Objective To investigate the changing trend of sleep disturbance in patients with hepatolenticular degeneration and the bidirectional relationship between sleep disturbance and depression through a cross-lagged regression analysis. Methods A total of 80 patients who met the diagnostic criteria for WD from January to June 2024 were enrolled in this longitudinal study and were followed up for 3 months.Pittsburgh Sleep Quality Index （PSQI） was used to assess sleep quality， and Beck Depression Inventory （BDI） was used to assess the severity of depression， at the time of enrollment （T0）， at 1 month after enrollment （T1），and at 2 months after enrollment （T3）. An unconditional growth model was used to analyze the trajectory of sleep disturbance， and a cross-lagged regression model was used to investigate the temporal relationship between sleep disturbance and depression. Results From T0 to T2， there were significant increases in PSQI and BDI scores in all WD patients（P<0.05）. The variance of the intercept factor （the initial status of sleep disturbance） was estimated at 10.83（P<0.01），and the variance of the slope factor （the rate of change in sleep disturbance） was 1.20 （P<0.01），with a significant negative correlation between the intercept and the slope （r=-0.25，P<0.01）. The correlation analysis of PSQI and BDI scores across the three time points revealed a positive correlation between PSQI and BDI scores （r∈[0.19，0.96]，P<0.01）.The cross-lagged model analysis showed that sleep disturbance significantly predicted subsequent depression （P<0.01），with standardized regression coefficients （β） of 0.392 and 0.347， respectively； meanwhile， depression also significantly predicted subsequent sleep disturbance （P<0.01）， with β of 0.273 and 0.372， respectively. These findings suggested a bidirectional predictive relationship between sleep disturbance and depression in WD patients over time. Conclusion There is a bidirectional relationship between sleep disturbance and depression in patients with WD， and depression has a more pronounced influence on sleep disturbance. Therefore， clinical interventions should focus on both sleep and psychological state， and combined management should be performed to improve the effect of disease control.
Depression

Inflammatory Bowel Diseases(IBD)is a class of genetically related diseases caused by multiple genes and environmental factors that accelerate the disturbance of the immune-gut-microbiome axis.Lesions often involve multiple organs and systems.Biological agents are an important means of treating IBD and its extraintestinal manifestations.Current studies suggest that biologics can bring benefits to patients,but paradoxical skin lesions,joint lesions,and ocular lesions appear during the treatment.Diseases,pulmonary lesions and other manifestations or lesions are easily ignored in clinical practice,thereby delaying the patient's condition and affecting the patient's quality of life.Therefore,by summarizing the clinical characteristics and diagnosis and treatment experience of contradictory extraintestinal manifestations in the current application of biological agents,this review aims to improve the understanding of clinicians,identify this clinical manifestation early,and avoid delaying the patient's condition.

Objective To systematically evaluate the efficacy and safety of different administration methods of recombinant human endostatin(Endostatin)in the treatment of malignant pleural effusion in non-small cell lung cancer(NSCLC),and to provide more evidence-based bases for the clinical standardization of the use of Endostatin beyond the drug specification.Methods PubMed,The Cochrane Library,Web of Science,Embase,ChiCTR,VIP,CNKI,WanFang,and SinoMed databases were searched by computer for randomized controlled trials(RCT)of Endostatin alone or combined with chemotherapy for malignant pleural effusion in NSCLC.Network Meta-analysis was performed using Stata 14.0 software.Results A total of 50 RCTs involving 3 429 patients were included,covering 5 intervention measures.Network Meta-analysis showed that in terms of clinical effectiveness,there was no statistically significant difference between Endostatin(thoracic perfusion)+chemotherapeutic drug(thoracic perfusion or intravenous drip)and Endostatin(intravenous drip)+chemotherapeutic drug(thoracic perfusion or intravenous drip),and Endostatin(thoracic perfusion)and chemotherapeutic drug(thoracic perfusion)(P＞0.05);there were statistically differences between Endostatin(thoracic perfusion)+chemotherapeutic drug(thoracic perfusion or intravenous drip)and Endostatin(thoracic perfusion)[OR=3.44,95％CI(2.29,4.50),P＜0.05],and Endostatin(thoracic perfusion)+chemotherapeutic drug(thoracic perfusion or intravenous drip)and chemotherapeutic drug(thoracic perfusion)[OR=3.78,95％CI(3.16,4.51),P＜0.05](P＜0.05).The surface under the cumulative ranking curve(SUCRA)showed that Endostatin(thoracic perfusion)+chemotherapeutic drug(thoracic perfusion or intravenous drip)＞Endostatin(intravenous drip)+chemotherapeutic drug(thoracic perfusion or intravenous drip)＞Endostatin(thoracic perfusion)＞chemotherapeutic drug(thoracic perfusion)＞chemotherapeutic drug(intravenous drip).In terms of adverse effects,such as gastrointestinal reaction,and reduction of white blood cells and platelets,there was no statistically significant difference among the different interventions(P＞0.05).Conclusion Endostatin either by pleural instillation or combined with first-line chemotherapy drugs significantly improves clinical efficacy in malignant pleural effusion in NSCLC,and it is better and safer with thoracic perfusion efficacy.

Inflammatory bowel disease (IBD) has recurrent and protracted course with unknown etiology and it can affect multiple organs and systems. At present, IBD patients tends to be younger, and the recurrent disease affects work, even resulting in unemployment, and consumes a lot of social and medical resources. Having been used for the treatment of IBD for more than 20 years, biologics increase the selectivity of treatment, but at the same time, current research has found that the use of biologics is one of the main factors increasing the economic burden of IBD. Compared with biologics, biosimilars have significant advantages in optimizing cost-benefit and have good application prospects. By summarizing the current research status of IBD health economics at home and abroad, this review aims to provide an economic basis for strengthening disease management and improving the quality of life of patients.

Inflammatory bowel disease (IBD) has recurrent and protracted course with unknown etiology and it can affect multiple organs and systems. At present, IBD patients tends to be younger, and the recurrent disease affects work, even resulting in unemployment, and consumes a lot of social and medical resources. Having been used for the treatment of IBD for more than 20 years, biologics increase the selectivity of treatment, but at the same time, current research has found that the use of biologics is one of the main factors increasing the economic burden of IBD. Compared with biologics, biosimilars have significant advantages in optimizing cost-benefit and have good application prospects. By summarizing the current research status of IBD health economics at home and abroad, this review aims to provide an economic basis for strengthening disease management and improving the quality of life of patients.

Inflammatory bowel disease (IBD) is an idiopathic inflammatory disease of gastrointestinal tract, which mainly includes Crohn’s disease (CD) and ulcerative colitis (UC). The existence of chronic diseases is an important influencing factor of sleep quality, and sleep quality is a key index to evaluate the quality of life. Sleep disorder can lead to fatigue, anxiety and stress. The incidence of sleep disorder in patients with active IBD is higher than that in remission IBD. When patients with IBD get worse, the sleep disorder is more serious, while sleep disorder can aggravate intestinal inflammation and injury recovery. This article summarized the research on the correlation between sleep disorder and IBD, and clarified their two - way interaction, so as to provide reference for the clinical management and treatment of sleep disorder associated with IBD.

In view of the problem of TCM diagnosis, grey relational analysis and fuzzy cluster are applied to TCM diagnosis of hepatocirrhosis and are presented in this paper. The validity of the two methods has been assessed through 900 cases in Shanghai. The results are in good agreement with the diagnosis of hepatocirrhosis made by the expert group, thus showing the fuzzy technology is of significance to the development of TCM modernization in an objective way.
Diagnosis, Computer-Assisted ; Diagnosis, Differential ; Fuzzy Logic ; Hepatitis B, Chronic ; complications ; Humans ; Liver Cirrhosis ; diagnosis ; etiology ; Medicine, Chinese Traditional ; methods ; standards