Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019 (COVID-19) survivors, few studies have focused on the effect of post-COVID-19 sleep disturbance (PCSD) on cognitive function. This study aimed to identify the impact of PCSD on neurocognitive function and explore the associated risk factors for the worsening of this condition. This cross-sectional study was conducted via the web-based assessment in Chinese mainland. Neurocognitive function was evaluated by the modified online Integrated Cognitive Assessment (ICA) and the Number Ordering Test (NOT). Propensity score matching (PSM) was utilized to match the confounding factors between individuals with and without PCSD. Univariate analyses were performed to evaluate the effect of PCSD on neurocognitive function. The risk factors associated with worsened neurocognitive performance in PCSD individuals were explored using binary logistic regression. A total of 8692 individuals with COVID-19 diagnosis were selected for this study. Nearly half (48.80%) of the COVID-19 survivors reported sleep disturbance. After matching by PSM, a total of 3977 pairs (7954 individuals in total) were obtained. Univariate analyses revealed that PCSD was related to worse ICA and NOT performance (P<0.05). Underlying disease, upper respiratory infection, loss of smell or taste, severe pneumonia, and self-reported cognitive complaints were associated with worsened neurocognitive performance among PCSD individuals (P<0.05). Furthermore, aging, ethnicity (minority), and lower education level were found to be independent risk factors for worsened neurocognitive performance in PCSD individuals (P<0.05). PCSD was related to impaired neurocognitive performance. Therefore, appropriate prevention and intervention measures should be taken to minimize or prevent PCSD and eliminate its potential adverse effect on neurocognitive function.
Humans ; COVID-19/epidemiology* ; Male ; Female ; Sleep Wake Disorders/epidemiology* ; Propensity Score ; Middle Aged ; Cross-Sectional Studies ; Adult ; SARS-CoV-2 ; Aged ; Risk Factors ; China/epidemiology* ; Cognition ; Cognitive Dysfunction/etiology* ; Neuropsychological Tests

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

[This corrects the article DOI: 10.1016/j.jpha.2023.08.006.].

Objective:To explore the therapeutic effect of traditional Chinese medicine emotional nursing combined with Baduanjin in rehabilitation nursing of patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods:This randomized controlled study enrolled 84 CHD patients undergoing PCI admitted in the First Hospital of Hunan University of Chinese Medicine between June 2022 and June 2023.Patients were ran-domly divided into control group(n=42)and intervention group(n=42).Patients in the control group received routine nursing,while those in the intervention group received additional traditional Chinese medicine emotional nursing combined with Baduanjin exercise.Both groups were continuously intervened for 8 weeks.Anxiety and de-pression,cardiac function and quality of life were compared between two groups.Results:After 8-week interven-tion,compared to patients in the control group,those in the intervention group had significant higher left ventricu-lar ejection fraction(LVEF)[(55.18±5.60)％vs.(50.34±5.28)％],6min walking distance(6MWD)[(321.27±19.92)m vs.(281.81±18.39)m],dimensional scores of physical limitation[(75.64±5.11)points vs.(65.14±4.32)points],anginal stability[(88.52±7.06)points vs.(73.66±7.28)points],anginal frequency[(82.79±6.20)points vs.(72.90±7.79)points],treatment satisfaction[(88.55±5.61)points vs.(73.80±7.51)points]and disease perception[(60.98±3.64)points vs.(50.30±5.60)points]of Seattle angina questionnaire(SAQ)(P＜0.001 all),and significant lower scores of self-rating anxiety scale(SAS)[(42.98±4.98)points vs.(47.95±4.49)points],self-rating depression scale(SDS)[(39.76±5.54)points vs.(43.98±5.28)points],left ventricu-lar end-diastolic diameter(LVEDd)[(48.07±4.74)mm vs.(51.71±4.31)mm]and left ventricular end-sys-tolic diameter(LVESd)[(45.20±4.31)mm vs.(49.52±4.55)mm](P＜0.001 all).Conclusion:Traditional Chinese medicine emotional nursing combined Baduanjin may relieve negative emotions,improve heart function and quality of life in patients with coronary heart disease after PCI.

Objective:To explore the therapeutic effect of traditional Chinese medicine emotional nursing combined with Baduanjin in rehabilitation nursing of patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods:This randomized controlled study enrolled 84 CHD patients undergoing PCI admitted in the First Hospital of Hunan University of Chinese Medicine between June 2022 and June 2023.Patients were ran-domly divided into control group(n=42)and intervention group(n=42).Patients in the control group received routine nursing,while those in the intervention group received additional traditional Chinese medicine emotional nursing combined with Baduanjin exercise.Both groups were continuously intervened for 8 weeks.Anxiety and de-pression,cardiac function and quality of life were compared between two groups.Results:After 8-week interven-tion,compared to patients in the control group,those in the intervention group had significant higher left ventricu-lar ejection fraction(LVEF)[(55.18±5.60)％vs.(50.34±5.28)％],6min walking distance(6MWD)[(321.27±19.92)m vs.(281.81±18.39)m],dimensional scores of physical limitation[(75.64±5.11)points vs.(65.14±4.32)points],anginal stability[(88.52±7.06)points vs.(73.66±7.28)points],anginal frequency[(82.79±6.20)points vs.(72.90±7.79)points],treatment satisfaction[(88.55±5.61)points vs.(73.80±7.51)points]and disease perception[(60.98±3.64)points vs.(50.30±5.60)points]of Seattle angina questionnaire(SAQ)(P＜0.001 all),and significant lower scores of self-rating anxiety scale(SAS)[(42.98±4.98)points vs.(47.95±4.49)points],self-rating depression scale(SDS)[(39.76±5.54)points vs.(43.98±5.28)points],left ventricu-lar end-diastolic diameter(LVEDd)[(48.07±4.74)mm vs.(51.71±4.31)mm]and left ventricular end-sys-tolic diameter(LVESd)[(45.20±4.31)mm vs.(49.52±4.55)mm](P＜0.001 all).Conclusion:Traditional Chinese medicine emotional nursing combined Baduanjin may relieve negative emotions,improve heart function and quality of life in patients with coronary heart disease after PCI.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

A major impedance to neuronal regeneration after peripheral nerve injury(PNI)is the activation of various programmed cell death mechanisms in the dorsal root ganglion.Ferroptosis is a form of pro-grammed cell death distinguished by imbalance in iron and thiol metabolism,leading to lethal lipid peroxidation.However,the molecular mechanisms of ferroptosis in the context of PNI and nerve regeneration remain unclear.Ferroportin(Fpn),the only known mammalian nonheme iron export protein,plays a pivotal part in inhibiting ferroptosis by maintaining intracellular iron homeostasis.Here,we explored in vitro and in vivo the involvement of Fpn in neuronal ferroptosis.We first delineated that reactive oxygen species at the injury site induces neuronal ferroptosis by increasing intracellular iron via accelerated UBA52-driven ubiquitination and degradation of Fpn,and stimulation of lipid peroxidation.Early administration of the potent arterial vasodilator,hydralazine(HYD),decreases the ubiquitination of Fpn after PNI by binding to UBA52,leading to suppression of neuronal cell death and significant ac-celeration of axon regeneration and motor function recovery.HYD targeting of ferroptosis is a promising strategy for clinical management of PNI.

Objective:To test the validity and reliability of the Chinese version of the Pre-sleep Arousal Scale(PSAS)in patients with brief insomnia disorder(BID).Methods:Totally 170 patients with BID and 150 normal sleepers(NS)were recruited.All participants were assessed with the PSAS,Hospital Anxiety and Depression Scale(HADS)and Insomnia Severity Index(ISI).After 3 months,72 patients with BID were retested with the PSAS,HADS and ISI.Results:The PSAS scores of BID group were characteristic of a normal distribution.The PSAS total scores were positively correlated with the scores of HADS and ISI(r=0.55,0.40,Ps＜0.01).Two factors of so-matic and cognitive arousal were extracted in PSAS by the exploratory factor analysis and parallel analysis,interval variance value was 55.84％,and the load scores of items were 0.46-0.89.The scores of PSAS and its subscales were higher in the BID group than in the NS group(Ps＜0.001).The best cut-off score for the overall PSAS was found at 32/33 and had high sensitivity(0.72)and specificity(0.81).The Cronbach's α coefficient and the Spearman Brown split reliability were 0.91 and 0.76,respectively,the correlation coefficients between the items and total score ranged from 0.46 to 0.89(Ps＜0.01),and the test-retest reliability was 0.37(P＜0.01).Addi-tionally,rate of change of PSAS scores was positively correlated with the rate of change of HADS scores and ISI scores(Ps＜0.05).Conclusion:The Chinese version of PSAS is a reliable and valid instrument to assess pre-sleep arousal in patients with brief insomnia disorder.

Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.