Objective To explore the effect of relaxation treatment (RT) on the sleep quality of patients with generalized anxiety disorder (GAD).Methods Ninety-two GAD patients were recruited and evenly divided into a study group (n =46) and a control group.The control group was treated with conventional medications,while the study group received RT in addition.The Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG) were used to test for changes in sleep before and after treatment.Results There were no significant differences between the two groups before treatment in terms of average PSQI scores or PSG results.After treatment,both groups scored significantly better on the PSQI than before the treatment.PSG showed that after treatment there was less awakening,greater sleep efficiency and longer total sleep time.There was shorter sleep latency and rapid eye movement sleep latency,shorter duration of shallow sleep,and longer duration of deep sleep and rapid eye movement sleep in the study group,as well as fewer awakenings,greater sleep efficiency and longer total sleep time.The PSQI and PSG results of the two groups after treatment were significantly different.Conclusions RT can significantly improve sleep disorders in GAD patients.

Objective To explore the reactive inhibition and electrophysiological changes under the GO/NOGO paradigm in patients with alcohol dependence (AD) in order to provide a theoretical basis for neuromechanism study of AD executive dysfunctions.Methods The GO/NOGO paradigm event related potentials (ERP) were tested in 51 AD patients and 29 healthy controls, this paradigm behavior and ERP-N1, N2 and P3 latency and amplitude were analyzed.ERPs and execution functions were followed at different time points of withdrawal(4, 9,13 weeks).Results The number of correct responses (29.18±3.03)lowered and error responses (5.16±3.77) heightened in AD patients, and differences had statistical significance compared with those in control group(32.35±2.58,3.19± 1.84, P＜0.05), and there was no group difference in response time.There was no statistical significance in group difference in N1 component under the GO/NOGO tasks and in P3 latency under GO.N2 ((3.48±2.21) μV, (4.49±3.00) pV) and P3 amplitude ((3.47±2.31) μV, (3.92±4.09) μV) decreased and N2 latency ((256.30±31.62) ms, (256.09±33.77)ms) prolonged in AD group under both GO/NOGO tasks and so did P3 latency ((355.33±25.96) ms) under the NOGO, and the differences had statistical significance.Group main effects in N2 and P3 component (P=0.000) and task main effects in N2 amplitude and P3 latency (P＜0.05) were significant,group and task interaction was significant only in P3 latency (P＜0.01).ERPs of AD patients had no notable changes at different time points of withdrawal, executive dysfunctions were the worst within the 1st week of withdrawal and gradually recovered to pre-withdrawal levels.Conclusion AD patients have lower reactive inhibition manifested mainly by weakened capacity to inhibit and adjust conflict monitor and pre-executive motor program, ERP and executive functions cannot be well improved during short-term withdrawal, and the GO/NOGO-ERP can completely reflect electrophysiological changes of reactive inhibition process of AD patients.

Objective To explore the clinical outcomes and complications of the Ilizarov technique for the treatment of femoral infec-tious ununtied fracture and bone defect.Methods A total of 40 patients with femoral infectious ununtied fracture or bone defect were admit-ted into our department from July 2006 to September 2012.After radical debridement,patients were given osteotomy and Ilizarov external fix-ation,and distraction osteogenesis were used in the treatment of bone defects.And the clinical effects and complications of the treatment were evaluated.Results All of the patients were followed up for 12 ~32 months (24.5 months averagely).Totally 39 patients of them acquired bone healing,and the mean healing time was 15.5 months (12 ~26 months).The knee joint range of motion of 32 patients were obviously decreased after operation (P =0.031).There were 10 cases of partial hip joint range of motion decrease,22 cases of leg length discrepancy (more than 1.1 cm),1 case of Iatrogenic vascular injury,and 10 cases required autologous cancellous bone graft.Pin loosening,deep infec-tion,clubfoot deformity,and deep vein thrombosis or bleeding were founded in parts of the patients.Conclusion Ilizarov technique can ac-quire success in the treatment of femoral infectious ununtied fracture and bone defect,but it has many complications.

Objective To explore the relationship between aural pre-attentive processing and non-rapid eye movement(NREM) sleep interictal epileptiform discharge (IED) in children with benign childhood epilepsy with central-temporal spikes (BECTS),in order to provide objective electrophysiological basis for early assessment of cognitive function lesion of BECTS children and intervention.Methods Twenty-nine children diagnosed as BECTS in the Second Affiliated Hospital of Xinxiang Medical University from February 2012 to November 2015 were selected,including 17 males and 12 females,and they were 4-14 years old with average age of (9.17 ±2.42) years,and the course of disease was 0.5-4.0 years.Twenty healthy children who had hospital routine check-up were selected as healthy control group,containing 14 males and 6 females,and they were 5-13 years old with average age of (8.55 ±3.09) years.Mismatch negativity (MMN) test was carried out in both groups,and the MMN amplitudes and latencies were analyzed.The long-term video electroencephalogram (VEEG) monitoring was conducted in the BECTS group to analyze the discharge phases (waking,sleep),locations and the IED indexes.The intergroup MMN indexes and the correlation between MMN and VEEG in the BECTS group were compared.Results The VEEG showed that the sleep structure of BECTS children did not change obviously.All children's epileptiform discharges were located in the Rolandic area,including 11 cases on the left side,8 cases on the right side,and 10 cases on both sides.Epilepsy discharge time:17 patients showed epileptiform discharges in sleep stages only and 12 patients showed epileptiform discharge in both sleep and waking stages.Epileptiform discharges of the 12 patients increased more significantly in sleep stage than thatin waking stage [(40.24 ± 25.15) times/min vs.(1.92 ± 1.38) times/rmin],and the difference was statistically significant (t =5.270,P =0.000).The sample IED index in stage 1 and 2 of NREM was (40.73 ± 10.69) times/min,in which 2 cases had IED indexes ＜ 5 times/min,the IED indexes of 3 cases ＞ 80 times/min who reached electrical status epilepticus during sleep,and others were 17.2-64.6 times/min.Clinical seizures in sleep stages were monitored in only 4 cases,which showed an electro-clinical segregation phenomenon from large quantities of sleep IED.The MMN amplitude was lower in the BECTS group than that in the healthy control group [(6.06 ± 1.89) μV vs.(7.28 ±1.64) μV],and the difference was statistically significant (t =2.346,P =0.025).Latency of BECTS group was longer than that in the healthy control group [(191.37 ±40.13) ms vs.(179.35 ±39.80) ms],but the difference was not statistically significant(t =1.037,P =0.355).Correlation analysis showed that the MMN amplitude was negatively related to discharge phases (r =-0.407,P ＜ 0.05) and the IED indexes (r =-0.644,P ＜ 0.01),and latency was positively related to the IED indexes (r =0.386,P ＜ 0.05),while the other VEEG indexes were not correlated with MMN.Conclusions The BECTS children have aural pre-attentive processing disturbance,especially unconscious automatic processing ability impairment,which weakenattention switch action of automatic processing switching to focused attention processing and fail to filter irrelevant information effectively.Sleep IED is an important factor in impairing the formation and reinforcement of acoustic discrimination and memory trace,interfering the acquisition,processing,storage and matching of new information,which induces children pre-attentive processing disturbance.The MMN may discover the electrophysiological changes of children pre-attentive processing disturbance in early stage.

Objective To explore schizophrenic′s executive function and characteristics of event-related potential-P300 (ERP-P300) in a Go/Nogo paradigm in order to provide electrophysiological basis for schizophrenic′s executive function. Methods The Wisconsin card Sorting Tests (WCST) were conducted and ERP-P300s in a Go/Nogo paradigm (Go/NogoERP-P300) were determined in 58 schizophrenics and 30 healthy persons. Results The WCST score was poorer in research group than that in control group. ERP amplitudes lowered and latencies prolonged in Go-P3 and Nogo N2 and P3, and all differences had statistical significances (P < 0.05). But there were no differences in N1 of both tasks and Go-N2; Go-P3, Nogo-N2 and -P3 amplitude and latency were related to the WCST well (P < 0.05). Conclusion Schizophrenics have such lowered executive functions as attention and cognition conversion and reactive inhibition and could normally process task prophase merely , and Go/NogoERP-P300 may be one of electrophysiological methods reflecting schizophrenic′s executive function.

Objective To observe the changes of brainstem auditory evoked potential (BAEP) and lower limb short latency somatosensory evoked potential ( SLSEP) in acute carbon monoxide poisoning patients and explore the predictive value of BAEP and SLSEP for delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods Sixty-six acute CO poisoning patients was divided into a DEACMP group and a non-DEACMP group according to their symptoms. At the same time, 60 healthy subjects were included in the control group. BAEP and lower limb SLSEP dynamic testing were conducted at different time points. Results The abnormal rates in the first test of BAEP and lower limb SLSEP in the acute CO poisoning patients were 31.8% and 68.2% respectively.The BAEP results in the acute stage and later in the DEACMP group were comparable to those of the non-DEACMP group and the normal control group. Interpeak latency of Ⅰ-Ⅲ was not significantly different, but the remaining indices were significantly longer. Compared to the control group, the lower limb SLSEP readings in the acute DEACMP group and the non-DEACMP group were significantly longer. Compared to the non-DEACMP group and the control group, the SLSEP results of the DEACMP group were significantly extended. The specificity index of the BAEP predicted DEACMP up to 85.7% , significantly more than SLSEP testing. Conclusions Early detection of BAEP can help predict DEACMP. This finding should be promulgated and applied.

【Objective】 To conduct Rh blood group serological testing and third-generation sequencing(TGS) on 22 RhD variant voluntary blood donors in Chongqing and explore the phenotypic distribution and genotyping of RhD variants in Chongqing. 【Methods】 From January to August 2023, individuals who participated in blood donation in our blood center were selected as the study objects. RhD variant phenotype identification was performed using routine serological methods. Once the RhD variants were identified, tests on different antigenic epitopes of RhD were conducted using a D-screen assay kit. Furthermore, after the genomic DNA from 22 RhD variant blood samples was extracted, imbraided primers design and multi-segment amplification and splicing were used to sequence the full-length RHD gene for TGS. The RHD gene sequence was analyzed using SnapGene software. 【Results】 Among the 22 RhD variants, 8 were DVI type 3 (36.36%), with the main mutation of RHD-CE (3-6)-D hybrid allele. Six cases (27.27%) showed partial weak D15 type, with the main mutation of c.845G>A. There were 6 cases of Asia type Del (27.27%), with the main mutation of c.1227G>A. One case was weak D17 type with a mutation of c.340C>T and 1 case speculated to be partial D (c.491A>T, p. Asp164Val, missense mutation). 【Conclusion】 The most common RhD variant phenotype among blood donors in Chongqing is DVI type 3, and the full-length haplotype sequence of RHD variant alleles can be obtained by Pacific Bioscience single-molecule real-time sequencing(SMRT).

BACKGROUND: Red-cell transfusion is critical for surgery during the peri-operative period; however, the transfusion threshold remains controversial mainly owing to the diversity among patients. The patient's medical status should be evaluated before making a transfusion decision. Herein, we developed an individualized transfusion strategy using the West-China-Liu's Score based on the physiology of oxygen delivery/consumption balance and designed an open-label, multicenter, randomized clinical trial to verify whether it reduced red cell requirement as compared with that associated with restrictive and liberal strategies safely and effectively, providing valid evidence for peri-operative transfusion. METHODS: Patients aged >14 years undergoing elective non-cardiac surgery with estimated blood loss > 1000 mL or 20% blood volume and hemoglobin concentration <10 g/dL were randomly assigned to an individualized strategy, a restrictive strategy following China's guideline or a liberal strategy with a transfusion threshold of hemoglobin concentration <9.5 g/dL. We evaluated two primary outcomes: the proportion of patients who received red blood cells (superiority test) and a composite of in-hospital complications and all-cause mortality by day 30 (non-inferiority test). RESULTS: We enrolled 1182 patients: 379, 419, and 384 received individualized, restrictive, and liberal strategies, respectively. Approximately 30.6% (116/379) of patients in the individualized strategy received a red-cell transfusion, less than 62.5% (262/419) in the restrictive strategy (absolute risk difference, 31.92%; 97.5% confidence interval [CI]: 24.42-39.42%; odds ratio, 3.78%; 97.5% CI: 2.70-5.30%; P <0.001), and 89.8% (345/384) in the liberal strategy (absolute risk difference, 59.24%; 97.5% CI: 52.91-65.57%; odds ratio, 20.06; 97.5% CI: 12.74-31.57; P <0.001). No statistically significant differences were found in the composite of in-hospital complications and mortality by day 30 among the three strategies. CONCLUSION: The individualized red-cell transfusion strategy using the West-China-Liu's Score reduced red-cell transfusion without increasing in-hospital complications and mortality by day 30 when compared with restrictive and liberal strategies in elective non-cardiac surgeries. TRIAL REGISTRATION ClinicalTrials.gov, NCT01597232.
Humans ; Adult ; Postoperative Complications ; Erythrocyte Transfusion/adverse effects* ; Blood Transfusion ; Hospitals ; Hemoglobins/analysis*