Objective:To analyze the development trajectory of sleep quality in patients with insomnia after cognitive behavioral therapy (CBT-I), and to explore the influencing factors of different development trajectories.Methods:A total of 418 patients with insomnia who received CBT-I at the Sleep Medicine Center of Xiamen Xianyue Hospital from February 2019 to June 2023 were recruited using convenience sampling. All patients completed the Pittsburgh sleep quality index (PSQI) at five time points: before CBT-I initiation (T1), at the end of treatment (T2), and at 3 months (T3), 6 months (T4), and 12 months (T5) post-treatment. At T1, all patients were evaluated by the insomnia severity index (ISI), Flinders fatigue scale (FFS), Beck depression inventory-Ⅱ (BDI-Ⅱ), Beck anxiety inventory (BAI), and dysfunctional beliefs and attitudes about sleep scale (DBAS). Latent class growth modeling (LCGM) was constructed and employed to analyze the development trajectories of sleep quality post-CBT-I using Mplus 8.0 software. Univariate analysis and Logistic regression analysis were conducted by SPSS 26.0 software to explore influencing factors of the sleep quality trajectories.Results:The PSQI scores of insomnia patients at T1, T2, T3, T4 and T5 were 15(12, 18), 8(6, 11), 5(3, 7), 5(3, 7) and 5(2, 7), respectively. Three distinct development trajectories were identified. Based on these trajectories, 418 patients were categorized into fluctuating development group ( n=44, 10.53%), slow improvement group ( n=193, 46.17%), and sustained improvement group ( n=181, 43.30%). Logistic regression analysis revealed that depressive symptom severity, anxiety symptom severity, family history of insomnia, and use of hypnotic medications were significant influencing factors for the sleep quality trajectories after CBT-I treatment (all P<0.05). Conclusion:The sleep quality of insomnia patients after CBT-I treatment shows different development trajectories, and its influencing factors are depression, anxiety, family history of insomnia and the use of hypnotic medications.

Objective To observe the effects of Huosha Oral Liquid on irritable bowel syndrome with diarrhea(IBS-D)rats with cold and dampness syndrome based on Notch1/Hes-1/Math-1 signaling pathway;To elucidate its mechanism of repair of intestinal mucosal barrier.Methods An IBS-D cold and dampness syndrome rat model was established by using restraint stress combined with bitter-cold cathartic method and cold and dampness environmental method.After modeling,the rats were randomly divided into model group,Western medicine group and Huosha Oral Liquid low-,medium-and high-dosage groups,with 6 rats in each group.An additional 6 rats were set as the normal group.The Western medicine group was given mebeverine(13.5 mg/kg)by gavage,while the Huosha Oral Liquid low-,medium-and high-dosage groups were given Huosha Oral Liquid(3.15,6.3,12.6 g/kg)by gavage,the normal group and model group were given distilled water by gavage,for 4 weeks.The general status of rats were ovserved,the body mass,loose stool rate,fecal water rate and abdominal withdrawal reflex(AWR)score were measured,the morphalogy of colon tissue were observed by HE staining,the mRNA expression of Occludin,ZO-1,Notch1,Hes-1 and Math-1 in colon tissue were detected by RT-PCR,the protein expression of Notch1 was detected by Western blot.Results Compared with the normal group,the model group had a reduced body mass(P<0.05)and increased loose stool rate,fecal water rate and AWR score(P<0.05),inflammatory cell infiltration was observed in colon tissue and the expressions of Occludin,ZO-1,Math-1 mRNA decreased(P<0.05),the expressions of Notch1,Hes-1 mRNA increased(P<0.05),and the expression of Notch1 protein increased(P<0.05).Compared with the model group,the body mass of rats in Western medicine group and Huosha Oral Liquid low-,medium-and high-dosage groups increased(P<0.05),loose stool rate,fecal water rate and AWR scores decreased(P<0.05),a small amount of neutrophils was visible in the colon tissue,the expressions of Occludin,ZO-1,Math-1 mRNA in colon tissue increased in Huosha Oral Liquid medium-and high-dosage groups(P<0.05)and the expressions of Notch1 and Hes-1 mRNA decreased(P<0.05),the expression of Notch1 protein decreased in Western medicine group and Huosha Oral Liquid groups(P<0.05).Conclusion Huosha Oral Liquid may regulate the expressions of tight junction proteins by inhibiting excessive activation of the Notch/Hes-1/Math-1 signaling pathway,thereby protecting the intestinal mucosal barrier function,improving diarrhea symptoms in IBS-D rats with cold and dampness syndrome,and reducing visceral sensitivity and colonic tissue inflammation.

Objective:To analyze the development trajectory of sleep quality in patients with insomnia after cognitive behavioral therapy (CBT-I), and to explore the influencing factors of different development trajectories.Methods:A total of 418 patients with insomnia who received CBT-I at the Sleep Medicine Center of Xiamen Xianyue Hospital from February 2019 to June 2023 were recruited using convenience sampling. All patients completed the Pittsburgh sleep quality index (PSQI) at five time points: before CBT-I initiation (T1), at the end of treatment (T2), and at 3 months (T3), 6 months (T4), and 12 months (T5) post-treatment. At T1, all patients were evaluated by the insomnia severity index (ISI), Flinders fatigue scale (FFS), Beck depression inventory-Ⅱ (BDI-Ⅱ), Beck anxiety inventory (BAI), and dysfunctional beliefs and attitudes about sleep scale (DBAS). Latent class growth modeling (LCGM) was constructed and employed to analyze the development trajectories of sleep quality post-CBT-I using Mplus 8.0 software. Univariate analysis and Logistic regression analysis were conducted by SPSS 26.0 software to explore influencing factors of the sleep quality trajectories.Results:The PSQI scores of insomnia patients at T1, T2, T3, T4 and T5 were 15(12, 18), 8(6, 11), 5(3, 7), 5(3, 7) and 5(2, 7), respectively. Three distinct development trajectories were identified. Based on these trajectories, 418 patients were categorized into fluctuating development group ( n=44, 10.53%), slow improvement group ( n=193, 46.17%), and sustained improvement group ( n=181, 43.30%). Logistic regression analysis revealed that depressive symptom severity, anxiety symptom severity, family history of insomnia, and use of hypnotic medications were significant influencing factors for the sleep quality trajectories after CBT-I treatment (all P<0.05). Conclusion:The sleep quality of insomnia patients after CBT-I treatment shows different development trajectories, and its influencing factors are depression, anxiety, family history of insomnia and the use of hypnotic medications.

Objective To observe the effects of Huosha Oral Liquid on irritable bowel syndrome with diarrhea(IBS-D)rats with cold and dampness syndrome based on Notch1/Hes-1/Math-1 signaling pathway;To elucidate its mechanism of repair of intestinal mucosal barrier.Methods An IBS-D cold and dampness syndrome rat model was established by using restraint stress combined with bitter-cold cathartic method and cold and dampness environmental method.After modeling,the rats were randomly divided into model group,Western medicine group and Huosha Oral Liquid low-,medium-and high-dosage groups,with 6 rats in each group.An additional 6 rats were set as the normal group.The Western medicine group was given mebeverine(13.5 mg/kg)by gavage,while the Huosha Oral Liquid low-,medium-and high-dosage groups were given Huosha Oral Liquid(3.15,6.3,12.6 g/kg)by gavage,the normal group and model group were given distilled water by gavage,for 4 weeks.The general status of rats were ovserved,the body mass,loose stool rate,fecal water rate and abdominal withdrawal reflex(AWR)score were measured,the morphalogy of colon tissue were observed by HE staining,the mRNA expression of Occludin,ZO-1,Notch1,Hes-1 and Math-1 in colon tissue were detected by RT-PCR,the protein expression of Notch1 was detected by Western blot.Results Compared with the normal group,the model group had a reduced body mass(P<0.05)and increased loose stool rate,fecal water rate and AWR score(P<0.05),inflammatory cell infiltration was observed in colon tissue and the expressions of Occludin,ZO-1,Math-1 mRNA decreased(P<0.05),the expressions of Notch1,Hes-1 mRNA increased(P<0.05),and the expression of Notch1 protein increased(P<0.05).Compared with the model group,the body mass of rats in Western medicine group and Huosha Oral Liquid low-,medium-and high-dosage groups increased(P<0.05),loose stool rate,fecal water rate and AWR scores decreased(P<0.05),a small amount of neutrophils was visible in the colon tissue,the expressions of Occludin,ZO-1,Math-1 mRNA in colon tissue increased in Huosha Oral Liquid medium-and high-dosage groups(P<0.05)and the expressions of Notch1 and Hes-1 mRNA decreased(P<0.05),the expression of Notch1 protein decreased in Western medicine group and Huosha Oral Liquid groups(P<0.05).Conclusion Huosha Oral Liquid may regulate the expressions of tight junction proteins by inhibiting excessive activation of the Notch/Hes-1/Math-1 signaling pathway,thereby protecting the intestinal mucosal barrier function,improving diarrhea symptoms in IBS-D rats with cold and dampness syndrome,and reducing visceral sensitivity and colonic tissue inflammation.

ObjectiveTo explore the recognition of oral breath odor map of chronic atrophic gastritis （CAG） patients with dampness-heat syndrome by electronic nose technique. MethodsPatients with chronic gastritis were recruited， including 60 cases in CAG group of dampness-heat syndrome， 50 cases in CAG group of non-dampness-heat syndrome， 60 cases in chronic non-atrophic gastritis （CNAG） group of dampness-heat syndrome， 50 cases in CNAG group of non-dampness-heat syndrome， and 30 cases of healthy volunteers were selected to set up the health control group. Ten cases in the CAG dampness-heat group and 50 cases in the CAG non-dampness-heat group were selected to form the CAG group， and 10 cases in CNAG dampness-heat group and 50 cases in CNAG non-dampness-heat group were selected to form the CNAG group. In addition to the health control group， the remaining patients were tested for Helicobacter pylori （Hp）； the electronic nose （GISXM-MQWA01） was used to collect the oral breath odor of all the participants to draw the mapping， and amplitudes and slopes of each curve （including curves A， B， C， D， E， F， G， H， I， J） of the oral odor mapping of health control group， CAG group， CNAG group， CAG dampness-heat group， CAG non-dampness-heat group， and CNAG dampness-heat group was compared. The modified transformer model was used to classify the odor mapping characteristics， and the confusion matrix method was used to evaluate the classification model， with metrics including accuracy and area under ROC curve （AUC）. ResultsThe Hp positivity rate in CAG dampness-heat group was 80.00% （48/60）， CAG non-dampness-heat group was 62.00% （31/50）， CNAG dampness-heat group was 46.67% （28/60）， and CNAG non-dampness-heat group was 42.00% （21/50）； the difference in Hp positivity rate between CAG dampness-heat group and CAG non-dampness-heat group was statistically significant （P＜0.05）. The amplitudes of response curves A， B， C， D， F， G， and I， and slopes of A and F in the odor mapping of the CAG group were lower than those in health control group， while the amplitude and slope of curve E were higher than those in the health control group and CNAG group （P＜0.05 or P＜0.01）； The amplitude of the response curves A， B， C， D， F， G， and I， and slopes of A， D， and F in the CNAG group were lower than those in the health control group （P＜0.05 or P＜0.01）. The amplitude of response curve D and slope of response curve J in the odor mapping of the CAG dampness-heat group were higher than those in CNAG dampness-heat group， the amplitude of curve F was lower than that in CAG non-dampness-heat group， and the amplitude of curve H and slopes of curve A， H， and J were higher than those in CAG non-dampness-heat group （P＜0.05）. The recognition accuracy of CAG group and health control group reached 77.78%， AUC = 0.88； the recognition accuracy of CAG group and CNAG group was 69.44%， AUC = 0.61； the recognition accuracy of CAG dampness-heat group and CAG non-dampness-heat group reached 75.8%， AUC=0.70. ConclusionElectronic nose technology can make a more accurate identification of the oral breath odor in CAG patients with dampness-heat syndrome， with a decrease in the amplitude of the curve F and an increase in the amplitude of the curve H and in the slopes of the curves A， H， and J may as the characteristics of their odor mapping.

Gas therapy has been proven to be a promising and advantageous treatment option for cancers. Studies have shown that nitric oxide (NO) is one of the smallest structurally significant gas molecules with great potential to suppress cancer. However, there is controversy and concern about its use as it exhibits the opposite physiological effects based on its levels in the tumor. Therefore, the anti-cancer mechanism of NO is the key to cancer treatment, and rationally designed NO delivery systems are crucial to the success of NO biomedical applications. This review summarizes the endogenous production of NO, its physiological mechanisms of action, the application of NO in cancer treatment, and nano-delivery systems for delivering NO donors. Moreover, it briefly reviews challenges in delivering NO from different nanoparticles and the issues associated with its combination treatment strategies. The advantages and challenges of various NO delivery platforms are recapitulated for possible transformation into clinical applications.

Objective:To investigate the safety, efficacy and application indication of intra-operative cell salvage (IOCS) in cesarean section.Methods:A total of 1 265 pregnant women who received IOCS blood transfusion during cesarean section in 11 tertiary A hospitals from August 2016 to January 2019 were collected and divided into <1 500 ml group (796 cases) and ≥1 500 ml group (469 cases) according to the amount of blood loss during cesarean section. The general clinical data, ultrasonic imaging data, perinatal and puerperium indicators were analyzed retrospectively. The risk factors of intraoperative blood loss ≥1 500 mL using IOCS transfusion were analyzed by logistic multivariate regression.Results:(1) A total of 848 001 ml of blood was recovered and a total of 418 649 ml of blood was transfused in 1 265 pregnant women who received IOCS transfusions, which was equivalent to 23 258 U red blood cell suspension, greatly saving medical resources. The intraoperative blood loss in <1 500 ml group and ≥1 500 ml group was 800 ml (300-1 453 ml) and 2 335 ml (1 500-20 000 ml), respectively. No amniotic fluid embolism, severe adverse reactions, shock and death occurred in the two groups. (3) Multivariate regression analysis showed that age ≥35 years ( OR=1.5, 95% CI: 1.1-1.9), prenatal hemoglobin level <110 g/L ( OR=1.7, 95% CI: 1.3-2.2), history of uterine surgery ( OR=1.8, 95% CI: 1.3-2.6), placenta previa ( OR=1.9, 95% CI: 1.1-3.1), placenta accreta ( OR=2.6, 95% CI: 1.8-3.9), blood pool in the placenta ( OR=1.6, 95% CI: 1.1-2.3), abnormal posterior placenta muscle wall ( OR=1.8, 95% CI: 1.2-2.6), placenta projecting to the anterior uterine wall ( OR=3.0, 95% CI: 1.3-7.0) were risk factors for blood loss ≥1 500 ml in obstetric transfusion using IOCS technique, with statistical significance (all P<0.05). Conclusion:IOCS is safe and effective in cesarean section, which could save the medical resources and reduces medical expenses, however, it is necessary to strictly master the application indication.

Diabetes is an important risk factor for ischemic stroke. The glycated hemoglobin (HbA1c) level reflects the mean blood glucose level in the past 8-12 weeks. It is a detection index of abnormal glucose metabolism and chronic hyperglycemia. Some studies have shown that high HbA1c is associated with the poor outcomes of patients with acute ischemic stroke, including patients treated with intravenous thrombolysis and endovascular mechanical thrombectomy. This article reviews the relationship between HbA1c and the outcomes of patients with acute ischemic stroke.

From 2018 to 2019, 3 453 cases of high-risk population were screened by the Cancer Screening Program in Urban China (CanSPUC) in Hebei Province, with the age of (53.94±8.00). 147 and 686 cases of breast cancer positive and suspicious positive patients were found, with the positive rate and suspicious positive rate of 4.26% and 19.87% respectively. The suspicious positive rate of 45-49 years old age group was the highest (28.32%), and the positive rate of over 70 years old age group was the highest (7.32%). The positive detection rate of mammography combined with ultrasound was 5.16%, which was higher than that of ultrasound alone (2.46%) (χ2=30.28, P<0.001) or mammography alone (3.06%) (χ2=14.56, P<0.001).

From 2018 to 2019, 3 453 cases of high-risk population were screened by the Cancer Screening Program in Urban China (CanSPUC) in Hebei Province, with the age of (53.94±8.00). 147 and 686 cases of breast cancer positive and suspicious positive patients were found, with the positive rate and suspicious positive rate of 4.26% and 19.87% respectively. The suspicious positive rate of 45-49 years old age group was the highest (28.32%), and the positive rate of over 70 years old age group was the highest (7.32%). The positive detection rate of mammography combined with ultrasound was 5.16%, which was higher than that of ultrasound alone (2.46%) (χ2=30.28, P<0.001) or mammography alone (3.06%) (χ2=14.56, P<0.001).