Objective To explore the application of polysomnography combined with arterial spin labeling(ASL)perfusion magnetic resonance imaging in the diagnosis of insomnia.Methods Forty-two insomnia patients admitted to Department of Neurology were included as insomnia group,while 41 healthy subjects during the same period were included as control group.The two groups were assessed using sleep habits questionnaire,hospital anxiety and depression scale,polysomnography,and ASL perfusion magnetic resonance imaging.Results Compared with control group,insomnia group took significantly more time to fall asleep(P<0.05),and has shorter sleep duration(P<0.05).The differences in the levels of anxiety and depression between two groups were trivial.The total sleep time,rapid eye movement sleep duration,and non-rapid eye movement sleep stage S2-S4were shorter,while the sleep latency and non-rapid eye movement sleep stage S1were longer in insomnia group as compared with control group(all P<0.05).In insomnia group,perfusion was increased in bilateral prefrontal lobes,right temporal lobe,left parietal lobe,right thalamus,and pons(P<0.05),but decreased in bilateral insula and bilateral basal ganglia(P<0.05).Conclusion The combination of polysomnography and ASL perfusion magnetic resonance imaging enables precise quantification of sleep condition.

Objective To develop"a guideline for pressure injury risk assessment and prevention of neonates in NICU",and to provide guidance and references for clinical staff in the implementation of pressure injury assessment and prevention for neonates in NICU.Methods Based on the World Health 0rganization Guideline Development Manual and the results of systematic search for identified clinical problems,the GRADE method was used to evaluate the evidence and grade the recommendations,and the RIGHT report specifications were referred to for writing,and the guideline was developed and revised according to the results and recommendations of the expert review,so as to form the official guideline.Results The guideline included 2 aspects of pressure injury risk assessment and prevention,resulting in 12 clinical questions and 19 recommendations.Conclusion The guideline for risk assessment and prevention of pressure injury of neonates in NICU is an evidence-based guideline based on the best available evidence,clinical practice,and professional judgment,and it can provide a practical basis for scientific decision-making by clinical staff and managers.

Objective To develop"guideline for risk assessment and prevention of noninvasive ventilation related facial pressure injuries in adults"and to provide a reference for clinical medical staff to evaluate and prevent noninvasive ventilation related facial pressure injuries.Methods Referring to the"WHO Guideline Development Manual",clinical problems were formed through 3 rounds of Delphi expert consultation.The relevant recommendation opinions and evidence were screened,extracted,integrated and evaluated to form a draft consensus.Through a round of Delphi expert consultation and a round of expert consensus meeting,expert opinions were combined to modify and improve the content of each item to form a final draft of the expert consensus.Results Recommendations for the constructed guideline included 7 aspects of risk factors,high-risk sites,assessment tools,assessment timing and content,selection of non-invasive ventilation equipment,selection of dressings,and preventive measures,including 7 clinical questions and 15 recommendations.Conclusion The"guideline for risk assessment and prevention of noninvasive ventilation related facial pressure injuries in adults"was an evidence-based guideline based on the best evidence,Chinese clinical reality,and professional judgment,and it can provide practice bases for scientific clinical decisions making by clinical medical staff and managers.

Objective To investigate the role of nuclear transcription factor kappa B (NF-κB) -matrix metalloproteinase-9 (MMP-9) signaling pathway in delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods 150 male SD rats were randomly assigned to air control group (AC group) , CO poisoning group (CO group) , pyrrolidine thiocarbamate (PDTC) + CO poisoning group (PC group). DEACMP model was reconstructed by modified intraperitoneal injections. The 1, 3, 7, 14, and 21 d after intraperitoneal injection were observed here by different approaches. Morris water maze test was used to test the learning and memory ability of rats.HE staining was used to observe the morphology of hippocampal CA3 cells. Immunofluorescence and Western Blot methods were used to detect the expression of NF-κB and MMP-9. RT-PCR was used to measure the expression of MMP-9 mRN A. Transmission electron microscopy was used to observe the ultrastructure of synapses. Results After14 days, the average intubation period of CO group was longer than that of AC group (P < 0.05) , and that of PC group was shorter than that of CO group (P < 0.05). However, average intubation period of PC group was longer than that of AC group (P< 0.05). In CO group, the expression of NF-κB in hippocampus increased (day 1). At day 3, the expression of NF-κB rapidly increased. The expression of MMP-9 gene and protein increased in the first three days and then decreased thereafter. The expression of NF-κB and MMP-9 in PC group was lower than that in CO group (P < 0.05) , while it was higher than AC group (P < 0.05). The peak value of apoptosis in CO group was delayed to 7-14 d after exposure, the apoptotic cells in PC group decreased significantly, and it was obvious on the 14 th day.Electron microscopy showed that the damage of synapses ultrastructure in CO group was significantly heavier than that in PC group on the 14 th day. Conclusions NF-κB-MMP-9 signal pathway leads to DEACMP, and PDTC could alleviate the impairment of learning and memory ability in rats with acute CO poisoning.

OBJECTIVE: To investigate the incidence and influencing factors of hypertension among civil aviation pilots. METHODS: A total of 1 169 civil aviation pilots in Northern China were selected into the study by the method of convenient sampling. Physical examination, laboratory test and questionnaire survey were conducted. RESULTS: The prevalence of hypertension in Northern China was 4.7%(55/1 169). Multivariate regression analysis showed that the relative risk factors ranking from high to low were, age over 30 years [odds ratio(OR)=6.81, 95% confidence interval(95%CI) 3.57-12.98)], total flight hours over 1 000 hours(OR=4.24, 95%CI 2.14-8.41), flight hours over 500 hours in the past year(OR=2.91, 95%CI 1.57-5.40), obesity(OR=2.50, 95%CI 1.08-5.81), fasting blood glucose(OR=2.24, 95%CI 1.21-4.13), and frequent long-distance flight(OR=2.38, 95%CI 1.24-4.58). These factors were the risk factors of hypertension in civil aviation pilots(P<0.05). CONCLUSION: Age, total flight hours, flight hours in the past year, obesity, fasting blood glucose, frequent long-distance flight are related to the prevalence of hypertension in civil aviation pilots.

Three cases of swimming pool granuloma are reported.Case 1:a 40-year-old female presented with a 2-month history of nodules and plaques on the right hand and forearm.She was a tropical fish salesperson but denied trauma history.Skin examination revealed multiple irregularly sized,dark-red nodules and plaques on the joints of right fingers,wrist,and elbow,as well as multiple subcutaneous nodules simulating strings of beads on the right upper limb.Case 2:a 48-year-old female presented with a 2-month history of nodules and plaques on the left hand and forearm.There was a history of trauma due to tropical fish tank and filter cleaning.Physical examination showed multiple deep purple plaques and painless subcutaneous nodules scattered on the left hand,wrist,and upper limb.Case 3:a 39-year-old male presented with a 3-month history of nodules on the fingers of both hands.There was no history of trauma,but he was a tropical aquarist.Skin examination revealed multiple soybean-sized dark-red nodules on the extensor aspect of interphalangeal joints of both hands.Fungal examinations yielded negative results in the 3 cases,while histopathology revealed infectious granuloma with a mixed inflammatory cell infiltrate.All of the cases showed positive results in purified protein derivative (PPD)skin test.Mycobacterium marinum was isolated from the lesional tissue of Case 1 and 2,but not from Case 3.All the patients were diagnosed with swimming pool granuloma,and given anti-atypical mycobacterial therapy including oral rifampin and clarithromycin.The lesions disappeared after 1 to 3 months of treatment,with the treatment course varying from 2 to 5 months.No recurrence was observed during a 3- to 12-month follow-up.

One hundred children aged 8-10 years and 100 adults aged 18-45 from their families in three townships Baoshan,Mingcheng,and Yantongshan of Panshi city,Jilin province were selected in April 2009. In addition,50 pregnant or lactating women,and their 50 infants aged 0-2 years were selected.The median level of iodine in salt at household was 30.2 mg/kg and that of drinking water was 2.8 μg/L.The median levels of urine iodine in school age chidren ( 196.5 μg/L),during pregnancy( 198.5 μag/L),lactation( 224.9 μg/L),and in infants (209.0 μg/L) all were optimal according to World Health Organization criteria.Only the median urine iodine in adults ( 269.0 μg/L) was more than adequate.The prevalence of goiter evaluated by B-ultrasound was 1.8％ in 8-10year-old children.The incidences of various thyroid dysfunctions were low in these residents,such as subclinical hyperthyroidism ( 2.1％ ),subclinical hypothyroidism ( 1.5％ ),and hyperthyroidism ( 1.2％ ). Subclinical hypothyroidism occurred mostly in adults (2.7％),pregnant women ( 1.7％ ),and lactating women ( 1.8％ ) ; and subclinical hyperthyroidism occurred mostly in 8-10 years old school chidren (4.5％) and lactating women (3.6％).These results show that the current iodized salt content has no harmful effect on thyroid function of rural residents in Jilin province.

Objective To evaluate the efficiency of BIOMED-2 system in detecting IGH gene clonal rearrangement and application in diagnosis of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma. Methods Forty-five cases were collected, including 36 MALT lymphomas from different organs, 3 extranodal lymphoid tissue proliferative lesions and 6 severe gastritis associated with H pylori. DNA was extracted from the formalin fixed paraffin embedded blocks of these cases and the quality of DNA was assessed using the BIOMED-2 specimen mixed control primers. IGH gene clonal rearrangement was detected using IGH VH-JH primers. The sensitivity and specificity of BIOMED-2 PCR were analyzed.Results Adequate DNA (≥ 300 bp) was obtained in 31 of 45 samples (including 22 MALT lymphomas, 3 lymphoid tissue proliferative lesions and 6 severe gastritis), and the DNA from the other 14 samples was degraded seriously. 16 of 22 MALT lymphomas were positive of IGH clonal rearrangement with the sensitivity of 72.7 ％.In contrast,none of 6 severe gastritis was positive with the specificity of 100 ％ IGH and clonal rearrangement were detected in one of 3 lymphoid tissue proliferative lesions. Conclusion BIOMED-2 assay is an effient and reliable method for diagnosis and differential diagnosis of MALT lymphoma which is important for clinical practical value.

To establish a rat model of rheumatoid arthritis (RA) with kidney deficiency syndrome.

Objective To evaluate the diagnostic value of autoantibodies to cell membrane associated with DNA (mDNA) in systemic lupus erythematosus (SLE) and the combination with other autoantibodies in the diagnosis of SLE. Method The anti-mDNA antibody had the characteristic pattern of perip-heral membrane fluorescence on cultured HL60. The same serum samples were detected for other antibo-dies of SLE. Pearson's Chi-square test was used for statistical analysis. Results This pattern was observed in 145 of 205 serum samples of SLE patients , but in 5 of 55 the serum samples of rheumatoid arthritis , in 10 of 45 primary Sjogren syndrome's patients and in 4 of 35 PM/DM and absent in 50 blood donors. The sensitivity and specificity of anti-mDNA antibody to SLE was 70.7% and 86.7%. The sensitivity and specificity of combined anti-mDNA antibody and ANA was 94.6% and 76.7%. The sensitivity and specificity of combined anti-mDNA antibody and anti-dsDNA antibody was 76.8% and 95.5%. The sensitivity and specificity of combined anti-mDNA antibody and anti-Sm antibody was 79.6% and 100%. The sensitivity and specificity of combined anti-mDNA antibody and AnuA was 93.0% and 100%. Conclusion This novel rapid immunofluorescence method can be a useful diagnostic test for SLE patients. Due to its high sensitivity and specificity, it is better than other diagnostic tests such as anti-dsDNA antibody and anti-Sm antibody for the diagnosis of SLE.