Objective::Observational studies indicate that insomnia may increase the risk of developing and/or dying from cardiovascular diseases, especially coronary artery disease (CAD). Our purpose is to explore the underlying causal relationship between genetic variants susceptible to insomnia and the risk of CAD by Mendelian randomization analysis.Methods::The study was conducted using publicly available statistical data on genetic variants identified from a genome-wide association meta-analysis of insomnia ( n = 113,006 individuals) and a genome-wide association meta-analysis of CAD ( n = 184,305 individuals), which consisted of both cases and non-cases. The genetic association between variants and CAD was assessed by the variants’ association with insomnia, and estimations were integrated by an inverse-variance weighted meta-analysis. Results::Among the Mendelian randomized analytical sample, 8 variants were associated with insomnia complaints and CAD. And there was no pleiotropic association with the latent confounders. In addition, in the inverse-variance weighted meta-analysis (the estimations combined from the 8 variants), the odds ratio was 1.15 (95% CI: 1.05-1.25; P= 0.002) for CAD, and in the weighted method analysis, the odds ratio was 1.14 (95% CI: 1.03-1.27; P= 0.015) for CAD. Conclusions::All of the data indicated that some valuable variants might involve in the development of CAD by leading the insomnia. Therefore, insomnia might be a causal factor for CAD, and improving the quality of sleep might be a new way for populations with insomnia to prevent CAD.

Objective::Observational studies indicate that insomnia may increase the risk of developing and/or dying from cardiovascular diseases, especially coronary artery disease (CAD). Our purpose is to explore the underlying causal relationship between genetic variants susceptible to insomnia and the risk of CAD by Mendelian randomization analysis.Methods::The study was conducted using publicly available statistical data on genetic variants identified from a genome-wide association meta-analysis of insomnia ( n = 113,006 individuals) and a genome-wide association meta-analysis of CAD ( n = 184,305 individuals), which consisted of both cases and non-cases. The genetic association between variants and CAD was assessed by the variants’ association with insomnia, and estimations were integrated by an inverse-variance weighted meta-analysis. Results::Among the Mendelian randomized analytical sample, 8 variants were associated with insomnia complaints and CAD. And there was no pleiotropic association with the latent confounders. In addition, in the inverse-variance weighted meta-analysis (the estimations combined from the 8 variants), the odds ratio was 1.15 (95% CI: 1.05-1.25; P= 0.002) for CAD, and in the weighted method analysis, the odds ratio was 1.14 (95% CI: 1.03-1.27; P= 0.015) for CAD. Conclusions::All of the data indicated that some valuable variants might involve in the development of CAD by leading the insomnia. Therefore, insomnia might be a causal factor for CAD, and improving the quality of sleep might be a new way for populations with insomnia to prevent CAD.

Objective To strengthen the management of the handover and transfer process of surgical patients in the department of thoracic surgery, improve surgery and transfer efficiency and ensure transfer safety. Methods In 2015, Shanghai Chest Hospital, Shanghai Jiaotong University reconstructed a nursing team by building the surgical handover and transfer process, analyzed the needs of transferees and transferees and the factors contributing to low efficiency and high safety risks in transfer, rebuilt, optimized and standardized the existing surgical handover and transfer process in the department of thoracic surgery, and enhanced relevant training after the process was rebuilt. Totally 1591 transferred patients who received thoracic surgery between January and March 2015 were selected as a control group, while 2126 patients who received thoracic surgery from January to March 2016 were selected as an observation group. The handover and transfer efficiency before and after the rebuilt process was then compared, including time of handover delay for the first surgery, time of delay for consecutive surgery, the number of patients detained in operation rooms postoperatively as well as doctors and nurses′ satisfaction to the rebuilt process.Results After the process was rebuilt, the delay rate for the first surgery was 1.7%; the delay rate for consecutive surgery was 2.7%; the retention rate in recovery rooms was 2.8%, lower than the figures before the process was rebuilt (χ2=24.059, 63.146, 53.675;P＜0.01). Doctors and nurses′ satisfaction to the rebuilt process was ＞90%.Conclusions Management optimization by process reengineering helps to improve surgical handover and transfer efficiency, safety as well as doctors and nurses′ satisfaction.

Postnatal cerebral development is a complicated biological process precisely controlled by multiple genes. To understand the molecular mechanism of cerebral development, we compared dynamics of mouse cerebrum transcriptome through three developmental stages using high-throughput RNA-seq technique. Three libraries were generated from the mouse cerebrum at infancy, adolescence and adulthood, respectively. Consequently, 44,557,729 (infancy), 59,257,530 (adolescence) and 72,729,636 (adulthood) reads were produced, which were assembled into 15,344, 16,048 and 15,775 genes, respectively. We found that the overall gene expression level increased from infancy to adolescence and decreased later on upon reaching adulthood. The adolescence cerebrum has the most active gene expression, with expression of a large number of reg-ulatory genes up-regulated and some crucial pathways activated. Transcription factor (TF) analysis suggested the similar dynamics as expression profiling, especially those TFs functioning in neurogenesis differentiation, oligodendrocyte lineage determination and circadian rhythm regula-tion. Moreover, our data revealed a drastic increase in myelin basic protein (MBP)-coding gene expression in adolescence and adulthood, suggesting that the brain myelin may be generated since mouse adolescence. In addition, differential gene expression analysis indicated the activation of rhythmic pathway, suggesting the function of rhythmic movement since adolescence;Furthermore, during infancy and adolescence periods, gene expression related to axon repulsion and attraction showed the opposite trends, indicating that axon repulsion was activated after birth, while axon attraction might be activated at the embryonic stage and declined during the postnatal develop-ment. Our results from the present study may shed light on the molecular mechanism underlying the postnatal development of the mammalian cerebrum.

Objective To determine normal reference values for conduction in the posterior antebrachial cutaneous nerve.Methods Antidromic sensory conduction examinations of the bilateral posterior antebrachial cutaneous nerve were conducted with fifty-eight healthy subjects.The onset latency,peak latency,peak-to-peak amplitude and conduction velocity of the sensory nerve action potentials (SNAPs) were recorded and the inter-side ratios of the peak-to-peak amplitudes were calculated.Results The observed means (and standard deviations) of the onset time,the peak latency,the amplitude and the conduction velocity were 1.96 (0.12) ms,2.48 (0.14) ms,7.39 (2.36) μV and 61.39 (3.69) m/s,respectively.The side-to-side amplitude ratio (smaller/larger) was 0.88 ± 0.09,and no significant difference was observed between the left and right side.The average peak latency and amplitude were significantly different for different age groups.There was no statistically significant difference among the age groups with regard to onset latency or conduction velocity.Conclusion Conduction in the posterior antebrachial cutaneous nerve is easy to study.The peak latency is prolonged and the amplitude decreases with age,suggesting that different normal reference values should be established for different age groups.

Objective To characterize the static balance and limits of stability (LOS) of postmenopausal women and evaluate the relationship between bone mineral density (BMD) and balance.Methods Sixty women more than 12 months past menopause and aged 50 to 60 years were included in the study.Group 1 (n =20) consisted of women with normal BMD,group 2 (n =20) women with osteopenia,and group 3 (n =20) women with osteoporosis.The static balance of all the participants was evaluated in upright postural situations for 60 s with the eyes open and with the eyes elosed.Their LOS was quantified using a force platform.Results There was no significant difference in static balance parameters or LOS among the 3 groups.The static balance parameters were not significantly different in either the eyes-open or eyes-closed situation in the osteoporosis and osteopenia groups.The medial and lateral LOS were greater than the anterior and posterior limits in all 3 groups.The anterior LOS was greater than the posterior limits among the women with osteopenia and normal density.Conclusion In postmenopausal women aged 50 to 60 years,BMD did not show any significant association with static balance or LOS.Postmenopausal women had better postural control in the mediolateral than in the anteroposterior direction.In postmenopausal women with osteoporosis,postural control in the anterior direction deteriorates from age 50 to 60.

Objective To estimate the test-retest reliability of limits of stability (LOS) measurement in healthy young adults. MethodsTwenty-five healthy young adults participated this study.Their center of pressure (COP) displacements were recorded while they stood on a force platform.The subjects performed maximal voluntary sway maneuvers in the anterior,posterior,left and right directions in turn.The LOS in each direction was calculated using balance clinic software.Each subject underwent 3 consecutive,identical tests at 7 day intervals with the same investigator.The test-retest reliability of LOS was analyzed using the intraclass correlation coefficient (ICC).ResultsFor the first test the ICC values ( ICC1 ) of the LOS ranged from 0.790 to 0.857.For the mean LOS of the first two tests the ICC2 ranged from 0.906 to 0.937,and for the mean LOS of three tests the ICC3 ranged from 0.910 to 0.948. ConclusionThe LOS test is a reliable measurement with healthy young adults.In clinical practice,averaging two LOS tests is suggested in assessing balance and postural control with young adults.