Objective:To investigate the clinical characteristics and associated factors of comorbid obstructive sleep apnea (OSA) coexisting with restless legs syndrome (RLS).Methods:A retrospective case-control study was conducted, enrolling hospitalized patients diagnosed with OSA or RLS at Peking University Sixth Hospital from June 2015 to May 2023. Participants were divided into three groups: OSA with RLS (comorbid group, n=26), OSA alone ( n=60, RLS-excluding), and RLS alone ( n=45, OSA-excluding). Demographic characteristics, clinical data, laboratory indicators (i.e., hemoglobin, ferritin, serum iron, folate, vitamin B 12, calcium, phosphorus, magnesium, fasting glucose), and polysomnography (PSG) parameters were collected. Group differences were analyzed using ANOVA, chi-square tests, and non-parametric tests. Multivariate logistic regression was performed to identify factors associated with OSA comorbid RLS. Results:Laboratory analyses revealed that patients in the comorbid group had significantly lower hemoglobin ( P=0.046) and ferritin levels ( P=0.024) than the OSA-alone group. Conversely, serum phosphorus was markedly elevated in the comorbid group compared to both control groups ( F=2.23, P<0.01). Polysomnography test found significantly higher periodic limb movement during sleep index (PLMSI) in the comorbid group vs. OSA-alone group (Dunn-Bonferroni correction P=0.001), reduced minimum oxygen saturation in the comorbid group vs. RLS-alone group (Dunn-Bonferroni correction P<0.001), and increased respiratory-related microarousals in the comorbid group vs. RLS-alone group (Dunn-Bonferroni correction P<0.001). Multivariate analysis adjusted for covariates confirmed that periodic limb movement during sleep index (PLMSI) ( OR=1.04, 95% CI=1.02-1.07, P=0.001) and serum phosphorus ( OR=6.51, 95% CI=1.86-27.40, P=0.003) independently contributed to OSA-RLS comorbidity. Conclusion:The coexistence of OSA and RLS manifests as dual dysregulation in iron-phosphorus metabolism and synchronized respiratory-motor dysfunction. Mechanistically, hypoxia-induced systemic inflammation may serve as a nexus linking metabolic perturbations and sleep fragmentation in this clinical subpopulation, highlighting potential biomarkers for targeted management.

Objective:To investigate the clinical characteristics and associated factors of comorbid obstructive sleep apnea (OSA) coexisting with restless legs syndrome (RLS).Methods:A retrospective case-control study was conducted, enrolling hospitalized patients diagnosed with OSA or RLS at Peking University Sixth Hospital from June 2015 to May 2023. Participants were divided into three groups: OSA with RLS (comorbid group, n=26), OSA alone ( n=60, RLS-excluding), and RLS alone ( n=45, OSA-excluding). Demographic characteristics, clinical data, laboratory indicators (i.e., hemoglobin, ferritin, serum iron, folate, vitamin B 12, calcium, phosphorus, magnesium, fasting glucose), and polysomnography (PSG) parameters were collected. Group differences were analyzed using ANOVA, chi-square tests, and non-parametric tests. Multivariate logistic regression was performed to identify factors associated with OSA comorbid RLS. Results:Laboratory analyses revealed that patients in the comorbid group had significantly lower hemoglobin ( P=0.046) and ferritin levels ( P=0.024) than the OSA-alone group. Conversely, serum phosphorus was markedly elevated in the comorbid group compared to both control groups ( F=2.23, P<0.01). Polysomnography test found significantly higher periodic limb movement during sleep index (PLMSI) in the comorbid group vs. OSA-alone group (Dunn-Bonferroni correction P=0.001), reduced minimum oxygen saturation in the comorbid group vs. RLS-alone group (Dunn-Bonferroni correction P<0.001), and increased respiratory-related microarousals in the comorbid group vs. RLS-alone group (Dunn-Bonferroni correction P<0.001). Multivariate analysis adjusted for covariates confirmed that periodic limb movement during sleep index (PLMSI) ( OR=1.04, 95% CI=1.02-1.07, P=0.001) and serum phosphorus ( OR=6.51, 95% CI=1.86-27.40, P=0.003) independently contributed to OSA-RLS comorbidity. Conclusion:The coexistence of OSA and RLS manifests as dual dysregulation in iron-phosphorus metabolism and synchronized respiratory-motor dysfunction. Mechanistically, hypoxia-induced systemic inflammation may serve as a nexus linking metabolic perturbations and sleep fragmentation in this clinical subpopulation, highlighting potential biomarkers for targeted management.

Objective:To explore the regulation of eight weeks aerobic exercise on brain spontaneous activity in individuals with subthreshold depression.Methods:Through subject recruitment, a total of 44 subjects with subthreshold depression (subthreshold depression group, StD) who scored≥5 according to Patient Health Questionnare-9 (PHQ-9) but did not meet the diagnostic criteria for clinical depression, and 34 healthy subjects (health control group, HC) were included. Two groups of participants were given 8-week moderate-intensity aerobic exercise intervention, and resting state functional magnetic resonance imaging (rs-fMRI) data were collected before and after the intervention to analyze the fractional amplitude of low frequency fluctuations (fALFF) in the two groups. Horizontal two-sample t-tests with years of education as a covariate and longitudinal paired-samples t-tests were performed for fALFF in both groups at baseline and after 8-week moderate-intensity aerobic exercise intervention. The relationship between the fALFF values in significant difference brain regions and psycho-psychological scales were examined by Spearman correlation. Results:After 8 weeks of moderate intensity aerobic exercise, the scores of PHQ-9 and Self-Rating Anxiety Scale (SAS) in StD were significantly lower than baseline ( t=7.08,5.99, both P<0.001). There was no significant difference in fALFF value between StD and HC at baseline. After aerobic exercise intervention, compared with the HC, the fALFF value of the left parahippocampal gyrus in the StD was significantly decreased, and the fALFF value of the left superior frontal gyrus and left precentral gyrus was significantly increased. After aerobic exercise intervention, compared with the baseline, the StD had significantly higher fALFF values in the left inferior parietal lobe (supramarginal gyrus and angular gyrus), right supramarginal gyrus and left anterior cingulate gyrus. In addition, compared with the baseline, the fALFF value of the right precentral gyrus in the HC was significantly decreased. After aerobic exercise intervention, the fALFF value of the left inferior parietal lobe was negatively correlated with the SAS scores ( r= -0.31, P=0.038), the fALFF value of the left anterior cingulate gyrus and the PHQ-9 item 2 (low mood) scores was negatively correlated ( r= -0.41, P=0.006), and the fALFF values of the left inferior parietal lobe, right supramarginal gyrus and the PHQ-9 item 6 (low self-evaluation) scores were negative correlated ( r=-0.39, P=0.010; r=-0.30, P=0.048). Conclusion:Eight weeks of moderate-intensity aerobic exercise can regulate the spontaneous activity pattern of local brain regions in individuals with subthreshold depression, and fALFF analysis can provide objective evidence for the antidepressant effect of aerobic exercise.

Objective:To explore the regulation of eight weeks aerobic exercise on brain spontaneous activity in individuals with subthreshold depression.Methods:Through subject recruitment, a total of 44 subjects with subthreshold depression (subthreshold depression group, StD) who scored≥5 according to Patient Health Questionnare-9 (PHQ-9) but did not meet the diagnostic criteria for clinical depression, and 34 healthy subjects (health control group, HC) were included. Two groups of participants were given 8-week moderate-intensity aerobic exercise intervention, and resting state functional magnetic resonance imaging (rs-fMRI) data were collected before and after the intervention to analyze the fractional amplitude of low frequency fluctuations (fALFF) in the two groups. Horizontal two-sample t-tests with years of education as a covariate and longitudinal paired-samples t-tests were performed for fALFF in both groups at baseline and after 8-week moderate-intensity aerobic exercise intervention. The relationship between the fALFF values in significant difference brain regions and psycho-psychological scales were examined by Spearman correlation. Results:After 8 weeks of moderate intensity aerobic exercise, the scores of PHQ-9 and Self-Rating Anxiety Scale (SAS) in StD were significantly lower than baseline ( t=7.08,5.99, both P<0.001). There was no significant difference in fALFF value between StD and HC at baseline. After aerobic exercise intervention, compared with the HC, the fALFF value of the left parahippocampal gyrus in the StD was significantly decreased, and the fALFF value of the left superior frontal gyrus and left precentral gyrus was significantly increased. After aerobic exercise intervention, compared with the baseline, the StD had significantly higher fALFF values in the left inferior parietal lobe (supramarginal gyrus and angular gyrus), right supramarginal gyrus and left anterior cingulate gyrus. In addition, compared with the baseline, the fALFF value of the right precentral gyrus in the HC was significantly decreased. After aerobic exercise intervention, the fALFF value of the left inferior parietal lobe was negatively correlated with the SAS scores ( r= -0.31, P=0.038), the fALFF value of the left anterior cingulate gyrus and the PHQ-9 item 2 (low mood) scores was negatively correlated ( r= -0.41, P=0.006), and the fALFF values of the left inferior parietal lobe, right supramarginal gyrus and the PHQ-9 item 6 (low self-evaluation) scores were negative correlated ( r=-0.39, P=0.010; r=-0.30, P=0.048). Conclusion:Eight weeks of moderate-intensity aerobic exercise can regulate the spontaneous activity pattern of local brain regions in individuals with subthreshold depression, and fALFF analysis can provide objective evidence for the antidepressant effect of aerobic exercise.

Objective:To explore the optimal surgical time of laparoscopic appendectomy after conservative treatment of appendiceal abscess in children.Methods:Clinical data of 86 children with appendiceal abscess diagnosed in the Department of General Surgery, Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2016 to June 2020 were retrospectively analyzed.According to the delayed laparoscopic appendectomy interval after the appendiceal abscess was cured, 86 children were divided into group A, B and C. Briefly, patients in the 3 groups were treated with laparoscopic appendectomy 4 weeks, 8 weeks and over 12 weeks after the appendiceal abscess was cured, respectively.Children with recurrent appendicitis during delayed operation were not included.The incidence of appendicitis recurrence during delayed operation, the incidences of intraoperative complications, conversion to laparotomy, and postoperative complications, operation time, the time of postoperative intestinal function recovery, and postoperative hospital stay were compared among 3 groups.Results:There were 10, 31 and 45 cases in group A, B and C, respectively.Among them 10, 30 and 39 patients received laparoscopic appendectomy, and 0, 1 and 6 cases had appendicitis recurrence in group A, B and C, respectively.There were no significant differences in the age, gender, diameter of appendiceal abscess, inflammatory indexes at diagnosis of diagnosing appendiceal abscess, cure time of conservative treatment of abscess, and inflammatory indexes at laparoscopic appendectomy among the 3 groups (all P>0.05). The incidence of appendicitis recurrence in group C(13.33%) was significantly higher than that in group A (0) and group B (3.22%)( P<0.05). There was no significant difference in the incidence of appendicitis recurrence between group A and group B( P>0.05). The incidences of intraoperative(group A, B, C was 40.00%, 10.00%, 10.26%, respectively) and postoperative complications (group A, B, C was 40.00%, 6.70%, 5.10%, respectively), and conversion to laparotomy(group A, B, C was 20.00%, 0, 0), operation time [group A, B, C was (106.70±7.42) d, 41.40±10.44) d, (39.60±11.27) d, respectively], postoperative intestinal function recovery time [group A, B, C was(5.80±2.15) d, (0.93±0.17) d, (0.83±0.11) d], and postoperative hospital stay[group A, B, C was(12.40±4.15) d, (1.67±0.31) d, (1.58±0.44) d] in group A were significantly higher than those in group B and group C(all P<0.05), but no significant differences were found between group B and group C(all P>0.05). Conclusions:Eight weeks are the best time for laparoscopic appendectomy after conservative treatment of appendiceal abscess in children.

Objective:To explore the clinical characteristics and risk factors of pediatric patients with Wiskott-Aldrich syndrome (WAS).Methods:This was a case-control study. Clinical data of 165 cases of pediatric patients with WAS, who visited the Department of Rheumatology, Children′s Hospital of Chongqing Medical University between January 2007 and August 2020 were retrospectively analyzed and divided into death group and survival group (control group) according to the prognosis in the follow-up. Two independent samples t-test, Welch approximate t-test, Mann-Whitney U test, Pearson χ2 test, Yates corrected χ2 test, or Fisher exact probability test were used for comparison between groups. Risk factors were analyzed by multivariate Logistic regression analysis. Results:A total of 165 patients with Wiskott-Aldrich syndrome were enrolled in this study, including 40 cases in the death group and 125 cases in the survival group. The WAS score was (4.1±0.8) score in the death group and (3.1±1.2) score in the survival group. The age was 19 (9, 28) months in the death group and 60 (36,86) in the survival group. The episode rates of recurrent infection and (or) severe infection, intracranial hemorrhage and eczema in the death group were significantly higher than those in the survival group (95.0% (38/40) vs.32.0% (40/125),25.0% (10/40) vs. 2.4% (3/125), 90.0% (36/40) vs. 72.0% (90/125), χ2=48.253, 18.325, 5.440, all P<0.05). Infection (22 cases, 55.0%) and intracerebral hemorrhage (15 cases, 37.5%) were the main causes of death, 3 cases (7.5%) died of severe graft-versus-host disease after transplantation. The Logistic regression model indicated that repeated infection and (or) severe infection and non-use of intravenous immunoglobulin (IVIG) replacement therapy were risk factors for death in Chinese WAS patients ( OR values were 8.999 and 2.860, 95% CI were (2.041-39.667) and (1.375-5.950), respectively, all P<0.05). Conclusions:Recurrent and (or) severe infection is the main risk factor of death for WAS patietns. Regular IVIG treatment can improve the survival rate of patients with WAS.

［18F］6-fluoro-3, 4-dihydroxy-L-phenylalanine(［18F］F-DOPA)has been used as a radiotracer for Parkinson′s disease over 30 years. The previously reported electrophilic synthesis method has low radiochemical yield(RCY), low specific activity(SA)and other defects. Recent reported nucleophilic synthesis of ［18F］F-DOPA could overcome the disadvantages. In this paper, the nucleophilic synthetic methods for ［18F］F-DOPA are reviewed.

Objective: To explore the characteristics of the default memory network (DMN) and working memory network (WMN) at resting state brain functional network of exercise addiction people. Methods: Twenty-nine sports addicts and 26 non-sports addicts matched by sex, age, average education level and sports dependence were screened by the exercise addiction index (EAI). Resting status brain scanning was performed with 3.0T magnetic resonance scanner.Sparse approximation coefficients independent component analysis (SACICA) model was used to analyze the independent components of brain networks. Results: Compared with the DMN template, four features were extracted, including " basic conformity" , " less frontal lobe" , " more frontal lobe" and " less occipitoparietal lobe" . Compared with the parameters of " basic conformity" , the proportion of exercise addiction group (33.3%, 9/27) was higher than that of control group (18.2%, 4/22). In the other three parameters, the proportion of exercise addiction group (37.0%, 10/27; 3.7%, 1/27; 22.2%, 6/27) was lower than those of control group (45.5%, 10/22; 22.7%, 5/22; 27.3%, 6/22). But Chi-square test showed that there was no significant difference between the two groups(all P>0.05). Compared with the WMN template, six features were extracted, including " basic conformity" , " more frontal and parietal lobes" , " more parietal lobes" , " more frontal lobes" , " less frontal lobes" and " less parietal lobes" . The percentages of the first three features in exercise addiction group (22.2%, 6/27; 7.4%, 2/27; 7.4%, 2/27) were less than those in the control group (45.5%, 10/22; 22.7%, 5/22; 9.1%, 2/22), while the percentages of the last three features in the exercise addiction group (7.4%, 2/27; 37.0%, 10/27; 14.8%, 4/27) were higher than those in the control group (4.5%, 1/22; 13.6%, 3/22; 0, 0). Chi-square test showed that there was no significant difference in all features between the two groups was statistically(P>0.05). Conclusion No significant characteristic changes are found in DMN and WMN networks of exercise addiction population.

Objective To explore the feasibility and effect of laparoscopic Ladd's surgery for the treatment of intestinal malrotation in infants.Methods The clinical data of 50 infants with intestinal malrotation who were admitted to the Wuhan Medical & Health Center for Women and Children from January 2011 to December 2013 were retrospectively analyzed.Of 50 infants, 27 infants receiving the open Ladd's surgery were allocated into the open surgery group and 23 infants receiving the laparoscopic Ladd's surgery were allocated into the laparoscopy group.The operation time, time to anal exsufflation, duration of hospital stay, postoperative incision infection and intestinal obstruction in the 2 groups were observed.All the patients were followed up by outpatient examination or telephone interview till March 2014.The measurement data with normal distribution were presented as x-± s and analyzed by the t test, and count data were analyzed using the chi-square test or Fisher exact probability.Results The operation time, time to anal exsufflation and duration of hospital stay were (69 ± 7)minutes, (41 ±9)hours and (10.4 ± 2.4)days in the open surgery group, which was significantly different from (92 ± 13)minutes, (28 ±5)hours and (6.4 ± 1.5) days in the laparoscopy group (t =6.21, 16.50, 6.34,P ＜ 0.05).Two infants had incision infection and 1 infant had intestinal obstruction in the open surgery group.There was no patient with complications in the laparoscopy group.All the patients were followed up for the median time of 13 months (range, 6-24 months), with a good survival and no other symptoms.Conclusion Laparoscopic Ladd's surgery is safe and feasible compared with open surgery, and it could be used as a prior operation method for treatment of intestinal malrotation in infants.