This paper focuses on extreme environments and systematically analyzes sleep disorders caused by multiple pathogenesis,including circadian rhythm disorder,yin-yang imbalance and qi-blood disorder under weightlessness,emotional depression due to environmental changes,abnormal diet and excretion,and six excesses pathogenic factors,in accordance with the theory of correspondence between nature and human.It proposes harmonizing yin and yang as the core therapeutic principle and guiding framework,with specific methods including calming rebellious qi-blood,regulating qi movement,harmonizing heart and kidney,and dredging and regulating blood vessels,thus forming the"one guiding principle and four specific methods"treatment strategy.Additionally,by integrating the modified application of classic formulas,a diagnostic and therapeutic approach targeting multi-dimensional pathogenesis is established.This study aims to promote the in-depth integration of Traditional Chinese Medicine(TCM)in extreme environmental medicine through TCM theories and innovative application of prescriptions,provide TCM-characterized solutions for health management of workers in extreme environments,and facilitate the transformation of extreme environmental medicine toward the modern medical model of"prevention-treatment integration".

Objective To summarize the treatment experiences and long-term surgical efficacy of spinal hemangioblastomas.Methods The surgical experiences of 46 patients with spinal hemangioblastomas were analyzed retrospectively.All patients underwent microsurgical resection without preoperative embolization, and 52 operations were performed and 58 tumors were resected.McCormick classification was used to evaluate the function of spinal cord.The mean follow-up time was 8 years.Results Total tumor resection was achieved in 55 tumors and subtotal ones in 3.A week later, improvement was obtained in 11 cases, no changes in 29 and aggravation in 6.No patients died.During a follow-up period from 7 to 9 years, the spinal function was improved in 18 patients, remained stable in 21 and deteriorated in 7.No tumor recurrence was found.The subtotal resection affected the prognosis (P =0.08, OR =10.8, 95 ％ CI 2.1-60.8).Conclusions The spinal hemangioblastomas are highly vascularized benign tumors that can be surgically cured under microscope.Subtotal resection is a risk factor of prognosis.

Objective To understand the experiences of patients prior to operation with recurrent glioma based on the Corbin and Strauss chronic illness trajectory framework. Methods Fourteen patients participated in the semi-structure interviews.Data were analyzed with Colaizzi′s phenomenologica l procedure. Results Based on the Corbin and Strauss chronic illness trajectory framework, experiences of patients prior to operation with recurrent glioma were extracted. (1) Illness-related work including severe symptoms of illness and lack of knowledge of illness. (2) Biographical work including loss of biography and identity of self. (3) Everyday life work including change of social roles, complicated mood combined negative experience and positive experience, heavy economic burden. Conclusions Nursing staff should attach importance to experiences of patients, and provide targeted interventions for successful operations and recovery of physical and spiritual healing.

Objective To explore the microRNA-16 (miR-16) and nuclear-transcription factor-κB1 (NF-κB1) expressions in human brain gliomas and their correlations with cell invasion and growth of malignant gliomas SHG44,U87 and U373.Methods (1) Twenty-nine cases of human glioma tissue samples and 6 normal brain tissues,collected in our hospital from January 2000 to January 2011,were chosen in our study; quantitative real-time polymerase chain reaction (qRT-PCR) was used to determine the expressions ofmiR-16 and NF-κB1 in these tissues.(2) In vitro cultured U87,U373 and SHG44 cells were divided into blank-control group,nonsense sequence transfected group and miR-16 mimics transfected group; 48 h after the transfection,qRT-PCR was used to detect the expressions of miR-16 and NF-κB1; tmnswell assay was used to observe the cell invasion capability; 72 h after the transfection,Western blotting was employed to detect the protein expressions of NF-κB1,matrix metallopeptidase 9 (MMP-9) and MMP-2.(3) Luciferase reporter assay was used to detect the target regulating role of miR-16 in NF-κB1 gene.(4) U87 cells were used as negative control group,and U87 cells carried stably expressed miR-16 gene were implanted into intracranial and subcutaneous nude mice (U87-miR-16 group); immunofluorescence was used to detect the MMP-9 expression,and immunohistochemical staining was used to detect the protein expressions of Ki-67,NF-κ B1 and MMP-9; subcutaneous tumor volume was measured and the growth curve was drawn.Results (1) The qPCR results showed that the expression of miR-16 in human brain glioma tissues was significantly lower than that in normal brain tissues; and gradually decreased miR-16 expressions were noted in gliomas of graded Ⅰ,Ⅱ,Ⅲ and Ⅳ (P＜0.05); NF-κB1 expression in human brain glioma tissues was significantly higher than that in normal brain tissues; and gradually increased NF-κB1 expressions were noted in gliomas of graded Ⅰ,Ⅱ,Ⅲ and Ⅳ (P＜0.05).(2) As compared with those in the blank-control group and nonsense sequence transfected group,miR-16 mimics transfected group had significantly increased miR-16 expression,decreased NF-κB1 mRNA expression,decreased invasiveness,and decreased protein expressions of NF-κB1 and MMP-9 (P＜0.05).(3) Luciferase reporter assay showed that the fluorescence normalized ratio in the pMIR-NF-κB1 group was signfcaintly higher than that in the pMIR-NF-κB1+pre-miR-16 group (P＜0.05).(4) As compared with the negative control group,the U87-miR-16 group on the 24-42 d of implantation had significantly smaller volume of tumors (P＜0.05),and lower MMP9 expression,and NF-κB1,MMP-9 and Ki-67 expressions (the proliferation index of Ki-67:13.91％ and 32.98％).Conclusion MiR-16 inhibits glioma cell invasion and growth through down-mgulating NF-κB1 and MMP-9 expressions.