Objective:To investigate the relationship between number of daily steps and insomnia in patients with chronic insomnia using "WeChat Sports" program.Methods:A total of 190 patients with insomnia who received treatment in Department of Neurology, Zhejiang University of Traditional Chinese Medicine Affiliated Wenzhou Hospital between October 2017 and October 2019. General data (age, sex, body mass index, history of smoking and alcohol use) and the number of daily steps recorded by "WeChat Sports" program were collected. Patients whose average number of daily steps was greater than 7500 were assigned to the sufficient exercise group ( n = 68), and the remaining patients were assigned to the insufficient exercise group ( n = 122). Patient symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI), The Patient Health Questionnaire-9, and generalized Anxiety Disorder scale-7. Scale evaluation and data collection were performed by two trained investigators. Data were compared between the two groups. The correlation between average number of daily steps and each scale score was analyzed. Results:Total PSQI score in the sufficient exercise group was significantly lower than that in the insufficient exercise group [(12.94 ± 3.14) points vs. (14.93 ± 2.99) points, t = 4.31, P < 0.001]. Scores of subjective sleep quality, sleep latency, habitual sleep efficiency, use of sleep medication, and daytime dysfunction were significantly lower in the sufficient exercise group than those in the insufficient exercise group ( P = 0.011, 0.008, 0.025, 0.039, 0.006). The Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7 scores in the sufficient exercise group were significantly lower than those in the insufficient exercise group ( P = 0.011, P = 0.002). The average number of daily steps was significantly negatively correlated with total PSQI score, Patient Health Questionnaire-9 score, Generalized Anxiety Disorder Scale-7 score, and score of each PSQI component (subjective sleep quality, sleep latency, habitual sleep efficiency, and daytime dysfunction) ( r = -0.29, -0.16, -0.19, -0.24, -0.15, -0.18, -0.23). Conclusion:Insomnia patients with insufficient daily exercise have more serious insomnia and emotional symptoms than those with sufficient daily exercise. Daily average exercise is correlated with the severity of insomnia and emotional symptom.

Objective:To evaluate the differential diagnostic efficacy of a predictive model of breast imaging reporting and data system (BI-RADS) classification combined with mammography radiomics classifier for various X-ray phenotype of breast lesions.Methods:A retrospective analysis was performed on 2 055 female patients who underwent mammography examination and were confirmed by pathology from May 2013 to August 2020 in Zhongda Hospital, Southeast University. Breast lesion was classified into mass or non-mass according to the fifth edition of BI-RADS. The mass was further divided into small mass (maximum diameter ≤ 2 cm) and large mass (maximum diameter>2 cm), the non-mass was further divided into asymmetric, calcification and structural distortions. By manually segmenting the region of interest of the lesion, the radiomics features were extracted and the model was constructed. Receiver operating characteristic curve and area under the curve (AUC) were used to assess the diagnostic efficacy of the BI-RADS classification, the radiomics model and the combined model for various phenotypes of breast lesions. Differences among the AUC were analyzed by the DeLong test.Results:The AUCs based on the BI-RADS classification, the radiomics model and the combined model were 0.924±0.006, 0.827±0.009 and 0.947±0.005 respectively. Compared with BI-RADS classification and the radiomics model, AUC of the combined model was the highest, and the differences were statistically significant ( Z=9.29, 14.94, P<0.001). For large mass, small mass and non-mass, combined model (AUC=0.958±0.007, 0.933±0.013, 0.939±0.008) showed the best performance when compared to the BI-RADS classification (AUC=0.937±0.010, 0.896±0.020, 0.916±0.011; Z=5.32, 3.90, 5.08, P<0.001) or the radiomics model (AUC=0.872±0.012, 0.851±0.021, 0.758±0.016; Z=7.86, 4.53, 12.13, P<0.001). The AUC of the combined model for benign and malignant asymmetric breast lesions (0.897±0.017) was higher than that of the BI-RADS classification (AUC=0.866±0.020, Z=4.27, P<0.001) and the radiomics model (AUC=0.633±0.029, Z=7.44, P<0.001); however, the AUC of the combined model for benign and malignant calcification and structural distortion of breast lesions (0.971±0.010, 0.811±0.057, respectively) was only higher than that of the radiomics model (AUC=0.827±0.021, 0.586±0.075, Z=7.40, 3.15, P<0.001), and there was no significant difference with the BI-RADS classification (AUC=0.959±0.012, 0.800±0.061, Z=1.87, 0.39, P>0.05). Conclusion:The combined model shows better differential diagnostic performance, which is valued in the clinical application.

Yishen Juanbi Method for Treating Rheumatism began from Mr. ZHANG Ci-gong to the formation and development of Mr. ZHU Liang-chun, and by the evidence-based source, innovation and perfection of the third and fourth generations of successors, has formed the unity of the principle, rule, method, medicine, and the unique diagnosis and treatment of rheumatism of integration of the internal treatment and external treatment. All of these provide original insights for rheumatology of TCM theory and the application of insect medicine, and provide valuable treatment technology for China's young rheumatology disciplines.

Objective To investigate the level of illness uncertainty and coping styles of parents of children with diabetes mellitus and their relationship, and provide theoretical basis of clinical intervention. Methods Totally 155 patients of children with diabetes mellitus were investigated with General Information Questionnaire, Parents′ Perception of Uncertainty Scale (PPUS) and Coping Health Inventory for Parents (CHIP) to analyze the correlation between illness uncertainty of parents and its influencing factors and coping styles. Results The total score of illness uncertainty was 80.15±10.38 in parents of children with diabetes mellitus. There was significant difference in total uncertainty score in parents with different number of children, parent′s age, education degree, profession, economic conditions and locations (P < 0.05). Coping style, education and Parent′s age entered into the multiple linear regression equation of illness uncertainty, predicting 23.2% of total variation in illness uncertainty. The level of illness uncertainty was negatively associated with coping styles (P < 0.01). Conclusions The illness uncertainty was at higher levels in parents of children with diabetes mellitus. Clinical nurses should measure illness uncertainty of parents of children with diabetes mellitus and improve their coping capacity to reduce illness uncertainty, so as to provide better services of family and promote the quality of life for children .

OBJECTIVE:To systematically analyze the efficacy and safety of benazepril vs. captopril in the treatment of prima-ry hypertension and provide evidence-based reference for the clinical treatment. METHODS:Cochrane Library,PubMed,EM-Base,CJFD,VIP database and Wanfang database were retrieved to collect the randomized controlled trials (RCT) of benazepril (experiment group)vs. captopril(control group)in the treatment of primary hypertension. After information collection and quality evaluation,Meta-analysis was conducted by using Rev Man 5.0 software. RESULTS:Totally 7 RCTs involving 405 patients were in-cluded. The results of Meta-analysis showed that the level of systolic blood pressure(SBP)[MD=-2.06,95%CI(-3.75,-0.38), P=0.02] and diastolic blood pressure(DBP)[MD=-3.10,95%CI(-5.19,-1.01),P=0.004] in experiment group was sig-nificantly lower than control group;however,there were no significant differences between the efficacy rate of antihypertension [OR=1.63,95%CI(0.69,3.83),P=0.26] and incidence of adverse drug reactions(ADR)[OR=0.81,95%CI(0.46,1.41),P=0.45] in 2 groups. CONCLUSIONS:Benazepril can more effectively lower the blood pressure of patients with primary hypertension than captopril. Due to the limitation of methodology quality,it remains to be further verified by high-quality and large-sample RCT.

OBJECTIVE Based on different drug loading models,three types of nanoparticulated HI-6 were prepared and their reactivations on inhibited acetylcholinesterase (AChE)in peripheral and central nervous syste ms were evaluated and compared in so man-intoxicated mice.METHODS Three kinds of nano-reactivators including HI-6 loaded human serum albunin nanoparticle (HSA-HI-6 NP),HI-6 absorptive mesoporous silica nanoparticle(MSN-HI-6),polylactico-glycolic acid nanoparticle coated HI-6 (PLGA-HI-6 NP)were prepared.The characteristic of all blank nanocarriers was observed through elec-tron microscope.HI-6 release rate of nano-reactivators was also determined in vitro.Then the reactiva-tion rate of nano-reactivators at a constant HI-6 dosage(22 mg·kg -1 )on so man-inhabited AChE both in blood and brain was assessed the so man intoxicated mice(120 μg·kg -1 ,sc).RESULTS All the syn-thetic nanocarriers met the de mand for nanodrug use in vivo.The rate of HI-6 release of nano-reactiva-tors was HI-6 >HSA-HI-6 NPs >MSN-HI-6 >PLGA-HI-6 NP in vitro.On the reactivations of so man-inhibited mice blood AChE,the free HI-6 and HSA-HI-6 NPs,as well as MSN-HI-6 showed co mparable reactivation rates(20% -30%)but were greater than that of PLGA-HI-6 NPs (6.2%)(P <0.01 ). However on the reactivations of so man-inhibited mice brain AChE,the reactivation rate of HSA-HI-6 NP (15.3%)was significantly higher than that of PLGA-HI-6 NP(3.3%)and free HI-6(6.3)(P<0.01 ).In addition,MSN-HI-6 group had a significant reactivation rate compared to PLGA-HI-6 NPs(P <0.01 ). But there was no statistic difference between MSN-HI-6 and free HI-6.CONCLUSION The reactivation potency changed obviously with different drug loading models and HSA-HI-6 NPs had the most potent reactivation on so man-inhibited AChE in both blood and brain.

Objective To study the imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome (AIDS).Methods X-ray and multi-slice CT (MSCT)data from 33 AIDS patients with disseminated pulnonary tuberculosis confirmed by clinical manifestations and laboratory tests were analyzed retrospectively.Results Thirty patients underwent initial chest radiography examination,29 patients showed abnormal appearances,including bilateral disseminations in 21 patients and unilateral multiple disseminations in 8 patients.All patients underwent MSCT examination,26 patients showed bilateral disseminations and 7 patients showed unilateral multiple disseminations.The abnormal pulmonary appearances included nodule (n =25),miliary nodule (n =22),air-space consolidation (n =22),cavity (n =11),fibrosis (n =7),ground-glass opacity (n =7),pneumatocele (n =4),calcification (n =2).There were 20 patients with more than 3 abnormal appearances and 13 patients with one or two abnormal appearances.The extra-pulmonary tuberculosis included pleural effusion (n =33),lymphadenopathy (n =30),intestinal tuberculosis (n =3),splenic tuberculosis (n =1) and cerebral tuberculosis (n =1).Conclusion Disseminated pulmonary tuberculosis should be highly suspected in AIDS patients with diffused nodules,miliary nodules,air-space consolidations or multiple cavities,accompanied with pleural effusion and lymphadenopathy.

Objective To compare the diagnostic values of US-guided optical imaging system (OPTIMUS) and full-field digital mammography (FFDM) in breast neoplasms. Methods Sixty-four patients suspected of breast neoplasms underwent OPTIMUS and FFDM before surgery. All patients were proved histopathologically. The accuracy of diagnosis was compared with chi-square test. Results Sixty-five masses were delineated by OPTIMUS and FFDM. The diagnostic accuracy, sensitivity and specificity of OPTIMUS were 86. 2% ( 56/65 ), 87.0% ( 20/23 ) and 85.7% ( 36/42 ), respectively. The positive likelihood ratio was 6. 09 and the negative likelihood ratio was 0. 175. The diagnostic accuracy, sensitivity and specificity of FFDM were 73.8% (48/65), 82. 6% ( 19/23 ) and 71.4% (30/42), respectively. The positive likelihood ratio was 2. 892 and the negative likelihood ratio was 0. 243. There were no significant differences between OPTIMUS and FFDM ( x2 = 3. 077 ,P ＞ 0. 05). Conclusion OPTIMUS is similar and supplementary to FFDM for the diagnosis of breast neoplasms.

Objective The purpose of this investigation was to investigate the neuroprotective effects of rhubarb for ICH,as well as its mechanism.Methods ICH was produced in adult Spargue-Dawley rats by injection of collagenase IV(0.05U/0.5uL).Intraperitoneal injection of rhubarb (70mg/kg) or saline,was started at 3,6 or 12 hours post-ICH respectivdy.Casepase-3 activity.TUNEL and neurological behavior function were performed 24hours after ICH.Results Rhubarb siven at 3 or 6 hours can inhibit casepase-3 activity(P<0.001),reduce TUNEL positive cells(P<0.05) and attenuate apomorphine-induced rotation(P<0.05) at 24 hours after ICH.However,the animals which were treated 12 hours showed no improvement.Conclusion Rhubarb may be a potential drug for ICH patients for its possible effect of inhibiting apoptosis.

Objective In the prosthetic socket design process, the high cost and radiation deficiency caused by CT scanning which is a routine way to obtain the cross section image of the residual limb remain problems. Ultrasonic measuring approach is proposed to gain the bones and skin contour of the residual limb. MethodsAn ultrasonic measuring device to get the multiple ultrasonic images of the residual limb was developed firstly, a compound algorithm to reconstruct the multiple images into 2D image was designed, and then the feature extraction on the bones and skin was made. Results Conclusion Comparing with the like-kind cross sectional scanning technique, the ultrasonic measuring method has the characteristic of no radiation and low cost.