Objective:To investigate the correlation between sleep quality and risk of female complicated vulvovaginal candidiasis (VVC).Methods:From January 2021 to June 2021, patients in the gynecological clinic of Xiangya Hospital of Central South University were continuously enrolled as the research objects using a cross-sectional survey. A self-made questionnaire was used to collect the age, marital status, education level, family monthly income, place of residence in the past two years, maternity history, number of births, intrauterine device, number of abortions, frequency of sex life, use of contraceptives within two months, use of antibacterial drugs within two weeks. Generalized Anxiety Disorder Scale, Patient Health Questionnaire, Health Questionnaire Somatic Symptom Group Scale, Pittsburgh Sleep Quality Index were used to collect patients′ anxiety, depression, somatization symptoms, and sleep quality conditions. The total scores of sleep quality and the scores of each dimension were used as observation indicators. Three logistic regression analysis models were constructed to explore the relationship between sleep quality and complicated VVC groups.Results:Patients in the complex VVC group were significantly higher in age, married, middle school education, rural area of residence in the last two years, birth history, number of births ≥3, sexual frequency≥1/week, and no antibiotic use within two weeks compared to those in the control group (all P<0.05). Without adjusting for confounding factors, women with poor subjective sleep quality had a 6.73-fold increased risk ( OR=7.73, 95% CI: 3.22-18.55) of complex VVC compared with those with good subjective sleep quality. After adjusting for confounding factors, the risk was further increased to 9.08 fold ( OR=10.08, 95% CI: 3.47-29.33)(all P<0.05). Compared with women without sleep disorders, women with mild sleep disorders had a 97% increased risk of complex VVC ( OR=1.97, 95% CI: 1.15-3.37). After adjusting for confounders, the risk remained 97% higher ( OR=1.97, 95% CI: 1.10-3.55)(all P<0.05). Conclusion:Poor subjective sleep quality and mild sleep disorder may be associated with the risk of complex VVC.

Objective:To investigate the relationship between cardiometabolic index and metabolic syndrome in people aged 40 and beyond in Guiyang city.Methods:A total of 4 506 residents over 40 years(including 3 067 females and 1 439 males) were enrolled in the analysis from those who participated in the epidemiological study of cancer risk in Chinese patients with type 2 diabetes in 2011 in Guiyang City. The cardiometabolic index (CMI) is calculated by triglycerides(TG)/high-density lipoprotein-cholesterol(HDL-C)×waist-to-height ratio (WHtR). Multivariable logistic regression was used to analyze the correlation between cardiometabolic index and metabolic syndrome, and ROC was used to analyze the predictive ability of CMI on the incidence of metabolic syndrome. Results:The average follow-up period was 3 years. According to the International Diabetes Federation (IDF) diagnostic criteria for metabolic syndrome in 2005, 985 patients (774 women and 211 males) had metabolic syndrome. The incidence rate of metabolic syndrome in the general population was 21.86%, the incidence rate of male metabolic syndrome was 14.66%, and that of women was 25.24%, and the incidence of CMI increased with the increase of the number of women. After multivariable logistic regression analysis, the odds ratio of CMI for metabolic syndrome in women is 1.303(95% CI 1.263-1.344) and 1.724(95% CI 1.162-2.558) in men, respectively. ROC results showed that CMI had a good ability to predict the incidence (AUC: 0.759 for men and 0.852 for women). Conclusion:CMI is positively associated with the incidence of metabolic syndrome. It supports CMI as a useful method to screen metabolic syndrome in China′s general population.

Objective:To explore the association of cardiometabolic index(CMI) and other body fat evaluation indicators [body mass index(BMI), waist circumference(WC), waist to height ratio(WHtR), lipid accumulation index(LAP)] with the prevalence of metabolic syndrome(MS) as well as the predictive value of the above indicators for MS.Methods:A total of 10 140 residents over 40 years old in Guiyang city who participated in the " Epidemiological study on tumor risk of type 2 diabetes patients in China" in 2011 were recruited. The 2005 International Diabetes Federation diagnostic criteria were used to identify MS. Logistic regression was used to analyze the association of CMI and other body fat evaluation indicators with MS. Receiver operating characteristic(ROC) curve was used to evaluate the predictive value and the optimal cut-off point of different indicators. Taking the best cut-off point value of each index as the boundary, the prevalence of MS was evaluated again by Chi square test.Results:The prevalence of MS in the study population was 39.81%(27.23% for men and 44.39% for women). Logistic regression analysis showed that the risk of MS increased with increasing CMI and quartile level of other body fat evaluation indicators in both men and women( P<0.05). The risks of MS in CMI Q4 group were 17.15(95% CI 11.64-25.27) for male and 45.14(95% CI 37.07-54.96) for female compared with Q1 group. In male, the area under curve(AUC) of MS by predicted CMI was 0.761(sensitivity 79.8%, specificity 63.2%, optimal cut-off point 0.71). WC displayed the highest value of AUC among the body fat evaluation indicators. In women, the AUC value of MS predicted by CMI was 0.831(sensitivity 76.8%, specificity 75.7%, optimal cut-off point 0.65), higher than those of BMI and WHtR while lower than those of WC and LAP. Further calculating the prevalence of MS with the best cut-off point value of each index as the boundary, WC was still the best predictor for male, while CMI was only secondary to LAP for women. Conclusion:CMI and other body fat evaluation indicators are significantly associated with MS. CMI could be used to predict MS.

Objective:To explore the application value of the method of judging the density of small shadows in the lung area by using CT and CT reference films for pneumoconiosis.Methods:The chest imaging data of 244 employees of a large copper company in Tongling City, Anhui Province who underwent occupational physical examination at Tongling Municipal Hospital in Anhui Province from January 2016 to December 2019 were retrospectively analyzed. Totally 244 cases underwent chest CT scan and chest DR radiography at the same time. The shape and size of the small shadows (the size of the circular and quasi-circular nodules in the lung area were represented by p, q, r, and the size of the irregular small shadows were represented by s, t, u), the overall density, the density of small shadows in each lung area, the large shadows, and the diagnosis stage were observed and compared. The small shadow density of each lung area was judged by the method of judging the small shadow density of CT lung area and the reference film, and other observation indicators were judged according to GBZ70-2015 Diagnosis of Occupational Pneumoconiosis. Results:There was a significant difference between CT and DR in judging s-shaped small shadows and no small shadows ( P<0.05), and there was no statistically significant difference in judging p, q, r, t, and u-shaped small shadows ( P>0.05). CT and DR had medium to high consistency in the judgment of the overall density of small shadows (Kappa=0.692, P=0.001), and the diagnostic coincidence rate was 82.38% (201/244). There was moderate to high agreement between CT and DR in the density of small shadows shown in the right upper, right lower, left upper, left middle, and left lower lung regions (Kappa ranged from 0.40 to 0.75, P<0.05), and the consistency in the right middle lung region was poor (Kappa=0.381, P=0.001). Eleven large shadows were detected in 8 cases by DR, 31 large shadows were detected in 23 cases by CT, and 20 (8.20%) large shadows were detected more frequently by CT than DR. The agreement between CT and DR for the diagnosis and staging of silicosis was excellent (Kappa=0.843, P=0.001), and the diagnostic coincidence rate was 91.80% (224/244). Conclusion:Applying the method of determining the density of small shadows in the lung area of pneumoconiosis and reference films, combined with GBZ70-2015 Diagnosis of Occupational Pneumoconiosis, can make a more accurate diagnosis of silicosis.

Objective:To investigate the outcomes and influencing factors of newly diagnosed prediabetic subjects aged 40 years and above in Guiyang.Methods:A total of 10 015 residents aged 40 years and above were recruited from the Yunyan community, Guiyang, from May to August 2011. Physical examination, laboratory measurements, and questionnaires were conducted. The follow-up survey was conducted in July 2014. A total of 2 530 newly diagnosed prediabetic subjects at baseline were included in the analysis.Results:The 3-year cumulative morbidity of diabetes mellitus was 14.3%, and the risk of diabetes mellitus in combined impaired fasting glucose(IFG)and impaired glucose tolerance(IGT)groups was significantly higher than that in isolated IFG(i-IFG)or isolated IGT(i-IGT)group( P<0.01). High baseline fasting plasma glucose, 2 h plasma glucose, and HbA 1C levels were the independent risk factors for the development of diabetes( OR=1.836, 95% CI 1.374-2.454; OR=1.398, 95% CI 1.261-1.550; OR=2.526, 95% CI 1.804-3.538, all P<0.01)and the inhibitory factors for reversion to normal glucose tolerance( OR=0.511, 95% CI 0.409-0.638; OR=0.715, 95% CI 0.661-0.774; OR=0.638, 95% CI 0.500-0.816, all P<0.01). High level of high density lipoprotein-cholesterol(HDL-C)was an promoting factor for reversion to normal glucose tolerance( OR=1.306, 95% CI 1.017-1.678, P=0.036). Subjects in the highest tertile of baseline HbA 1C level and body mass index(BMI)change before and after follow-up(ΔBMI=follow-up BMI minus baseline BMI)had a higher risk of diabetes mellitus than those in the lowest tertile( OR=2.398, 95% CI 1.733-3.322; OR=2.402, 95% CI 1.859-3.105, both P<0.01). The risk of diabetes mellitus in the significant weight loss group was reduced by 40.4% compared with the non-significant weight loss group when the subjects were divided into two groups according to the cutoff of the lower tertile of ΔBMI( RR=0.596, 95% CI 0.463-0.766, P<0.01). Conclusion:The risk of diabetes mellitus in combined IFG/IGT group was significantly higher than that in i-IFG or i-IGT group. High baseline fasting plasma glucose, 2 h plasma glucose, and HbA 1C levels were the independent risk factors for the development of diabetes. High level of HDL-C was an promoting factor for reversion to normal glucose tolerance. Weight loss can significantly reduce the risk of progression to diabetes in individuals with prediabetes.

Objective:To observe and compare the changes of pulmonary function in patients with pulmonary tuberculosis regular treatment for 3 months.Methods:From April 2018 to June 2019, 500 tuberculosis patients who received regular anti tuberculosis treatment in our hospital were selected.The pulmonary function of patients with pulmonary tuberculosis was measured before treatment and at the end of three months; the results of pulmonary ventilation function, lung volume, diffusing capacity, and the value of forced vital capacity (FVC), maximum expiratory volume in 1 second (FEV 1), maximum expiratory volume in 1 second/forced vital capacity (FEV 1/FVC), total lung volume (TLC), residual volume (RV), carbon monoxide diffusing capacity (D LCO) were compared. Results:252 patients with pulmonary tuberculosis were included. Before treatment and at the end of three months, the abnormal pulmonary function results were 204 cases (80.95%) and 193 cases (76.59%), respectively, and the difference was not statistically significant ( P>0.05). Among them, abnormal pulmonary ventilation function is the most common, especially with obstructive, followed by abnormal diffusing capacity. At the end of three months, the proportions of patients with normal pulmonary ventilation function and normal lung volume were higher than that before treatment ( P<0.05), but there was no significant difference in the proportion of normal diffusing capacity before and after treatment ( P>0.05). The values of FVC, FEV 1, TLC and D LCO at the end of three months were higher than those before treatment, and the difference was statistically significant ( t=-6.414, -6.754, -3.863, -3.311, all P<0.01). Conclusions:Most patients with pulmonary tuberculosis have abnormal pulmonary function. At the end of the three months treatment, the normal rates of the pulmonary ventilation function and lung volume as well as the values of FVC, FEV 1, TLC and D LCO in patients with pulmonary tuberculosis were significantly improved compared with those before treatment.

Objective: To explore the influence of metabolic syndrome on the risks of cardiovascular disease (CVD) events and all-cause mortality. Methods: In this prospective cohort study, urban residents aged 40-79 years in Guiyang were followed-up for three years. The end-points were CVD events and all-cause mortality. COX proportional hazards model were used for the corresponding hazard ratios (HRs) of CVD events and all-cause mortality. Metabolic syndrome was defined according to the 2005 International Diabetes Federation (IDF) criteria. Results: A total of 7 313 subjects were included. 146 cases of CVD events and 80 cases of all-cause mortality were recorded. After adjusting for gender, age, smoking, alcohol consumption, and blood lipid levels, the metabolic syndrome increased the risks of CVD events and all-cause mortality. The HRs were 1.43 (P=0.037) and 1.25 (P=0.418), respectively. As compared metabolic syndrome with non-metabolic syndrome, an increased risk of CVD events was found. The HR was 1.43 (P=0.013). No significantly increased risk of all-cause mortality was found in subjects with metabolic syndrome. Conclusion The metabolic syndrome was associated with increased risk of CVD events and there was no significant increase in all-cause mortality. Metabolic syndrome is an important risk factor for CVD events.

Objective: To investigate the predictive value of thromboelastography (TEG) for early neurological deterioration (END) in patients with acute ischemic stroke. Methods: Patients with acute ischemic stroke admitted to the Department of Neurology, Jiujiang Hospital Affiliated to Nanchang University from January 2018 to May 2019 were included as case group, and the healthy physical examinees in the same period were selected as control group. END was defined as an increase of ≥2 of the National Institutes of Health Stroke Scale score from baseline within 7 d after the onset of acute ischemic stroke. All subjects were routinely tested for traditional coagulation function, including prothrombin time, activated partial thromboplastin time, thrombin time, and plasma fibrinogen level. The reaction time (R value), coagulation time (K value), coagulation angle (α) and maximum amplitude (MA value) were monitored by TEG. Univariate analysis was used to compare the differences in clinical and laboratory results between the END group and the non-END group, and then multivariate logistic regression analysis was used to determine the independent risk factors for END. Results: A total of 96 patients with acute ischemic stroke and 20 controls were included. Compared with the control group, the traditional coagulation parameters of the case group were not significantly different. For the TEG parameter, compared with the control group, the R value and K value of the case group were significantly shortened, and the α angle and MA value were significantly increased (all P<0.05). A total of 31 patients (32.3%) developed END, and the R and K values in the END group were significantly shorter than those in the non-END group (all P<0.05). Multivariate logistic regression analysis showed that R value (odds ratio 1.192, 95% confidence interval 1.006-1.410; P=0.001) and K value (odds ratio 1.054, 95% confidence interval 1.012-1.150; P=0.001) shortening were the independent predictors of END. Conclusion The sensitivity of TEG in the monitoring of coagulation function in patients with acute ischemic stroke is higher than that of traditional coagulation indicators. The shortenings of R and K values are independent predictor of END in patients with acute ischemic stroke.

BACKGROUND:Sufentanil exerts protective effects on tissues, but its roles in the repair of nervous system injury and the underlying mechanism are stil unknown.
OBJECTIVE:To explore the protective effect of sufentanil preconditioning in the repair of spinal cord injuries and the underlying mechanism.
METHODS:Mouse models of spinal cord injuries were prepared through clipping spinal cord fol owed by intraperitoneal injection of 3 and 6μg/kg sufentanil, respectively.
RESULTS AND CONCLUISON:(1) Western blotting, ELISA and TUNEL assays showed that 6μg/kg sufentanil significantly down-regulated the protein expression levels of TLR4, nuclear factor-κBp65, cleaved-caspase 3, tumor necrosis factor-αand interlenkin-1βin the spinal cord of mice (P<0.05);at the same time, the number of apoptotic neurons was significantly decreased (P<0.05). (2) Furthermore, high-dose sufentanil preconditioning significantly ameliorated the recovery of limb function at 14 days after injury (P<0.05). (3) These results administrate that the neuroprotection provided by 6μg/kg sufentanil preconditioning for spinal cord injuries in mice maybe related to the TLR4/nuclear factor-κB signaling pathway inactivation.

_ Objective_ To examine the association between sleep duration, TV watching time, and the incidence of metabolic syndrome in people aged 40 or older in Guiyang city. Methods Data were obtained at the baseline examination ofThe epidemiological study on the risk of cancer in patients with type 2 diabetes in China in 2011. Follow-up study was conducted in 2014 to 2015. A total of 4 392(female 2 987, male 1 405)were included in the analysis. Results According to diagnostic criteria of International Diabetes Federation(IDF)in 2005, 1 035(812 women, 223 men) of the cohort developed metabolic syndrome during an average follow up for 3 years. Sleep duration was classified as≤7 h/d, 7-9 h/d,≥9 h/d, the incidence of metabolic syndrome was 24. 46%, 22. 43%, 23. 65%, respectively. TV watching time was divided into 0-1 h/d, 1. 1-2 h/d, 2. 1-4 h/d,>4 h/d, the incidence rates were 20. 67%, 22. 91%, 24. 61%, 25. 76%, respectively. In multivariate logistics regression analysis, compared with 0-1 h/d, the RR values of women with TV watching time during 1. 1-2 h/d, 2. 1-4 h/d,>4 h/d were 1. 098(95%CI 0. 789-1. 528), 141. 6(95% CI 1. 052-1. 906), 1. 559(95% CI 1. 090-2. 233), respectively. Conclusion The standardized incidence rate of metabolic syndrome in the general population was 23. 12%, the crude rate was 23. 57%. The incidence of metabolic syndrome was unrelated to the sleep duration and TV watching time as a whole or in men. TV watching time more than 2 hours a day may increase the risk of the metabolic syndrome in women.