Objective To evaluate the effects of total intravenous anesthesia on the circadian rhythms in the patients undergoing cardiac transcatheter closure.Methods Thirty patients undergoing cardiac transcathe-ter closure under elective intravenous anesthesia were included in this study.Paired t-tests were performed to com-pare the mRNA levels of the genes encoding circadian locomotor output cycles kaput(CLOCK),brain and mus-cle ARNT-1 like protein-1(BMAL1),cryptochrome1(CRY1),and period circadian clock 2(PER2),the Munich Chronotype Questionnaire(MCTQ)score,and the Pittsburgh Sleep Quality Index(PSQI)score be-fore and after anesthesia.Multiple stepwise regression analysis was performed to screen the factors influencing sleep chronotype and PSQI total score one week after surgery.Results The postoperative mRNA level of CLOCK was higher[1.38±1.23 vs.1.90±1.47;MD(95％CI):0.52(0.20-0.84),t=3.327,P=0.002]and the postoperative mRNA levels of CRY1[1.56±1.50 vs.1.13±0.98;MD(95％CI):-0.43(-0.81--0.05),t=-2.319,P=0.028]and PER2[0.82±0.63 vs.0.50±0.31;MD(95％CI):-0.33(-0.53--0.12),t=-3.202,P=0.003]were lower than the preoperative levels.One week after surgery,the pa-tients presented advanced sleep chronotype[3:03±0:59 vs.2:42±0:37;MD(95％CI):-21(-40--1),t=-2.172,P=0.038],shortened sleep latency[(67±64)min vs.(37±21)min;MD(95％CI):-30.33(-55.28--5.39),t=-2.487,P=0.019],lengthened sleep duration[(436±83)min vs.(499±83)min;MD(95％CI):62.80(26.93-98.67),t=3.581,P=0.001],increased sleep efficiency[(87.59±10.35)％vs.(92.98±4.27)％;MD(95％CI):5.39(1.21-9.58),t=2.636,P=0.013],decreased sleep quality score[1.13±0.78 vs.0.80±0.71;MD(95％CI):-0.33(-0.62--0.05),t=-2.408,P=0.023],and declined PSQI total score[6.60±3.17 vs.4.03±2.58;MD(95％CI):-2.57(-3.87--1.27),t=-4.039,P＜0.001].Body mass index(BMI)(B=-227.460,SE=95.475,t=-2.382,P=0.025),anesthesia duration(B=-47.079,SE=18.506,t=-2.544,P=0.017),and mRNA level of PER2(B=2815.804,SE=1080.183,t=2.607,P=0.015)collectively influenced the sleep chronotype,and the amount of anesthesia medicine(B=0.067,SE=0.028,t=2.385,P=0.024)independently influenced the PSQI one week after surgery.Conclusions Total intravenous anesthe-sia can improve sleep habits by advancing sleep chronotype.BMI,anesthesia duration,and mRNA level of PER2 collectively influence sleep chronotype one week after surgery.The amount of anesthesia medicine independently influences the PSQI total score one week after surgery.

The paraventricular thalamic nucleus (PVT) is a key nucleus involved in wakefulness. PVT plays an important role in normal sleep-wake regulation, but its role may vary during anesthesia depending on the stage of anesthesia. This article will review the role of PVT in sleep and anesthesia based on its wakefulness function neural pathways.

OBJECTIVE: To explore the genetic basis for an individual with a para-Bombay phenotype. METHODS: A proband with mismatched forward and reverse serotypes for the ABO blood group was identified. Weakly expressed ABH blood type antigen on the surface of red blood cells was verified by absorption and release test, and the blood group substances in saliva was detected by sialic acid test. Exons 6 and 7 of the ABO gene and exons of the FUT1 and FUT2 genes were subjected to direct sequencing. RESULTS: The proband was found to be of O type by forward ABO serotyping and AB type by reverse ABO serotyping, though H and substance A and B were detected in her saliva. DNA sequencing revealed that she has harbored c.35C/T, c.328G/A, and c.504delC compound heterozygous variants of the FUT1 gene. Haploid analysis showed that her FUT1 genotype was h328A/h35T+504delC, which has been uploaded to the NCBI website (No. MW323551). CONCLUSION The para-Bombay phenotype of the proband may be attributed to the novel compound heterozygous variants including c.504delC of the FUT1 gene, which may affect its function by altering the activity of FUT1 glycotransferase.
ABO Blood-Group System/genetics* ; Alleles ; China ; Female ; Fucosyltransferases/genetics* ; Genotype ; Humans ; Phenotype

Objective:To explore the factors influencing complete remission in patients with diffuse large B-cell lymphoma (DLBCL), and to explore the effect of the interaction of Karnofsky performance status scale (KPS) scores and the level of lactate dehydrogenases (LDH) on whether patients with DLBCL are completely relieved.Methods:The clinical data of 373 DLBCL patients admitted to Shanxi Province Cancer Hospital from January 2014 to December 2020 were retrospectively analyzed. SPSS 25.0 logistic regression model and Cox proportional risk regression models were used to explore the factors affecting complete remission in patients with DLBCL and to explore whether there was a multiplicative interaction between the factors. For factors with multiplicative interactions, the Matrix package, epiR package, and survival package in R 4.2.0 software were used to analyze whether there was an additive interaction. The relative excess risk of interaction (RERI), attributable proportion due to interaction (AP), and the synergy index (S) were used to evaluate the presence of additive interactions.Results:Elevated β 2 macroglobulin (β 2-MG), KPS scores below 80, and elevated LDH were risk factors for incomplete remission in patients with DLBCL (all P < 0.05). The risk of incomplete remission in patients with elevated β 2-MG, KPS scores below 80 and LDH was 1.971 times ( OR = 1.971, 95% CI 1.161-3.346), 2.056 times ( OR = 2.056, 95% CI 1.057-4.000) and 3.351 times ( OR = 3.351, 95% CI 1.783-6.300) higher than those in patients with normal β 2-MG, KPS scores above 80 and non-elevated LDH, respectively. There was a negative multiplicative interaction between the two risk factors of KPS scores below 80 and elevated LDH ( OR = 0.317, 95% CI 0.126-0.785). The estimated value of RERI, AP and S was -2.07 (95% CI -4.79-0.64),0.50 (95% CI -1.68-0.32),0.50 (95% CI 0.22-1.13), respectively; and there was no additive interaction among them. Conclusions:Elevated β 2-MG, KPS scores below 80, and elevated LDH are risk factors influencing incomplete remission for patients with DLBCL. The combined effect in patients with the combination of elevated LDH and KPS scores below 80 is lower than the single effect of the multiple of the both. There is a negative multiplicative interaction and no additive interaction in DLBCL patients with KPS scores below 80 and elevated LDH level.

Objective:To evaluate the effect of orexin A on morphine-induced gastrointestinal dysfunction in mice.Methods:Forty SPF C57B/6 mice, aged 6-8 weeks, half male and half female, weighing 18-22 g, were divided into 5 groups ( n=8 each) using a random number table method: control group (group C), morphine group (group M) and morphine + different doses of orexin A groups (MOH, MOM and MOL groups). Normal saline 8 ml/kg was subcutaneously injected daily in group C, morphine 6 mg/kg was subcutaneously injected daily in the other four groups, and orexin A 75, 50 and 25 μg/kg were subcutaneously injected daily for 10 days at the same time in MOH, MOM and MOL groups.The fetal water content was calculated and averaged daily.After the last administration, the mice were gavaged with black nutrient paste, and the gastric emptying rate and small intestinal propulsion rate were detected 30 min later.Blood samples were collected from the orbit, and the concentration of serum gastrin (GAS) was detected by enzyme-linked immunosorbent assay.The mice were then sacrificed, and colon tissues were removed for determination of c-kit positive cell area (by immunohistochemistry) and expression of c-kit, substance P (SP) and neural nitric oxide synthase (nNOS) in colon tissues (by Western blot). Results:Compared with group C, the rate of fecal water content, gastric emptying rate, small intestinal propulsion rate and serum GAS concentration were significantly decreased, the area of c-kit positive cells was decreased, and the expression of c-kit and SP was down-regulated, and the expression of nNOS was up-regulated in group M ( P<0.05). Compared with group M, the small intestinal propulsive rate and serum GAS concentration were significantly increased, and the area of c-kit positive cells was increased, and the expression of c-kit was up-regulated in group MOH, the rate of fecal water content, gastric emptying rate, small intestinal propulsion rate and serum GAS concentration were significantly increased, the area of c-kit positive cells was increased, and the expression of c-kit and SP was up-regulated, and the expression of nNOS was down-regulated in group MOM, and the serum GAS concentration and c-kit positive cell area were significantly increased in group MOL ( P<0.05). Conclusions:Orexin A 50 μg/kg can effectively alleviate the gastrointestinal dysfunction induced by morphine in mice, and the mechanism may be related to promotion of GAS secretion, interstitial cells of Cajal growth and SP release and inhibition of NO release.

Objective To explore the functional properties of the brain's resting state networks in neonates with hypoxic ischemic encephalopathy.Methods Use the methods of functional MRI probabilistic tractography and graph theory to compare the global and local functional properties of the brain's resting state network between 12 cases of children with mild HIE and 14 cases of children with moderate/severe HIE.Results In terms of global topological properties,both the mild and moderate/severe group showed small-world properties.The γ and λ in the mild group were 2.450± 1.642 and 1.542±0.564 and in the moderate/severe group were 2.331± 1.554 and 1.353±0.672,respectively,which were in line with the characteristics of small-world properties (γ＞ 1 and λ ≈ 1).As far as local topological properties were concerned,the distribution of hub regions in the functional networks had smaller number of nodes in the moderate/severe group (8 nodes) than the mild group (14 nodes).The comparison of nodal efficiencies showed that the moderate/severe group had significantly reduced nodal efficiency in the left insula opercula,left supramarginal gyrus,left and right temporal pole and right middle temporal gyrus(the nodal efficiencies of the moderate/severe group:0.4089±0.0865,0.3377±0.1223,0.3842±0.0898,0.3508±0.1295,0.3564±0.0843;the nodal efficiencies of the mild group:0.4801±0.0762,0.4465±0.0898,0.4655 ±0.0812,0.4640±0.0690,0.4271±0.0636,all P＜0.05).Conclusion The topological structure of resting state functional network in children with moderate and severe hypoxic-ischemic encephalopathy is obviously backward than that in children with mild hypoxic-ischemic encephalopathy,which may be related to abnormal language,movement and cognitive function in the late stage.

Objective To compare and analyze the event related potential ( ERP ) and behavioral characteristics of sleep disordered breathing ( SDB ) and normal children by the persistent operating test ( CPT-AX) task,and to explore the characteristics and neural mechanism of the cognitive deficits in the left and right brain of school age SDB children. Methods SDB children( n=20) and normal children( n=20) aged 6-8 were selected. All subjects were tested by CPT-AX ( Go/Nogo task) . The ERP behavior of SDB and normal children was recorded,and the N2,P3 amplitude and latency of F3,Fz,F4 lead were compared. Re-sults ( 1) There was no significant difference between SDB group and normal group in behavioral correct number (36. 45±4. 69 vs 35. 00±3. 46),the reaction time ((516. 84±54. 14)ms vs (496. 94±78. 89)ms) and false alarm number( 1. 0 ( 0. 25,3. 75) vs 0. 5 ( 0. 00,3. 00) ) ( all P>0. 05) . ( 2) Comparison of F3,Fz and F4 lead:(1) SDB group:there was no significant difference in Go-N2 amplitude (-7. 75(-12. 03,-1. 09)μV vs (-8. 69±5. 72) μV vs ( -7. 12±4,68)μV) and Nogo-N2 amplitude((-10. 72±4. 49)μV vs (-12. 16±4. 60) μV vs (-11. 78±4. 44) μV) in the left,middle,and right of frontal regions. (2) Control group:there was no statistical difference between F3 and Fz ((-7. 26±3. 18)μV vs (-9. 09±3. 11)μV)(P>0. 05) in N2 amplitude and there was no statistical difference between F3 and F4((-7. 26±3. 18) μV vs (-6. 10±3. 36)μV) in N2 amplitude (P>0. 05). The N2 amplitude difference of Fz and F4 ((-9. 09± 3. 11) μV vs (-6. 10±3. 36)μV ) was statistically significant (P<0. 05). The Nogo-N2 amplitude differ-ence between F3 and Fz((-14. 05±3. 31) μV vs (-15. 50±3. 52) μV) was no statistically significant (P>0. 05) . The left frontal lobe Nogo-N2 amplitude was significantly higher than that of the right frontal lobe ((-14. 05±3. 31) μV vs-11. 75(-12. 68,-10. 43) μV) (P<0. 05),and the center of the frontal lobe No-go-N2 was significantly higher than that in the right frontal lobe((-15. 50±3. 52) μV vs -11. 75(-12. 68,-10. 43) ) ,and the difference was statistically significant (P<0. 05) . ( 3) There was no significant difference in N2 latency,P3 amplitude and latency between F3,Fz and F4 leads (P>0. 05). Conclusion Compared with normal children,SDB children showed no left dominant brain region while dealing with the same conflict monitoring tasks. It is suggested that left hemisphere activation is poor and function is incompatible. Left fron-tal lobe injury in SDB is more obvious than that in the right side.

Objective To discuss the prognostic evaluation of magnetic resonance diffusion tensor imaging (DTI) in term neonates with mild and severe asphyxia.Methods Eleven neonates with mild asphyxia,14 neonates with severe asphyxia and 10 control neonates were studied.All the neonates were examined by conventional magnetic resonance imaging(MRI) and DTI.Fraction anisotropy (FA) values,apparent diffusion coefficient (ADC) values,voxel numbers and fiber numbers were calculated in seven regions of interest(ROI) and compared among the 3 groups.The correlation between FA values and neonatal behavioral neurological assessment (NBNA) scores were analyzed.Results (1) FA values in the left and the right thalamus were 0.54 ± 0.08 and 0.56 ± 0.15 in control group,0.45 ±0.03 and 0.44 ± 0.10 in mild group,and 0.21 ± 0.11 and 0.25 ± 0.13,respectively in severe group.FA values in posterior limbs of internal capsule were 0.49 ± 0.09 and 0.48 ± 0.08 in control group,0.37 ± 0.08 and 0.38 ± 0.03 in mild group,and 0.20 ± 0.04,0.19 ± 0.13 in severe group;FA values in thalamus and posterior limbs of internal capsule had statistical differences among the 3 groups (F =9.12,9.11,8.18,8.55,all P ＜ 0.05).Voxel numbers in the left and the right superior longitudinal fasciculus were 1 094 ± 112 and 1 123 ± 113 in control group,986 ± 111 and 1 009 ± 144 in mild group,450 ± 116 and 671 ± 126 in severe group.Voxel numbers in anterior limbs of internal capsule were 947 ± 104 and 1 237 ± 184 in control group,854 ± 118 and 799 ± 114 in mild group,324 ± 110 and 311 ± 126 in severe group.Voxel numbers in posterior limbs of internal capsule were 2 047 ± 129 and 2 137 ± 238 in control group,1 843 ± 233 and 1 753 ± 247 in mild group,867 ± 118 and 999 ± 167 in severe group.Voxel numbers in superior longitudinal fasciculus,anterior and posterior limbs of internal capsule had statistical differences among the 3 groups (F =10.11,9.45,7.33,8.45,12.65,11.23,all P ＜ 0.05);Fiber numbers in the left and the right cingulate gyrus were 245 ±72 and 405 ±94 in control group,225 ±52 and 365 ± 114 in mild group,145 ±62 and 185 ±84 in severe group.Fiber numbers in inferior front-occipital fasciculus were 56 ± 19 and 212 ± 33 in control group,49 ±22 and 197 ± 33 in mild group,33 ± 12 and 156 ± 39 in severe group.Fiber numbers in posterior limbs of internal capsule were 284 ± 112 and 988 ± 233 in control group,234 ± 67 and 678 ± 234 in mild group,114 ± 67 and 188 ± 84 in severe group.Fiber numbers in cingulate gyrus,inferior front-occipital fasciculus and posterior limbs of internal capsule had statistical differences among the 3 groups (F =3.11,3.45,9.88,9.12,7.45,8.88,all P ＜ 0.05).(2) The correlation between FA value and NBNA scores was analyzed:the correlation coefficient in posterior limbs of internal capsule was 0.666 which was higher than those of the other areas.The area under the ROC curve of FA values in anterior limbs of internal capsule was 0.816 (P =0.005),used NBNA scores ≥ 35 as a good outcome.FA values (≥ 0.375) in the posterior limbs of the internal capsules predicted a good outcome and the corresponding sensitivity and specificity was 73.1％ and 77.8％,respectively.Conclusion In some ROIs,FA values,voxel numbers,and fiber numbers can quantitatively reflect the degree of white matter injury in neonates with asphyxia.Furthermore,the FA values in the posterior limbs of the internal capsules are closely correlated with NBNA scores,so it has more important clinical significance,and can accurately and objectively assess the prognosis in neonates with asphyxia.

Objective To improve quality standard of Fufang Shenghua granules.Methods TLC was used to identify chief components in the preparation, Radix et Rhizoma Glycyrrhizae and Salvia Miltiorrhiza.HPLC was applied to identify Amarogentin and to determine the content of Salvianolic acid B.Salvianolic acid B assay was performed on Agilent HC-C18(4.6 mm×250 mm, 5 μm) column with Acetonitrile-0.1% phosphoric acid (23∶77)as mobile phase.The flow rate was 1.0 ml/min.The column temperature was 30 ℃.The detection wavelength was set at 286 nm.Results The spots on TLC were fairly clear with good separation.There was no interference from the negative control samples.However, HPLC was a more accurate, reliable and objective method for qualitative identification.Salvianolic acid B showed a good linear correlation in the range of 1.56~49.92 μg/ml (r=0.999 9).The average recovery was 100.07%, RSD 1.61% (n=9).Conclusion A simple, accurate and reliable method was developed for the quality control of Fufang Shenghua granules.

OBJECTIVE:To explore and analyze signals of Xiyanping injection-induced urticaria from spontaneous reporting system database of Jiangxi province. METHODS:The continuous ADR report monitoring data were collected from spontaneous re-porting system of Jiangxi province,and established database. Bayesian confidence propagation neural network(BCPNN) method was used to calculate information component,IC value of Xiyanping injection-induced urticaria. The year-to-year changes of IC val-ue and its interval were analyzed. RESULTS:A total of 328324 ADR reports were collected in Jiangxi province during 2004-2016. The IC value of Xiyanping injection-induced urticaria detected by BCPNN method was 1.10(the lower limit of IC value was 0.65, and upper limit was 1.54),i.e. there was signal and the IC value ranged from-0.87 to 1.65. CONCLUSIONS:The results of BCPNN method suggest that urticaria is a warning signal of Xiyanping injection. The risk is increasing gradually,and prediction precision increase with the addition of report quantity.