: Insomnia is one of the most often complaints in the stroke patients and its incidence rate in the stroke patients is more higher than in general population.Insomnia can adversely affect the stroke patients' rehabilitation.Sedative hypnotics are still the most often used for insomnia after stroke currently.Furthermore,several studies have compared different pharmachotherapies and nonpharmachological treatments for insomnia after stroke.

Objective To discuss the causes and the prevention measures of the complications occurred after interventional therapy for different type of Budd-Chiari syndrome (BCS). Methods Based on the type of BCS, the corresponding interventional management was adopted in 204 patients with BCS. The interventional procedures included PTA and stent placement of inferior vena cava (IVC), percutaneous transhepatic recanalization and dilation (PTRD) of hepatic vein, percutaneous transjugular or transinferior vena cava recanalization, dilation and stent placement of hepatic vein and transjugular intrahepatic portal-systemic stenting shunt (TIPSS). Results The successful rate of interventional therapy was 95.5% (21 / 22) for type Ia, 81.8% (9 / 11) for type Ib, 97.3% (109 / 112) for type IIa, 92.9% (13 / 14) for type IIb, 88.9% (8 / 9) for type Ⅲa, 100% (2 / 2) type Ⅲb, 92% (23 / 25) for type Ⅳa and 88.9% (8 / 9) for type Ⅳb BCS. The main complications occurred during or after the operation included acute cardiac insufficiency (n = 2), pulmonary arterial embolization (n = 4), disseminated intravascular coagulation (n = 1), extravasation of contrast medium (n = 3), arrhythmia (n = 2), and cardiac tamponade (n = 1). Conclusion Interventional therapy is simple, safe and effective for the treatment of BCS, but its indications should be strictly considered and all kinds of effective prevention measures should be taken to avoid or to reduce the possible complications.

AIM:To analyze the relationship between epicardial adipose tissue (EAT) thickness and plasma N-terminal pro-B-type natriuretic peptide ( NT-proBNP ) level in the patients with stable coronary artery disease . METHODS:The patients with chest pain ( n=115) admitted to our hospital underwent coronary artery computer tomo-graphy and further underwent coronary angiography for confirming whether they had coronary artery disease .EAT thickness was evaluated at the right ventricular free wall imaged by coronary artery computer tomography .Plasma NT-proBNP level was examined by an automatic biochemistry analyzer .RESULTS:Eighty-one patients were confirmed to have stable coro-nary artery disease and thirty-four patients were excluded to have coronary artery disease .Left ventricular ejection fraction of these patients of 2 groups were all normal.The natural logarithm of plasma NT-proBNP level [ln(NT-proBNP)] of the patients with stable coronary artery disease was significantly higher than that of the patients without coronary artery disease (P<0.05).EAT thickness of the patients with stable coronary artery disease was also higher than that of the patients with -out coronary artery disease(P<0.05).EAT thickness was related to ln(NT-proBNP) positively (P<0.05).After adjust-ment of related impact factors , EAT thickness was still related to ln (NT-proBNP) positively (P<0.05).Multiple-factor regression analysis showed that EAT thickness was the independent influence factor on LnNT -proBNP (P<0.05).CON-CLUSION:EAT thickness and plasma NT-proBNP level are both increased significantly and is related to each other in the patients with stable coronary artery disease .

Objective:To study the prevalence of pre-excitation and Wolff-Parkinson-White (WPW) syndrome in adolescents in Beijing area.
Methods: A total of 19 484 adolescents at the age of (15-20) years from Xicheng district of Beijing and the freshmen from Peking University were enrolled for our survey; 12-lead electrocardiography (ECG) screening was conducted and the diagnosis, classification of pre-excitation, WPW syndrome were recorded. The follow-up study was performed in relevant patients.
Results: There were 19 389 qualiifed ECG obtained, among them, 30 (0.15%) patients with ventricular pre-excitation and WPW syndrome identiifed including 17 male (0.17%) and 13 (0.13%) female, the prevalence between male and female was similar (χ2=0.495,P>0.05). There were 6/19389 (0.03%) patients with palpitation and 2 (0.01%) documented by super-ventricular tachycardia. There were 16/30 (53.33%) patients with type A and 14(46.7%) with type B ventricular pre-excitation, the prevalence between male and female was similar (χ2=4.693,P>0.05). The patients were followed-up at the mean of 2.5 (1.5-3) years and no malignant arrhythmia events occurred.
Conclusion: In this cohort survey, prevalence of pre-excitation and WPW syndrome is about 0.15% in adolescents from (15-20) years in Beijing area; the prevalence is similar between male and female subjects.

Decompression is an effective and widely used treatment for jawbone cystic lesions that can, to a great extent, preserve the function and appearance of the jawbone. However, some problems exist with its clinical application, such as the inappropriate determination of indication and the lack of standardized operational guidelines, resulting in treatment ineffectiveness or even failure. This paper aimed to summarize the clinical value of decompression for jawbone cystic lesions in terms of mechanism, scientific evidence, advancement, indications and effective evaluation by reviewing relevant literature and our clinical experience.

Acupressure ; Adult ; Cervical Vertebrae ; Female ; Humans ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Spondylosis ; therapy

Objective To compare the genetic barriers to development of primary mutations related to drug resistance to protease inhibitors (PI), nucleioside reverse transcriptase inhibitors ( NRTI ), and non-nucleioside reverse transcriptase inhibitors ( NNRTI ) among human immunodeficiency virus (HIV)-1 CRF01_AE, CRF07_BC, and CRF08_BC strains, and to understand the difference of varying patterns of drug resistance related mutations within these subtypes. Methods One hundred and ninety naive HIV-positive subjects from Nanning City and Liuzhou City, Guangxi Zhuang Autonomous Region, were recruited. Peripheral blood samples were collected from all participants. HIV-1 RNAs were extracted from plasma, and the pol regions were amplified and sequenced. Sequences were subjected to phylogenetic analysis to determine the subtypes of HIV-1 isolates. Nucleotide transitions and transversions were counted for each primary mutation in these sequences. According to the phenomena that transitions occur on average 2. 5 times frequently than transversions, each transition was scored as 1, and each transversion scored as 2. 5. The sum of the scores for a particular substitution was calculated, and this value was taken as the genetic barrier to development of this mutation. Then, the differences of genetic barriers among the subtypes were assessed by Kruskal-Wallis test and Nemenyi test. Results A total of 123 sequences of CRF01_AE,CRF07_BC and CRF08_BC strains were selected. CRF08_BC had a lower genetic barrier for T/S69Dsubstitution than CRF01_AE and CRF07_BC (χ2 =107. 501, P＜0.01), while CRF01_AE and CRF07_BC had lower genetic barriers for V118I and L210W substitution than CRF08_BC. In addition,CRF07_BC had a decreased genetic barrier for V106M compared with CRF01_AE and CRF08_BC.Conclusions In the presence of the same selective pressure, subtypes CRF01_AE and CRF07_BC may be more likely to develop V118I and L210W substitution than CRF08_BC. However, CRF08_BC may be more likely to develop T/S69D substitution than CRF01_AE and CRF07_BC. Meanwhile, CRF07_BC may be easier to develop V106M substitution than CRF01_AE and CRF08_BC.

Objective To understand dynamic variation of CD4-Positive T-Lymphocytes counts and influencing factors among patients receiving highly active anti-retroviral therapy (HAART) in Guangxi.Methods Adult patients who received antiviral treatment for the first time after 1 January 2013 were selected.Their CD4-Positive T-Lymphocytes counts at baseline,6 months and 12 months after treatment were analyzed.By using the general linear model repeated measures ANOVA,CD4-Positive T-Lymphocytes dynamic variations and influencing factors were described and analyzed.Results The average CD4 cell counts of 4 082 patients at baseline,6th months and 12th months were (195.3 ± 155.7) cells/mm3,(331.9 ± 202.6) cells/mm3 and (380.9 ± 221.3) cells/mm3,respectively.The time specific differences in CD4-Positive T-Lymphocytes count among them were statistically significant (F=3 161.124,P=0.000).CD4-Positive T-Lymphocytes counts increased over time after treatment.The main influencing factors were sex,age,baseline CD4 cell count,medication,discontinuation of treatment or dose miss.Influenced by sex,age,medication,discontinuation of treatment or dose miss,the increased CD4-Positive T-Lymphocytes count showed a linear trend.Influenced by baseline CD4-Positive T-Lymphocytes counts and dose miss,the increase of CD4-Positive T-Lymphocytes count showed a trend which was conformed to quadratic curvilinear equation.Conclusion CD4-Positive T-Lymphocytes counts among patients receiving HAART in Guangxi were influenced by many factors.It is necessary to select the time to start treatment according to patient' s characteristics to get good outcome.

Objective:To investigate the prognostic value of serum free triiodothyronine (FT3) in patients with hepatitis E-related acute liver failure (HEV-ALF).Methods:Clinical data of 88 patients with HEV-ALF and 86 patients with acute hepatitis E (AHE) were collected from the member hospitals of Chinese Consortium for the Study of Hepatitis E between January 2016 and December 2021; the data of 100 health subjects who underwent health check-up in Suzhou Municipal Hospital were also collected as healthy control (HC) group. Serum FT3 levels were analyzed in all subjects. HEV-ALF patients were divided into survival group ( n=73) and death group ( n=15) according to their 30 day survival. Correlation between serum FT3 level and prognosis of HEV-ALF patients were analyzed by Cox regression and orthogonal partial least squares discriminant analysis (OPLS-DA). The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to assess the predictive value of serum FT3 levels for predicting the prognosis of patients, and its prediction efficacy was compared with conventional Model for End-Stage Liver Disease (MELD), King’s College Hospital criteria (KCH) and Child-Pugh models. Results:The levels of serum FT3 in HEV-ALF patients were significantly lower than those in AHE patients and HC group ( P=0.006 or <0.001). Cox regression analysis showed that international standardized ratio ( HR=17.984, 95% CI 2.804-115.362), hepatic encephalopathy ( HR=12.895, 95% CI 2.386-69.695) and total cholesterol ( HR=2.448, 95% CI 1.108-5.409) were independent risk factors for death in HEV-ALF patients, and serum FT3 level ( HR=0.323, 95% CI 0.119-0.876) was a protective factor. OPLS-DA results showed serum FT3 levels had high predictive value. ROC curve analysis results showed that the area under the curve was 0.828 (95% CI 0.733-0.900, P<0.001), the sensitivity was 80.00%, and the specificity was 78.08%. DCA showed that FT3 has good prediction ability and decision-making level serum FT3 levels in patients with improvement and fluctuation were significantly higher than those in the patients with deterioration ( P<0.05 or <0.01). Conclusion:Serum FT3 levels are closely related to the prognosis of HEV-ALF patients and it may be used as a biomarker for the prognosis of patients with HEV-ALF.

OBJECTIVESTo investigate the incidence of syphilis infection and to determine the risk factors related to syphilis infection among young men who had sex with men (YMSM), which were documented for developing effective intervention to prevent sexually transmitted diseases among YMSM.

METHODSA cohort study was conducted in 8 cities (Beijing, Shanghai, Kunming,Guiyang, Chongqing, Chengdu, Urumqi and Nanning) from May to December, 2009. A total of 1 037 syphilis-negative YMSM aged 18-25 were enrolled in the cohort and the two follow-up surveys were carried out every six months. The contents of study included sociodemographic characteristics, HIV-related knowledge, sexual behavior and condom use in the 6 months prior to survey. All participants were tested for syphilis with whole blood specimens. Chi-square test was used to compare demographic characteristics of participants in baseline with those of two follow-up, and Cox regression analysis was used to identify risk factors associated with syphilis infection.

RESULTSThe rates of participants in 6, 12 months follow-up surveys was 79.85% (828/1 037) and 82.16% (852/1 037) respectively.39 syphilis seroconversions were found in the 12 months follow-up survey. Cumulative observed person-years during follow-up time was 1 106.67. The syphilis incidence rate was 3.5%. The Multivariate Cox regression analysis showed that the education of senior high school (senior high school vs some college or higher, RR = 2.19, 95% CI:1.21-3.98), bisexual orientation (bisexual orientation vs homosexual orientation, RR = 2.19, 95% CI:1.21-3.97), score of HIV/AIDS knowledge <8 (score of HIV/AIDS knowledge <8 vs knowledge = 8, RR = 2.39, 95%CI:1.35-4.21), had two and more sexual partners and inconsistent condom use in the past 6 months (inconsistent condom use vs consistent condom use, RR = 3.10, 95% CI:1.39-6.91) were significantly associated with syphilis seroconversion in the 12-month period.

CONCLUSIONSThe syphilis incidence was high and risk behaviors were common among YMSM of China.

Adolescent ; Adult ; China ; epidemiology ; Cohort Studies ; Homosexuality, Male ; Humans ; Male ; Risk Factors ; Risk-Taking ; Syphilis ; epidemiology ; Young Adult