Paradoxical insomnia is a common clinical phenomenon.Due to the lack of comprehensive understanding of its pathogenesis, there were wide variability in diagnostic criteria and treatment outcomes, thus interfering with the correct statistics of its epidemiological data.Through the summary of previous studies, combination with our own research on the pathogenesis of chronic insomnia, we propose that the differences in the subjective and objective assessment of paradoxical insomnia are related to the asynchronous inactivation of the thalamus and cortex during the sleep initiation phase and the cortical activation sequence and intensity disorders in each region after sleep.Furthermore, the diagnosis of paradoxical insomnia and clinical characteristics are described according to the related pathogenesis and a targeted treatment strategy is formulated.Paradoxical insomnia is a type of insomnia with specific pathophysiological mechanism.

Objective To investigate the value of endoscopic retrograde appendicitis therapy ( ERAT) in the diagnosis and treatment of atypical acute appendicitis. Methods All the 48 patients suspected of atypical acute appendicitis in Jiangsu Province Hospital from January 2015 to December 2016 were randomly divided into ERAT group and conservative treatment group according to the treatment method. The final appendectomy rate of the two groups was analyzed. Results Only 17 of the 24 patients in the ERAT group received endoscopic treatment because of complex conditions or personal wishes, and 16 cases were diagnosed as acute appendicitis. Surgical resection was performed in 5 cases because of recurrence of the disease after ERAT, and the appendectomy rate was 31. 2％ ( 5/16 ) . In the conservative treatment group, all 24 patients were treated with antibiotics. Twenty of them underwent surgical resection with appendectomy rate of 83. 3％ ( 20/24) , and 1 of them had appendiceal perforation. The appendectomy rate of the ERAT group was significantly lower than that of the conservative treatment group (χ2=11. 111, P<0. 05) . Conclusion ERAT has a high diagnostic and therapeutic value for atypical acute appendicitis.

This article systematically reviews the research results related to the machine learning based suicide ideation prediction on social networking platforms， so as to provide references for group and individual suicide prediction. This article will address the current states （issues of algorithm accuracy and efficiency， privacy leakage and stigma） and limitations of machine learning based suicide prediction on different platforms （light blogging， acquaintance social platforms， forums， picture and video sharing applications and clinical databases）.