with laryngoscopically confirmed vocal fold nodules and 50 age-matched controls. Sustained vowel /u/ phonations were analyzed using MFCC-based acoustic extraction. Group differences in MFCC parameters were assessed. Five machine learning models were developed to classify vocal fold nodules, and feature importance was examined using Shapley Additive exPlanations (SHAP). RESULTS:Children with vocal fold nodules showed significantly lower MFCC-Std and MFCC-Var values, as well as notable changes in MFCC-Min and MFCC-Skew compared with controls. Among the five machine learning algorithms, the XGBoost model demonstrated the highest classification performance, with an area under the curve of 0.7936. SHAP analysis identified MFCC-Var, MFCC-Min, and MFCC-Skew as the most influential features. CONCLUSION:The integration of MFCC-derived acoustic features with an XGBoost classifier enables accurate, noninvasive identification of pediatric vocal fold nodules. These findings support the potential application of voice-based modeling in scalable screening and therapeutic monitoring of pediatric vocal fold nodules. LEVEL OF EVIDENCE: 3:

Streptococcus pyogenes (group A streptococcus, GAS) is the leading bacterial cause of acute pharyngitis in children and adolescents. Rapid and reliable diagnosis of GAS pharyngitis is essential for guiding a timely antibiotic treatment. Here, we developed a rapid, highly sensitive, and specific test platform for the detection of GAS, designated GAS-MCDA-CRISPR. In this diagnostic platform, the multiple cross displacement amplification (MCDA) technique was utilized to preamplify the specific speB gene of GAS. Subsequently, the CRISPR-Cas12a-based biosensing system was employed to decode the MCDA products. MCDA primers, a guide RNA (gRNA), and a quenched fluorescent single-stranded DNA (ssDNA) reporter were designed to target the speB gene of GAS. The GAS-MCDA-CRISPR assay demonstrated the ability to detect GAS genomic DNA at a concentration as low as 45 fg per microliter while exhibiting no cross-reactivity with other non-GAS pathogens. Moreover, 56 clinical samples were correctly detected by the GAS-MCDA-CRISPR assay. These data highlighted that the GAS-MCDA-CRISPR assay is a reliable diagnostic tool for the reliable and quick diagnosis of GAS infection.

Pediatric vocal cord nodules and laryngopharyngitis are common childhood voice disorders. Previous studies have shown that novel acoustic indices developed based on Mel frequency cepstral coefficients (MFCCs) demonstrate promising value in assessing hoarseness in adults. We therefore explored the value of these new acoustic parameters in the detection of vowel sounds in pediatric patients with vocal cord nodules and laryngopharyngitis. Study design Cross-sectional study. Methods A total of 100 children aged 3-9 years who underwent fiberoptic laryngoscopy at the Department of Otolaryngology, Head and Neck Surgery, Capital Center for Children's Health, Capital Medical University, Beijing, China, between May 2024 and January 2025 were included in the study. The control group comprised children free of laryngeal abnormalities via fiberoptic laryngoscopy. The laryngopharyngitis group included those diagnosed with laryngopharyngitis through fiberoptic laryngoscopy evaluation. The vocal cord nodules group included those diagnosed with vocal cord nodules through fiberoptic laryngoscopy. Clinical histories and vowel samples were collected from all participants. MFCC features, including mean, variance, standard deviation, median, percentiles (25th, 75th), maximum, minimum, skewness, and kurtosis, were computed using the librosa package in Python 3.10. Subsequently, Kruskal-Wallis H tests followed by Dunn’s multiple comparisons were performed to identify parameters that significantly discriminated between the vocal cord nodule, normal control, and laryngopharyngitis groups. Result The MFCC-Std and MFCC-Var values in children with vocal cord nodules were significantly lower than those in the control group, while the MFCC-Std and MFCC-Var values in children with laryngopharyngitis were significantly higher than those in the control group (P < 0.001). Conclusion The MFCC-Std and MFCC-Var significantly decreased in children with vocal cord nodules and significantly increased in children with laryngopharyngitis. MFCC-Std and MFCC-Var may serve as potential indicators for screening vocal cord nodules.

ObjectiveThe objective of this study was to investigate the effectiveness of a machine learning algorithm in diagnosing OSA in children based on clinical features that can be obtained in nonnocturnal and nonmedical environments.Patients and methodsThis study was conducted at Beijing Children's Hospital from April 2018 to October 2019. The participants in this study were 2464 children aged 3–18 suspected of having OSA who underwent clinical data collection and polysomnography(PSG). Participants’ data were randomly divided into a training set and a testing set at a ratio of 8:2. The elastic net algorithm was used for feature selection to simplify the model. Stratified 10-fold cross-validation was repeated five times to ensure the robustness of the results.ResultsFeature selection using Elastic Net resulted in 47 features for AHI ≥5 and 31 features for AHI ≥10 being retained. The machine learning model using these selected features achieved an average AUC of 0.73 for AHI ≥5 and 0.78 for AHI ≥10 when tested externally, outperforming models based on PSG questionnaire features. Linear Discriminant Analysis using the selected features identified OSA with a sensitivity of 44% and specificity of 90%, providing a feasible clinical alternative to PSG for stratifying OSA severity.ConclusionsThis study shows that a machine learning model based on children's clinical features effectively identifies OSA in children. Establishing a machine learning screening model based on the clinical features of the target population may be a feasible clinical alternative to nocturnal OSA sleep diagnosis.

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. 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. 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. Activation of Wnt signaling pathway by hippocampal Tet1 is associated with cognitive dysfunction induced by IH.

IntroductionEpstein-Barr virus (EBV) is a highly dangerous virus that is globally prevalent and closely linked to the development of nasopharyngeal cancer (NPC). Plasma EBV DNA analysis is an effective strategy for early detection, prognostication and monitoring of treatment response of NPC.MethodsHere, we present a novel molecular diagnostic technique termed EBV-MCDA-LFB, which integrates multiple cross displacement amplification (MCDA) with nanoparticle-based lateral flow (LFB) to enable simple, rapid and specific detection of EBV. In the EBV-MCDA-LFB system, a set of 10 primers was designed for rapidly amplifying the highly conserved tandem repeat BamHI-W region of the EBV genome. Subsequently, the LFB facilitate direct assay reading, eliminating the use of extra instruments and reagents.ResultsThe outcomes showed that the 65°C within 40 minutes was the optimal reaction setting for the EBV-MCDA system. The sensitivity of EBV-MCDA-LFB assay reached 7 copies per reaction when using EBV recombinant plasmid, and it showed 100% specificity without any cross-reactivity with other pathogens. The feasibility of the EBV-MCDA-LFB method for EBV detection was successfully validated by 49 clinical plasma samples. The complete detection process, consisting of rapid template extraction (15 minutes), MCDA reaction (65°C for 40 minutes), and LFB result reading (2 minutes), can be finalized within a 60-minutes duration.DiscussionEBV-MCDA-LFB assay designed here is a fast, extremely sensitive and specific technique for detecting EBV in field and at the point-of-care (PoC), which is especially beneficial for countries and regions with a high prevalence of the disease and limited economic resources.

BackgroundAlterations gastrointestinal diseases (GDs) were reported in individuals with obstructive sleep apnea (OSA), however, the genetic background between OSA and GDs is still unclear.MethodsThis investigation employed Mendelian randomization (MR) analyses to evaluate the causal effect between OSA and 19 types of GDs (gastroesophageal reflux disease (GERD), ulcerative colitis, celiac disease, Crohn’s disease, chronic gastritis, irritable bowel syndrome, primary biliary cholangitis, diverticular disease, gastroduodenal ulcer, acute pancreatitis, non-alcoholic fatty liver disease, primary sclerosing cholangitis, cirrhosis, calculus of bile duct, calculus of gallbladder, pancreatic cancer, gastric cancer, colorectal cancer, and esophageal cancer). The inverse-variance weighted (IVW) method was used to evaluate the main effects model of causality.ResultsThis MR study suggests that OSA may play a causal role inflammation-related GDs (GERD, PIVW=5.94×10-9; gastroduodenal ulcer, PIVW=1×10-4; chronic gastritis, PIVW=0.0214; ulcerative colitis, PIVW=0.0296), and gallstones (calculi of the gallbladder, PIVW=0.0429; calculi of the bile duct, PIVW=0.0068). After accounting for obesity, type 2 diabetes, smoking, and alcohol consumption, the multivariate MR (MVMR) analysis identified that OSA is an independent risk factor for GERD, gastroduodenal ulcer, and calculus of the bile duct. The reverse MVMR analysis showed a causal effect of GERD on OSA. Besides, we did not find that the predisposition to OSA was associated with 4 cancers.ConclusionThis MR analysis provides compelling evidence of an independent causal relationship between genetically predicted OSA and an elevated risk of inflammation-related GDs. Besides, no causal association was observed between OSA and cancers. Further studies should be carried out to verify our findings.

The objective of this study is to explore the associations between obesity, body composition, and the self-reported risk of obstructive sleep apnea (OSA) and to examine whether the risk of OSA is related to metabolic abnormalities in children and adolescents aged 6-17 years. Utilizing data from the 2022 to 2023 Beijing Children and Adolescents Health Cohort baseline survey, 5000 school-aged participants were analyzed. OSA risk was assessed via the Pediatric Sleep Questionnaire, with anthropometric and body composition measurements taken. Metabolic markers included blood pressure, lipid levels, blood glucose, and uric acid. Associations were analyzed using logistic regression and generalized linear models. Results showed that 88.6% were low-risk and 11.4% were high-risk for OSA. Overweight (aOR 1.53, 95% CI 1.22-1.92), obesity (aOR 1.94, 95% CI 1.57-2.40), and abdominal obesity (aOR 1.59, 95% CI 1.31-1.93) significantly increased OSA risk. High fat mass was a critical factor, while muscle mass was not, especially in those who were overweight and obese. Associations of OSA risk with metabolic abnormalities were non-significant after adjusting for BMI. Our research highlights the significant associations of obesity and body composition with OSA risk, with child BMI influencing the relationship between OSA and metabolic abnormalities. Future research should explore causative relationships and the enduring impacts of OSA on metabolic health in children.

OBJECTIVES:To investigate the efficacy and safety of carbon dioxide (CO2) laser cauterization in the treatment of pediatric congenital pyriform sinus fistula (CPSF), and to track and follow up the long-term outcome of the postoperative patients. METHODS:This retrospective study was conducted at a single center, where clinical data and follow-up information of children with CPSF who underwent CO2 laser cauterization with the assistance of a suspension laryngoscope and microscope were collected and analyzed their clinical characteristics and prognosis. Subsequently, multiple logistic regression analysis was performed to identify potential predictors of the number of laser cauterization procedures. RESULTS:A total of 238 children diagnosed with CPSF were recruited for this study, with 235 patients successfully achieving closure of the internal fistula through one or more CO2 laser cauterization procedures without recurrence. The median duration of follow-up was 6.46 (5.20, 7.64) years. Merely three patients (1.3%) developed recurrent cervical infection and eventually underwent open neck surgery. There were no instances of permanent perioperative complications throughout the follow-up. Additionally, our analysis revealed that the age at the first operation of CO2 laser cauterization was an independent risk factor associated with the number of operations. CONCLUSIONS:The CO2 laser cauterization for children with CPSF is an effective and safe treatment with a low recurrence rate and minimal complications during the follow-up period. Consequently, it is advisable to consider CO2 laser cauterization as a viable therapeutic option for managing pediatric CPSF. LEVEL OF EVIDENCE:4 Laryngoscope, 134:5193-5200, 2024.