Background:Some functional dyspepsia(FD)patients are accompanied by sleep disorder,which severely affects the quality of life. Aims:To explore psychological factors and quality of life of FD patients with sleep disorder. Methods:A total of 240 FD patients from Jan. 2013 to Jan. 2014 at the Second Affiliated Hospital of Xi’an Jiaotong University and the Affiliated Hospital of Yan’an University were enrolled,and were divided into sleep disorder group and non-sleep disorder group according to Pittsburgh sleep quality index. Zung’s self rating anxiety scale,Zung’s self rating depression scale and SF-36 quality of life questionnaire were performed in all the patients. Results:Compared with non-sleep disorder group, the incidence of anxiety(72. 5% vs. 40. 8% )and incidence of depression(65. 0% vs. 37. 5% )were significantly higher in sleep disorder group(P < 0. 05). Score of physical function(86. 65 ± 3. 84 vs. 88. 88 ± 4. 56),vitality(44. 79 ± 18. 13 vs. 54. 63 ± 9. 63),mental health(46. 90 ± 11. 47 vs. 63. 42 ± 17. 60),general health(42. 79 ± 11. 07 vs. 58. 29 ± 14. 99)in sleep disorder group were significantly lower than those in non-sleep disorder group,and no significant differences in physical role function,emotional role function,social role function,and body pain were found between the two groups(P > 0. 05). In patients with sleep disorder,the incidence of mental disorder was significantly different among young age group,middle age group and old age group(50. 0% ,55. 0% ,80. 0% ,respectively)(χ2 = 8. 10,P < 0. 05), and the incidence of mental disorder in male patients was significantly lower than that in female patients(32. 6% vs. 79. 2% ;χ2 = 25. 62,P < 0. 05). Conclusions:FD patients with sleep disorder has its own clinical characteristics. Study on the clinical characteristics of FD patients with sleep disorder could facilitate the effectiveness therapy,and has important significance in improving the quality of life.

Background:Nocturnal gastroesophageal reflux (nGER)is associated with severe complication of gastroesophageal reflux disease (GERD),such as esophagitis,esophageal stricture and Barrett's esophagus,and has certain effect on quality of life. Aims:To study the characteristics of nGER and its influencing factor in patients with GERD. Methods:GERD patients with typical reflux symptoms (heartburn or/ and regurgitation)and nGER confirmed by MII-pH monitoring were included. Effects of gender,age,BMI,DBI on nGER were analyzed. Results:In 130 patients with GERD,97 (74. 6%)had nGER. Of the 97 patients with nGER,only 18 (18. 6%)patients complained nocturnal heartburn or/ and regurgitation. During nocturnal period,female and elderly GERD patients had delayed bolus clearance time. Percentage of time with pH < 4 and acid reflux of GERD patients with BMI≥25 kg/ m2 were significantly higher than patients with normal BMI. Nocturnal acid reflux was much lower in patients with DBI≥2. 5 hours than patients with DBI < 2. 5 hours. The weakly acidic reflux could significantly decrease along with the getting longer of DBI. Conclusions:nGER is prevalent in GERD patients,and weakly acidic reflux is the leading type,however,only a small part of patients having nocturnal reflux symptom. The female and elderly GERD patients have delayed bolus clearance time during nocturnal period. BMI≥25 kg/m2 is associated with nGER. DBI≥2. 5 hours could significantly reduce acid reflux during nocturnal period. DBI should be as long as possible for reducing weakly acidic reflux.

Objective To explore the treatment strategies of pleuroparenchymal fibroelastosis (PPFE). Methods A 22-year-old male patient was complicated with PPFE after receiving chemotherapy in combination with stem cell transplantation for lymphoma. He underwent thoracoscopic left lung tongue wedge resection, bilateral pleurodesis followed by allogeneic left lung transplantation. Literature review was performed to analyze the etiology, pathogenesis, imaging features, pathological features and treatment of PPFE. Results The PPFE patient required the non-invasive ventilator for 24 h before lung transplantation. After lung transplantation, the shortness of breath and respiratory failure were cured and the quality of life was significantly improved. No eligible studies was found in the domestic database, and 26 literatures published in English were found in the international databases. Among them, 9 literatures (case reports) were finally included after screening. PPFE could be divided into the primary and secondary categories according to the etiology. The clinical manifestations of PPFE mainly included dry cough, dyspnea on exertion, chest pain, repeated pneumothorax and body weight loss. Chest CT scan demonstrated irregular thickening of the pleura in bilateral upper lungs. Pathological manifestations consisted of evident thickening of the visceral pleura, fibroelastosis and arrangement disorder in the pleura and the underlying pulmonary interstitium. PPFE could progress rapidly. Adrenocortical hormone and other immunosuppressive agents yielded low clinical efficacy and poor clinical prognosis. Lung transplantation was a necessary treatment for PPFE. Conclusions PPFE cannot be effectively treated by conservative therapy. It is recommended to deliver lung transplantation as early as possible.

OBJECTIVE To analyze the dose-adjusted concentrations of Posaconazole oral suspension in patients undergoing hematopoietic stem cell transplantation （HSCT） and their influential factors. METHODS Data were collected from hospitalized HSCT patients admitted to the First Affiliated Hospital of Shandong First Medical University （Shandong Provincial Qianfoshan Hospital） from January 2021 to April whtwhm@yeah.net 2023 who took Posaconazole oral suspension for the prevention of invasive fungal disease （IFD） and received blood concentration of posaconazole. The rate of concentration attainment and clinical failure rate of posaconazole for the prevention of IFD were evaluated， and one-way and multiple linear regression analyses were performed for the influential factors of dose-adjusted concentrations （C0/D） of posaconazole. RESULTS A total of 44 patients were enrolled； the mean C0 of posaconazole in patients was （0.99±0.94） µg/mL， and 20 patients had a C0≥0.7 μg/mL， with a concentration attainment rate of 45.45% for the prevention of IFD； 13 cases were clinical failures， with a clinical failure rate of 29.55%. Of 24 patients who did not achieve C0/D of posaconazole for IFD prophylaxis， one patient was a clinical failure despite timely dose adjustment of posaconazole in seven patients； seven of the thirteen patients who did not undergo dose adjustment were clinical failures； and the remaining four patients were switched to other antifungal agents. The results of univariate analysis showed that gender， body mass index （BMI）， renal function， combined use of sodium phenytoin， omeprazole and metoclopramide had a significant effect on the C0/D of posaconazole （P＜0.05）； the results of multivariate linear regression analysis showed that gender， BMI and combined use of sodium phenytoin were the independent factors affecting the C0/D of posaconazole （P＜0.05）. CONCLUSIONS Significant individual differences are reflected in the blood concentration of Posaconazole oral suspension； gender， BMI and combined use of sodium phenytoin are independent factors affecting the C0/D of posaconazole.