Objective To describe clinical features,polysomnographic (PSG) alterations and characteristics of motor and distribution during rapid eye movement (REM) sleep in narcoleptic patients with REM sleep behavior disorder (RBD).Methods We retrospectively summarized general features of 22 narcoleptic patients with RBD,96 narcoleptic patients without RBD and 21 healthy subjects as controls.We compared their PSG and the related indexes in 3 groups.Then we analyzed a full-night video-PSG recording in a continuous series in 22 narcoleptic patients with RBD to identify their motor behavior and distribution features.Results There was no significant difference in PSG parameter and correlation index between the narcoleptic patients with RBD group and without RBD group.However,compared with normal control group (20.15 ± 4.52),narcoleptic patients with or without RBD (24.07 ± 5.44,23.40 ± 4.50) showed increased the body mass index(F =4.869,P =0.009),shortened NREM sleep and REM sleep (min) latency at night (4.41 ±7.01,3.55 ±3.98 and 14.69 ±9.62,x2 =31.697,P =0.000;69.39 ±81.39,71.04 ±74.45and 115.31 ± 45.13,x2 =11.485,P =0.003),increased percentage of sleep stage 1,decreased percentage of slow wave sleep,delayed the arousal time and increased number of arousal episode longer than 5 minutes.In narcoleptic patients with RBD,RBD episodes occurred frequentlyatany stage of REM sleep through whole night and the frequency of vocalizations did not significantly differ between the two halves of the night.Pantomimes were significantly more frequent in RBD episodes of the second half of the night.Conclusions The prevalence of RBD is high in narcoleptic patients.Sleep architecture doesn' t differ between narcoleptic patients with and without RBD.There is no correlation between the occurrence of RBD and narcoleptic duration.In narcoleptic patients with RBD,vocalizations and pantomimes accounted formajor proportion of RBD episodes while aggressive-violent movements are rare.

Objective To explore the value of minute ventilation recovery time (VERT) as a weaning predictor in mechanically ventilated patients with chronic obstructive pulmonary disease (COPD).Methods A prospective study was performed from March 2008 to July 2012.Fifty-two COPD patients under mechanical ventilation for more than 48 hours in our RICU tolerated a spontaneous breathing trial (SBT) and were ready for planned extubation.After SBT,these patients were placed back on their pre-SBT ventilator settings for up to 25 minutes,during which VERT was obtained.VERT was defined as the time for minute ventilation to return to baseline measured before SBT.Respiratory rate,tidal volume,minute ventilation and respiratory rate/tidal volume ratio were also obtained before SBT and just after SBT.Arterial blood gas data were measured and recorded before weaning.According to the weaning outcome,the patients were classified as successful group (40 cases) or failed group (12 cases).VERT and other quantitative variables were compared using t test.A multiple logistic regression was performed to explore possible factors associated with the weaning outcome.The sensitivity and specificity of VERT for predictive capacity in weaning were assessed using ROC cure.Results VERT and respiratory rate after SBT were significantly different between two groups.Multiple logistic regression revealed that VERT was the only predictor associated with weaning outcome (b =0.282,P ＜0.001).The area under ROC curve for VERT was 0.957 (95％ CI:O.907-1.008).With a cut-off value of 10.5 minutes,the sensitivity and specificity of VERT for predicting weaning failure were 1.0 and 0.85,respectively.Conclusions VERT may be a new predictor for extubation and determination of mechanical ventilation weaning in patients with COPD.VERT is a variable to be easily measured thereby being conveniently used in clinical practice.

Objective To determine the clinical features and the factors affecting the recurrence of ovarian borderline epithelial tumors. Methods A retrospective data of 112 cases with ovarian borderline epithelial tumors admitted in General Hospital of Tianjin Medical University from 2000 to 2015 were analyzed. Results The average age was (50.59±16.90) years in 112 patients with FIGO stageⅠof 102 (91.07%) patients, stageⅡof 4 (3.57%) and stageⅢof 6 (5.36%). The serum tumor marker (CA125) was examined in 102 patients, and 27 cases with the elevated indicator (26.47%). Surgical treatment was performed in 112 patients. Younger patients were more likely to choose conservative surgery. Ninety-seven patients were followed up, and 5 of them relapsed. Non fertility preserving surgery was performed in patients with recurrence. The recurrence rates of patients with different clinical pathological factors were compared. The recurrence rate was higher in patients with micro infiltration than that of patients without micro infiltration [37.50%(3/8) vs. 2.25%(2/89), P=0.004]. And the recurrence rate was higher in patients with microemulsion type borderline serous tumor than that of patients with non-papillary tumors [40.00%(2/5)vs. 0(0/41),P=0.019]. Seven patients underwent conservative surgery had normal spontaneous pregnancy. Conclusion The fertility-sparing surgery can be used as the treatment procedures for young patients, which is safe and effective. It is necessary to be on alert of recurrence for the cases with micropapillary pattern, and microinvasive tumor.

Objective To explore the expression and function of galanin and its receptor in the female mice of anxiety-and depression-like behavior.Methods In situ hybridization was used to detect the expression of galanin,GalR1,GalR2 and GalR3 in the hippocampus of C57BL/6J female mice.A total of thirty female mice was divided into two groups:experiment group (n=15) and control group (n=15).The experiment group was subjected to the chronic unpredictable mild stress (CUMS) for four weeks,and the control group was not subjected to any treatment.Four weeks later,a series of tests were performed on those two groups,including the sucrose preference test,the novel object recognition test,the open field test and suspension tail test.After behavior tests,the hippocampus RNA was extracted from eight mice in each group to test the expression of galanin and its receptor through qPCR.The rest part of mice were used to mark C-Fos immunostaining in the dentate gyms (DG) of hippocampus.Results The result of in situ hybridization showed that galanin,GalR1 and GalR2 distributed in the Hillus of ventral hippocamous,GalR3 had no positive signal.In the sucrose preference test,the experiment group drunk less sucrose when compared with the control group (P＜0.05).In the novel object recognition test,the experiment group contacted shorter time to the novel object when compared with the control group (P＜0.05).In the open field test,the experiment group had shorter in session time when compared with the control group (P＜0.05).In the suspension tail test,the experiment group had longer immobility time when compared with the control group (P＜0.05).The qPCR result showed that the higher expression of galanin and GalR1 in the hippocampus of experiment group (P＜0.05).More C-Fos positive cells in the DG of hippocampus of experiment mice were immunostained (P＜0.05).Conclusions Galanin,GalR1 and GalR2 mainly distribute in the Hillus of the ventral hippocampus.Galanin may be involved in the anxiety-and depression-like behavior of C57BL/6J through GalR1.

Objective:To investigate the effects of TLR4 knockout on immune cells and adipokines in mouse visceral adipose tissue.Methods: Cells were isolated from the spleen and epididymal adipose tissue of 20-week-old male wild type mice C57BL/6 and TLR4-/-.The expression of F4/80,CD11b,CD11c,CD3,CD4 and CD8 in these cells were analyzed by flow cytometry.The expression of IL-6,HMGB1,TNF-α,adiponectin and resistin in epididymal adipose tissue were detected by qPCR.Results: Compared with wild type C57BL/6 mice,the percentage of M1 macrophage which marked F4/80+CD11b+CD11c+ in spleen and epididymal adipose tissue of TLR4-/-mice increased(P<0.05) greatly,while that of M2 macrophage which marked F4/80+CD11b+CD11c-was decreased(P<0.05)significantly.This trend was more remarkable in epididymal adipose tissue than in spleen(P<0.05).In epididymal adipose tissue,the percentage of CD4+T cells decreased but that of CD8+T cells increased in TLR4-/-mice.Moreover,the high-level expressions of IL-6,HMGB1,resistin were found in epididymal adipose tissue of TLR4-/-mice.However,the expressions of TNF-α and adiponectin decreased obviously.Conclusion: TLR4 knock-out could lead to a disorder in adipokine and immune cells in visceral adipose tissue.

Lung cancer is currently one of the most common malignant tumors in the world. The occurrence and development of lung cancer, especially non-small cell lung cancer (NSCLC), are closely related to the abnormal expression of long non-coding RNA (lncRNA). lncRNA with a transcript of more than 200 nucleotides is involved in chromatin modification, transcription activation, transcription interference and other regulatory processes, and has varying degrees of regulation on the proliferation, migration, and invasion of tumor cells. It is characterized by up-regulation or down-regulation of expression. At present, there are a large number of studies on lncRNA, because lncRNA has considerable application prospects in the diagnosis, clinical treatment, drug resistance research and prognosis evaluation of NSCLC. In this paper, the overview of lncRNA, the up-regulation or down-regulation of NSCLC-related lncRNA expression, NSCLC clinical treatment and drug-resistant lncRNA were summarized.

Objective To study the effect of fish skin collagen peptide on skin collagen metabolism.Methods Twenty-two rots were divided into treatment and control groups.In rats of the treatment group,fish skin collagen peptide at a dose that is 20 times of the recommended dose for human was added to the food for 40 days. Skin HYP was isolated by hydrolysis with hydrochloric acid. The concentration of skin HYP was determined by visible spectrophotometer and converted it to collagen concentration and compared between the 2 groups.Results The skin collagen concentration was significantly higher in the treatment group than that in the control group (69.79%±4.36%;64.36%±4.36%,P＜0.05).At 40 days,the average body weight of rats in the treatment group was (32.1±3.16)g;while it was(36.5± 2.19)g in the control group (P＜0.05).Conclusion Fish skin collagen peptide may help to increase collagen concentration of skin and control body weight.

Neck myoclonus is part of sleep-related dyskinesia characterized by sudden myoclonus during night sleep. Myoclonus causes pronounced brief rotation or flexion of the head. As a single event, neck myoclon ususually occurs during rapid eye movement (REM) sleep, and it lasts longer than 0.5-1.0 s. At present, neck myoclonus is rarely reported. A 28-year-old male whose clinical manifestation was repeated head swing during sleep was admitted to Tangdu Hospital. Video-polysomnography showed that all the events occurred during REM sleep, and some of them were accompanied by micro-arousal reaction and leg movement. Small does of clonazepam could relieve symptoms.

Objective:To investigate the mechanism of excessive iodine-induced apoptosis of chorionic trophoblast cells associated with missed early miscarriage.Methods:Patients with unexplained missed early miscarriage ≤12 weeks of gestation (MA group, n = 43) and normal pregnant women (control group, n = 64) who were treated at Tianjin Central Obstetrics and Gynecology Hospital from September 2019 to September 2022 were selected as the study subjects, and villous tissues were collected for proliferating cell nuclear agtigen Ki67 immunohistochemistry and apoptosis assay, while urine samples were collected for urinary iodine content assay. Different doses of iodine were used to stimulate the cultivation of human chorionic trophoblast cell line (HTR8/SVneo) for 24 h. Cell proliferation viability was detected using cell counting kit 8 (CCK8), and apoptosis was detected using flow cytometry. Results:(1) Urinary iodine values were 159.70 (114.21, 218.73) μg/L in the control group and 210.80 (143.10, 336.70) μg/L in the MA group, the difference between the two groups was statistically significant ( Z = 2.26, P = 0.024). (2) The proportion of positive and strong positive Ki67 immunohistochemical staining of the villous tissues in the MA group was significantly lower than that in the control group (χ 2 = 37.00, P < 0.001). (3) The apoptosis rate of villous tissue in the MA group was significantly higher than that in the control group [(26.24 ± 1.06)% vs (2.96 ± 1.97)%, t = 92.23, P < 0.001]. (4) The cell proliferation rates of HTR8/SVneo in the 50, 100, 300 and 500 μg iodine groups were significantly lower than that in the 0 μg iodine group ( P < 0.05), with the 500 μg iodine group below the median lethal dose (LD 50). (5) The apoptosis rates of 0, 50 and 500 μg iodine groups were (8.79 ± 0.12)%, (9.56 ± 0.08)% and (19.86 ± 0.05)%, respectively, and the differences among the three groups were statistically significant ( F = 7.32, P = 0.007); in which the 50 and 500 μg iodine groups were higher than that of the 0 μg iodine group, and the 500 μg iodine group was higher than that of the 50 μg iodine group ( P < 0.05). Conclusions:Urine iodine content significantly increases in patients with missed early miscarriage. Excessive iodine intake may lead to a decrease in the proliferation viability and an increase in cell apoptosis of chorionic trophoblast cells.

Objective:To investigate optimal antiplatelet therapy options based on the CYP2C19 genotype in elderly patients with acute coronary syndrome(ACS).Methods:Elderly patients with ACS admitted to our hospital from January 2018 to March 2019 were enrolled and received CyP2C19 gene testing.Patients with the intermediate metabolic genotype of CYP2C19 were randomly divided into two groups: the Ticagrelor group and the double-dose Clopidogrel group.After a one-year follow-up, the risk of bleeding and incidences of cardiovascular events in the two groups were analyzed.Results:468 elderly patients meeting the criteria, 214 had the intermediate metabolic genotype of CYP2C19, accounting for 45.7% of the total, and were randomly divided into the ticagrelor treatment group( n=107)and the double-dose Clopidogrel treatment group( n=107). There were significant differences between the Ticagrelor treatment group and the double-dose Clopidogrel treatment group in incidences of minor bleeding, massive hemorrhage, recurrent angina and recurrent acute myocardial infarction(11.2% vs.22.4%, 2.8% vs. 9.4 %, 4.7% vs.13.1%, 3.7% vs. 11.2%, P<0.05). The double-dose Clopidogrel group not only had a higher risk of cardiovascular events, but also a higher risk of bleeding. Conclusions:For elderly ACS patients with the intermediate metabolic genotype of CYP2C19, a standard dose of ticagrelor is recommended.