Narcolepsy is a chronic rapid eye movement sleep disorder that is characterized by lethargy and its four common clinical features are excessive daytime sleeps, cataplexy, hypnagogic and hypnopompic hallucinations, and sleep paralysis. Narcolepsy onset usually occurs in childhood. Because of the onset with atypical symptoms, the poor expression in children and currently no special diagnostic criteria for children, the rate of missed diagnosis and misdiagnosis were increased in children. This paper reviews the progress of research in pathogenesis of narcolepsy and the differences of children from adult in clinical symptoms, diagnosis and treatment.

Objective To assess the epidemiology and clinical characteristics of sleep disorders in a single center in northwest China.Methods Using the International Classification of Sleep Disorders, 3rd Edition, all consecutive patients which were suspected as sleep disorders in Tangdu Hospital between January 2007 and December 2016, were included retrospectively.Results The average age of 8 037 patients was (46.59±15.83) years with male-female ratio 1∶1.24.Chronic insomnia was found in 3 848 (47.9%) patients, obstructive sleep apnea was found in 2 648 (32.9%) patients, narcolepsy was found in 294 (3.7%) patients, Kleine-Levin syndrome was found in 11 (0.1%) patients, circadian rhythm sleep-wake disorders were found in 14 (0.2%) patients, rapid eye movement behavior disorder was found in 193 (2.4%) patients, restless legs syndrome was found in 139 (1.7%) patients, periodic limb movement disorder was found in 109 (1.4%) patients, and other possible sleep disorders were found in 478 (5.9%) patients, respectively.Chronic insomnia and obstructive sleep apnea combided with somatic diseases.Conclusions Patients diagnosed by polysomnography in our single center suggested consultation rate of sleep disorders was increasing in past ten years, of which chronic insomnia and obstructive sleep apnea were dominant and comorbided with somatic diseases.

Objective To establish CT image-based, three-dimensional finite element models of healthy tibiae and plateau-fracture tibiae, and to calculate the displacement and stress distribution of the tibial models .Methods Continuous-time tomographic images of knee joints of a healthy adult and a patient with tibial plateau fractures were obtained using multi-slice spiral CT scan , and inputed to Mimics to establish three-dimensional surface mesh models of tibiae .The models underwent global meshing procedures and material properties assignment to construct finite element models of normal and plateau-fracture tibiae in ANSYS , and the newly established models were analyzed and calculated .Results In case of applied load on the tibial plateau , the peak strains of the load-contact sites in the healthy subject and the patient presented divergent directions , with peak strains on the medial tibia in the healthy subject and lateral tibia in the patient , respectively . Equivalent stress decreased gradually down the tibiae and concentrated in the one -third of the upper and middle regions in both types of tibiae .Moreover, concentration of stress was also present in the locus of the fractured tibia .The deformation displacement gradients were more evident in the healthy tibia than in the fractured tibiae .There was significant difference in overall stress distribution between the two types of tibiae .Conclusion Three-dimensional finite element models of tibiae have been established that can demonstrate the differences in biomechanical properties between healthy and plateau -fracture tibiae, which might provide reference and guidance for orthopedic regimens .

Objective To explore the therapeutic effects of 660 nm red light on sciatic nerve injury in adult rats.Methods Forty-five adult,male rats were divided into a control group and treatment groups 1,2,3 and 4.Sciatic nerve injury was modeled by crushing the nerve.The treatment groups received irradiation with red light once daily for 21 consecutive days.The power density of red light and irradiation time varied among the groups.The latency and amplitude of compound muscle action potentials (CMAPs) and nerve conductive velocity were examined at different time points.The Sciatic Function Index (SFI) was used to evaluate walking function.Results After 21 days of red light therapy no statistically significant differences were observed between the control group and treatment groups 1 to 4 with regard to the latency or the amplitude of the CMAPs.There was a significant difference between the control group and treatment group 3 in terms of sciatic nerve conduction velocity.The average Sciatic Function Indexes of treatment groups 2,3 were significantly different from that of the control group.Conclusion Red light irradiation can promote recovery after sciatic nerve injury,at least in rats,thereby improving walking function.

Parkinson's disease(PD)and restless legs syndrome(RLS)are relatively common movement disorders.There has been much debate over whether an etiological link exists between these two diseases and whether they share common pathophysiological mechanisms.PD and RLS may co-occur and respond well to dopaminergic agents, suggesting there is underlying dopamine dysfunction in both conditions.Despite the overlapping clinical features, the mechanisms underlying idiopathic RLS and RLS associated with PD may differ.In this article, we review studies related to the epidemiology, pathophysiology and genetics of PD with concurrent RLS, in order to provide evidence for exploring the link between RLS and PD.

Restless legs syndrome is a common motor-sensory disease of the nervous system. The main manifestations are an urge to move the legs, usually accompanied by or thought to be caused by uncomfortable and unpleasant sensations in the legs. These symptoms may begin or worsen during periods of rest or inactivity such as lying down or sitting and be partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues. This article will systematically review the pathogenesis, clinical manifestations, diagnostic criteria, differential diagnosis and treatment of restless legs syndrome.

Objective　To analyze the use of drugs andinfluencing factors of objective sleep disturbance among chronic insomnia patientsand to provide some normalization reference for clinical drug use. Methods　357 patients with definite chronic insomnia were selected. All patients were assessed with the Symptom Checklist （SCL-90），Hamilton Anxiety Scale （HAMA），Hamilton Depression Scale （HAMD），Pittsburgh sleep quality index （PSQI），Epworth sleepiness scale （ESS）. Polysomnography was used to evaluate objective sleep quality. Results　（1）The use of sedative and hypnotic drugs and other drugs that may affect sleep in the past 1 month before the first visit to the Sleep Center of our hospital was 53.50% for no drugs，46.5% for drugs and 18.21% for BzRAs among them. （2） The ESS scores of pharmacologic-therapy group was significantly lower than those in no-drugs group （Z=-2.463，P=0.014）. The total time sleep（Z=-3.521，P<0.001），Sleep efficiency（Z=-3.164，P=0.002），R%（Z=-3.044，P=0.003）were both significantly lower than those in no-drugs group. （3）The multivariate logistic regression results showed male （OR=1.938，95%CI 1.071～3.505，P=0.029），highly educated（OR=2.222，95%CI 1.196～4.130，P=0.012），anxiety state（OR=2.029，95%CI 1.018～4.043，P=0.044） and medication history（OR=1.974，95%CI 1.091～3.573，P=0.025） were the factors influencing SL>30 min. Age is the common factors for WASO>30 min（OR=1.052，95%CI 1.023～1.082，P<0.001），WASO>60 min（OR=1.068，95%CI 1.046～1.091，P<0.001） and SL>30 min and/or WASO>60 min （OR=1.068，95%CI 1.046～1.091，P<0.001）. Conclusion　Some patients have a high percentage of sleep-related medications before their first visit in our center，Most used was benzodiazepine receptor agonists. Gender，education，anxiety state and medication historywere the factors influencingsleep latency. Age is the common factors for difficulty maintaining sleep.

Objective To investigate the shedding of CAV2-ΔE3-CGS after immunization and the background of canine adenovirus (CAV) infection, and to establish a dual fluorescent quantitative PCR detection method for rabies virus (RV) and canine adenovirus type 2 (CAV2). Methods A dual fluorescent quantitative PCR detection method was established by designing specific primers and probes for E1 gene of CAV and G gene of RV for the detection of CAV2-ΔE3-CGS. Oral swabs, anal swabs and environmental samples of stray dogs from experimental animal farm and dog detention center were tested. Results The standard curves generated by this method were Y=-3.351 × logX + 44.895, R² = .999 and Y=-3.413 × logX + 45.192, R²=0.996, respectively. The linear relationships were good, and the minimum detection limits were both 102 copies/μL. CAV2-ΔE3-CGS was not detected in experimental animal farm. CAV was detected in dog detention center, and the positive rates were 5.88% (5/85) in oral swabs, 8.24% (7/85) in anal swabs, and 4% (1/25) in environmental samples. Conclusion The dual fluorescent quantitative PCR method can be used for the detection of CAV2-ΔE3-CGS after immunization and the investigation of CAV infection. The present study has shown that no CAV2-ΔE3-CGS has been detected after immunization and CAV infection rate of stay dogs is low in Shanghai. CAV2-ΔE3-CGS oral immunization meets requirement and is applicable.

Objective: To investigate the clinical outcomes of selective major aortopulmonary collaterals(MAPCAs) unifocalization and report histopathological findings in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals(PA/VSD/ MAPCAs). Methods: The study enrolled 6 MAPCAs/VSD/PA patients with age ranged from 6 to 96 months and body weight ranged from 5.0 to 23.0 kg. These patients underwent selective MAPCAs unifocalization and primary repairs. Preoperative cardiac catheter, selective arteriography, cardiac CTA and intraoperative pathology were performed to identify different function, anatomic distribution and histopathology of MAPCAs. Results: 6 MAPCAs/VSD/PA patients underwent selective MAPCAs unifocalization and primary repair. No death occurred after operation and at follow-up which lasted for 1 to 20 months. Preoperative cardiac catheter, selective arteriography and intraoperative histopathology demonstrated distribution of functional MAPCAs similar to native pulmonary artery arborization and participating in arterial gas exchange. Functional MAPCAs were classified into elastic arteries according to histopathology. Conclusion There are two histological type of MAPCAs which play different roles. Selective unifocalization to functional MAPCAs which are classified into elastic arteries like native pulmonary artery is a safe and effective treatment approach for PA/VSD/MAPCAs.