Objective: To investigate the sleep quality in patients with burning mouth syndrome (BMS) and its influencing factors, providing a basis for developing sleep intervention measures to reduce the impact of BMS symptoms. Methods: This study was reviewed and approved by the Medical Ethics Committee, and informed consent was obtained from patients. A total of 150 patients with BMS and 150 healthy volunteers were enrolled as subjects in this study. The Pittsburgh sleep quality index (PSQI) was used to assess the sleep quality of patients with BMS. Visual analog scale (VAS) was used to assess the degree of oral mucosal pain, generalized anxiety disorder 7-item scale (GAD-7) was used to assess the frequency of anxiety symptoms, and the patient health questionnaire depression questionnaire (PHQ-9) was used to assess the frequency of depression symptoms. Univariate analysis was performed to identify potential influencing factors affecting sleep quality in patients with BMS, and multiple linear regression analysis was employed to determine independent risk factors. Results: The PSQI score for patients with BMS was 7.61 ± 4.29, which was significantly higher than that of healthy controls (P = 0.016). In the PSQI subscale analysis, patients with BMS exhibited increased sleep latency, decreased sleep duration, and lower sleep efficiency compared to healthy controls (P<0.05). Patients with BMS and comorbid sleep difficulties had significantly higher scores on GAD-7 and PHQ-9 compared to the patients with BMS without sleep difficulties (P<0.001), but there was no significant difference in pain VAS scores between the two (P = 0.068). Multiple linear regression analysis revealed that longer disease duration (>6 months), the presence of systemic concomitant symptoms (such as headache and mental stress), and higher depression scores were identified as independent risk factors affecting sleep quality in patients with BMS. Conclusion For patients with BMS, long course of illness, presence of headaches, high mental stress, and depressive symptoms may be independent factors affecting their sleep quality.

The typical manifestations of primary aldosteronism (PA) are hypertension with or without hypokalemia, high aldosterone, and low renal level. However, PA with normal blood pressure is rare in clinical practice. This article reported the diagnosis and treatment of a patient with subclinical PA, admitted for "adrenal accidental tumor" with normal blood pressure and serum potassium. We summarized and analyzed the clinical characteristics and treatment strategies, in order to provide some reference for clinicians.

Liver is the central hub regulating energy metabolism during feeding-fasting transition. Evidence suggests that fasting and refeeding induce dynamic changes in liver size, but the underlying mechanisms remain unclear. Yes-associated protein (YAP) is a key regulator of organ size. This study aims to explore the role of YAP in fasting- and refeeding-induced changes in liver size. Here, fasting significantly reduced liver size, which was recovered to the normal level after refeeding. Moreover, hepatocyte size was decreased and hepatocyte proliferation was inhibited after fasting. Conversely, refeeding promoted hepatocyte enlargement and proliferation compared to fasted state. Mechanistically, fasting or refeeding regulated the expression of YAP and its downstream targets, as well as the proliferation-related protein cyclin D1 (CCND1). Furthermore, fasting significantly reduced the liver size in AAV-control mice, which was mitigated in AAV Yap (5SA) mice. Yap overexpression also prevented the effect of fasting on hepatocyte size and proliferation. Besides, the recovery of liver size after refeeding was delayed in AAV Yap shRNA mice. Yap knockdown attenuated refeeding-induced hepatocyte enlargement and proliferation. In summary, this study demonstrated that YAP plays an important role in dynamic changes of liver size during fasting-refeeding transition, which provides new evidence for YAP in regulating liver size under energy stress.

Objective:To compare the effectiveness and recurrence rate of different types of mesh or without mesh in laparoscopic hiatal hernia repair.Methods:From Jan 2016 to Mar 2022 at the three hospital 90 patients with hiatal hernia, including 26 cases without mesh, 29 cases using synthetic mesh, and 35 cases using biological mesh underwent laparoscopic hiatal hernia repair.Results:The surgical procedures was successful in all the 90 cases without conversion to open surgeny. There were no statistically significant differences in operative time, intraoperative blood loss and postoperative hospital stay among the three groups ( P>0.05), and there were statistically significant differences in hospital cost between the group without mesh and synthetic mesh and biological mesh ( P<0.05). Long-term follow-up was achieved in 87 patients, with a follow-up rate of 96.7% (87/90), and a median follow-up time of 44 months. There were no significant differences in the incidence of postoperative complications (diarrhea, dysphagia, abdominal distension, chest pain), recurrence rate of symptoms (acid reflux, heartburn) and patient satisfaction among the three groups ( P>0.05). Conclusion:In laparoscopic hiatal hernia repair, the mesh should be carefully selected according to the specific intraoperative situation for a satisfactory clinical efficacy.

Objective:To investigate the correlation between heart rate variability (HRV) and symptom severity in patients with somatic symptom disorder (SSD).Methods:Thirty-three patients with somatic symptom disorder (SSD group) who were outpatients or inpatients in Sichuan Provincial People′s Hospital from May 2020 to December 2020 and thirty-three gender-and age-matched healthy controls (HC group) were selected. The patient health questionnaire (PHQ-9), generalized anxiety disorder scale (GAD-7), patient health questionnaire PHQ-15 were applied to assess the severity of depression, anxiety and somatic symptoms in both groups. The somatic system disorder-B criteria scale (SSD-12) and the Whiteley-8 Scale (WI-8) were selected to assess the severity of symptom in SSD. All subjects underwent HRV measurement within one week of enrollment. The differences of HRV between the two groups were compared and the correlation between HRV and symptom severity were analyzed. Independent samples t-test was used for comparison between groups, and Pearson correlation analysis was used for correlation analysis between HRV index and symptom severity. Results:The levels of GAD-7, PHQ-9 and PHQ-15 in SSD group(5.0(2.0, 10.5), 8.0(3.5, 13.0), 11.0(8.0, 15.0)) were significantly higher than those in HC group (1.0(0, 2.0), 0(0, 2.0), 3(0, 6.0)), and the differences were statistically significant (all P<0.05). The SDNN ((25.41±11.24)ms), lnLF ((1.91±0.50)ms 2) and lnTP ((2.65±0.43)ms 2) in the SSD group were lower than those in the HC group ((32.87±12.01)ms, (2.27±0.43)ms 2, (2.93±0.32)ms 2), and the differences were statistically significant( t=-2.605, -3.160, -2.883, all P<0.05). RMSSD of SSD patients was negatively correlated with GAD-7, PHQ-9, and behavioral and cognitive factor scores of SSD-12 ( r=-0.360--0.404, P<0.05), lnHF was negatively correlated with GAD-7, PHQ-9 and behavioral factor scores of SSD-12 scores ( r=-0.491--0.402, all P<0.05), and lnLF/HF was positively correlated with PHQ-9 ( r=0.413, P<0.05) and lnTP was positively correlated with GAD-7 ( r=0.383, P<0.05). Conclusion:HRV is reduced in SSD patients and correlated with symptom severity, indicating the clinical potential of HRV index as a biological marker of SSD.

Objective:To explore the clinical characteristics and influencing factors of myocarditis induced by immune checkpoint inhibitors (ICIs).Methods:Using programmed death receptor-1 (PD-1), nivolumab, pembrolizumab, programmed cell death receptor ligand-1 (PD-L1), atezolizumab, durvalumab, avelumab, cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), ipilimumab, tremelimumab as keywords respectively, we combined these words with myocarditis or the corresponding Chinese to search.Results:A total of 49 articles were reported, including 64 patients. Nivolumab was the most reported, followed by pembrolizumab and ipilimumab. The average age was (65.47±13.24)years, mainly elderly patients; 37 cases (57.81%) were male; the overall mortality rate was 31.25%(20/64). The clinical symptoms were diverse and nonspecific, with dyspnea being the most common (39/64, 60.94%). Heart biomarkers were elevated in 94.64%(53/56) of the patients. 35 patients (54.69%, 35/64) developed myocarditis after 1-2 doses and 17 patients died. 60 patients received steroids as initial treatment, and immunosuppressive therapies such as infliximab, intravenous immunoglobulin, antithymic globulin, and/or plasmapheresis were used in 25 patients, symptoms improved in 17 cases (68.00%).Conclusions:ICIs can cause myocarditis, with high mortality, and should be closely monitored and timely treatment. Steroids can be used as initial first-line therapy and immunosuppressants and/or plasmapheresis may improve clinical symptoms and survival rate.

Objective:To investigate whether attentional bias exists in somatic symptom disorders and its correlation with negative cognition and childhood trauma.Methods:Totally 33 patients with physical disorder (physical disorder group) and 33 healthy controls (healthy control group) who met the inclusion and exclusion criteria in the outpatient or inpatient department of Sichuan Provincial People's Hospital were collected as the research objects.The patient health questionnaire (PHQ-15) and somatic system disorder-B criteria scale (SSD-12) were used to evaluate the severity of the disease, the childhood trauma scale (CTQ) was used to evaluate the childhood trauma experience, and the dot probe task edited by E-prime software was used to measure the reaction time.The repeated measurement variance analysis and independent sample t-test were used to compare the attention bias of the two groups, and the Pearson correlation analysis was used to analyze the correlation between attention bias, disease severity and childhood trauma. Results:The reaction time to negative pictures((510.86±124.72)ms) was longer than that to positive pictures ((504.21±117.21)ms, F=9.10, P<0.05) for physical disorder group and healthy control group, and the negative orienting index(5.22±28.02) in physical disorder group was significantly higher than that in healthy control group(-12.62±32.33)( t=2.397, P<0.05). Disengaging index to positive emotions in SSD patients was positively correlated with their negative cognition of the disease ( r=0.403, P<0.05), and the disengaging index to negative emotions in SSD patients was negatively correlated with emotional neglect ( r=-0.399, P<0.05). Conclusion:Reducing the occurrence of childhood trauma and correcting patients' negative cognition may help to improve the attention bias of somatic symptom disorders.

Objective: To analyze the CT manifestations of the 2019 novel coronavirus pneumonia (NCP) combined with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) literature review, and to summarize the characteristics of CT imaging, so as to improve the ability of rapid and accurate diagnosis. Methods: CT manifestations of two confirmed cases of NCP were reported, meanwhile the literatures on SARS and MERS imaging performance were reviewed and summarized. Results: The two cases of NCP were both in acute stage, the CT imaging showed multiple and scattered ground-glass opacity (GGO) in both lungs, which is similar to the CT performance of SARS and MERS in acute stage. Conclusions The CT features of 2019 novel coronavirus pneumonia are similar to SARS and MERS. It has certain characteristics and changes rapidly with the course of the disease. In the acute stage, GGO and paving stone sign were the main manifestations. In the acute phase, GGO and crazy paving are the main manifestations. In the progress stage, the interlobular septal thickening and consolidation appeared. During the absorption period, the lesions disappeared or fibrosis was left behind, with lung structure distortion and bronchiectasis. Lymphadenopathy and hydrothorax were rare.

One patient with recurrent attacks of pancreatitis and pancreatic head mass had a long history of recurrent abdominal pain, abdominal distension, nausea and vomiting, and no significant alleviations were observed under non-surgical treatment in many hospitals. After the diagnosis and treatment by the multidisciplinary team of gastroenterology, hepatobiliary and pancreatic surgery, oncology, pathology, radiology and other departments of Third Xiangya Hospital of Central South University, the patient underwent pancreaticoduodenectomy to completely remove the painful lesion, without leaving histological basis for canceration caused by chronic inflammation. The safety of the surgery was greatly improved and no obvious complications were observed.

Objective: To identify potential relationship between single uncoding RNA-25-3p (miR-25-3p) expression level and the sertraline efficacy in patients with panic disorder. Methods: Sixty cases of patients with panic disorder(case group) and sixty healthy-controls(control group) were collected with demographic data and peripheral venous blood before and after treatment.All the patients were evaluated using the 14-item Hamilton Anxiety Rating Scale (HAMA) and Panic Disorder Severity Scale (PDSS) at baseline, and then received sertraline treatment for 6 weeks.After six-week treatment, each patient was evaluated again with HAMA and PDSS.RT-PCR was used to detect the level of miR-25-3p expression. Results: There was no significant difference in the miR-25-3p levels between control group (1.27±0.32) and case group (1.73±1.09) before treatment(t=1.53, P=0.14), but the levels in case group were much higher than that in control group after the treatment (5.72±4.13 vs 1.73±1.09, t=-2.15, P=0.04). Besides, the changes of the miR-25-3p levels were positively related with both the changes of PDSS3 and PDSS7 items before and after the treatment (r=0.60, P=0.02 for PDSS3 and r=0.61, P=0.02 for PDSS7). Conclusions miR-25-3p is associated with the drug efficacy and the outcome of some clinical symptoms of panic disorder.These findings might provide some evidence for the individualized treatment of patients with panic disorder according to regulation of gene expression in the future.