At present, insomnia treatments mainly contain drug therapy and non-drug therapy. The non-drug therapy included sleep hygiene instruction, cognitive behavioral therapy, psychological therapy, physical therapy, relaxation therapy, and music therapy, etc. The non-drug therapy is a safe and effective treatment, and it plays a good effect whether using with drug or alone.

Objective:To study the clinical significance of plasma D-dimer for extended anticoagulation in the elderly patients with hip fracture after discharge.Methods:The data were retrospectively analyzed of the 355 elderly patients with hip fracture who had been admitted to Emergence Center of Trauma and Department of Orthopedic Surgery, The Third Hospital of Hebei Medical University from January 2016 to November 2020. There were 107 males and 248 females with a mean age of 79.0 years (from 65 to 102 years). There were 179 femoral neck fractures, 159 intertrochanteric fractures, and 17 subtrochanteric fractures. Plasma D-dimer concentrations were detected at admission, before surgery, and 35 days after surgery. Color Doppler ultrasonography of deep veins of lower extremities was performed at admission, before surgery, before discharge, and 35 days after surgery. The patients with deep vein thrombosis (DVT) at the time of discharge should were reexamined 15 days after discharge. Strategies for anticoagulation prevention and treatment were formulated according to the patients' plasma D-dimer, color Doppler ultrasonography results, symptoms and signs. Plasma D-dimer concentrations were compared between patients with thrombosis and without thrombosis at different time points.Results:The plasma D-dimer concentrations for the 355 patients at admission, before surgery and 35 days after surgery were 2.73 (1.72, 5.13) mg/L, 1.31 (0.72, 2.58) mg/L, and 0.49 (0.25, 0.80) mg/L, respectively. The level of D-dimer at 35 days after surgery was significantly lower than that at admission and before surgery ( P<0.05). There were, respectively, 105, 126,191 and 148 patients with DVT at admission, before surgery, before discharge and 35 days after surgery, and the DVT was distal in most cases. The D-dimer concentrations for patients with thrombosis and without thrombosis at 35 days after surgery was 0.64 (0.32, 1.00) mg/L and 0.37 (0.22, 0.68) mg/L respectively, showing a significant difference ( P<0.05). The area under the receiver operating characteristic curve of plasma D-dimer for the diagnosis of DVT at 35 days after surgery was 0.665. Conclusions:Extended anticoagulation and continuous monitoring of plasma D-dimer are very important for elderly patients with hip fracture after discharge. For patients with DVT at discharge, negative plasma D-dimer is a sign for termination of anticoagulation; for patients without DVT at discharge, it is reasonable to extend anticoagulation 35 days after surgery.

【Objective】 To study the mechanism of Apocynum leaves in the treatment of sepsis by network pharmacology method in order to explore the multi-dimensional research method of Xinjiang ethnic medicine treatment of infectious diseases and provide scientific theoretical basis for clinical medication. 【Methods】 TCMSP and literature collection were used to screen the main active components of Apocynum venetum leaf, and target prediction analysis was conducted by SwissTarget Prediction database. We used Genecards database to screen relevant targets for sepsis, used Omicshare to calculate Venn figure of the intersection targets, constructed the protein-protein interaction network diagram in the STRING database, used Ensembl for name conversion of protein targets, then entered Omicshare server for Go function and KEGG pathway enrichment of dynamic analysis. Last we used Cytoscape3.6.0 software to construct "Apocynum venetum leaf-the active ingredients-targets-Go-KEGG-sepsis" network to explore the mechanism of action of Apocynum’s resistance to sepsis. 【Results】 Kaferol, luteolin, proanthocyanidin B1 and phytosterol in Apocynum venetum leaves may treat sepsis by controlling signal transduction, regulating hormone level and anti-infection through predictive biological targets such as Akt1, VEGFA, MAPK3, EGFR, Src and PTGS2. They can play an important role through VEGF, EGFR, erbB, HIF-1, RAS and other enrichment pathways. 【Conclusion】 The active components of Apocynum venetum leaves can fight against sepsis through multiple targets and multiple pathways.