BACKGROUND:After internal fixation, limb fracture nonunion is the most common complication. Many factors affect fracture healing, but in recent years researchers have found that serum leptin may be involved in the process of fracture healing to regulate a variety of metabolisms. OBJECTIVE:To analyze the relationship between the changes of serum leptin and fracture healing in patients with long tubular fracture of the limbs after internal fixation. METHODS:Sixty patients with long tubular bone fracture who underwent internal fixation treatment were selected, and divided into two groups, union group (n=30) and nonunion group (n=30), according to the degree of fracture healing at 8 months after operation. Another 30 healthy volunteers served as normal control group. Peripheral blood samples were extracted before and after internal fixation to detect the changes in serum leptin levels using ELISA. RESULTS AND CONCLUSION:Preoperative serum leptin level was higher in the union group and nonunion group than the normal control group as wel as higher in the union group than the nonunion group (P < 0.05). There was no difference in the serum leptin levels in the union group before and after operation, but the nonunion group had a higher preoperative serum leptin level than the postoperative level. These findings indicate that the serum leptin may have an influence on fracture healing.

ObjectiveTo discuss the relationship between objective sleep quality and cognitive function in remission depression patients with insomnia. MethodsA total of 47 patients with depression in remission in Beijing Huilongguan Hospital were enrolled. Insomnia Severity Index （ISI） and the sleep efficiency calculated by the first four items of Pittsburgh Sleep Quality Index （PSQI） were defined as insomnia. Among the selected patients， 22 subjects were classified into insomnia group， and 25 subjects in non-insomnia group. The objective sleep status of all subjects was evaluated by polysomnography （PSG）， and the cognitive function was evaluated with the Repeatable Battery for Assessment of Neuropsychological Status （RBANS）. A regression model was established to explore the relationship between objective sleep quality and cognitive function in remission depression patients with insomnia. ResultsThere was statistically significant difference in immediate memory factor scores of RBANS between depression patients in remission with and without insomnia （t=-2.102， P<0.05）. The sleep efficiency （Z=-2.113， P<0.05）， the proportion of N3 sleep stage （Z=-3.175， P<0.01） and the duration of N3 sleep stage （Z=-3.196， P<0.01） in insomnia group were all lower than those in non-insomnia group， and the nocturnal awakening （Z=-2.058， P<0.01）， the proportion of N1 sleep stage （Z=-2.399， P<0.05） and the duration of N1 sleep stage （Z=-2.463， P<0.05） were higher than those of the insomnia group. Within insomnia group， the increased proportion of REM sleep was correlated with the improvement of attention function （β=0.953， 95% CI： 0.123~2.038， P<0.05）， and the increase of nocturnal awakening was correlated with the decline of delayed memory （β=-0.173， 95% CI： -0.325~-0.024， P<0.05）. ConclusionObjective sleep is associated with cognitive impairment in remission depression patients with insomnia， the proportion of REM sleep has a positive impact on attention function， and frequent nocturnal awakening at night has a negative impact on delayed memory.