Sleep plays an important role in the modulation of endocrine function and energy metabolism;hormone levels are markedly different during a sleepless night compared with a night of normal sleep.Sleep deprivation may change the levels of cortisol,growth hormone(GH)and thyrotropin(TSH)at night.In addition,sleep curtailment disturbs the balance of anorexi- genic(leptin)and orexigenic(ghrelin)factors,and does harmful to glucose tolerance.

Objective To explore the characteristic and clinical meaning of myocardial bridge in patients with multi-slice spiral CT(MSCT) coronary angiography.Methods 875 patients with suspected or diagnosed coronary artery disease were studied with MSCT coronary angiography,579 cases were male and 296 cases were female,ranged from 30~87 years old in age with average of 60 years old.The heart was scanned with retrospectively ECG-gated,reconstruction from phase for all original tomographic source images at 30%~40% R-R phase interval according to heart rate ≥75 bpm and at 40%~50% R-R phase interval according to heart rate ≤75 bpm.The images of maximum intensity projection,multiplanar reconstruction and vulume reconstruction were gained to show left and right main coronary artery and their main branchs on mulliple angle.Results The myocardial bridges were detected in 89 cases,the positive rate was 10.2%,36 cases(40.5%)had different grade stenosis(≤50%).The myocardial bridges located at middle segment of anterior descending artery(79.8%),the thickness of myocardial bridge was 0.06~0.55 cm,the atherosclerosis plaques were found in 20 cases,the vascular stenosis was approximate to 50%.39 cases with simple myocardial bridges had angina,21 cases hadn’t angina.23 cases with myocardial bridges accompanied by coronary artery atherosclerosis had angina.Conclusion MSCT coronary angiography may clearly detect the myocardial bridge,which can provide more worthy information for clinical diagnosis and treatment.

Objective To investigate the effect of Galangin of different purity on melanocyte proliferation and melanin synthesis of A375-HaCaT co-culture system. Methods The A375-HaCaT co-culture system was established with Transwell technology, and 0.1, 0.5, 1.0, 5.0, 10 μg/mL Galangin of the purity of 70%and 90%was used to act on the co-culture system. Cell proliferation, melanin content and tyrosinase of A375 were measured by MTT assay, NaOH lysis assay and L-DOPA oxidation assay respectively. The cytokines such as ET-1 and SCF in HaCaT were detected by ELISA. Results A375 cells in co-culture system grew well, and 0.1, 0.5, 1.0, 5.0, 10 μg/mL Galangin of the purity of 70% and 90% had up-regulation effect on cell proliferation, melanin content and tyrosinase of A375. Moreover, Galangin could increase the expression level of ET-1 and SCF of HaCaT at more than 0.5 μg/mL, and the effect of Galangin of 70% purity was better than 90% purity. Conclusion Galangin could promote the cell proliferation, melanin content and tyrosinase of A375, and mechanism of the pathways is probably related to the up-regulation on the expression of ET-1 and SCF of HaCaT.

Objective To investigate the corelation between neutropenia (ANC) incidence and infection during treatment with peginterferon alfa and ribavirin for chronic hepatitis C.Methods A retrospective cohort study of 399 patients treated with peginterferon and ribavirin derived from database of Department of Infectious Diseases, the Second Affiliated Hospital, Harbin Medical University was conducted.The incidence of infections and their relation with ANC were investigated.Potential risk factors for infection were identified by multivariate analysis.Results During treatment,neutropenia (ANC ＜ 1.50 ×109/L) occurred in 251 patients.Among which,mild neutropenia [ANC: ( ＞ 0.75-＜ 1.50) x 109/L],moderate neutropenia [ANC: ( 0.50-0.75 ) × 109/L]and severe neutropenia ( ANC ＜ 0.50 × 109/L)occurred in 132 patients,103 patients and 16 patients,respectively.A total of 80 infections (20.1％ )occurred,among which,14 infections were defined as severe.There was no significant difference in infection rate between patients with and without neutropenia ( 19.9％,50/251 vs 20.3％,50/251 ; x2 =0.007,P =0.933).There was no significant difference in infection rate between patients with and without peginterferon dose reduction ( 21.5％,31/144 vs 19.2％,49/255 ; x2 =0.307,P =0.580 ).In multivariate logistic regression analysis,the independent factors associated with infection were age (P =0.021),diabetes (P =0.004) and cirrhosis (P =0.012).Conclusions Infections during treatment with peginterferon alfa and ribavirin for chronic hepatitis C are irrelevant to neutropenia.The independent factors associated with infection are age,diabetes and cirrhosis.

ObjectiveTo investigate the surgical method, experience, and skills in clipping anterior communicating artery aneurysm (ACoAA) via supraorbital keyhole approach.MethodsThe ACoAA case data of selectively clipping via non-dominant supraorbital keyhole approach according to the A2 open plane formed by the anterior communicating artery and the bilateral A2 segments were analyzed retrospectively.The surgical method and experience were analyzed.The indications and advantages and disadvantages of this method were summarized.ResultsACoAA in 12 patients were completely clipped via supraorbital keyhole approach from the side of non-dominant A1, and the dominant A1 segment arteries were well exposed.The patients were followed up for 4-29 months after procedure.No recurrence or rupture of the aneurysms was found.The Glasgow Outcome Scale score was 5 in 11 patients and 4 in 1 patient.Conclusions ACoAA can be completely clipped via supraorbital keyhole approach from the side of non-dominant A1.It is a minimally invasive surgical approach with good efficacy.

Objective To evaluate the safety,middle or short -term effect and indication of the endovascular treatment for ischemic stroke patients with extracranial carotid stenosis.Methods The clinical datas with percutaneous transluminal angioplasty and stenting for extracranial carotid artery stenosis cases were retrospectively reviewed,from which 106 cases with ischemic stroke in the past were selected for study.And theinformation including operation opportunity,operation experience,serious complications such as cerebral hemorrhage and secondary ischemic stroke were summarized.Their clinical features,methods of treatment and prognosis were analyzed specially.Results The placement of 106 cases with 120 stents was satisfaction.Cerebral hemorrhage occurred in 3 cases while thrombosis fol-lowing stent placement in 2 cases,hypotension and bradycardia in 6 cases,vasospasm in 11 cases,gastrointestinal stress bleeding in 1 case,restenosis occurred in 8 cases and no cerebral infarction occurred after operation.Apart from one case of death cerebral hemorrhage,8 cases of restenosis,the,middle or short -term results of the remaining 97 patients were satisfactory.83 cases were followed up for 3 months to 5years,there were no ischemic attack and cerebral infarction occurred.Conclusion The satisfactory effect and safety are achieved in the therapy of carotid stenosis by percutaneous transluminal angioplasty and stenting.Angioplasty and stenting may improve the cerebral hemodynamics of patients with severe /moderate internal carotid artery stenosis.It is suitable for previous ischemic stroke patients.We must be individualized to more carefully assess these patientsˊsurgical risk,strictly adhere to the indications of surgery,and general measures is the key of preventing the complications during the perioperative period.

Objective To evaluate the efficacy and safety and to analyze related complications and potential prognostic factors of allogeneic hematopoietic stem cell transplantation(allo-HSCT ) on hematological malignancies .Methods Patients with hemato-logical malignancies who underwent allo-HSCT from June 2010 to June 2015 were investigated in this retrospective study .Accord-ing to the donor types ,it was divided into compatriots sibling-matched transplantation group (n = 52) and haploid transplantation group (n= 98) .The preconditioning regimens were busulfan/cyclophosphamide ,and anti-thymocyte globulin were needed in haploid transplantation group .Short-term methotrexate + cyclosporine A + mycophenolate mofetil were used for prevention of graft-ver-sus-host disease .The efficacy and safety and related complications of allo-HSCT were analyzed .Results All patients achieved full donor type engraftment ,which was identified by blood type ,chromosome test and DNA polymorphism .The mean times of neutro-phil and platelet engraftment were 12 d and 16 d in compatriots sibling-matched transplantation group and 13 d and 16 d in haploid transplantation group ,respectively .59 cases (39 .3% ) patients were oral mucosa ulcer ,47 patients (31 .3% ) were bacteria and/or fungal infection ,41 cases (27 .3% ) patients were CMV infection ,48 cases (32 .0% ) were acute GVHD ,43 patients (28 .7% ) were chronic GVHD .The median follow-up time of 23 months (1 - 60 months) ,115 patients (76 .7% ,115/150) were disease-free sur-vival ,including 38 cases (73 .1% ,38/52) in compatriots sibling-matched transplantation group ,77 cases (78 .6% ,77/98) in haploid transplantation group ;35 cases (23 .3% ,35/150) patients were died ,including 14 cases (26 .9% ,14/52) in compatriots sibling-matched transplantation group ,21 cases (21 .4% ,21/98) in haploid transplantation group .Death cause analysis showed that 12 ca-ses (8 .0% ) complications from transplantation related death ,of which 5 cases (3 .3% ) were severe infection ,7 cases (4 .7% ) caused by acute GVHD ,23 cases (8 .7% ) patients died because of the primary disease recurrence .The survival rate and mortality was similar between the two groups (P> 0 .05) .Conclusion Allo-HSCT is safe and effective treatment in hematological malignan-cies .The curative effect and security with haploid transplantation were similar to compatriots sibling-matched transplantation .It is necessary to prevent prognostic impact factors such as acute GVHD and infection early .

ObjectiveTo investigate the effects of extracts ofLiaoxuan Kaxifu Powders (LE) on proliferation and transcription of IL-8 and ICAM-1 in HaCaT induced by TNF-α; To discuss its mechanism of action.Methods Cultured HaCaT was assigned into normal group, TNF-α group and low-, medium- and high-dose of LE group. Every group was induced by 40 ng/mL TNF-α except for normal group, and then LE groups were treated by different concentrations (8, 40, 200μg/mL) of LE for 48 h. The proliferation of HaCaT was evaluated by MTT and the apoptosis was detected by inverted fluorescence microscope. Levels of IL-8 and ICAM-1 in HaCaT were assessed by ELISA, and their mRNA expressions was detected by semi-quantitative RT-PCR.Results Compared with normal group, the absorbency of HaCaT and the contents and mRNA expressions of IL-8 and ICAM-1 increased in TNF-α group (P<0.05,P<0.01); compared with TNF-α group, LE of all dose groups could significantly inhibit the absorbency, decrease the contents and mRNA expressions of IL-8 and ICAM-1 (P<0.05,P<0.01).Conclusion LE is able to inhibit the proliferation of HaCaT induced by TNF-α, and the mechanism is probably related to promoting apoptosis and down-regulating the gene expressions of IL-8 and ICAM-1, and then maintaining the normal level of HaCaT.

Objective To study the impact of ribavirin cumulative dose on virological response rates in genotype 1 hepatitis C virus(HCV)infected patients.Methods The medical records of 225 genotype 1 chronic hepatitis C(CHC)patients treated with peginterferon α-2a plus ribavirin were retrospectively analyzed.These patients were divided into four groups according to ribavirin cumulative dose:>97%,80%-97%,60%-79%and<60%of standard cumulative dose.The relationship between ribavirin cumulative dose and virological response rates was studied.Data as analyzed by chisquare test or F test.Results The incidence of ribavirin cumulative dose<97%was 43.1%(97/225),which was higher than peginterferon alfa-2a(27.1%,61/225)(x2=12.641,P=0.001).The sustained virological response rate(SVR)was 27.8%(5/18)in group of ribavirin cumulative dose <60%,which was much lower than those in groups of ribavirin cumulative dose>97%(65.6%,84/128),80%-97%(60.5%,26/43),60%-79%(58.3%,21/36)(x2=9.538,P=0.023).The relapse rate was 61.5%(8/13)in group of ribavirin cumulative dose<60%,which was significantly higher than those in groups of ribavirin cumulative dose>97%(20.0%,21/105),80%-97%(23.5% ,8/34),60%-79%(27.6%,8/29)(x2=10.837,P-0.013).Among patients achieved rapid virological response(RVR),SVR in groups of ribavirin cumulative dose>97%,80%-97%,60%-79%and<60 % of standard dose were 92.0%(23/25),88.9%(8/9),85.7%(6/7)and 75.0%(3/4),respectively(x2=1.098,P=0.778).Conclusiom Mlid reduction of ribavirin dose not affect SVR of genotype 1 HCV infected patients.However,the relapse rate is high and SVR is low in patients treated with ribavirin cumulative dose<60% of standard dose.

Objective To study the effects of repetitive transcranial magnetic stimulation(rTMS) of the supplementary motor area(SMA)on the cortical excitability in patients with Parkinson's disease(PD).Methods Sixteen patients with PD were included in this study.The motor evoked potentials(MEP)and the N30 component of somatosensory evoked potentials(SEP) were assessed for each patient before and after 1200 pulses of rTMS of the SMA at 5 Hz and an intensity of 100% of relaxed motor threshold (RMT) for the abductor pollicis brevis.Results Ten minutes after the rTMS intervention,the peak-to-peak amplitude of the SEP component P20-N30 increased significantly(P<0.05),with the P/F index decreased simultaneously(P<0.05).The MEP amplitude increased significantly,and reached the highest value at 10min after the rTMS intervention. Conclusion 5 Hz rTMS of the SMA can improve the excitability of the SMA itself temporarily.Meanwhile,it can induce a short-lasting facilitation of the excitability of M1 connected with SMA.