Objective To investigate the impact of sleep modes on the risk for diseases of the body systems.Methods Based on a subset of UK Biobank dataset comprising 87 617 participants,3 sleep dimensions including 6 sleep indicators were obtained through a wrist-worn accelerometer,that is sleep duration and onset,sleep rhythm(relative amplitude and stability),and sleep quality(sleep efficiency and number of awakenings).Latent profile analysis(LPA)was applied to identify and classify distinct sleep modes.Then their longitudinal medical records were the association between different sleep modes and the risk for 467 diseases.Results LPA identified 5 subgroups of unique sleep modes in the participants.Among the 5 subgroups,the subgroup 4 had relatively optimal levels in above sleep indicators.Compared to the subgroup 4,the other 4 subgroups exhibited variations in different sleep dimensions,with at least one indicator demonstrating an unfavorable trend.These subgroups also revealed differences in racial composition,shift work and social deprivation index.Moreover,there were notable differences in the risk of various system diseases among the subgroups(P<0.05).When compared to the subgroup 4,the other 4 subgroups exhibited an elevated risk for certain diseases(comprising a total of 126 diseases),with the diseases of the circulatory system,digestive system and musculoskeletal system most common.Among the 5 subgroups,the subgroup 2(shorter sleep duration and later sleep onset)and the subgroup 5(rhythm disorder)had the highest counts of associated risks,amounting to 85 and 91 types,respectively,but there was certain difference in their systematic composition.Conclusion There are different sleep modes within the participants,and the modes are potentially associated with an increased risk for diseases of body systems.Comprehensive interventions targeting overall sleep modes rather than single sleep indicator may yield obvious health benefits.

OBJECTIVE To investigate the relationship between kinesin superfamily(KIF)18B,20A and epithelial-mesenchymal transition(EMT)markers,clinicopathological features and prognosis in nasopharyngeal carcinoma.METHODS 116 cases of nasopharyngeal biopsy tumor tissues diagnosed as nasopharyngeal carcinoma in Department of Otolaryngology,Yulin Traditional Chinese Medicine Hospital from July 2017 to May 2019 were selected,nasal mucosa biopsy tissues of 116 chronic nasopharyngitis patients were used as control,the expression of KIF18B,KIF20A,and EMT markers epithelial calreticulin(E-cadherin),vimentin,twist in nasopharyngeal carcinoma tissues and nasopharyngeal chronic mucositis tissues were compared.The relationship between KIF18B,KIF20A expression and EMT marker expression and clinicopathological features in nasopharyngeal carcinoma tissues were analyzed.5 years after follow-up,the relationship between KIF18B,KIF20A expression and the prognosis of nasopharyngeal carcinoma patients were analyzed by the Kaplan-Meier method and multivariate Cox regression analysis.RESULTS The positive expression rates of KIF18B,KIF20A,Vimentin and Twist in nasopharyngeal carcinoma tissues were 55.17％,42.24％,20.69％,and 26.72％respectively,which were higher than 13.79％,9.48％,4.31％,and 5.17％in nasopharyngeal chronic mucosal inflammation tissues;The positive expression rate of E-cadherin in nasopharyngeal carcinoma tissues was 68.10％,which was lower than 91.38％in nasopharyngeal chronic mucosal inflammation tissues(P<0.05).KIF18B and KIF20A were negatively correlated with E-cadherin expression(rs=-0.439,-0.432,P<0.05),KIF18B,KIF20A were positively correlated with Vimentin(rs=0.418,0.456,P<0.05)and Twist(rs=0.427,0.427,P<0.05).The KIF18B and KIF20A positive expression rates in patients with low differentiation,lymph node metastasis,TNM stage Ⅲ-Ⅵa,clinical efficacy stable disease(SD)/progressive disease(PD)were higher than those in patients with high differentiation,no lymph node metastasis,stage Ⅰ-Ⅱ,and complete response(CR)/partial response(PR)(P<0.05).4 patients were lost to 5 years after follow-up,the success rate of follow-up was 96.55％(112/116),31 patients died,and the 5-year overall survival rate was 72.32％(81/112).The 5-year cumulative survival rate in KIF18B and KIF20A positive expression nasopharyngeal carcinoma patients were lower than those in KIF18B and KIF20A negative expression nasopharyngeal carcinoma patients(P<0.05).TNM stage Ⅲ-Ⅵa(HR=1.154,95％CI:1.018-1.308),clinical efficacy SD/PD(HR=1.287,95％CI:1.132-1.654),KIF18B(HR=1.823,95％CI:1.332-2.493)and positive expression of KIF20A(HR=2.110,95％CI:1.460-3.051)were independent risk factors affecting the prognosis of nasopharyngeal carcinoma patients(P<0.05).CONCLUSION KIF18B and KIF20A are abnormally highly expressed in nasopharyngeal carcinoma tissues,the positive expression of the two are closely related to EMT,tumor malignant progression and prognosis,and KIF18B,KIF20A positive expression patients have shorter survival time.

Objective To investigate the expression pattern of GFAP and VEGF after closed brain injury in rats,and to infer the time elapsed after brain injury,and then to provide reference for the inference of injury time.Methods Male rats were randomly divided into control group and experimental group,in which the experimental group was divided into 1 h,6 h,12 h,1 d,3 d,7 d and 14 d groups according to the different elapsed time after injury.Immunohistochemistry and ELISA were used to detect the expression of GFAP and VEGF in brain tissue and serum of rats after closed brain injury.Results(1)In each immunohistochemistry experimental group,GFAP was mainly expressed in the cytoplasm of astrocytes,with an obvious increase at 1 h after injury,a progressive increase of expression in 7 d,and a decrease of expression close to the level of the control group at 14 d after injury.While VEGF was mainly expressed in the cytoplasm of neurons,with an obvious increase at 1 d after injury,a peak at 3 d post-injury,and a decrease in expression at 14 d.(2)In each ELISA experimental group,the VEGF content in serum of each experimental group increased earlier than the VEGF expression in brain tissue,which began to increase significantly at 6 h after injury,and the content was the most at 3 d after injury,and was close to that of the control group at 14 d after injury.Conclusion(1)It has showed temporal changes in the expression of GFAP and VEGF,and both are expected to be biological markers for inferring the time of injury in forensic work.(2)GFAP and VEGF have high sensitivity and specificity and are important for the extrapolation of early craniocerebral injury time.

Objective To investigate the expression pattern of GFAP and VEGF after closed brain injury in rats,and to infer the time elapsed after brain injury,and then to provide reference for the inference of injury time.Methods Male rats were randomly divided into control group and experimental group,in which the experimental group was divided into 1 h,6 h,12 h,1 d,3 d,7 d and 14 d groups according to the different elapsed time after injury.Immunohistochemistry and ELISA were used to detect the expression of GFAP and VEGF in brain tissue and serum of rats after closed brain injury.Results(1)In each immunohistochemistry experimental group,GFAP was mainly expressed in the cytoplasm of astrocytes,with an obvious increase at 1 h after injury,a progressive increase of expression in 7 d,and a decrease of expression close to the level of the control group at 14 d after injury.While VEGF was mainly expressed in the cytoplasm of neurons,with an obvious increase at 1 d after injury,a peak at 3 d post-injury,and a decrease in expression at 14 d.(2)In each ELISA experimental group,the VEGF content in serum of each experimental group increased earlier than the VEGF expression in brain tissue,which began to increase significantly at 6 h after injury,and the content was the most at 3 d after injury,and was close to that of the control group at 14 d after injury.Conclusion(1)It has showed temporal changes in the expression of GFAP and VEGF,and both are expected to be biological markers for inferring the time of injury in forensic work.(2)GFAP and VEGF have high sensitivity and specificity and are important for the extrapolation of early craniocerebral injury time.

Objective:To verify Baveno VI criteria, Expanded-Baveno VI criteria, liver stiffness×spleen diameter-to-platelet ratio risk score (LSPS), and platelet count/spleen diameter ratio (PSR) in evaluating the severity value of esophageal varices (EV) in patients with non-cirrhotic portal hypertension (NCPH).Methods:111 cases of NCPH and 204 cases of hepatitis B cirrhosis who met the diagnostic criteria were included in the study. NCPH included 70 cases of idiopathic non-cirrhotic portal hypertension (INCPH) and 41 cases of nontumoral portal vein thrombosis (PVT). According to the severity of EV on endoscopy, they were divided into the low-bleeding-risk group (no/mild EV) and the high-bleeding-risk group (moderate/severe EV). The diagnostic value of Baveno VI and Expanded-Baveno VI criteria was verified to evaluate the value of LSPS and PSR for EV bleeding risk severity in NCPH patients. The t-test or Mann-Whitney U test was used to compare the measurement data between groups. Comparisons between counting data groups were performed using either the χ2 test or the Fisher exact probability method. Results:Considering endoscopy was the gold standard for diagnosis, the missed diagnosis rates of low/high bleeding risk EVs in INCPH/PVT patients with Baveno VI and Expanded-Baveno VI criteria were 50.0%/30.0% and 53.8%/50.0%, respectively. There were no statistically significant differences in platelet count (PLT), spleen diameter, liver stiffness (LSM), LSPS, and PSR between low-bleeding-risk and high-bleeding-risk groups in INCPH patients, and the area under the receiver operating characteristic curve (AUC) of LSPS and PSR was 0.564 and 0.592, respectively ( P=0.372 and 0.202, respectively). There were statistically significant differences in PLT, spleen diameter, LSPS, and PSR between the low and high-bleeding risk groups in PVT patients, and the AUCs of LSPS and PSR were 0.796 and 0.833 ( P=0.003 and 0.001, respectively). In patients with hepatitis B cirrhosis, the Baveno VI and Expanded-Baveno VI criteria were used to verify the low bleeding risk EV, and the missed diagnosis rates were 0 and 5.4%, respectively. There were statistically significant differences in PLT, spleen diameter, LSM, LSPS and PSR between the low-bleeding-risk and high-bleeding-risk groups ( P<0.001). LSPS and PSR AUC were 0.867 and 0.789, respectively ( P<0.05). Conclusion:Baveno VI and Expanded-Baveno VI criteria have a high missed diagnosis rate for EVs with low bleeding risk in patients with INPCH and PVT, while LSPS and PSR have certain value in evaluating EV bleeding risk in PVT patients, which requires further clinical research.

Objective:To study the efficacy of direct intrahepatic portosystemic shunt (DIPS) in treatment of Budd-Chiari syndrome (BCS).Methods:From January 1, 2015 to June 31, 2017, consecutive patients with BCS who were treated with DIPS at the Department of Interventional Therapy of Beijing Shijitan Hospital, the Liver Disease Research Center of Beijing Friendship Hospital and the General Surgery Department of Beijing Ditan Hospital were retrospectively analyzed. The symptoms, physical signs (including abdominal distension, ascites, pleural effusion, splenomegaly, hepatic encephalopathy) and perioperative laboratory results of these patients were collected and analyzed. Biochemical indicators including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil), and portal pressure gradient were compared before and 2 weeks after treatment. The patients were followed up for at least 3 years to assess their clinical symptoms, patency of shunt, oncological status and survival.Results:Of 67 patients with BCS who were included in the study, there were 45 males and 22 females, aged (38.12±23.22) years. The BCS classification of these patients were hepatic vein type ( n=65), including 62 patients with complete hepatic vein obstruction, 3 patients with hepatic vein occlusion due to thrombosis, and 2 patients with mixed hepatic vein and inferior vena cava occlusion. All 67 patients underwent DIPS with 93 stents being implanted. In addition, 43 patients underwent gastric coronary vein embolization, and 2 patients with mixed type of BCS underwent inferior vena cava stenting. The portal pressure gradient decreased from (22.17±9.16) mmHg (1 mmHg=0.133 kPa) to (9.87±4.75) mmHg, the difference was statistically significant ( P<0.05). Abdominal distension was relieved, at one month and ascites completely subsided in 3 months after operation. The liver congestion and swelling were obviously relieved. Comparison of patients 2 weeks after operation and before operation, ALT decreased from (65.28±27.75) U/L to (28.43±13.46)U/L, AST from (68.75±29.23) U/L to (26.92±13.33)U/L, TBil from (175.31±80.48)μmol/L to (45.08±26.54)μmol/L, DBil from (127.55±44.65)μmol/L to (35.12±10.77)μmol/L, and albumin increased from (31.56±7.22) g/L to (44.18±11.36)g/L, the difference was statistically significant (all P<0.05). All patients were followed up for at least 3 years. Shunt stenosis was detected in 5 patients (7.46%) with shunt expansion being performed, variceal bleeding in 2 patients (2.99%), ascites recurrence in 4 patients (5.97%) and hepatic encephalopathy in 2 patients (2.99%). No patients were diagnosed with hepatic cancer, and no patients died. Conclusion:DIPS was efficacious, safe and reliable to that BCS patients. It rapidly reduced portal venous pressure, relieved liver congestion, and restored liver morphology and liver function in these patients.

Objective To investigate the innovation ability status of undergraduate students in Third Military Medical University,and put forward some effective suggestions.Methods A questionnaire was applied to survey the innovation ability status of undergraduate students in Third Military Medical University.A total of 210 valid questionnaires were collected.The questionnaires covered five aspects including undergraduate students' basic information,innovative consciousness,innovation thinking,innovation skills and basic knowledge.The results were assessed by using SPSS 19.0 statistical software for t-test or ANOVA of students from different grades,majors and academic years.Inspection level was α=0.05.Results The total score of innovation ability in undergraduates was (70.5 ± 8.2) point,and no significant difference was observed in the total score of undergraduates' innovation ability within different grades (P=0.435).However,the innovation thinking ability of undergraduates in Grade Four was significantly higher than that in Grade Two [(77.0 ± 10.7) vs.(72.6 ± 10.9),P=0.030)],and the score of basic knowledge of undergraduates in Grade One was significantly higher than that in Grade Four [(76.2 ± 6.0) vs.(69.3 ± 8.7),P=0.014)].The total score of innovation ability of undergraduates from clinical medicine was significantly higher that of undergraduates from preventive medicine and other majors [(72.5 ± 8.8) vs.(69.9 ± 7.5),P=0.035;(72.5 ± 8.8) vs.(66.7 ± 7.9),P=0.004].There were no significant differences in total score of innovation ability or score of any first level index of undergraduates between eight-and five-year system of preventive medicine (P＞0.05).Conclusion The overall innovation ability of undergraduates in military medical university was relatively high,and undergraduates from different grades,majors and academic years have their own special advantages in innovative consciousness,innovation thinking,innovation skills and basic knowledge,and it is necessary to carry out more researches focusing on educational and training mechanism of innovation ability according to the personality of undergraduates in military medical universities.

Objective To investigate the role of a transcription factor p 53 in dengue virus infec-tion.Methods A plasmid expressing siRNA specific for p 53 gene was constructed and then used to prepare HepG2 cell line with a suppressed expression of p 53 protein.The expression of p53 protein was detected by Western blot assay .A wild type control group and a siRNA group were set up by infecting wildtype HepG 2 cells and p53 low expressing HepG2 cells with type 2 dengue viruses,respectively.The virus titers in two dif-ferent cells were determined by plaque forming assay using Vero cells .Indirect immunofluorescence assay was performed to detect virus multiplication .The apoptosis of virus infected cells were analyzed by flow cytome-try.ELISA was performed to analyze the levels of IFN-βsecreted by infected cells from two groups .Results Compared with wildtype control group ,the cells in siRNA group showed a suppressed expression of p 53 pro-tein,suggesting that the HepG2 cell line with low p53 protein expression was successfully established .The vi-rus titer in supernatants of the cells from siRNA group was about 100-fold higher than that of wildtype control group at 24 hours after viral infection .Fluorescence activated cell sorting analysis showed that the numbers of green fluorescence labeled cells were remarkably increased in siRNA group .We speculated that p53 protein might play a role in the inhibition of dengue virus infection as indicated by the observed results .The numbers of apoptotic cells showed no significant difference between two groups .However,the level of IFN-βsecreted by wildtype HepG2 cells was six times higher than that of the cells in siRNA group .Conclusion p53 pro-tein might inhibit dengue virus infection through the activation of type Ⅰ interferon signaling pathway rather than enhance cell apoptosis .