The treatment of insomnia currently involves drug and non-drug therapies, with varying treatment outcomes. There is no consensus on the treatment option for insomnia in patients in different post-stroke phases. This article provides a detailed literature review of common insomnia treatment methods based on their application in insomnia in the acute phase, subacute phase, and recovery phase following stroke, aiming to provide guidance for the treatment of post-stroke insomnia. Currently, there is a lack of high-quality randomized controlled trials on the treatment of stroke-related insomnia. Existing research does not support the use of benzodiazepine drugs for the treatment of stroke-related insomnia. Studies suggest that sleep hygiene education and cognitive behavioral therapy for insomnia, non-benzodiazepine drugs, melatonin receptor agonists, antihistamine H1 receptor medications, certain sedative antidepressants, orexin receptor antagonists, and traditional Chinese medicine therapy can improve sleep quality in the subacute and recovery phases after stroke, facilitating the recovery of neurological function in patients. However, there is insufficient evaluation of the impact on neurological function recovery and the side effects.

Objective To clarify the role of MafA gene in development of MODY (maturity onset diabetes of the young) by studying insulin production,gene expression,and serum glucose level in heterozygous MafA gene knockout mice.Methods C57BL/6J mice were used as control animals,MafA gene heterozygous mice were analyzed.The distribution curve of blood sugar levels over time and serum insulin of heterozygous mice were determined by using IPGTT.The sensitivity of the mice to insulin was examined by injecting insulin assay.The expression levels of genes of MafA,insulin,pdX1,Beta2,and other genes of heterozygous mice were analyzed by semi-quantitative RT-PCR.Morphological changes in pancreatic tissue and α-and β-cell counts were obtained by using immunofluorescence/histological examination.Results (1) Two weeks after birth,MafA gene heterozygous mice began to show that the blood glucose level was increased,weight was reduced,and the amount of insulin secretion was clearly decreased (P＜0.05 or P＜0.01) while the insulin sensitivity did not change significantly.(2)The islet volume in MafA gene heterozygous mice was increased significantly as compared with the control group.However there were no significant changes in the number of pancreatic cells,distribution patterns,and the ratio of α and β cell.(3) Semi-quantitative RT-PCR detection showed that,compared with the control group,MafA gene level,the amount of insulin and Beta2 gene in MafA gene heterozygous mice were significantly reduced(all P＜0.05),while no changes in the amount of glucagons and level of Pdx1 were found.Conclusions The blood glucose level of MafA gene heterozygous mice was raised early after birth.MafA gene is likely to be a new disease ralated gene of MODY.

Objective To explore the application value of quantitative analysis of tissue diffusion by ultrasound elastography in evaluating the evolution of achilles tendinopathy and indirectly reflecting the feature of tendon biomechanics.Methods Rabbits underwent 0.1 ml (group M) or 0.3 ml (group S)collagenase or 0.2 ml saline (group C) injection.The percentage of area displaying blue (％AREA) in the area of interest was measured by the diffusion quantitative technique of ultrasound elastography at baseline and 1,3,7 and 14 days after model.The achilles tendon was obtained for pathological examination to observe the changes of collagen fibers and tested to measure the maximum tensile load by the universal testing machine.Results (1) The ％AREAs in group M and S at 1,3,7 and 14 days after model were smaller than those in group C (P ＜0.05),and reached its lowest value at 3 days after model.％ AREA in groupSwas significant lower than that in group M at 3 or 7 days after model (P ＜0.05).(2) The maximum tensile loads in group M at 1,3 and 7 days after model were smaller than those in group C (P ＜0.05),but there was no significant difference between group M and C at 14 days after model (P ＞0.05).The maximum tensile load in group S was significant lower than those in group M and C after model (P ＜0.05),and arrived its lowest point at 3 days after model.(3) The ％AREA was positively associated with the maximum tensile load of achilles tendon (r =0.87,P ＜0.001).Conclusions Ultrasound elastography can dynamically monitor the evolution of achilles tendinopathy and reflect the biomechanical state of achilles tendon.

Objective To understand the seroprevalence of Toxoplasma gondii infections among patients with autoimmune diseases, so as to provide the scientific evidence for the management of toxoplasmosis in patients with autoimmune diseases. Methods A total of 237 patients with definitive diagnosis of autoimmune disease were selected as the study subjects, including 79 cases with systemic lupus erythematosus, 71 cases with rheumatoid arthritis and 87 cases with inflammatory bowel disease, while 237 healthy volunteers served as controls. The serum anti-T. gondii IgG antibody was detected using enzyme-linked immunosorbent assay (ELISA) in patients with autoimmune diseases and healthy controls, and the detection of serum IgG antibody against T. gondii was compared between the autoimmune disease patients and healthy controls. Results The seroprevalence of serum IgG antibody against T. gondii was significantly greater in patients with autoimmune diseases than in healthy controls (29.96% vs. 4.22%; χ² = 55.41, P < 0.01), and the seroprevalence of T. gondii infection was all significantly higher in patients with systemic lupus erythematosus (31.65%), rheumatoid arthritis (23.94%) and inflammatory bowel disease (33.33%) than in healthy controls (χ² = 45.25, 26.58 and 50.95; all P values < 0.01). Conclusion The seroprevalence of anti-T. gondii IgG antibody is significantly higher in patients with autoimmune diseases than in healthy controls, and T. gondii infection may be a potential risk factor for the development of systemic lupus erythematosus, rheumatoid arthritis and inflammatory bowel disease.

Objective To investigate the prevalence of Toxoplasma gondii and Toxocara infections among pregnant women in Hangzhou City, so as to provide baseline data for decreasing birth defects and improving the population quality. Methods A total of 235 pregnant women receiving prenatal diagnosis at the First People’s Hospital of Yuhang District during the period between February 2018 through December 2019 were recruited as the observation group, and 235 age-matched, non-pregnant healthy women at the same hospital during the same period served as the control group. The subjects’medical records were captured from the hospital management information system. Blood samples were collected from the observation and control groups and detected for the presence of IgG antibodies against T. gondii and Toxocara using an enzyme-linked immunosorbent assay (ELISA). The seroprevalence of the IgG antibodies against T. gondii and Toxocara was compared between the observation and control groups. Results The subjects in the observation group had a mean age of 26.5 ± 4.3 years (range, 23 to 31 years), and gestational ages of 10 to 27 weeks, and the subjects in the control group had a mean age of 26.1 ± 5.7 years (range, 20 to 30 years). The seroprevalence rates of IgG antibodies against T. gondii (28.51% vs. 4.68%; χ² = 34.85, P < 0.01) and Toxocara (24.26% vs. 5.11%; χ² = 25.77, P < 0.01) were both significantly higher in the observation group than in the control group, and the seroprevalence of T. gondii and Toxocara co-infections was also significantly greater in the observation group than in the control group (13.19% vs. 2.13%; χ² = 17.49, P < 0.01). Conclusions The seroprevalence rates of T. gondii and Toxocara infections and their co-infections are all high among pregnant women in Hangzhou City. Screening of T. gondii and Toxocara infections is strongly recommended during pregnancy.

BACKGROUND:The knee joint acts as the body’s largest and most complex joint, which is a commonly seen perplex in patients because of synovium and cartilage diseases. Moreover, clinical physicians are often confused on the ultrasonic diagnosis of synovium and cartilage diseases.
OBJECTIVE: To review the ultrasound misdiagnosed cases of knee cartilage and synovial lesions and to summarize the common misconceptions and discrimination methods.
METHODS: A retrospective analysis was performed in the ultrasound misdiagnosed cases of knee cartilage and synovial lesions reported from 2002 to 2014, and then the common misconceptions and corresponding identification methods were summarized.
RESULTS AND CONCLUSION: High-frequency ultrasound is most likely to have six “mistaken ideas” addressing knee cartilage and synovial lesions: (1) cartilage degeneration; (2) synovial calcification; (3) echo intensity from synovial lesions; (4) blood flow in the synovium; (5) synovial effusion; (6) lesions involving intraarticular structures. High-frequency ultrasound runs through dynamical observation and contrast observation of bilateral knee joint lesions, which is a valuable imaging method for diagnosis of cartilage and synovial diseases based on vigilance at the “mistaken ideas” and mastery of the distinguishing ideas and methods.

Objective:To clarify the evidences of hippocampal injury after radiotherapy avoiding hippocampus and explore its relationships with cognition.Methods:A prospective design was adopted in this study.A total of 183 patients with nasopharyngeal carcinoma treated by intensity modulated radiation therapy (IMRT group) and 30 matched healthy control (HC group)were collected in the Affiliated Hospital of Jiangsu University and Southeast University Affiliated Zhongda Hospital from January 2017 to December 2019. All subjects were assessed by Montreal Cognitive Assessment (MoCA-B) at baseline and 6 months after radiotherapy, then the patients with nasopharyngeal carcinoma were divided into cognitive impairment group and non-cognitive impairment group. Subjects were scanned with Siemens 3.0 T MR, and T 1WI was used as analysis sequence.The individual standardized hippocampus ROIs were extracted based on Montreal Neurological Institute(MNI) brain template.All texture features were calculated using the Radiomics developed by C++and Delphi, and the intra group correlation coefficients (ICC), average direction, machine learning (random forest) and autocorrelation matrix were used for reducing the features dimension. One-way ANOVA and generalized linear models were used to compare the differences among different groups. Pearson correlations analyses were used to evaluate the relationships between important texture features and clinical data. Logistic regressions were used to calculate the abilities of texture features to predict cognitive impairment. Results:After 9 patients who lost follow-up were excluded, a total of 164 patients with nasopharyngeal carcinoma were included as IMRT group.Texture features of ROIs were extracted and dimensionally reduced successfully. Five differences features (Variance, Entropy, GlevNonU, RLNonUni and Contrast)were found among HC group, cognitive impairment group and non-cognitive impairment group, and the last three further showed significant differences within IMRT group (GlevNonU, P=0.011;RLNonUni, P<0.001;Contrast, P<0.001). Hippocampal doses were positively correlated with Variance ( r=0.448, P<0.05), and negatively correlated with Entropy ( r=-0.461, P<0.05). There was a positive correlation between MoCA-B scores with GlevNonU, RLNonUniand Contrast ( r=0.503, P<0.05; r=0.587, P<0.05; r=0.531, P<0.05). GlevNonU and Contrast were independent predictors of cognitive impairment in hippocampal avoidance of radiotherapy (OR=0.731, 95%CI 0.610-0.857; OR=0.651, 95%CI 0.496-0.853). Conclusion:Results of texture analysis could be used as micro imaging evidences of hippocampal injury in radiotherapy avoiding hippocampus, and could also effectively predict the occurrences of cognitive impairment.

Objective To investigate the prevalence of tuberculosis among silicosis patients and silica exposure patients,and to analysis the risk factors of tuberculosis among these population.Methods A total of 1 227 silica exposure patients from Wenling,Zhejiang were enrolled in this field study.Basic demographic information was collected and chest X-ray was taken for each patient.Sputum was collected for Mycobacterium tuberculosis culture and strain identification. In univariate analysis,t test was performed for continuous variables andχ2 test for categorical variables.In multivariate analysis,the odds ratio (OR )was calculated along with a 95 % confidence interval (CI )by binary Logistic regression. Results A total of 1 204 silica exposure patients had full basic information and 99.8% were male patients with mean age of (59.4 ± 6.8 )years.The patients in phase 0 + to phase Ⅲ were 172 (14.3%),255 (21 .2%),160 (13.3%)and 617 (51 .2%),respectively.The tuberculosis prevalence rate was about 7.3% among these population.The risk factors for tuberculosis including phase Ⅱ silicosis (OR =2.96, 95 %CI :1 .05 -8.32,P =0.04)and phase Ⅲ silicosis (OR=3.88,95 %CI :1 .58-9.56,P <0.01),and contacting with tuberculosis patients (OR=4.14,95 %CI :1 .91 -8.98,P <0.01).Patients complicated with tuberculosis lacked specific symptoms,but fever and weight loss were more frequent.Conclusion Tuberculosis is highly prevalent in silicotic patients,especially in patients with phase Ⅱ/Ⅲ silicosis and in patients with tuberculosis contact history.

OBJECTIVE: To explore an available and sensitive method to detect cervical lymph node micrometastasis in patients with laryngeal squamous cell carcinoma. METHOD: The primary tumors and 182 neck lymph nodes from Twenty cases with supraglottic cancer dissection were examined with immunohistochemical (IHC) staining using cytokeratin 19 (CK19), and haematoxylin and eosin (HgE) staining. The frequency of lymph node metastasis and the clinical relevance, and the relationship between overall survival time and lymph node metastases by Log Rank test were analyzed. RESULT: The expression of CK19 was 23. 6% of lymph nodes and all of the primary tumors. In Hg-E staining, 16.5% of lymph nodes were positive. There was highly significant difference between them. There were 88.4% lymph nodes, 9.3% lymph nodes and 2.3% lymph node corresponding to the II, III and IV levels by IHC. Lymph node metastases were detected on the II (86.7%) and III levels (13.3%) with H&E. The highest rate of positive lymph nodes was on the II level of the neck. There was highly significant difference between overall survival time and lymph node metastasis in CK19 analysis. CONCLUSION The expression of CK19 may be served as an available method to evaluate occult micrometastases in laryngeal squamous cell carcinoma. High frequency of CK19 was associated with a decreased probability of survival time.
Aged ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; Female ; Glottis ; pathology ; Humans ; Keratin-19 ; analysis ; Laryngeal Neoplasms ; diagnosis ; pathology ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Staining and Labeling

OBJECTIVETo study the growth characteristics of different germplasm and analyze the correlation between morphologic and individual yield of Isatis indigotica.

METHODThe planting samples were collected during the growth period, morphological characteristics and root yield per plant in 13 germplasm of I. indigotica from all over the country were determined by correlation and path analysis.

RESULTThe growth characteristics of various I. indigotica germplasm were consistent. The difference of morphological characteristics and root yield with various germplasm were significant. The root yield per plant was positively correlated to the main root length and the number of individual plant leaves.

CONCLUSIONThe number of leaves per plant and root length are selected for high-yield lines, meanwhile, leaf length and leaf diameter are important factors for breeding high-yield lines as well.

Biomass ; China ; Isatis ; anatomy & histology ; genetics ; growth & development ; Plant Leaves ; anatomy & histology ; genetics ; growth & development ; Plant Roots ; anatomy & histology ; genetics ; growth & development