Objective To assess the effect of remote-interactive cognitive behavioral therapy in pa-tients with chronic insomnia.Methods A total of 62 patients with chronic insomnia were randomly divided into combined treatment group,cognitive behavioral therapy for insomnia ( CBTI) group and drug treatment group.The study lasted for 6-8 weeks.The curative effects were assessed using sleep diary and scales.Results The sleep onset latency (SOL) ((39.9±23.7)min) and wake time after sleep onset(WASO) ((79.1± 39.4) min) in the drug treatment group were higher than that in the combined treatment group ( ( 25.5 ± 11.2)min and (54.4±38.5)min,respectively) and CBTI group ((27.8±11.6)min and (51.8±29.0)min,re-spectively) at the end of treatment,the difference was statistical significance( P=0.018 and P=0.046 respec-tively).The sleep efficiency(SE) in drug treatment ((76.5±11.9)%) was lower than that in the other two groups((83.8±8.7)%and (82.8±7.0)%respectively),(P=0.042).And no similar difference were seen in TST after treatment(P>0.05).The Brief Version of Dysfunctional Beliefs and Attitudes about Sleep(DBAS-16) score in the drug treatment group (97.6±16.4) was higher than the other two groups((67.5±20.1) and ( 75.0±26.9) respectively) after treatment(P=0.000) .No significant difference was seen in scores of the oth-er scales among the three groups(P>0.05) .After treatment,a greater proportion of patients in the combined treatment group had withdrawn from hypnotics use completely (29%(6/20) vs 5%(1/18);odds ratio( OR ) was 7.286);and the combined treatment group produced significant reduction in frequency of hypnotics use ((3.35±3.05) nights/week) when compared with drug treatment group((5.56±2.33) nights/week, P=0.016) .Conclusions Remote-interactive cognitive behavioral therapy was effective and acceptable for treating pa-tients with chronic insomnia,combining drug treatment in the early period could quickly relieve the symptoms of in-somnia,and can avoid the adverse effect from the hypnotics.And the treatment method can reduce the dropout rate.

Objective To explore the correlation between oxygen reduction index(ODI) with blood lipid and renal function in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) .Methods Selected 208 patients by polysomnography (PSG) and diagnosed as OSAHS ,divided into four groups according to ODI(ODI ≤ 7 ,7 < ODI ≤ 18 ,18 < ODI ≤ 38 and ODI > 38) .Four groups were compared in total cholesterol (TC) ,triglyceride (TG) ,high‐density lipoprotein cholesterol (HDL‐C) ,low density lipo‐protein cholesterol (LDL‐C) ,apolipoprotein A1 (ApoA1) ,apolipoprotein B (ApoB) ,urea ,creatinine ,uric acid and other differ‐ences ,analysis the correlation between ODI with blood lipid and renal function .Results There were significant different in TC ,TG , HDL‐C ,LDL‐C ,ApoB ,urea ,creatinine ,uric acid in four groups with different degree of ODI (P< 0 .05) ;ODI were positively relat‐ed to TC ,TG ,LDL‐C ,ApoB ,urea ,creatinine ,uric acid levels ,and negatively related to the level of HDL‐C .Conclusion Abnormity of blood lipid metabolic and changes in renal function are associated with the increase of ODI in patients with OSAHS .

Objective To evaluate the role of Toll-like receptor 4 (TLR4) in non-medullary andmedullary cells in lung ischemia-reperfusion (I/R) injury in mice.Methods Ten healthy male TLR4+/+ in non-medullary cells/TLR4+/+ in medullary cells (WT/WT) mice,10 TLR4-/-in non-medullary cells/ TLR4-/-in medullary cells (KO/KO) homozygote mice,10 TLR4+/+ in non-medullary cells/TLR4-/-in medullary cells (WT/KO) mice,and 10 TLR4-/-in non-medullary cells/TLR4+/+ in medullary cells (KO/WT) heterozygote mice,aged 6-8 weeks,weighing 20-25 g,were used in the study.Lung I/R was induced by occlusion of the left hilum for 60 min followed by 240 min of reperfusion in anesthetized mice.Blood samples were obtained from the femoral artery at 240 min of reperfusion for blood gas analysis,and the oxygenation index (PaO2/FiO2) was calculated.The animals were then sacrificed and lung tissues were immediately removed for determination of wet/dry weight ratio,myeloperoxidase activity and contents of tumor necrosis factor-alpha,interleukin-1beta (IL-1β) and IL-6 (by enzyme-linked immunosorbent assay) and for microscopic examination of the pathological changes of lungs which were scored.Results Compared with WT/WT mice,the oxygenation index was significantly increased in sequence,and lung injury scores,wet/dry weight ratio,myeloperoxidase activity and contents of tumor necrosis factor-alpha,IL-1β and IL-6 were decreased in sequence in WT/KO,KO/WT and KO/KO mice (P＜0.05).Conclusion TLR4 in non-medullary cells plays a rnore important role in lung I/R injury than that in medullary cells of mice.

OBJECTIVETo explore the role of mitochondrial DNA 5178 C/A (Mt5178) polymorphism of NADH-dehydrogenase subunit 2 (ND2) gene in type-2 diabetes mellitus (T2DM) among ethnic Han Chinese through a case-control study.

METHODSThe Mt5178C/A polymorphism was determined by sequencing 1103 T2DM patients and 791 healthy controls. Logistic regression analysis was conducted to estimate odds ratios (OR) and 95% confidence intervals (CI). To confirm the results, a meta-analysis was conducted based on published literature on the association of Mt5178 variant with T2DM.

RESULTSNo significant association was found between the Mt5178C/A variant and T2DM either by our study or the meta-analysis which included eight published studies. Nevertheless, it was found that the T2DM patients with 5178C genotype were at a higher risk for nephropathy complication (OR=1.49, 95%CI: 1.005-2.197, P<0.05) and at significantly lower risk for hypertension complication (OR=0.744, 95%CI: 0.556-0.996, P<0.05) compared with those carrying a 5178A genotype.

CONCLUSIONNo association was found between the Mt5178C/A polymorphism of mitochondrial ND2 gene with the increased risk of T2DM. However, the polymorphism may affect the development of nephropathy and hypertension complications among T2DM patients.

Adult ; Aged ; Blood Glucose ; metabolism ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; DNA, Mitochondrial ; chemistry ; genetics ; Diabetes Complications ; blood ; genetics ; Diabetes Mellitus, Type 2 ; blood ; complications ; genetics ; Diabetic Nephropathies ; blood ; genetics ; Fasting ; blood ; Female ; Humans ; Hypertension ; blood ; complications ; genetics ; Male ; Meta-Analysis as Topic ; Middle Aged ; Odds Ratio ; Polymorphism, Single Nucleotide ; Sequence Analysis, DNA ; Triglycerides ; blood

Objective To explore the relationship between serum heme oxygenase-1(HO-1),CD39 levels and cardiac function and major adverse cardiovascular events(MACE)in patients with successful cardiopulmo-nary resuscitation.Methods A total of 160 patients admitted to the Zigong First People's Hospital from De-cember 2019 to December 2022 who underwent successful cardiopulmonary resuscitation due to sudden heart-beat and respiratory arrest were selected as the study group.The study group was divided into cardiac function grade Ⅱ group,cardiac function grade Ⅲ group and cardiac function grade Ⅳ group using the New York Heart Association(NYHA)cardiac function grading method.In addition,100 healthy subjects who underwent physical examination in the same period were selected as the control group.The levels of serum HO-1 and CD39 in two groups were detected.After 6 months of follow-up,there were 91 cases in non-MACE group and 69 cases in MACE group.The predictive value of serum HO-1 and CD39 levels for MACE in patients with successful cardiopulmonary resuscitation was evaluated by receiver operating characteristic curve.Binary Lo-gistic stepwise regression analysis was used to investigate the influencing factors of MACE in patients with successful cardiopulmonary resuscitation.Results The serum levels of HO-1 and CD39 in the study group were higher than those in the control group,and the difference was statistically significant(P＜0.05).The levels of serum HO-1 and CD39 in cardiac function grade Ⅳ group were higher than those in cardiac function grade Ⅲ group and cardiac function grade Ⅱ group,and the difference was statistically significant(P＜0.05).Spearman correlation analysis showed that serum HO-1 and CD39 levels were positively correlated with NY-HA cardiac function classification in patients with successful cardiopulmonary resuscitation(r=0.534,0.496,P＜0.001).The serum levels of HO-1 and CD39 in MACE group were higher than those in non-MACE group,and the difference was statistically significant(P＜0.05).The area under the curve(AUC)of serum HO-1 and CD39 to predict MACE in patients with successful CPR were 0.725(95％CI:0.682-0.774)and 0.864(95％CI:0.814-0.917),respectively,and the AUC of the combined prediction was 0.901(95％CI:0.851-0.946).The time from cardiac arrest to resuscitation in non-MACE group was lower than that in MACE group,and the left ventricular ejection fraction(LVEF)was higher than that in MACE group,the difference was statistically significant(P＜0.05).Binary Logistic stepwise regression analysis showed that LVEF＜50％(OR=3.466,95％CI:1.537-7.818),serum HO-1≥5.13 ng/mL(OR=3.804,95％CI:1.706-8.479)and serum CD39≥29.87％(OR=4.345,95％CI:1.852-10.192)were the risk factors for MACE in patients with successful cardiopulmonary resuscitation(P＜0.05).Conclusion Serum HO-1 and CD39 levels have high predictive value for MACE in patients with successful cardiopulmonary resuscitation.

Objective GenomeLab Genetic Analysis System (GeXP) and multiplex-PCR were combined to detect Noroviruse Ⅰ、Ⅱ,Astrovirus and Rotavirus.Methods The sequences of these viruses were obtained from Genbank of NCBI,and specific primer pairs were designed by GeXP eXpress Profiler.After optimization,the GeXP system could amplify specific fragments of each virus.The sensitivity and specificity of multiple PCR assay was also evaluated.Optimized assay was further validated with 120 clinical specimens collected from the CDC.Results These primer pairs were successfully used for detecting these viruses at the level of 5 × 103copies/ μl without cross reaction.The sensitivity,specificity and efficiency of GeXP assay was 100％,99.53％ and 99.62％,respectively.Comparing to Real-time PCR,the consistence rate reached 99.51％ in 120 clinical samples.Conclusions The combined detection of GeXP and multiplex PCR assay could be a high-throughput,rapid and highly specific and sensitive method used in the screening of the diarrhea viruses.

Objective·To verify the accuracy and clinical feasibility of fluoroscopic stereophotogrammetric analysis(FSA)technology based on two dimension(2D)-three dimension(3D)registration for early migration detection of aseptic loosening of joint prostheses.Methods·2D-3D registration algorithms centering on the light source and projected object respectively in FSA technology were verified under various working conditions through image synthesis experiments,and the feasibility of clinical application was verified through real model experiments.The image synthesis experiment established a perspective projection environment with the same parameters as the real environment in a virtual environment,the 2D perspective images of the 3D model(bone or prosthesis)during the six degrees of freedom transformation were recorded,and the six degrees of freedom transformation of the 3D model was restored by using different 2D-3D registration algorithms.The error of each registration algorithm was calculated.For real model validation,the migration between bone and prosthesis after joint replacement surgery was simulated with a high precision bone prosthesis migration simulator.The 3D model of the bone or prosthesis was reconstructed by using computed tomograph(CT)images and optical scanning,and the 2D perspective images before and after prosthesis migration were captured by using a fluoroscopy device.The migration of the prosthesis was restored by using FSA technology based on 2D-3D registration,and the error of FSA technology was calculated.Results·The accuracy of the 2D-3D registration algorithm centering on the light source was higher than that of the algorithm centering on the projected object under different working conditions.When the initial registration conditions were favorable,the algorithm centering on the light source reduced the rotation error compared to the algorithm centering on the projected object,with a statistical difference(P=0.021),and the displacement error decreases,with a significant statistical difference(P=0.000).Moreover,algorithms centering on the light sources required lower similarity and fewer registration times to meet clinical application requirements.Conclusion·The accuracy of FSA technology based on 2D-3D registration in early migration detection of artificial joint prostheses meets clinical application requirements.This technology can warn of late aseptic loosening of prostheses by detecting early migration of prostheses after joint replacement surgery,and is expected to be applied to clinical practice through further research.