Objective To objectively analyze the manifestation of sleep disorders in patients with Parkinson' s disease (PD) using polysomnogram (PSG) and multiple sleep latency test (MSLT). Method Twenty-six patients (PD group)with PD and 31 controls without CNS diseases( control group) underwent all night ambulatory video-polysomnographic monitoring and MSLT on the next day. Sleep architecture, mean sleep latency,sleep onset rapid eye movement (REM) periods(SOREMPs) and sleep attacks(Sas) of the two groups were analyzed. Results When compared to the controls, percentage of NREM stage 2 sleep,percentage of REM sleep, mean sleep latency in the PD patient group were significantly decreased (32.8% ±13.1% vs40.2% ±9.1%,t = -2.515;8.6% ±5.3% vs 11.5% ±5.1%,t = -2.054;(9.6 ± 4. 4) min vs ( 15.7 ± 3. 1 ) min, t = - 6. 1 64, all P ＜ 0. 05 ), while arousal index was significantly increased ( (41.8 ± 32. 1 )/h vs ( 28.6 ± 1 1. 0 )/h, t = 2. 151, P ＜ 0. 05 ). The prevalence of excessive daytime sleepiness (EDS; 7/26, 26. 9% ) was higher in the PD patient group than in the controls (1/31,3. 2%; ×2 =4. 764,P＜0. 05). Multivariate linear regression analysis showed that after adjusting for sleep efficiency, apnea hypopnea index, arousal index, decreasing mean sleep latency in PD patients was significantly associated with both age( β = -0. 328) and levodopa equivalents( β = -0. 008; t = -2. 829,-2. 352,all P ＜ 0.05). SOREMPs occurred in 5 of 26 (19.2%) PD patients and Sas occurred in 3 ( 11.5% ) PD patients but did not occur in the controls. Conclusion Changes in sleep architectures and EDS are more common in PD patients. Physicians should be highly vigilant in recognizing Sas, which are uncommon in PD patients.

OBJECTIVE To analyze the monitoring performance and testing efficacy and reliability of standardized disposable B-D test pack and standard linen test pack,and summarize the corrective actions based on failure analyses for future reference.METHODS The two different test packs were employed to evaluate the vacuum performance of dynamic air removal sterilizer.RESULTS We enrolled 400 standardized disposable B-D test packs and standard linen test packs respectively.The disposable pack failed 4 cases with the success ratio 99%,while the linen pack failed 30 cases with the success ratio 92.5%.CONCLUSIONS The poor conformity of hand-made linen test pack,variation of steam pressure,sterilizer failure,and unprofessionalism of sterilizer operator contribute as main failure causes in B-D test.Standardized disposable B-D test pack can decrease subjective factors significantly,and the test results are more reliable and standardized.

2.83 cm(left-right).The density of lymphocele was homogeneous ,with 0~15 HU(mean value,5.7HU).Adjacent organs were displaced by compression of lymphocele.Conclusion It should be diagnosed as a lymphocele if a pelvic cyst is found in postoperation of pelvic malignant tumor.

Objective To explore the effect of three surgical positions on needle-assisted thoracoscopic sympathicotomy. Methods Sixty patients undergoing needle-assisted thoracoscopic sympathicotomy were divided into lateral position group，Fowler position group，and modified Fowler position group. The position of the endotracheal tube，noninvasive blood pressure (NIBP) and heart rate were monitored before and after the body position was changed. Moreover，the exposure of surgical field,operation time and comfort degree of patients were recorded. Results The operations were completed successfully under the three positions. Modified Fowler position provided better surgical field and higher comfort degree of patients. Moreover,it was convenient for operative procedure and shortened the operation duration. Conclusion During the operation of needle-assisted thoracoscopic sympathicotomy,modified Fowler position can provide better surgical exposure,enhance comfort of patients,stabilize hemodynamics and shorten operation duration.

AIM:To investigate the renal function and pathological changes in Npc1 mutant ( Npc1-/-) mice. METHODS:Different genotypes of Niemann-Pick disease type C1 (Npc1) mice were identified by PCR.Subsequently, the renal function of Npc1-/-and Npc1 +/+mice at postnatal day 60 ( P60) was evaluated by measuring the activity and con-tent of important indicators in the serum including ALT , AST, LDH, urea, UA and Cr.Furthermore,β-galactosidase stai-ning and Masson staining were performed to examine the aging and fibrosis of the renal tissues , respectively .RESULTS:Compared with the Npc1 +/+mice, the body weight and kidney weight had a significant reduction ( P<0.01) in the Npc1-/-mice.The results of hepatic and renal functions showed that the activities of ALT , AST and LDH, and contents of urea, UA and Cr had marked increases (P<0.05) in the Npc1-/-mice.Moreover, the results of senescence-associatedβ-galacto-sidase staining in the renal tissues demonstrated accelerated aging in the Npc1-/-mice (P<0.01), and these results were confirmed by Masson staining, which clearly showed the formation of collagen fibers (P<0.01).CONCLUSION:Muta-tion of the Npc1 gene results in abnormal lipid metabolism , which accelerates kidney senescence by promoting fibrosis in the renal tissue and subsequently causes reduction in renal function .

Objective:To evaluate the diagnostic value of digital breast tomosynthesis (DBT) and digital mammography (DM) for radial lesions.Methods:The data of 76 patients (78 lesions) with radial lesions confirmed by operation and pathology on DBT between December 2016 and May 2020 in the Affiliated Hospital of Qingdao University were analyzed retrospectively. Taking pathological results as the gold standard, 78 lesions were divided into benign radial lesions ( n=46) and malignant radial lesions ( n=32), and their DBT features were compared. According to the standard of breast imaging report and data system (BI-RADS), the wheel-spoke structure, central density, overall size, central size and surrounding burr length of the two groups of radial lesions were compared on DBT. Results:The detection rates of DM and DBT for 78 radial lesions were 59.0% (46/78) and 100% (78/78), the difference had statistically significant ( P<0.05). The diagnostic accuracy rates of DM and DBT for 78 radial lesions was 65.2% (30/46) and 74.4% (58/78), the difference had no statistically significant ( P>0.05). The sensitivity, specificity, misdiagnosis rates, missed diagnosis rates of DM and DBT in the diagnosis of malignant radial lesions were 64.3%(18/28) and 84.4%(27/32), 66.7% (12/18) and 67.4%(31/46), 33.3%(6/18) and 32.6%(15/46), 35.7%(10/28) and 15.6%(5/32), respectively. The difference was not statistically significant ( P>0.05). There were significant differences in the overall size of lesions [18.0 (14.9, 29.2) mm, 26.5 (20.2, 34.9) mm], central size [3.5 (2.5, 4.5) mm, 4.5 (3.5, 5.5) mm] and peripheral burr length [(11±6) mm, (13±4) mm] between benign and malignant radial lesions on DBT ( P<0.05). When the central size of the lesion was 5 mm, there was significant difference in the distribution of benign and malignant radial lesions ( P<0.05), and when the overall size of the lesion was 2 cm, there was significant difference in the distribution of benign and malignant radial lesions ( P<0.05). Conclusion:DBT can improve the detection and diagnosis accuracy of radial lesions, and provide an important basis for clinicians to make surgical treatment decisions.

Objective To investigate the primary autoantigens which contribute to the production of anti-DNA antibodies. These antibodies are serological hallmark and pathogenic factor of systemic lupus erythematosus (SLE).Methods Nonautoimmune predisposed BALB/c mice were immunized with concanavalin A (Con A) activated, lipopolysaccharide (LPS) activated and nonactivated syngeneic spleen cells. Nuclei and chromatin from activated/nonactivated lymphocytes were isolated and syngeneic mice were immunized. Sera were taken after the third immunization. IgG anti-dsDNA antibody was determined by ELISA (calf thymus DNA treated with S1 nuclease was used as the coated antigen). The glomerular IgG deposition was observed by immunofluorescence one month after the third immunization.Results Con A activated T cells and LPS activated B cells induced anti-double stranded (ds) DNA antibody in syngeneic nonautoimmune BALB/c mice and formed the glomerular IgG deposition. Further studies showed that active chromatin isolated from activated lymphocytes induced anti-ds DNA antibody, but not resting chromatin isolated from nonactivated lymphocytes.Conclusions Activated lymphocytes and their active chromatin could be the autoimmunogen(s) driving the anti-dsDNA antibodies. The change of chromatin's antigenicity by environmental factors and genetic background may be the common pathway to SLE pathogenesis.

OBJECTIVE To investigate the correlation between benign paroxysmal positional vertigo (BPPV) and bone mineral density (BMD) in menopausal women with BPPV.METHODS 50 patients between the ages of 50-80 years old of menopausal women with Idiopathic benign paroxysmal positional vertigo(iBPPV)as case group,and postmenopausal healthy people of same age doing physical examinations in hospital medical examination center were selected as control group.The lumbar spine(L1-L4) and femoral neck were measured respectively using dual energy X-ray absorptiometry and expressed in T value.The case group and the control group were divided into three age groups,and the T values of three age groups were statistically analyzed.RESULTS There was significant correlation between the case group and control group(The t values are-3.68、-5.98 and-3.33,respectively,P＜0.05).Pearson correlation analysis showed that there was a negative correlation between iBPPV and bone mineral density(BMD) (r=-0.496,P＜0.05).CONCLUSION There was a correlation between benign paroxysmal positional vertigo and BMD in menopausal women.The results of this study may be helpful for the diagnosis,treatment,prognosis and precaution of iBPPV.

Objective To compare the diagnostic value of digital breast tomosynthesis (DBT), digital mammography(DM),and ultrasonography(US)for the non-calcified ductal carcinoma in situ(DCIS) of the breast.Methods To retrospectively analyze the imaging and clinical data of ductal carcinoma in situ which was confirmed by surgical pathology and displayed as non-calcified lesions in mammography in 110 patients.DBT,DM and US were performed in all the 110 cases.The breast imaging report and data system (BI-RADS)classification and breast density classification were evaluated using the 5th edition of BI-RADS. In our study, BI-RADS 4B, 4C, and 5 were regarded to be in agreement with the pathologic findings, BI-RADS 1,2,3,and 4A were considered to be negative.BI-RADS c and d were classified as dense breasts, BI-RADS a and b were classified as fatty breasts.The imaging findings of the non-calcified ductal carcinoma in situ were evaluated.The differences in the detection rate and the diagnostic accuracy among the DBT,DM and US in all cases and in different breast density were compared using χ2 test. Results The detection rates of DBT,DM,and US for non-calcified DCIS in all cases were 84.5%(93/110),70.9%(78/110),95.5% (105/110).Pairwise comparisons among the three techniques showed statistically significant difference(P<0.05). The diagnostic accuracy of DBT, DM, and US were 70.0% (77/110), 44.5% (49/110), and 69.1% (76/110),respectively.The diagnostic accuracy of DBT and US were significantly higher than that of DM(P<0.01). Of the 110 patients, 89 patients were classified as dense breasts and non-dense breasts in the remaining 21 patients.The detection rates of DBT,DM,and US for non-calcified DCIS in dense breasts were 82.0%(73/89),65.2%(58/89),and 96.6%(86/89).Pairwise comparisons among the three techniques showed statistically significant difference(P<0.01).The diagnostic accuracy of DBT,DM,and US for non-calcified DCIS in dense breast were 65.2% (58/89), 38.2% (34/89) and 66.3% (59/89), respectively.The diagnostic accuracy of DBT and US were significantly higher than that of DM in dense breast(P<0.01).The detection rate and diagnostic accuracy for DBT,DM,and US in non-dense breasts were not statistically different(P>0.05).By DBT and DM,most cases of non-calcified DCIS presented as a mass lesion with an irregular shape, indistinct margin,and isodense composition.Conclusion US is more advantageous to the detection of the non-calcified DCIS and the non-calcified DCIS in the dense breast.

Objective:To comparative analyze mammographic and clinicopathological findings of ductal carcinoma in situ (DCIS) and DCIS with microinvasion (DCISM), and to investigate the predictive factors for DCISM.Methods:A total of 626 patients with DCISM and DCIS confirmed by surgery and pathology in the Affiliated Hospital of Qingdao University from January 2016 to July 2020 were collected and underwent preoperative mammography. The X-ray findings of DCISM and DCIS patients were classified and diagnosed according to the Breast Imaging Reporting and Data System (BI-RADS) criteria. The differences in clinicopathological and radiographic findings between DCISM and DCIS patients were analyzed using χ 2 test or Fisher exact test. The risk factors of DCISM were evaluated by using univariate and multivariate binary logistic regression analysis. Results:Among the 626 cases, 171 were diagnosed as DCISM, 455 were diagnosed as DCIS. Large diameter (≥2.7 cm), high nuclear grade, comedo type, axillary lymph node metastasis, high Ki67 proliferation index, negativity of estrogen receptor and progesterone receptor were found to be predictors of DCISM in the univariate analysis (all P<0.05). And large diameter (≥2.7 cm)(OR 2.229,95% CI 1.505-3.301, P<0.001), high nuclear grade(OR 1.711,95%CI 1.018-2.875, P=0.043) and axillary lymph node metastasis(OR 4.140,95% CI 1.342-12.773, P=0.013) were found to be independent predictors of DCISM in the multivariate analysis (all P<0.05). Mammographically, the lesion types, the presence and distribution of calcification were statistically significant between DCIS and DCISM patients (χ 2=17.42, 9.65, 9.10, P<0.05). Up to 17.6% (80/455) of DCIS were occult leisions, and DCISM showed more lesions with calcification in mass, asymmetry, and architectural distortion (49.1%, 84/171). Grouped calcifications were usually associated with DCIS (41.5%, 120/289), while regional calcification were commonly found in DCISM (35.9%, 47/131). Conclusions:Lesions with calcification and regional calcification were more likely associated with DCISM on mammography. Large diameter (≥2.7 cm), high nuclear grade and axillary lymph node metastasis were found to be independent predictors of DCISM.