Sleep deprivation (SD) has a profound impact on the central nervous system, resulting in an array of mood disorders, including depression and anxiety. Despite this, the dynamic alterations in neuronal activity during sleep deprivation have not been extensively investigated. While some researchers propose that sleep deprivation diminishes neuronal activity, thereby leading to depression. Others argue that short-term sleep deprivation enhances neuronal activity and dendritic spine density, potentially yielding antidepressant effects. In this study, a two-photon microscope was utilized to examine the calcium transients of anterior cingulate cortex (ACC) neurons in awake SD mice in vivo at 24-hour intervals. It was observed that SD reduced the frequency and amplitude of Ca2+ transients while increasing the proportions of inactive neurons. Following the cessation of sleep deprivation, neuronal calcium transients demonstrated a gradual recovery. Moreover, whole-cell patch-clamp recordings revealed a significant decrease in the frequency of spontaneous excitatory post-synaptic current (sEPSC) after SD. The investigation also assessed several oxidative stress parameters, finding that sleep deprivation substantially elevated the level of malondialdehyde (MDA), while simultaneously decreasing the expression of Nuclear Factor erythroid 2-Related Factor 2 (Nrf2) and activities of Superoxide dismutase (SOD) in the ACC. Importantly, the administration of gallic acid (GA) notably mitigated the decline of calcium transients in ACC neurons. GA was also shown to alleviate oxidative stress in the brain and improve cognitive impairment caused by sleep deprivation. These findings indicate that the calcium transients of ACC neurons experience a continuous decline during sleep deprivation, a process that is reversible. GA may serve as a potential candidate agent for the prevention and treatment of cognitive impairment induced by sleep deprivation.

Objective:To study the value of myocardial perfusion imaging (MPI) and coronary flow reserve (CFR) combined with coronary artery calcium score (CACS) in the diagnosis of obstructive coronary artery disease (CAD).Methods:From January 2019 to December 2020, 96 confirmed or suspective CAD patients (65 males, 31 females; age: 30-81 years) who completed rest/stress MPI, CFR and CACS defection in Fuwai Central China Cardiovascular Hospital were retrospectively analyzed. Coronary angiography (CAG) was used as the diagnostic standard to calculate the sensitivity and accuracy of MPI, CFR and MPI/CFR combined with CACS in the diagnosis of CAD. The χ2 test was used to compare the diagnostic efficiency of different methods. Results:The diagnostic sensitivity of MPI was 76.06%(54/71), and the accuracy was 75.00%(72/96), while the sensitivity increased to 97.18%(69/71; χ2=13.67, P<0.001) and the accuracy increased to 87.50%(84/96; χ2=4.92, P=0.020) with significant differences after combined with CACS. The sensitivity and accuracy of CFR were 91.55%(65/71)and 87.50%(84/96), which increased to 97.18%(69/71; χ2=2.12, P=0.137) and 89.58%(86/96; χ2=0.21, P=0.411) with no significant differences after combined with CACS. The sensitivity of MPI in the diagnosis of three-vessel CAD was 70.00%(21/30), which increased to 100%(30/30; χ2=7.75, P=0.004) after combined with CACS; while the sensitivity of MPI combined with CACS in the diagnosis of single-vessel and double-vessel CAD were not significantly improved ( χ2 values: 3.29, 1.51, P values: 0.114, 0.416). Conclusion:The combination of MPI and CACS can significantly improve the diagnostic efficiency of CAD, contributed by the improvement of the diagnostic sensitivity in three-vessel disease; whereas the diagnostic efficiency of CFR for CAD is not significantly improved after combined with CACS.

Objective:To compare the clinical efficacy of autologous fat injection and conjunctival pedicled orbital septal fat grafting for infraorbital margin depression in young people.Methods:Fourty young patients with lower eyelid pouch and infraorbital margin depression with age of 20 to 40 years and average age of 30.6 yaers in the First Affiliated Hospital of Nanchang University from September 2017 to September 2019 were enrolled. According to the surgical method, all patients were divided into 2 groups with 20 cases each. Group 1 underwent transconjunctival orbital septum fat reset. Group 2 underwent various autologous fat injection after proper amount of orbital septal fat being removed, including structural fat, fine-particle fat and nano-fat, performed in different parts and layers. The tear trough rating scale (TTRS) scores and patients＇ satisfaction at 1 year after operation between 2 groups were compared.Results:Compared with the preoperative TTRS scores, the differences in scores at 6 months and 1 year after surgery were statistically significant ( P<0.01). The scores between two groups were compared at 6 months and 1 year respectively after the operation, and the difference were both statistically significant ( P<0.01). 6 months after the operation, the TTRS scores including four items were carefully compared between the two groups. It showed that the reduction of tear groove depth ( P<0.05), pigmentation ( P<0.01) and wrinkle ( P<0.01) in group 2 were more obvious than those in group 1. The percentage of satisfaction in group 2 (95%) was higher than that in the group 1 (70%), and the difference was statistically significant ( P<0.01). Conclusions:For infraorbital margin depression of young people, after proper amount of orbital septal fat being removed, various free fats graft injection into different parts and layers could obtain better treatment results, reducing not only the depth of the tear groove, but also periorbital pigmentation and fine wrinkles.

Objective:To investigate the status of exposure to xylene and Formaldehyde of medical and technical personnel in Pathology Department of a hospital, and to provide references for prevention of occupational hazards.Methods:From July to October in 2019, 52 medical workers and working places in Pathology Department of a third-class hospital in Jiangxi Province were selected as survey objects, the distribution of occupational hazards, protective measures and personal protective equipment were investigated, and the control wind speed of Formaldehyde, xylene and ventilation facilities were detected and analyzed statistically.Results:It showed that the detection rate of xylene and formaldehyde was 82.1% (23/28) , and the detection rate of xylene CSTEL in the two sampling posts was 14.3% (2/14) , the local suction device on each side and the control wind speed of the fume hood do not meet the national standards. Conclusion:It is necessary to strengthen the prevention and control of the occupational hazards in the Department of Pathology to prevent the occurrence of occupational diseases.

Objective:To investigate the status of exposure to xylene and Formaldehyde of medical and technical personnel in Pathology Department of a hospital, and to provide references for prevention of occupational hazards.Methods:From July to October in 2019, 52 medical workers and working places in Pathology Department of a third-class hospital in Jiangxi Province were selected as survey objects, the distribution of occupational hazards, protective measures and personal protective equipment were investigated, and the control wind speed of Formaldehyde, xylene and ventilation facilities were detected and analyzed statistically.Results:It showed that the detection rate of xylene and formaldehyde was 82.1% (23/28) , and the detection rate of xylene CSTEL in the two sampling posts was 14.3% (2/14) , the local suction device on each side and the control wind speed of the fume hood do not meet the national standards. Conclusion:It is necessary to strengthen the prevention and control of the occupational hazards in the Department of Pathology to prevent the occurrence of occupational diseases.

Objective To firstly report 4 cases of dermatomyositis characterized by painful palmar eruptions complicated by fatal rapidly progressive interstitial lung disease (RP-ILD) in China.Methods Four patients with dermatomyositis with painful palmar eruptions complicated by fatal RP-ILD were enrolled from the Department of Dermatology,Zhongshan Hospital,Fudan University between December 2014 and April 2017,and their clinical and pathological features were analyzed.Results Among these patients,3 were female and 1 was male.Their age ranged from 47 to 59 years.Of the 4 patients,3 had no muscular involvement.All of the 4 patients had multiple solid red papules or nodules on the bilateral palms,palmar and lateral surfaces of fingers,which preceded,followed or concurred with the onset of other skin lesions of dermatomyositis.The occurrence of type Ⅰ respiratory failure was preceded by 3 weeks to 5 months of painful palmar eruptions in the 4 patients.Early-stage palmar eruptions were easily misdiagnosed as contact dermatitis,eczema or erythema multiforme.Histopathological examination of the skin lesions on the finger palmar surface showed perivascular infiltration of a few lymphocytes in the dermis,and deposition of varying amounts of mucin-like substances around blood vessels and appendages.Of the 4 patients,3 showed positive staining for anti-melanoma differentiation-associated gene 5 antibody.Although the 4 patients received anti-inflammatory and immunosuppressive therapies,they all finally died of respiratory failure.Conclusions Dermatomyositis with painful palmar eruptions may indicate the occurrence of fatal RP-ILD,and early biopsy of skin lesions is needed to help to identify the disease.Immunosuppressive treatment should be performed timely to improve the prognosis in these patients.

Objective To analyze clinical and pathological features of dermatomyositis with panniculitis as a skin manifestation.Methods Clinical data were collected from 9 cases of dermatomyositis with panniculitis as a skin manifestation in Department of Dermatology of Zhongshan Hospital affiliated to Fudan University from October 2012 to July 2016,and their clinical and pathological features were analyzed.Results Of the 9 cases,6 were female and 3 were male,and the age ranged from 28 to 73 years.Panniculitis lesions of the 9 patients all manifested as painful indurated plaques or nodules on the buttock,thigh,waist,back,abdomen,upper extremities and cheeks.These lesions occurred before,after or simultaneously with the onset of characteristic skin and muscle lesions of dermatomyositis,especially preceded the onset of characteristic lesions of dermatomyositis by 30 years in 1 case.Histopathological examination of lesions showed liquefaction degeneration of basal cells,inflammatory infiltration of lymphocytes and plasma cells around blood vessels,in the fat lobules as well as between the lobules and septa in the dermis.The necrosis and calcification of lipocytes,lipomembranous changes,fibrinoid necrosis of damaged vessel walls and microvascular occlusion were observed in some cases.Because panniculitis preceded the onset of characteristic lesions of dermatomyositis,2 patients were misdiagnosed with lupus panniculitis and morphea profunda for several times.Most patients had good response to systemic glucocorticoids combined with immunosuppressive agents,while the patients with lipomembranous fat necrosis had poor response to the combination therapy.Conclusions Panniculitis lesions of dermatomyositis are histologically characteristic,and may do not coincide with the onset of characteristic lesions of dermatomyositis.If panniculitis lesions precede characteristic lesions of dermatomyositis,patients will be easily misdiagnosed.Thus,persistent follow-up visit will be of great importance for the diagnosis.

Objective To investigate the interrelated liver damage and hepatitis B virus infection among breast cancer patients after chemotherapy, to provide guidance for future breast reduction combined hepatitis B virus infection after chemotherapy liver damage.Methods120 cases of breast cancer patients undergoing chemotherapy combined hepatitis B carries from June 2012 to November 2016 in ningbo women and children's hospital were selected as the research object, depending on whether the infection with the hepatitis B virus into the study group and the control group, the study group HBV-DNA, HBsAg are positive, totaling 62 cases;control group, HBV-DNA, HBsAg were negative, totaling 58 cases;compare two groups of patients after chemotherapy in cases of liver damage.ResultsThe study group after chemotherapy, the incidence of liver dysfunction 48.28% in the control group after chemotherapy, the incidence of liver dysfunction 6.45 percent, the study group after chemotherapy, the incidence of liver dysfunction was significantly lower than the control group, the difference was statistically significant (P<0.05).Study group Ⅰ liver damage degree, degree Ⅱ, degree Ⅲ, degree Ⅳ of apparent higher, the difference was statistically significant (P<0.05), antiviral therapy 20 cases, no antiviral treatment in 42 cases.Antiviral therapy HBV reactivation rate and incidence of liver dysfunction were 5.0%, 20.0%;no antiretroviral therapy in HBV reactivation rate and the incidence of liver dysfunction 31.0%, 52.4% respectively;HBV antiviral therapy re-activation rate and the occurrence of liver dysfunction were significantly lower than not antiviral therapy, and the data were statistically significant (P<0.05).ConclusionThe clinical having close links between liver damage and breast cancer combined hepatitis B virus infection with hepatitis B virus are more likely to occur after infection liver dysfunction chemotherapy, and breast cancer patients after chemotherapy.

Objective To explore the risk factors of hypotension of patient with acute myocardial infraction(AMI)after emergency per-cutaneous coronary intervention(PCI).Methods The data of 300 patients with AMI who received PCI in our hospital from January 2015 to August 2015 were collected.According to the symptom of hypotension,the patients were divided into hypotension group and normal group.The general information and relative clinical data were recorded and compared.The risk factors were analyzed by logistics regressive analysis. Results The incidence of previous angina of hypotension group was lower than that of normal group,the difference was significant(P <0.05), there was no difference in other general information between two groups(P >0.05).There was no difference in level of LDL-C between two groups(P >0.05).And the differences in peak value of CK-MB,inferior wall or right ventricular infarction were statistical significance (P <0.05).There was no significant difference in multi-vessel lesions(P >0.05),and the difference in others of coronary artery lesion be-tween two groups was statistical significance(P <0.05).Conclusion The peak value of CK-MB,inferior wall or right ventricular infarction and TIMI <2 after PCI can increase the possibility of hypotension after PCI,and angina pectoris before infarction can reduce the incidence of hypotension after PCI.

BACKGROUND:Autologous peroneus brevis and alogeneic tendon are often used for reconstruction of lateral colateral ligament of the ankle joint, but these two kinds of materials have different histological and biomechanical properties. OBJECTIVE:To compare the clinical effects of autologous peroneus brevis and alogeneic tendon to reconstruct lateral colateral ligament of the ankle joint. METHODS: Sixty-six patients with chronic external ankle instability caused by old injury to lateral colateral ligament of the ankle joint were enroled, aged 15-63 years. The 34 of 66 patients underwent lateral ligament reconstruction using autologous peroneus brevis and the rest 32 patients received lateral ligament reconstruction using alogeneic tendon. After reconstruction, reaction time of the peroneous brevis, talar tilt angle and anterior talar translation, visual analog scale score and the American Orthopaedic Foot and Ankle Society (AOFAS) score were compared between the two groups. RESULTS AND CONCLUSION:At the last folow-up, the visual analog scale score, tilt angle and anterior talar translation were lowered in the two groups compared with the previous (P < 0.05), and the AOFAS scores were increased significantly in the two groups (P < 0.05); the reaction time of the peroneous brevis was increased inthe autologous peroneus brevis group (P < 0.05) and decreased in the alogeneic tendon group (P < 0.05); the above-mentioned indexes had no difference between the two groups. These findings indicate that autologous peroneus brevis and alogeneic tendon have similar effects on the lateral ligament reconstruction in terms of postoperative ankle function, stability and activity levels, but the alogeneic tendon shows advantages on less trauma and shorter operation time.