Sleep is essential for organisms.Sleep disorders,such as insomnia,sleep fragmenta-tion,and sleep deprivation,deeply impact the physical activity and mental health of humans.The signifi-cant role of sleep in brain function has been well accepted in recent years.This article aims to summarize the research related to sleep disorders,sleep-wake control,the relationships between sleep and atten-tion,and the potential underlying mechanisms.Current interventions are also outlined in the hope of providing insights into sleep and cognitive function.

Sleep is essential for organisms.Sleep disorders,such as insomnia,sleep fragmenta-tion,and sleep deprivation,deeply impact the physical activity and mental health of humans.The signifi-cant role of sleep in brain function has been well accepted in recent years.This article aims to summarize the research related to sleep disorders,sleep-wake control,the relationships between sleep and atten-tion,and the potential underlying mechanisms.Current interventions are also outlined in the hope of providing insights into sleep and cognitive function.

Objective To observe clinical curative effect of long-acting recombinant human growth hormone(rhGH)and short-acting rhGH,and their influences on growth and development indexes,serum thyroid function indexes and insulin in children with idiopathic short stature(ISS).Methods The children with ISS were randomly divided into long-acting group[subcutaneous injection of polyethylene glycol recombinant human growth hormone(0.2 mg·kg-1·w-1,qw)]and short-acting group[subcutaneous injection of recombinant human growth hormone(0.15 U·kg-1·d-1)at 30 min before sleep every night].All children were treated for 12 months.The growth and development[growth velocity(GV),height standard deviation of points(Ht SDS)],thyroid function,fasting insulin(FINS)and insulin-like growth factor-1(IGF-1)were compared between the two groups.The occurrence of adverse reactions was recorded.Results In the 68 children,there were 4 cases with loss to follow-up and shedding due to personal reasons.Finally,there were 33 cases in long-acting group and 31 cases in short-acting group for statistical analysis.After 6 months of treatment,GV in long-acting group and short-acting group were(4.53±0.56)and(3.97±0.48)cm·year-1,Ht SDS were-2.45±0.23 and-2.66±0.21,IGF-1 levels were(551.62±41.48)and(524.36±37.84)mg·mL-1,respectively.After 12 months of treatment,GV in long-acting group and the short-acting group were(9.44±0.82)and(8.46±0.77)cm·year-1,Ht SDS were-1.68±0.19 and-1.91±0.20,IGF-1 levels were(642.46±36.49)and(593.14±40.12)mg·mL-1,differences were statistically significant(all P＜0.05).There were no significant differences in FT3,FT4,TSH and FINS between the two groups after treatment(all P＞0.05).There was no significant difference in the total incidences of adverse drug reactions between long-acting group and short-acting group[6.06％(2 cases/33 cases)vs 12.90％(4 cases/31 cases),P＞0.05].Conclusion Compared with short-acting rhGH,promotion effect of long-acting rhGH is better on short-term growth and development in ISS children,which can increase level of serum IGF-1 and has no obvious effects on thyroid function,with good safety.

This study was aimed at understanding the etiological and genetic characteristics of Yersinia enterocolica isolated in Jiangsu Province between 2005 and 2019.All 110 identified strains of Y.enterocolica were from patients with foodborne diar-rhea in Jiangsu Province,or from pigs,dogs,cattle,sheep,poultry,flies,or food.Virulence genes,biological serotypes,drug resistance,multilocus sequence typing(MLST),and core genome multilocus sequence typing(cgMLST)based on whole-genome sequencing were performed.The strains included 27 pathogenic strains(24.5％)and 83 non-pathogenic strains(75.5％).Non-pathogenic strains accounted for a high proportion,particularly among strains from patients(15/16,93.8％).The biological serotypes of pathogenic strains were mainly type 3/O∶3(26/27,96.3％).Non-pathogenic strains included 1A/O∶8 type(23/83,27.7％),1 A/O∶5 type(14/83,16.9％),and the other four biological serotypes(excluding unknown se-rotypes).Pathogenic strains were dominated by type 3/O∶3(26/27,96.3％),and more than 80％of these strains were sensi-tive to 19 antibiotic types.Whole-genome sequencing indicated that the pathogenic strains were all ST135 type,whereas the non-pathogenic strains were more diverse and scattered.HierCC clustering analysis grouped all strains into three clus-ters:pathogenic strains were in one cluster,and strains from patients were found in all three clusters.In conclusion,the Y.enterocolica strains from patients were primarily non-patho-genic.Non-pathogenic strains showed richer epigenetic and ge-netic diversity than pathogenic strains.The monitoring of these strains should be strengthened to decrease the risk of human infection.

This study was aimed at understanding the etiological and genetic characteristics of Yersinia enterocolica isolated in Jiangsu Province between 2005 and 2019.All 110 identified strains of Y.enterocolica were from patients with foodborne diar-rhea in Jiangsu Province,or from pigs,dogs,cattle,sheep,poultry,flies,or food.Virulence genes,biological serotypes,drug resistance,multilocus sequence typing(MLST),and core genome multilocus sequence typing(cgMLST)based on whole-genome sequencing were performed.The strains included 27 pathogenic strains(24.5％)and 83 non-pathogenic strains(75.5％).Non-pathogenic strains accounted for a high proportion,particularly among strains from patients(15/16,93.8％).The biological serotypes of pathogenic strains were mainly type 3/O∶3(26/27,96.3％).Non-pathogenic strains included 1A/O∶8 type(23/83,27.7％),1 A/O∶5 type(14/83,16.9％),and the other four biological serotypes(excluding unknown se-rotypes).Pathogenic strains were dominated by type 3/O∶3(26/27,96.3％),and more than 80％of these strains were sensi-tive to 19 antibiotic types.Whole-genome sequencing indicated that the pathogenic strains were all ST135 type,whereas the non-pathogenic strains were more diverse and scattered.HierCC clustering analysis grouped all strains into three clus-ters:pathogenic strains were in one cluster,and strains from patients were found in all three clusters.In conclusion,the Y.enterocolica strains from patients were primarily non-patho-genic.Non-pathogenic strains showed richer epigenetic and ge-netic diversity than pathogenic strains.The monitoring of these strains should be strengthened to decrease the risk of human infection.

OBJECTIVE: To investigate the factors related to renal impairment in patients with diabetic kidney disease (DKD) from the perspective of integrated Chinese and Western medicine. METHODS: Totally 492 patients with DKD in 8 Chinese hospitals from October 2017 to July 2019 were included. According to Kidney Disease Improving Global Outcomes (KDIGO) staging guidelines, patients were divided into a chronic kidney disease (CKD) 1-3 group and a CKD 4-5 group. Clinical data were collected, and logistic regression was used to analyze the factors related to different CKD stages in DKD patients. RESULTS: Demographically, male was a factor related to increased CKD staging in patients with DKD (OR=3.100, P=0.002). In clinical characteristics, course of diabetes >60 months (OR=3.562, P=0.010), anemia (OR=4.176, P<0.001), hyperuricemia (OR=3.352, P<0.001), massive albuminuria (OR=4.058, P=0.002), atherosclerosis (OR=2.153, P=0.007) and blood deficiency syndrome (OR=1.945, P=0.020) were factors related to increased CKD staging in patients with DKD. CONCLUSIONS Male, course of diabetes >60 months, anemia, hyperuricemia, massive proteinuria, atherosclerosis, and blood deficiency syndrome might indicate more severe degree of renal function damage in patients with DKD. (Registration No. NCT03865914).
Humans ; Male ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Hyperuricemia ; Kidney ; Proteinuria ; Renal Insufficiency, Chronic/complications*

BACKGROUND: Albuvirtide is a once-weekly injectable human immunodeficiency virus (HIV)-1 fusion inhibitor. We present interim data for a phase 3 trial assessing the safety and efficacy of albuvirtide plus lopinavir-ritonavir in HIV-1-infected adults already treated with antiretroviral drugs. METHODS: We carried out a 48-week, randomized, controlled, open-label non-inferiority trial at 12 sites in China. Adults on the World Health Organization (WHO)-recommended first-line treatment for >6 months with a plasma viral load >1000 copies/mL were enrolled and randomly assigned (1:1) to receive albuvirtide (once weekly) plus ritonavir-boosted lopinavir (ABT group) or the WHO-recommended second-line treatment (NRTI group). The primary endpoint was the proportion of patients with a plasma viral load below 50 copies/mL at 48 weeks. Non-inferiority was prespecified with a margin of 12%. RESULTS: At the time of analysis, week 24 data were available for 83 and 92 patients, and week 48 data were available for 46 and 50 patients in the albuvirtide and NRTI groups, respectively. At 48 weeks, 80.4% of patients in the ABT group and 66.0% of those in the NRTI group had HIV-1 RNA levels below 50 copies/mL, meeting the criteria for non-inferiority. For the per-protocol population, the superiority of albuvirtide over NRTI was demonstrated. The frequency of grade 3 to 4 adverse events was similar in the two groups; the most common adverse events were diarrhea, upper respiratory tract infections, and grade 3 to 4 increases in triglyceride concentration. Renal function was significantly more impaired at 12 weeks in the patients of the NRTI group who received tenofovir disoproxil fumarate than in those of the ABT group. CONCLUSIONS: The TALENT study is the first phase 3 trial of an injectable long-acting HIV drug. This interim analysis indicates that once-weekly albuvirtide in combination with ritonavir-boosted lopinavir is well tolerated and non-inferior to the WHO-recommended second-line regimen in patients with first-line treatment failure. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02369965; https://www.clinicaltrials.gov.Chinese Clinical Trial Registry No. ChiCTR-TRC-14004276; http://www.chictr.org.cn/enindex.aspx.
Adult ; Anti-HIV Agents/adverse effects* ; Antiretroviral Therapy, Highly Active ; China ; Drug Therapy, Combination ; HIV Infections/drug therapy* ; HIV-1 ; Humans ; Maleimides ; Peptides ; Ritonavir/therapeutic use* ; Treatment Outcome ; Viral Load

Here we reported a Chinese case of bilateral peripheral facial paralysis (PFP) in human immunodeficiency virusc (HIV) infected population. A 38-year-old homosexual male patient was referred to our hospital for bilateral facial paralysis. 21 days prior to admission he had developed high fever, chills, headache, fatigue, general malaise, nausea and vomiting. Neurological examination revealed bilateral ptosis of lower lip and cheeks, as well as failure of bilateral eyes closure. Analysis of cerebrospinal fluid (CSF) revealed pleocytosis, a marked rise of micro total protein and a marked rise of intrathecal lgG synthesis. The result of HIV-1 serology was positive by ELISA and that was confirmed by western blot. His CD4 cell count was 180 cells/mm . HIV-1 viral load in CSF was almost 10 times higher than that in plasma. The patient's condition improved steadily and experienced complete resolution of bilateral PFP after 2 months.
Adult ; Facial Paralysis ; blood ; pathology ; physiopathology ; HIV Infections ; blood ; pathology ; physiopathology ; HIV-1 ; Humans ; Male ; Meningitis ; blood ; pathology ; physiopathology