Objective:To analyze the correlation between poor sleep status in late pregnancy and postpartum depression and anxiety.Methods:In this prospective cohort study, a total of 401 women in early pregnancy were consecutively enrolled at Beijing Tian Tan Hospital, Capital Medical University, from December 2020 to April 2021. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were used to assess the sleep status in late pregnancy. The Edinburgh Postnatal Depression Scale (EPDS) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) were used to assess the emotional status in late pregnancy and 6 weeks after delivery. During the follow-up, 123 subjects did not complete the sleep and emotional assessment in late pregnancy, 77 subjects did not complete the postpartum emotional assessment, and 201 cases were finally included in the study. Multivariate logistic regression analysis was used to analyze the correlation between poor sleep status in late pregnancy and postpartum depression and anxiety.Results:Among 201 women in early pregnancy included in the analysis, the detection rate of postpartum depression and anxiety was 15.4% (31/201) and 27.4% (55/201), respectively. Poor sleep quality ( OR=2.49, 95% CI: 1.02-6.07), difficulty falling asleep ( OR=6.74, 95% CI: 2.31-19.70), and excessive daytime sleepiness ( OR=6.34, 95% CI: 2.08-19.32) in late pregnancy were positively correlated with postpartum depression (all P0.05). Poor sleep quality ( OR=3.89, 95% CI: 1.81-8.40), difficulty falling asleep ( OR=6.75, 95% CI: 2.43-18.77), short-time sleep ( OR=2.89, 95% CI: 1.36-6.11), fragmented sleep ( OR=5.69, 95% CI: 2.27-14.28) and excessive daytime sleepiness ( OR=3.07, 95% CI: 1.07-8.78) in late pregnancy were positive correlation factors for postpartum anxiety (all P0.05). Conclusions:Poor sleep status in late pregnancy is associated with postpartum depression and anxiety. Strengthening screening and management of poor sleep status in late pregnancy may help maintain healthy postpartum emotion.

Objective:To analyze the correlation between poor sleep status in late pregnancy and postpartum depression and anxiety.Methods:In this prospective cohort study, a total of 401 women in early pregnancy were consecutively enrolled at Beijing Tian Tan Hospital, Capital Medical University, from December 2020 to April 2021. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were used to assess the sleep status in late pregnancy. The Edinburgh Postnatal Depression Scale (EPDS) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) were used to assess the emotional status in late pregnancy and 6 weeks after delivery. During the follow-up, 123 subjects did not complete the sleep and emotional assessment in late pregnancy, 77 subjects did not complete the postpartum emotional assessment, and 201 cases were finally included in the study. Multivariate logistic regression analysis was used to analyze the correlation between poor sleep status in late pregnancy and postpartum depression and anxiety.Results:Among 201 women in early pregnancy included in the analysis, the detection rate of postpartum depression and anxiety was 15.4% (31/201) and 27.4% (55/201), respectively. Poor sleep quality ( OR=2.49, 95% CI: 1.02-6.07), difficulty falling asleep ( OR=6.74, 95% CI: 2.31-19.70), and excessive daytime sleepiness ( OR=6.34, 95% CI: 2.08-19.32) in late pregnancy were positively correlated with postpartum depression (all P0.05). Poor sleep quality ( OR=3.89, 95% CI: 1.81-8.40), difficulty falling asleep ( OR=6.75, 95% CI: 2.43-18.77), short-time sleep ( OR=2.89, 95% CI: 1.36-6.11), fragmented sleep ( OR=5.69, 95% CI: 2.27-14.28) and excessive daytime sleepiness ( OR=3.07, 95% CI: 1.07-8.78) in late pregnancy were positive correlation factors for postpartum anxiety (all P0.05). Conclusions:Poor sleep status in late pregnancy is associated with postpartum depression and anxiety. Strengthening screening and management of poor sleep status in late pregnancy may help maintain healthy postpartum emotion.

Objective:To evaluate the mood and psychological state of pregnant women with different working states and analyze the influence of working on depression state during the entire pregnancy.Methods:A total of 396 women aged 20-45 years were prospectively enrolled in Capital Medical University Affiliated Beijing Tian Tan Hospital in early pregnancy from December 2020 to April 2020. The ones who had a history of depressive disorder, bipolar disorder, and other mental disorders were excluded. Their psychological states were assessed by the Edinburgh Postnatal Depression Scale (EPDS), the Fatigue Severity Scale (FSS), and the Connor-Davidson Resilience Scale (CD-RISC) at baseline, the second and third trimester of pregnancy accordingly. Based on employment status during pregnancy, they were analyzed into Full-time (252 cases), Part-time (97 cases), and Unemployed (47 cases) groups. A 3 (Group) ×3 (Pregnancy trimester) repeated measures ANOVA was used to compare the differences in EPDS scores among the three groups. Multivariate Linear Regression was used to analyze the effects of employment status and other factors on EPDS scores during pregnancy.Results:Compared to the Full-time and Part-time employment groups, the Unemployed group had lower education levels and higher FSS scores [ones who own a bachelor′s degree or below: 85.2% (40/47) vs 64.3% (162/252); FSS score: (37.5±9.3) vs (33.1±11.2)] (all P<0.05). Repeated measures ANOVA showed the main effect of group and time on EPDS depression scores was statistically significant ( F=3.19, P=0.043; F=6.20, P=0.002). EPDS scores in early pregnancy were significantly higher than those in late pregnancy [(0.6±0.01) vs (0.5±0.01), P=0.003]. There was no significant difference in EPDS scores among different groups ( PBonferroni correction >0.017). There were no statistically significant interaction effects between the three groups and three trimesters of pregnancy ( F=1.34, P=0.253). Regression analysis results showed that Full-time or Part-time employment, higher marital satisfaction, better psychological resilience contributed fewer depression scores in the second trimester of pregnancy ( R 2adjusted=0.34, F=22.37, P<0.001). Conclusion:Both Full-time and Part-time employment during pregnancy have a positive impact on depressive mood in the second trimester of pregnancy but probably no impact in the early and late pregnancy.

Objective:To evaluate the mood and psychological state of pregnant women with different working states and analyze the influence of working on depression state during the entire pregnancy.Methods:A total of 396 women aged 20-45 years were prospectively enrolled in Capital Medical University Affiliated Beijing Tian Tan Hospital in early pregnancy from December 2020 to April 2020. The ones who had a history of depressive disorder, bipolar disorder, and other mental disorders were excluded. Their psychological states were assessed by the Edinburgh Postnatal Depression Scale (EPDS), the Fatigue Severity Scale (FSS), and the Connor-Davidson Resilience Scale (CD-RISC) at baseline, the second and third trimester of pregnancy accordingly. Based on employment status during pregnancy, they were analyzed into Full-time (252 cases), Part-time (97 cases), and Unemployed (47 cases) groups. A 3 (Group) ×3 (Pregnancy trimester) repeated measures ANOVA was used to compare the differences in EPDS scores among the three groups. Multivariate Linear Regression was used to analyze the effects of employment status and other factors on EPDS scores during pregnancy.Results:Compared to the Full-time and Part-time employment groups, the Unemployed group had lower education levels and higher FSS scores [ones who own a bachelor′s degree or below: 85.2% (40/47) vs 64.3% (162/252); FSS score: (37.5±9.3) vs (33.1±11.2)] (all P<0.05). Repeated measures ANOVA showed the main effect of group and time on EPDS depression scores was statistically significant ( F=3.19, P=0.043; F=6.20, P=0.002). EPDS scores in early pregnancy were significantly higher than those in late pregnancy [(0.6±0.01) vs (0.5±0.01), P=0.003]. There was no significant difference in EPDS scores among different groups ( PBonferroni correction >0.017). There were no statistically significant interaction effects between the three groups and three trimesters of pregnancy ( F=1.34, P=0.253). Regression analysis results showed that Full-time or Part-time employment, higher marital satisfaction, better psychological resilience contributed fewer depression scores in the second trimester of pregnancy ( R 2adjusted=0.34, F=22.37, P<0.001). Conclusion:Both Full-time and Part-time employment during pregnancy have a positive impact on depressive mood in the second trimester of pregnancy but probably no impact in the early and late pregnancy.

Objective:To analyze the fail mode of neoadjuvant therapy combined with surgery for locally advanced esophageal squamous cell carcinoma (ESCC) after long-term follow-up.Methods:Clinical data of consecutive 238 patients with locally advanced resectable ESCC who underwent neoadjuvant therapy combined with surgery in Zhejiang Cancer Hospital from September 2012 to October 2019 were retrospectively analyzed. The failure mode in the whole cohort was analyzed after long-term follow-up. The overall survival (OS) and disease free survival (DFS) rates were analyzed by Kaplan-Meier method. Survival differences were determined by log-rank test.Results:The pathological complete response (pCR) rate was 42.0% in 238 patients. After a median follow-up of 46.1 months, tumor progression occurred in 96 patients (40.3%), including 25 patients (10.5%) with local recurrence, 61 patients (25.6%) with distant metastases, and 10 patients (4.2%) with simultaneous local recurrence and distant metastases. The median OS and DFS were 64.7 months and 49.9 months. And the 3-, 5-, and 7-year OS and DFS rates were 70.0%, 52.8%, 36.4% and 63.5%, 42.5%, and 30.0%, respectively. The 3-, 5-, and 7-year locoregional recurrence-free survival rates and distant metastasis-free survival rates were 86.0%, 71.4%, 61.2% and 70.6%, 55.9%, 43.0%. Compared with non-pCR patients, the overall progression rate and distant metastasis rate of pCR patients were lower (26.0% vs. 50.7%, 16.0% vs. 32.6%, both P<0.05). And the 3-, 5-, and 7-year OS (83.0% vs. 60.2%, 69.7% vs. 41.7%, 50.4% vs. 27.7%, all P<0.001) and DFS rates (80.4% vs. 51.4%, 63.9% vs. 31.2%, 45.9% vs. 20.3%, all P<0.001) were significantly better in pCR patients. Conclusions:Distant metastasis is the main failure mode of patients with locally advanced ESCC after neoadjuvant therapy. Patients with postoperative pCR can achieve better long-term survival.

Malnutrition is a common complication of cancer patients, and solving nutrition problems is still one of the challenging tasks in clinical practice. The incidence of malnutrition in head and neck cancer patients during the peri-radiotherapeutic period is high, which is not only related to disease-mediated metabolic disorders, complications and psychological factors, but also associated with the toxic and side effects induced by radiotherapy. Malnutrition will reduce the tolerance, accuracy, and therapeutic effects of radiotherapy, which in turn lowers the quality of life and even adversely affects the prognosis of disease. Medical nutrition therapy can improve the nutritional status of the body, ensure smooth progress of radiotherapy, and improve the efficacy of comprehensive cancer treatment. It is necessary and urgent to deliver standardized nutrition therapy and management of head and neck cancer patients during the peri-radiotherapeutic period. Nutritional risk screening, nutritional assessment, and acute radiation injury assessment are required to develop an individualized nutrition treatment plan and make dynamic adjustment. In this article, relevant literature of nutrition therapy for head and neck radiotherapy at home and abroad was summarized, and the standardized nutrition therapy for head and neck cancer patients during the peri-radiotherapeutic period was reviewed.

Objective: To evaluate the cognitive impairment in elderly patients with minor ischemic stroke and to analyze risk factors for stroke recurrence. Methods: This was a retrospective case-control study.Ninety-five elderly patients with acute ischemic stroke hospitalized in the neurology department of Second People's Hospital of Liaocheng were enrolled from January 2016 to January 2017.Based on the National Institutes of Health Stroke Scale(NIHSS), all cases were divided into the minor stroke group(NIHSS score≤3, n=62)and the medium-severe stroke group(NIHSS score>3, n=33). After 12-month follow-up, the NIHSS, modified Rankin scale(mRS)and Montreal cognitive assessment(MoCA)were used to evaluate the study subjects. Results: Of the 95 patients, there were 62 males(65.3%)and 33 females(34.7%), with age of(68.3±6.7)years.No significant differences were found in baseline characteristics of age, male ratio, subtypes and history between two groups(all P>0.05). But, the treatment rate of intravenous thrombolysis was lower in minor stroke group than in medium-severe stroke group[6.5%(4 cases)vs.42.4%(14 cases)(P<0.01)]. The scores of NIHSS[(1.0±0.5)vs.(3.2±1.1), P<0.01], mRS[(1.6±0.7)vs.(2.4±1.1), P<0.01]were lower in the minor stroke group than in the medium-severe group.After a mean follow-up of(12.6±1.9)months, the rate of cognitive impairment was comparable between the two groups(P>0.05), while the rate of post stroke depression had a significant difference between two groups(P<0.05). Furthermore, there was lower rate of mortality and stroke recurrence in the minor stroke group than in the medium-severe group(0.0% or 0/62 vs.30.3% or 10/33, and 21.0% or 13/62 vs.42.4% or 14/33, P<0.05). Cox proportional hazard model showed that baseline NIHSS score, diabetes and stroke history were the risk factors for stroke recurrence in patients with minor stroke(P<0.05). Conclusions The treatment rate of intravenous thrombolysis with rt-PA, mortality rate and stroke recurrence rate are lower in patients with minor stroke than in patients with medium-severe stroke, while the incidence of post stroke cognitive impairment is high.High score of baseline NIHSS, diabetes and stroke history are risk factors for stroke recurrence in elderly patients with minor stroke.

Objective To observe the effect of remote post-ischemic conditioning(RPIOC)on the cerebral blood flow,neural function and prognosis of patients with acute cerebral infarction and the risk factors for short-term prognosis.Methods 133 patients with acute cerebral infarction in the Second Hospital of Beijing from January 2016 to December 2017 were selected,and randomly divided into the RIPOC group(66 cases,with RPIOC)and the control group(67 cases,without RIPOC).In the first day after hospital,patients in the RIPOC group were given RIPOC,which was tightening the left aim with a tonometer bandage for 5 minutes per time and 2 times a day at an interval of 5 minutes.All patients were provided routine treatment.All patients' cerebral blood flow,neural function and survival data were recorded.Recovery was assessed by modified Rankin Scale(mRS)180 d after stroke.Logistic regression was used to evaluate the risk factors for prognosis.Results Of the 133 patients enrolled,there were 67 males.The mean age was (73.1 ± 10.1)year.Basic clinical characteristics,neural function and cerebral blood flow were similar between groups(P＞0.05).After 10 d treatment,cerebral blood flow and neural function was significantly increased (P＜0.05)in the RIPOC group.After 180 d follow up,the RIPOC group had significantly higher rate of adverse cerebrovascular events(P＜0.05).Logistic regression analyses demonstrated that advanced age(P =0.003),hypertension(P =0.03)and high NIHSS score(P =0.005)were all risk factors for prognosis.Conclusions RIPOC can enhance the cerebral blood flow,activities of daily living,limb function and prognosis.However,it does not reduce the risk of mortality.Advanced age,hypertension and high NIHSS score are risk factors for short-term prognosis.

Objective To analyze the differential expression of D2 and D3 alternative splicing sites of human kinectin in human hepatocellular carcinoma (HCC) tissues, adjacent non-cancerous tissues and normal liver tissues, and to investigate a possible relationship between alternative splicing sites of kinectin and hepatocarcinogenesis. Methods The cDNA was obtained by RT-PCR in 45 coupled HCC cancerous and adjacent tissues, and 10 normal liver tissues. The difference in the expression of D2 and D3 alternative splicing sites in cDNA was examined by semi-quantitative PCR, and statistical analysis was performed. Results The ratio of D2L (long segment contains of the D2 region)/D2S (short segment that does not contain a D2 zone) in hepatocellular cancerous tissues was 2.709 ± 1.025, the ratio of D2L/D2S in adjacent non-cancerous tissues was 1.564 ± 0.357, and the ratio of D2L/D2S in normal liver tissues was 1.507 ± 0.499. The differences were statistically significant (F=29.698, P<0.05);the ratio of D2L/D2S in hepatocellular cancerous tissues was higher than that of adjacent non-cancerous tissues and normal liver tissues (P<0.05). The ratio of D3L (long segment contains of the D3 region)/D3S (short segment that does not contain a D3 zone) in hepatocellular cancerous tissues was 1.232 ± 0.041, the ratio of D3L/D3S in adjacent non-cancerous tissues was 1.156 ± 0.309, and the ratio of D3L/D3S in normal liver tissues was 1.282 ± 0.343. The ratio of D3L/D3S was not significantly different among hepatocellular cancerous tissues, adjacent non-cancerous tissues and normal liver tissues (F = 0.989, P > 0.05). Conclusion Variant containing D2 is over expressed in cancerous tissues and this alteration may be tumor associated.

Based on the known IRAK4 inhibitors MK-32 and AU-5,we designed and synthesized 12 pyridine-based target compounds by adopting open-ring and hybrid strategies,and combining molecular docking technology.The bioassays determined by radioisotope labeling demonstrated that the target compounds displayed good inhibitory activity against IRAK4.Among them,the IC50 value of 5 compounds was less than 1 μmol/L,suggesting that these compounds may be candidates for further investigation.