BACKGROUND:With the extensive development of national fitness activities,nighttime exercise has gradually become a social trend.However,what effects nighttime exercise will have on sleep,the characterization of sleeping changes and the mechanisms of action are not clear. OBJECTIVE:To analyze the characterization and mechanisms of nighttime exercise on sleep. METHODS:We searched the China National Knowledge Infrastructure(CNKI),PubMed database,and Web of Science database with the search terms of"sport,exercise,physical activity,physical exercise,workout,sleep,asleep,daily routine"in Chinese,and"nocturnality,night,nighttime,exercise,sport,physical activity,sleep,slumber,dorm"in English for literature on how nighttime exercise affects sleep and its mechanism of action.Finally,55 articles were included. RESULTS AND CONCLUSION:Sleep consists of two phases:rapid eye movement and non-rapid eye movement.Sleep regulation relies on the close coordination of neural circuits and molecules in different brain regions,while the homeostatic components of the organism and circadian rhythms are also important factors in the regulation of sleep.The effects of exercise on sleep have evolved from an early focus on the central nervous system to the addition of somatic physiology,and now multiple dimensions have been investigated,revealing multifaceted effects of exercise on sleep,including subjective sleep quality,sleep continuity,and sleep quantity and sleep structure.Nighttime exercise-affected sleep is subjected to the constraints of exercise conditions and exercisers and shows certain complexity,but the heterogeneity,time-dependence,and instability characteristics of nighttime exercise-affected sleep can provide some guidance for nighttime exercisers in minimizing the impact on sleep.Mechanisms by which nighttime exercise affects sleep are related to the reduction of melatonin secretion,the increase of core body temperature,and energy expenditure.People with high sensitivity of their own sleep to nighttime exercise should avoid nighttime exercise as much as possible,and those with low sensitivity should also pay attention to the fact that the time of nighttime exercise should have a long interval with sleeping time,and the intensity should not be too high.Some measures can be adopted to safeguard sleep after exercise,such as energy replenishing after exercise,and reduced use of electronic devices.

To explore the effectiveness of "near peer learning" (NPL) in the electromyography(EMG)teaching module for neurology residents.

The Department of Neurology, Peking Union Medical College Hospital implemented an NPL instructional design for a course on EMG for residents from November 2020 to March 2024. This teaching session was held annually, in which senior residents instructed juniors who were 1 or 2 years earlier in their training. The residents participated in the pre-course/post-course tests and completed a feedback survey at the end of the session. This evaluation method was used to understand the effectiveness of the NPL intervention in EMG teaching.

Over four years, a total of 83 residents participated. Among them, there were 24 postdoctoral students, 52 postgraduates and 7 junior residents. The results showed that the post-course test scores were significantly improved compared with pre-course test scores (74.33±2.43 vs. 70.11±2.49, P=0.005), with the most remarkable improvements seen for "tutees" (73.84±20.53 vs. 70.29±21.46, P=0.020), postgraduates (74.04±22.51 vs. 68.97±21.40, P=0.009), first-year residents (70.19±4.02 vs. 63.59±3.59, P=0.040) and first-time participating residents (65.23±3.24 vs. 60.97±3.21, P=0.030). The post-program feedback showed that both tutors and tutees thought highly of NPL, believing that it enabled them to gain knowledge and helped them to improve teaching skills.

The NPL intervention is suitable for the teaching of EMG, because of its contribution to knowledge acquisition and basic clinical skills improvement. The NPL is worth replicating in other teaching and learning programs.

Objective:To discuss the surgical strategies of atlantoaxial dislocation in children with mucopolysaccharidosis IVA.Methods:8 cases of atlantoaxial dislocation in children with mucopolysaccharidosis IVA treated with posterior atlantoaxial reduction, decompression, bone graft and internal fixation from April, 2019 to October, 2020 were retrospectively analyzed, including 6 males and 2 females, aged 6.2±3.1 years (range, 2-10 years). All the 8 children had lower limb weakness and walking instability, and some of them could not even stand and walk, and all of them had odontoid hypoplasia, atlantoaxial dislocation and systemic skeletal dysplasia. Measures, including American Spinal injury Association (ASIA) grade, modified atlanto-dental interval (mADI) and reduction rate, screw placement type and fusion of bone graft, were recorded and analyzed.Results:The follow-up time was 17.8±7.4 months (range, 8-27 months). The total operation time was 144.0±43.1 mins (range, 90-220 min) and the blood loss during the surgery was 89.1±55.1 ml (range, 15-180 ml). The ASIA grade were 3 cases of "C" level, 4 cases of "D" level and 1 case of "E" level before the operation, and 1 case of "C" level, 1 case of "D" level and 6 cases of "E" level at the latest follow-up. The mADI reduced from 7.38±2.62 mm pre-surgery to 2.50±1.60 mm ( t=5.71, P=0.001). The reduction rate of the latest follow-up mADI was 65.0%±26.3%. 31 pedicle screws were inserted, including 26 Type I screws (83.9%), 4 Type II screws (12.9%) and 1 Type III screw (3.2%), and no injury of spinal cord or blood vessels were observed associated with the Type III screw. One unilateral axial lamina screw was used in 1 case. 5 patients showed fusion (autogenous bone) 6 months after the surgery, 2 patients got fusion (allogeneic bone) 1 year after the surgery, and other patients showed bone graft resorption (allogeneic bone) at the latest follow-up. One patient developed type II respiratory failure on the night of operation and recovered after rescue. Other patients had no complications such as vascular and nerve injury, screw loosening and so on. Conclusion:The majority of children with type IVa mucopolysaccharidosis are accompanied by absence of odontoid process. If such children are complicated with atlantoaxial dislocation and cervical spinal canal stenosis resulting in cervical spinal cord injury, timely surgical intervention should be carried out. Posterior atlantoaxial fusion is a safe and effective surgical method. As children have the characteristics of multi-system involvement, multi-disciplinary cooperation may be needed to ensure perioperative safety.

Objective To explore the impact of exercise on the learning and memory of rats undergoing nicotine withdrawal and its underlying mechanism.Methods Forty four-week-old male SpragueDawley rats were subjected to nicotine conditioned place preference(CPP) training before being randomly separated into a high-,moderate-,low-intensity exercise and control(no exercise) group.Rats in exercise groups underwent the treadmill running at low,moderate or high intensity 30 minutes per day for 10 days consecutively.The nicotine-associated context memory was evaluated using the CPP preference score.Morris water maze (MWM) tasks were used to examine the spatial learning and memory.The protein level of α7 acetylcholine receptors(nAChRs) in the prefrontal cortex and hippocampus was visualized by Western blotting.Results Rats undergoing exercises at a high or moderate intensity had a significantly lower CPP score than the control group (P＜0.01 and P＜0.05 respectively).However,there was no significant difference in the CPP score between the low-intensity exercise and control groups.Only rats doing moderate-intensity exercise presented a significantly shorter escape latency than controls in the MWM place navigation test(P＜0.01).Significant increase in time spent and distance swam in the target quadrant was observed in the moderate-and high-intensity exercise group,but without significant differences between the two groups.Moreover,a significant increase in the number of crossing target quadrant was only observed in rats that exercised at a moderate intensity (P＜ 0.05).The protein level of α7 nAChRs was significantly elevated in the prefrontal cortex(P＜0.01),but not in the hippocampus of rats doing moderate intensity exercise.Conclusion Ten-day treadmill running at a moderate intensity may improve learning and memory performance,and facilitate the extinction of nicotine reward memory of nicotine-treated rats via increasing α7 nAChR-mediated signaling in the frontal cortex.

Objective To clarify the clinical features of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) with minor endoscopic abnormalities. Methods The clinical data of 6 patients with MEITL characterized by minor endoscopic abnormalities in Peking Union Medical College Hospital from 2012 to 2016 were retrospectively analyzed, including clinical manifestations, endoscopic, pathological features, medications and prognosis. Results Five out of 6 patients were male, with an average age of 61.2 years old. The median disease duration was 4.5 months. All patients initially presented with diarrhea without specific findings for serologic testing. CT enterography showed continuous intestinal lesions, including symmetric thickening of the bowel wall, abnormal hyperenhancement of mucosal surface and lymphadenopathy. Endoscopic appearances were only mildly abnormal, including mucosal swelling, atrophy of villus, mosaic sign and shallow ulcers. Histopathologic findings revealed massive small to medium sized T lymphocytes infiltration with positive expression of CD3 and CD8. Chemotherapy and palliative treatment were administrated after diagnosis. Conclusions Clinical presentations of MEITL are non-specific with minor endoscopic abnormalities. Therefore, biopsy is indispensable for patients with a relatively normal endoscopic result.

A 60-year-old man presented with severe watery diarrhea for 2 months complicated with weight loss and acute kidney injury.He did not respond well to antidiarrheal medicines,empirical antibiotics and dietary exclusion of gluten or even complete bowel rest.The final diagnosis of autoimmune enteropathy (AIE) was made based on histopathologic findings of endoscopic biopsy from duodenal mucosa after excluding neoplastic disease,inflammatory bowel disease,and infectious diarrhea,etc.Chronic diarrhea and oliguria alleviated after the administration of corticosteroids.

Objective: To compare the value of two 3D imaging reconstruction methods for left atria and pulmonary vein on guiding the catheter ablation for atrial fibrillation (AF). Methods: From January 2014 to January 2017, a total of 100 drug refractory paroxysmal AF patients were divided into left atria direct angiography group (n=50), and indirect angiography group (n=50). 3D CARTO system was applied for mapping and guiding the ablation procedure. Patients assigned to direct angiography group were treated as follows: intraoperative puncture of atrial septum, inject contrast agent directly into the left atrium, conduct left atrial and pulmonary venous rotation angiography, reconstruct three-dimensional image, integrate the image into real-time X-ray system to facilitate circumferential pulmonary vein isolation. Patients assigned into the indirect angiography group were treated as follows: inject contrast agent through the right ventricle, conduct delayed rotation angiography of the left atria and pulmonary vein to guide circumferential pulmonary vein fixation and ablation. The left atrial and pulmonary venous image acquisition, the operation and X-ray exposure time, the success rate and the incidence of complication of the two groups were compared. The patients were followed up for 3-6 months. Results: General clinical characteristics of the two groups were similar(all P>0.05). Ablation was successful in all 100 patients. The operation time[(112.0±21.4)min vs. (134.0±24.3)min]and X-ray exposure time((10.7±4.7)min vs. (15.8±5.2)min)were significantly lower in direct angiography group than in indirect angiography group (both P<0.01). There was no significant difference between the two groups in the immediate (86%(43/50) vs. 82%(41/50), P=0.59) and short-term (76%(38/50) vs. 72%(36/50), P=0.65) success rate and complication rate (1 aneurysm in the direct angiography group, 1 pericardial tamponade in the indirect angiography group). In-hospital mortality was zero percent. Conclusion It is safe and effective method to guide the radiofrequency catheter ablation of paroxysmal atrial fibrillation by reconstruction 3D image of left atrium and pulmonary vein. Compared with indirect angiography group, direct angiography group can improve the imaging quality of left atrium and pulmonary vein, decrease the X-ray exposure time of the ablation procedure.

This study was aimed to investigate the effects of Chai-Hu Shu-Gan Tang (CHSGT) on levels of TNF-α and 5-HT in lithium chloride–pilocarpine caused epilepsy–depression comorbidity rat model, in order to discuss the intervention effect of CHSGT on TNF-α and 5-HT in epilepsy–depression comorbidity. The lithium chloride–pilocarpine caused epilepsy–depression comorbidity rat model was established. After 6 weeks of animal establishment, rats were randomly divided into 5 groups, which were citalopram group (A), physiological saline group (B), CHSGT high dose group (C), medium dose group (D), and low dose group (E). Intragastric administration was given for 4 weeks, twice a day. Before and after the treatment, RT-PCR was performed to detect hippocampal TNF-αlevels. Liquid chromatography-mass spectrometry was performed to detect hippocampal 5-HT levels. Both forced swimming test (FST) and saccharin preference test were carried out to monitor the depressive behaviors of rats. In the meantime, 24 hours a day video camera surveillance were performed to record the number of seizures of rats. The results showed that after treatment, the number of seizures of rats were significantly reduced, the accumulative immobility time in FST was shortened, and the consumption of sucrose increased significantly (P < 0.01) in group A, C and D. Compared with group B, after the treatment, the expressions of hippocampal TNF-α mRNA of rats in group A, C, D were distinctly downregulated, with the level of 5-HT significantly increased (P < 0.05,P < 0.01). Compared with group A, group C and D showed no significant changes. It was concluded that TNF-α played a role in the pathogenesis of epilepsy–depression comorbidity through mediating the level of 5-HT. High and medium doses of CHSGT can downregulate the expression of TNF-α mRNA in depression comorbidity of chronic temporal lobe epilepsy, increase 5-HT level, reduce the number of seizures of rats, and improve depressive behaviors.

OBJECTIVETo analyze the status of maternal health behaviors and it's risk factors for Yi-nationality women in poor rural areas of Sichuan province.

METHODSIn 2012, multi-stage stratified cluster sampling method was used to select 14 villages of two poor counties in Liangshan Yi-nationality autonomous prefecture Sichuan province. At least 10 women who have infants aged 0-12 months were selected in each simple villages, a total of 284. The structured questionnaire was developed on the basis of the theory of reasoned action. Yi-nationality female college students were trained as investigators. Research indicators included prenatal care rate, hospital delivery rate, postpartum examination rate, socio-demographic characteristics, maternal health care knowledge. χ² test was used to compare the differences of above indicators among different groups. The structural equation model were used to statistical analyze.

RESULTSIn the 284 subject women, 51.7% (147/284) women owned more than 2 children, 41.6% (118/284) women were more than 30 years old, 87.3% (248/284) women were illiteracy. The prenatal care rate was 69.7% (197/284), the hospital delivery rate was 26.8% (76/284), and the postnatal check rate was 22.9% (65/284). The influence factors of maternal health behaviors included the number of children, age and education (χ² were 10.92, 13.24, 9.58; P values were 0.027, 0.004, 0.008, respectively).The structural equation model analysis results showed that the maternal health behaviors were directly or indirectly affected by subjective norms (β = 0.236, P < 0.001), women's cognition (β = 0.226, P = 0.020) and women's attitudes on maternal health behavior (β = 0.157, P = 0.001). Among subjective norms, women have high compliance to their husbands (β = 0.850, P < 0.001), their peers (β = 0.708, P < 0.001), and their mothers-in-law (β = 0.636, P < 0.001).

CONCLUSIONThere were still serious problems in maternal health behaviors for Yi-nationality women in poor rural areas. The main factors included not only the women's cognition and attitudes for maternal health, but also the attitudes of important social relationships.

Child ; China ; Ethnic Groups ; Family ; Female ; Health Behavior ; ethnology ; Humans ; Infant ; Maternal Health ; ethnology ; Maternal Health Services ; Postpartum Period ; Pregnancy ; Prenatal Care ; Risk Factors ; Rural Population

Objective To analyze the status of maternal health behaviors and it's risk factors for Yi-nationality women in poor rural areas of Sichuan province. Methods In 2012, multi-stage stratified cluster sampling method was used to select 14 villages of two poor counties in Liangshan Yi-nationality autonomous prefecture Sichuan province. At least 10 women who have infants aged 0-12 months were selected in each simple villages, a total of 284. The structured questionnaire was developed on the basis of the theory of reasoned action. Yi-nationality female college students were trained as investigators. Research indicators included prenatal care rate, hospital delivery rate, postpartum examination rate, socio-demographic characteristics, maternal health care knowledge. χ2 test was used to compare the differences of above indicators among different groups .The structural equation model were used to statistical analyze. Results In the 284 subject women, 51.7%(147/284) women owned more than 2 children, 41.6%(118/284)women were more than 30 years old, 87.3%(248/284)women were illiteracy. The prenatal care rate was 69.7%(197/284), the hospital delivery rate was 26.8%(76/284), and the postnatal check rate was 22.9%(65/284). The influence factors of maternal health behaviors included the number of children, age and education (χ2 were 10.92,13.24,9.58;P values were 0.027, 0.004, 0.008, respectively).The structural equation model analysis results showed that the maternal health behaviors were directly or indirectly affected by subjective norms (β= 0.236, P<0.001), women's cognition (β= 0.226,P=0.020) and women's attitudes on maternal health behavior (β=0.157, P=0.001). Among subjective norms, women have high compliance to their husbands (β=0.850, P<0.001), their peers (β=0.708, P<0.001), and their mothers-in-law (β=0.636, P<0.001). Conclusion There were still serious problems in maternal health behaviors for Yi- nationality women in poor rural areas. The main factors included not only the women's cognition and attitudes for maternal health, but also the attitudes of important social relationships.