Insomnia disorder is a common clinical mental disorder.Currently, clinical subtyping of insomnia disorder relies primarily on symptomatic descriptions, lacking objective measures and subtyping-based treatment approaches. In recent years, increasing attention has been drawn to sleep electroencephalography (EEG) as a valuable tool for observing abnormal sleep architecture and continuity of insomnia disorder. Sleep EEG analysis holds the potential to elucidate the underlying biological mechanisms of insomnia disorder, facilitating data-driven subtyping and enhancing personalized therapeutic strategies.Five types of sleep EEG subtypes of insomnia disorder were systematically searched and summarized: classifications derived from objective sleep duration, power spectral characteristics, cyclic alternating pattern, spindle and microarousal.EEG characteristics of each subtype and clinical outcomes are discussed.This review aims to provide evidence-based insights for clinical subtyping and personalized treatment of insomnia disorder.

OBJECTIVE To observe the clinical efficacy of endoscopic type Ⅰ tympanoplasty in patients with chronic suppurative otitis media accompanied by fungal otitis media.METHODS Based on the symptom characteristics of the external auditory canal and tympanic mucosa,80 patients were divided into four groups:dry ear without fungi group,dry ear with fungi group,wet ear without fungi group,and wet ear with fungi group.Record its clinical characteristics.Patients with fungal otitis externa should receive medication treatment during the perioperative period.Failure to heal the tympanic membrane repaired 6 months after surgery,recurrent perforation of the graft,and/or persistent inability to dry the ear are considered repair failures.RESULTS A total of 80 patients were included in this study,and the overall healing rate of the tympanic membrane in the four groups of patients was 98.8％.There was no significant difference in the postoperative tympanic membrane healing rate among the four groups of patients.The postoperative air bone conduction difference in all four groups of patients decreased compared to preoperative levels,but the difference was not statistically significant.CONCLUSION Patients with chronic suppurative otitis media accompanied by fungal otitis media undergoing type Ⅰ tympanoplasty showed no decrease in tympanic membrane healing rate and no significant improvement in efficacy.

Objective:To observe the efficacy and safety of the M receptor antagonist Bencycloquidium bromide nasal spray in treatment of seasonal allergic rhinitis with runny nose as the main symptom. Methods:From August 2021 to September 2021, 134 patients with seasonal allergic rhinitis were enrolled in the otolaryngology Outpatient Department of Peking University Third Hospital, First Affiliated Hospital of Harbin Medical University and China-Japanese Friendship Hospital of Jilin University, including 71 males and 63 females, with a median age of 38 years. TNSS score and visual analogue scale（VAS） of total nasal symptoms were observed during 2 weeks of treatment with Bencycloquidium bromide nasal spray. Results:TNSS score decreased from （8.89±3.31） on day 0 to （3.71±2.51） on day 14（P<0.001）, VAS score of nasal symptoms decreased from （24.86±7.40） on day 0 to （6.84±5.94） on day 14（P<0.001）, VAS score of rhinorrhoea decreased from （6.88±2.06） on day 0 to （1.91±1.81） on day 14（P<0.001）. Rhinoconjunctivitis quality of life questionnaire（RQLQ） score decreased from （94.63±33.35） on day 0 to （44.95±32.28） on day 14（P<0.001）. The incidence of adverse reaction was low and no serious adverse events occurred during the whole experiment. Conclusion:Bencycloquidium bromide nasal spray has significant efficacy and good safety in the treatment of seasonal allergic rhinitis.
Male ; Female ; Humans ; Adult ; Rhinitis, Allergic, Seasonal/drug therapy* ; Nasal Sprays ; Quality of Life ; Administration, Intranasal ; Rhinorrhea ; Double-Blind Method ; Treatment Outcome ; Rhinitis, Allergic/drug therapy*

Atrial fibrillation (AF) is a common arrhythmia, which can lead to thrombosis and increase the risk of a stroke or even death. In order to meet the need for a low false-negative rate (FNR) of the screening test in clinical application, a convolutional neural network with a low false-negative rate (LFNR-CNN) was proposed. Regularization coefficients were added to the cross-entropy loss function which could make the cost of positive and negative samples different, and the penalty for false negatives could be increased during network training. The inter-patient clinical database of 21 077 patients (CD-21077) collected from the large general hospital was used to verify the effectiveness of the proposed method. For the convolutional neural network (CNN) with the same structure, the improved loss function could reduce the FNR from 2.22% to 0.97% compared with the traditional cross-entropy loss function. The selected regularization coefficient could increase the sensitivity (SE) from 97.78% to 98.35%, and the accuracy (ACC) was 96.62%, which was an increase from 96.49%. The proposed algorithm can reduce the FNR without losing ACC, and reduce the possibility of missed diagnosis to avoid missing the best treatment period. Meanwhile, it provides a universal loss function for the clinical auxiliary diagnosis of other diseases.
Algorithms ; Atrial Fibrillation/diagnosis* ; Electrocardiography ; Humans ; Neural Networks, Computer ; Stroke

Objective:To explore the eye movement characteristics of social cognitive processing in schizophrenia patients across different stages and its association with clinical symptoms.Methods:Fifteen patients with first-episode schizophrenia, forty-six patients with chronic inpatient schizophrenia, thirty-six patients with psychiatric clinical high-risk syndrome, and twenty-six healthy controls were recorded using eye tracking technology when viewing social interaction pictures. Covariance analysis and partial correlation analysis were conducted by SPSS17.0.Results:When watching the pictures of person communication, there were statistically significant differences in the average fixation duration of the four groups of subjects ((294.6±36.7)ms in control group, (280.0±54.0)ms in clinical high-risk group, (268.5±34.9)ms in first-episode group, and (315.7±75.7) ms in chronic group, respectively, F=3.18, P=0.027). When viewing the pictures of no person landscape, the average saccade amplitude of the four groups of subjects was significantly different (5.3±1.1) ° in control group, (4.7±1.1) ° in clinical high-risk group, (5.2±1.0) ° in first-episode group, and (4.4±1.2) ° in chronic group, respectively, F=3.37, P=0.021). The average fixation duration of chronic patients when observing person communication pictures was positively correlated with the total score of PANSS (partial correlation coefficient=0.313, P=0.039). The average fixation duration of chronic patients when observing the other two types of pictures were also positively correlated with the total score of PANSS (partial correlation coefficient=0.320, P=0.034, no person communication pictures; partial correlation coefficient=0.372, P=0.013, no person landscape pictures) . The average fixation duration of chronic patients when observing pictures of no person landscape was positively correlated with the PANSS positive symptom score (partial correlation coefficient=0.321, P=0.034). The average fixation duration of chronic patients when observing any type of picture was positively correlated with the PANSS general symptom score (person communication pictures: partial correlation coefficient=0.385, P=0.010; no person communication pictures: partial correlation coefficient=0.409, P=0.006; no person landscape pictures: partial correlation coefficient=0.465, P=0.001). In the first-episode patient, the average saccade amplitude when observing no person communication pictures was positively correlated with the PANSS positive symptom score (partial correlation coefficient=0.555, P=0.049). In the clinical high-risk group, the average saccade amplitude when observing person communication pictures was negatively correlated with the SOPS positive symptom score (partial correlation coefficient=-0.373, P=0.030). Conclusion:There are statistically significant differences of eye movement characteristics of social cognitive processing in patients with schizophrenia across different clinical stages.The average saccade amplitude is more sensitive than the average fixation duration in predicting the severity of symptoms in clinical high-risk patients.

Objective　To evaluate the effect of anterior cervical fusion or non-fusion surgery for the treatment of Hirayama disease.Methods　The patients with Hirayama disease who underwent anterior cervical surgery in our hospital from July 2008 to December 2015 were retrospectively enrolled in this study.These cases were divided into two groups:fusion group(11 cases)and non-fusion group(12 cases).In fusion group,there were 9 males and 2 females,with an average age of 17.92±0.61 years(range,15-29).In the non-fusion group,there were 10 males and 1 female,with an average age of 19.18±1.14 years(range,15-23).Muscle strength,muscular atrophy,and the Michigan score for hand function were compared between the two groups preoperatively and postoperatively.The indexes such as arc cervical physiological curvature index,the maximum flexion angle,the maximal range of motion(ROM),flexion ROM of adjacent segments of lower(cervical vertebra were measured from the X-ray of the two groups,and the cross-sectional area of spinal cord was measured and compared on neutral position MRI.Results　There were no significant differences between the two groups in grip strength,preoperative hand function Michigan score,cervical physiological(curvature index,the maximum flexion angle,the maximal ROM,flexion ROM of adjacent segments of lower cervical vertebra,and cross-sectional area of spinal cord on neutral position MRI(P>0.05).Patients in fusion group were followed up for 38-103 months with an average of 59.73±5.57 months,while patients in non-fusion group were followed up for 40-95 months with an aver-age of 56.25±4.57 months.Clinical outcomes:At the last follow-up,the finger tremor and cold paralysis were alleviated in all patients,but the symptoms in fusion group and non-fusion group were not completely disappeared in 2 and 3 cases,respectively.The grip strength of fusion group(preoperative 17.14±6.09,postoperative 17.47±5.64)and the non-fusion group(preoperative 17.75±5.49,postoperative 17.40±4.58)were not significantly improved compared with preoperative(P>0.05).The Michigan score for hand function of fusion group(preoperative 10.27±0.41,postoperative 6.64±0.24)and the non-fusion group(preoperative 9.25±0.35,postoperative 6.83±0.24)were significantly improved compared with preoperative(P<0.05).There was no significant difference in postoperative Michigan score between the two groups(P>0.05).Radiological outcomes:The cervical physiological curvature index and cross-sectional area of the spinal cord of the two groups increased after operation,while the maximum flexion angle,the maximal ROM decreased.There was no significant difference in these indexes between the two groups postoperatively(P>0.05).The spinal cord had no compression on flexion MRI.The cross-sectional area of C4-C7 spinal cord in Neutral MRI were significantly increased at C6 and C7 levels in both groups.There was no significant difference in the cross-sectional area of C4-C7 spinal cord between the two groups postoperatively(P>0.05).Two cases of internal fixation loosening occurred in non-fusion group 3 years after the operation,while there were no cases of loosening in the fusion group.Conclusion　Anterior cervical fusion or nonfusion surgery can limit excessive cervical kyphosis in patients with Hirayama disease,reduce atrophy of compressed cervical spinal cord,and alleviate the disease progress of muscular atrophy of the distal upper limb.It can be selected as a treatment method for Hirayama disease.However,there is a risk of internal fixation loosening in non-fusion cases,and also a risk of adjacent segment degeneration in fusion cases.The appropriate cases should be selected carefully for surgery.

Objective To investigate the influence factors of Cornell product and its clinical value in pa-tients with left ventricular high voltage.Methods 104 patients with left ventricular high voltage were studied and divided into two groups according to Cornell product:Cornell product normal group(n = 78)and Cornell product abnormal group(n=26). Clinical manifestations ,complicaions and ultracardiographic data in these patients were collected and analyzed. Results Chronic kidney disease(CKD)(OR=4.266,95%CI 1.276-14.257,P=0.018) and left ventricular mass index(LVMI)(OR = 1.023,95%CI 1.004-1.043,P = 0.016)were related to Cornell product. Cornell product was positively correlated LVMI appeared(r=0.497,P<0.001). The correlation of Cor-nell product with left ventricularend-diastolic dimension ,interventricular septal thickness and left ventricular poste-rior wall thickness was weak.ROC-AUC of Cornell product for CKD was 0.634,95%CI=0.506-0.780,P=0.039, sensibility 47.8%,and specificity 81.5%. Conclusions LVMI and CKD are independent influence factors of Cor-nell product. Cornell product has a certain diagnositc value for left ventricular hypertrophy ,but it has no associa-tion with the location of ventricular hypertrophy.

This study was to evaluate the cellular inhibition effects induced by anti-AGR2 monoclonal antibody 18A4 in two AGR2-negative melanoma cells, A375 and B16-F10, treated with external oncoprotein AGR2. MTT assay and colony formation assay were performed to detect the cell proliferation rate. Flow cytometry analysis was performed to evaluate cell cycle transition. Cell migration rate was analyzed by wound healing assay. Cell morphological changes were detected by phalloidin staining. The expression of p53 was detected by Western blotting and immunofluorescence. Results showed that 18A4 inhibited the AGR2-dependent tumor properties including enhanced proliferation, accelerated cell cycle, increased cell migration and morphological changes of cells. In addition, by Western blot analysis and immunofluorescence, AGR2 blocking antibody 18A4 also restored p53 expression that was repressed by external AGR2 treated by chemotherapeutic drug doxorubicin. These findings suggest that 18A4 is able to inhibit the cellular tumorigenic properties induced by external AGR2 and is a potential drug against fumor.

OBJECTIVETo evaluate the colorectal cancer (CRC) prevention effect of metformin in comparison with that of other T2DM medications from a Markov model perspective.

METHODSLiterature concerning CRC morbidity of T2DM patients with metformin or other diabetes medications treatment was reviewed in PubMed and Cochrane Library database from September 2010 to December 2016.

INCLUSION CRITERIA(1)enrolled population was adult patients with T2DM but without CRC; (2) any of the parameters applied in our model was reported; (3) randomized clinical trials (RCTs), quasi-randomized trials, prospective or retrospective cohort studies. With CRC morbidity as endpoint, parameters were extracted to construct Markov model to assess CRC morbidity and cumulative tumor-free survival in each group over 11 years' follow-up period. Finally, Monte Carlo analysis was performed to evaluate the influence of parameter instability on the model.

RESULTSSeven literatures were recruited and 10 000 patients were virtually allocated for each arm. In contrast with non-metformin group, T2DM patients treated with metformin had a lower rate of CRC(1.670% vs. 2.146%, P=0.016). Moreover, cumulative tumor-free survival of metformin group was, slightly but significantly, better than that of non-metformin group (10.908 years vs. 10.882 years, P=0.000).

CONCLUSIONST2DM patients treated with metformin have a lower morbidity of CRC and a better cumulative tumor-free survival than those of non-metformin group. Large scale RCTs are needed to illustrate the role of metformin in the prevention of CRC.

This study investigated the development characteristics of Dermacentor everestianus under laboratory conditions. The time taken for D. everestianus to complete the whole life cycle was 110.2 days on average, and the average developmental durations of larvae and nymphs were 17.1 days and 29.5 days, respectively. The summation of the prefeeding, feeding, and preoviposition periods of females was 17.8 days, and the oviposition and egg incubation lasted for 18.1 days and 27.7 days, respectively. A highly positive correlation was observed between the weight of engorged female and the number of egg mass laid (r=0.947). The reproductive efficiency index and the reproductive fitness index were 7.1 and 6.1, respectively.
Dermacentor* ; Female ; Genetic Fitness ; Humans ; Larva ; Life Cycle Stages* ; Nymph ; Oviposition ; Ovum