Objective: To analyze the association between insufficient sleep and score of depressive symptoms among junior and senior high school students, so as to provide a scientific reference for targeted early intervention measures of adolescents depressive symptoms. Methods: From September to November 2023, a stratified cluster random sampling method was used to select 96 080 junior and senior high school students from 409 schools in 113 districts and counties in Shaanxi Province. A questionnaire survey was conducted using the 2023 Shaanxi Provincial Common Student Diseases and Health Influencing Factors Survey Form, and their height and weight were measured. Propensity score (PS) matched (1∶1) analysis was used to match participants with insufficient sleep to those sufficient sleep students. Through the gradual correction of the confounders, three multilevel linear models were established to analyze the association between insufficient sleep and depressive symptoms score, and subgroup analysis was conducted afterward. Results: A total of 70 135 (73.00%) students had insufficient sleep. After PS matching, 25 894 pairs were matched. Before PS matching, after adjusting for gender, educational stage, region, adolescent characteristics, boarding status, smoking, alcohol consumption, outdoor activities and body mass index grouping, linear regression analysis results showed that compared with students who got adequate sleep, students who lacked sleep had an increase of 1.39 scores ( B=1.39, 95%CI =1.28-1.51) in depressive symptoms; after PS matching, students with insufficient sleep got an increase of 1.32 scores ( B=1.32, 95%CI =1.17- 1.45 ) in depressive symptoms score compared with those who had adequate sleep (both P <0.05). Conclusions The insufficient sleep is associated with the increase of the depressive symptoms score of junior and senior high school students. It is recommended that junior and senior high school students should keep a good sleeping habit, so as to reduce the prevalence of depressive symptoms.

Objective:To explore the clinical phenotype and genetic characteristics of a Chinese Han pedigree with Darier′s disease(DD).Methods:A DD pedigree, who visited Tongji Hospital of Tongji University on October 22, 2023, was selected as the study subject. Clinical data of the pedigree were collected, and whole-genome exom sequencing was performed on the proband. Suspected variant loci were screened, and Sanger sequencing was used to validate the variant in pedigree members. Bioinformatics analysis was performed on the variant loci. This study was approved by the Medical Ethics Committee of Tongji Hospital of Tongji University(Ethics No.K-W-2024-004).Results:① The proband is a 67-year-old female with clinical features of DD, such as keratotic papules in sebaceous areas. ② Whole-genome exom sequencing revealed a missense variant, c. 68G>A (p.Gly23Glu), in the exon 1 of ATP2A2 gene of the proband. Sanger sequencing showed that the proband′s eldest daughter also carried this variant. This variant was not detected in other pedigree members, indicating a co-segregation of the variant with the disease phenotype in the pedigree. ③ According to the interpretation principles of gene variants by the American College of Medical Genetics and Genomics (ACMG), this variant was classified as pathogenic (PS1+ PM1+ PM2_Supporting+ PP1+ PP3+ PP4). Conclusions:The c. 68G>A (p.Gly23Glu) variant in the ATP2A2 gene may be the genetic cause of the disease in this pedigree. This finding further enriches the genetic variant spectrum in DD patients and provides a basis for clinical diagnosis and genetic counseling for patients.

OBJECTIVE: To explore the clinical phenotype and genetic characteristics of a Chinese Han pedigree with Darier's disease (DD). METHODS: A DD pedigree, who visited Tongji Hospital of Tongji University on October 22, 2023, was selected as the study subject. Clinical data of the pedigree were collected, and whole exome sequencing was performed on the proband. Suspected variant loci were screened, and Sanger sequencing was used to validate the variant in pedigree members. Bioinformatics analysis was performed on the variant loci. This study was approved by the Medical Ethics Committee of Tongji Hospital of Tongji University Ethics No.K-W-2024-004). RESULTS: The proband is a 67-year-old female with clinical features of DD, such as keratotic papules in sebaceous areas. whole exome sequencing revealed a missense variant, c.68G>A (p.Gly23Glu), in the exon 1 of ATP2A2 gene of the proband. Sanger sequencing showed that the proband's eldest daughter also carried this variant. This variant was not detected in other pedigree members, indicating a co-segregation of the variant with the disease phenotype in the pedigree. According to the interpretation principles of gene variants by the American College of Medical Genetics and Genomics (ACMG), this variant was classified as pathogenic (PS1+PM1+PM2_Supporting+PP1+PP3+PP4). CONCLUSION The c.68G>A (p.Gly23Glu) variant in the ATP2A2 gene may be the genetic cause of the disease in this pedigree. This finding further enriches the genetic variant spectrum in DD patients and provides a basis for clinical diagnosis and genetic counseling for patients.
Aged ; Female ; Humans ; Male ; China ; Darier Disease/genetics* ; Exome Sequencing ; Mutation, Missense ; Pedigree ; Phenotype ; East Asian People ; Sarcoplasmic Reticulum Calcium-Transporting ATPases

Objective To investigate the syndromic characteristics of upper airway cough syndrome in children and the rules of tra-ditional Chinese medicine(TCM)prescription and medication.Methods The literature related to the treatment of upper airway cough syndrome in children by TCM in CNKI,Weipu,Wanfang and China Biomedical Literature Service System from the establishment of the database to December 1,2023 was retrieved,extracted the symptoms,signs and prescriptions,and performed data mining using the Chi-nese Medicine Inheritance Computing Platform V3.5.Results Ninety-three articles,25 types of symptoms,119 prescription and 199 flavors of TCM were finally included in the study.The cough was mainly in the morning,and the high-frequency symptoms were nasal congestion,runny nose,and mucus adherence on the posterior wall of the pharynx,and the postnasal drip sensation was present in 25.29％of the children;The main type of symptoms was"wind-heat offending the lungs",followed by"phlegm-heat depleting the lungs"and"wind-phlegm adhering to the lungs",etc.The top five TCM used were Flos magnoliae,Balloonflower root,Siberian cocklebur fruit,Liquorice root and Angelica dahurica;the medicinal properties of these medicines were mainly warm-natured and cold-natured,and the five flavors of these medicines were mainly pungent and bitter;most of the categorized meridians were the lung meridian,and the core medicinal pairs were"Flos magnoliae,Siberian cocklebur fruit""Flos magnoliae,Balloonflower root","Balloonflower root,Liquo-rice root".Three pairs of core drug combinations were obtained by K-Means clustering,all of which were additions to Siberian cocklebur fruit decoction,and their treatment was based on ventilate the lung and inducing resuscitation.Conclusion The diagnosis and treatment of upper airway cough syndrome in children should pay attention to the nasopharyngeal signs,and should pay attention to the passage of the orifices and the pharynx while dredging the wind and clearing the heat and promoting the lung to stop coughing,so as to achieve the effect of the simultaneous treatment of the lung and nose and the lung and throat.

Objective To investigate the syndromic characteristics of upper airway cough syndrome in children and the rules of tra-ditional Chinese medicine(TCM)prescription and medication.Methods The literature related to the treatment of upper airway cough syndrome in children by TCM in CNKI,Weipu,Wanfang and China Biomedical Literature Service System from the establishment of the database to December 1,2023 was retrieved,extracted the symptoms,signs and prescriptions,and performed data mining using the Chi-nese Medicine Inheritance Computing Platform V3.5.Results Ninety-three articles,25 types of symptoms,119 prescription and 199 flavors of TCM were finally included in the study.The cough was mainly in the morning,and the high-frequency symptoms were nasal congestion,runny nose,and mucus adherence on the posterior wall of the pharynx,and the postnasal drip sensation was present in 25.29％of the children;The main type of symptoms was"wind-heat offending the lungs",followed by"phlegm-heat depleting the lungs"and"wind-phlegm adhering to the lungs",etc.The top five TCM used were Flos magnoliae,Balloonflower root,Siberian cocklebur fruit,Liquorice root and Angelica dahurica;the medicinal properties of these medicines were mainly warm-natured and cold-natured,and the five flavors of these medicines were mainly pungent and bitter;most of the categorized meridians were the lung meridian,and the core medicinal pairs were"Flos magnoliae,Siberian cocklebur fruit""Flos magnoliae,Balloonflower root","Balloonflower root,Liquo-rice root".Three pairs of core drug combinations were obtained by K-Means clustering,all of which were additions to Siberian cocklebur fruit decoction,and their treatment was based on ventilate the lung and inducing resuscitation.Conclusion The diagnosis and treatment of upper airway cough syndrome in children should pay attention to the nasopharyngeal signs,and should pay attention to the passage of the orifices and the pharynx while dredging the wind and clearing the heat and promoting the lung to stop coughing,so as to achieve the effect of the simultaneous treatment of the lung and nose and the lung and throat.

Objective:To explore the clinical phenotype and genetic characteristics of a Chinese Han pedigree with Darier′s disease(DD).Methods:A DD pedigree, who visited Tongji Hospital of Tongji University on October 22, 2023, was selected as the study subject. Clinical data of the pedigree were collected, and whole-genome exom sequencing was performed on the proband. Suspected variant loci were screened, and Sanger sequencing was used to validate the variant in pedigree members. Bioinformatics analysis was performed on the variant loci. This study was approved by the Medical Ethics Committee of Tongji Hospital of Tongji University(Ethics No.K-W-2024-004).Results:① The proband is a 67-year-old female with clinical features of DD, such as keratotic papules in sebaceous areas. ② Whole-genome exom sequencing revealed a missense variant, c. 68G>A (p.Gly23Glu), in the exon 1 of ATP2A2 gene of the proband. Sanger sequencing showed that the proband′s eldest daughter also carried this variant. This variant was not detected in other pedigree members, indicating a co-segregation of the variant with the disease phenotype in the pedigree. ③ According to the interpretation principles of gene variants by the American College of Medical Genetics and Genomics (ACMG), this variant was classified as pathogenic (PS1+ PM1+ PM2_Supporting+ PP1+ PP3+ PP4). Conclusions:The c. 68G>A (p.Gly23Glu) variant in the ATP2A2 gene may be the genetic cause of the disease in this pedigree. This finding further enriches the genetic variant spectrum in DD patients and provides a basis for clinical diagnosis and genetic counseling for patients.

Objective·To compare the effectiveness of hydrodynamic debridement versus conventional debridement in the treatment of burn wounds through a systematic review,focusing on differences in time to complete healing after graft,time to debride a 1%total body surface area(TBSA)wound,hospitalization duration,skin graft survival rate at 7 d post-surgery,secondary debridement rate,and positive rate of bacterial culture of wound exudate at 3 d post-surgery,aiming to select a more effective debridement method for burn wounds requiring debridement.Methods·A systematic literature search was conducted in PubMed,Embase,Web of Science,Cochrane Library,CNKI,SinoMed,China Science and Technology Journal Database,and Wanfang Database,for studies comparing hydrodynamic debridement and conventional debridement in the treatment of burns.The search included articles published in Chinese and English,and the search period was from the inception of the databases to October 1,2024.The study type was randomized controlled trials(RCTs).After literature search and screening,the included studies was evaluated for quality,and relevant data were extracted.Qualitative variables were presented as relative risk(RR),and quantitative variables as mean difference(MD).Forest plots were created by using RevMan 5.4 software with fixed-or random-effects models.Funnel plots were generated and Egger's test was performed by using Stata 14.0 software.Results·Fifteen high-quality RCTs were included in this study,involving 1 261 patients with burn injuries requiring debridement.The analysis results showed that compared to the conventional debridement group,the hydrodynamic debridement group had significantly shorter time to complete healing after graft(MD=-3.29,95%CI-3.88?-2.70,P<0.001),shorter time required to debride a 1%TBSA wound(MD=-0.63,95%CI-0.76?-0.50,P<0.001),and reduced hospitalization duration(MD=-4.22,95%CI-6.17?-2.28,P<0.001).The skin graft survival rate at 7 d post-surgery in the hydrodynamic debridement group(MD=8.62,95%CI 7.21?10.04,P<0.001)was significantly higher,while the secondary debridement rate(RR=0.21,95%CI 0.12?0.37,P<0.001)and the positive rate of bacterial culture of wound exudate at 3 d post-surgery(RR=0.30,95%CI 0.17?0.53,P<0.001)were significantly lower compared with the conventional debridement group.There was no statistically significant difference in the postoperative infections rates between the two groups(RR=1.06,95%CI 0.66?1.69,P=0.820).Conclusion·In the treatment of burn wounds,hydrodynamic debridement outperforms traditional debridement.In the management of burn wounds,hydrodynamic debridement outperforms conventional debridement by shortening debridement and hospitalization durations,reducing the need for secondary debridement,decreasing early bacterial colonization,and improving skin graft survival.In terms of postoperative infection risk,no significant difference was observed between the two methods,indicating comparable safety profiles.

Objective·To compare the effectiveness of hydrodynamic debridement versus conventional debridement in the treatment of burn wounds through a systematic review,focusing on differences in time to complete healing after graft,time to debride a 1%total body surface area(TBSA)wound,hospitalization duration,skin graft survival rate at 7 d post-surgery,secondary debridement rate,and positive rate of bacterial culture of wound exudate at 3 d post-surgery,aiming to select a more effective debridement method for burn wounds requiring debridement.Methods·A systematic literature search was conducted in PubMed,Embase,Web of Science,Cochrane Library,CNKI,SinoMed,China Science and Technology Journal Database,and Wanfang Database,for studies comparing hydrodynamic debridement and conventional debridement in the treatment of burns.The search included articles published in Chinese and English,and the search period was from the inception of the databases to October 1,2024.The study type was randomized controlled trials(RCTs).After literature search and screening,the included studies was evaluated for quality,and relevant data were extracted.Qualitative variables were presented as relative risk(RR),and quantitative variables as mean difference(MD).Forest plots were created by using RevMan 5.4 software with fixed-or random-effects models.Funnel plots were generated and Egger's test was performed by using Stata 14.0 software.Results·Fifteen high-quality RCTs were included in this study,involving 1 261 patients with burn injuries requiring debridement.The analysis results showed that compared to the conventional debridement group,the hydrodynamic debridement group had significantly shorter time to complete healing after graft(MD=-3.29,95%CI-3.88?-2.70,P<0.001),shorter time required to debride a 1%TBSA wound(MD=-0.63,95%CI-0.76?-0.50,P<0.001),and reduced hospitalization duration(MD=-4.22,95%CI-6.17?-2.28,P<0.001).The skin graft survival rate at 7 d post-surgery in the hydrodynamic debridement group(MD=8.62,95%CI 7.21?10.04,P<0.001)was significantly higher,while the secondary debridement rate(RR=0.21,95%CI 0.12?0.37,P<0.001)and the positive rate of bacterial culture of wound exudate at 3 d post-surgery(RR=0.30,95%CI 0.17?0.53,P<0.001)were significantly lower compared with the conventional debridement group.There was no statistically significant difference in the postoperative infections rates between the two groups(RR=1.06,95%CI 0.66?1.69,P=0.820).Conclusion·In the treatment of burn wounds,hydrodynamic debridement outperforms traditional debridement.In the management of burn wounds,hydrodynamic debridement outperforms conventional debridement by shortening debridement and hospitalization durations,reducing the need for secondary debridement,decreasing early bacterial colonization,and improving skin graft survival.In terms of postoperative infection risk,no significant difference was observed between the two methods,indicating comparable safety profiles.

Bacteremia induced by periodontal infection is an important factor for periodontitis to threaten general health. P. gingivalis DNA/virulence factors have been found in the brain tissues from patients with Alzheimer's disease (AD). The blood-brain barrier (BBB) is essential for keeping toxic substances from entering brain tissues. However, the effect of P. gingivalis bacteremia on BBB permeability and its underlying mechanism remains unclear. In the present study, rats were injected by tail vein with P. gingivalis three times a week for eight weeks to induce bacteremia. An in vitro BBB model infected with P. gingivalis was also established. We found that the infiltration of Evans blue dye and Albumin protein deposition in the rat brain tissues were increased in the rat brain tissues with P. gingivalis bacteremia and P. gingivalis could pass through the in vitro BBB model. Caveolae were detected after P. gingivalis infection in BMECs both in vivo and in vitro. Caveolin-1 (Cav-1) expression was enhanced after P. gingivalis infection. Downregulation of Cav-1 rescued P. gingivalis-enhanced BMECs permeability. We further found P. gingivalis-gingipain could be colocalized with Cav-1 and the strong hydrogen bonding between Cav-1 and arg-specific-gingipain (RgpA) were detected. Moreover, P. gingivalis significantly inhibited the major facilitator superfamily domain containing 2a (Mfsd2a) expression. Mfsd2a overexpression reversed P. gingivalis-increased BMECs permeability and Cav-1 expression. These results revealed that Mfsd2a/Cav-1 mediated transcytosis is a key pathway governing BBB BMECs permeability induced by P. gingivalis, which may contribute to P. gingivalis/virulence factors entrance and the subsequent neurological impairments.
Animals ; Rats ; Bacteremia/metabolism* ; Blood-Brain Barrier/microbiology* ; Caveolin 1/metabolism* ; Gingipain Cysteine Endopeptidases/metabolism* ; Permeability ; Porphyromonas gingivalis/pathogenicity* ; Transcytosis ; Virulence Factors/metabolism*

BACKGROUND: Intensive phototherapy (IPT) and exchange transfusion (ET) are the main treatments for extreme hyperbilirubinemia. However, there is no reliable evidence on determining the thresholds for these treatments. This multicenter study compared the effectiveness and complications of IPT and ET in the treatment of extreme hyperbilirubinemia. METHODS: This retrospective cohort study was conducted in seven centers from January 2015 to January 2018. Patients with extreme hyperbilirubinemia that met the criteria of ET were included. Patients were divided into three subgroups (low-, medium-, and high- risk) according to gestational week and risk factors. Propensity score matching (PSM) was performed to balance the data before treatment. Study outcomes included the development of bilirubin encephalopathy, duration of hospitalization, expenses, and complications. Mortality, auditory complications, seizures, enamel dysplasia, ocular motility disorders, athetosis, motor, and language development were evaluated during follow-up at age of 3 years. RESULTS: A total of 1164 patients were included in this study. After PSM, 296 patients in the IPT only group and 296 patients in the IPT plus ET group were further divided into the low-, medium-, and high-risk subgroups with 188, 364, and 40 matched patients, respectively. No significant differences were found between the IPT only and IPT plus ET groups in terms of morbidity, complications, and sequelae. Hospitalization duration and expenses were lower in the low- and medium-risk subgroups in the IPT only group. CONCLUSIONS In this study, our results suggest that IPT is a safe and effective treatment for extreme hyperbilirubinemia. The indication of ET for patients with hyperbilirubinemia could be stricter. However, it is necessary to have a contingency plan for emergency ET as soon as IPT is commenced especially for infants with risk factors. If IPT can be guaranteed and proved to be therapeutic, ET should be avoided as much as possible.
Child, Preschool ; Exchange Transfusion, Whole Blood/adverse effects* ; Humans ; Hyperbilirubinemia, Neonatal/therapy* ; Infant ; Infant, Newborn ; Kernicterus/therapy* ; Phototherapy/methods* ; Retrospective Studies