This study aimed to explore the specific AT-rich sequence-binding protein 2 (SATB2) regulated Warburg effect of laryngeal squamous cell carcinoma (LSCC) and its possible mechanism of action. Bioinformatic and single-cell analyses revealed that SATB2 expression was suppressed in patients with LSCC. In an in vitro model, SATB2 suppressed LSCC cells proliferation and migration. Si-SATB2 promotes LSCC cells proliferation and migration. Additionally, sh-SATB2 promotes LSCC proliferation in a mouse model. SATB2 suppresses Wnt expression in an in vitro model and si-SATB2 induces Wnt expression in an in vitro model. Additionally, sh-SATB2 suppresses Wnt expression in a mouse model. Wnt inhibitors reduce the effects of siSATB2 or sh-SATB2 on the Warburg effect and cell proliferation in a mouse or in vitro model of LSCC. SATB2 interacts with Wnt proteins to reduce Wnt protein ubiquitination. Methyltransferase-like 3 (METTL3)-mediated m6A modification decreases SATB2 stability in a YTH N6-methyladenosine RNA binding protein 1 (YTHDF1) -dependent manner in an LSCC model. The interaction between the active constituents of SATB2 and Wnt1 results in the inhibition of Wnt/(3-catenin, thereby affecting the Wnt/(3-catenin-mediated Warburg effect. This study demonstrated that METTL3-mediated m6A modification reduces SATB2 stability in a YTHDF1-dependent manner in an LSCC model, with remarkable efficacy in inducing the Warburg effect in an LSCC model.

This study aimed to explore the specific AT-rich sequence-binding protein 2 (SATB2) regulated Warburg effect of laryngeal squamous cell carcinoma (LSCC) and its possible mechanism of action.Bioinformatic and single-cell analyses revealed that SATB2 expression was suppressed in patients with LSCC. In an in vitro model, SATB2 suppressed LSCC cells proliferation and migration. Si-SATB2 promotes LSCC cells proliferation and migration. Additionally, sh-SATB2 promotes LSCC proliferation in a mouse model. SATB2 suppresses Wnt expression in an in vitro model and si-SATB2 induces Wnt expression in an in vitro model. Additionally, sh-SATB2 suppresses Wnt expression in a mouse model. Wnt inhibitors reduce the effects of si-SATB2 or sh-SATB2 on the Warburg effect and cell proliferation in a mouse or in vitro model of LSCC. SATB2 interacts with Wnt proteins to reduce Wnt protein ubiquitination. Methyltransferase-like 3 (METTL3)-mediated m6A modification decreases SATB2 stability in a YTH N6-methyladenosine RNA binding protein 1 (YTHDF1) −dependent manner in an LSCC model.The interaction between the active constituents of SATB2 and Wnt1 results in the inhibition of Wnt/β-catenin, thereby affecting the Wnt/β-catenin-mediated Warburg effect. This study demonstrated that METTL3-mediated m6A modification reduces SATB2 stability in a YTHDF1-dependent manner in an LSCC model, with remarkable efficacy in inducing the Warburg effect in an LSCC model.

ABSTRACTPurposePositive airway pressure (PAP) is the primary treatment for obstructive sleep apnea (OSA). This study aims to predict the optimal PAP pressure in Chinese OSA patients by their polysomnography (PSG) variables and demographic characteristics.MethodsPatients with an apnea–hypopnea index (AHI) ≥ 15 times/h who received PAP therapy (residual AHI < 5 times/h) and underwent PSG were included in this study. Sex, age, body mass index (BMI), Epworth Sleepiness Scale (ESS), AHI, supine AHI, lowest oxygen saturation (LSaO2), percentage of total sleep time spent with SaO2 < 90% (CT90), and PAP pressure were recorded. PAP pressure and other variables were analyzed using univariate correlation and multivariate linear stepwise regression analysis.ResultsA total of 167 patients were enrolled, with 122 in the study group and 45 in the validation group. Univariate correlation analysis revealed a significant correlation between PAP pressure and age, BMI, ESS, AHI, supine AHI, LSaO2, and CT90. The multivariate linear regression analysis showed that PAP pressure was correlated with gender (b = 1.142, p = 0.032), age (b = −0.039, p = 0.005), AHI (b = 0.047, p = 0.000), and CT90 (b = 0.037, p = 0.000). The final PAP pressure prediction equation was PAPpre (cmH2O) = 8.548 + 1.142 × sex −0.039 × age + 0.047 × AHI + 0.037 × CT90 (R2 = 0.553) (male is defined as 0 and female as 1). This model accounts for 55.3% of the optimal pressure variance, and the area under the ROC curve of PAP prediction pressure is 0.7419.ConclusionPSG variables can be used to predict PAP pressure in Chinese OSA patients, but for some individuals, the prediction model is not very good. PAP is correlated with age, BMI, ESS, AHI, supine AHI, LSaO2, and percentage of total sleep time spent with SaO2 < 90% (CT90), which can be used to predict the optimal PAP pressure.

Obstructive sleep apnea-hypopnea syndrome (OSAHS) significantly impairs children’s growth and cognition. This study aims to elucidate the pathophysiological mechanisms underlying OSAHS in children, with a particular focus on the alterations in cortical information interaction during respiratory events. We analyzed sleep electroencephalography before, during, and after events, utilizing Symbolic Transfer Entropy (STE) for brain network construction and information flow assessment. The results showed a significant increase in STE after events in specific frequency bands during N2 and rapid eye movement (REM) stages, along with increased STE during N3 stage events. Moreover, a noteworthy rise in the information flow imbalance within and between hemispheres was found after events, displaying unique patterns in central sleep apnea and hypopnea. Importantly, some of these alterations were correlated with symptom severity. These findings highlight significant changes in brain region coordination and communication during respiratory events, offering novel insights into OSAHS pathophysiology in children.

Objective: This study aims to analyze the tongue body shape and upper airway anatomical parameters in patients with Obstructive Sleep Apnea (OSA) and to explore the anatomical causes of OSA. Methods: A total of 345 subjects participated in this study. Lateral pharyngeal images of the upper respiratory tract were captured in both normal and mandibular advancement states using X-ray plain film. Measurements were taken for the following parameters: Depth, Palatal Airway Space, Tongue Depth Space, and Mental Posterior Space. The correlation between the Apnea-Hypopnea Index (AHI) and these upper airway anatomical factors was analyzed using both univariate and multivariate analyses to develop a predictive model for OSA. Results: The anatomical structure of the upper airway in patients with OSA is narrower compared to non-OSA individuals, and these patients exhibit a longer and thicker tongue. During mandibular advancement, the pharyngeal airway widens; however, the tongue length decreases while its thickness increases. Univariate correlation analysis revealed that the severity of OSA was significantly associated with tongue length, the ratio of tongue length to tongue thickness, the distance from the mandibular plane to the hyoid, soft palate length, and body mass index (BMI) in both the normal position and during mandibular advancement (p < 0.001). Multivariate linear analysis indicated that the severity of OSA is linked with the mandibular plane to hyoid distance in the normal position (MPH(N)) and BMI. A nomogram was utilized to develop a predictive model for OSA, achieving an area under the receiver operating characteristic curve of 0.838. Conclusion: The pathogenesis of OSA is related to pharyngeal anatomy and tongue length in the state of mandibular advancement, which can be predicted by the measurement indexes of normal and anterior mandibular displacement lateral pharyngeal radiograph. This may potentially aid in early screening and diagnosis of OSA.

Abstract Obstructive sleep apnea hypopnea syndrome negatively affects the cognitive function of children. This study aims to find potential biomarkers for obstructive sleep apnea hypopnea syndrome in children by investigating the patterns of sleep electroencephalography networks. The participants included 16 mild obstructive sleep apnea hypopnea syndrome children, 12 severe obstructive sleep apnea hypopnea syndrome children, and 13 healthy controls. Effective brain networks were constructed using symbolic transfer entropy to assess cortical information interaction. The information flow pattern in the participants was evaluated using the parameters cross-within variation and the ratio of posterior-anterior information flow. Obstructive sleep apnea hypopnea syndrome children had a considerably higher symbolic transfer entropy in the full frequency band of N1, N2, and rapid eye movement (REM) stages (P < 0.05), and a significantly lower symbolic transfer entropy in full frequency band of N3 stage (P < 0.005), in comparison with the healthy controls. In addition, the cross-within variation of the β frequency band across all sleep stages were significantly lower in the obstructive sleep apnea hypopnea syndrome group than in the healthy controls (P < 0.05). What is more, the posterior-anterior information flowin the β frequency band of REM stage was significantly higher in mild obstructive sleep apnea hypopnea syndrome children than in the healthy controls (P < 0.05). These findings may serve as potential biomarkers for obstructive sleep apnea hypopnea syndrome in children and provide new insights into the pathophysiological mechanisms.

INTRODUCTION:Many scales are designed to screen for obstructive sleep apnoea-hypopnoea syndrome (OSAHS); however, there is a lack of an efficiently and easily diagnostic tool, especially for Chinese. Therefore, we conduct a cross-sectional study in China to develop and validate an efficient and simple clinical diagnostic model to help screen patients at risk of OSAHS.METHODS:This study based on 782 high-risk patients (aged >18 years) admitted to the Sleep Medicine department of the Sixth Affiliated Hospital, Sun Yat-sen University from 2015 to 2021. Totally 34 potential predictors were evaluated. We divided all patients into training and validation dataset to develop diagnostic model. The univariable and multivariable logistic regression model were used to build model and nomogram was finally built.RESULTS:Among 602 high-risk patients with median age of 46 (37, 56) years, 23.26% were women. After selecting using the univariate logistic model, 15 factors were identified. We further used the stepwise method to build the final model with five factors: age, BMI, total bilirubin levels, high Berlin score, and symptom of morning dry mouth or mouth breathing. The AUC was 0.780 (0.711, 0.848), with sensitivity of 0.848 (0.811, 0.885), specificity of 0.629 (0.509, 0.749), accuracy of 0.816 (0.779, 0.853). The discrimination ability had been verified in the validation dataset. Finally, we established a nomogram model base on the above final model.CONCLUSION:We developed and validated a predictive model with five easily acquire factors to diagnose OSAHS patient in high-risk population with well discriminant ability. Accordingly, we finally build the nomogram model.

Currently, there is some controversy surrounding surgery for papillary thyroid carcinoma (PTC) that involves more than half of the cricoid cartilage, as some studies suggest that partial cricoidectomy may cause tracheal stenosis and total laryngectomy may be necessary. The aim of this study was to describe a new technique for subtotal cricoid resection and crico-trachea reconstruction that preserves laryngeal function. A 51-year-old man with recurrent PTC underwent subtotal cricoid cartilage resection, tracheal resection and crico-tracheal reconstruction. The PTC had spread to the frontal and right lateral parts of the cricoid cartilage and the 1st to 3rd tracheal rings. The surgery involved removing three quarters of the cricoid cartilage and the 1st to 4th tracheal rings, and modifying, rotating, and anastomosing the remaining trachea to the remaining part of the cricoid cartilage. The procedure was successful in completely removing the tumor, preserving speech function, and avoiding tracheal stenosis. The patient did not experience dyspnea after tracheal cannula removal. This novel crico-trachea reconstruction surgery shows promise in preserving speaking function while avoiding complications associated with partial cricoidectomy.

This study aimed to explore the prognostic value of thyroid invasion of parathyroid carcinoma without lymph node or distant metastasis. Two hundred and nine cases of parathyroid carcinoma from the SEER (1989–2014) were eligible for this study. A Chi-squared test, t test, X-tile, Kaplan–Meier curves, and multivariate Cox proportional hazard regression were used for analysis. Thyroid invasion, sex, race, age, radiation, and surgery were not significantly associated with cancer-specific survival by multivariate analysis. However, tumor size ≥ 4 cm was significantly associated with worse cancer-specific survival (P < 0.001). Thyroid invasion, which was the criterion for T1 and T2 staging criteria of parathyroid carcinoma according to the AJCC, did not affect the prognosis of patients with parathyroid carcinoma without local lymph node or distant metastasis. Our study indicates that a tumor size ≥ 4 cm may be an appropriate indicator of T1 and T2 cancer staging.

Background Airway management, including noninvasive endotracheal intubation or invasive tracheostomy, is an essential treatment strategy for patients with deep neck space abscess (DNSA) to reverse acute hypoxia, which aids in avoiding acute cerebral hypoxia and cardiac arrest. This study aimed to develop and validate a novel risk score to predict the need for airway management in patients with DNSA. Methods Patients with DNSA admitted to 9 hospitals in Guangdong Province between January 1, 2015, and December 31, 2020, were included. The cohort was divided into the training and validation cohorts. The risk score was developed using the least absolute shrinkage and selection operator (LASSO) and logistic regression models in the training cohort. The external validity and diagnostic ability were assessed in the validation cohort. Results A total of 440 DNSA patients were included, of which 363 (60 required airway management) entered into the training cohort and 77 (13 required airway management) entered into the validation cohort. The risk score included 7 independent predictors (p < 0.05): multispace involvement (odd ratio [OR] 6.42, 95% confidence interval [CI] 1.79–23.07, p < 0.001), gas formation (OR 4.95, 95% CI 2.04–12.00, p < 0.001), dyspnea (OR 10.35, 95% CI 3.47–30.89, p < 0.001), primary region of infection, neutrophil percentage (OR 1.10, 95% CI 1.02–1.18, p = 0.015), platelet count to lymphocyte count ratio (OR 1.01, 95% CI 1.00–1.01, p = 0.010), and albumin level (OR 0.86, 95% CI 0.80–0.92, p < 0.001). Internal validation showed good discrimination, with an area under the curve (AUC) of 0.951 (95% CI 0.924–0.971), and good calibration (Hosmer–Lemeshow [HL] test, p = 0.821). Application of the clinical risk score in the validation cohort also revealed good discrimination (AUC 0.947, 95% CI 0.871–0.985) and calibration (HL test, p = 0.618). Decision curve analyses in both cohorts demonstrated that patients could benefit from this risk score. The score has been transformed into an online calculator that is freely available to the public. Conclusions The risk score may help predict a patient’s risk of requiring airway management, thus advancing patient safety and supporting appropriate treatment.

目的 研究新型个性化可调式口腔矫治器治疗轻中度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的疗效及安全性.方法 采用多中心自身对照方法,38例轻中度OSAHS患者佩戴口腔矫治器治疗1个月,记录佩戴前、后呼吸暂停低通气指数(AHI)、最低动脉血氧饱和度(lowest SaO2,LSaO2)、鼾声指数、Epworth嗜睡量表(Epworth sleepiness score,ESS)评分、鼾声视觉模拟量表(visual analogue scale,VAS)评分及口腔矫治器使用情况.结果 37例OSAHS患者完成临床试验,有效率为67.6％ (25/37),AHI、鼾声指数、ESS评分、鼾声VAS评分下降,LSaO2上升,具有统计学意义(P＜0.05).患者主要不良反应为佩戴时轻微疼痛(1/37),佩戴时对言语功能轻微影响(4/37),佩戴时对吞咽功能轻微影响、流口水(3/37).结论 新型个性化可调式口腔矫治器治疗轻中度OSAHS具有较好的疗效及安全性,不良反应少,依从性高.

Background Whether patients with medullary thyroid carcinoma (MTC) who have unresectable synchronous distant metastases should undergo primary surgical resection (PTR) remains controversial. This study aimed to identify predictive factors associated with the survival of such patients. Methods We conducted a retrospective study of patients with MTC who were registered in the Surveillance, Epidemiology, and End Results registry. The overall and cancer-specific mortality rates were assessed using risk-adjusted Cox proportional hazards regression modeling and stratified propensity score matching. Results One hundred and eight matched patients were assessed. Patients in the PTR group had lower overall mortality than did those in the non-PTR group. The 1-, 3-, and 5-year overall and cancer-specific survival rates in the PTR group were significantly higher. Conclusions PTR appears to be the most appropriate intervention for patients with good performance status. Such patients are likely to benefit from surgery and to experience long-term stable disease.

Objective:To explore the safety and short-term efficiency of modified lateral pharyngoplasty combined with surgeries in other sites including nose and tongue. Methods:Thirty-five patients with OSA confirmed with polysomnography received modified lateral pharyngoplasty under general anesthesia. Some of the patients may also receive glossopharyngeal or nasal surgeries according to their physical examination, Müller test with electronic nasolaryngology and polysmnography. The postoperativepain, capacities of swallowing and speaking, and related postoperative complications after surgeries were recorded. And the changes of epworth sleep scale （ESS） snoring sore, apnea and hypopnea index （AHI） and lowest oxygen saturation （LSaO2） were compared before and after surgeries. Results:Among the 35 patients, 1 patient experienced experienced dyspnea after extubation and 2 patients experienced postoperative bleeding. The mean VAS after 1, 4 and 7 days of the surgery were 5.41±2.42, 2.93±1.80, 2.91±1.26, respectively. The mean pain visual analogue scale（VAS） was 5.41±2.42, 2.93±1.80 and 2.91±1.26 on the 1st, 4th and 7th day after operation. The mean time of starting to eat liquid and semi-liquid were （3.23±2.11） dand （5.55±2.67） d after surgery, respectively. Twenty-eight patients underwent 3-6 months follow-up, there was no significant difference in body mass index （BMI） before and after surgery, while mean ESS and snore index were significantly improved, ESS decreased from 11.33±4.91 to 6.19±4.45, and snore index decreased from 6.93±2.23 to 1.25±1.96. Among them, 23 of patients those patients received polysomnography after surgeries, AHI, LSaO2 and time with oxygen saturation below 90% （CT90） were significantly improvement. The mean AHI decreased from 45.05±27.90/h to 18.61±20.85/h，and mean SaO2 increased from 71.17% to 80.87%. Conclusion:Modified lateral pharyngoplasty combined with selective nasal and lingual plane surgery in the treatment of OSA is safe and can significantly improve ESS, snoring, AHI， LSaO2and other indicators.Modified lateral pharyngoplasty selectively with surgeries of nose or tongue is a kind of safe and effective surgery to treat OSA that ESS, snoring, AHI and SaO2can have satisfactory improvement.

Sleep apnea–hypopnea syndrome (SAHS) is an independent risk factor for various cardiovascular and cerebrovascular diseases, but the underlying relationship of its physiological subsystems remains unclear. Thus, we aimed to investigate the effect of SAHS on central and autonomic nervous system (CNS-ANS) interactions during sleep. Thirty-five patients with SAHS and 19 healthy age-matched controls underwent overnight polysomnography. The absolute spectral powers of five frequency bands from six EEG channels and ECG morphological features (HR, PR interval, QT interval) were calculated. Multivariable transfer entropy was applied to analyze the differences of the CNS-ANS network interactions between patients with SAHS of different severities and healthy controls during deep, light, and rapid eye movement sleep. The CNS-ANS network interacted bidirectionally in all researched groups, with the cardiac information modulating the brain activity. The information strength from QT to most EEG components and PR to some EEG components was significantly affected by SAHS severity during light sleep, which indicates the coupling features of QT-brain nodes are important indicators. The driver effects from the β-band significantly increased in patients with SAHS. Respiratory events may be the main reason for the CNS-ANS interaction changes in SAHS. These findings help explain the physiological regulation process of SAHS and provide valuable information for analysis of the development of SAHS-related cardiovascular and chronic diseases.

BACKGROUND AND OBJECTIVES:Sleep apnea hypopnea syndrome (SAHS) is a prevalent sleep breathing disorder that can lead to brain damage and is also a risk factor for cognitive impairment and some common diseases. Studies on cortical effective connectivity (EC) during sleep may provide more direct and pathological information and shed new light on brain dysfunction due to SAHS. However, the EC is rarely explored in SAHS patients, especially during different sleep stages.METHODS:To this end, six-channel EEG signals of 43 SAHS patients and 41 healthy participants were recorded by whole-night polysomnography (PSG). The symbolic transfer entropy (STE) was applied to measure the EC between cortical regions in different frequency bands. Posterior-anterior ratio (PA) was employed to evaluate the posterior-to-anterior pattern of information flow based on overall cortical EC. The statistical characteristics of the STE and PA and of the intra-individual normalized parameters (STE* and PA*) were served as different feature sets for classifying the severity of SAHS.RESULTS:Although the patterns of STE across electrodes were similar, significant differences were found between the patient and the control groups. The variation trends across stages in the PA were also different in multiple frequency bands between groups. Important features extracted from the STE* and PA* were distributed in multiple rhythms, mainly in δ, α, and γ. The PA* feature set gave the best results, with accuracies of 98.8% and 83.3% for SAHS diagnosis (binary) and severity classification (four-way).CONCLUSIONS:These results suggest that modifications in cortical EC were existed in SAHS patients during sleep, which may help characterize cortical abnormality in patients.

Objective. Sleep apnea hypopnea syndrome (SAHS) induces abnormalities in brain function. This study aims to find features that can characterize the impact of SAHS on the brain functional connectivity (FC) during sleep.Approach. Seventy-eight participants (39 SAHS patients and 39 age-matched healthy controls) were recruited and underwent a whole night of polysomnography. The improved weighted phase lag index algorithm was utilized to evaluate FC inδ,θ,α,β, andγbands of six EEG channels. The regional FC features were further constructed to characterize the asymmetries of FC between the left and right hemispheres, the imbalances of FC between the inter- and intra-hemispheres, and those between the anterior and posterior cortex, respectively. Then, support vector machines and feature evaluation were used to verify the discriminative ability for the abnormal FC in SAHS patients of the above-mentioned features.Main results.The study observed abnormal FC changes in SAHS patients during sleep in multiple frequency bands. Moreover, regional FC features performed better in SAHS screening, and important features were mainly distributed inβandγbands.Significance. Our research exhibited the abnormal regional FC in SAHS patients during sleep, which provided new insights and established indicators to investigate the changes of brain function in patients.

OBJECTIVES:Inner ear malformations (IEM) with cerebrospinal fluid (CSF) leakage in children is a rare condition, nevertheless, it may lead to meningitis. Early diagnosis and treatment are crucial. The aims of the study were to summarize the clinical characteristic of pediatric CSF leakage secondary to IEM, and to recommend transcanal endoscopic ear surgery (TEES) as an effective surgical technique for the treatment of CSF leakage with IEM in children.METHODS:This was a retrospective study. Thirteen children and fourteen ear surgery were included. Demographics, detail history, laboratory data, Audio test, and imageological examination results were recorded. All the pediatric patients underwent TEES.RESULTS:Most (92.31%) of the children presented with a history of rhinorrhea. 69.23% (9/13) of the children had suffered from meningitis, and the other had presented with respiratory tract infections. The follow-up duration ranged from 0.75 years to 5.29 years. Transcanal endoscopic repair of CSF leakage secondary to IEM was the first surgery with a success rate of 92.86% (13 out of 14 cases). A fistula could be found in the stapes footplate in all pediatric patients.CONCLUSION:Even if there has been no history of meningitis, the diagnosis of CSF leakage in children suffering from unilateral rhinorrhea and recurrent respiratory tract infection is considered. Auditory brainstem response (ABR) and Temporal bone computed tomography (CT) examinations are suggested to identify IEM. The TEES procedure is recommended in our study as the first choice that repairs CSF leakage secondary to IEM.

Objective:To analyses the value of an improved methods of Muller's test, pharyngeal airway pressure monitoring test（PAPMT）, in topodiagnosis of OSA. Method:One hundred and one cases with OSA（AHI≥5 times per hour） and 30 normal adults were included in the study. Under the pressure monitoring, the electronic laryngoscope were stayed at the palatopharyngeal and glossopharyngeum. First, observe the maximum expiratory pressure and the minimum spiratory pressure. And then measure and record changes of pharynx cross-sectional area at palatopharyngeal and glossopharyngeum under the different pressure. At Last, analyses the correlation between changes of Pharynx cross-sectional area with polysomnography（PSG）. Result:①In 101 cases with OSA, the maximal inspiratory pressure of Müller's manerver distribution is between 1 and 8 kPa. ②The changes of pharynx cross-sectional area of OSA at palatopharyngeal and glossopharyngeum is significantly greater than the control group, and there were obvious differences between OSA and the control group. ③In OSA group, the plug rate at palatopharyngea was 96% and the plug rate at glossopharyngeum is 34% at the minimum pressure. There are no cases have pharynx jams at the control group. ④The main cause of the palatopharyngeal obstruction was strictures in left and right（73%）, and the anatomical factors causing obstruction mainly were, thicken of the pharyngeal wall. The main cause of the hypopharyngeal obstruction was strictures in front and back（71%）, and the redundant lymph tissue at tongue base and posterior displacement of the tongue base, and collapse of pharyngeal wall played an important role at tongue-pharyngeal obstruction. ⑤The changes of pharynx cross-sectional area at palatopharyngeal and glossopharyngeum when the pressure is ±4 kPa is greater than when the pressure is ±2 kPa. ⑥When the pressure is ±2 kPa, The changes of pharynx cross-sectional area at palatopharyngeal is greater than at glossopharyngeum. ⑦Diminished pharyngeal apertures and collapsibility were associated with increased rates of apnea and hypopnea index and the suction pressure（P<0.05）. Conclusion:①PAPMT is able to measure and calculate the changes of pharynx cross-sectional area, determine the site of obstruction, and help the treatment. ②The primary site of obstruction is at velopharyngeal in OSA group. ③The changes of pharynx cross-sectional area at palatopharyngeal and glossopharyngeum of patients can reflects the severity of the OSA.