ObjectiveThis paper aims to study the effects of four weeks of aerobic exercise combined with Anmeidan on the synaptic plasticity marker protein and synaptic ultrastructure of the hippocampus in the model rats with sleep deprivation， thereby investigating the possible mechanism of its action to improve the learning memory of rats with sleep deprivation. Methods50 Sprague-Dawley （SD） rats were randomly divided into blank control group （group C）， sleep deprivation group （group M）， aerobic exercise + sleep deprivation group （group MEX）， Anmeidan + sleep deprivation group （group MA， 18.18 g∙kg^-1∙d^-1）， and aerobic exercise + Anmeidan + sleep deprivation group （group MEXA， 18.18 g∙kg^-1∙d^-1）. Anmeidan was administered by gavage in the MA group for four weeks. Aerobic exercise was performed in the MEX group for four weeks. Anmeidan was administered by gavage in the MEXA group in combination with aerobic exercise for four weeks， and sleep deprivation was performed for 72 h by using the multi-platform water environment method. At the end of sleep deprivation， Morris water maze was used to assess the learning and memory ability of rats in each group， and hematoxylin-eosin （HE） staining was used to observe the morphological changes of rats' hippocampal neurons. A transmission electron microscope was used to observe the synaptic ultrastructure of rats' hippocampus. The expression levels of brain-derived neurotrophic factor （BDNF）， tyrosine kinase receptor B （TrkB）， cAMP-response element binding protein （CREB）， postsynaptic density-95 （PSD-95）， and synaptophysin （SYN） were detected by Western blot， and the real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the relative mRNA expression levels of BDNF， TrkB， and CREB in the rats' hippocampus. ResultsCompared with those in group C， rats in group M had significantly longer latency and total swimming distance on the platform （P<0.01） and a significantly reduced number of traversals across the platform as well as the residence time in the target quadrant （P<0.01）. Part of the hippocampal neurons damaged， with a reduced number， disorganized arrangement， fuzzy synaptic gaps， thinning of post-synaptic dense material， and uneven density of synaptic vesicles. The protein expression levels and relative mRNA expression levels of BDNF， TrkB， and CREB were significantly reduced （P<0.01）， and the protein expression levels of PSD-95 and SYN were significantly reduced （P<0.01）. Compared with those in group M， rats in MA， MEX， and MEXA groups showed a decrease in latency to platform and total distance swum， an increase in the number of traversals across the platform and residence time in the target quadrant （P<0.05， P<0.01）， a reduction in hippocampal neuronal damage， a better arrangement， a more intact synaptic structure， a thickening of post-synaptic dense material， a uniform density of synaptic vesicles， and an increase in the protein expression levels and mRNA expression levels of BDNF， TrkB， and CREB （P<0.05， P<0.01）. The protein expressions of PSD-95 and SYN rose （P<0.05， P<0.01）. ConclusionAerobic exercise combined with Anmeidan can improve learning memory in rats with sleep deprivation， and its mechanism of action may be related to the modulation of the BDNF/TrkB/CERB signalling pathway， up-regulation of the expression of PSD-95 and SYN， and improvement of synaptic structural damage. The combination of interventions is superior to single exercise or drugs.

Objective To evaluate the patterns of sleep duration by integrating nocturnal and daytime sleep,and to explore their asso-ciations with activities of daily living(ADL)in middle-aged and older adults.Methods The data of sleep and ADL were obtained from 11 085 subjects aged 45 and older,which were collected from the China Health and Retirement Longitudinal Study(CHARLS).At enrollment in 2011,data on nocturnal and daytime sleep duration were collected through questionnaires.Firstly,subjects were divided into three groups based on the 33rd and 66th percentiles of nocturnal sleep duration,assigned scores of 1,2 and 3,respectively.Subsequently,subjects were divided into three groups based on the 33rd and 66th percentiles of daytime sleep du-ration,assigned scores of 3,2 and 1,respectively.Finally,the scores for nocturnal and daytime sleep were summed to create a total sleep score ranging from 2 to 6.A total sleep score of 6 was defined as sleep duration pattern 1,indicating a longer nocturnal sleep duration with no or shorter daytime sleep duration.Similarly,total sleep scores of 5,4,3 and 2 were defined as sleep duration patterns 2,3,4 and 5,respectively,with sleep duration pattern 5 indicating a shorter nocturnal sleep duration and a longer daytime sleep duration.The status of ADL was assessed using the Activities of Daily Living Scale(Katz edition)at baseline and during follow-up in 2013,2015 and 2018.The association between sleep duration patterns and the risk of ADL disability was evaluated us-ing a Cox proportional hazards model.Results A total of 63 015 person-years were followed,with 11 085 subjects,during which 3 239 individuals experienced ADL disability.The 33rd and 66th percentiles of the nocturnal sleep duration in the study population were 6.00 hours and 7.00 hours,respectively;while the 33rd and 66th percentiles of the daytime sleep duration were 0.00 hours and 1.00 hours,respectively.Of those,1 522 were classified into sleep duration pattern 1,2 196 into sleep duration pattern 2,4 299 into sleep duration pattern 3,2 304 into sleep duration pattern 4,and 764 into sleep dura-tion pattern 5.Compared to sleep duration pattern 1,the risk of ADL disability of patterns 3,4 and 5 were higher(P<0.05),with P-value for the trend less than 0.001,after adjusting for age,sex,body mass index,marital sta-tus,educational level,residence,smoking,drinking,history of chronic diseases,depression status and season.No interaction effect between gender,age and season,and sleep duration patterns was observed(P>0.05).Com-pared to subjects with nocturnal sleep duration≥9 hours and daytime sleep duration<2 hours,those with noctur-nal sleep duration<7 hours and daytime sleep duration≥2 hours had a higher risk of ADL disability(P<0.05).Conclusion Older adults who sleep less at night but take longer naps during the day are at a higher risk of experiencing limitations in their ADL.Sleep patterns may influence ADL among middle-aged and older populations,and man-aging their sleep duration patterns could help prevent the onset of ADL limitations.

Objective To evaluate the patterns of sleep duration by integrating nocturnal and daytime sleep,and to explore their asso-ciations with activities of daily living(ADL)in middle-aged and older adults.Methods The data of sleep and ADL were obtained from 11 085 subjects aged 45 and older,which were collected from the China Health and Retirement Longitudinal Study(CHARLS).At enrollment in 2011,data on nocturnal and daytime sleep duration were collected through questionnaires.Firstly,subjects were divided into three groups based on the 33rd and 66th percentiles of nocturnal sleep duration,assigned scores of 1,2 and 3,respectively.Subsequently,subjects were divided into three groups based on the 33rd and 66th percentiles of daytime sleep du-ration,assigned scores of 3,2 and 1,respectively.Finally,the scores for nocturnal and daytime sleep were summed to create a total sleep score ranging from 2 to 6.A total sleep score of 6 was defined as sleep duration pattern 1,indicating a longer nocturnal sleep duration with no or shorter daytime sleep duration.Similarly,total sleep scores of 5,4,3 and 2 were defined as sleep duration patterns 2,3,4 and 5,respectively,with sleep duration pattern 5 indicating a shorter nocturnal sleep duration and a longer daytime sleep duration.The status of ADL was assessed using the Activities of Daily Living Scale(Katz edition)at baseline and during follow-up in 2013,2015 and 2018.The association between sleep duration patterns and the risk of ADL disability was evaluated us-ing a Cox proportional hazards model.Results A total of 63 015 person-years were followed,with 11 085 subjects,during which 3 239 individuals experienced ADL disability.The 33rd and 66th percentiles of the nocturnal sleep duration in the study population were 6.00 hours and 7.00 hours,respectively;while the 33rd and 66th percentiles of the daytime sleep duration were 0.00 hours and 1.00 hours,respectively.Of those,1 522 were classified into sleep duration pattern 1,2 196 into sleep duration pattern 2,4 299 into sleep duration pattern 3,2 304 into sleep duration pattern 4,and 764 into sleep dura-tion pattern 5.Compared to sleep duration pattern 1,the risk of ADL disability of patterns 3,4 and 5 were higher(P<0.05),with P-value for the trend less than 0.001,after adjusting for age,sex,body mass index,marital sta-tus,educational level,residence,smoking,drinking,history of chronic diseases,depression status and season.No interaction effect between gender,age and season,and sleep duration patterns was observed(P>0.05).Com-pared to subjects with nocturnal sleep duration≥9 hours and daytime sleep duration<2 hours,those with noctur-nal sleep duration<7 hours and daytime sleep duration≥2 hours had a higher risk of ADL disability(P<0.05).Conclusion Older adults who sleep less at night but take longer naps during the day are at a higher risk of experiencing limitations in their ADL.Sleep patterns may influence ADL among middle-aged and older populations,and man-aging their sleep duration patterns could help prevent the onset of ADL limitations.