Objective To explore the characteristic of sleep disorders in the initial stage of withdrawal and their relationships with alcohol craving levels in alcohol dependence (AD) patients,and provide support for diagnosis and prevention of re-drinking.Methods Thirty-two AD inpatients were assigned to AD group and 20 male healthy volunteers to control group.Alcohol craving was assessed with the Pennsylvania Alcohol Craving Scale (PACS) within the 2nd week after alcohol withdrawal for AD patients,and then the whole-night polysomnogram (PSG) tracings were conducted on the day of the night.Results The five item scores of the PACS were from 3.48 to 4.26 in AD patients.The sleep latency was(42.48±22.42) min,total sleep time was(289.61± 103.22)min,sleep efficiency was(71.45± 19.86) ％,S1 sleep was (23.47± 11.07) ％,arousal frequencies was (8.01 ± 2.77),S3+4 sleep was(6.26±5.35)％ in AD group.Compared with control group((19.65±8.57) min,(407.33±21.29) min,(81.52 ± 6.46) ％,(8.79± 1.83) ％,(2.17 ± 1.04),(15.87 ± 5.24) ％ respectively),the differences had statistical significances(t=2.206-9.082,P＜ 0.05-0.001).Alcohol craving levels were positively related to sleep latency,arousal frequencies and S1 sleep (r=0.424-0.898,P＜0.05-0.01) and negatively to total sleep time,sleep efficiency and S3+4 sleep (r=-0.416--0.662,P＜0.05-0.01) in AD group.Conclusion AD patients have sleep continuity and structure disturbances in the initial stage of alcohol withdrawal,sleep continuity and structure disturbances are related to alcohol craving.Improvements of sleep disorders should be paid during clinical alcohol dependence treatment.

Objective To investigate the levels of nutritional knowledge, attitude and dietary habits and its influential factors of the officers and soldiers in frontier forces to provide the theory basis for nutrition education.Methods Using self-designed nutritional knowledge-altitude-practice (KAP) questionnaires to survey 90 officers and soldiers who lived in plateau for at least 6 months. Questionnaires were handed out and handed over on the spot. According toMilitary Nutrition Survey and Evaluation Methods (GJB 1636A-2016), we measured the physical index of officers and soldiers, including height, weight and skin thickness of triceps. And we also evaluated body mass index (BMI) and upper arm muscle circumference.Results Nutrition knowledge, attitude and practice conditions of plateau forces were at the average, better and average levels respectively. Nutritional knowledge was significantly positively related to the practices (r=0.283,P=0.003), and was also significantly positively related to the age of the soldiers (r=0.228,P=0.04). Nutritional attitude was positively related to source of officers and soldiers (r=0.339,P=0.035), and nutritional practices were positively related to the upper arm muscle circumference (r=0.222,P=0.030). 65.6% of the officers and soldiers would like to know the knowledge about relationship between diet and disease. 25.6% of the officers and soldiers in the plateau were alcohol users.Conclusions Although the nutrition knowledge of plateau forces were poor, and the nutritional practices were influenced by nutritional knowledge, but the soldiers' attitude of changing unhealthy dietary habits was very positive. It is necessary to undertake the dietary nutrition education related to the high altitude nutrition among plateau forces to guild their nutritional practice scientifically.

Objective:To explore the relationship between sleep structure changes and state or trait anxiety in patients with insomnia.Methods:Investigations were conducted with the State-trait Anxiety Inventory (STAI) and whole-night ploysomnography (PSG) recorded in 31 patients with insomnia and 20 normal controls.Repeated examinations were conducted in return visits 3～4 months after discharge.Results:Compared to control group,the patients with insomnia had decreased sleep time[(333.71±84.33) min vs.(403.65±19.29) min] and sleep efficiency[(70.41±17.35) % vs.(83.45±4.42) %],and increased sleep latency[(39.48±24.24) min vs.(19.65±8.57) min],REM sleep latency[(106.60±42.89) min vs.(86.80±12.25) min],proportion of S_1 sleep time[(25.36±14.22) % vs.(8.86±1.77) %]and awakening times[(4.45±2.51)vs.(1.75±1.07)].The proportions of S_(3+4) time[(7.38±9.70) % vs.(13.78±4.24) %] and REM sleep time reduced[(14.54±5.61) % vs.(19.18±2.14)%] (Ps<0.05).According to the STAI,scores of both state anxiety[(47.94±8.96) vs.(39.15±4.51)] and trait anxiety[(49.94±8.90) vs.(42.05±7.13)] were significantly higher in insomnia group than in control group (Ps<0.05).State anxiety was positively correlated with sleep latency (r=0.42),REM sleep latency (r=0.25),awakening times (r=0.44) and proportion of S_1 sleep time (r=0.34) (Ps<0.05),and negatively correlated with proportion of REM sleep time (r=-0.41,P<0.01).Trait anxiety was positively correlated with sleep latency (r=0.37,P<0.01) and wakefulness frequency (r=0.29,P<0.05).In return visits,the sleep structure improved,state anxiety score reduced,and trait anxiety had no significant changes.Conclusion:Patients with insomnia have significant sleep structural changes and higher state and trait anxiety.Their sleep structural changes are possilly related to state and trait anxiety.

Objective To investigate the dietary nutrition status of plateau frontier forces and to make recommendations on food and nutrients intake for plateau forces.Methods The dietary status of the plateau forces located at an altitude of 4600 m and 4030 m was investigated by weighing method.The dietary ration for soldiers, their daily dietary allowance and dietary balance index were used to evaluate their dietary patterns and nutrient intake.The concentrations of serum vitamin A and 25-OH vitamin D(25-OH VD) were detected by high performance liquid chromatography (HPLC).The arm muscle circumference and body fat rate of soldiers were evaluated by GJB 1636A-2016 and body composition related standard respectively.Results The intake of eggs, milk and plant oil of Unit A was sufficient, while the rest of the food intake did not reach the military standard;The intake of grain and plant oil of Unit B was sufficient,but the rest of the food intake was insufficient.The intake of protein,calcium,phosphonium,sodium,iron,selenium,iodine,copper,manganese,vitamin E and vitamin B3 of Unit A were adequate, but that of energy,potassium,zinc,magnesium,vitamin D,vitamin C,vitamin B1 and vitamin B2 was insufficient, and the intake of vitamin A,vitamin B6,vitamin B9 and vitamin B12 of Unit A was deficient.The intake of energy, protein,vitamin E,vitamin C,vitamin B1 and vitamin B3,and most of the minerals was adequate in Unit B, but vitamin B2 was insufficient.Furthermore, the intake of calcium,iodine,vitamin A,vitamin D and vitamin B was deficient.The proportion of nutrients which supply energy and the energy distribution of three meals in the two units were imperfect.The concentration of plasma vitamin A in both units was sufficient,but the concentration of plasma 25-OH VD was deficient.93.5% soldiers of unit A and 97.7% soldiers of unit B reached the standard of proper muscle circumference,80.6% soldiers of unit A and 70.5% soldiers of unit B had a low body fat rate.Conclusion The dietary structure of plateau border forces is not balanced.The intake of some foods and nutrients is insufficient so that nutritional education is badly needed to improve the dietary status of plateau forces.

Objective:To explore the correlation between the number of sentinel regional lymph node (SALN) and non-sentinel regional lymph node (NSALN) metastasis in patients with early breast cancer after sentinel regional lymph node (SALN) biopsy.Methods:Retrospectively selected 400 female patients with early breast cancer who underwent SALN biopsy at the Department of Thyroid and Breast Surgery, Yijishan Hospital of Wannan Medical College from January 2016 to July 2021, and summarized and analyzed their clinical case data. The Chi-square test or Fisher exact probability method was used to compare the count data between groups. Perform single-factor analysis on the research indicators, then screen out indicators with statistically significant differences, then perform multi-factor Logistic regression analysis, draw a receiver operating characteristic curve, and combine the area under the curve to establish a predictive model.Results:SALN biopsy was performed in 400 patients with early breast cancer. A total of 1 504 lymph nodes were detected in 320 cases of total mastectomy, with an average of 4.7, 47 cases of macrometastasis, and 2 cases of postoperative macrometastasis. The false negative rate was 4.3%. Among 400 cases, 67 cases were positive for SALN, and the positive rate was 16.75% (67/400). The results of univariate analysis showed that the number of tumor thrombus in the vessel, the number of positive SALN and the metastasis of NSALN were closely related ( χ2=8.775, 16.53, P=0.003). The results of multivariate Logistic regression analysis showed that the number of tumor thrombi and SLN-positive ≥3 in the vessel were independent predictive risk factors for NSLN metastasis ( OR=16.149, 95% CI: 3.016-86.473, P<0.001; OR=31.76, 95% CI: 5.242-192.43, P<0.001). SALN positive was closely related to NSALN metastasis, but as the number of SALN detected increases (more than 6) and when only 1 to 2 SALN was positive, the probability of NSALN metastasis was significantly reduced ( P<0.05). Conclusions:The positive number of SALN and intravascular tumor thrombolus were closely related to NALN metastasis. SALN positive number ≥3 was the most important independent predictor of NSALN metastasis. The recurrence risk of sentinel lymph node can be reduced by increasing the number of SALN detected, when 1-2 positive sentinel lymph node are detected and the number of sentinel lymph node detected >6, axillary lymph node dissection can be exempted as appropriate.

Objective:To evaluate the efficacy of hematoporphyrin monomethyl ether-mediated photodynamic therapy (HMME-PDT) in the treatment of adult patients with port-wine stains (PWS) in China, and to analyze factors influencing the efficacy.Methods:A retrospective study was conducted on the data from 265 adult patients with PWS who underwent HMME-PDT at the Department of Dermatology, West China Hospital, Sichuan University from February 2017 to October 2023. Patients were intravenously injected with hemoporfin at doses of 5 - 6.5 mg/kg, followed by irradiation with a 532-nm green light-emitting diode at the energy density of 100 - 130 J/cm 2 (power density, 85 - 100 mW/cm 2) for 19 - 25 minutes. Treatments were conducted every 2 - 6 months. The treatment response in the treated area was observed after each treatment, and the clinical efficacy was assessed at least two months after the last treatment. Chi-square test was used to analyze the differences in efficacy between groups. Results:Among the 265 adult patients with PWS, the male to female ratio was 90∶175, the patients' age ranged from 18 to 56 years (26.48 ± 6.88 years), and they underwent 1 to 8 treatment sessions (2.67 ± 1.33 sessions). After treatment, 102 (38.4%) patients achieved complete remission, 74 (27.9%) achieved marked improvement, 59 (22.2%) had moderate improvement, and 30 (11.3%) showed no response, resulting in an overall response rate of 88.7%. Among 146 patients without hypertrophic lesions, 69 (47.3%) achieved complete remission, with a response rate of 92.5%; among 102 with slightly thickened lesions, 32 (31.4%) achieved complete remission, with a response rate of 87.3%; among 17 with markedly thickened lesions, only 1 achieved complete remission, and 11 achieved marked improvement. Among 50 patients who received more than 3 treatment sessions, 28 (56%) had complete remission, with a response rate of 100%; among 45 who received only one session of treatment, 5 (11.1%) achieved complete remission, with a response rate of 68.9%. Among 232 patients without soft tissue hyperplasia, 95 (40.9%) achieved complete remission, with a response rate of 88.8%; among 33 with soft tissue hyperplasia, 7 (21.2%) achieved complete remission, with a response rate of 87.9%. The therapeutic effects significantly differed among patients with different lesion thicknesses, among those with different treatment sessions, as well as between patients with soft tissue hyperplasia and those without (all P < 0.05). There were no significant differences in the therapeutic effect among patients of different genders, different ages, with different lesion colors, as well as between patients with nodules and those without, and between patients with treatment history and those without (all P > 0.05). During and after the treatment, patients experienced varying degrees of swelling, burning sensation, pain, and itching, all of which could be relieved by common treatment; scars occurred in 10 (3.8%) patients, and were managed by symptomatic treatment; no systemic adverse reactions, such as drug allergies or impairment of liver and kidney function, were observed during the treatment. Conclusions:HMME-PDT is safe and effective in the treatment of adult patient with PWS. The therapeutic effect of HMME-PDT was associated with lesion thickening and soft tissue hyperplasia, and increased with the increase in treatment sessions.

N-glycosylation modification, one of the most common protein post-translational modifications, occurs in heat shock protein gp96. The purpose of this study is to investigate the effect of N-glycosylation modification on immunologic function of the recombinant gp96 using the mutant gp96 in N-glycosylation sites. Firstly, wild-type and mutant gp96 proteins were expressed by insect expression system and their glycosylation levels were detected. To determine the effect of N-glycosylation on gp96 antigen presentation function, the IFN-γ+ CD8+ T cells in gp96-immunized mice and secretion level of IFN-γ were examined by flow cytometry and ELISA. The ATPase activity of gp96 was further detected by the ATPase kit. Finally, the effect of N-glycosylation on adjuvant function of gp96 for influenza vaccine was investigated in immunized mice. It was found that total sugar content of mutant recombinant gp96 was reduced by 27.8%. Compared to the wild type recombinant gp96, mutations in N-glycosylation sites resulted in decreased antigen presentation ability and ATPase activity of gp96. Furthermore, influenza vaccine-specific T cell levels induced by mutant gp96 as adjuvant were dramatically reduced compared to those by wild type recombinant gp96. These results demonstrate that N-glycosylation modification is involved in regulation of ATPase activity and antigen presentation function of gp96, thereby affecting its adjuvant function. The results provide the technical bases for development of gp96- adjuvanted vaccines.
Adjuvants, Immunologic ; Animals ; CD8-Positive T-Lymphocytes/metabolism* ; Glycosylation ; Heat-Shock Proteins ; Influenza Vaccines ; Mice